m~ &■ &\, s ^m^\ I i I POPULAR MEDICINE; OR, FAMILY ADVISER; CONSISTING OF OUTIIHES ANATOMY, physiology, and hygiene, WITH SUCH HINTS ON THE PRACTICE OF PHYSIC, SURGERY, AND THE DISEASES OF WOMEN AND CHILDREN, AS MAY PROVE USEFUL IN FAMILIES WHEN REGULAR PHYSICIANS CANNOT BE PROCURED I BEING A COMPANION AND GUIDE FOR INTELLIGENT PRINCIPALS OF MANUFAC- TORIES, PLANTATIONS, AND BOARDING-SCHOOLS, HEADS OF FAMILIES, MASTERS OF VESSELS, MISSIONARIES, OR TRAVELLERS; AND A USEFUL SKETCH FOR YOUNG MEN ABOUT COMMENCING r"*7 THE STUDY OF MEDICINE. REYNELL COATES, M. D. P 3/6£v J Fellow of the College of Physicians of Philadelphia—Honorary Member of the Philadelphia Medical Society—Correspondent of the Lyceum of Natural History of New York- Member of the Academy of Natural Sciences of Philadelphia—Formerly Resident Surgeon of the Pennsylvania Hospital, &c— Assisted by several Medical Friends. PHILADELPHIA: CAREY, LEA & BLANCHARD. 1838. / • PREFACE. The medical profession has opposed, at all times, the publication of works on domestic medicine, and it has been the custom of the public, to attribute their opposition to a selfish motive. The projector of the present treatise, however, does full justice to the character of his professional bre- thren, well knowing the immense sacrifices of time, money, and comfort, which they cheerfully encoun- ter in their unceasing and ill-requited exertions to promote the cause of humanity. Admitting, then, on the one hand, that it is impossible to communicate mere practical directions for the treatment of disease to those who are ignorant of the science of physiology, without employing extreme caution or producing in- calculable mischief, he repels with scorn, on behalf of that profession the best interests of which have been the study of his life, all charges of sinister or meanly mercenary motives, when cast upon a great body of benevolent men who are ever willing to undergo the maximum of labour for the minimum of reward. But it appears to the author, that the principal evils which have resulted, and are likely to result hereafter, from attempts at popular medical instruction, are at- tributable rather to the manner in wdiich the subject has been treated, than to the nature of the subject itself. Without wishing to detract from the merit of se- veral works already before the public, he believes that all his predecessors have passed too slightly over many matters wThich may be rendered quite intelligible to VI PREFACE. persons unacquainted with the science of medicine; while they have attempted to lay down directions for the treatment of many states or conditions of disease, which can only be distinguished with certainty, or managed with success, by those who have obtained the moral right to employ the most potent, but most dangerous weapons by the acquisition of extensive learning, aided by long continued observation and experience. In venturing upon this publication, the endeavour has been made to avoid the errors just men- tioned ;—with wiiat success, the public must deter- mine. It forms no part of the author's intention, to induce an under estimate of the necessity of medical advice, when such advice can be obtained; but, at the same time, he is not so warmly attached to what may be considered right in the abstract as to cast aside all considerations of expediency. We must deal with so- ciety as we find it,—not as the best friends of hu- manity wrould have it; and it is a well known fact, that, even among those who are enabled, both by wealth and location, to command the services of the best practitioners, a very considerable number pre- scribe, and will continue to prescribe for themselves and their families, when labouring under complaints wdiich they consider simple and easily cured. Persons of another more numerous class endeavour to elude the payment of fees, by adopting the gratui- tous, or indirectly requited advice of the apothecary; thus preferring " half a loaf to no bread" The gentlemen of the pharmaceutical profession, whose situation differs widely from that of their bre- thren in England, will doubtless feel grateful for any effort to relieve them from a serious responsibility, which is at once annoying and unprofitable, while it appears censurable in the eyes of those who know the serious evils growing out of its assumption. For the regularly educated portion of the medical profession, we will pledge ourselves, unhesitatingly, that they would gladly relinquish a share of those considerable emoluments which they now derive from the mis- PREFACE. Vll management and complication of cases originally sim- ple, through the folly of empirics, in consideration of the serious amount of human suffering which would be saved if the domain of quackery wTere limited, by the general diffusion of some physiological know- ledge.. While, then,, a large and respectable portion of the community areresolved to resort to domestic, or to semi- professional skill, in the management of their health, it is assuredly desirable that they should acquire some knowledge of the machine upon which, they ope- rate, and the forces that they employ. But there are other far more important arguments in favour of extending some medical information to the public in general. Even in our large cities,—the centres of science,— a portion of the population is too poor to remunerate a physician, and too proud to ap- peal to his charity, unless under the most pressing emergency. To such, the services of a kind neigh- bour, or pastor, or an intelligent relative, might prove invaluable, if directed by some knowledge of disease: he might relieve unpleasant symptoms when not of great importance, and he would be prepared to warn the unwary of the approach of dangers demanding the sacrifice of all scruples. In the West,—where the tide-of immigration swTeeps on so rapidly, that newT communities are created every year, and in such numbers that heaven and earth are ransacked to find appellatives for the growing host of towns and villages,—a very considerable portion of the population is placed entirely beyond the aid of the profession; and much larger masses reside at so great a distance from the physician, that the most important period in the progress of all acute diseases necessarily elapses, before his arrival. At the south, still greater difficulties exist. On the large estates of the planters, a family composed of thirty, fifty, or even a hundred or more individuals, often remains cut off in a great degree from the rest of the wTorld, and dependent almost exclusively upon the agriculturist for hygienic, medical, and even surgi- Vlll PREFACE. cal treatment. It has been truly said that, a little knowledge is a dangerous thing; but certainly, in the situation just described, the remainder of the couplet is inapplicable. Another incalculable advantage which results from the extension of correct medical knowledge beyond the limits of the profession, is the difficulty which it throws in the way of the ignorant pretender, by ena- bling the public to judge more correctly of medical information. For, although the writer contemns the arrogance of those who have ventured, in similar works, to persuade their readers that all opinions dif- fering from their own are the offspring of ignorance or folly, yet he believes that the principles laid down, and the practical directions given, in the following pages, will be found generally in accordance with received doctrines. They will therefore enable the patient, or his friends, so to direct their questions to the practitioner, and to comprehend the replies, as to distinguish between the mere empiric, and the man who has really studied his profession; an advantage of immense value to both parties, in situations distant from large cities. Among the strongest proofs of the propriety of the present undertaking, are the constant demand for a popular medical guide of some kind, and the circum- stance that the very few works of this character now extant, which can be considered as adapted to the present state of the science, have their subject matter arranged m alphabetical order:—an arrangement which precludes the possibility of preserving the recollection of the mutual relations of facts, and de- stroys that system which is best calculated to aid the memory, facilitate reference, and impress correct prin- ciples. r In executing his task, the author has endeavoured conscientiously to inculcate such caution as is calcu- lated to secure his readers against a rash dependence upon their own partially enlightened endeavours when other and more efficient assistance is at hand while he has exerted himself to communicate, in a form as much condensed as possible, whatever infor- PREFACE. IX mation he considers likely to aid the cause of huma- nity under less favourable circumstances. The foregoing explanations are due to the practi- tioners of an honourable profession. To those who propose to commence the study of that profession, it may be stated that, under the present organization of our universities and medical colleges, the pupil, at the moment of entering upon his career, is overwhelmed by the quantity of scientific matter forced upon his attention by the number and variety of the lectures he is called upon to attend. These lectures treat of a variety of sciences, the very terminology of which is unknown to him ; and much of the value of his first year of study is usually lost in obtaining a few gene- ral ideas, laboriously gleaned from a great mass of more profound, but, to him, unintelligible learning. Some weeks spent in perusing and reflecting upon the contents of the first three chapters of the present work, will communicate, it is confidently believed, such broad views and impressions on anatomical, physiological, and hygienic subjects, as will enable him to listen with pleasure and advantage to the first course of medical instruction;—that tedious, and, to many, almost intolerable portion of the labour of a stu- dent. It is now time to address the public in general, on the design of the present work. The best advice that can be given to an individual actually suffering un- der disease, or desirous of pursuing such a course of diet, exercise, &c, as is likely to promote his health, and invigorate and preserve the force of his constitu- tion, is, most unquestionably, to recommend a con- sultation with some deservedly eminent physician. But the directions and reasonings of a physician are better understood by a patient who has himself some knowledge of the first principles of medicine. This knowledge is also a protection against the machi- nations of wonder-working empirics; for who, that has the slightest idea of the structure of the most com- plicate of all the works of nature, would confide the management of such a delicate machine to the hands of an ignorant pretender. X PREFACE. It is not always possible to obtain the desired assist-1 ance in due time, and in many situations it is alto- gether impracticable to obtain it at all. There are few medical men who have reached middle age with- out witnessing much misery and some loss of life, re- sulting from the ill-directed efforts of those who are compelled to act on an emergency, before the arrival of a physician. The writer of this treatise could ad- duce, from personal observation, a list of startling in- stances of that nature; all of which might have been prevented by the presence of any one possessed of a small share of the information wrhich he trusts may be derived from the following pages. There is, there- fore, no intelligent man wiio may not find his own comfort consulted, and his sphere of usefulness in- creased, by studying the first principles of physiolo- gy, hygiene, practical medicine, and surgery. To heads of families, principals of large manufac- tories, seminaries, and landed estates, missionaries on foreign stations, and the captains of vessels, such knowledge is still more important. " The Medical Friend," being designed not to su- persede the family physician, but merely to supply his place, when inaccessible, it will be found that the practical part of the work dwells chiefly on diseases of an acute character, and that when chronic complaints are mentioned, directions for the management of the earlier stages have received more attention than the after treatment, Those diseases which are incurable in their nature, or which defy domestic treatment at any stage, are omitted, or but lightly touched upon; and when such remedies or operations as are em- ployed only by the profession become the subject of remark, they are introduced merely to gratify the na- tural curiosity of the reader. When, in the current of a case, the requisite treatment becomes dangerous, or demands superior skill, the subject is generally fore-closed by referring the reader to competent me- dical advisers. The work is divided into two parts ; of which the first is descriptive and theoretical, the second practi- PREFACE. XI cal. It is desirable that all who would qualify them- selves for rightly comprehending the practical part should peruse, previously and attentively, the first four chapters, which may be regarded as introduc- tory. Technicalities have been avoided throughout the treatise, and it has been the constant endeavour of the writer to shun whatever pre-supposes an acquaint- ance with medicine or its collateral branches. The vast range of the subject renders impossible any consi- derable attention to detail in the first part, and it is hoped that the style will be found as light and enter- taining as comports with the gravity and importance of the matter. After a short preliminary chapter, containing a very cursory view of certain broad principles in compara- tive anatomy, the second chapter presents a more par- ticular notice of human general anatomy, with but little that appertains to the department of special ana- tomy; but, to enliven a subject usually considered peculiarly dry, a few physiological remarks are occa- sionally interspersed. The third chapter contains a view of the principal animal functions, and some comments on their aber- rations from healthy action. The artificial division between physiology and pathology, very properly adopted in the schools, has been here neglected, as calculated to confuse the general reader. Although it would be absurd to attempt to teach the details of the science of physiology within thrice the compass of the volume now offered to the public, and although years of application, with all the advantages of a thorough elementary education, wTould be necessary to complete the study, there are nevertheless certain general principles herein contained, which may be easily acquired, and which render the information presented in the succeeding chapters much more available. The subject is highly interesting in its na- ture, and it is hoped that the reader will find, in the entertainment which it furnishes, an ample remune- ration for the labour of a careful perusal. Xll PREFACE. The fourth chapter, on hygiene, or the art ol pre- serving health, is by no means the least important portion of the work, and is worthy the attention of every head of a family, or principal of a school. The several subjects of food, clothing, air and moisture, exercise, the errors of female school discipline, and matrimony, are discussed under distinct heads. Many valuable rules for gradually imparting strength to the constitution, and for the preservation of health under atmospheric vicissitudes, or in unhealthy situations, will be found in this chapter. The second, or practical portion of the work is di- vided into five chapters, on the following several sub- jects : surgical accidents and diseases, medical, prac- tice, diseases of married women, diseases of children, and diseases of adult females. It has been already remarked, that the alphabetical arrangement of sub- jects has not been adopted in any part of this work; but all the conveniences derived from such a distribu- tion, may be obtained by reference to the very copious index provided for each of the two great divisions of this volume. An appendix contains a list of many of the simple medicines and compound prescriptions recommend- ed in the work, with the mode of preparing the latter. It is remarked, that the most experienced practitioners generally employ the smallest number of remedies, as the most able mechanic often uses but few implements. Instead, then, of following the ex- ample of his predecessors, by perplexing the minds of his readers with a history of a great multitude of me- dicines, the writer has confined his attention to those of established reputation, and named in the body of the work. Having thus narrated the contents of the volume, it is proper to mention what portions of the labour have been performed by the avowed author, and what part has been executed by the professional friends, who have aided him in departments to which they have devoted more especial attention, though they have declined the announcement of their names. PREFACE. Xlll The author is directly responsible for the whole of the first part of the work, and for all that is strictly surgical in the second part, with the excep- tion of the articles hemorrhoids, hip-joint disease, and wiiite swelling, and the surgical section on constitu- tional diseases. The science of medicine in modern times has taken a range so vast in extent, and complex in detail, that it would be presumptuous in any one individual, whatever may be his position, to undertake the pro- duction of a work glancing over nearly the whole field of the theory and practice of medicine, without the aid of those whose observations have been more ex- tensive than his own in such departments as he has neglected by necessity, or avoided by preference. The more cursory, and general the treatise, the more profound is the knowledge required to give value to the pages, and to avoid the danger of serious error: for, wiien numerous facts are systematically expressed and arranged, it is much easier to include them within definite rules, than when these facts rest only in the memory of one who writes the results of past study, reflection, and experience, as the author of this work has written—currente calamo. For these reasons, it was thought advisable that the subject of internal dis- eases should be intrusted to different hands from those which had been charged with the anatomical, physiological, hygienic, and surgical departments. The avowed author has added occasional comments and incidental observations or opinions, in the course of the strictly medical chapters, and here his connexion with them properly ceased. He regrets that circum- stances induce his coadjutors to decline the announce- ment of their names, and feels that some apology is necessary for the acknowledgment of* his own, wiien unattended by theirs. The motive may be briefly stated. When a writer presumes to address the public on subjects of high importance, and such as are usually regarded as recondite,—especially if his subject matter be drawn from general study and experience, without XIV PREFACE. compilation, or frequent reference to special authori- ties,—the value of his labours depends chiefly upon his opportunities for the acquisition of information, and the confidence felt in his mode of employing those opportunities. In other words, his personal character and position are necessary elements in the calculation of the dependence which should be placed upon his dicta. A book upon a scientific subject, un- supported by any name is, therefore, justly regarded with some suspicion; and, whether the name, wrhen appended, be calculated to elevate or depress its cha- racter, there is justice in its announcement. It is true, most of the facts and doctrines con- tained in the following pages may be regarded as the common property of the profession; yet there are not wanting frequent individual opinions, and practical observations, which require a sponsor for the legitima- cy of their deduction, or the accuracy of their state- ment. No parade of these original remarks is at- tempted. They will be recognised at once, by those who are proficient in the science, and to such, alone, the question of their origin is interesting. For these reasons, the projector, and principal wri- ter of the work, has thought it incumbent upon him to attach his name to the volume, although the step is taken with some reluctance; partly, because there are those of his fraternity, who disapprove such un- dertakings ; and partly, because it places his name in juxta-position with that of some previous authors, whom to rival, or with whom to affiliate, falls not within the compass of his ambition. Had the author aimed at reputation, he might have said much, with justice, in extenuation of defects of style; but if he have succeeded in composing a book of real utility, he cares little for any reputation which may flow from it. The book is before the public. Let it stand or fall by its own merits. All that is asked for it, is a fair examination. CONTENTS. Preface, ....--- Page 5 PART FIRST. OUTLINES OF ANATOMY, PHYSIOLOGY, AND HYGIENE, 15 CHAPTER I. PRELIMINARY REMARKS ON THE ORGANIZATION OF ANIMALS, ------ 17 CHAPTER II. STRUCTURE OF THE HUMAN BODY, - . • 25 Of the cellular tissue, ------ 25 Of fat, or adipose tissue, - ~~ Of the bones, or osseous system, - - - ol Of the skeleton, """"""«! Of the muscles or muscular system, anatomy, 5o Of the digestive apparatus, ... - o7 Of the stomach, - 'Jt Of the duodenum, ------ 75 Of the liver,...... ™ Of the pancreas, - 7,o Of the small intestine, „ . - - 79 Of the great intestine, " " " " " qq Of the circulation, ------ 06 Of the circulating fluids, " " " " ' c« Of the route of circulation, J °£ Of the portal vessels, -; °* Of the capillaries, - - - \ - - - »i Of the function of nutrition, - - - - - y^ Of the function of absorption, *«* Of respiration, - |*_ Of the apparatus of respiration, - »? Of secretions, ------ XVI CONTENTS. Page Of the urinary apparatus, ----- 103 Of the urine, - -.....JJJJ Of the skin or integument, ----- 107 Of the nerves, - - - " J1* Of the brain, - " " " ' " ^ On the duplicative of certain organs, - - - - 122 CHAPTER III. PHYSIOLOGICAL REMARKS, ... - 126 Of assimilation and nutrition, - - - 126 Of the reproduction of parts as displayed in the healing of wounds, 133 Of symptomatic fever, ... - - 13e Of irritation and hyper-nutrition, inflammation, physiological, • 147 Of capillary irritation, - 153 Of nervous irritation, ----- 159 Of the balance of vital action and re-action, - - - 162 Of vicarious discharges and transformations of tissues, - - 163 CHAPTER IV. REMARKS ON HYGIENE, .... 166 Offood, -......166 Of clothing, -......183 Of air and moisture, ------ 197 Of exercise, ------- 206 Of the food and exercise of children, - - - - 213 Errors of female school discipline, - 220 Of matrimony, ------ 226 PART SECOND. PRACTICAL DIRECTIONS FOR THE TREATMENT OF MEDICAL AND SURGICAL DISEASES, - - 235 CHAPTER I. OF SURGICAL ACCIDENTS AND DISEASES, - - 235 Sect. 1. Of wounds and contusions, - 235 Of incised wounds, ----- 236 Of incised wounds of the scalp, - - - 247 Of incised wounds of the neck and throat, - - 248 Of incised wounds of the chest, ... 249 Of incised wounds of the abdomen, - 250 Of incised wounds of the joints, - 252 Of lacerated wounds, - 254 Of contused wounds, - 259 Of contusions, - 261 Of injuries of the head, - 263 Concussion of the brain, - 265 Fractures of the skull, - 268 Of contusions in the cavity of the spine, - . 271 Of fractures, dislocations, and sprains of the spine, - 271 Of concussions of the spine, - 273 Of contusions of the chest, - 274 CONTENTS. XV11 Page Of contusions of the abdomen, - - - 275 Of contusions of the pelvis and perineum, - - 278 Fractures of the'pelvis, - - - - 279 Of contusions or sprains in the joints, - - 281 Of punctured woui.df, - - - - 283 Sect. 2. On the dilatation of natural passages, and its consequences, 285 Dilatation of the anus, - - - 287 Of dilated or varicose veins, - , - - - 290 Of varicocele, ------ 293 Of piles, or-hemorrhoids, - 296 Of dilatations of the heart and arteries, - - 298 Of aneurisms, - - - - - - 298 Of anem*ismal varix and varicose aneurism, - - 299 Of mother-spots, or aneurism from anastomosis, - 300 Of hernia, or rupture, - - - - - 302 Sect. 3; On deformities from imperfect nutrition of the osseous and muscular systems, ----- 311 Of curvatures of the spine, - - - - 311 Of club foot, - - ' - - - 318 Sect. 4. Of fracture?, - - : - - - - 319 Fraptures of the clavicle, - - - - 321 Fractures of the shoulder blade, - - - 323 Fractures about the shoulder joint, - 323 Fractures of the arm, - - - - ' - 323 Fractures of the elbow joint, --."-• 324 Fractures of the fore-arm, - - - - 325 Fractures of the lower extremities, - - - 325 Fractures of the thigh, - 326 Fractures of the leg, - - - ■ - , 327 Fractdres of the fingers and toes, - - - 328 Fractures of the lower jaw, -. - - - 329 Of dislocations in genera], - - - - 330 Dislocation of the arm into, the arm-pit, - - 331 Dislocations of the wrist, ' - - - - 332 Dislocation of the ankle, with fracture of the fibula, - 332 Sect. 5. On inflammation and its consequences, - - 333 External inflammations, - 333 Terminations of inflammation, - - - 334 Treatment of inflammation, - - - - 335 Of suppuration,, - -, - - - 337 . Of ulceration, - - -' - - - 338 Of gangrene, - - ".."•" " 342 Malignant pustule, - - - ..- , - 342 Gangrene of old men, - - - - - 342 Dry gangrene, -•-''' 343 Gangrene from excess of inflammation, from internal and constitutional causes, - - . - - 343 Gangrene from pressure, - - - 344 Gangrene from cold, - - - - 344 Gangrene1 from mechanical injuries, ' - - - 345 Terminations of inflammation coupled with collapse, '- 346 Of the sty, ------ 349 Ulceration of the eye-lashes, - - - , > - 349 Foreign substances in the eye, - - - 350 Inflammation of the eye, .... 351 Ulceration of the cornea, - - - • 354 Films on the eye, - - - 354 Foreign bodies in the ear, - - ' 355 Ear-ache, and suppurations of the ear, - - 356 C XV111 CONTENTS. Page Ulcerations of the mouth, - - - - 356 Gum-biles, ------ 357 Suppurations of the urinary passages, - 357 Excoriations about the mucous orifices, - - 359 Chafing,......359 Of abscesses, ------ 359 Run-round, ------ 361 Whitlow......361 Nails growing into the flesh, - - - 362 Biles, ------- 363 Furuncle and carbuncle, . _ - - 364 Canker, or gangrenous sore mouth of children, - 366 Burns and scalds, - - - - - 368 White swelling, .... - 370 Hip-joint disease, - - - - - 371 Sect. 6. Corns, warts, and moles, ... - 373 Soft corns, ------ 374 Warts, - - - - - 375 Moles,......375 Sect. 7. Constitutional diseases, .... 376 Scrofula, - - ... -. - 376 Of cancer, - - - - ' - - 378 Venereal disease, - - - - - 380 Scurvy, - - - J -. - - 384 CHAPTER III. MEDICAL PRACTICE OR TREATMENT OF INTERNAL DISEASES, ------- 387 Sect. 1. Fever, ---.--- 387 Intermittent fever, ----- 388 Continued fever, - ■ . - - - 393 Bilious remittent fever, , - - - - 400 Yellow fever, - - - - - - 401 Petechial or spotted fever, - . . . 403 Sect. 2. Eruptive diseases, - 405 Small-pox, ---... 405 Varioloid, - - - - - . 409 Chicken-pox, - - - ... 409 Cow-pox, ---... 410 Measles, ------ 412 Scarlet fever, ------ 413 Miliary fever, - - - - . 415 Nettle-rash, ------ 416 Prickly heat, or lichen, - 417 Shingles, - - - - - . 417 Ring-worm, - - - - - - 418 Itch, ------- 418 Rose-rash, ------ 4ig Gum-rash, ---... 420 Pruriginous rash, - 420 Sect. 3. Erysipelatous affections, - 421 Poisoned wounds, ----- 422 Erysipelas phlegmonodes, or diffused inflammation of the cellular tissue, - - - . 425 Inflammation of the veins and absorbents, - - 426 Sect. 4. Diseases of the respiratory apparatus, - - 428 Catarrh, ---... 428 Influenza, ------ 430 CONTENTS. XIX Pleurisy, -...._ 431 Lung fever, -._.-. 432 Consumption, -....- 435 Spitting of blood, - . , - - 439 Pulmonary hemorrhage, .... 440 Asthma, --__.. 441 Angina pectoris, ----- 443 Sect. 5. Diseases of the throat, ... - 444 Mumps, ------ 444 Quinsy, ---.-.. 444 Croup, -_-_.. 447 Sect. 6. Diseases of the abdomen, - 449 Cholera morbus, ----- 449 Spasmodic or malignant cholera, - - - 450 Diarrhoea, or looseness, - - - - 454 Dysentery, ------ 457 Colic, ------- 459 Painter's colic, ..... 452 Liver complaint, - 464 Inflammation of the kidney, - - - . 466 Jaundice, --.... 457 Passage of gall stones, - 468 Worms, ------ 470 Sect. 7. Diseases of fibrous tissue, - - >- - 473 Rheumatism, - - ... . 473 Gout, - - - - - - 476 Sect. 8. Nervous diseases, - - . . . 479 Chorea, or St. Vitus's dance, - - - - 479 Shaking palsy, ..... 48Q Convulsions, - - - - - 481 Epilepsy, ...... 491 Hysteria, - - - - "- - 482 Catalepsy, or trance, ----- 483 Apoplexy, ...... 434 Palsy, - - - - - - - 487 Sect. 9. Prominent symptoms and accidents, - 488 Dropsy, -.--.. 488 Heart-burn, ...... 492 Water-brash, ------ 493 Flatulence, - - - - - - 493 Costiveness, ------ 494 Indigestion, or dyspepsia, .... 497 Vomiting, ------ 502 Hiccough, ------ 504 Cramp, ------ 505 Bleeding from the nose, ... - 507 Strangury, -.---. 508 Diabetes, ...... 509 Gravel, - - - - - . - 509 Drowning, ..--.- 511 Death from suspension, .... 512 CHAPTER III. DISEASES OF MARRIED WOMEN, - - - 513 Of pregnancy, and the position and connexions of the child in the womb, ..... 513 Approach of labour, - - - - 518 Of labour,......520 XX CONTEXTS. Page . Uterine hemorrhage, ----- 526 Of puerperal convulsions, - - - - 527 Inversion of the uterus, ... - 530 Inflammation of the womb, - 531 Puerperal fever, - "'".•" " " °32 Swelled leg, milk leg, or phlegmasia dolens, - - 534 Puerperal nervousness, mania, and melancholy, - 535 Of palsy of the bladder, - - - - 537 Of swelled throat, .... - 537 Inflammation and abscess of- the mamma, - - 537 Of inflammation of the nipple, - - - 539 CHAPTER IV. ON DISEASES OF CHILDREN, - - - 541 Tongue-tie, - - - - - - 541 Swelled breasts, - - - - ' - 542 Sore navel, ------ 542 Of the yellow skin and jaundice of infants, - - 543 On retension and suppression of urine, - - 545 On painful urination, - - - - - 546 Incontinence of urine, - - - -. - 547 Excessive urination, urinary consumption, or diabetes, 547 Sore mouth, thrush, aphthse, - - - - 548 Colic, --- - - - - 551 Costiveness, ------ 554 Vomiting, ------ 555 Erysipelas, - - - - - - 557 Dentition, - - - - - - 558 Worms, ------ 56I Convulsions, ------ 561 Dropsy in the brain, ----- 562 Whooping-cough, ----- 563 Inflammation of the tonsils, quinsy,. - - - 566 Cholera infantum, ----- 567 CHAPTER V. ON DISEASES OF ADULT FEMALES, - - . 570 Appearance of the menses, - 570 Chlorosis, or green sickness, - - - - 570 Suppression of the menses, - 572 Obstructed menstruation, - • - - - 573 Painful menstruation, ----- 573 Excessive menstruation, or flooding, - - - 574 Final cessation of the menses, - - . - 575 Leucorrhcea, fluor albus, or whites, ' - . «-.. 575 Pruritis vulvas, ----- 576 Falling, or prolapsus of the uterus, Retroversion, or falling of the womb backwards, Antiversion of the womb, Polypus of the uterus, - Cancer of the uterus, - - - . Appendix, - - - - . Formulary, - - - . List of drugs, - List of apparatus, - Index to the first part, - Index to part second, - Errata, - : : 577 579 579 580 580 583 583 596 599 601 607 615 CHAPTER I. PRELIMINARY REMARKS ON THE ORGANIZATION OF ANIMALS, When we look at the wonderful machine which the Deity has placed upon the earth to preside over his creation—when we consider the beautiful adaptation of its various parts to the purposes for which they are designed—we are struck with awe and admiration, even upon a superficial glance at its beauty and propriety. But when we penetrate beneath the surface, and behold the play of its ten thousand arteries carrying sus- tenance to every part of the system—the veins returning their purple current "to the heart and lungs, to be resupplied with the elements of life,—when we observe the lacteals taking up the nutritious particles from the bowels, and conveying them through countless channels to be mingled with the blood— the absorbents removing those parts which are no longer fitted to fulfil their duty, and the glands rejecting them from the body as useless incumbrances, while the vessels again supply their place with fresh materials,—when we reflect, I say, that this most intricate machine is so constantly undergoing waste and repair, that in a very few years it loses every individual atom which formed a part of its original structure, while it still preserves its form and motions unimpaired, we are lost in wonder; not less at the wise ordinations of Nature that re- gulate its operations, than at the audacity of those who dare to interfere with her arrangements, even when disorder is perceived among the wheels and springs of this masterpiece of Divine wisdom and power. But Nature governs all her works by a few simple laws; and when these laws are discovered, the explanation of her most involved phenomena are often brought within the grasp of human reason. By contemplating the fall of an apple, New- ton was enabled to expose the hidden cause of all the move- ments of the heavenly bodies. Now, although we have not arrived at nearly the same simplicity in the study of the sci- ence of life which that philosopher has reached in speculating 3 18 OUTLINE OF ANATOMY. on Natural Philosophy, we have discovered many general principles which shed no inconsiderable litiht on the other- wise incomprehensible operations of the human frame in health and in disease. Let us, then, proceed to elucidaie these prin- cip'es, as far as the limits and the object of this work will per- mit. The simplest of all animals—which mostly reside in the wa- ter—appear to be entirely divested of feeling, or voluntary mo- tion ; they have no blood vessels, no nerves, no intestines, no organs; they are composed of a kind of membrane containing many cells and fibres of different shapes and sizes, filled and surrounded with a peculiar fluid. In structure they are not unlike a sponge, enclosed in a bladder of the same substance, and shaped into different forms according to the species. In composition this membrane does not differ very widely from the white of an egg when boiled. Such is the picture of the simplest specimens of animal life, and although the labours of recent naturalists have proved the existence of more complex organs in many of the tribes of minute beings, whose existence is scarcely perceptible, except by the aid of powerful micros- copes, there are not wanting many of much larger size, and, therefore, open to accurate observation, in whom the whole pody is devoid of any systematic arrangement, other than that which has been just described. These animals live by imbibing their sustenance through the skin from the fluid in which they swim, and as they select such particles as are fitted to their wants, they may be said to perform a kind of external digestion. The membrane of which they are composed is supposed to contract when touched, and also, when acted on by light, heat, electricity, and, perhaps, other causes; thus the fluids which it contains are agitated and moved from place to place, so that an imperfect kind of circu- lation is effected without the aid of blood vessels, and all parts of the body are nourished and furnished with the means of growth. If respiration be necessary to these animals, it must be effected by the external surface, and whatever matters re- quire to be ejected from the body are compelled to pass by the 'same route. This substance, of which they are composed, and which is called cellular membrane, or cellular tissue, seems, therefore, to be capable of fulfilling all the functions of life, as far as they are necessary to the existence of the most simple animals, and, strange as it may appear, even the human em- bryo, when it first becomes visible, and for some time after- ward, cannot be distinguished from a small mass of cellular tis- sue! Although it is obvious that it must be endowed with life, It contains no vessels nor organs, but resembles a mere piece of animated jelly. OUTLINE OF ANATOMV. l'J When we begin to examine animals more and more ad- vanced in the scale of nature, we find that those which are de- signed to move about in search of food, instead of having their food brought to them, require to be furnished with organs especially devoted to this purpose. They have muscles: for the occasional, and, as it were, accidental contractions of the cellular tissue are too irregular and uncertain to answer their necessities, and they require an apparatus for locomotion-. From the moment that the character of perfect simplicity is thus lost, it seems that mere absorption from the surface is in- sufficient to supply the materials for the different organs, and the animal is supplied with an internal cavity or stomach, and bowels more or less complex in structure, in which food may be enclosed until it can undergo a more careful and deliberate digestion. Still these muscles, of which we have spoken, though they look like fibres of considerable length, are thought, by most, to be in reality composed of globules or particles, ranged in rows in the midst of the cellular tissue, which ties them together in bundles and keeps each particle in its proper place; they are strictly interstitial deposites, filling the cavities and adhering to the layers of the membrane. Now the movements of the muscles would be embarrassed and, perhaps, destroyed, if the liquids which support life were permitted to pervade the whole body, in these, as they do in the simplest animals, which have no well defined organs; the nutritive fluid or blood, is, therefore, generally enclosed in distinct vessels, formed ultimately of the same cellular tissue, but having no communication with its cells. These vessels divide and redivide, carrying the blood to every part of the body, and returning it again to a reservoir, or Heart, which forms the centre of the circulation. As every part of the body receives its nourishment from the blood, it is obvious that this fluid is constantly undergoing considerable waste; nature has, therefore, provided a system of vessels which is rather an appendage to the circulatory ap- paratus than a part of it. These vessels, which physicians call the Lacteals, arise in countless numbers from every part of the bowels. They take up, by some invisible means, such parts of the food as are suited to enter the blood, leaving the rest to be ejected from the body by the natural passages. They pursue a winding course, uniting gradually with each other, and thus becoming larger, as the little streams from a thousand springs are slowly collected first into rivulets, then into brooks, until, at length, they give rise to a noble river. The river of the lacteals into which they are all finally col- lected is, in man, a vessel about as large as a crow-quill, which, running for some distance along the spine, near the back part 20 OUTLINE of an atom v. of the chest, empties its contents into one of the principal veins of the body just before it enters the heart. The Heart is a strong hollow muscle, which alternately receives the blood as it flows toward it, and then forces it by a strong contraction through vessels, which go on continually branching until they reach every part of the system, like the limbs and twigs of a great tree. The principal trunk and great branches of this class of ves- sels are termed Arteries; the blood is propelled through them chiefly by the direct force of the heart, but they are provided with a coat or envelope of fibres resembling those of muscles, which aid in urging the current more uniformly in proper di- rections, and as the arteries grow smaller, these fibres increase in their relative strength, as the bark of the smaller twigs be- come thicker in proportion, than that of the body of the tree. At length these little arteries become capable of hastening or retarding the flow of blood, and sometimes, perhaps, they check it altogether for a moment. They now change their name, and are called the Capillaries. I-t is. through the capillaries that all those particles which are required for the growth and preservation of the body and its several organs, are separated from the blood and placed in their proper stations. The same vessels are supposed by some to take up and mingle with the blood those particles which have done their duty and are worn out in the service, in order that they may be disposed of, in the manner in which most bodies corporate reward the past services of friends no longer found necessary; that is, by being turned out of doors. In this most thankless duty, however, they are certainly aided by a subsidiary class of vessels called the Absorbents, which eon- vey only colourless fluids collected from all parts of the body, Most of these last named vessels, finally empty their contents into the common trunk of the lacteals, and thus into the veins; but some of them reach the same destination by a more direct route. This constant addition of nutritive matter to the blood by the lacteals, its distribution to every organ of the animal by the heart and arteries, its separation from the mass of circulation, and its application to the growth and repair of all parts by the capillaries, together with the removal of injured, useless, or de- bilitated particles by the absorbents, are subjects connected with the all-important process of nutrition. After the blood has passed the capillaries it falls into anc~ ther system of vessels called the Veins, by which it is returned to the heart. The veins are destitute of the seemingly mus- cular coat of the arteries and capillaries, and although the blood is constantly pushed into them bv the joint action of outline of anatomy. 21 the heart, the arteries, and the capillaries, they are unable to propel it by any effort of their own; they are mere passive conduits. To supply this apparent defect, they are provided with numerous valves, set here and there along their course, which permit the blood to pass toward the heart, but prevent its return in the opposite direction. By the constant motion of the muscles in breathing, walking, coughing, sneezing, &c, the veins are very frequently compressed, and their contents urged forward more rapidly; hence the healthfulness of exer- cise and gymnastics, but of this I shall speak more fully in the chapter on Hygiene. All the veins of the body are gradually collected into a few great trunks or canals, which pour their contents into the heart, and those which belong to the general circulation,—that circulation which is destined to supply nutri- ment to the body—form, in the more perfect animals, two great conduits; one coming down from the head and upper extremi- ties, the other coming up from the trunk and inferior ex- tremities. These conduits meet directly end to end, so as to form but one trunk, which opens into the heart by a gap at the side. The blood thus returned is of course altered, in the first place, by having parted with a great deal of matter for the repair and growth of the different organs, and secondly, by being loaded with all the useless particles which the absorbents have taken up. In order then that it may be fitted for circu- lating again, it must receive considerable additions and it must cast off considerable impurities. The former are supplied by the lacteals, but the latter process requires a different set of vessels endowed with other powers. One of the chief impurities which the blood receives from the absorbents is carbon or charcoal. To rid it of this, a part, and in the more perfect animals, the whole of the blood, is made to pass through an organ where the vessels come almost into contact with the element in which the animal lives, as the water in fishes, and the air in birds and man. Both these elements contain oxygen or vital air, and by some hidden means, the carbon of the blood, being supposed by most to unite with this vital air, escapes through the thin coats of the vessels in the form of carbonic acid gas, the same gas that rises from fermented liquors, soda water, &c. Thus, we see some animals breathing water, and others, air. The former, gene- rally have the breathing organs placed externally; they are termed Branchiae or gills; in the latter, they are situated within the body, and are called Lungs, or lights. The function per- formed by these organs is called respiration. It is believed by many physiologists that nature, always un- 2v! outline of an atom r. willino- to perform any useless labour and anxious to effect as many operations as possible with a very few materials, has so ordered the laws of respiration that it shall preserve the warmth of the animal at the same time that it purifies the blood. While the blood is acted upon by the atmosphere in the lungs, or by the water in the gills, it is supposed to absorb a great quantity of heat, and as it flows towards every part of the body, undergoing a gradual change, it is thought to throw out this heat, and thus to keep every part at its proper tem- perature. The effects of respiration are not sufficient to remove all the impurities of the blood, and, therefore, a number of curious organs, called Glands, are provided, some of which aid in sepa- rating many of these impurities, each gland furnishing its Own peculiar fluid, which it pours out either into the bowels or into the skin. The product of many of these glands is made useful for various purposes before it is thrown off from the body; thus the liver, the largest of the glands, forms the bile, which is the natural purgative, producing, when healthy, regu- lar and comfortable stools; and when diseased, occasioning cOs- tiveness or bowel complaints: the pancreas and the glands about the mouth pour out the spittle which assists digestion. These useful fluids are called Secretions, but those which are ejected, like the urine, without fulfilling any important purpose, are called Excretions. From what has been said, it is obvious that the motions ne- cessary to maintain life even in very simple animals are nu- merous and complex. The stomach and intestines must re- ceive and digest food; the lacteals must take up the nutritious part of the food and carry it to the blood; the arteries must convey this blood to the different organs; the capillaries must supply the growth and waste of those organs; the absorbents must aid the capillaries in taking away the worn out and use- less parts to mingle them with the blood in the veins; these vessels must, convey the blood back to the heart, which must then pass it to the lungs to be deprived of some of its impurities, and to enable it to sustain the heat of the body. In addition to all this, the glands must assist in purifying the blood, or they must furnish fluids to aid in digestion and other functions, or to purge away those useless remains of the food, which cannot be digested. So many different motions all dependent on each other, would necessarily produce continual confusion, by acting irre- gularly and to cross purposes, if they had not some common bond of union by which they can mutually inform each other, as it were, of their several wants and actions. This bond of union is furnished by the nerves. outline of anatomy. 23 In the more simple animals, we find only a few nervous fibres running in different directions, with here and there lit- tle knots called Ganglions, joining several fibres together. When any impression is made upon one of these fibres, it is instantly communicated to the parts with which it is connect- ed, and calls them into action. If the fibre is united with others, or with one or more of the little knots just mentioned, they are also called into action, and several different parts are then put in motion at once. Thus when food enters the sto- mach, its nerves receive the impression and cause the capil- laries of that organ to dilate in order to receive the blood required to carry on the process of digestion; they also give notice to the heart, which, if necessary, acts with more force in hastening the circulation, and the capillaries of the skin contract and drive the blood from the surface toward the bowels. This is the cause of the slight chill and consequent fever so often felt during and after a hearty dinner. The ani- mal, however, remains unconscious of all this hurry of business within, and the nerves which are the messengers and agents of the manufactory are called the nerves of organic life. They are altogether independent of the will, and are found in ani- mals supposed to have no brain. In beings of a higher order, that are obliged to choose their food with judgment, and to travel far in search of it, other nerves are required to enable them to recognise its presence; these are the nerves of sensation. There must also be a brain to enable the animal to judge of its impressions, and to per- ceive its wants, and another system of nerves is required to • pass from the brain to the different muscles, by which the former may direct the motions of the latter; these are the nerves of voluntary motion. AH these several systems, though, in some degree, independent, are connected together by the brain and the little knots or ganglions, so that they mutually influence each other. Finally, to enclose and protect this multiform and delicate structure, there is a coat of condensed cellular tissue cover- inc the whole body, and called the true skin, over which is spread a thin layer of horny matter called the cuticle or scarf skin. This cuticle is totally insensible, and forms a mere crust which protects the delicate and exquisitely sensitive sur- face of the true skin. The horns, nails, hair, spines, shells, and crusty coverings of various animals, are all classed pro- perly with the cuticle, being either excrescences of, or substi- tutes for, that membrane. Each of the parts of an animal that have now been enume- rated may be found even in a common snail, or in the mean- est of the reptiles; but, as we ascend in the scale of nature, '21 outlive of an atom v. everv system of organs is observed to become more and more complex in structure, and capable of actions more and more various. Man, the most perfect of animals, not only requires the whole of this complex apparatus, but his brain also contains systems of nervous fibres, for the exercise of the higher in- stincts, moral feelings, and reasoning faculties. He is at first nothing but a little mass of cellular tissue; but as the infant in the mother increases in size, one organ is added after another, nearly in the order described, and many of his parts do not reach their full development until he approaches middle life. We will now proceed with a hasty review of the several parts and systems which compose the human body, with such notice of their action as our narrow limits will permit, pur- suing the order in which we have already arranged the prin- cipal functions which belong lo all animals.