WBA F664f 1845 m 1 in i mii;iu)N'!; .; ,j j!i»{ii','':Jir,:i:1!:;1' WmiW.¥':-'--.--.' il|li.ii!!S- ;:v;: >tt! iUjiiihji { A 5\r~ TO THE HISTORY AND CURE OF GENERAL ^ S0FFJC£ DISEASES. DEC,~31M897 THE THIRD, ItQ JLrj <% TO THE HISTORY AND CUREi OF DfeAsESTNpI*' ' DENT TO CHILDREN AND FEMALES.- * AND THE FOURTH, TO THE HISTORY OF MEDICINES, &c, &c. BY ALFRED M. FOLGER. OF STOKES COUNTY, N. C. (Formerly one of the Attending Physicians in the Cherokee Hospital.) Published by Z. D. Cottrell, Printed by G. H. Joyce, Spartanburg C. H., S. C. 1845. i/ /sir '.'..St'.. *Li t ■i !*:•■ (Copy Right Secured.) TO JOHN W. LIDE, M. D., formerly Directing Physician, in the Cherokee Emigration; for whose kindness, while I was in the service of the United States, as Attending Physician in the Indian Hos- pital, I shall ever fee> grateful ; whom I highly es- teem as an Honorable Gentleman, as a Profound Scholar, and, as a Skilful Physician, This Work ie Respectfully Inscribed, by His Sincere Friend, THE AUTHOR. TO THE PUBLIC. In Appearing as an Author, I can but be aAvare that I shall subject myself to much criticism. I do not flatter my- self that I shall be able to lay before the Public, a Work devoid of error; and, therefore, can but expect, that those of the Medical Profession, Avho vieAv this Volume Avith an eye of scrutiny, Avill find in it much to merit their just criti- cism. Those of the Profession Avho are actuated by pure principles, I doubt not will readily accord to such a work, all the merit due to it. The ingenuous and enlightened mind, will examine Avell the work, and decide impartially, accord- ing to the merit of the same. Such will first enquire what has been done ; whether anything calculated to enhance the public good, and if convinced of the utility of the work, will not hesitate to pronounce it a Volume worthy of a place in each Family Library. I am aAvare of the probabil- ity of there being many of the Profession Avho Avill oppose every medical work calculated to inform the people on the subject of disease. Such selfishness, such want of philan- thropy, is characteristic of low, groveling minds ; and an Author should regard not the vile invective of such men.— An individual who opposes any literary production from motives of avarice, envy, or prejudice, does not deserve a passing rebuke. vi. In writing the present Volume, I have endeavored to be as plain and as explicit as possible. I am opposed to too much prolixity in any medical work intended for the use of priAate individuals; consequently, I have been as brief as the nature of the case would admit. All technicalities have been carefully avoided, making the work perfectly plain to an ordinary scholar. Such diseases as require the immediate attendance of the Physician, I have not treated upon, further than to point out the symptoms, fearing that persons may delay calling in a Physician until it be too late. Like all writers on the practice of medicine, I have only been able to lay down general plans of treatment; but, I assure the reader, with that candor which I hope will ever characterize my life, that general or undeviating plans will not always ansAver the purpose intended. The disease should be treated agreeably to the symptoms manifested, and should the complaint vary from its ordinary course, the treatment should vary also. I know there are Physicians in our County, of age and experience, who contend for an universal course of treatment, to be pursued in all patients laboring under the same disease; but I care not for the opin- ions of any Physician, however aged he may be, when they are so destitute of reason. Men often grow gray in igno- rance and folly, and the Physician should be judged by his success in practice, and not by his age. I hope, however, that the plans I have laid down for the treatment of disease, will answer in ordinary cases; and, when great rariatioiw vii. occur, persons may be aware of the impropriety of pursuing the beaten path, and call for medical aid. With these preliminary remarks, I lay the <•' FAMILY PHYSICIAN" before the community, with a hope that some good may result from my feeble efforts, and with an assurance, that however I may be censured, my motives are good, and if this work be good, it will continue to benefit my fellow b«ings, long after this hand shall have crumbled into dust. A. M. FOLGER. Stokes Co., JY. C, Jan. 1844. PART FIRST. ON HYGIENE AIR. The necessity of pure air to the health of an individual, is acknoAvledged by all medical men. The air of crowded apartments will soon become impure, in consequence of so many persons breathing together, that the room is com-^ pletely filled with air, that has passed through the lungs, perhaps half a dozen times or more. One of the most re- markable instances of the injurious effects of confined air, is to be found in the history of persons who died in the Black Hole at Calcutta, giA^en by Dr. Ewell, and others. There we discover, that many persons actually perished, in consequence of being croAvded together. People should In- cautious, therefore, of the air of theatres, ball-rooms, &>•.. croAvded with a large company. My OAvn opinion is, that dAvellings should be in as high a situation as convenient, and the rooms large, particularly sleeping apartments. The experience of any one, avIio has ever slept in a small, close room, Avith several others, should convince him of the impropriety of such a thing. Hoav unrefreshing his slumbers during the night, and Iioav feeble and relaxed his system in the morning, when he arises. It seems to have been the practice among the first settlers of this country, to build their chvellings in low places, in order to be convenient to a spring. This, I consider very im- proper, and suppose that the observation of any man, Avould convince him of the fact. If he will only notice the sickness that prevails in autumn, he will see many more cases of fever in such places than in high, airy locations. While in the service of the United States, as attending HYGIENE AIR. 9 Physician in the Cherokee Emigration, it fell to my lot to attend to twelve hundred Indians, encamped in the woods, about three months. Some of them Avere situated in the low ground, near a small stream; others on a considerable eminence, from fifty to one hundred yards distant. Dysen- tery, and some other diseases, prevailed among them, but not one third of the sickness in proportion among those on the hill, that there Avas among those in the valley; and Avhile several died in the latter situation, not one death occurred in the former. This shoAVs the advantage of free air. Sitting rooms should be freely ventilated in warm weath- er ; and in cold Aveather, persons should avoid keeping small rooms closely shut, in which a large fire is kept burn- ing. Fire, in a room Avhich admits air from Avithout, is beneficial, by rarefying the air Avithin, thereby "causing a constant current of fresh air from Avithout." Fire, on the contrary, kept in a room so closely shut, as to prevent the admission of air from Avithout, Avould soon render the air Avithin, totally unfit for respiration : sleeping rooms should also be freely ventilated in warm weather, throughout the day, unless the weather is at the same time damp. With regard to keeping fires in sleeping apartments, during the night, in cold weather, I consider it entirely improper. During my residence in the State of Indiana, I slept sev- eral Aveeks, in a room in which a large fire was left burning every night; and the consequence Avas, my system became feeble and relaxed, I Avas much more susceptible to the ef- fect of the intense cold of the day, and eventually Avas at- tacked with a painful nervous affection, which almost des- troyed my life. My opinion is, that fire should not be kept in sleeping apartments, eAren in the day, except in clamp weather; and then it should be suffered to burn doAvn before bedtime. Medical men seem to differ in sentiment about the admission of night air in sleeping rooms; some con- 10 EXERCISE. demning it entirely, others recommending it universally. My individual opinion, is this; when the weather is warm and dry, and no epidemical disease prevailing in the coun- try, air should be admitted into the sleeping rooms in the ' night, especially those that are small. A current of air should not be suffered to bloAV upon the person; neither should the opening be immediately over his head; but the bed should be placed as far from the window as convenient; and if the upper sash could be lowered a few inches, in- stead of raising the lower one, I should prefer it. I would therefore advise every one in building dAvellings, to prepare the window sash, so as to let the upper one down. This would be better both day and night. I think a better plan still for admitting night air into sleeping apartments, when practicable, is this: when there is another room adjoining the one in which the person sleeps, and a door leading from one to the other, open the door and a window of the room adjoining the one in which the person sleeps. If there be a window that is not on a direct line with the door in the partition, admit the air at such a window. The experience of any one Avho ever slept in a close small room in summer, has convinced him, I presume, of the improprie- ty of such a course. Being, when a boy, of a delicate con- stitution, I was very particular in keeping the windows of my sleeping room, ahvays closed, and I am convinced that my Aveakness was much increased thereby. EXERCISE. The course pursued by almost all animals, should be suf- ficient to convince man, that he was not formed for inactivi- ty. Nearly all the animals of which we have any know- ledge, seem to delight in exercise. EXERCISE. 11 The sloth, perhaps, is the only exception; and it is one of the most miserable, loathsome creatures upon earth. Without appropriate, exercise, it is impossible to enjoy any degree of good health, long. An eminent Physician says, "I know not which is more necessary to the support of the human frame, food or motion." In early life, free exercise should by all means be allowed. You cannot show me a solitary case, of a child in health, averse to motion. You see children universally delight in exercise. This disposition to play about the yard and prem- ises, should always be allowed, when the weather is favora- ble. Those dear, affectionate mothers, who keep their chil- dren constantly*within doors because the dear little creatures are delicate, pursue a very proper course to render them more delicate, and to fit them for a premature grave. Ex- tremes in this, as well as other things should be carefully avoided : but I repeat, that free exercise in mild weather, should by all means be alloA\Ted to children. If children be allowed to run about unrestrained, they are very apt to indulge in that regular exercise, so essential to health. Persons of more mature age, should profit by their example, and exercise regularly every day. An occa- sional effort will not ansAver; but a portion of exercise should be freely indulged in everyday; and not do as a farmer with whom I was once acquainted, who was not re- markably fond of manual labor. He would go into his field, and work manfully one day, which would produce such soreness throughout his system, that he would be obliged to rest a week. Exercise is essential to the health of the mind, as well as the body. Josiah Walker, who resided some years since in the State of Connecticut, and who had his intellectual faculties but little impaired, at the age of 99, attributed such health of body and mind, not only to his temperate habits, but his having preferred walk- 12 EXERCISE, ing to riding. It was a maxim of Plato, that " he is truly a cripple, who cultivating his mind alone, suffers his body to languish through sloth, and inactivity."— Wlien I Avas a student, I thought that I must apply myself constantly to study, in consequence of the in- auspicious circumstances, in which I was placed; and by doing so, and neglecting entirely to exercise myself, I almost ruined my constitution beyond reparation. I nra iioav satisfied, that I could have devoted one-fourth of my time, to some active employment, and progressed as rapidly in my studies as I did, if not more so.— With regard to the kind of exercise proper for persons in youth and middle age, I think any gommon labor on a farm, so as not to produce undue fatigue, very appropriate. In the opulent classes of society, persons are apt to neglect Avalking, too much. True, riding on horse-back is tolerable exercise, but walking is much better. People Avho are wealthy, are too fond of reclining on cushioned sofas, in close rooms; and Avhen they do ven- ture out, they must have a carriage, that SA\rings so nice- ly, that they are carried along as smoothly as if they aw re sitting in a steamboat; hence Ave see so many sal- Ioav complexions, and find so many Ioav nervous affec- tions, among opulent people. Dancing, is recommended by the majority of Medical men, as a healthful exercise. Under proper limitations, I doubt not the fact; but as it is generally indulged in, it is highly injurious. At our country dances, Ave gener- ally see the rooms croAvded, by as many as can possibly get in, and cadi individual seems to be exerting him or herself to dance longer, and Avith more activity than the others. Often after fatiguing themselves until the system is much debilitated, and the body covered with perspiration, they will sally forth in the night air, well EXERCISE. 13 prepared for contracting pleurisies, pulmonary consump- tions, and many other highly dangerous affections. I would ask those physicians who recommend dancing for exercise, if it is not in the power of every individ- ual to exercise sufficiently in the day, to alloAV him to devote the evening, to reading some useful book, or to rational conversation? I consider that those who are blessed with wealth, so as not to be necessarily obliged to labor for a support, can look around them, and see poverty and distress among their neighbors that might be in some degree relieved, if they would appropriate to that object, the profits arising from the work of a few hours each day. It is the duty of every individ- ual to be as useful to others as possible; and if those opulent persons who loiter about taverns from day to day drinking wine, playing at whist, &c, &c, would devote that time which they thus throAv away, to alle- viating- the distress of their felloAV beings; they would o t be much better, much more healthful, and much hap- pier men. The young and robust, amongst the males, should use active exercise, such as chopping, plowing, hoeing, and pursuing the various mechanical occupations, and amongst the females, in pursuing the duties of a house-wife. Let not the refined lady of quality sneer at these remarks. Hoav much more fascinating the beautiful girl, whose cheeks glow with the roseate hue of health, who with symmetrical form, and elastic step, bounds along with the agility of a faAvn, than the pale and emaciated figure, Avho Avith melancholy aspect goes moping about, labor- ing under low nervous disease, the unhappy result of a life of inactivity, spent in attending parties of pleasure, and lounging about when at home. Ischomachus, conversing with Socrates, complained of having found his wife one day, with her face painted, and 14 EXERCISE. high-heeled shoes on. He chid her for her folly, and told her if she wanted a better complexion, "why not weave in the loom, standing upright in the open air ? why not em- ploy herself in baking, and other family exercises, which would give such a bloom as no paint could imitate?" What a pity that some of our fashionable ladies, who seem to consider it disgraceful to know how to bake a hoe-cake, would duly appreciate this remark of the Athenian, and by useful and appropriate exercise, supercede the necessity of using rouge. With regard to the exercise of old people, and those who are unable to perform manual labor, walking is certainly the most proper; and should a person be unable to bear the fa- tigue of a walk, he had better take an occasional ride in a carriage, or on horseback, as he may be able. FOOD. It would be a difficult task for any medical man to pre- scribe a proper regimen for every healthy individual. As a general rule, however, I am of the opinion that less flesh, and more vegetables than Ave usually make use of, would be much better for the health of the people. Children especially should not be allowed to use much meat. Those children who are fed with bread and milk chiefly, appear to enjoy better health than those Avho indulge in the use of meat, coffee, and tea. Some mothers appear altogether opposed to starving the darling, by restricting him to the use of bread and milk; and in their kindness and sympathy for the child, keep him almost constantly sick, by stuffing him with bacon, chicken, pies, custard, &c.; and every time the poor infant screams with pain caused by his food his cries are supposed to arise from hunger, and he i§ again crammed with the cause of his pain.. Thus many EXERCISE. 16- a parent goes on until the child is ruined by over-eating. During the first year of an infant's life, nothing is so proper for its food as the mother's milk, if she be healthy, and for several years thereafter, a bread and milk diet is decidedly the best. Among adults, especially the males, it seems that the most of those who labor, suppose that they would be unable to bear the fatigue and hardship to which they are accustomed, if they were to abstain from the use of animal food. In this I think they are mistaken. If they will consult the history of mankind, they will find that a large majority are almost destitute of animal food throughout the year. Many in Asia are sustained by rice, with a little oil to season it; and in Italy, and the Southern part of Europe, the people who are very robust, live on bread, lettuce, and a little oil. Coarse bread and potatoes, constitute the chief food of the Lazaroni at Naples, a people active and finely proportioned. Look at the people of Ireland, who live principally upon potatoes and oat meal, and you will find them a hearty race of men. Then turn your attention to the young, dullr and stupid Laplander, Esquimaux, and others, who live almost entirely upon animal food : you will here discover that animal food does not afford as proper nourishment as vegetable. Among the articles of animal food, I con- sider mutton decidedly more wholesome than most of the articles in common use. Venison, young beef, squirrel) &c, are also good. I do not consider chicken so proper for invalids, as is generally supposed. The skin especial- ly, of the chicken, is hard of digestion. Among the vegetables, the cucumber is supposed to be as unwholesome, as any article of food in common use amongst us. The celebrated Dr. Abernathy, recommends the following method of preparing this article for the table: "Peel it, slice it down into pieces, put vinegar 16 EXERCISE. and pepper to it, and then throw it away." The cu- cumber is totally unadapted to the nourishment of the body, and should not be much used by any one, merely to gratify the palate. The Irish-potatoe^ tomato, the-. common bean, garden pea, lettuce^ &c, are generally vieAved as wholesome articles for those in health.— Those Who are sickly, especially whose digestive poAvers are Weak, should avoid the use of cabbage, turnips, &c. Coffee used tAvo of three times daily, is certainly unwhole- some, and to those Whose nervous systems are weak, one cup in the morning is injurious. The various teas sold under the names of Imperial, Hyson, Gunpowder, &c, &c, are also unwholesome as common table drink. True, some learned individuals have advocated the use of these articles; but as one who wishes to do all he can to mitigate the sufferings of his fellow beings, the physician should warn the feeble, the nervous, dyspeptic, gouty, &c, &c, against the use of tea and coffee. Milk appears to be the most, natural drink for man; and the experience of more than nine- tenths of the human family, is sufficient to convince them of the wholesornerress of this article. If sedentary persons, e'speeially those who study much, would live upon bread and milk, there would be feAver painful nervous diseases amongst themv In conclusion, I Avill make a few remarks upon the " Staff of life," as it has been called, viz: bread. Bread should not be eaten while hot, as many prefer it, but it would be much better to be at least. two days old. Bread, with yeast, is better than that without.— Corn-meal bread is more wholesome than that made of flour; and oat-meal bread is better than either, for those whose digestive powers are weak. Biscuit, as commonly made without yeast, and eaten hot from the oven, I think the most unwholesome bread in common use. Perfect SLEEP. 17 regularity in taking meals should be. observed, and sup- pers should always be light, and taken early. SLEEP. I wish to impress upon the mind of the reader, in the beginning of my remarks on Sleep, the importance of recollecting, at all times, that night is the time de- signed by our Creator for repose. After the fatigue of the day, the system of man needs a respite from all ac- tive exercise; the earth is now enveloped in darkness; the business of the day is suspended; the busy throng have retired ; the domestic animals around the farmer have gone to rest; the hum of insects is no longer heard; and noAv is the time for man to indulge in tired " nature's SAveet restorer, balmy sleep." It is true, children, up to the age of tAvo or three years, require some sleep in the day; but the adult in health, should never indulge in his daily nap, if he expects to preserve his health.— Very aged persons, sometimes find it necessary, to take a short nap in the day; but even they, should not in- dulge in such a course too freely. Some people think it will answer to substitute the day for night, and ac- cordingly, spend a large portion of the latter, in their occupations, and sleep in the day. Two Colonels in the French army, once had a dispute about the proper pe- riod for marching, and that for sleeping; one contend- ing, that it would be better to march in the night, the other in the day. They accordingly made the experi- ment. One of them, in the heat of summer, marched his men in the day, and rested at night, and marched six hundred miles without the loss of a man or horse: the other marched only in the cool of tho evening, and part 18 SLEEP. of the night, taking the day for sleep, he at the end of the same march, had lost many men and horses. Hete was a fair test, and resulted in proving, that night only, is the .proper time for sleep. Any one, I presume, who has ever tried the experiment, is satisfied of the injury sustained by sleeping in the day, instead of the night. With regard to the time for retiring to rest, I am decidedly in favor of its being early ; but at the same time, it is essential to take supper early, also. No one should retire to bed until two hours shall have elapsed, from the time of having taken supper. Could I have my own choice, at all times, in taking supper, and going to bed, I would prefer to take my supper at six, P, M., invariably, summer or winter, and retire to rest in two and a half or three hours after. As to the length of time required for sleep, I consider it altogether uncertain. Old and young persons are apt to require more sleep, than those of middle age, or early manhood. Persons of the same age, owing to a difference in the general health or consti- tution, require different lengths of time for sleep, so that I view it impracticable for the Physician to lay down any precise rule in this particular. In general, however, I would say, that eight hours in the winter, and six in the summer, would answer very well for sleep. I would advise each individual to adopt the plan of the Rev, John Weslev to ascertain the time to be indulged in sleep. Weslev was in the habit of retiring at ten, and he avouIJ generally lie until near eight the next morning. Wrhile pursuing this course, he would usually awake every night at twelve or one, and lie some two or three hours without sleep. Con- cluding that this was owing to his lying in bed too long, he got some one to arouse him at seven in the morning He still awoke at his usual hour in the night and lay awake — next morning he got some one to arouse him at six the CLOTHING. 19 next morning at five, and the next at four. The following night, after having been aroused at four, he awoke not, but slept soundly all night until four. Believing that this prov- ed to him how long he should lie in bed, he adopted it as, a general rule, for sixty years, to go to bed at ten, and rise at four. If every one would adopt this plan, I think he would find the result a good one. Perfect regularity in retiring to bed and rising, I think advisable, and persons should al- ways go to bed sufficiently early, to have slept enough by daylight, and rise at that time. In order to procure unin- terrupted sleep, a person should remember a remark of Dr. Franklin, and endeavor at all times to have a conscience void of reproach. Let a man live a life of temperance in all things, be in friendship with all mankind, act justly under all circumstances, and above all, be a devout wor- shipper of the Supreme Ruler of the Universe, and his sleep will always be sweet when in health. ------" On him the balmy dcwi Of Bleep vritk double nutriment dt$etud." CLOTHING. I consider but few remarks necessary on this subject, as the most of people can provide themselves with clothing to suit the climate, &c. Custom, however, sometimes causes persons to clothe themselves in a manner, greatly injurious to the system, especially females. The practice of lacing, has been productive of mUch mischief; but as I shall say much on this subject, when treating on female diseases, I shall omit saying more in this place. I have known ladies to contract diseases by wearing their white dresses in cold weather, because fashion required it; also taking off yarn stockings, and putting on cotton to go to a party. These '20 CLEANLINESS. things should be carefully avoided by every one, and cloth-" ing worn to suit the season of the year, regardless of fash- ion. Persons should be careful about changing warm clothes for cool or thin ones. Winter clothes should not be taken off too soon, nor summer clothes worn too long. Ev- ery step should be taken to make the clothing correspond with the weather, constitution, &c. Old or delicate people require warmer clothes than the young and robwst. In age the perspiration becomes defi- cient, and in some invalids also. These Avould derive ad- vantage from the use of flannel worn next to the skin. I once, after having been affficted for some weeks, in the lat- ter part of winter, and during the spring, Avore flannel throughout the following summer, with decided benefit.. The clothing should ahvays be sufficiently free and loose to not bind any part of the body, and this is more particularly necessary with children, in order that every part of *h@ sys- tem, may be fully and proportionably developed^ Even the shoes should be free and easy, instead of being made pur- posely to alter the form of the foot, imd make it extremely pretty, at the same time causing a defofmit-y,. and much suf. fering to the person wearing such shoes. Every part of the clothing should be so fitted as to place no restraint on any motion of the limbs whatever. I shall probably say more on the subject of the clothing of invalids,. when treating on the various diseases to which avc are sub^ ject. CLEANLINESS. I will offer a few brief remarks on the subject of cleanli- ness, as this is of deep importance in the preservation of health. With regard to the skin, any one who has arrived to the age of discretion, is aware of the advantage of keep- CLEANLINESS. 21 ing it pure. We all know that our sleep is more refreshing, after having taken a bath in some river or pond, the prev- ious day, and that our systems are renovated in a consider- able degree. Frequent washing promotes the perspiration, and a person would do well to wash the entire body once or twice a week, especially in the summer season. A mere swimming frolic is not sufficient, but soap and a cloth should be freely used, as well as water. Frequent changes of apparel tend, also, very much to the promotion of health. The continual discharge from the skin, renders this quite essential. A person should change his clothes once or twice a-week, or oftener, agreeably to the occupation he folloAvs. Suffice it to say, the clothes, particularly those worn next to the skin, should be clean, so that the matter that should be carried off by the perspiration, may not be re-absorbed from dirty clothes. Cleanliness about houses and yards should be strictly observed at all times. Hogs should not be kept in pens near dwellings, neither summer nor vvinter. I once knew an entire family, with perhaps one or tAvo ex- ceptions, to have an attack of fever, in consequence of a filthy sewer, placed in one corner of the kitchen. Not only the houses should be kept clean, but the yard about a dAvel- lin"- should be, also. Weeds and grass should not be alloAV- ed to groAV luxuriantly about the house, to remain until the fall of the year, and then suffered to decay, thereby produc- ing a miasma, which causes sickness. No little ponds of water, in which chickens and ducks are allowed to play, should be about the yard. No decomposition of animal or vegetable matter, should take place near a dwelling. The most sickness caused by a want of cleanliness, is in our pop- ulous villages. The streets in some villages are but little better than stables, being covered with straw, and trash of almost eArery kind, and even in some of our most respecta- ble to^ns, we often see slaughter-houses in the centre. 22? ORDINARY LABOR. Sometimes we may enter one of our commercial towns, and while on the streets, see nothing but the strictest cleanliness; but at the same time, on going into the back yards, espe- cially about the ware-houses, we will find sufficient filth, to cause a wide spread fever in the fall season. What a pity that the men in high life in cities, do not pay more atten- tion to the same, than they do. Such individuals, seem to think the subject beneath them, when in fact a gentleman of genius and learning, might achieve more for his fellow beings in this respect, than he could in our national legis- lature. In ancient Rome, it appears, that the greatest men, did not think this a matter unworthy their notice, and when such men as Tarquinius and Agrippa have paid attention to such things, surely none of us would be disgraced by imi- tating their example. ORDINARY LABOR. As the " bone and sinew of the land" are those who are in obedience to the will of Him " in whom we live," en- gaged in making a support for themselves and families, by " the sweat of the brow," I think it my duty to say some- thing, for the especial benefit of this important class of citi- zens. The business of the farmer, renders him peculiarly liable to exposure to wet and cold, and a few remarks up- on this subject may be some benefit to him. In attending to his ordinary business, he should be careful, as much as possible, to avoid working in the rain; and should acci- dent or necessity cause him to get wet, he should by all means, change his wet clothes for dry ones, as soon as prac- ticable. I have known individuals who would labor all day, with wet clothes on. This is highly injurious, as it gives a check to the perspiration, thereby renderinf a per- ORDINARY LABOR. 23 son liable to colds, pleurisies, and many other dangerous diseases. Wet feet should also be avoided. ' Another prolific cause of disease amongst laborers, is, becoming very warm, and cooling off suddenly. It is no uncommon thing for an individual to work hard, until he becomes greatly heated and fatigued, and when he stops to rest, seek a cool shade where the winds blow freely, that he may become sud- denly cool. This is also dangerous, as well as taking large draughts of cold spring water, while the body is hot. When a person gets extremely warm by labor, and stopsf; to indulge in a respite from work, it would be well for him to put on a coat, that he may cool gradually, and if he be thirsty, let him cool himself first, then take a small draught instead of a large one, and repeat it, as occasion may require. I once knew an individual, who was in the habit of drinking large draughts of cold water; but it was his practice to rest after labor until he became cool, then take his drink and go forthwith to work, and in a few mi- nutes would perspire freely. He was a very robust man, and would often drink half a gallon of cold water, :at a single draught. He lived to upwards of eighty years of age, without a day's sickness, until he was attacked with a disease that terminated his life. Some laborers will lie down in the sun, to rest and sleep. This should not be done, as persons have some- times awaked in a burning fever. Heavy lifting has often been productive of serious injury to the laborer. Some lift great weights in consquence of genuine laziness. They will carry all at one load, that should be carried at two or three, to avoid retracing their steps for a second load. Others will carry heavy burdens, from a desire to excel in lifting; hence we know more athletic men injured by heavy lifting than those who are weaker. I knew an individual when I was a boy, who in attemp- 24 ' ORDINARY LABOR. ting to lift more than another, suddenly cried out that he felt something give way in his right side, which caused him great pain. He was never well afterwards, for he was soon after attacked with typhus fever, which resulted in death. On dissection, the physicians discovered a portion of the right lobe of the liver unsound, and the flesh in his side, contiguous thereto. I knew another, a schoolmate of mine, who bore the appearance of a healthy man, un- til he lifted, or assisted in lifting some heavy timber for two or three days, which brought on hemorrhage from the lungs, and he died within one year, with confirmed consumption. No person should lift very heavy burdens from motives of avarice, vanity, or anything else ; but en- deavor to do well with what strength his Creator has given him. Poverty is sometimes pleaded, as an excuse for laboring in inclement weather. This, it is true, is the most reasona- ble apology, as many a poor fellow works for his more prosperous neighbors for a bare pittance, and seems obliged to labor incessantly every day to make a support for his suf- fering family. Here is an object of charity, and he who rides about in a gilded coach from day to day, should not only relieve such, when he happens to find ihem, but he should visit, the wretched ho\'els of the poor, and afford all the relief possible. How many there are, who profess to be humble followers of the meek and lowly Lamb of God, who live in all the splendor of wealth, and seem to think, that there is not an object around them in need of assistance ! Hoav manv such who spend a large sum, yearly, in superfluous articles of clothing for sons and daughters, while the children of some poor neighbor, not one mile distant, are suffering for neces- sary food and raiment! Is this in imitation of Him whom they profess to worship? ■SEDENTARY OCCUPATIONS. 25 *'lPo relieve 'the industrious poor in distress," says Dr. »Buchan, "is surely the most exalted act of religion and hu- manity." Th»?s is a true remark, and it is strange how the wealthyclviistian, can let the poor suffer for food and cloth- ing in his owa neighborhood. In conchesfoDn I will say, that my own, and the success of other business depends upon agriculture. Farming is the main jpMair wpon which our national fabric stands, and it is a deficieftcy in agricultural pursuits, that has caused, in a great measure, the present pecnniary distress of our coun- try. We should all, therefore, be willing to assist, in promo- ting ttJhe long life and prosperity of the farmer; and I will here say to him,—take eAery step, use every precaution to preserve your health, both in and out of the field, and suf- fer not the loAre of gain, or any other thing, to influence you, to endanger your health by undue fatigue and exposure. SEDENTARY ^OCCUPATIONS. As there are many, too many persons in our country, who are engaged in Sedentary occupations, I wish to make some remarks upon the subject. My OAvn opinion is, that there are about four times the number of sedentary people that there should be. Curl1 not your lip, dear reader, and accuse me of dictating to the in- telligent people of these United States. In the spirit of kindness, and not in the spirit of dictation, I make the remark. Some will say, that we have no more mechanics than we actually need; and that Ave have not a sufficiency of land for all to be farmers. The latter assertion I think incorrect. We are told that an ancient Roman could support a family on one acre of ground; and hrre in North Carolina, tAventy acres of land, Avell improved, and 26 SEDENTARY OCCUPATIONS. rightly cultivated, would support a large family. Suppose that each family had but twenty acres allowed for a support, how many lawyers and doctors, mechanics, and others who are now living by other means, could have farms upon which to Live and rear a family! As to the remark, that we have no more mechanics than we need, I must say that I do not know that we have. I think it necessary that we should have some first rate me- chanics ; but I Relieve that we have more who depend solely upon mechanical trades than we should have. Where is the farmer who could not, in a short time, enable himself to make a shoe, a plough-stock, a harness, or even a losr-house ? And where the female who could not soon learn to make a coat or waistcoat? I say, let every farmer be a mechanic. Let us have one fourth the number engaged constantly in some mechanical trade that we have; or (better still), let e\Tery mechanic be also a farmer; work one day in the shop, and three in the field ; and we would then have sufficient articles to get along with, and they would get a better price for their work. Then, we would not find so many bankrupts in the villages, or on the farm. Each mechanic, by making something for his own family on the farm, and getting a fair price for his work, can live out of debt; and the farmer would not be so apt to purchase this pretty piece of furniture, and that, and thereby involve himself, so as to be unable to meet his engagements. These are not half the advantages to be derived, from every farmer be- ing a mechanic, and every mechanic a farmer. Then, instead of the pale, meagre look of the tailor, shoe-ma- ker, hatter, painter, silversmith, &c. &c, we would be- hold the roseate cheek of the farmer. Those who will pursue some mechanical trade constantly for a support should not sit all day if they can avoid it. The tailor or shoe-maker, though he is obliged to sit some, can STUDY. 27 stand a part of his time, without ceasing work ; and when he has time to spend away from his bench, instead of spending it at the card-table, in the bar-room, or even riding out in the country, let him, if he will not seize the hoe or plough, Walk briskly about in the open air. Many mechanics should not be crowded in a room to- gether. By this, tailors and others are often injured, in consequence of the impurity of the air which they breathe. In conclusion, I will say, let the mechanic, the merchant, the clerk, the lawyer, the legislator, the scholar, and the divine, occasionally seize the plough, Cincinnatus like, and make part of a support by the "sweat of the brow."1 Then would we have fewer cases of consumption, asthma, scrofula, and other diseases; and then would we doctors, as a matter of course, for want of sufficient business in our profession, adopt the rule we lay down for others, and grasp the axe, the plough, and the hoe, ourselves. STUDY. Those who study much, are subject to become much dis- eased, as the body is too inactive, and the mind so intense- ly engaged as to affect the body also. The thoughtless youth, who has not sufficient intellect to bestow a thought on any important subject, will enjoy excellent health and spirits; while the man of profound intellect, who studies long and deep, soon becomes effected with general nerv- ous debility, and sinks sometimes, into a state of nlelan- choly. The studious are liable to many diseases, among which are dyspepsy, jaundice, functional disorder of the liver, consumption, inflammation of the eyes, and hypo- chondriasis. The student should select, if convenient, a large, well 28 STUDY. &ired apartment to pursue his studies. His diet, contrary to the 'Opinion of Buchan and others, should be lighter than 'ti>at of the laborer. While reading, he should change his (posture often, and not sit as some do, bent over his book constantly. He 'should not confine himself to the M^foset all day, but should relax his mind by going into cheerful company, engaging in conversation upon subjects remote from the subject of his sudies, and joining in in- nocent amusements. He must engage occasionally in ac- tive exercise, such as working in the garden, walking or riding out a few miles, &c. By relaxing his mind from study, he not only promotes his health, but he progresses much better in his studies. When I was studying, I ap- plied myself closely all day; and sometimes for many days in succession, I was not one hour from my book, at once, from sunrise until nine, ten, or even eleAen o'- clock at night. I had cause to repent this course, as I found I had almost ruined my constitution thereby.— I pursued such a course, partly on account of my adverse circumstances ia life; and I am noAV convinced, that my progress was slower than it would have been, had I de- voted less of my time to study. An eminent individual has said—" a painter will wash his pencil; a smith will look to his hammer, anvil, and forges; a husbandman will mend his plough-irons, and grind his hatchet if it be dull ; a falconer, or huntsman, will have an especial care for his hawks, hounds, and horses ; a musician will string and unstring his lute; the lite- rati alone neglect that instrument, the brain, which they daily use—by which they range over the Avorld, and which, by much study, is consumed." Midnight studies should be avoided, but at the same time, I would not advise the student to be engaged in playing cards, drinking wine, keeping tbe company of IcavcI women, or any other vice ; but be as he should ahvavs be, at that hour of the niffht. \ TEMPERANCE* 29 in his chamber, indulging the sweet repose of a quiet conscience. The morning is, I know, a favorable time for study, but I think the student had better rise at day-light, take a walk ©>f one mile before breakfast, and then he will be prepared! for study. Some students suppose that they must take a little French brandy, to " brighten their ideas," in order to get along well in their studies ; others seem to think, that as men of great genius, they should use it, because Byron and some others of talent were so un- fortunate as to have fallen victims to the inebriating bowl.. On the contrary, nothing stimulating' should be used, as the mind will be injured thereby, instead of being bright- ened ; and I presume, that those who wish to use spirits in imitation of great men, would not like, in following such examples, to fall like Alexander, the victim of one night's debauch. I knew a medical gentleman, who, while pur- suing his studies, kept under the exhilarating influence of opium some months. He commenced practice with an enervated constitution, and it was years ere he recovered from the effects of his imprudence. No stimulating liquid, no potent drug, should be taken to assist the mind of the student. A proper devotion to study, innocent recreation, proper diet and exercise, a moral and virtuous course of conduct, perseverance and a good intellect, will insure him success. * * ._,—„ TEMPERANCE. No subject is more closely connected with the moral hap- piness of mankind, than this. Nothing has a greater ten- dency to destroy a man's health, his fortune, his fame, his domestic peace and prosperity ; and to introduce him into that broad road that leads to eternal destruction, than in- temperance. It is the grand lever made use of by the en- emy of the souls ef men, to people the regions'of darkness. 30 TEMPERANCE. It is my province, however, in this place, to speak prin- cipally of the physical effects of intemperance ; and I shall confine myself more particularly to the use of spiritu- ous liquors. These articles (I mean rum, brandy, whiskey, wine, &c.) all possess the property of a diffusible stimulant,. which acts in the following mariner, when taken in a mod- erate dose, by a person in health. The pulse is increased in fulness, force, and frequency ; the strength becomes more vigorous, and the individual is much exhilarated. These effects continue but a short time, and are succeeded by diminished action ; the pulse sinks as far below its prop- er or healthy standard, as it was raised above it, and the person is somewhat dull and stupid. Taken in more ex- cessive quantities, it produces eventually tremors, sickness, headache, and even death. Those who use ardent spirits or wine, moderately, are not exempt from its baneful ef- fects. We have a case on record, of a gentleman who used only one teaspoon full of rum every day for seventy years, and died, upwards of one hundred years old. His living to sueh an extreme old age, the advocates of moderate drinking contended, was proof conclusive that such a use of spirits was not injurious ; but as he died without any apparent disease, he was examined after death in order to ascertain the cause of his death, when it appeared to the satisfaction of the physicians who made the post mortem •examination, that his death was causoil by this teaspoon full of rum per day, as his stomach was cancrous from its effects !!! By making a calculation, we find that he on- ly tused fifty and a half gallons in seventy years: yet this destroyed his life. One of the physicians who examined the /body, states that he found every part of the svstem sound except the stomach, and that it appeared more like the body of a young man than an old one. He further de- clared that every other part justified the belief that the old temperance. 31 gentleman might have lived another century. This shoAvs the danger of the most moderate drinking. Let no one, who knows a moderate drinker that has lived even one hundred years, apply such a circumstance as a pleasing unction to his soul, for he knows not what ravages it is ma- king within. It is unfortunately the case, that few moder- ate drinkers are seen at the age of fifty. The moderate drinker at twenty is apt to become the free drinker at thir- ty, the excessive drinker at forty, and the perfect sot at fif- ty. Wine is included in my remarks on spirits, as the ac- tive principle of both is alcohol; and the only difference in the effects is, that a larger quantity of wine is required. Dr. Rush says, " while the effects of the one, like those of tyranny in a well ordered government, are first experienced in the extremities, the other, as a bold invader, seizes at once upon the vitals of the constitution, producing irreparable mischief." Ardent spirits produce many diseases, such as dyspepsy, palsy, apoplexy, consumption and many other diseases. The physical effects ought to be sufficient to de- ter men from using it; but this is only the bright side of the picture. When we look at the moral effects, and see the wretchedness it causes at the fireside—when we are aware of the pauperism, crimes, &c, arising from the use of the article ; then, as patriots, philanthropists, and Christians, we should use every laudable means to prevent its use ;. especially when we gg further, and think of the hundreds and thousands of human souls, that we have reason to be- lieve, have gone to eternal destruction by drinking it. I shall conclude with the following remarks by Dr. Chap- man—" It is the sacred duty of every one exercising the profession of medicine, to unite with the moralist, the di- vine, and the economist, in discouraging the consumption of those baneful articles; and as the first step in the scheme of reformation, to discountenance the popular notion of their 32 BATHING. remedial efficacy. Chained by a species of infatuation to the use of these intoxicating liquors, as firm as Prometheus to his rock, mankind have hitherto seemed equally heedless to the admonitions of the wise, and the suggestions of their own understandings. " Leaving such as wish precise information, to consult some of the more formal disquisitions on the subject, which trace their pernicious effects, as Avell on the mind as body, I shall merely remark, that so great is the mischief, in ev- ery vieAV, that the emptying of Pandora's box was but the type of Avhat has since happened in the diffusion of rum, brandy, gin and Avhiskey among the human species." BATHING. As some people appear to have a wish to do anything that " papa or mammy" had preA'iously done, I will men- tion, as an inducement to bathe, the antiquity of the cus- tom. The people in ancient days, bathed in rivers, as Ave observe from the fact of Pharaoh's daughter bathing in the Nile, of Nausicaa and other females bathing in a river, and of the Amazons indulging in the same in the Avaters of Thermodon. The Greeks, Ave are informed, plunged their children, when quite young, into cold wa- ter, to make them healthy; and the Spartan girls, bathed in the Eurolus. Domestic baths were also in use, as far back as the time of Diomede and Ulysses. Andromache prepared Avarm water for Hector, upon a certain occasion; and Penelope resorted to bathing to dispel gloomy thoughts. Homer mentions a hot spring near a cold one, as a place for bathing. We read, that Alexander was astonished at the luxury BATHING, 33 and grandeur of the baths of Darius; so we see that the Persians carried the custom to a great extent. Go amongst any of the American Indians, and you will there discov- er, that those children of nature delight in bathing.— Thus it appears, that man in our day, cannot refuse to indulge in this healthful recreation, for the want of a pre- cedent. There are seA-eral kinds of baths. The common cold bath, that is, bathing every part of the system, requires the advice and attendance of a physician. I shall there- fore lay down no rules, for its practice, as much harm might be done by persons resorting to it, who are ig- norant of its effects. The topical application of cold water to burns, strains, bruises, and chronic-rheumatism, is Avell understood by the common people, and can be used with safety, in such cases. The shoAver is an excellent mode of using the cold bath, and is applied by means of an apparat- us, in which there are many apertures, through Avhich, cold water is poured from a considerable height upon the body. In the use of this, the advice of a physician should also be had. The tepid bath is that, in Avhich the water is about 30 degrees of Fahrenheit, which is tAvelve degrees below blood heat. This bath is some- times used in fevers, when the system is too weak to bear the cold bath. In diseases of the skin, this bath is sometimes valuable. I consider it the most proper bath, for people in health, and it may be used often in the summer, at least, sufficiently so, to keep, the skin pure and clean. I would say, rather, that this would be a very proper temperature, for water to be, with which persons wash their entire bodies, in warm weath- er. The hot bath is from 93 to 96 degrees of Fahren- heit, and is used with benefit in palsy, cramp, colic, and many other diseases, in which there is no peculiar de 34 BEDS. termination of blood to the brain. The advice of a phy- sician should be had, before using this bath, and the vapor bath also. I shall therefore, not describe the man- ner of applying the latter. BEDS. Some persons think that if they had to sleep on any- other kind of beds but the doAvny couch, their situation would be uncomfortable in the extreme, and express much sympathy for those Avho are obliged to repose, upon their beds of straAv. These people are much mis- taken in the matter; and were they to exchange their feather-beds, for those of straw, they would sleep much more soundly, and feel better the fofloAving day. Of this any one is convinced Avho has tried the experiment; but pride prevents them from adopting as a general plan, the sleeping on straw-beds or mattresses. The warmth and excessive perspiration, caused by laying on a feather- bed in the summer, produces general debility, and renders an individual much more susceptible to the influence of cold. A mattress made of moss, or beds of straw, hay, hair, or leaves, would be far better both for children and adults, than feather-beds. Even pillows of feathers, in consequence of their warmth, are improper in warm weather, as they sometimes produce inflammation of the ears, eruptions,and serious diseases of the head. The bed should be placed in the centre of an airy apartment raised high on a stead, and should by no means be shrouded with curtains. Keeping the bed upon which children have to repose, pushed under another bed during the day, is very improper, as all beds should be placed in a situation where they could be TOBACCO. 35 freely ventilated during the day. The practice of cov- ering the heads of children, Avhen asleep, should be care- fully avoided; and groAvn persons should never alloAV themielves to sleep with the head covered in any kind of weather. A sufficient quantity of clothes should be placed upon a person Avhile asleep, to protect him from the cold, and nothing more. Many people sleep under too many blank- ets in cold Aveather, thereby rendering themselves more liable to attacks of cold, bssides enervating the system to a considerable extent, if indulged in long. Beds and bed clothes ought to be often put out in the sun, in mild Avea- ther at least. Bed clothes that have been recently wash- ed, must be put near the fire, a sufficient leng(h Of.tinie to remove all dampness from them ; and persons should be careful to examine sheets when taken frcm the draw- er, to see that they be perfectly dry, as such are often put aAvay damp, and will retain their dampness a long time. In very damp weather, the sheets on beds that were previously dry, may become damp ; these therefore should also be attended to, and Avell dried by the fire before sleeping in them. TOBACCO. The use of this noxious weed has become so fashionable among all classes, from the clerical fop, doAvn to the red- nosed bacchanalian, that any individnal will run the risk of receiving a severe castigation for attempting to discoun- tenance the use of it; but the man Avho takes*his pen to lay down some rules to be observed for the preservation of health, should not shink from the responsibility of con- demning any practice, however common, that tends to unr 36 TOBACCO. dermine the constitution. That the use of tobacco is a fruitful source of dyspepsy and some other diseases, no me- dical man, I presume, Avill dispute. In a dissertation on tobacco, Dr. McAllister declare*— " That few substances are capable of exerting effects so sud- den and destructive as this poisonous plant. Prick the skin of >. mouse Avith a needle, the point of which has been dip- ped in the essential oil of tobacco, and immediately it swells and dies. Introduce a piece of common twist as large as a Kidney-bean, into the mouth of a robust man unaccustomed to this weed, and soon he is affected with fainting, vertigo, nausea, vomiting, and loss of vision ; at length the surface becomes deadly pale, the cold sweat gathers upon his brow, the puis? flutters, or ceases to beat, an universal tremor comes on, with slight spasms, and other symptoms of dis- solution. If such be its effects on the human system, if it require all the skill of the most experienced practitioners to guard against those sudden depressions, which uniformly follow its use, when administered with the utmost circum- spection ; and if, with all this caution, its operation is still followed by the most alarming and even vital consequences, what shall we say of those who habitually subject them. selves to the destructi\ e influence of this Avorse than Bohon Upas." The above are the remarks of an eminent physi, cian, and the truth of the same is beyond successful con- tradiction. We do not confine our remarks to the practice of chewing, but wish to be understood as including the use of this poisonous stuff in every way. Few animals will make use of tobacco through choice. A species of goat, (one of the most disagreeable creatures of which Ave have anv knowledge,) the tobacco worm, and man, are the only ani- mals that make use of it, unless somewhat forced into it bv man. Chewing, smoking, or even snuffing, is productive of much disorder of the stomach, the abdominal viscera Tobacco* xz^l and the nervous system generally. I know severaCTpdi- viduals at this time, who are evidently dyspeptic, from the use of this article ; and I recently had a case of epilepsy under my care-, which was attended with every symptom of dyspepsy ; and believing, as I did, that the excessive chewing of tobacco, greatly aggravated the disease, I forbid the use of it. The patient for a time, ceased to chew, dur- ing which time he had not one violent fit, and the symp- toms of dyspepsy left him. At the end of four Aveeks, how- ever, he resumed the unfortunate habit of chewing tobac- co, even indulging in it after he AATent to bed. In a few days the dyspepsy returned, and fits also, and three weeks thereafter., he, in a fit, fell into the water, and was drown- ed. Indulging in smoking, or in fact, in any way using to- bacco, opens the door for other vices, especially thai of us- ing ardent spirits. Dr. McAllister telk <©f an individual with whom he was well acquainted, who became a wretched drunkard, and who often told the Doctor, that his miserable condition was produced by a thirst, caused by smoking a cigar. He first only sipped a little gin and water, to quench that thirst, but went on increasing his stimulus, until he reduced him- self to the state of the drunkard. This individual was a man of high intellectual endowments, but becanif lost to society, by smoking a cigar. It has often happened, that an individual, who has labored for some time, under n*en- tal depression, dyspepsy, and a nervous debility, caused by a free use of thi6 article, on abandoning the use of it, has recovered his strength and health. The use of tiw dgar and snuff, i« but little below the chewing in its pernicious effects. A person much in the habit of using *nuff in company, and politely reaching it to a. bystander, often carries it to such excess, as to produce narcotic effects ; and cigar smoking, particularly in our villages, is apt to induce habits of idleness, the sure precursor to vice of al- ^ . TOBACCO. mfst^rery grade. A parcel of young fops collect together for the purpose of taking a social Avhiff: they must then walk the streets half the night, occasionally popping in- to a tipling shop to get a horn—are found at the billiard ta- ble, ajnd perhaps one half the number, ere five years roll around, are members of some clan of highway robbers. I have seen an amusing article from the London Literary Gazette, Avhich I must here introduce, or a part of it. It i$ on the subject of smoking, and is truly diverting, and mostly true. " A more disagreeable nuisance," says the Editor, " does not infest the streets of London, than a yev.ng shop-boy smoking a cigar. An Irish market woman, or a hod man \\rith a dudheen, is tolerable; but to see the Avhelps, Avho make the air noisome almost wherever they oo in and about the m:-vopolis, is indeed an offence of mental and physical bile to the beholder. Their faces are gener- ally of a lightish dun smoke color ; their mouths pursed up like monkeys munching soft apples ; their eyes bleary and dissipated;- their nostrils, as it were, disgusted with their mouths, and having a nightman tAvist and expression; their air most impertinent, and their whole puppy, at once rid- iculous, and provocative to kicking." What a faithful re- presentation is here given, of the very self-important cox- combs who infest the streets of our toAvns and cities .'—who sirut along Avith an air of insulting impudence, with their handkerchiefs hanging from their pockets, half way to the ground, with a cigar stuck in one corner of their mouth (for which they have perhaps paid their last picayune,) puffing their noxious vapors into the face of every one they may happen to meet. It seems that some of these crea- tures think, that the cigar and a dandy appearance, will answer as substitutes for intellectual capacity, and acquired information. The Editor of the Gazette goes on to say :—« We do not mention their continual and filthy squirts of expectoration, TOBACCO. 39 as they take the stinking roll of weeds from their dirty lips, and tip off the burnt ashes Avith an amusing consequence, and siaring about with a vacant stolidity; lor really the picture is so revolting that even its grotesque absurdity fails to excite the laugh of contempt, and we cannot but pity the ' critters,' Avith their snivelling, turnip-built countenan- ces, Avhile Ave are annoyed by their apish practices." In another place he says—"Smoking is an expensive indul- gence ; and an honest shop-boy, an apprentice to a trade, an ill-paid attorney's clerk, and multitudes in many simi- lar walks of life, cannot afford it. The tAVo or three cigars a-day, not to speak of their attendant tipplii g, are a heavy cost to such persons ; and we firmly believe, that a large proportion of the minor crimes committed in London, and ather populous places, OAve their origin to the paltry exhi- bition of smoking. " Thieving, robbing masters, breaches of trust, petty swindling, discontent, lying, idling, keeping bad company, resorting to demoralizing haunts, are all the notorious fruits of this pernicious habit; and the cells of Clerkenwell, Iron Monger Lane, Cold Bath Fields, and Newgate, contain hundreds of ruined witnesses to the truth of our statement." Our Editor in another place, Avhen speaking of men with moustaches smoking, says,—" Moustaches, Avhich may Le bought at from fourpence to half a crown a pair, in the little barbers' back-shops, in back-streets; blouses, cheap and nar- ty, shapeless and sheep-stealing in outward appearance, dir- ty hair and the worst appurtenances of the tribe of Benja- min, and cigars polluting the circumambient air, are in- deed the characteristics of these would-be gentlemen. Only look at the ' critters,' the last pilfered sixpence, perhaps, thus consuming ; truly tobacco in such cases, may Le cal- led the * anodyne of poverty," and this might be some ex- cuse for it, were it not also too frequently the cause, as well 40 MALT LIQUORS. as the cure, and the anodyne of thievery, more than of beggary." The language of the Gazette, is, in some places severe, but not more severe than many cigar smokers merit; and those who are more gentlemanly than to deserve it, should become ashamed of participating in such a vulgar practice, and abandon it. We must judge a man's harshness of ex- pression in part, by the reasons he has for being thus harsh; and no doubt the object of the Editor was, to correct the excessive use of the cigar about the metropolis, which he knew to be so pernicious to health and good morals. To conclude; we, as medical men, are obliged to know that such an active narcotic—such a virulent poison as tobacco, must be deleterious to the human system ; consequently, we should privately and publicly, discountenance the use of it as far as practicable ; for I consider, that it is the duty of the physician, as a patriot, a philanthropist, and a chris- tian, to enlighten the public mind in every possible man- ner, upon those subjects, calculated to prevent disease ; thereby lessening the mortality amongst mankind. MALT LIQUORS. Upon the subject of malt liquors, medical men appear to differ; some saying that they are perfectly innocent, and even beneficial; others declaring them to be pernicious. In one medical work Ave find the folloAving remark : " Malt liquors, when of a good quality, and drunk in moderation constitute, for many persons, an innocent and wholesome beverage." In the same work we find in an article on water, the fol- lowing :—" Water, says a French medical writer, is the MALT LIQUORS. 41 only fitting drink ; and this is an opinion sanctioned by the soundest authorities in hygiene and medicine, as well as by the experience of the larger number of those persons who have attained to a very advanced age in the plen- itude of health. Can we conceive of any emergency, in which a man desires the free and vigorous possession of his faculties, in which a necessary or fitting aid could be furnished by any other drink than water. The first canto of ' Childe Harold,' was written by Byron, a water drinker, while i Don Juan' was written by Byron, a gin drinker and tobacco cheAver. Let the latter poem be the text-book of him who cries out nonsense, when we advocate the cause of temperance." Thus we see that even some who advocate the use of malt liquors, will after a " sober second thought," array themselves on the side of cold Avater. " Honest water," says Shakespeare, is too weak to be a sinner ; it never left a man in the mire"—Avhereas, " Avine is a mocker, strong -drink is raging, and whoever is deceived thereby is not wise." Those Avho think that a person whose digestive powers are weak or feeble, should use beer, or something stronger than Avater, are much mistaken. Malt liquors on- ly tend to increase the debility and impair digestion more and more. I once had the management of a dyspeptic, who occasionally indulged in the use of beer, contrary ta my advice, which always aggravated the disease very much. As one evidence of the debilitating influence of malt li- quors, I refer you to the case of Dr. Franklin and his as- sociate laborers in London ; not because the Dr. av,i«s a rel- ative of mine, but because he Avas a man of uncommon "•enius, and his testimony is to be relied upon in every re- spect. We there learn that Franklin, the American etguq*- ic, as they called him, was able, by the use of cold water, to bear much more fatigue, and carry almost tAvice the 42 MALT LIQUORS. weight that any one of those could, Avho drank beer. Wa- ter, pure spring Avater, is the natural beverage of man, and the individual Avho uses it alone, as a common drink, is not so liable to appoplexy, palsy, gout and many other diseas- es, as one Avho is in the habit of pouring down ale, cider, porter, &c. I kneAv a minister of the Friend's church, who resided in London, and came to the United States at the age of seventy-five. He had not tasted of tea, coffee, spirits, malt liquor or cider, or ate "fish, flesh, or fowl," in thirty years, and often said that he felt more active and -Uovg at seventy-fiVe, than he did at forty. The most of my readers, I presume, are acquainted with the history of Le-Avis Cornairo, Avho died at Padua, at the age of ninety- eight, in 1565. This man who, in his youth, had injur- ed his health by intemperance, re-established it ly a ri- gid course of temperance, and in his eighty-third year, says, "I noAV enjoy vigorous state of body and mind. I mount my horse from the ground, I climb steep as- cents Avith1 ease; and have lately wrote a comedy full of mirth and raillery. When I return home, either frcm private business, or from the Senate, I have eleven grand- children, Avith Avhose education, amusement and ici^s, I am greatly delighted; and I frequently sing Avith them, for my voice is clearer and stronger now, than it ever was in my youth. In short, I am in all respects happy, and quite a stranger to the doleful, morose, dyino- life of lame, deaf, and blind old age, worn out with intemper- ance." COFFEE AND TEA. 43 COFFEE AND TEA. Of the use of these two articles, which is carried to such excess in the United States, I Avish to make a few remarks. Though the use of co!Fee is so strongly recom- mended by nearly all the good old mothers of our country, and even by some of our medical men, I shall take the liberty to differ with them in a general point of view. Dr. Hooper, in his Medical Dictionary says, "If coffee be drunk warm Avithin an hour after dinner, it is of sin- gular use to those Avho have head-ache, from weakness of the stomach, contracted by sedentary habits, close at- tention, or accidental dr ..ikness. It is of service, when the digestion is weak ; and persons afflicted with the sick head-ache are much benefitted by its use, in some instan- ces, though this effect is by no means uniform." This is high auihority in favor of coffee occasionally, but I shall assume the liberty of differing with the above statement in most points. A cup of coffee in the morning after a drunken frolic the preceding night, of course may be of temporary benefit, by allaying for a time the nervous irritability produced by drunkness; but I am of the opin- ion, that it only in this case answers the purpose, of an- other drink of whiskey, and its effects soon vanish, though I would advise the use of the coffee in preference to the whiskey. I think it would be a very rare case of head-ache, in which coffee would be useful, unless it would be some one Avho has been stimulating too freely with spirits, or has been so long accustomed to using coffee as common drink, that he cannot do well without it. I consider it decidedly injurious to the nervous system, and have ne- ver had a case of dyspepsy, that was not aggravated by its use. By the habitual use of strong coffee for some thirty or forty years, the system becomes so enervated 44 WET FEET. by the over excitement, and consequent depression, it has so often produced, that an individual cannot well support the strength, Avithout its accustomed stimulus— and like all other stimulants, it must be increased in strength or quantity, to have the desired effect; hence we hear so many respectable old ladies crying out, "Ah, you doctors need not tell us that coffee is not whole- some, when our OAvn experience has proven the contra- ry; for we old folks could not live without it." Mis- taken lady: only reduce your quantity of coffee, used to-day, to one-fourth less to-morrow, and continue to re- duce it in the same ratio eAery day, until you bring it down to the smallest possible portion ; then cease to use it entirely, and you will soon realize the benefit, in nights of sAveet repose, and days of more nervous ener- gy, unless you are far advanced in life, and have im- paired your constitution to such a degree, by the use of strong coffee, that you could not bear the shock. Of the use of tea, my opinions are no more in fa- vor than of coffee. Every kind of tea to be purchased in our stores, has narcotic properties when green, and the experience of any person who has used the article to much extent, I should think, has convinced him or her, that it is highly injurious to the nervous system, The hysterical lady, and hypochondriacal .gentleman es- pecially, had best avoid, the use of tea at all times. WET FEET. Many diseases with which mankind are afflicted have their origin from Avet feet. The rosy cheeked little girl is seen running about, gay and sprightly in the morningjwith WET FEET. 45 her prunellas on, through which the water penetrates without difficulty; ere midnight, we are summoned to the bed-side of the little creature, whom we find laboring under that alarming disease, the croup; and before the morning dawns, her little spirit has fled to Him who gave it. In vain the tender mother wrings her hands, and in the agony of her soul, implores us to exert our utmost skill to save her darling, lamenting the careless- ness that suffered the child to run out in such damp weather. In vain the anxious father wishes that he had not purchased such thin shoes, because they were fash- ionable ; and in vain we, administer our most potent remedies to arrest the disease, in its omvard course.— All our efforts to control it, prove abortive; the breath- ing becomes more and more difficult; the little sufferer casts an imploring look upon us, struggles, and dies. One day we beheld the industrious youth, who had just married a beautiful bride, busily engaged in preparing his farm for cultivation, in a situation that caused his feet to be constantly damp; and perhaps ere one short month rolls round, Ave see him moving about upon his crutch- es, the victim of rheumatism, of which he is never after- wards free. Walking the street on a day, when the earth is damp from previous rain, Ave see the young lady of fashion, tripping along with the elasticity of youth, with her fine silk stockings and thin soled shoes completely saturat- ed with water. In this situation she enters the church, and remains until service is over; and on the following day, her physician being called in, finds her severely at- tacked with a pleurisy, to which she soon falls a victim, and like a beautiful floAver nipt by an untimely frost, drops to the ground. How many fond mothers, are made to weep over the re- mains of their prattling babes; how many wives, to lament 46 MANAGEMENT OF THE HAIR. the early loss of dear husbands ; and Iioav many young fe- males to bemoan the death of those to Avhom they have plighted their vows, by not taking the necessary precaution in this particular. There are feAV diseases incident to man- kind, but may be brought on by wet feet; and persons, in every situation, should carefully avoid getting damp feet; and should any one get his feet AATet by accident, he should by all means, dry them as soon as practicable. Good, thick, leather shoes, should ahvays be Avorn in cold or Avet weather, and if the occupation is such that one pair, will not suffice to keep the feet dry, a good pair of over shoes, should be Avorn also. Let not the love of fashion, or the fear of ridicule, deter the polite young Miss, from wear- ing a good, comfortable pair of shoes, at all times. It is true, thin shoes can be worn in dry, Avarm Aveather, Avith perfect safety, but when the Aveather changes, the shoes should be changed also, regardless of fashion. MANAGEMENT OF THE HAIR. As this is something of importance to health, I must say a few Avoids about it here. It has generally been remark- ed, that the head should be kept cool, and the feet warm ; and this is a tolerably just remark. To keep the head cool, the hair had better be short, and I Avould advise gentlemen, under all circumstances, (when in health) to keep their hair short. It seems, that long, flowing tresses, have been considered an ornament to the fair sex, from the earliest his- tory of the Avorld". I shall, therefore, not insist upon a change in this ancient custom : but at times, when the hail becomes irregular, nothing is so well calculated to restore its groAvth and beauty, as cutting it off. The hair of children, should be invariably kept short. We often see children who have long hair, with pale com- NOSTRUMS. 47 plexions, Aveak eyes &c. They are also liable to head ache, inflammation of the brain, and other complaints of the head, from having the head covered Avith a thick, long coat of hair. The hair of children should be kept short, until they arrive at the age of eight or ten years, and particular pains ought to be taken to keep it Avell combed, and perfect- ly clean at all times. I shall conclude this article by insert- ing a feAV remarks, found in a little work entitled, "Ad- vice to young mothers, by a grandmother." "The hair on children should be kept short, until they are eight or nine years old—as the cooler the head is kept, the less danger there is of many maladies peculiar to that part of the body, especially Avater in the brain. Besides, there is good reason for believing, that most children, Avho have a great quantity of hair, are those most liable to eruptions ; such as scald head, &c. Mothers, Avhose vanity may be alarmed, lest re- peated cutting the hair, for so many years, should make it coarse, may be assured, they have no cause for this appre- hension, provided the hair be kept constantly brushed. I have never seen softer, finer hair, than on girls Avho have had it kept short, like that of school boys, until they AArere in their tenth year." NOSTRUMS. As many an individual has ruined his constitution by the use of patent medicines, I Avish to make a few re- marks on the subject of nostrums. Great injury has re- sulted from the use of the many specifics, sold in the United States. The love of money, prompts many men to manu- facture pills, cough lozenges, &c, which are used in- discriminately, by many, to the manifest injury of their 48 NOSTRUMS. health. Not many years have elapsed, since the cele- brated Swaim's Panacea, was first used in the Northern cities. It was tried by some of the most eminent phy- sicians in the city of Philadelphia, and as it happened to have no deleterious effects, those gentlemen prema- turely recommended it to the public. In a short time, its fame spread from Maine to Flor- ida, and many persons fell victims to its use. After mature reflection, and more sufficient trials Avith the Pan- acea, those same medical gentlemen of Philadelphia, like true philanthropists, acknowledged that they were too has- ty in recommending it to the public; and published certifi- cates, showing that the inventor had practiced deception on the community, by recommending it to be free from any preparation of mercury, Avhen it actually contained a large proportion of corrosive sublimate, one of the most active and dangerous preparations of mercury. Doubtless hundreds of constitutions Avere ruined by the use of the Panacea, before the people were aAvare of the danger of using it. A few years since, anti-bilious pills were vended in our own State, as purely vegetable, and Avere extensivelv sold, before they were analyzed; but when that was done, a good portion of calomel was found in them. I could enumerate many more frauds that have been practiced upon the people, but, suffice it to say, our country is completely stocked Avith "Peters' Pills," " Brandreth's Pills," " Moffat's Pills and Bitters," "Spencer's Pills " and many other nostrums, recommended as specif- ics in almost all diseases incident to men. The mere fact of any article being puffed in all of the papers in the country, by the inventor himself, ought to be sufficient to make men distrustful of it. They should also be care- ful to avoid any medicine, involved in mystery. If, indeed, an individual be so fortunate as to hit upon a •ompound, that is so extremely efficacious, as some of them NOSTRUMS. 49 arc purported to be, every principle of humanity calls up- on him to develope it, that it may continue to benefit the human race, long after he shall have been laid in the dust. The man, howeArer, who vends a medicine enveloped in mystery, and recommends it to be, Avhat in reality it is not, deserves the execration of every honorable man. Seven or eight years past, a medicine Avas vended in this country, puporting to have been made by a celebrated phy- sician in Germany, when he had actually been dead one hun- dred years ! ! ! An old empiric, whose nostrums are now for sale in this State, travelling through my neighborhood, three years ago, had the bare-faced effrontery to tell a brother of mine, Avho is a medical man, that he was a cele- brated physician of whom we read, who has also been dead many years. Hoav long will an intelligent community suffer them- selves, to be imposed upon by men so reckless as to en- danger the lives of their fellow creatures for money 1— How long Avill the multitude delight in any thing novel, and seize upon a remedy unknoAvn to them, and use it in their families 1 I feel it my duty, to caution the pub- lic against the use of patent medicines, without the ad- vice of a physician; and, while on the subject of nostrums, suffer me to make a feAV remarks about those vile impostors who go about the country, abusing the members of the me- dical profession, and boasting that they can cure all diseas- es in a shorter time than others. There is a certain class of human beings in the United States, who call themselves " Thompsonians," " Steam Doctors," " Botanic Doctors," " Yarb Doctors," &c, some of whom are as ignorant of the human system as a com- mon school boy; and in their ignorance, have doubtless hurled many a fellow mortal into a premature grave.— These steaming machines, are ever ready to make fair pro- mises to cure the patient, and charge low; and many are 50 NOSTRUMS. so completely ignorant of what a physician should be*, that they trust their lives in their hands. Many of them who have failed to make fortunes, in some other employment, have the impudence to force their vile stuff and services on the people, and afterwards malce a charge. The steam practice has become so unpopular, hoAvever, that we seldom meet with one at this time, but will tell us that he pursues both the Thompsonian and the universal practice. Our section of country is cursed with one of those worth- less creatures at this time, Avho is riding about the country, abusing the members of the medical profession, and tel- ling the most incredible stories about his own success, imag- inable ; and yet, strange as it may appear, many place confidence in his self-applauding tales, This fiend in human shape; this clerical fop; this North Carolina Paracelsus, seems to have infused his principles of quackery into the minds of almost every ignoramus in the country ; so that some of them, who have inhaled the same atmosphere with him, are actually going about and offering to heal the sick, with their pockets stuffed with number six, and composition powders. That the reader may judge of the intelligence of one of his vicegerents, I will give a few specimens of his spelling the names of medicines, &c. " Wurs," for worse "red percipity," for red precipitate, "roses sublumvt" for corrosive sublimate, and many other words, about as badly spelled. This is only one instance, among many, of the ignorance to be found among the disciples of Thompsonian- ism. If any of the learned members of steam, should peruse my remarks in this article, and feel chagrined about them 1 have not a word of consolation to offer for his wounded spirit; and I can assure him, that he has seen but the ru- diments of that sarcasm, that I feel prepared to pour in tor- rents upon his guilty head, if he dare to assail me. PERIODICAL BLEEDINGS. 51 PERIODICAL BLEEDINGS. A pernicious custom, kept up by some individuals, is that of being bled at certain seasons of the year, particularly in the spring. Many persons suppose, that when they feel in any degree unwell, they must be bled ; and, as it is gener- ally the case, that people feel dull and feeble as spring approaches, that is the season to be freely bled, by some celebrated bleeder in the neighborhood, who knows Avhat state of the system requires bleeding, about as Avell as his horse is acquainted with the changes of the moon. Thus', they will increase that languor which they endeavor to re- move ; and, by contracting a habit of bleeding at certain times, become, like the toper by his morning dram, unhap- py at such periods, until the blood is floAving. I have frequently had a person to come to me in the spring, to be bled, Avho would say, " I know it is a bad practice, but I have folloAved it tAventy years, and it seems like I can't live without it." I usually let such an one know, that the sooner a bad practice is broken the better, by re- fusing to bleed, though I have often been censured for so doing. While on the subject of bleeding, I must remark, that Avhen some disease, under which a person may labor, makes it necessary to bleed, there are no signs to prevent it. I have often had an individual to say to me, that he wished to be bled, but must postpone it, because the sign was in the heart. This is something I do not understand, as the blood is always in the heart, and bleeding should be done when necessary, regardless of the state of the atmosphere, the time of the year, month, or day ; or the situation of the moon. I have also been gravely told, Avhen about to bleed in the right arm, when there was pain in the leftside, that I must not do so, for fear of drawing the pain across the heart and producing instant death / / / I must here say, in order ANGER. ai»M. 62 RELIGION. RELIGION. Though some persons may be astonished, that the sub- ject of religion should be introduced in this place, I assure the reader that religion has a powerful effect upon the health of an individual ; consequently, I think it my duty to make some remarks on the subject. When I speak of religion, I mean the pure religion of Jesus Christ; that re- ligion which consecrates the sou1 to the practice of every virtue, and breathes forth love to God and good will to man. In looking over the causes of disease, Ave Avill see that intemperance is a fruitful source of "many of the dis- eases of our country. Religion fortifies a man against ev- ery species of intemperance ; and Avould, therefore, greatly lessen sickness amongst us, if it were to prevail univer- sally. We also discover, that the mind has a powerful influence upon the animal economy; ai.d surely, nothing tends more to render the mind easy, under all circumstan- ces, than religion. Hoav often do Ave see a man, Avho has been unfortunate in business, and became involved, soon become despondent and sink under affliction. A christian is seldom so much affected Avith the loss of property. He does not value gold so highly as the man of the Avorld ; but has his treasure in Heaven. If he be so unfortunate as to lose his earthly substance, he is ready to say, like the food old Quaker in Philadelphia, that he is still rich. The good old man had all his property, worth many thousands of dollars, consumed by fire, leaving him and a laro-e fam- ily, Avith nothing but the clothes they wore at the time. Next morning, a friend of his, seeing him walking in the street, stepped up, and taking him by the hand, began to condole with him on his loss, saying, that he supposed all his property Avas destroyed. The good old Quaker replied with a smile—" Yes, it is all gone, but I am still rich. I RELIGION. 63 have endeavored to serve my God all my life, and though my property is all burnt, I am still rich." What a hap- py frame of mind was this to be in. How different Avould have been the situation of the mercenary wretch, who had pursued Avealth as the chief good, regardless of his duty to God and man. The truly good man can smile under affliction, and feel thankful to his benevolent Creator, that he is not Avorse ; like the good old philosopher, who fell and broke his leg, and thanked God that it was not his neck. The christian is enabled to bear with fortitude all the dispensations of Providence ; and though he may be bereft of property, wife and children, he is ready to conclude at once that it is bet- ter so than otherwise, or an all-Avise Creator would not have so ordered it. His mind being thus at ease, under all difficulties,'he is not so subject to disease as the man who sinks in despondency under every misfortune. The advantages to be derh'ed from religion, in this life alone, one would think, ought to be sufficient to induce all mankind to embrace it. It deprives us of no real pleasure on earth, but prepares us for the enjoyment of such pleas- ure. You generally behold the pious man calm and com- posed. His life glides on smooth as the unruffled stream ; though he may be surrounded with enemies, who are con- tinually persecuting and oppressing him. If the desire to be happy in this world should be sufficient to influence us to become pious, how much more should Ave wish to be christians, for the sake of eternal felicity beyond the tomb. As to myself, I have ever been a strict moralist, and for many years depended upon that morality to carry me to the realms of eternal glory. I verily thought, at times, that I was a happy man, and that it was not necessary for me to repent. This was for the Avant of due reflection. I would not suffer myself to think on the necessity of regeneration as I should, and viewed the professors of religion as poor, 64 RELIGION. deluded creatures, who kneAV not what they professed. I felt proud of that philosophy (as I Avas pleased to term it), that enabled me to sit under the sound of the most pa- thetic sermon, Avithout evincing the least feeling; but it pleased heaven, in its mercy, to sheAv me my error, and to cause me, at the hour of eleven in the night, in my own chamber, while my family were sleeping, to arise from my bed, to fall upon my knees, and implore the God of heav- en for mercy. That night, for the first time in my life, I knew what it Avas to be in favor with God; and I assure you, dear reader, that there is more real enjoyment in one hour of the converted man's life, than in the whole life of the unregenerated. "Oh then, while penitence can fate disarm, While lingering justice yet withholds its arm, While heavenly patience grants the precious time, Let the lost sinner think him of his crime ; Immediate, to the seat of mercy fly, Nor wait to-morrow lest to-night be die."—Bon.*. INTERMITTING FEVER, OR AGUE. 65 PART SECOND. OF DISEASES GENERALLY. 9 INTERMITTING FEVER OR AGUE. Symptoms.—A feeling of lassitude, frequent yawning and stretching, and pains in the back and extremities, are the first symptoms of this disease. Soon after these symptoms appear, slight sensations of cold are felt along the back, the feet and hands become cold, the patient is restless and ill, and at length, coldness extends all over the body. The skin is pale, the pulse small and frequent; a trembling of the muscles takes place, first in the jaws, and soon spreads over the system. This stage continues, from a few minutes to several hours, and is folloAved by the hot stage. The skin is now hot and dry, the face flushed, the pulse full and strong, thirst great, with pain in the head and back. This lasts an uncertain length of time, and is succeeded by the third, or sweating stage. The fever abates, and perspira- tion begins to appear ; the breathing becomes free, and the sweating continues, until it ends in convalescence. The par- oxysms in this disease, come on once every day ; every se- cond or third day. Causes.—The only general cause of ague, is the miasma arising from the decomposition of vegetable matter; hence its prevalence in low, marshy districts, near large water courses, or ponds. Though the decomposition of animal and vegetable matter, be the most general cause, there arc 66 INTERMITTING FEVER, OR AGUE. other causes, such as intestinal worms; eating too freely ; irritating articles of food, &c. I once had a son, about five years of age, who was attacked with this affection, from the effects of worms. • Treatment.—My usual plan, is to give from twenty to thirty grains of calomel, with fifteen or twenty of rhubarb, for a cathartic; after the operation of which, I administer quinine, a grain every hour; so that the patient may take seven or eight doses immediately preceding the expected paroxysm. One grain of opium, given one hour before the attack, is sometimes necessary. The quinine must be con- tinued, from day to day, during the intermission, until the disease is arrested; the bowels being kept in a regular con- dition. In cases of long standing, that prove obstinate, the patient should be freely sweated, after the operation of the purgative. Dover's poAvder given every fourth hour in fifteen grain doses, until sweating is induced, ansAvers well for this purpose. To prevent a return of the disease, |ho patient should avoid exposure to Avet and cold; use light diet, and use bit- ters, made of wild cherry and dogwood bark; or, what is still better, he should take fifteen or twenty'grains of rust of iron, three or four times a day. In cases that prove obstin- ate, or complicated with other diseases, a skilful physician should be called. Persons are often too careless, with re- gard to this affection. Though one seldom dies Avith this fatal disease, many constitutions are ruined, by laboring for a long time under this complaint. Enlargement of the liver, and spleen; jaundice and dropsy, often result from neglected ague. REMITTING, OR BILIOUS FEVER. 67 REMITTING, OR BILIOUS FEVER. Symptoms.—The first symptoms of bilious fever, do not differ from those in the first stage of intermitting fever. Pains in the head, back and extremities, are among its first symptoms. As the fever comes on, the eyes acquire a yellowish tinge; the tongue becomes furred, nausea, and sometimes vomiting occur; the breathing is oppressed; the urine high colored; and the pulse full and frequent. Re- missions will often take place for an indefinite period ; the patient perspiring freely for a short time, and as the sweat- ing ceases, the fever returns. This is a brief description of the most usual form of the disease, which varies, however, very much in different indi- viduals, and at different seasons. Causes.—Marsh miasma, is also the principle cause of this form of fever; though worms, and whatever produces irritation in the abdominal region, tend to produce this af- fection. Treatment.—In cases attended with violent pain in the head, a full, strong pulse, and intense fever, bleeding is generally necessary. Some practitioners practice bleeding to a great extent, in almost every case of bilious fever; but I am of the opinion, that much injury often results from this practice. Abstracting blood, will, as a matter of course, lessen the momentum of the circulation, and con- sequently, will allay, to some extent, the febrile excite- ment ; but it strikes not at the root of the disease, and can produce temporary benefit only, while it often produces too/great prostration. Emetics were much in use in this disease, some years since, by the physicians in this section of country ; and some adhere closely to this plan. I con- fess myself somewhat sceptical with regard to this class of remedies. 68 REMITTING, OR BILIOUS FEVER. Free, actiA-e vomiting will remove the offensive matter from the stomach, and relieve the patient for a season ; so that Ave Avill find emetics popular among the people in any section of country. An emetic, however, does not af- fect the source of the disease; and in a practice of nine years, I have given but three emetics in bilious fever. Ca- thartics are universally used in this form of febrile disease, and Avith decided benefit. No article of the Materia Med- ica, has such an impression upon the disease as large doses of calomel. My plan is to administer from twenty to thir- ty grains of calomel, with fifteen or twenty grains of rhu- barb, agreeably to thexstrength of the patient, and the vio- lence of the disease. After the operation of such a dose as this, the bowels should be regulated with nitrous- pow- ders and castor 'oil. The formula for preparing nitrous poAvders you will find in the list of compounds. I usually commence the use of this compound about 12 o'clock in the day, and give from ten to fifteen grains, once in four hours until midnight, unless they should operate as a purgative. Should the patient take all four of the doses, and no effect be produced on the bowels, by four o'clock the following morning, I give a large spoonful of castor oil, and repeat every two hours, until purging takes place. My object is to produce from two to four operations in twenty-four hours. A teaspoon full of sweet spirits of nitre, should also be given in a little cold water, every hour or two, while the fever is up, agreeably to the violence of the same; except the hour at which the nitrous pow- ders are given. A mucilage of slippery-elm bark,, should be freely used throughout the course of the fever. Cold water and vinegar mixed, should be frequently applied to the feet, hands, arms and breast, when the feA-er is high, and the skin is hot and dry. Should the feet grow cold, while the fever rages, exertions should be made to warm them, by rubbing them with bran- INFLAMMATORY FEVER. 69 dy or vinegar, as hot as the skin will bear. If the disease assumes a more alarming form, or does not yield readily to the above remedies, a physician should be called in, Avithout too much delay. INFLAMMATORY FEVER. Symptoms.—This complaint is attended with the highest grade of febrile excitement. It comes on suddenly, with chills, followed with high fever. The whole surface be- comes exceedingly hot; the pulse full and vigorous; the face flushed; the eyes suffused and sparkling; great pain in the head; breathing hurried; thirst great; the tongue fur- red ; the boAvels torpid ; the urine high-colored; and the skin hot and dry. The ears are morbidly sensible to sounds; delirium is often very violent. Remissions take place in the morning, but fever returns in the evening. This disease seldom continues more than nine days, and the symptoms often vary from the above. Causes.—Excessive heat, great cold, sudden changes in the atmosphere, intemperance, free indulgence in high- seasoned food, a draught of cold water when the body is heated, violent passion, &c., are among the causes of in- flammatory fever. Treatment.—When the pulse is full and strong, blood should be draAvn freely from a large orifice, until some im- pression is made upon the pulse. It answers better to draAv from twelve to twenty ounces at once, than to draAv that quantity at several bleedings. After bleeding, a small dose of calomel (tAvelve or fifteen grains,) should be given, fol- lowed in three or four hours by a dose of salts ; but as I consider this a highly dangerous affection, I shall pursue the plan of treatment no further, but remark that a skil- ful physician, should in all cases, be called as speedily as 70 TYPHUS OR NERVOUS FEVER. possible. If a physician is not convenient, the above plan might be adopted, previous to his arrival, in preference to great delay. TYPHUS OR NERVOUS FEVER. Symptoms.—In the first stage, the patient feels an un- easy sensation in the stomach ; loss of appetite ; giddiness y sickness of the stomach; the countenance is pale and de- jected ; the eyes heavy; hands trembling j great debility and aversion to exercise. These symptoms continue from three to seven days, Avhen the patient is attacked with slight chills, alternated Avith flashes of heat; loss of appetite entirely; tongue fur- red ; vomiting sometimes occurs ; the pulse quick and ir- regular ; mind confused, and the physical depression very great. This stage lasts from five to twelve hours, and is. followed by the stage of excitement. The fever is now high ; pulse strong and full ; skin parched ; thirst exces- sive ; the bowels torpid ; the mind still more confused ; the patient exhibits an anxious expression of countenance ; is fretful and peevish ; the urine is high-colored and scan- ty ; and, occasionally, delirium occurs. About the third day of this stage, the patient is affected as Avith a com- mon cold, the eyes suffused, dry cough, difficulty of breath- ing, &c. Pain is felt in the back and limbs, and soreness of tShe Avhole body. ToAvards the end of this day, the patient appears as though under the influence of a large dose of opium ; the brain being much affected, the hearing dull, and delirium almost constant. The stage of excite- ment lasts six or seAen days, and the collapse, or sinking stage folloAvs. The fever subsides; the patient grows re- markably feeble; the pulse frequent; the tongue becomes a dark brown, and ultimately black; the lips and teeth TYPHUS, OR NERVOUS FEVER. 71 are covered with a dark crust; also, low muttering occurs, with constant delirium; indifference to everything pres- ent ; deafness ; twitching of the muscles of the face ; trem- bling of the hands; and, in violent cases, dark spots ap- pear on the skin. The abdomen becomes tender to the touch; the urine pale and copious, and diarrhoea often comes on. The period of collapse, lasts from seven to nine days, and Avhen the disease tends to a fatal termination, a tor- pid state supervenes, from which the patient can be aroused only a few minutes, and soon sinks to be no more resuscitated. The above is the ordinary course of the dis- ease, though it varies very much in some individuals. Causes.—Physicians differ in opinion with regard to the cause of typhus fever ; some contending that it depends on a peculiar virus,—others being of opinion, that it may be produced by the same miasma, that produces intermittents and remittents. From the best information I can obtain, I do not doubt the possibility of this form of fever being brought on by ordinary miasma—especially in constitutions broken doAvn by excessive drinking or debauchery, or per- sons laboring under mental distress. Typhus, has also prevailed in districts, where intermit- tents, and remittents, Avere unknoAvn. It is not doubted, by any of the profession, so far as I am able to learn, but that the disease may be generated by a species of miasma, evolved in crowded apartments, ill ventilated ships, jails, the miserable dAvellings of the poor, &c. Treatment.—In prescribing for typhus, I .shall be brief, as I am aAvare that it is a disease, not to be successfully trea- ted by the uninformed. I will remark, hoAvever, that in the initial stage, there will be safety in giving a teaspoon full of antimonial wine, in Avarm Avater, every fifteen min- utes, until vomiting occurs, and folloAA'ing in a short time, with from tAventy to thirty grains of calomel. This should 72 GLOSSITIS, OR INFLAMMATION OF THE TONGUE. be done, if a physician is not convenient, until one can be procured; but, if a physician be within ten miles, have him called, previous to administering any medicine, as the most skilful aid should be had in all cases of this kind. Being aware of the injury that might be done, by the igno- rant attempting the cure of this disease, I shall not lay down a plan for treatment any further. GLOSSITIS, OR INFLAMMATION OF THE TONGUE. This is an unusual disease, but sometimes is very vio- lent, beginning with a throbbing pain in the tongue, ac- companied with high fever. The tongue becomes hot, red, and much sAVollen, so as sometimes to fill the mouth in a few hours ; breathing difficult; a sense of suffocation is ex- perienced, and the patient can neither speak nor swalloAv ; suppuration in some cases takes place. Cases have also occurred in Avhich mortification of the tongue occurred ; and in others, the patients have died in a few hours from suffocation. Treatment.—If the pulse be full and frequent, the pa- tient should be bled to the extent of twelve or fifteen oun- ces, or more, agreeably to the violence of the disease, and the strength of the patient. The tongue must be scarified in different places, or a deep incision, an inch and a half, or two inches in length, made in the middle of the tongue. As medicines 'cannot be SAvalloAved, injections should be used repeatedly, until copious discharges are procured from the bowels. A physician should ahvays be called, if pos- sible. CYNONICHE TONSILLARIS, OR QUINSEY. 73 CYNONICHE TONSILLARIS, OR QUINSEY. Symptoms.'—Slight chills, succeeded in a short time with high fever, Avith some pain and soreness about the throat, are the first symptoms 0/ this disease. In a short time sAvallowing becomes difficult; the tonsils are much swel- led, and "the tongue coated with a Avhite fur, and also sometimes swollen. The face is red ; the pulse full and strong; breathing difficult, and the voice Avhispering.— The throat, on the outside, is someAvhat sAvollen and ten- der to the touch. The disease is apt to result in suppura- tion, in a few days, and sometimes death has occurred in a short time, by the excessive SAvelling closing up the air pas- sages and producing suffocation. Causes.—Some persons are predisposed to this affection, especially those who have had one or tAvo attacks of the disease. The usual exciting cause is cold or damp air, ap- plied so as to check the perspiration suddenly. Standing long, on the cold, Avet ground, is a fruitful source of the disease. Treatment.—Copious bleeding, is highly recommended, by most writers, in this affection; but I have seldom found it necessary in my practice. I am confident, that I never have failed of success in any case, and I have not bled in a solitary case, in six years past. My ordinary plan, is to give from tAA'enty, to twenty-five grains of calomel, and tAvelve or fifteen of rhubarb, im- mediately after being called to a patient. I have some- times found, an emetic, beneficial—given early ; but, I am not in the habit of giving an emetic, at this time. In slight eases, I apply a flannel, saturated with the volatile liniment to th< throat, as soon as the purgative has any effect; and, in more violent cases, I blister that part. As soon as the system is reduced, by the effect of the ca- 74 PAROTITIS, OR MUMPS. lornel, ten grains of Dover's Powder should be given every third hour, or, a teaspoonfull of sweet spirits of nitre, and antimonial wine, combined, giAren every fifteen minutes, with Avarm drinks, until sAveating is produced. In the ma- lignant form of the disease, the throat should be gargled with an infusion of Peruvian bark, in which a small quan- tity of alum has been dissolved. In severe cases, a physi- cian should be called in, without delay. PAROTITIS, OR MUMPS. Symptoms.—Slight fever, stiffness of the jaws, with some SAvelling of the parotid glands, are among the first symptoms of mumps. The swelling increases slowly, until the fourth day, Avhen it is considerable, and the part tender to the touch. Much pain is experienced, both in chewing and sAvalloAAring. Some degree of fever ahvays exists, and the patient is Very restless. After the fourth day, the SAvelling of the glands begin to subside; soon after the subsidence of which, the breasts of the female, or the testicles of the male, begin to swell, and become hard. The complaint, is generally .attended with little danger; but sometimes, the. patient, by taking cold,, causes the swelling to leave the glands, and attack the testicles; and suppuration of this part has taken place. Cases have occurred, in which the patient, by taking cold, brought on inflammation of the brain, and death has come on in a feAV hours. Mumps can be propagated by contagion, and has been knoAvn to prevail as an epidemic. Treatment.—In moderate attacks of mumps, all that is necessary, is to avoid exposure to cold, and keep the boAvels open, living on light diet at the same time. When, on the ACUTE GASTRITIS, OR INFLAMMATION OF THE STOMACH. 75 contrary, the inflammatory symptoms are violent, active bleeding should be resorted to, early in the disease. After bleeding, an active dose of calomel, and rhubarb, must be given; after the operation of which, sweating should be produced, with DoArer's poAvder, as directed in the preceding disease. When the swelling suddenly leaves the neck, and attacks the testicles, a blister should immediately be draAvn over the parotid glands. ACUTE GASTRITIS, OR INFLAMMATION OF THE STOMACH. Symptoms.—Inflammation of the stomach commences, with vomiting, (sometimes at least,) and purging, Avith a burning pain in the inflamed part. Sometimes it begins with tenderness of the epigastrium, nausea and vomiting. The desire for cool drinks, is urgent. ..After vomiting, the patient experiences an abatement of the symptoms tempora- rily. In some cases, there is considerable difficulty of sAval- loAving, and some difficulty of breathing, also. The brain, is often sympathetically affected, causing delirium. The patient, is Ioav spirited and feeble ; the pulse, though full at first, soon becoming quick, and" tense; and, at length, so weak as scarcely to be felt. When the stomach alone is inflamed, obstinate costiveness prevails. The skin, in this disease, is hot and dry; the tongue, sometimes clean and red; and at other times, covered with a thick white crust in the centre, with red edges. TOAvards the close of fatal cases, hiccough, cold extreme- ties faintings and delirium occur, which soon terminates in death. Causes.—Inflammation of the stomach, is often produced by irritating substances taken into it, such as large draughts 76 CHRONIC INFLAMMATION OF THE STOMACH. of cold Avater, taken .when the system is heated; stim- ulating drinks, &c. The external application of cold, and suppressed habit- ual discharges, will produce the disease. There are oth- er causes, such as typhus fever, &c. Treatment.—Bleeding, in this, as in other inflamma- tory complaints, is highly recommended; and I doubt not the propriety of it, in some cases ; but to the indis- criminate use of the lancet in this, or any other disease, I should object. When the patient is strong, and the pulse full and strong, bleeding should be practised in the early stage of the attack; but, otherwise, leeching over the stomach would be better. If leeches cannot be pro- cured, a large blister should be draAvn over the stomach, as soon as possible. Mucilaginous drinks, such as an infusion of slippery elm bark, flax-seed, or gum arabic, should be freely used throughout. Injections should be given and repeated, to operate on the* boAvels. Ta\o ounces of castor-oil, Avith one drachm of Venitian soap, and half a pint of flax-seed tea, Avould ansAA^er AATell for an injection. One grain tof calomel with one of opium, given three times a day, is highly recommended by some writers, and I should place confidence in the plan. A physician should be consulted in such a case as inflammation of the stomach, if convenient. CHRONIC INFLAMMATION OF THE STOMACH. Symptoms.—The first symptoms of this affection, are similar to those of dyspepsy, such as oppression after eating, acidity, pain in the stomach, flatulence, heart- burn, &c, &c. The patient feels easy, when the stom- CHRONIC INFLAMMATION OF THE STOMACH. 77 ach is empty, but is apt to crave food, and to feel dull. As the disease progresses, the epigastrium becomes ten- der to the touch, and eventually, nausea and vomiting occur. Pain in the stomach increases, especially after eating; the patient, often complaining of a very disa- greeable sensation soon after a meal; hence, the disease is often mistaken for dyspepsy. In some cases, the patient vomits matter, resembling the white of an*egg. Costiveness usually attends. The patient is Ioav spirited, as in the acute form; the cheeks and lips red, and the tongue, also of a redish hue, and clean. In the last stage of the disease, the patient be- comes greatly emaciated; a slight cough supervenes ; the pulse is quick, and tense; great prostration • exists; and the suffering being, at length sinks into the grave. Causes.—This form of disease, sometimes folloAvs the acute form ; but, is generally the' result of eating indi- gestible or irritating articles of food; drinking spirits, exposure to cold and damp air, mental distress, &c, &c. Treatment.—The treatment of this affection depends, principally, upon proper diet. All irritating articles of food, or even solid food, must be carefully avoided. Rice, arroAV-root, tapioca, sago, boiled milk, mucilaginous drinks, such as a decoction of barley, infusion of slippery-elm, and animal jellies, should be used by the patient. Cupping or leeching over the stomach Avould be beneficial. Pustula- tion, with emetic tartar, would also be proper. To relieve the distressed feeling of the stomach, two or three grains of Dover's poAvder may be taken at bed-time. The follow- ing mixture I have seen recommended: Balsam Copavia, one and a half drachms; powdered gum Arabic, two drachms; lemon syrup, half an ounce; water, half a pint ; laudanum, thirty drops. Mix the above ingredients, and o-ive a teaspoon-full of the mixture twice daily. 78 ACUTE EUTERETIS, OR INFLAMMATION OF THE INTESTINES. ACUTE EUTERETIS, OR INFLAMMATION OF THE INTESTINES. Symptoms.—Uneasiness is generally first felt in the ab- domen, resulting, continually, in a burning pain about the region of the navel. The pain, however, is sometimes dif- fused over the abdomen; at others, confined to one spot only. Costiveness, to a great degree, generally exists, and nausea and vomiting often supervenes. The tongue is dry, sometimes covered Avith a white fur, and at others a brown fur along the middle, Avith pale, red edges ; thirst great 3 Urine high-colored and scanty; skin dry and hot; breath- ing laborious, and the pulse small, tense and frequent.— These are among the first symptoms. In the sinking stage, the pulse groAvs Aveak—the feet and legs groAV cold, and great prostration occurs. The disease is apt to terminate in gangrene. When it is about to take place, the pain subsides ; the pulse sinks rapidly; the skin becomes pale ; the extremities cold, and death soon closes fhe scene. Causes.—Inflammation of the boAvels may be produced by external injury, cold, drastic purges, hernia, an accu- mulation of hardened fceces, &c. Treatment.—Bleeding should be done early in this dis- ease, and repeated agreeably to the effect produced on the pulse, and upon the disease. After bleeding, tAventy o-rains of calomel, with ten of Dover's powder, must be given, and folloAved in five hours, by a dose of castor oil, if the former should not operate Avithin that time. Should the patient continue to suffer Avith pain, after the operation of the cal- omel, a large blister should be draAvn forthwith, over the affected part; and immediately after the cuticle, or thin skin is removed from the blistered surface, a poultice of light bread and sweet milk, should be applied cold, to the blistered part. Small doses of Dover's powder, say five ©r DYSENTERY. 79 six grains, may be given, once in three hours, until the pain subsides. Mucilaginous drinks must be freely used, and injections administered occasionally. It is of the deep- est importance that a skilful physician should be early call- ed in. DYSENTERY. Symptoms.—'A sense of chilliness, weakness, nausea, want of appetite, thirst, dry skin, and pain in the bowels, are among the first symptoms of this disease. Sometimes the patient is attacked with griping, and mucous and bloody' stools, Avithout any previous symptoms. In a short time after the commencement of the disease, fever comes on, the pulse growing quick, and sometimes full. The patient has almost a constant inclination to go to stool, but little, however, is discharged from the bowels, except mucous and blood ; and these discharges have a very disagreeable smell. ToAvards the fatal termination of the complaint, the pulse sometimes groAvs better; the griping, and the desire to go to stool, remit; and the friends of the patient flatter themselves that recovery is about to take place; but soon the restlessness increases; the extremities cold; a clammy sAveat breaks out; hic- cup comes on, and death closes the scene. Causes.—A cold and damp autumn following a dry, warm summer, is apt to be productive of dysentery.— The miasma producing ague also sometimes causes dys- entery to prevail. The use of unripe fruit, unwholesome food, and anything of an irritating nature, taken into the stomach, is apt to produce the disease. Treatment.—Active bleeding, according to the state of the pulse, is advised by some in this disease; but, I 80 DYSENTERY. have not resorted to it once, in a practice of ten years, Avithout the loss of a single patient with dysentery ; ex- cept a small child or tAVO, that were neglected, until they Avere in the sinking stage of disease, before I was con- sulted. Purgatives, are highly necessary in every grade of this affection. In mild cases, I have succeeded well with tAVO table-spoonful's of castor-oil, and thirty drops of laudanum, to an adult. In more severe cases, how- ever, I use calomel and Dover's powder, in doses of from 25 to 40 grains of the former, to 10 or 15 grains of the latter, to an adult; and doses to children, in proportion to the age. ■' Mucilaginous drinks, such as the infusion of slippery elm bark, or solution of gum arabic, should be used throughout the disease. Emetics, Avere once much used, in the management of dysentery. I do not use emetics, myself, in this complaint, but doubt not their utility, in some cases; especially, Avhere nausea and vomiting occur. Ipecacuanha, is the article I would prefer as an emetic, as it increases, instead of impairing the tone of the stom- ach, as most articles used to produce vomiting, are apt to do. Medicines, to act upon the skin, are quite essential; and Dover's poAvder is assuredly the best article we can use for this purpose. In very severe cases, Avhere much disorder of the liver exists, after giving one active dose of calomel, and Dover's poAvder, I often give those two articles in small and repeated doses. Four or five grains of calomel, with ei°-ht or ten of Dover's poAvder, given every three or four hours, so as to act upon the skin, and bowels, is an excellent plan to adopt in the treatment of this affection. Should active purging, or symptoms of salivation occur, the calomel and Dover's powder must not be used any further; but, the Do- ver's powder, can be used alone, so as to keep up gentle CHRONIC ENTERITIS, INFLAMMATION, &C. 81 sAveating throughout the whole course of the disease.— Sweating, in mild cases, can be kept up by giving sweet spirits of nitre and antimonial Avine combined, in tea-spoon- ful doses eArery hour in some Avarm tea, such as hyssop, balm or sage. Blisters are sometimes recommended in this disease, and are necessary, Avhen there is great pain in the boAvels, accompanied with external soreness over the abdo- men. When these symptoms occur, a large blister should be draAvn on the abdomen; and, as soon as it is draAvn suf- ficiently, a light Avheat bread poultice, must be applied to the blistered surface. This must be repeated often, until the tenderness is removed. With children, I haATe often resorted to the use of the Avarm bath, instead of blistering, to allay irritation of the bowels, with the happiest effect. Tonics must be given Avith caution, in the latter stage of this disease. ( If the pa- tient, however, be very Aveak, after the inflammatory symp- toms have been effectually subdued, the pulse feeble and sIoav, and all irritation allayed, the adult may take ten or fifteen drops of elixir vitriol, with two or three table-spoon- fuls of cold Avater, three times a day, on an empty stomach. If the above plan is not likely to succeed in a few days, u physician should be called. CHRONIC ENTERITIS, OR CHRONIC INFLAMMA- TION OF THE BOWELS. Symptoms.—Pain, in this disease, is seldom felt in tin- boAvels, except Avhen the patient moves suddenly, coughs, sneezes, or presses on the abdomen. The system is very Aveak ; the extremities apt to be cold ; the pulse AAreak, ex- cept in the evening, when there is fever. The patient then complains of burning in the palms of the hands and soles of the feet, and the face is flushed. 82 ACUTE INFLAMMATION OF THE PERITONAEUM. Sometimes diarrhcea comes on, and continues throughout the whole course of the disease. The appetite is variable, and some pain is generally experienced in the stomach, soon after eating. After the disease has prevailed for a considerable length of time, the victuals pass through the stomach imperfectly digested, and the patient is reduced in flesh, greatly. The skin is of a sallow complexion ; the tongue furred along the middle, but red at the edges, and the patient is fretful and easily irritated. Causes.—Chronic inflammation of the bowels, often ari- ses from the acute form of the disease. It is caused, also, by unwholeseme and indigestible articles of food, long ex- posure to cold, damp air, &c. Treatment.—A dose of castor oil should first be given in this disease, and repeated as occasion may require. Do- ver's powder, given tAvo or three times a day, in five or six grain doses, is an excellent remedy to allay the irritation of the bowels and determine to the skin. Leeching the abdomen, should be practiced, if convenient. Balsam co- paiva, spirits of turpentine, sulphate of zinc, and some oth- er articles, are recommended by medical writers. The diet should be of the mildest kind, such as arrow-root, rice, boiled milk not thickened, barley properly prepared, oatmeal gruel, sago, tapioca, &c. ACUTE INFLAMMATION OF THE PERITONAEUM. Symptoms.-—Acute inflammation of the Peritonaeum, or the membrane that lines the abdomen, is often characterized by the following symptoms : weakness, slight chills, with alternate flashes of heat, pain in the joints, and headache. Aoute pain is generally felt in the abdomen, more partic- ularly after the fever comes on, when it comes on with much violence, causing intense agony. The abdomen is ACUTE INFLAMMATION OF THE PERITONEUM. ' 83 extremely tender to the touch ; the bowels constipated ; the tongue covered with a whitish fur, and moist; the pulse quick and tense. Nausea and vomiting often occur. The features are expressive of great anxiety, and the skin generally pale. In the course of a day or two, the abdo- men becomes swelled, tense and elastic; the breathing is difficult; partial, and sometimes complete suppression of urine, &c. This affection generally lasts only six or se- ven days, when it either terminates in death or in resolu- tion. Causes.—Over exertion in lifting, running, leaping, or any violent exercise, may produce this disease. Sudden suppression of the perspiration from cold, wet feet, and par- turition, may also cause it. Treatment.—Blood letting is recommended by medical writers generally in this affection; but I have never resort- ed to it, and my success in inflammation of the peritonaeum has been entire, except in a single case, where mortification had taken place, previous to my being called. Leeching the abdomen is very proper. I generally give from twenty-five to forty grains of calo- mel, with from ten to twenty of jalap, agreeably to the vio- lence of the disease, and the strength of the patient. At the same time, if the abdomen be very tender to the touch, a blister should be drawn on that part. A light wheat bread poultice applied over the blistered surface, is also of benefit. After an active effect on the bowels, from a dose of the a- bove kind, the boAvels should be regulated, by giving three or four doses of calomel and Dover's powder; four grains of the former, with seven or eight of the latter, given three or four hours apart, every day. It is highly important that a gentle sweating should be kept up during the whole course of the disease. If calo- mel and Dover's powder,,given as above directed, does not answer to produce three or four stools per day, castor-oil 8 1 CHRONIC INFLAMMATION OF THE PERITONAEUM. should be given, so as to produce that effect. A free use of flax-seed tea, or mucilage of gum-arabic, or slippery elm bark, is of vast importance ; and if difficulty in making water takes place, a tea-spoonful of spirits of nitre, should be added to the mucilage, and taken every hour, until that symptom is removed. Light diet should be the only kind used, throughout the disease. If this plan fail of success, call a physician ; in fact, if one be in any degree convenient, he should by all means be called in at the onset.. CHRONIC INFLAMMATION OF THE PERITONAEUM. Symptoms.—Tenderness of the abdomen also takes place in this complaint. No acute pain is felt. The loAver part of the abdomen is generally tender to the touch, and by placing the hand on the part, you will find the skin loose ; but the Peritoneum, or lining of the abdomen, will be dis- tinctly felt, like a bandage drawn tight beneath the skin, and muscles. The patient will sometimes tell you, that he feels a ball rolling about Avithin the abdomen. CostiATeness usually prevails. The skin is pale, with the exception of some fever sometimes occurring in the evening.. Causes.—This form of inflammation often follows the a- cute form of the disease, and sometimes is the consequence of acute inflammation of the bowels. Injuries receh. ACUTE BRONCHITIS, &C 97 ACUTE BRONCHITIS, OR INFLAMMATION OF THE BRONCHIA. Symptoms.—This affection generally begins like an or- dinary cold, Avith a sense of chilliness, a slight cough, and oppression of the chest. Little or no pain is felt in the breast. Some fever generally comes on, but is often quite moderate. As the disease advances, the oppression in- creases ; anxiety is depicted op the countenance; hoarse- ness takes place ; the breathing is quite difficult, and ac- companied with A\Theezing. The cough which at first Avas dry, is eventually accom- panied by free expectoration,the patient throwing up matter resembling, at first, the Avhite of an egg; but changing, as resolution is about to take place, into a yelloAvish, thick matter. The tongue is covered with a Avhite fur—the pulse frequent and tense, and the skin, on the upper part of the body, generally hot and dry, though the feet and hands are often cold. This is a highly dangerous affection, and if it be not checked soon, Avill sometimes prove fatal in three or four days. Children and old people are most lia- ble to this complaint. Cause.—Cold operating on the system, checking sucL ^ denly the perspiration, is generally the cause of this mal- ady. It is apt to prevail in autumn and winter, and is most prevalent in cold, damp countries. Treatment.—The bowels, in this affection, must be kept gently open, with senna or castor oil; but gcnerallyac- tive cathartics are unnecessary. Sometimes, howeArer, it is best to give twenty or twenty-five grains of calomel, Avith ten grains of Dover's powder, and work it off in five or six hours with castor oil; this is particularly necessary in cases attended with much fever, or a bilious stomach. The skin must be kept moist, by giving four or five grains of Dover's powder, once in four or five hours, when there is but little 98 PHTHISIS PULMONALIS, OR CONSUMPTION. fever; or SAveet spirits of nitre, in doses of a tea-spoonful every hour or two, Avhen there is much fever. An emetic given soon after the operation of the calomel, is very es- sential, and should be repeated occasionally, as long as there is much difficulty of breathing, and a collection of much matter in the Avindpipe. Pustulation, or blisters, should be kept up with tartar emetic ointment, over the greater part of the breast, throughout the whole course of the disease ; and in se- vere cases, a seton must be introduced, immediately over the space between the shoulders. If the disease cannot be checked in its course, in a feAV days, a skilful physician should be called Avithout delay. PHTHISIS PULMONALIS, OR CONSUMPTION. Symptoms.—A slight tickling cough and oppressed brea- thing, are generally the first symptoms of this dreadful disease. Sooner or later pain is felt in the chest—the brea- thing becomes more and more difficult—the cough much more violent—the debility extreme, and emaciation pro- ceeds rapidly. As the disease advances, the cheeks be- come flushed Avith a circumscribed red spot in the evening of each day; the breathing is short—the pulse feeble and frequent; the palms of the hands, and soles of the feet are hot, until toAvards midnight, when a profuse colliquative sAveat comes on and continues until morning, when the patient finds himself remarkably languid. The couo-h at this stage of the complaint, is frequent and harrassing ; the expectoration copious, the patient throwing up large quan- tities of pus. The left side of the chest sometimes sinks, so as to be an inch lower than the other side. The counte- nance exhibits marks of anxiety and distress, though the eye retains its brilliancy* CONSUMPTION. 99 The complexion is pale, except during the evening, when the hectic flush is on the cheeks. Towards a fatal termination, a colliquative diarrhoea comes on, which soon puts an end to the patient's sufferings. Causes.—A predisposition to consumption exists in some persons from infancy. Individuals Avith flat breasts, long necks, high shoulders, light hair and fair complexions, are said to be most liable to this disease ; but a large majority of the patients that have come under my oAvn observation, had black hair and dark skins. Neglected colds, intemperance, sedentary occupations— particularly those of tailors, shoemakers, and clerks—ex- cessive venery, midnight debaucheries, and the depressing passions, are among the exciting causes of this disease. Treatment.—It is with a full conviction of the inefficien- cy of medical treatment, in this truly formidable disease, that I attempt to lay down a plan of treatment; but Avhen I cast my eyes around me, and behold the most noble, and highly intellectual of our youths, falling early victims to it, I feel constrained to offer a feAV remarks with regard to the treatment. But a feAV years have elapsed since I followed to the tomb one of the earliest friends of my youth; one Avho Stood high as a youth of talent, honor and virtue; one Avho might, with proper cultivation, have shone as a briliant star in the political horizon ; Avho fell like a blighted floAArer, nipt by an untimely frost, the victim of consumption. Could I, Avith my feeble pen, be instrumental in snatch- ing one such youth from an early grave, the recollection of such an event, Avould afford me more genuine satisfaction, than all the wealth of this earth. Bleeding, in this affection, Avas once much resorted to by physicians in this section of country, and is yet the practice of many. I shall assume the privilege of con- 100 CONSUMPTION. demning the practice in a general point of view; in fact, I never met Avith a case in Avhich I considered it advisable to bleed to the smallest extent. The pulse, it is true, is quick and tense ; but an attempt to reduce it by direct de- pletion, is perfectly absurd, as the experience of many em- inent physicians has fully proven. Copious abstractions of blood often repeated, serve but to increase rapidly that debility under which the patient already labors ; and in- stead of alleviating his sufferings in the smallest degree,. only tend to precipitate him into the grave. The physician will resort to copious bleeding once, and finding the pulse still remain quick and tense, he will repeat it. Thus he will go on, bleeding from time to time, until his patient is reduced to that degree that he cannot walk across the room, and the desired effect upon the pulse will not have been accomplished. The system is excitable and irritable, and something ought to be done to reduce the ve- locity of the circulation, without direct depletion. Digitalis, or fox-gloA*e, has long been the sine qua non to effect this, and answers the purpose admirably. The tinc- ture of this article has had a good effect in my hands.— From 10 to 40 drops may be given three times daily. The safe plan is to commence Avith ten drops, and increase two- drops every day up to forty, unless unfavorable symptom* are produced. If, hoAvever, as you increase it, giddiness.. dimness of sight, nausea, tremors, or any unfavorable symp- toms occur, you must decrease gradually, until such symp-v toms cease. Flannel should bo constantly worn next to the skin in this affection, and gentle diaphoresis or SAA'eating ought to be kept up. One ounce of gum arabic, dissolved in one quart of water, to which is afterwards added one grain of tartar emetic, ansAvers Avell for this purpose. This quan- tity must be taken in divided doses every day. External irritating applications I consider of infinite importance in CONSUMPTION* 101 this complaint. It is truly astonishing how much this is neglected by the physicians of our country. Counter irritation, by any means, I would consider ben- eficial to some extent, but pustulation with tartar emetic, and setons the most advantageous. The ointment should be rubbed over the chest, three times daily, until pustules are brought out ever the larger portion of the breast. At the same time a seton must be introduced over the spine, as near the lungs as practicable. Both of these ought to be repeated, as often as necessary, to keep up the irritation. Expectorants may be used Avith advantage, and any of the cough mixtures mentioned in this Avork would answer. I will iioav speak of those things which I consider of more importance in consumption than medicine, viz: diet, air and exercise. Without attention to these, no cure can possibly be performed. A mild, unirritating diet ought to be obser- ved throughout. Milk, rice, rye-mush, crackers, ripe fruit, &c, may be freely used. All stimulating drinks ought to be carefully avoided. Meat, coffee, and tea are all improp- er for a consumptive. A warm, genial climate should be sought. I have seen two or three individuals, Avho resided in some of the Northern States, who had been attacked with consumption, and by spending three or four years in Florida, were re- stored to perfect health; and a gentleman from Massa- chusetts, stayed a day or two with me, in the Avinter of 1843, who informed me that he had been low in consump- tion, but by pursuing a similar course to that which I have laid doAvn, and spending three years in Florida and Geor- gia, he was restored to good health. Many persons who go South, Avhen they are affected with this disease, Avait too long. I believe that some cases are aggravated by a residence in a warm climate, in the last stage of the disease. When a man is attacked with consumption, he should fly to the South without delay. 102 YELLOW FEVER, Exercise on horseback or in a carriage, when the weather is mild, would be good. Sailing in a steamboat, or trav- elling by railroad Avould also be proper; but a voyage on sea, in a mild climate, would be still better. YELLOW FEVER. When treating on fevers generally, I thought I would omit this dangerous affection entirely ; but after more ma- ture reflection, I have concluded that a description of the various symptoms attending yellow fever, might enable my readers to distinguish it from other diseases, and cause any one in Avhose family a case may occur, to seek medi- cal aid at an early hour. • Symptoms.—It generally begins with pain in the back and extremities, giddiness of the head, extreme weakness, chills and nausea. After a few hours have elapsed, high fever conies on, accompanied with redness of the eyes, hot and dry skin—the face flushes—excessive thirst—violent headache—pain greatly increased in the extremities, and a feeling of great weight in the stomach. In the course of twenty-four hours from the attack, vomiting is apt to take place. No fluid can be taken Avithout producing excessive vomiting. Bilious matter is thrown up in abundance, from a velloAvish to a dark green color. The countenance now exhibits the utmot distress ; great tenderness is experienced OAer the stomach, and delirium is apt to come on. An at- tack of this kind generally contjnues from twenty-four to forty-eight hours, Avhen a remission takes place in the fever, and almost every symptom, except the sickness and vom- iting. The pulse becomes natural, the skin moist and soft, and the patient becomes so easy that his friends flatter them- selves that he is much better ; but alas! this state lasts but a few hours, Avhen all the symptoms return Avith increased violence. The pain and heat in the stomach is distress- YELLOW FEVER, 103 ing, and the vomiting almost incessant, the patient throw- ing up a dark matter resembling coffee-grounds. The thirst is intolerable, and everything taken into the stomach is immediately rejected. This stage lasts from twelve to thirty-six hours, and is folloAved by the last stage. The skin becomes quite yelloAV, and also the Avhites of the eyes. In the last stage the pulse sinks—becomes slow and feeble; the vomiting is almost constant—the extremities become cold, and covered Avith a clammy sAveat, and the counte- nance expressive of the deepest distress. Diarrhoea generally comes on in this stage of yellow fe- ver, the discharges being of a dark green color. The skin is of a yeilow color—the delirium increases, and soon death closes the scene. Cauw?.—-Much has been said, by the medical world, re- specting the cause of this fatal malady ; some contending that it is strictly contagious—others that it is of miasmatic origin. Reason is on the side of the latter opinion. In whatever city yelloAV fever has prevailed, in the United States, it has universally been the Avorst in the filthy, and Ioav, damp parts of the city. It appears from the best tes- timony, that in Ioav, damp situations, and in places Avhere much filth is to be found, the disease is apt to prevail more generally ; and Avhen a case does occur in any part of a town that is dry and cleanly, it is comparatively mild ; so that the citizens of large tOAvns should be careful to keep the streets clean. Treatment.— Much difference of opinion exists among medical men respecting the treatment of this formidable dis- ease. Some advise the most prompt and energetic treat- ment, while others recommend the mildest treatment. As the disease assumes at one time, quite a mild form—at oth- ers a highly dangerous grade, it is evident that the treat- ment should vary, to suit the form of the complaint. When the fever is high—the pulse is full and frequent, and all 104 NEPHRITIS, OR INFLAMMATION OF THE KIDNIES the symptoms of an aggravated form, profuse bleeding should at once be resorted to. As high as fifty, or even sixty ounces of blood has been draAvn. No invariable rule, hoAvever, should be practiced Avith regard to the quantity draAvn ; but it should be in proportion to the strength of the patient and the violence of the disease. The blood should be suffered to Aoav until a decided impression be made on the pulse. Bleeding should be practiced in the early stage of the disease. Purgatives are highly beneficial in yelloAV feA~er, and a- mongst them calomel stands the highest. From twenty to thirty grains should be given in the onset of the disease, and repeated in four hours ; and if both should not affect the boAvels in four hours after the exhibition of the last dose, castor oil, or an injection, should be used to assist the op- eration. The abo\re are the first steps to be taken in yel- Ioav fever ; and as it is an extremely dangerous affection, a physician should be called previous to taking further steps'. NEPHRITIS, OR INFLAMMATION OF THE KIDNIES. Symptoms.—Slight chills, Avith flashes of heat, sometimes ushers in this disease. An acute pain is felt in the region of the kidnies ; sometimes on one side only, and sometimes on both. Bending the body in any direction, so as to shock the system, increases the intensity of the pain very much. The pain often darts doAvn the urethra towards the testi- cles, which are sometimes draAvn up ; but if one kidnev alone be affected, the testicle on that side only will be draAvn up A sense of numbness is experienced in the thighs. The boAA'els are generally in a state of constipation ; the urine high-colored and often mixed with blood. When both of NEPHRITIS, OR INFLAMMATION OF THE KIDNIES. 105 the kidnies are affected, the urine is very often entirely suppressed. The pulse is full and frequent, and the skin hot and dry. Causes.—Qold is the most frequent cause of this com- plaint. It sometimes arises from causes acting directly up- on the kidnies, such as irritating diuretics, gravel, bruises, strains by lifting heavy burdens, wrestling, jumping, &c. Treatment.—Prompt bleeding is generally necessary in this disease. If the pain be severe, and the pulse full and frequent, blood must be drawn in the early stage of the disease, so as to make a decided impression on the pulse. A poultice of flaxseed must be applied over the kidnies. warm; and if relief be not afforded in a short time, the poultice kuist be renewed, and cupping resorted to in that part. Immediately after bleeding, a good dose of calomel and rhubarb must be given, folloAved in the course of five or six hours with a dose of castor oil, if necessary, so as to operate with acthity upon the bowels. The bowels must after- wards be kept in a loose condition, by giving castor oil in quantity and frequency sufficient to produce that effect.— After the system has been reduced, by bleeding and active purging, sweating is necessary, and can be produced by giving one or two doses of DoATer's powder, (fifteen grains for a dose,) four hours apart; or a tea-spoonful of spirits of nitre and antinionial wine, combined equally, and repeat- ing the dose every hour until five or six doses shall have been taken ; promoting the effect by giving warm hyssop or balm tea freely, between the doses of medicine. A free use of mucilaginous drinks, throughout the Avhole course of treatment, is very essential. The mucilage of gum ara- bic, or slippery elm bark, wrill ansAver well for this purpose. Light and cooling diet must be strictly observed ; avoiding meat, coffee, and every article of diet, heating, or stimulat- ing in the smallest degree. 106 CYSTITIS, OR INFLAMMATION OF THE BLADDER. CYSTITIS, OR INFLAMMATION OF THE BLADDER, Symptoms.—Extreme burning pain is felt in the region of the bladder ; difficulty of making water, and Avhat passes off is frequently tinged Avith blood. The boAvels are in a state of obstinate constipation; the pulse is full and fre- quent, and the skin hot and dry. The patient complains of much soreness over the region of the bladder, Avhen pres- sure is made thereon. The thirst is urgent in the extreme, nausea and vomiting are apt to occur, and after the disease has existed for some time, SAvelling is apt to take place, OArer the region of the bladder, and sometimes it extends as far as the thighs. Causes.—Cold AAret feet; long retention of urine ; gravel; irritating substances applied externally, and conveyed by the absorbents into the bladder, such as cantharides and spirits of turpentine, and gonorrhoea, are among the causes of inflammation of the bladder. Treatment.—This is a dangerous affection, and requires early and vigorous treatment. Blood must be drawn, as recommended under the head of Inflammation of the kid- nies, until the pulse is reduced thereby. Leeching over the region of the bladder is of great importance, and should be done if leeches can be procured. A flax-seed, or light wheat-bread poultice, ought also to be applied over that part. The boAvels must be kept open, by giving castor oil, as occasion may require, and using injections of flax-seed tea. The hip bath, taken by sitting in warm water, so that it may reach the hips, is very useful in this complaint.— The catheter should not be used to draAv the Avater from the bladder, if a discharge can be affected without; but ne- cessity sometimes compels us to resort to the use of this in- strument. Setons should be resorted to, after the system shall have HYSTERITIS, OR INFLAMMATION OF THE WOMB. 107 been reduced by bleeding; and this can be effected by the plan prescribed for inflammation of the kidnies. I should, hoAvever, prefer the use of sweet spirits of nitre, to produce sweating, as it has also an effect upon the urinary organs. A tea-spoonful of this article may be given every hour, using as an auxiliary, some Avarm tea, until a gentle perspiration is produced, and it would be well to keep up a moisture of the skin for a considerable length of time. If the fore- going means fail to check the disease in a short time, a skilful physician should be called in. HYSTERITIS, OR INFLAMMATION OF THE WOMB. Symptoms.—Sometimes inflammation of the Avomb be- gins, like other inflammatory affections, with distinct, chills, followed by fever, previous to any pain being experienced in the womb ; but it more usually happens that pain is felt in that part in the onset of the disease, fhe pain in the loAver part of the abdomen is greatly increased by pressure. Urine is generally voided Avith pain, and sometimes wholly suppressed. As the disease advances, the uterus or womb swells, which may be discovered by applying the hand over it externally. The pulse is sometimes full and frequent; at others small, quick, and tense. Severe headache is apt to accompany this complaint, and nausea and vomiting generally occur. These are the ordinary symptoms of hysteritis'; but the disease varies in different cases. Cause.—Hysteritis is caused by parturition, or child-bear- ing, and is apt to come on in a few days after child-birth. ^Treatment.—Active bleeding should be practised in the earlv stage of this disease-provided the pulse be full and frequent. Leeching, over the region of the womb, is also 108 ACUTE RHEUMATISM. of much benefit. After leeching, a Avarm, soft poultice, either of flax-seed or light Avheat-bread, should be applied over the pubes and external organ of generation. Imme- diately after bleeding, from fifteen to twenty-five grains of calomel, Avith ten or fifteen of rhubarb must be given, and if no effect be produced on the boAvels, in five or six hours thereafter, a dose of castor oil must be administered. No stimulating injections, as advised by some, must be resorted to ; but, the use of flax-seed tea as an injection, might prove of some advantage. Mucilaginous drinks must be freely used. In cases attended Avith much suffering, after bleed- ing and purging, from four to six grains of Dover's poAvder ma}r be administered every two hours, in order to procure ^ase, and to act upon the skin. Should this fail to relieve the patient's sufferings in a few hours, a grain of opium may be given and repeated every third hour, until rest be procured. Light diet only should be used. Should the above plan fail to mitigate the sufferings of the patient in a feAV hours, a physician must be called. ACUTE RHEUMATISM. Symptoms.—Slight chills, succeeded by heat, loss of ap- petite, and loAvncss of spirits, are the premonitory symptoms of acute rheumatism. Pain in a joint or joints, soon comes on, Avith inflammation and SAvelling of the affected parts. Die pain increases very much at night—the pulse is full and frequent—the skin hot and dry—the thirst urgent, and the urine small in quantity and of a deep red color. The bowels are generally obstinately constipated, and as the dis- ease' advances, the SAvelling of the affected part increases, until the distension becomes enormous. Caitses.—Suppression of the perspiration by cold, is the ACUTE RHEUMATISMv 109* usual cause of this complaint. Cold and Avet f?et, expo- sure to rain, Avhen the body has been heated, sleeping in cold, damp rooms, or in damp bed-clothes; travelling in ex- treme cold Aveather, and lying out of nights, as Avaggoners generally do, are amongst the most fruitful sources of acute rheumatism. Treatment.—When the pulse is full and frequent, bleeds ing should forthwith be practised, so as to make a decided im- pression on the pulse, and repeated according to the state of the pulse and the violence of the pain. From twenty- five to forty grains of calomel, with fifteen or twenty of rhubarb, mnst be given in the commencement of the dis- ease, and followed, in five or six hours, Avith a dose of castor oil, if necessary, to procure copious evacuations from the boAvels. After the reduction of the system by bleeding and purg- ing, sweating must be induced and kept up as much as possible, by giving ten or twelve grains of Dover's poAV- der every three or four hours. It will doubtless be ne- cessary to give an occasional purgative during the whole course of the disease. External stimulating applications to the affected parts, are essential. Opodledoch, british-oil, the volatile liniment, and many other compounds are re- commended for this purpose, but anything of a stimulat- ing nature would prove of some benefit. I have found the volatile liniment, as it is usually formed with the addition of a little camphor and laudanum, to be as good as any other. A large number of empirical remedies are recommended as specifics in this affection. Those steam engines Avith which some parts of the Uuited States are infested, boast of their power to control this disease with "number six," " composition powders," &c, and it is true, that in cases in which their active stimulants fail to kill the patient in the first stage, they sometimes prove 110 CHRONIC RHEUMATISM. beneficial. Any ignoramus may, by shooting one hundred times at random, accidentally hit a mark; and a "stea- mer" by being called to many patients, may happen to get to some one at a period Avhen his vile nostrums may do good; and among such creatures as usually adopt the Thompsonian plan, to make themselves doctors in a day, success in one case in a hundred, is sufficient to make the dear fellow place the utmost confidence in his vast medi- cal acquirements. Should the plan prescribed not prove of considerable ad- vantage in arresting the disease in its progress in a short time, a skilful physician ought to be called, as great de- lay might result in causing the patient to be an invalid for life. CHRONIC RHEUMATISM. Symptoms.—In this species of rheumatism, the affected part is painful, but not red and SAvelled as in the acute form. No fever accompanies the complaint, and the pain which is obtuse, is not confined to any particular part, but flies from joint to joint. The pain is always more annoying during the night, and just before, and during falling Aveather. The patient, after exercise, is apt to ex- perience temporary relief; but he soon feels stiff in his joints, and in a short time the pain returns with as great an extent as usual. Causes.—This is sometimes the consequence of the a- cute form of the disease; but it is also often the result of cold acting upon the system. Aged persons are more apt to become affected Avith this form of rheumatism, than the young; and as the acute form, it is most prevalent in cold damp countries, such as Indiana and Illinois. GOUT. Ill Treatment.—It is extremely difficult to eradicate this form of rheumatism from the system. Bleeding is not required, as it generally is in the acute form. Purging is decidedly useful, as it is in the other form; but it is scarcely necessary to carry it to the same extent. The boAA'els should be kept regular throughout the whole course of the disease. Gentle SAveating Avith Do- ver's poAvder, would be good. The tincture of gum gua- iacujm, is a favorite remedy, given in doses of from a tea-spoonful to a table-spoonful three times a day, avoid- ing at the same time exposure to Avet and cold. It can be taken in Avater and SAveet milk. In lumbago or rheu- matism of the back, spirits of turpentine is highly re- commendeded by some. Dr. Eberle states that twenty drops of spirits of turpentine with' one scruple of lat sulphuris, given three times a day, has been used by him Avith good effect. Several other remedies have been recommended in this form of rheumatism, but a good skilful physician ought to be consulted. GOUT. Symptoms.—The attacks of this disease come on in the night, arousing the patient from his slumbers, with an acute pain in the toe, heel or instep. The pain becomes intense, and continues from a feAV hours to three or four days and nights. A remission will eArentually take place, but will last but a short time, when the pain will return with all its violence. The foot and ancle are much swelled and red, and the slightest touch will sometimes produce the most excruciating agony. 112 OPTIIALMIA, OR INFLAMMATION OF THE EYE, Causes.—The causes Avhich tend to the developement of this disease, are the too free use of rich articles of food, the excessive use of stimulating drinks, and a Avant of ac- tive exercise. Treatment.—Cathartics are indispensably necessary in this painful affection. The folloAving pill is highly rec- ommended by Scudamore: Take extract of colocynth, half a drachm; calomel, fifteen grains; emetic tartar, one grain. Mix and divide into sixteen pills. Of these, two or three are to be taken at bed-time. The boAvels ought to- be freely acted upon throughout the paroxysm. Take ten grains of calomel; ten grains of opium; and one grain of tar- tar emetic. Mix these together, finely pulverized, and di- vide in ten doses. One of them must be giAen every five or six hours, so as to keep up a gentle perspiration. As the patient grows better, he must avoid all stimula- ting drinks and high seasoned food. His diet should be of a mild cooling nature, and used as sparingly as possible. Should the foregoing remedies not afford some relief in a few days, at most, a skilful physician ought to be consulted by all means. OPTIIALMIA, OR INFLAMMATION OF THE EYE- There are several forms of inflammation of the eve, but I shall confine my remarks to the most ordinary form of the disease, viz : Catarrhal Opthalmia, or inflammation of the eye from the effects of cold. Symptoms.—The patient complains of a sensation, as though the eye had sand in it; a Aversion to any light shining upon the eye, and some pain is experienced in the eye. A thin, transparent matter Aoavs from the eye, in the first stages; but if the complaint be severe and protracted, the matter becomes thick and opaque. The eye becomes red VARIOLA, OR SMALLPOX. 113 and feels hot to the patient. Headache sometimes accom- panies the disease, but no fever exists. Cause.—As was intimated above, exposure to cold pro- duces this affection. I have sometimes known it to prevail epidemically as an influenza, throughout a neighborhood. It has prevailed once, in this manner, in my neighborhood ; and I recently passed through a settlement, in the southern part of North Carolina, in Avhich the people were sorely afflicted Avith this disease. Treatment.—An active dose of calomel and rhubarb must be giATen, in the onset of this complaint, so as freely to evac- uate the boAvels. After this, the boAvels must be kept loose with castor oil, or salts and cream of tartar. Salts and cream of tartar combined, in equal quantities, and given in doses of a tea-spoonful night and morning, I have found a very useful combination. An occasional sweat Avith Do- ver's poAvders, has a good effect. The eye may be occa- sionally washed, three times a day, in a Aveak solution of sugar of lead and Avhite vitriol. Fotjr or five grains of su- gar of lead, with one of Avhite vitriol, may be dissolved in one ounce of water. The diet must be light and cooling. If no amendment takes place, in a feAV days, apply to a skilful physician. VARIOLA, OR SMALL POX. There are tAAro forms of the small pox, viz : the distinct and confluent. Symptoms of the Distinct Variety.—The patient experi- ences general languor, slight chills, alternating with flash- es of heat, with pain in the head and back. Some soreness is felt about the throat, pain in the stomach, attended Avith nausea, and sometimes vomiting. The tongue is covered with a white fur, the skin hot and drv, the bowels consti- H 114 ArARIOLA, OR SMALLPOX. pafced, and the urine small in quantity and of a deep red color. In the first forty-eight hours, bleeding from the nose is apt to occur. The mind is apt to be dejected. ToAvards the third or fourth day, the tongue assumes a red color. About this period, an eruption begins to make its appear- ance ; first on the face, aftenvards on the breast and arms, and eventually, in the course of twenty-four hours from its first appearance, it covers the entire surface of the body.— Minute red spots first appear, but in two days small eleva- tions are to be seen, with inflamed edges, and by the third or fourth day from the appearance of the eruption, matter is formed. BetAveen the fifth and seventh day, suppuration commences. The fever, which generally abates Avhen the eruption is fully developed, hoav returns. The pustules noAV become distended with matter, the face sAvells, and the upper eyelid sometimes swells, so as to close the eye.— When the swelling of the face begins to. subside, Avhich is about the tenth day, the feet and hands, and eventually the Avhole body begins to swell. The saliva, about this period, is copious, and so viscid that it is very difficult to discharge it by spitting. The inside of the mouth and throat are swelled and red ; and the breath is very offen- sive. About the tAvelfth day, the pustules are complete—the matter being thick and opaque, and the pustule is of a more yelloAV color. Soon after the suppurative process is com- plete, the pustules begin to shrink and grow drier, until a scab is formed. In a short time the scab falls off, and in mild cases of this form of smallpox, no scar is left; but in more severe cases, the skin is left pitted or marked. Symptoms of the Con/Incut Variety.—The first symptoms of this form of smallpox, differ from those in the distinct; variety only, in being much more violent. The fever is apt to assume, the typhus form. The pa- VARIOLA, OR SMALLPOX. 110 tient is drowsy, and the arteries about the head and neck are seen to beat more violently than usual, and the red pimples Avhich appear first—as in the distinct variety of the disease—soon run into each other, so as to present an uni- form red surface. The Avater contained by the pustules. in this form of smallpox, is apt to be of a dark color, thin. and sometimes of a corroding nature. The above are the ordinary symptoms of the smallpox ; but great variations occur in different cases. Cause.—We are aAvare of no cause of smallpox, except a peculiar contagion, the true nature of Avhich is not knoAvn to the medical Avorld. It seems to haAre appeared, at times. epidemically, caused by certain atmospheric constitutions. of Avhich Ave are also ignorant. All the learned,specula- tions of the scientific world, on the subject of that peculiar contagion, productive of smallpox, and that state of the atmosphere, predisposing to the disease, are at best h\ - pothetical, and do not serve to dispel that darkness which envelopes the mind of the reader. Treatment.—Much depends on prophylactic treatment in smallpox. A person Avho has been liable to the disease should commence, forthwith, restricting himself to light di- et. Mush and milk, or rice and milk, light Avheat-bread, &c, should constitute the principal part of his diet. All heating articles of food, and stimulating drinks, ought to be carefully avoided. By pursuing this course, the attack is apt to be mild. As soon as the fever comes on, give a small dose of cal- omel and rhubarb, and immediately call a skilful physi- cian Avithout delay ; or, if one be convenient, attempt noth- ing until he be consulted, as this is a highly dangerous af- fection, and should not be entrusted to those who are but little informed. 116 RUBEOLA, OR MEASLES. RUBEOLA, OR MEASLES. Symptoms.—The time that intervenes betAveen the op- portunity of contracting this disease, and the developement of the same, varies from a ftuv days, to tAvo or three Aveeks. It begins with a redness of the eyes, sneezing, a dry cough, and a discbarge from the nose, creeping chills and r'nshes of heat. The breathing is laborious and throat soie. Vomiting often occurs about the third day. The pulse is frequent, and the skin hot and dry. BetAveen the'third and fifth days, an eruption appears in sirmll red spots, first on the face, neck and breast, and e- ventually on every part of the system. In about three or four days from its first appearance, it begins to disappear. first on the face and then 0ATer the entire system. Causes.—This is strictly a contagious disease, and gen- erally occurs but once in the same individual; though in- y'ances have been knoAvn of its having attacked the same- person twice. Treatment.—in mild attacks of measles. Aery little is re- quired but to avoid exposure to cold and Avet, and regulate the boAArels with castor oil. In aggravated cases, more treatment is required. The treatment, hoAAever, must va- ry to suit the symptoms. When the fever is high, bleed- ing Avill sometimes be of benefit; but, generally speaking. bleeding can be very Avell dispensed with. In cases attended with high fever, my usual plan is to give, in the first stage, an active dose of calomel and rhu- barb, so as to operate Avell on the boAvels. After the ef- fect of the calomel, the skin must be kept moist, by giving- sweet spirits of nitre and antimonial AA'ine, in equal quan- tities, in tea-spoonful doses every hour or two. Mucilagi- nous drinks, such as flax-seed tea or an infusion of slip- pery elm bark, should be freely used. When the fever i* SCARLATINA, OR SCARLET FEVER. 117 high, cold Avater may be used Avhen required by the patient. I'nder the above treatment the eruption is apt to appear in due time, and danger is generally avoided. When the patient is languid, and the pulse feeble, a con- trary course to the above must be pursued. Nothing should be done to reduce the system, but stimulating remedies re- sorted to. I usually give four or five grains of Dover's poAv- der, every three or four hours, assisted Avith the use of Avarm teas, so as to act gently upon the skin. In some cases it U necessary to apply sinapisms to the ancles and, to rub the skin, especially the extremities, with hot brandy. When the eruption disappears suddenly, and the system is low, a tea-spoonful of spirits of camphor may be given ever}- hour, until the pulse is raised and the eruption re-appears. When dangerous symptoms take place, indicating inflammation of any part, a physician should be called by all means.— The diet ought to be light. Exposure to cold and Avrt should be carefully avoided, for several weeks after conva- lescence from measles. The most dangerous cases Avhich have come under my notice, Avere produced by neglect in this particular. SCARLATINA, OR SCARLET FEVER. Symptoms.—This disease, agreeably to the most of medi- cal Avriters, appears in three distinct forms, viz : the sim- ple, the anginose, and the malignant varieties ; and I am satisfied that there exists a fourth variety, differing from the above three. The simple form commences, as other fevers, Avith pain in the head and back, slight chills, flushes of hear, &c. In two days from the attack, an eruption appears, fir>t on the face,then on 6ther parts, until it covers the Avhole bo- dy. The throat becomes sore and swollen, the tongue fur- 118 SCARLATINA, OR SCARLET FEVER. red, the skin hot and dry, and the pulse full and frequent. About the fifth day the eruption begins to disappear, and by the seventh is generally gone. The anginose form is ac- companied Avith much more violent fever, headache, nausea and vomiting. There is much stiffness in the neck and jaAV.s. The voice is hoarse, the breathing laborious and SAvalloAV- ing very difficult. The febrile symptoms soon arise to a great height, the pulse being full and frequent; but not so full as in the simple form. The eruption makes its ap- pearance about the third day from the commencement of the attack, in irregular patches over the surface of the body. In extremely violent cases, ulcers form about the throat, which sometimes becomes affected, and the disease proves fatal in a very few days. The malignant form commences in a similar manner to the other varieties, but soon assumes a more violent grade. The eruption appears from the second to the third day—is at first pale, but soon becomes of a livid hue. It sometimes disappears in a day or two, and then conies out again.— The pulse, at first active, soon groAvs feeble. The patient is very apt to become delirious in the early stage, and often continues so throughout the Avhole course of the disease.— The tongue is covered Avith a dark brown fur, and the breath very offensive. The disease proves fatal by the ef- fects on the brain, as in the anginose form of the complaint: but generally, ulcers form in the fauces, the tongue becomo black, the pulse frequent and feeble, and the patient sinks. In the fourth variety of the disease, no eruption is to be *een at any time, and the other symptoms are similar to those mentioned under the head of the anginose yarietv. This form of scarlet fever has prevailed to as great an ex- tent as any other, in our immediate section of country for two Avinters past, Treatment.—The treatment varies in scarlet fever, accord- SCARLATINA, OR SCARLET FEVER. 119 ing to the form of the complaint. In the simple variety, confinement in a Avarm room, Avith mild and cooling regi- men, is sufficient to effect a cure. In the anginose form, an emetic givTen in the Commence- ment, is said to have an excellent effect. I have not, how- over, resorted to emetics in this affection. In the commencement of the attack, I usually give a dose of calomel, proportionate to the age of the patient, and the violence of the disease ; adding thereto from four to ten grains of Dover's powder. After the operation of a dose of this kind, I generally reg- ulate the boAvels Avith castor oil, or in severe cases, by giv- ing small doses of calomel and DoAer's poAvder, and repeat- ing as occasion may require. When the heat is intense, and the skin dry}> sponging the body with cold water is bene- ficial. Mucilaginous drinks ought to be freely used through- out the whole course of the disease. With regard to the various gargles recommended in scarlet fever, I have de- pended very little upon them. Blistering the throat I have found to be of the greatest benefit. My plan has been not to delay the application of a blister plaster across the throat, so as to extend from one ear to the other. If the swelling be severe, and the diffi- culty of breathing great, it should be clone forthwith. I am aware that medical men, generally, oppose blistering Avhen the system is in a high degree of excitement; but when de- lay Avould be dangerous, I often blister Avhen the fever is high. Although I have succeeded, in a practice of several years, Avithout the loss of one patient from scarlet fever, and have been in the habit of using emetics, I will here remark, that I have been informed that Dr. Watson, of Greensboro', a feAV miles beloAV this, uses emetics almost universally, and succeeds Avell ; and 1 luive a brother in Rockford, N. C, who has pursued a similar course Avith entire success. 120 SCARLATINA, OR SCARLET FEVER. In the malignant form of the disease, some advise prompt bleeding Avhen the excitement is high. I do not doubt the propriety of this, in some cases ; though it has not been my practice. I have treated this form of the dis- ease much as the anginose variety, in a general point of vieAV. In the sinking stage, it is sometimes necessary to give stimulants and tonics- Wine, camphor, and quinine, have been used Avith success. Blistering the throat has been objected to in this variety, in consequence of the dan- ger of gangrene. 1 have, hoAvever, uniformly resorted to blistering Avith the happiest effects. When I discover any symptoms of gan- grene, I apply a red-oak bark poultice, over the blistered mu face. In this form of scarlet fever, as well as in the an- ginose variety, the brain often becomes violently affected, and inflammation sometimes takes place. Blisters to the temples and the back of the neck, are necessary in such cases. I have also met with a feAAr cases, in which it Avas necessary to blister the stomach, as it became quite painfnl to the touch immediately over it. The diet should also be of a light kind. After recovery from scarlet fever, the utmost caution is necessary in avoiding exposure to cold and AATet. Strong food and hearty meals, should not be indulged in, as such things are apt to produce dropsy. In the anginose and ma- lignant forms, a physician should ahvays be called, if prac- ticable. ERYSIPELAS, OR ST. ANTHONY'S FIRE. 121 ERYSIPELAS, OR ST. ANTHONY'S FIRE. Symptoms.—This disease commences with a burning heat, redness of the skin, and SAvelling of some part of the body. The patient has head-ache, loss of appetite, and sickness of the somach. The inflammation attack* various parts of the body, sometimes affecting one side of the face and head, and sometimes one limb. The part is very greatly swelled and uneaven; and a sting- ing pain is experienced. After the inflammation -has con- tinued three days, small blisters appear on the surface. filled with a yelloAV fluid. In a day or tAvo, these veh- icles break, and discharge the contents, and crusts or scabs form on the surface. When the disease Avears off spontaneously, Avhich it often does about the sixth day. the redness gradually disappears; the' SAvelling subsides; the fever groAvs lighter ; N and in a short time the patient recovers. Sometimes the disease, affects the entire sys- tem, and in some instances only one limb becomes -o violently affected, that the patient eventually loses it. and in some cases even his life. Treatment.—In the first stage, Avhen the inflammation is high, bleeding is necessary; but in the majority of casc^. this can be dispensed with very well. An active purga- tive is generally essential. In the commencement of the attack, giA-e an active close of calomel and rhubarb, and after the operation ef that ceases, regulate the boAvels with cream of tartar, and salts combined. A tea-spoonful of these two articles given in the morning, and another at bed time, generally answers the purpose. As a diaph- oretic, you can dissolve half an ounce of sal ammoniac. in half a pint of cold water, and take a table-spoonful ©nee in four hours. As an external application, dissolve forty grains of luna caustic in one pint of water, and wash 1-22 RIXGAVORM—HERPES ZOSTER, OR SHINGLES. the affected part tAvo or three times daily. Should it fail affecting relief in a few days, you had best call a phy- sician. HERPES CIRCINNATUS, OR RINGWTORM. This affection is so well known, that it needs no des- cription from me. It has been successfully treated with a solution of luna caustic, sulphate of zinc, or copper, used is a wash, and by ointments of various kinds ; but the application I prefer, is one part of elixir vitriol, to three parts water, and apply in small quantities three or four times a day. Conjointly with this, the patient should take every night at bed time, a tea-spoonful of cream of tartar, and flour of sulphur combined, and live upon the lightest diet. HERPES ZOSTER, OR SHINGLES. This is also known by people generally, but as some persons appear to be alarmed about it, thinking that if the eruption extends around the body, it will cause cer- tain death, I Avill remark that it has neA'er been known iu reach more than half Avay around the body, and can generally be cured Avith mild laxatives, (such as salts,) light diet, and the use of the solution of luna caustic, as re- commended for St. Anthony's lire. NETTLE RASH--VARICELLA, OR CHICKEN POX. 123 URTICARIA, OR NETTLE RASH. This is characterized by an eruption of the skin, white in the centre and red around the margins, itching, and a stinging smarting pain, &c. Treatment.—In general, mild laxatives, cooling drinks, and the Avarm bath, will be found sufficient to remove this disease. VARICELLA, OR CHICKEN POX. Symptoms.—The fever in this affection is very slight. About the second or third day from' the commencement of the febrile symptoms, an eruption appears in fine red pimples, first on the breast, then on the face, back, head., and at length over the entire system. The itching is gen- erally very troublesome. In a short time from the ap- pearance of this rash, vesicles are formed, which are first filled with a thin whitish fluid, which takes .place about the second day. By the third day, this fluid assumes a yelloAV color, and by the fourth, the vesicles begin to dry up ; and in three or four days, a dry brown crust is for- med. About the ninth or tenth day, the scales or scabs fall off. Cause.—This disease is strictly contagious; an indh'idu- al having it but once, as the measles, hooping-cough, &c. Children are, much moie liable to it than groAvn persons. Treatment.—Generally speaking, but little treatment i> required in chicken pox. A light diet, Avith.au occasion- al dose.of salts and cream of tartar combined, most usu- ally answers for the mitigation of the symptoms. When the patient has been billions previous to the attack, and remains so at the time of attack, the fever being very 124 PRURIGO, OR ITCH. high in consequence thereof, a dose of calomel (twenty grains for an adult) and ten grains of Dover's powder, may be given. PRURIGO, OR ITCH. There arc several varieties of itch ; but I shall only speak of the most ordinary form of the disease. Symptoms.—The itch is characterized principally by an eruption Avhich breaks out first on the hands and wrists, and spreads afterwards over the Avhole body. This c- ruption is' accompanied with a most intolerable itching. Pustules appear, filled sometimes with a thin fluid; at other times with'thick pus. If the disease be" neglected, the skin will often be covered with large blotches or scabs, and at other times with a dry scurf. Causes.—This is also a contagious or infectious dis- ease, being very easily contracted by sleeping Avith <-ui individual laboring under the complaint, and even sonic- times by merely shaking bands with such an one.— The disease will sometimes come on spontaneously from a want of cleanliness. Treatment.—There are various pious of treatment th.it have been adopted Avith success in the itch. An oint- ment made by mixing two ounces of dour of sulphur, and tAvo drachms of sal ammoniac, powdered Avith four ounces of lard, has cured the disease by rubbing a small quantitv over the surface of the bodv at bed time, three or four times in the course of a week. Mercurial ointment, rubbed on each wrist, at the bend of each elboAv, and beneath the joint of each knee, has also been used Avith prompt success. A very small quan- tity may be applied and Avell rubbed in every ni^ht at HERPES LABIALIS. 125 bed time, until the disease be subdued. The best and neatest preparation, hoAvever, for external use, is a solu- tion of corrosive sublimate and sal ammoniac. One drachm of corrosive sublimate, and three drachms of sal ammoni- ac, may be dissolved in one pint and a half of water.— The affected parts must be washed Avith this solution three times daily. During the use of any of the above exter- nal applications, a tea-spoonful of salts should be taken every night and morning; or Avhat would ansAver better, a tea-spoonful of cream of tartar and flour of sulphur combined, equally taken in like manner. Great care must be taken to avoid cold and Avet, Avhile using any of the above remedies; and light diet must be used. HERPES LABIALIS. This is an eruptive disease Avhich appears generally on the upper lip, of the nature of the disease common- ly called tetter. Symptoms.—Sometimes the eruption is preceded by pain and inflammation, tenderness, and swelling; and some- times it comes on suddenly without any premonitory symptoms. The lip is tender, hard and stiff; and ves- icles are formed, filled at first with transparent water; but by the third or fourth day it becomes opaque, and of a yellowish color. About the fifth day, brown scabs are formed, Avhich fall off in two or three days there- after. Cause.__This affection is generally caused by slight fever from cold; but it also appears in diseases of the. liver, spleen, and other diseases (especially when much fever has attended) during the subsidence of those com- plaints. 326 HERPES &C.—BLEEOING FROM THE NOSE. A ... Treatment.—Very v little treatment is required in this disease. Washing the part Avith a solution of sugar' of lead, twice a day, and applying immediately after each application, a plaster of Turner's cerate, Avill generally be sufficient to effect a cure in a feAV days. HERPES PREPUTALIS. Symptoms.—This affection begins 'with red spots on the prepuce, attended Avith heat and itching, which sometimes produces great alarm in the mind of the patient, from their great resemblance to chancre. Small vesicles soon appear, which become dry, forming a scab about the sixth day, the scab falling off about the ninth day, leaving the skin sound. Treatment.—Washing the affected parts Avith a solution of borax, is of much benefit in this complaint. The solu- tion should be applied three times a day, to the part cov- ered with vesicles, and if they do not appear to be healing in a few days, a weak solution of lunar caustic- must be used, instead of the sugar of lead. This can be made agree- ably to the directions given under the head of St. Anthony's. fire. A tea-spoonful of salts may be taken every other night, and light diet must be used. EPISTAXIS, OR BLEEDING FROM THE NOSE. Causes.—Whatever causes an unusual Aoav of blood to the head, such as stimulating drinks, long intense study, coughing, playing on Avind instruments, "heavy" lifting, hanging the head, &c, tend to produce this hemorrhage. Treatment.—When bleeding at the nose is accompanied BLEEDING FROM THE BLADDER. 127 Avith a full, active pulse, and congestion in the brain, it should by no means be arrested, but a physician consulted. When the person is weak and nervous, and the pulse Ioav, the bleeding had best be stopped. Apply cold water to the back part of the head and neck, and bathe the feet in warm Avater, and if this does not succeed soon, give.sugar of lead in molasses, in one grain doses evTery half hour, and upon failure of this plan, call in medical aid, as delay may prove fatal. ' r HEMATURIA—BLEEDING FROM THE BLADDER. Causes.—Bleeding from the bladder is often caused by gravel in the bladder or kidnies ; by cantharides, spirits of turpentine, &c. It is often produced by violent exercise, and many "other causes. Treatment.—In the treatment of this affection, attention must be particularly paid to the constitution of the patient. In plethoric patients, with a full, strong pulse, bleeding should Tre resorted to at an eaiiy period—the blood to be drawn from the arm. When gravel exists, and the patient is in great pain, he should have one fourth of a grain of opium, and one grain of sugar of lead every hour, until re- lief is afforded. Mucilaginous drinks, such as flax-seed tea, mucilage of slippery-elm bark, or gum arabic, should be freely used ev- ery day. I have used the infusion of uva ursi, in doses of two or three table-spoonfuls, three times a day, with ben- efit. During the whole course of the disease, I use a tea- spoonful of salts and cream of tartar combined, every night and morning. If these remedies fail, apply to a physician. 128 BLEEEING FROM THE STOMACH. HJEMATEMESIS, OR BLEEDING FROM THE STOM- ACH. Symptoms.—The first symptoms of approaching vomiting of blood, are a loss of appetite, acidity of the stomach, man- ifested by sour eructation; a disagreeable breath; tender- ness of the stomach ; nausea; palpitation of the heart;— ringing in the ears ; cold feet and legs ; a weak pulse: unusual paleness of the countenance; great anxiety, and a feeling of approaching fainting. At length vomiting takes place, the patient throwing up dark blood, sometimes in dots, at other times liquid. I have seen an instance in Avhich the blood vomited was as black as tar, and tolerably thick as to consistence. Causes.—Affections of the liver and spleen, often cause vomiting of blood. It often occurs in young females, from retention of the menses. It may be produced by acid sub- stances taken into the stomach, bloAvs on that part, and also by malignant fever. Treatment.—When the pulse is full and frequent, blood should be drawn, so as to make an impression on the pulse. The feet should be bathed in Avarm water, and a mustard seed poultice applied to the stomach. A mild injection should also be administered. In those cases attending young females, who labor under irregularity of the menses purgatives have been recommended. The diet must be- light. As this is a very dangerous affection, a physician ought always to be called, if practicable. HAEMOPTYSIS, OR BLEEDING FROM THE LUNGS, $LC. 129 HAEMOPTYSIS, OR BLEEDING FROM THE LUNGS, Symptoms,—The patient experiences a tightness across the breast, a dry cough, anxiety, a burning sensation, ac- companied with pain under the breast bone, cold extremi- ties, chills, alternating with flushing of the face, a frequent, corded pulse, and a disagreeable taste in the mouth. After some time, coughing comes on, the patient hawks, and throws up blood. These are the most ordinary symptoms of hemorrhage from the lungs; but varieties occur very often. Causes.—Diseased liver or spleen., cold, the excessive use of spirits, violent exertions, disease of the heart, drying up old ulcers, blows on the breast, singing too 4ong and loud, and costiveness are among the causes of this complaint. Treatment.*—If the pulse be full and frequent, blood must be drawn forthwith. Mustard seed must be ap- plied to the breast and ancles, and a tea-spoonful or more of common salt, should be given, and repeated in an hour, if the disease be not checked. This is also a highly dangerous disease, and a physician should be had ras speedily as possible, GONORRHOEA, OR CLAP, Symptoms,—At first an itching sensation is experienc ,e4 in the urethra- (o*r passage for the urine.) In a few hours a yellowish fluid is discharged.; the itching in- creases, and the patient cannot void urine without pain. After a day or two, the penis swells, and becomes quite tender to the touch; the discharge assumes a greenish appearance, and the patient is often troubled with erec^ 130 SYPHILIS, OR POX. tions of the penis, especially while abed. As the disease progresses, the urine is passed with considerable pain, and some difficulty* These are trie general symptoms of clap, Avhich admit, however, of many variations and accompanying symptoms. Causes.—This is an infectious disease, produced gen- erally by indulging the carnal propensity with an in-,, dividual affected with it, and comes on in from three to ten days after connexion. Treatment.—Gonorrhoea is usually quite easily man- aged. The patient should take at first a large dose of salts; or if there, be much fever and a billious habit. a^ dose of calomel and rhubarb ought to be taken.— Thirty drops of balsam copaiva, should then be taken. three times a day before eating, and a tea-spoonful of salts and cream of tartar combined, be taken night and morning. I often combine the balsam with sweet spir- its of nitre equally, and give a, tea-spoonfuj for a dose. There are other combinations to be found in the' list of compounds in this work, which , are very good. The patient must also use mucilaginous drinks; avoid ven- ereaL indulgence, and eat light diet, such as milk and bread, mush, rice, &c.; avoiding meat,, coffee, and every thing stimulating. If the above plan fail many days. call a physician by all means, SYPHILIS, OR POX, * This is also an infectious disease caused by Venereal indulgence with a person having it. Symptoms.—From a few days to as many; woek$N after venereal intercourse, small pimples appear on the gen- itals, accompanied withf itching. In a short time the pimple breaks, and degenerates into an ulcer, called w SYPHILIS, OR POX. 131 chancre. The bottom of this is covered with a viscid mu- cous. The edges become hard, and the centre is gen- erally depressed. Tumors soon form in the groin called buboes. WThen the system becomes affected, an eruption appears upon the throat and mouth somewhat'higher than the general surface, covered with thin hard scales, someAvhat white. These scales are very easily removed; and leave shining copper colored spots. The forehead, breast, arms and legs are also often affected Avith this eruption. Ulcers eventually form abput the tonsils,- and palate; the periosteum (or covering of the bones) and even the bones themselves become carious, and come away in pieces. The bones of the face are most liable to be destroyed. Treatment.—The , principle constitutional treatment in this affection, is mercury, given so as to keep up a gen- tle mercurial impression for some days; but as syphilis is a highly dangerous complaint, and, one dangerous to manage, I shall not lay down any general plan of treat- ment. Prescribing for' this disease, in domestic medical works, has led to disastrous consequences, by causing the uninformed to attempt the treatment. The fear of developing a person's situation, who is affected Avith ven- ereal, causes many an individual to delay sending for a physician, until the disease becomes incurable; and'it also often happens that such an one finding any plan laid down in a medical work intended for family use, attempts a cure himself, ahd only precipitates himself into the grave. The best prescription I can make in this affection, is to advise any individual who is so un- fortunate as to labor under it, to call on a skilful phy- sician without delay. 132 EXCESSIVE DISCHARGE OF URINE. DIABETES, OR EXCESSIVE DISCHARGE Ofr URINE. Symptoms.—The urine' flows in great abundance j is thin and pale; and has a sweet taste. The thirst is ex- treme; skin dry, and above; the natural temperature; ap- petite impaired; feet swelled, and the emaciation great. Causes.—Excessive Aoav of urine, is produced by exces- sive fatigue ; such as jumping, lifting heavy lifts, &c; the use of stimulating drinks, fevers, taking too frequently spirits of turpentine, tincture of cantharidies, and other causes. Treatment.—The bowels must be regulated with small doses of rhubarb. Four or five grains of Dover's powder may be taken once in four hours. Alum in scruple do- ses, three or four times >a day, has been used by some with good effect. Emetics have also been used with sup- posed benefit, but I have never tried any article of the kind. Carbonate of ammonia, in doses of from five to fifteen grains three times a day, has been successfully employed. All stimulating drinks ought to be carefully avoided. Light diet, such as rice, bread and milk, rye mush, &c, would be proper. Flannel should be worn next the skin. Daily exercise ought to be taken, but not so as to produce fatigue. Lying on a soft feather-bed is quite injurious; the patient ought to lie upon-,a hard bed, or mattrass. A good physician should always be consulted, if practicable, at an early day. ', i APOPLEXY. 133 APOPLEXY. Symptoms.—Apoplectic attacks "sometimes come on sud- denly ; but generally the patient isgiddy, has a pain in the head, ringing in tjie ears, interrupted Speech, dim- ness of sight, bad memory, occasional deafness,. flashes before the eyes, bleeding of the nose, disturbed sleep, &c. Sometimes the symptoms continue weeks, or even months, previous to an attack; and vat: other times, only a feAV hours. When the fit comes on, The patient sometimes falls suddenly down? and appears tbyhe hra deep sleep, from Avhich he cannot be "aroused: at other times he is seized Avith violent pain in the head", trembling of the arms and legs, sickness of the stomach, and giddiness. He soon loses his senses, and sinks in an apparent savooh, from avhich he soon recovers, gets up, Avalks and con- verses, but soon sinks as before. In the first mentioned case, the disease generally proves fatal in a feAV hours, and in the most of cases, it proves fatal under any form, at some time. Causes.—The causes of this disease are many. Persons having large heads, short necks, full chest, broad shoul- ders, short stature, red .and full faces; and those who are corpulent, are predisposed to-this-complaint. The most common age for the attacks to occur, is between ( forty and fifty. Whatever causes a flow of blood to the brain, such as full diet, drinking spirituous liquors, using much strong coffee, and intense study, predisposes to apoplexy. The exerting causes are many, as -heavy lifting, tight cravats, intemperance in eating and drinking, exposure to great heat in Avarm climates, violent lage, healing up old ulcers, &c. Treatment.—The first indication is, to lessen the de- termination of blood to the head. The head should be 134 PARALYSIS, OR PALSY. raised, and kept elevated, and blood drawn from the arm without regard to quantity, until a decided impres- sion is made upon the pulse. Dr. Cheyne remarks, that from six to eight pounds of blood have been sometimes taken before the disease began to yield. The blood should be drawn from a large orifice. Cupping should also be resorted to on the temples, and back of the neck. Cloths dipped in cold Water should be applied to the head, and mustard seed poultices to the feet. As soon as the patient can swallow, give twenty-five or thirty grains of calomel, Avith fifteen or twenty of jalap, and administer an injection of thirty or forty grains of aloes, in a pint of warm water every hour, until you produce free evacuations from the boAvels. In conclusion, I musl say that if practicable, medical aid should invariable be had on the first recurrence of the symptoms of apoplexy x PARALYSIS, OR PALSY. Symptoms.—This disease is knoAvn by a loss of motion or sensation, or both, in some part of the system.. Sometimes it affects all of one side;—sometimes only from the hips doAvn ; and sometimes only a small part of the system.__ In some cases the patient is attacked suddenly with the dis- ease ; but at others he has symptoms, previously, similar to those of apoplexy. Causes.—The causes of this complaint do not differ o-en- erally, from those pointed ont in apoplexy; the reader is therefore, referred to that article for an examination of the causes. Treatment,—The treatment to prevent a stroke of pal- sy, is similar to that recommended in apoplexy. Wheis EPILEPSY 135 a person discovers symptoms of approaching palsy, a seton in the back Of the neck would be of service. Light diet and gentle exercise should be resorted to, and all the exciting causes carefully avoided, such as stimulating drinks, heavy meals, &c. Purgatives are very useful in palsy. Calomel in twelve or fifteen grain doses, with twen- ty grains of.mUstard seed, and followed in three hours with a table-spoonful of castor oil, ansAvers well for this purpose. External stimulants should be used, and the volatile lini- ment, made of equal parts of ammonia and sweet oil, is an excellent article for external use. When the disease be- comes chronic, stimulating liniments, blisters, and sina? pisms should be applied to the parts affected, If convenj,- ent apply to a physician. EPILEPSY, Symptoms.—Preceding the attack, the following symp- toms occur: A peculiar feeling in the head, dimness of sight, sparks before the eyes, trembling of the limbs, loss of sleep, and interrupted speech. The patient, just before the fit, feels a sensation like" a stream of Cold air, commen- cing at the feet, and extending up to the head, as the fit comes on. If the patient be standing, he immediately falls doAvn, and is violently convulsed. The whole frame is agitated—the eyes roll about, and the tongue often pro- trudes betAveen the teeth, and is often bitten. The pulse is irregular and frequent, breathing difficult, and the patient eventually falls into a deep sleep, which sometimes lasts three or four hours, and Avhen he awakes feels languid and stupid. Causes,—Epilepsy is sometimes hereditary, as we read 136 CHOREA, OR St. VtTtrs' DANCE. of many in the same family having been affficted with -it. The exciting causes are numerous, as injuries of theskull, causing portions of bone to press upon the brain; various affections of the' brain ;: sudden emotions of the mind, as fear, grief, terror and anger. Worms often occasion • epi- lepsy "'in children. Excessive venefy sometimes brings, on this complaint; and intemperance is a fruitful source of it also. Treatment.—The causes being many, the treatment i> variable; in general, however, bleeding is the first step to be taken, particularly in strong;, plethoric persons. Active purgatives, such as calomel and jalap, are all necessary in this disease. Issues or setons over the spine, should be resorted to immediately. On the approach of a fit, cold Avater should be applied to the head, and the feet bathed in AVater, or mustard poultices applied to them. I would here impress upon the minds of my readers, the importance of procuring the best medical aid possible, in any case of ep- ilepsy, and depend solely upon the physician called. Ep- ileptic fits are the most prevalent of any fits in our coun- try, and there are many remedies, eminating from ignorant persons, recommended for the cure of such fits, that are cal- culated to do injury, instead of -good.1 . . CHOREA, OR ST. VITUS' DANCE. Symptoms.—-This complaint approaches, generally, under the following symptoms: slight pains in the stomach or bow- els, variable appetite, costiveness, giddiness, palpitation of the heart, and cold feet. After these symptoms occur for some time, the muscles of some part of the body be«rin to twitch; and sometimes this twitching increases, until it affects the Avhole system. Sometimes only one side is Chorea, or st. vitus' dance. 137 affected, so that one arm, one leg, and all the muscles on one side are in action. Even the muscles on one side of the face are affected,, so that the eye is draAvn to one side, simultaneously with the motion of the limbs, Avhile the eye on the other side, remained..perfectly still. V Causes.—Chorea seldom affects persons over, twenty, or under se\Ten years of age; but I have had one case in a child eighteen months old. Dr. Eberle states that he has had a case in an infant nine months old. Many others arere corded; by'medical Avriters. Some AA-riters consider this disease often hereditary. To this opinion I subscribe. as I am aware thai there are several cases, at this lime, in one'family with Avhom.I am acquainted; and I am also informed that several of their relatives, who have been dead some time, had the disease many years previous to 'theirAdeath^ Among the exciting causes of St. Vitus' dance, are fear, terror, disappointed love, irritating substances in the intestinal canals, as', worms, faecal matter, suppressed menses, drying up of eruptions of the skin, unsatisfied venereal propensities, &c. Treatment.—-Every exertion should be made to re- move the exciting cause, and after the disease is remo- ved, to invigorate the system, so as to prevent a return. Purgatives are much resorted to for this purpose. Cal- omel and rhubarb should be given, in doses correspon- ding to the age, of the patient. When the disease pro- ceeds from worms, the usual remedies for worms, mu soft and elastic, and the skin covering it lose; but even- tually it becomes more firm; and though in the early period of the disease, no pain is experienced. When the swelling becomes great and indurated, occasional pain is felt in the enlarged gland. The tumor is apt to produce difficulty of breathing, and sometimes it grows internally, so as to cause difficulty in sAvalloAving, also, great anxiety, palpitation of the heart, &e. Causes.—Medical men differ very much about the cau- ses operating on the human system, thereby producing goitre. It seems to have prevailed in mountainous dis iricts in different sections of country, more than else- where. In the valleys of the Alps and Appenines, in SCROPHULA, OR KING'S EVIL. 155 the valley of the Rhone, in many parts of Asia, in Derbyshire, Surry, and Suffolk in England ; and in ma- ny parts of the United States, goitre prevails to a great extent. Some suppose that the disease is produced by the use of siioav water, others that lime-stone Avater is apt to produce it; but it has been knoAvn to prevail where neither lime-stone or snow is common. We read of the great prevalence of this affection among persons who use river Avater throughout the Avinter. Some med- ical writers contend that it is produced by certain arti- cles of food; some, that the state of the atmosphere cau- ses it; and others that some; peculiarity in the water used, is the cause. Each individual gives instances to prove the correctness of his opinion, so we are induced to belieA'e that their opinions are mostly founded upon conjecture. Treatment,—The principal article now used for the re- moval of goitrous tumors, is iodine. I have used this medicine Avith prompt success in bronchocele. My usual plan is to give ten drops of the tincture of iodine, twice daily, applying the same externally to the swelling, three times a day. A mucilage of gum arabic, must be free- ly used. A physician should be consulted. SCROPHULA, OR KING'S EVIL. Symptoms.—A predisposition to scrophula often exists, characterized by a languid expression of countenance, pale skin, light hair, blue eyes, large head, flat temples, pe- culiar liability to the effects of cold, indigestion, variable -appetite, sore eyes and ears, sIoav groAvth of the body, &c, &c. Sooner or later the glands about the neck savcII, and eventually suppurate and break, leaving sometimes di»- 156 SCROPHULA, OR KING'S EVIL. agreeable ulcers. In the advanced stage of the disease, scabs appear on different parts of the body, the ends of the long bones enlarge, and the patient is often affected with the disease called "white swelling." Causes.—That scrophula is a hereditary disease, I pre- sume no one pretends to doubt, but there are other causes tending to the development of this complaint. A hot climate is apt to produce a predisposition to this affection in children, though it is more apt to become developed afterwards in a cold variable atmosphere. Persons born and brought up in North Carolina, who have removed to the cold damp atmosphere of Indiana, have become much more affected in proportion than those who have remained in this State. The impure air of populous cities, is said to give rise to scrophula. Other diseases, such as whooping-cough, scarlet fever and measles, are- apt to produce it. Treatment.—All the exciting causes must be carefully avoided. An individual predisposed to scrophula, should live in a mild, dry atmosphere, and use wholesome nour- ishing food, in as small qauntities as conA'enient. All stim- ulating drinks must be avoided. Little flesh of any kind must be used, the person using bread and milk, soup, bar- ley, rice, &c. Flannel should be worn next to the skin, both in summer and winter. Moderate execise in the open air ought to be indulged, in mild Aveather. The aw alon°" the sea coast is the most proper for this affection. When the disease is fully developed so as to require medi- cal treatment, a physician ought by all means to be called, as the disease is difficult to manage, and no unskilful, per- son should attempt it. SCORBUTUS, OR SCURVEY. 157 SCORBUTUS, OR SCURVEY. Symptoms.—Scurvey begins with lassitude, stiffness of the knees and feet, loAvness of spirits, and an aATersion to exercise. The countenance is pale, the skin is dry, and separates in scales on parts of the body. Dark livid spots at length appear at first on the legs and thighs, and af- terwards on the arms and body. The taste is very dis- agreeable, the pulse Aveak and soft; the gums separate from the teeth, which sometimes become loose and drop out. Causes.—The constant use of unAvholesome food, espe- cially salt animal food, damp air, anxiety of mind, a sed- entary occupation, and the use of ardent spirits, are among the causes of this disagreeable affection. Treatment.—If the patient be situated in a damp or im- pure atmosphere, he should remove to a healthy dry situa- tion. He should avoid the use of salt flesh, and con- fine himself to a milk and vegetable diet. He should use acidulated drinks freely, such as good vinegar or lemon acid, put into water, so as to make it agreeably sour. Horse radish, onions, lettuce, carrots, cabbage, mustard, arid many other vegetables, would be found useful. Milk and bread especially ; buttermilk may be used freely. With regard to medicine, very little is required. Eight ounces of nitre dissolved in three pints of vinegar, and given in doses of two table spoonfuls three times a day, is a very good remedy. After the disease is subdued in a great measure, fifteen drops of elixir vitriol in half a tea cupful of water, should be taken three times a day, until the health is restored. 158 FURUNCULUS, OR BOIL--TUMORS, OR WEN3. FURUNCULUS, OR BOIL. These inflamatory swellings are so well known as to need no description here. While the tumor is forming, or at least in the first stage of its formation, it may sometimes be dispersed by applying a solution of sugar of lead freely to it. When it comes to a suppuration, it should be poul- ticed with a flax seed poultice. When it becomes so as to be opened, a free incision should be made into it. When the boil is large, the incision should be made in a crucial manner, that is, one incision made, and anotheT im- mediately across it. The incision should be made deep, so as to suffer the matter to Aoav freely, and the poulticing continued as long as the matter Aoavs. TUMCRS, OR WENS. Of these I will remark, that there are some wens, as they are commonly called, that can be dispersed by mere fric- tion ; hence the superstitious belief among some people that they can be charmed off, &c. Sometimes a wen will go away spontaneously. I would advise any one having a tumor of any kind, to consult a physician immediately,' as there are some kinds that may be aggravated by resort- ing to external application. I have sometimes succeeded in dispersing them by the application of a strong solution of sal ammoniac, three or four times a day. I have taken off several with he knife with entire suc- cess, and in the most of cases, this is the only certain plan. If it be nescessary to use the knife, it should be done with- out delay. WOUNDS. 159 WOUNDS. When an individual receives a Avound from a cutting instrument, without dividing a large blood vessel, it is sometimes necessary to apply sutures to such a wound in consequence of the extent of it, or in common lan- guage, "to seAV it up," and the sooner it is done, the better. I say it is sometimes necessary to apply a suture When a large blood vessel is not divived, because, when such accident happens, as the division of a large artery especially, a physician should be called without delay. When there is no great, danger from bleeding, and the wound is two or more inches in length, any one can apply the suture, if no physician be convenient. Com- mon .flax-thread doubled, ansAvers a good purpose for su- tures. It should be put into a common needle, when no surgeon's needle can be had, and carried through both edges of the wound one inch from one extremity, the lips of the wound brought into contact,, and the su- ture tied and cut off. The sutures should thus be ap- plied one inch distant from each other, the extent of the wound. A portion of lint should then be applied along the wound, and Turner's cerate spread thin upon a cloth placed over it, and the wound bound up. This dressing should remain in the winter five days, and in the summer three days. It should then be removed, the wound washed with a weak solution of shaving soap, and a similar dressing re-applied twice a day, until the wound heals. When the edges of the wound are once united, the sutures may be cut asunder, and removed. Should the wound appear slow in healing, wetting the lint after it is applied, with tincture of myrrh, will be advantageous; and when high inflammation exists, ap- plication of the solution of sugar of lead in like man- 160 BURNS—HERNIA, OR RUPTURE. ner, would be useful. The diet of the patient during the above treatment must be light, avoiding the use of meats, coffee,, tea, and all stimulating drinks. In smaller wounds, where the sUtureis'not required, as a matter of course, the above treatment without the suture, would be proper. Other ointments are used, as the basilicon oint- ment, &c, &c. BURNS. '.'Various applications are recommended iii burns. A mixture of lime water and SAveet oil, is said to be good. SAveet "oil alone I 'have used Avith prompt success.. I have also used spirits of turpentine with good effect.— Plunging the burned part immediately into cold water, has a powerful effect. In extensive burns, carded cotton covered Avith SAveet oil, and applied over the entire sur- face, is a very good plan. HERNIA, OR RUPTURE. This is an affection characterized by some portion of an intestine protruding through an unnatural opening, and forming a tumor under the skin. It sometimes occurs at the navel, sometimes in one groin, and sometimes in •the scrotum of men and other places. It is caused by jumping, lifting heavy Weights, wrestling, and many oth- er things -requiring violent exertions. Treatment.—When a person meets with an accident of this kind, an attempt should immediately be made to re- duce the intestine in a gentle manner. The part at PROLAPSUS ANI. 161 which the rupture is made, must be raised higher than any other part of the abdomen, and an attempt made Avith the fingers gently, to replace the intestine. If the reduction cannot be made conveniently, dissolve saltpetre, or sal ammoniac, in cold water, and apply cloths frequent- dipped into the solution, to the place for half an hour, and then make the attempt at reduction again ; and if you fail in this, call in a physician, as delay may prove fatal. After the intestine is reduced, it can be kept to its proper place by Avearing a truss, which you can ob- tain by application to a physician. PROLAPSUS ANI. This is a protrusion of the rectum or large intestine, during evacuations from the boAvels. After this has oc- curred often in relaxed persons, the least exertion of the abdominal muscles, will cause the intestine to come down. When the rectum comes down, it should be carefully returned, and supported by a compress and a T. ban- dage. This can be made by taking a strip of cloth two inches Avide, and of sufficient length to go around the body above the hips, and another piece of the same width, and sufficiently long to reach from the former when round the body, down between the legs and up to the former bandage. This latter piece should be fas- tened to the former in the middle of the same, and the former fastened around the body. Now, a compress should be made, by folding a soft cloth two or three times. This should be wet with a solution of sugar of, lead, and placed upon the anus after the rectum is re-. placed, after Avhich, the tale of the bandage should be placed' over the compress, drawn through between the 162 DISLOCATION OF THE SHOULDER. legs, and fastened to the band around the body. The compress should be wet two or three times a day. A tea-spoonful of cream of tartar, and flour of sulphur com- bined, should be taken night and morning. The diet should be light. DISLOCATION OF THE SHOULDER. A dislocation^ of the humerus or upper bone of the arm happens'generally dowmvards. In order to reduce it, one person should hold the body, a second take the arm, and a third take hold ofi^be upper part of the arm near the end of the bone that lsxrrsplaced. While the two former pull with considerable force in opposite directions, the patient standing or sitting upright, and the arm in a horizontal position ; the third person should raise the head of the bone and replace it properly. Another meth- od is, for the patient and tAvo individuals to be placed in the above manner, and a third to place a ball of yarn three inches in diameter, in the armpit, holding that firmly, while the person holding the hand, pulls forcible, until he has extended the arm sufficiently, then with a sudden jerk doAvmvards, the head of the humerus can be throAvn into the socket. The attempt should be made to reduce the bone immediately, as the least delay will render it more difficult. I once had my right shoulder dislocated, and reduced it instantly by placing my left fist in the armpit, and bringing my right hand suddenly down to my side* DISLOCATION OF THE ELBOW—THIGH, &C 163 DISLOCATION OF THE ELBOW. The bones of the forearm may be dislocated in any direc- tion. Its reduction requires three persons as the shoulder. One must grasp the arm about the elboAV, a second below, both pull in contrary directions while the third replaces the bones. The arm should afterwards be supported in a sling for ten or twelve days. DISLOCATION OF THE THIGH. When the head of the thigh bone is pushed inward, the patient must be placed upon his back, and Avhile two persons extend the limb, a third should force the bone into the proper place. If the bone is pushed outward, the patient should be placed upon his face. Other dislocations are reduced in a similar manner, but I will here remark, that if a physician be convenient, he had best be called without delay. MORTIFICATION. Symptoms.—Mortification from inflammation takes place as follows: the pain and inflammation subsides, the part becomes soft, and of a dark color, loses in a degree its natural Avarmth, and visicles appear on the skin of the affected part, filled with a yello\v fluid. This is the first stage of mortification, called gangrene, which often ad- vances rapidly to complete mortification, the part be- coming cold, black, anJ senseless. Causes.—There are many causes of mortification, but inflammation is by far the most frequent cause. It some- Ih-i MORTIFICATION. tmes arises Avithout inflammation by an obstruction in the circulation of the blood, by tight bandages,, severe con- tusion of a limb, &c. Treatment.—When Ave first discover that a part is dis- posed to mortify, if inflammation exists, Ave should use antiphlogistic means, such as blood-letting, agreeably to the violence of the symptoms, purging, cooling sAveats, &.',-. ; but Avhen the inflammation abates, and the patient begins to grow Aveak, an opposite course should be pur- sued. The diet should be nourishing, and stimulants and tonics administered. Wine in quantities proportionate to the strength of the patient, with a tea-spoonful of per- uvian bark, from two to five times a day, ansAvers Avel! in such cases. Iri order to procure rest of nights, ten or fifteen grains of Dover's poAvder should be given each night at bed time. The affected part should be wash- ed (if a Avound) with a decoction of red oak and poAA'- dered charcoal, sprinkled OA'er the surface. I have suc- ceed in restoring gangrenous flesh to perfect health in a few days,, by washing the part Avith a decoction of red oak bark, sprinkling the surface with powdered char- coal, and then applying a poultice made by thickening t\y decoction of oak bark with corn meal, addino- a small quantity of poAvdered myrrh, three times a day. Some contend that charcoal is of no benefit, except to ,-o»;ect the disagreeable smell. My OAvn experience has convinced me that this is not the case, but that it is one of the best external applications to Avhich Ave can resort. I once had a case, about which I became alarmed, fearing mortification would take place, and call- ed in an old physician. Notwithstanding all our efforts. the part became gangrenous. I proposed the external application of charcoal, to which he objected; and hav- ing given up the case to him entirely, I gave \A'ay.__ >'W (.{.fixation advanced rapidly, the patient was taken out -SPINAL IRRITATION. ]t>5 of our hands, and all the blame was thrown upon me as the "young quack;" and the physicians under Avhose care the patient Avas placed, applied charcoal, and ar- rested completely the mortification. Even at this day, the question is asked by low, envious., narrow-minded men, who Avish to destroy my usefulness, and trample me under foot, why I did not arrest that mortification, instead of asking Avhy it was not done by him, who had the entire control of the case. I attach no blame to the gentleman himself for the remarks about me, as I have ever found him to be a perfect gentleman, and liberal towards the younger members of the profession. SPINAL IRRITATION. Under this head, I shall endeavor to treat of diseases originating from irritation of the nerves, springing forth from the spinal cord or marrow. My attention has been particularly directed to diseases of this kind, having had several difficult cases to mange; and believing as I do, that medical men have not paid half that attention to spinal diseases that they should have done. It is often the case, that the extreme 'branches of a nerve are se- verely pained, when the nerve is diseased at, or near its origin; hence it is that physicians so often fail oi •success in such cases. Instead of making a thorough examination, to ascertain the true seat of the disease, they Avill depend on information derived from the pa- tient alone, and attempt to cure the disease without re- moving the cause. Any individual can have an idea of the effects pro- duced upon the extremity of a nerve, by an injury re- 166 CONSUMPTION, CASE THE SECOND. ceived elsewhere, from the pain felt in one side of the hand and fingers, upon receiving a blow upon the ulna nerve at the elbow. When you receive a blow upon this nerve, you experience instantly sharp pain in the fingers on that side. My own experience has convinced me that there are diseases arising from spinal irritation, resembling consumption, asthma, inflammation of the liver, and many other diseases. I have a work by Dr. John Marshall, of London, in Avhich he gives a history of several cases that come under his care, and as they are interesting, I Avill here give a feAV of them :— "CONSUMPTION, CASE THE SECOND. "Miss----was consulted for the first time to-day on this case, and received the following history of it from the young lady's mother. She had been very robust. and enjoyed excellent health till some less than a year ago, when, from no visible cause, she began to droopr and from that time, in spite of a variety of medical treat- ment which she has undergone, her health has become steadily AArorse. She is noAV for the most part, confined to bed, and the ordinary medical attendent of the fam- ily, announced it as his opinion that her complaint i> consumption, and that nothing more can be done, for her recovery. I found her extremely emaciated; the complexion of a peculiarly salloAV hue; lips bloodless ; eyes sunk, and yet staring; countenance expressive of great anxiety and suffering; complains of stitches in various parts of the chest, and of a fixed pain coverim: a considerable extent.in the centre of the sternum, reach- ing to the scrobiculis cordis, frequent hard hacking couo-h, Avhich greatly aggravates this pain and the stitches, and is occasionally accompanied with expectoration of mucu» slightly tinged with blood, great pain of the head, some- CONSUMPTION, CASE THE SECOND. 167 times most severe at the occiput, sometimes across the forehead, at other times diffused over the whole scull. Night perspirations are very severe; and debility so great. that when out of bed, she snatches at each successive chair for support, as she moves through the room. "The respiration is quick and hurried, greatly excited by motion; and the palpitation of the heart is then so violent, as almost to take aAvay breath, the shoulders are pulled up, and the chest holloAved; cannot make a deep inspiration; the voice peculiarly feeble; catamenia re- ported regular; bowels rather torpid; urine scanty, and peculiarly foeted; tongue flat, yellow, and slimy at the posterior portion; pulse 120, small, and very feeble; thirst considerable; appetite very poor and capricious. Such was the state of this patient at my first visit, and feAV will be inclined to deny that here Avere very strong symptoms of phthisis; yet finding, on the most careful examination, nothing Avhich I considered as a decisive proof of organic lesion of the lungs, I felt inclined to view it as one of long neglected nervous irritation, and therefore requested permission to examine the spine.— After considerable difficulty, this Avas granted. On draAV- ing my fingers gently down the column, no pain Avas experienced; but on increasing the pressure, and drawing my fingers doAvn on each side of the spinous process, no sooner did I reach the middle and lower portion of the dorsal vertebrae, than the patient Avinced, drew herself forAvard to escape from me, and complained of great in- crease of pain at the sternal aspect. On repeating pres- sure still more firmly, she gasped for breath; the pain in the breast covered a larger portion; and the cough Avas severely excited; at the same time a most disagree- able thrilling sensation darted doAvn the inner side of the thigiis to the very soles of the feet. The curvature 168 CONSUMPTION, CASE THE SECOND. in the dorsal portion of the spine Avas very evident, even without a plummet. " Satisfied that I discovered the source of all the pa- tient's ailments, I directed the attention of her mother to it, and endeavored to explain to her my views on the subject. The result Avas, that she requested me to take the case entirely under my oAvn management. I order- ed, notAvithstanding the extreme debility of the patient, that eighteen or twenty leeches should be applied over the pained vertebrae, gentle friction over all the other parts of the spine, and over the Avhole thorax, sedulous- ly attended to. The boAvels to be regulated by a sim- ple laxative pill and magnesia, the stomach to be trea- ted Avith tonics of quinine and iron; the diet to be gen- erous, but not heating; the recumbant posture to be preserved, unless the patient felt desirous of moving about —exercise never to be poshed to the length of fatigue. The leeches AArere applied at intervals of two and three days ; and before a AVeek had elapsed, the sternal pain seemed to give AVay, and as it Avere, to recede from its first situation. At each successive application of the leech- es, it seemed to retreat toAATards the spine, at the same time lessening in severity. If, trusting to these favora- ble appearances, leeches Avere omitted for a day or two longer than usual, the pain advanced again tOAvards the sternum, ahvays retreating on a renewal of vigorous ap- plications to the spine. The general health at the same time made a sensible advance, and all the urgent symp- toms declined in severity. I then applied strips of blis- ter plaster an inch broad, on each side of ihe spinous processes in the dorsal region, keeping them open as long as seemed prudent, then alloAving them to heal ; opened them again a little farther up or down the col- umn, occasionaly alternating them Avith leeches. The CONSUMPTION, CASE THE SECOND. 169 progress of the case under this mode of treatment, was by no means steadily onAvard. It seemed at times to stand still—at others, almost to recede, instead of ad- vancing. Nevertheless, Avhen I considered that hectic Avas subdued, the cough abated, and the flesh improv- ing, I Avould not alloAV myself to despair. As summer advanced, I sent her to the mildest and most inland situations that could be selected, for change of air; and, as in all cases of nervous irritation, this produced a most beneficial effect—she returned home in high spirits, great- ly increased 'in flesh—and every thing in her case, wear- ing a favorable appearance. "By the end of July, every symptom of phthisis hav- ing completely disappeared, she Avas sent to the island of Bute, Avhere she enjoyed sea-bathing for several Aveeks, rapidly progressing to a state of perfect health. On her return home, it Avould have been difficult to recognise in the blooming, plump, )'oung Avoman she appeared— the same emaciated, and to all appearance, dying per- son, I beheld at my first visit in February. " Our profession is an arduous one. It has beyond all others, its days and its nights of unmitigated toil, and intense anxiety ; but there is no denying that it ■ flso has its moments of heartfelt satisfaction, and be- nevolent enjoyment no other profession can boast ot.— This young lady has continued to enjoy uninterrupted health; is married, and I believe a mother." 170 CONSUMPTION, CASE THE THIRD. " CONSUMPTION, CASE THE THIRD. " Miss N., aged 17. This young lady had been in del- icate health from the thirteenth year, Avhen she had a sore throat, accompanied Avith enlargement of the submax- illary, and the parotid glands. This left her extremely emaciated, and Avith a constant tendency to catarrhal symptoms, such as a short dry caugh, pain of the chest, and slight feverishness, on the least exposure to cold. The greatest care to Avard off these attacks, had been taken by the ordinary family attendant, and by her mother, who Avas a very sensible and experienced person. Notwithstanding all their efforts, hoAvever, she was, Avhen first placed under my care, in April, 1832, labouring under many symptoms of incipient phthisis, rendered the more alarming by the circumstance that five or six of her pa- ternal aunts and uncles, had died of that malady. She complained of extreme languor and aversion to move; loss of appetite ; acidity of the stomach ; pain of the chest; cough ; breathlessness on taking the least exercise, par- ticularly on going up stairs; and severe night sweats. The voice Avas feeble and shrill; the shoulders drawn up, and the head poked forAA'ards ; the left shoulder loAver than the right, shown by the dress invariably hanging off that side. The boAvels Avere very torpid. The face Avas ex- tremely pale, but not salloAv; the lips colourless, and the ryes sunk, the pulpils greatly dilated, >hoAving4the peculiar amaurotic symptoms I have so often mentioned. I exam- ined the chest Avith the greatest attention, but found noth- ing to countenance the apprehension of phthisis. On ex- aming the spine I found the Avhole of the dorsal vertebra lender to the touch, firm pressure on them exciting a very marked increase of the sternal pain, and spasmodic gasp- ing, and continued palpitations of the heart, rapid respi- ASTHMA, CASE THE FIRST. 171 ration, sickness at stomach, and disposition to faint. Duly- considering the hereditary predisposition to phthisis in this case, my prognosis to the relations, Avas a very guarded one. The mode of treatment ordered was nearly similar to that in case the second, and I am most happy to say, it Avas in all respects equally successful. At the end of autumn, the young lady returned from sea-bathing, in ex- cellent health, though wearing a delicate aspect and com- plexion. By degrees those too disappeared, and I had the great satisfaction of seeing her recover flesh, strength, and robust health." "ASTHMA, CASE THE FIRST. "On the evening of 9th January 1829, I received a hur- ried call to A. H., the son of a respectable farmer, a stout lad, fourteen years of age, accustomed to constant out-of- door work. The message bore that he had been suddenly seized with croup. On my arrival, I found him sitting at the fireside quite composed, and Avas informed that tlyj at- tack had gone off as suddenly as it came on. •'The face, however, retained the appearance of a recent and a violent struggle, being swelled and bloated, Avith streaks of a livid hue. The eyes looked starting from their sockets, and the conjunctive Avas suffused, the respiration hurried, pulse quick. From these appearances, joined to the description given of the attack by those who Avitnessed it, I Avas convinced that it had not been one of croup, but of spasmodic asthma. On requesting him to strip, I found the chest Avell formed and developed, and percussion ex- cited no uneasiness whatever. On proceeding to examine the spine, my hand no sooner came in contact with the se- cond, third and fouth dorsal vertebra;, than it elicited a 172 DISEASED LIVER, CASE THE FIRST. gasp from, the patient, like that caused by a sudden plunge into cold Avater, and he complained that it seemed as if it would cause a second attack, of all his previous sufferings and breathlessness. I could not, hoAvever, repress my curi- osity to repeat the experiment, and did so several times, invariably Avith the same results. There Avas not the slightest displacement or t.Avist of any of the vertebrae, nor did the same pressure that caused the gasping, cause any pain to the parts. The Avhole column Avas apparently healthy. Satisfied that I had discoA'ered the source of the spasmodic attack, I ordered two dozen of leeches to be applied over and around the spot, Avhere the pressure occa- sioned the gasping. Those to be applied every feAV days, and if the attack of asthma did not cease to return, blis- ters to be applied, and kept up as an issue. The Iioav- els to be kept open by mild purgatives, combined with tonics of iron -and quinine. Under this treatment, the attack of asthma declined in violence and frequency; and in tAvo months, the boy Avas restored to perfect health,. He greAv very rapidly during this time and immediately after; has, as far as I knoAv, never experienced any recur- rence of asthma, and is remarkably hale and robust." "DISEASED LIVER, CASE THE FIRST. " J. R-—-, aged 29, a cook in a gentleman's family in Greenock, has hitherto enjoyed good health, con- sulted me in consequence of extreme debility, which ren- ders her unable to move about or take the least exercise. If she walks a little distance, or ascends a light stairs, the fatigue is so intense as to oblige her to sit down every two or three minutes; her heart palpitates violently, the breathing becomes rapid and oppressed, and faintness fre- quently supervenes. She complains of a short dry cough. DISEASED LIVER, CASE THE FIRST. 173 pain in the chest, from the sternum extending round the sides, loathing of food, and constant acidity of the stom- ach. Voice Aveak and husky, talking a feAV Avoids com- pletely exhausts it so, that she stops and breaths hard. Her appearance has in a few months altered from that of a stout athletic Avo-man, Avith a clean, blooming complexion. to the emaciated appearance of disease, the skin ex- ceeding jaundiced, the eyes languid, pupils dilated, bowels torpid, urine scanty, of a peculiar odour, depositing red sand on cooling, pulse quick and feeble. Catamenia reg- ular. Has felt her present ailments coming on for some months, but cannot state any particular cause for them. Consulted the family attendant of her master; he gave her some medicine, which she supposed Avas calomel, as he told her that the jaundiced appearance of her skin showed that her complaint Avas in her liver. Derived no benefit from the medicine. On examination, I found noth- ing to countenance the idea that the liver was the seat of disease, but I found lateral curvature of the spine, which threAv it nearly an inch and a half from the perpendicular line at the centre of this dorsal region; pressing down the sides till they approximated to the ilium on the right side, so as probably to occasion functional disturbance of the liv- er, and give rise to the jaundice of the skin. The pain on pressure, was not so great, as the magnitude of the curve would have led one to expect. Pressure doAvn each side of the spine, caused a deep sob, and very marked increase of uneasiness for the moment. I ordered treatment sim- ilar to most of the cases already detailed. That she might be attended without difficulty or interruption, she left her; situation, and Avent to her father's house, where I attended her three or four months. Her convalescence Avas tedi- ous, but very satisfactory ; and before I left port Glasgow in May, 1834, her health Avas quite restored." 174 DVSPEPSIA, CASE THE FIRST. "DYSPEPSIA, CASE THE FIRST. "----, a young lady, aged 12, tall of her age, and slen- der; dark eyes, hair and complexion; complains of con- stant acidity of stomach, disinclination to food, amount- ing to nausea; acid eructations, accompanied with py- rosis, and what comes up, is occasionaly so sour as to set the teeth on edge; constant languor, and aversion to exercise; frequent head-ache, and fits of the most unaccountable dejection, and irritability. The bowels are torpid, the tongue foul, breath peculiarly foeted of a morn- ing, pulse Ioav and irregular, flesh and color altered very much for the worse. One uncommon symptom, is a con- stant craving for acids, so that it required considerable attention to prevent the child from drinking up vinegar or sucking lemons, whenever she can by any means procure them. "Observing that this young lady's dress constantly hung off the left shoulder, I Avas induced to examine the state of the spine, and found it exhibiting a double curvature, the true italic /, Avith a very Avell marked gibbosity of the ribs on the right side, and great tenderness to touch in the cer- vical and dorsal vertebrae. I ordered that she should be confined to the recumbent posture, on a hard couch, with a small hair cushion strapped over the gibbous ribs, so as to produce gentle pressure Avhen she lay on that side. All school tasks to be given up, and the child's mind kept as easy and as much amused as possible. Very frequent and long continued frictions with stimulating liniments, exercise in the open air at stated intervals, to be increased as the strength revives ; and a certain portion of vinegar to be al- lowed with the child's dinner, the only meal she ever takes with a relish. Under this mode of treatment, the patient's st. vitus' dance, case the first. 175 recovery was satisfactory, and she is noAV a remarkably healthy and handsome woman. "Two things are remarkable in this case—the one is the apparently depraved desire for acids, which literally proved to have been "the voice of nature supplicating for relief," for, from the time she Avas allowed the free use of vinegar, the extreme gastric irritation was allayed—and the other is, that she subsequently confessed having received severe blows on the dorsal portion of the spine, in the act of swing- ing ; some so severe as to produce nausea at the moment.— I think there can be no doubt entertained that these blows were the original cause of the nervous irritation productive of the dispeptic symptoms. The catamenia was not estab- lished till her sixteenth year, and then without any consti- tutional disturbance." " ST. VITUS' DANCE, CASE THE FIRST. " C. H., aged 23, a fine formed, remarkably blooming girl, was placed under my care in November 1823, in con- sequence of inflammation and tumefaction of the left knee joint, which caused great pain to the parts, but little or no constitutional disturbance. Over the patella, a tumor form- ed, which I punctured, and it contained pure scrum. Wet spunge and a roller, as recommended by the late Mr. Allen, in his 'System of Surgery," were used Avith the happiest ef- fect. The fluid did not re-appear, and the joint remained free from disease, though for a considerable period, it felt weak and tender on any ununial exertion. She continued to enjoy good health till January 1825, when she complain ed of an indescribable, but most painful sensation in the head, cau?in-r gid \ r\m, dim i >ss of vision, loss of memory, a:id mv^bl ati;aliioi. W!i3i callel to her, I found the 176 " ST. VITUS' DANCE, CASE THE FIRST. eyes dull and languid ; the countenance most particularly vacant; the temper, formerly the most gay and cheerful in the Avorld, altered to sudden, reserved, melancholic. The motion listless and sIoav; the flesh and muscular power greatly reduced. The appetite Avas bad, the bowels torpid, pulse quick and small, heat of surface natural. Whenever the question was asked by those around her, Avhat caused so great mental depression, she replied in the most mourful voice, "the apprehension that the disease in the knee will return, and render me incapable of gaining a livelihood, who have no home." Ahvays when thus speaking, and sometimes even when silent, it was remarked that she often shook her head in a most extraordinary manner. It soon became evident that these motions of the head were invol- untary. "The attacks were sudden, and occurred on any mental excitement. The chin was jerked from one shoulder to the other, with rapidity. The violence was no less remarkable than the rapidity. During these paroxysms, she Avas quite unconscious of all surrounding sights or sounds. The med- ical treatment varied from time to time, as I found sucees- siAre remedies fail. In January, purgatives, and free appli- cations of leeches to the forehead and nape of the neck, the head sha\Ted, and cold applications kept to it. In Feb- ruary, the boAvels kept open by mild laxatives ; valerian Avith oxide of zir;c, in powerful doses, twice a day. On the 22d, the whole head Avas blistered. On the 27th, she Avas bled from the arm, and on the 28th, an issue Avas opened on the posterior fontanelle. I then tried her Avith opiates. On the 15th of March, I inserted a seaton in the neck, over the uppermost cervical vertebrae, and as much to my sur- prise as gratification, I found this remedy succeeded in ar- resting, and finally curing this disease. In the course of a feAV days, the involuntary motion of the head ceased, but as the strength and flesh was severely reduced, it required SPINAL IRRITATION, 177 great care and attention ere-the patient was restored to health. Frictions along the Avhole spine ; change of scene, and sea-bathing contributed most materially to this end, but she never recovered her robust v appearance, and fine com plexion. In 1832, this patient married, and pa?ssed through eight' months of her first pregnancy, -without any unusual occurrence; she then experienced a sudden attack of the in voluntary motion, of the head, which ceased in an hour, and she was delivered of a dead child. She met with a second accident of the kindj but by change of scene, sea-bathing, and frictions over the spine, she has this year had a living child:" The foregoing are some of the cases described by Dr. Marshal; His writing shoAvs that he devoted much atten- tion, to cases, of spinal irritation; and if the young self-im pqrant physicians of the present day, Avould spend less of their time in boasting of their vast acquirements, and of having listened to a few lectures in Philadelphia) and de- vote their leisure hours to "the study of the Human sy» tem, and the diseases to which it; is liable, there would be fewer incurable diseases; and they would show to the world what they had accomplished, instead of appearing before the;. public, with open blandishments, declaring Avith the vanity of a .-Paracelsus, what miracles they can per form. When I am called to' any case that assumes an unusual appearance, attended at'.the same, time with much nervous irritability', "I depend riot upon the description given mer of the various symptoms by the patient, but carefully examine the whole extent of the spinal column, or back-bone, by placing a finger on' each side of it, and pressing move or less firmly, agreeably to the tenderness tnat may' ex>st every half inch through the length there- of. I often find some particular spot externally tender to the touch, though at other times, especially in cases of }ong standing, the nervous affection seems to be diffused 178 SPINAL IRRITATION. throughout the system; and no one spot along the spine more sensitive than another. Even in some cases of the latter kind, I have successfully resorted to applications over the spine, together with tonics and antispasmodics. In affections of this kind, various plans Of treatment have to be pursued agreeably t6 the symptoms that may be developed. I place great confidence in external stimulat- ing applications over the spine. In mild cases, the use of the volatile lihiment, ariswers well; in more violent cases, I resort to blistering" Avith tartar emetic ointment, by rubbing it over the affected part three times daily, until pustules or blisters appear over the surface. ' In cases of a still more violent nature, I find the introduc- tion of a setori necessary. The jSetori introduced in the affected part, I find the most effectual as an external, ir- ritant. With regard'to the internal use of medicine, the same articles will^ not answer in every case. I have sometimes found it necessary to give an active dose ^ of calomel in the commencement of the disease, to remove the billious matter from the stomach, and to produce Some effect on the liver; though I am Opposed to much use of mercury in any form in a disease of this, kind, Salivation, oreven a persevering use of the blue pill, with- out producing the mercurial influence, T consider decid- edly perniciousi. In fact, 1 am convinced that I have seen three cases of spinal irritation, Avhich Avere produced by excessive Salivation. In all cases, costiveness must be obviated; but this should be done Avith the use of calo mel, if possible. If the patient cannot rest of nights, ten grains of tWer's poAvder may be given at bed-time, about eArcry third night—but this medicine or any other containing opium, ought not to be Used, Unless the pa tion cannot well do without it. I have found more benefit to result from the use of tonics and antispasmodics, than any other articles; and SPINAL IRRITATION. 179 the following combination has answered well in the most of cases that have come nnder my care. Take one ounce of sulphate of iron, one ounce, of gum asafcetida, one ounce of myrrh, and half an ounce of gum aloes —poAvder these ingredients,'and. put, them into one quart of spirits. In three days it Avill be fit for use. Of this a tea-spoonful must be taken three times a day by. an adult. In some cases, I combine equal quantities of sul- phuric ether, and tincture of castor, and give a tea- spoonful at ten o'clock in the morning, and one at three in the evening,'while using the above mixture of sul- phate of iron, &c. Cases attended Avith much spasmod- ic symptoms, I have found to require the use of ether and castor. Those cases accompanied with < symptoms of dyspepsy, should be restricted to such diet as prescribed under that head; but in the majority of cases, but little restriction in diet is necessary in -cases of spinal disease. Exercise must be moderate, and regular. The patient must retire to bed early, and rise early apd Avalk out, if he be able, and take morning air. Bathing the feet and « legs in warm salt Avater every night at bed-time, f have found useful. Exposure to Avet and cold, must be avoi- ded, and nothing done to ruffle, the mind. In October 1841, I Avas called to a lady betAveen-.thirty and forty years of age, aaIio had been gradually losing her health for some thirteen or fourteen years, and for.f. ten months previous to my having been called to sei- ner,'had been mostly confined to her bed., and under the care of two excellent physicians. They had suppos- ed her laboring under a disease of the liver a part of the time, and had accordingly given her' the ,blue pill, without, however, producing any mercurial influence.— Emetics had been freely administered, for what-intention I could never imagine. Blisters had been applied to the back of the neck (in order to remove an involuntary con- 180 SPINAL IRRITATION. traction of the muscles of that part, which diew the head forcibly back) without producing, however, any beneficial effect whatever. I found her confined to her bed most of the time—complained of dull pain in the right side* extending occasionally to the top of the shoulder, arid sometimes in the breast and neck. The muscles • of the back of the neclc~ were so violently contracted as to jerk her head backwards, and she had no poAver to bring it forward without the assistance of her hands. The mus. cles of the face were also affected, so that the eyelids were often suddenly closed, the upper lip drawn up, &c. The lower limbs and, one arm, Were somewhat paralyzed —the patient complaining of numbness of those parts.-r- The pulse was weak and quick, and the bowels con- stantly constipated. On, examining the spine, I found a slight curvature or crook between the shoulders. I found a spot a little below this- curvature very tender to the touch, and another in the small of the back. Finding her billious, I gave her,an active dose of cal- » omel and rhubarb, at the commencements. I introduced at different times three setons in the affected part on the back, and had the volatile liniment applied to the spine also, and to the breast. I gave the aloes, myrrh, asafcetida, and sulphate of iron,, as heretofore recommen- ded, only that I gave it in pills,, instead of tincture. She also took occasionally the tincture of castor, and that of asafcetida combined—and I varied the tonic plan occasionally, by giving quinine and elixir vitriol. I had the extreme satisfaction of seeing her in five months re- stored to perfect health. Soon after I discharged this case, I was called to a boy eight years old, who had; been treated some months for worms, by a respectable physician. When I arrived, I found him greatly ema- ciated—his lower extremities in constant motion, and whenever he walked, he was continually rubbing the SPINAL IRRITATION. 181 small of his back, with one of his hands. I saw not the first symptom of worms, but pronounced it at once a case of spinal disease. I adopted a similiar plan of treatment to that pursued in the first case, and in four or five months he Avas restored to a fine state of health, which has continued up to this time k> far as 1 am able to learn. It seems that the older physicians paid but little atten- tion to the spine, in searching for the seat of the many chronic nervous affections with which man is afflicted,— I am firmly of the opinion, that at least one half of the ,chronic nervous diseases of this country, originate in the spinal marrow; and that the reason why such cases so often defeat the attempts of the physician to cure them, i-»if that he treats them empirically, not sufficiently under- standing the nature of them, to treat them otherwise.-— I find but few physicians that appear to know anything about affections of the spine. Some of them have even sneered at my remarks on this subject, and consider me almost a monomaniac about it. I care not for the scoffs of such men. If I am in error, Avhy is it that I .in my ignorance succeed in cases that appear unmanageable in the hands of others? I do assert that I have just ground* for the opinion, that many of my suffering felloAv mor tals have been suffered to linger, for years, in pain arid distress, in consequence -of physicians not seeking and finding out the true nature and source of disease. I talk with some physicians, Avho seem to have reflected some little on diseases of the spine—others laugh at my opin- ions, and others in their profound ignorance and stupid- ity, stare at me like perfect fools, Avho knoAv not whe- ther the nerves have their origin in the brain and spinal marrow, or in the marrow of the shin bone. I Avas called to a case last Avinter, some miles from fapme, which had been under the care of some three or — 182 SPINAL IRRITATION. four physicians for four years. The lady, instead of hav- ing received any benefit from these professed medical men, had groAvn gradually worse, and \Vas now confin- ed to her bed. The day on Avhicli I visited her first, I happened to be in a croAvd previous to seeing her, and one Of her medical attendants Avas present. Passing through the croAvd, I heard this doctor ask one of the lady's friends, Iioav she Avas. The gentleman replied that he thought she Avas better, or at least she was more composed. The learned doctor, Avith a long face, and knowing look, draAvled out, "well, the mind is the main thing with her ; I think if her mind was satisfied,, she mout soon be up.yI When I arrived at her oVelling, I found her very feeble, and greatly emaciated—subject to spasms, affect- ing the extremities; frequent attacks of palpitation of the heart; difficulty of breathing, and many other dis- agreeable symptoms. J3y the use of the volatile lini- ment, and tartar emetic ointment along the spine, I suc- ceeded in allaying the extreme .irritation' that existed in that part of the system;' and a curvature which existed in the spinal column,, Avas entirely removed in,, a few weeks.- She took from twelve to fifteen grains of car^ bonate, Or rust of iron, three times a day, with' an oc- casional dose Of tincture of asafcetida, and. sulphuric eth- er. As-.she -was .somewhat dyspeptic, I restricted her to light diet—and a part of the time she took,, the pill for dyspepsia, mentioned in the list of compounds in this work. In the course of four or five months, she Avas mi good health and has so remained:, Here was a young lady treated empirically for four years, when the,slight- est examination of the spine Avould have convinced any ma.n of ordinary judgment, thab in that part Avas the seat of the affection. Instead of that, hei physicians had been pouring their medicines into her, without knowing SPINAL IRRITATION. 183 for what purpose they Avere giving any one article—at the same time crying out that there Avas hilt little the matter, except dejection of mind. It is truly astonish- ing that any gentleman well acquainted with the nervous system, will attempt to manage a nervous disease, for months, without endeavoring to ascertain the seat of the disease, acknoAvledging his ignorance of the true nature of the affection. Many an unfortunate being suffers for a number of years, from spinal irritation, and still more from j the mismanagement of his case by a physician at- tempting to cure him, and is at last doomed to spend his feAV remaining days unable to move about, and sinks into a premature grave. I Avas called to a gentleman in February 1843, Avho had beenv for seven years treated for a diseased liver, by a physician in whom he placed the most implicit confidence. I found him laboring under a disease of the spinal cord, Avith the most considerable curvature I ever beheld. His liver was sympathetically affected, and his limbs were affected as Avith the rheumatism. I learned that just before he Avas first taken, he received an in- jury by a fall backwards, in Avhich his back got a se- vere bloAv. On examination, I found a sensitive spot rive or six inches long, just beloAV the curvature. 1 introduced a seton in that part, and prescribed the sul- phate of iron, asafcetida, &c, as heretofore mentioned, and in four weeks, he was able to walk; two-miles to see a friend. His health improved rapidly for some five or -six Aveeks, when he happened to meet Avith his for- mer physician, Avho in his profound wisdom, told him that there-was no such disease as the one for Avhich I was treating him, and he accordingly abandoned the use of medicine. He is yet living, but is a miserable spectacle truly, and will never be cured, ^y 184 ANEURISM, &C. ANEURISM.—ENLARGEMENT OF A PART OF AN ARTERY. This affection is characterised by a tumor or swelling, produced by an enlargement of some part of an artery. Sometimes the tumor is of an oblong' form, the body of the artery being generally dilated for some distance; at other times the turilor is almost round, caused by one coat of the artery being ruptured, and the others distended. The tumor pulsates or throbs simultaneously with the action of the heart or beating of the pulse. The SAA-elliog is generally Unattended Avith any pain. When the sAvell- ing increases to much extent, the throbing can not be distinguished. Causes.—An aneurism seems to be, produced by the coat? of the artery at that particular point, being weaker than elseAvhere. This may be caused by a bruise, strain or a violent exterision of the artery in any way. It has been often produced iri unskilful bleeding in which the artery is wounded. Many persons Avho pretend to understand bleeding, bleed immediately over an artery, and by intro- ducing the lancet too deep, cause it to wound the arterVi This is often done by bleeding in the arm. Those Whose self-conceit prompts to undertake to bleed their neigh- bors, Avithout any knowledge of the human system or disease, and who are so stupidly ignorant as not to know their imperfection, ought ahvays to examine the part of the vein Avhich they intend to puncture, and should they feel the pulsation of the, artery beneath, they should omit bleeding in that part by all means, as it Avould be attended with much danger. The best advice however, I can ""ive these natural bleeding machines that infest our country, h for them to exchange their lancets for Webster's Spelling Book, and commence the study of it, so as to be capable of distinguishing between an artery and a muscle. Many FISTULA IN ANO. 185 an arm, yea many a life Avould be saved, did such men know themselves aright, and wOuld cease to tamper with the human system. Treatment.—The cure of a small round aneurism may be attempted by compression. A piece of lead made thin by hammering, and of sufficient size only to cover the tumor, applied to it, covered with a ''pledget and bandage, will sometimes prevent an increase of the swelling, and even ef- ffect a cure. Should this, hoAvever, fail, a surgical physi- cian should be called without delay. FISTULA IN ANO. With the anceint medical writers this disease was repre- sented as an opening near the anus suirounded by. a callous Or long edge; but subsequent experience has shown that there are openings often attended with no callosity what- ever, and therefore the term "abscess" is much more ap- propriate. Sympto7ns.—Abscess of the anus or near that part is often preceeded by pain, chills, fever, &c. A part near the anus Will become swelled and hardened, assuming in a short time a red appearance, and eventually matter is formed. The febrile excitement is often very great, and the pain severe ; the tumor being tender to the touch. When suppuration however takes place, the fever subsides, the pain ceases, and the patient becomes entirely easy. After an indefinite period, the tumor will burst and dis- charge matter or pus. When the opening extends from the external part contiguous to the anus, into the rectum or large intestine a few inches up, so that the pus is discharged both by the external opening in the skin, and the anus, the disease is termed the complete fistula ; but when it docs not 186 FISTULA IN ANO. affect the rectum, it is called incomplete. The above is a brief description of the common abscess occuring near the anus, but there are many variations in the symptoms, a full description of which, Avould exceed the limits of this work. Causes.—Vexsons who are very fleshy are liable to this affection ; costiveness Avill sometimes tend to produce it, by the passage of the hardened faxes or excrements producing irritation, and eventually inflammation. The disease also arises from piles, by one of the tumors becoming inflamed, and aftenvards suppurating. Treatment.—Any attempt to prevent suppuration in a SAvelling of the above kind would be fruitless. An emmol- lient poutice of some kind, such as that made of light wheat bread and SAveet milk, or of flaxseed, ought to be repeatedly applied to the part, until the skin is almost ready v to burst. If the pulse be full and frecpient, blood may be drawn from the arm until some impression be made upon the force of the pulse. An occasional dose of castor oil may also be given, agreeably to the strength of the patient. If difficulty of passing urine occur, the patient should take a tea-spoonful of spirits of nitre, occasionally, and use freely the-mucilage of gum arabic, or slippery elm bark^ When the intestine is not affected, a free opening made into the tumor, after it is in a situation for opening, will sometimes effect a perfect, cure. In performing this opera- tion, the lancet should be introduced sufficiently deep to r.ach the matter, and an orifice cut in the skin, so as to ex- tend as far either way as the matter beneath. After an opening is; made, any person'can easily ascertain whether the rectum be affected, by the introduction of a probe into the abscess, and at the same time that of one finger into the rectum. If the probe enter the rectum, or be distinctly felt by the finger, shewing that the intestine is hare at that part, a good physician should .be called Avithout delay. SCIRRHUS, OR CANCER. 187 When the skin on a swelling of this^ kind j&of a dark pur- ple color with but little sensibility, the pulse at the same time irregular and feeble, extreme debility of the general system, &c, there, is much danger, and a skillful physi- cian should be had if possible. SCIRRHUS, OR CANCER. The Avord scirrhus, is sometimes given by medical men, to cancer; and sometimes to that stage only which precedes ulceration. Symptoms.—A cancer, usually commences Avith.a small swelling or tumor, Avhich is at first hard and moveable, pro- ducing no change in the color of the skin. At length, the tumor, as it increases, becomes immoveable, by adhering more to the skin. Lancinating pains are now felt, occasion- ally darting through the tumor'with the speed of electricity. The veins about the tumor become varicose, and can easily be discovered through the skin. The tumor eATentually breaks out into an ulcer, discharging an offensive matter.— The disease has a tendency to spread, corroding or eating away the flesh as it progresses. Causes.—A cancer may be produced by a IiIoav on some particular ^gland. Tumors that are at first only scirrhus, have been aggravated by empirical remedies, until they have become cancers. Caustic or stimulating applications, have a tendency to produce this effect. Those vile impos- tors, called "cancer doctors," that are to be found in some sections of country> often convert the most indolent tumors into cancers. Luxurious living is said to predispose to can- cerous affections. Treatment.—When a tumor of the foregoing kind has be- come really cancerous, I consider there is no possibility of u 188 CHILBLAINS. cure in any other manner than by the use of a knife-^—and even that will prove ineffectual, if the system has become effected Avith the disease. Though Ave may succeed in re- moving the original cancer, and healing the wound, the disease is apt to seize upon some other gland in a short time. When a gland becomes obstructed by a blow or any- other cause, and becomes inflamed, the patient should be bled, if the pulse be strong and frequent, and take an occa- sional gentle purgative. He should also restrict himself to light diet. The injured gland must be poulticed AA'ith some emollient poultice. By such precautionary means, a cancer may be prevented, After the disease becomes cancerous, or even scirrhus, no attempt should be made to effect a cure, without the aid of a good physician. CHILBLAINS. This is an affection arising from cold, and generally af- fects the extremities. Symptoms.—The part affected becomes red and SAvelled, and is attended with an intolerable itching, especially when it becomes warm. Sometimes the swelling is considerable ; the skin assumes a bluish color, and the heat and itching are so violent, that the patient cannot use the affected limb. In very severe cases, small vesicles appear, which in a short time burst, and leave excoriations, Avhich sometimes degen- erate into ulcers extending down to the bone, and dis- charge a thin acrid matter. If neglected or mismanaged, the entire flesh, for some distance, is destroyed to the bone. Cause—Chilblains are generally produced by applying warmth suddenly to a part that has previously been expos- ■ed to great cold; hence those parts of the body that are lia- ble to sudden transitions from cold to heat, are usuallv af PARACUSI8, OR DEAFNESS* 189" fected. The toes, heels, fingers, nose, lips, and ears, are peculiarly liable to chilblains, by persons who are suffering with cold in those parts, rushing to the fire when they en- ter a house and warming too suddenly* Treatment.—In mild cases, rubbing the affected part with snow three or four times a day, or bathing as often in very coid water, will answer to remove the affection. After bathing or rubbing a few minutes, the-part should be wiped dry, and wrapped in flannel. Alcohol, strong vinegar, and a strong solution of alum, have been used in some instances^ as external applications, with good effect. When the pa- tient is averse to cold applications, the above stimulating applications may be used. One part of tincture of canthar- ides, with six of the soap liniment, has been successfully used externally. When suppuration and ulceration takes. place, lime water, warm vinegar, or the tincture of myrrh* may be frequently applied, and a soothing ointment should afterwards be used. Should the flesh become dead, and be- gin to slough, a good physician should by all means be calik- ed in, without delay.. PARACUSIS, OR DEAFNESS. Symptoms.—Deafness is generally preceded by a peculiar humming noise in the ear. Sometimes the patient fails to hear words that are spoken, or any other sound distinctly ; at other times, he imagines that he hears sounds, that in re- ality he does not hear. Causes.—Deafness may be produced'by loud noises, such as firing a cannon near the head. It may also be caused by violent colds, hard wax, a deficiency of the same, and paralysis of the auditory nerve. Other diseases, such as fe- ver, venereal, &c, may be productive of deafness. Some / 190 ECTROPIUM, OR TURNING OF THE EYELID. persons are deaf from birth, in consequence of some defect in the original formation of the ear. Treatment.—This of course depends much upon the ori- ginal cause. In cases produced by cold, especially Avhen there is a considerable discharge from the ear, I have suc- ceeded very Avell by syringing the ear three times a day, Avith shaving soap suds, and aftenvards putting a small lump Of cotton, Avet Avith SAveet oil into the ear. Sulphuric ether, dropped into the ear, has sometimes had the happiest effect in removing deafness. When deafness arises from insects creeping into the ear, warm water may be thrown into the ear, at the same time turning it doAvnAvards so that the Avater may again pass out. Any insect that may have entered the ear, will be apt to creep out as the water flows. Worms are sometimes gener ated in the ear, and can be destroyed by infusing tobacco in the oil of almonds, and aftenvards dropping a feAV drops in- to the ear occasionally, and introducing a bit of cotton af- terwards to retain it. If the above means should fail to afford relief, a physician should be called Avithout delay. ECTROPIUM, OR TURNING OF THE EYELID. Symptoms.—The eyelid in this singular disease is some times completely turned so that the lining is outside. From being thus exposed, the lining of the eyelid soon Bwells, and becomes inflamed. The tears Aoav continually over the cheek, and the eye is much affected with the light. Causes.—SAvelling of the lining of the eyelid causing ec tropium, is produced by a natural laxity of the membrane, increased by inflammation, &c. Persons affected with scrophula are liable to this affection. A physician should be consulted in such cases. ECCHYMOSIS. 191 ECCHYMOSIS. Symptoms.—This is a slight SAvelling, with a dark livid, or blue color of the skin, produced by extravasated blood beneath, and is generally called a blood blister. Though usually a trifling matter, it is sometimes necessary to resort to prompt treatment for a removal of such effects, Cause.—An ecchymosis is produced by bloAArs and bruises, the extravasation sometimes taking place soon after the accident, at others not until some hours have elapsed. Treatment.—The practice of opening a blister of this kind, is generally improper, as by the admission of air, that portion of the blood Avhich remains, soon putrefies, produc- ing inflammation and suppuration. The better plan, is, to take one or two doses of salts, agreeably to the extent of the injury ; and apply to the part affected some stimulating application, such as Avarm vinegar, the volatile liniment &c. When, however, an ec- chymosis is very extensive, causes much SAvelling, pain, and suppuration, a free incision ought to be made into the tumor, so that the blood may be discharged* I have some- times knoAvn the blood to be drawn from a tumor of this kind, and all the soreness remeved in a short time by intro ducing a lancet or knife half an inch from the edge of the extravasated blood, and pushing it just beneath the skin until it enters the collection of blood, the blood thus pass- ing out at the opening. Pressing the blood through a channel of this kind, is much better than to make the incision immediately into the affected part. 192 EXOSTOSIS, OR A GROWTH OF BONE. EXOSTOSIS, OR A GROWTH OF BONE. Symptoms.—This affection Avhich generally attacks the bones of the scull, the loAver jaw, breast-bone, and the bones of the arm and leg, is known by an enlargement of the bone or a tumor groAving out of the bone. Sometimes the entire bone is enlarged, at others, a circumscribed bony substance grows on one side of the bone only, resembling an affection among horses, generally knoAvn by the name of "splent." Sometimes the tumor is of solid bone, but often it is composed of spongy bone. Considerable pain often at- tends an exostosis while growing, especially those of quick growth. When the growth is extremely rapid, it is apt to affect the entire system, producing considerable fever, loss of appetite, &c. After the tumor ceases to expand, (as it sometimes does,) it is generally free from pain. Causes.—The causes of exostosis are not satisfactorily un- derstood among surgeons, even those of great eminence.— Some attribute it to internal causes, such as venereal, sc'ro fula, &c, while others contend that those diseases do not increase the liability to bony tumors. It is evident thai some persons are much more liable to this affection than others. A blow received by one individual will produce an exostosis, when a similar blow on another will cause noth mg of the kind. I knew a case produced by a blow receiv ed on the lower jaw from a fall in wrestling. Mr Aberna thy, a celebrated surgeon, speaks of having ^en a boy who was so afflicted with a predisposition to exostosis, that a ve ry tnflmg blow on almost any bone of the body, would pro duce a bony excrescence. Treatment.-When an exostosis is attended with much pain the application of camphor and laudanum combined would be ^^i K A ^^ rf ^ ^ , imle opmm » added, would also be good. The volatile FUNGUS HiEMATODES. 19$ liniment,, mercurial ointment, and ointment of iodine, are recommended. As internal remedies, iodine and mercury are the only remedies much to be depended upon. A good physician should be consulted as to the propriety of usinif those articles. When an exostosis has ceased to enlarge. is productive of no pain, and is not so large as to be ol great inconvenience, no attempt should be made to. remove- it by a surgical operation—but if it be painful, increasing in size, or occasion much deformity, it Avould be best to have it removed. A good surgeon, should be called upon to perforin the operation',. - FUNGUS HiEMATODES. This is one of the most ajarniing diseases to which a hu- man being is liable, and seldom admits of a cure in any other manner than by removal of the part affected, with the knife.. Symptoms.-—As the name implies, a tumor of this kind is a fungus excrescence, resembling blood, or a bleeding fun- gus. It sometimes arises from an ordinary wen, or tumor,. which, at first may have been simple ; but by exposure and ulceration, assumes a malignant form, throwing out fungus, or proud flesh, Avhich is liable to a disdiarge of blood, more or.less frequent and profuse. The term, hcematodes cannot be strictly applied to any tumor, unless a discharge of blood does take place from, such tumor. A fungus hsematodes, is of a dark color, resembling coagulated blood, the consist ence soft,, and of a sloughy appearance. On being injured,, it is apt to bleed at first but slightly,, and often becomes vc- rv profuse, and cannot be arrested. The vessels in the dis~ eased mass, seem to have lost their poAver to contract— hence the bleeding cannot be controled. The tumor will 194 HEMATOCELE, &C often groAV to an enormous size in a short lime, though generally, a bleeding fungus is not large. If the diseased part be removed superficially, it will again form with the utmost rapidity, and increased malignancy. Some Avriters apply the term fungus hamdtodcs to all tumors that become fungus, AVhile others even consider a tumor of almost any kind, that has not ulcerated itself, fun- gus hcematodes. I recently saAV a scrofulous enlargement of the knee^ that had ho appeaiance of ulceration, or of fun- gous flesh, that Avas pronounced by the medical attendant "fungus hcematodes." The disease generally attacks the eye, one of the limbs, the testicles, or the female breast-, though other parts have been knoAvn to be affected. Treatment.—No external applications can possibly be of any benefit to a tumor of the above kind ; neither will an entire removal of the morbid mass be calculated to do am good. The early removal of the affected member, is the only method of curing this shocking disease, aiid this often fails. An early application should be made to a skilful surgeon* HEMATOCELE—SWELLING OF TrlE SCROTUM. Symptoms.—The scrotum (or sack containing the testi- cles) becomes SAvelled from a collection of blood Avithin.—- Sometimes the spermatic cord only is affected with hemat- ocele, and sometimes the blood Avill be extravasated within the coat of one testicle, so that it Avill only be enlarged. Causes.—Hamiatocele is sometimes produced by an op- eration for hernia ; it will also occur after an operation for hydrocele. The disease has been known to occur after cas^ "ration* HARE-LIP. 195 Treatment,—The patient ought to keep his bed, and the swelled part should be supported by a cushion adapted to the case. If the part be painful, warm fomentations can be applied to it. After the pain has ceased, the absorption of the blood can be promoted, by frequently washing the af- fected part, with a strong solution of sal ammoniac, or a so- lution of alum. An occasional dose of salts may be taken during the continuance of the disease, and the diet should be light. If the above plan fail to arrest the swelling, the part becoming more painful, and increasing in dimensions, a physician should be called Without further delay. HARE-LIP. This affection is a fissure, or division, perpendicularly, of one or both lips, and the term hare-lip arose from a resem- blance of the affected lip, to the upper lip of a hare. Some- limes the fissure is just below the middle of the nose, at others, directly under one nostril. The division is some- times double. The two portions of the lip are generally moveable. In most cases, the lip only is affected, in others one or more front teeth are wanting, and sometimes even the upper jaw-bone is imperfect, a part of it being also wanting. The affection is rarely found in the loAver lip. Treatment.—The only plan to remedy the deformity oc- casioned by a hare-lip, is by an operation. The edges of the fissure must be pared off, so that when they are brought together, they will fit closely. This can be done with a sharp knife, or a pair of sharp scissors. If done Avith scissors the operator should commence at the edge of the lip, and cut as near the edge of the fissure as practicable, in a strait line, until he extends the cut above the angle of the fissure. The opposite side should be cut in like manner.-^ 196 HYDROCELE--DROPSY, &C, If the knife be used, a thin piece of wood or lead, may be placed beneath the edge of the fissure on one side,, and tin; lip draAvn out over it; the knife can then be introduced above the extent or angle of the fissure, and with a single sweep, the cut can be made'down to the edge of the lip.— Both sides can be thus cut. This is much. the better Avay, for though cutting Avith the scissors should be done Avith a single stroke on each side, the lip is much more apt to be bruised than with the knife. After the edges of the pissure have been thus pared off, the edges should be brought into contact, and tAyo silver pins introduced to keep them togetli-. er, One pin must be introduced near the edge of the lip, and the other, betAveen that and the angle of the Avound.— The edges of the AAround can then be kept in contact by ap- plying the twisted suture, viz: by putting a strong thread around the end of a pin, and carrying it across the piri and around the other end in the form of a figure 8. The thread should be passed several times around each pin. Some. times the fissure is so short, that one pin will be sufficient. Care should be taken to introduce the pins sufficiently deep to prevent them from tearing out. No dressing is required. The operation ought never to be performed Avhen the pa- tient is in infancy, as convulsions and death have occurred in such cases. From tAvo and a half to four years of age, is the proper period for performing the operation, h HYDROCELE.—DROPSY OF THE SCROTUM. This term is applied to a watery collection in the sper- matic cord, the coat of a testicle, or the scrotum itself. When the scrotum is filled with a fluid collection, the SAvelling is general, enveloping both testicles, and pro- ducing no discoloration of the skin. Children are liable MAMMARY ABSCESS. 197 to encysted hydrocele of the spermatic cord. The swel- ling is of an oval form, and situated betAveen the tes- ticle and groin. A fluid collection in the tunica vaginalis, or coat of a testicle, is quite common among laboring people, being caused by IiIoavs and bruises, lifting heavy weights, or almost anything requiring great muscular exertion. The growth of the tumor is gradual, commencing at the low- er part of the scrotum, and gradually ascending, until the testicle sometimes attains an enormous size. The patient complains of a dragging sensation, but seldom of pain. As this is an affection that is very difficult to man- age, no one but a physician or surgeon should attempt a cure, I shall therefore lay doAvn no plan for a cure. MAMMARY ABSCESS. ;Females Avho suckle, are particularly liable to inflam- mation and suppuration of the breast. Symptoms.r^-The affected 'part becomes much enlarged, sense and painful. Sometimes the skin only is inflamed, together with the cellular substance, the surface be- ing smooth; but when the entire gland is affected, the SAvelling is irregular, presenting an uneven surface, as thousrh several distinct tumors had formed Avithin the aland. The pain often extends to the axillary glands, situated in the arm-pit. Sometimes the secretion of milk is entirely suppressed ; at others, no effect is pro- duced upon it. The entire system is in some cases af- fected Avith fever, and a general derangement of the health attends. If the SAvelling be sIoav, it sometimes -fails to suppurate, but if it progresses rapidly, and con- 198 MAMMARY ABSCESS. tfnues thus to increase four or five days, suppuration may be expected. Causes.—The general causes of mammary abscess are,, an early suppression of the secretion of milk, mental distress, exposure te cold, blows or bruises, moving the arms too freely when the breast is very large, &c. Treatment.—In the early stage of the disease, resolu- tion must be attempted. If the pulse be full and fre- quent, the general system being greatly excited, bleed- ing should be resorted to early.. A dose of castor-oil, or salts, may be taken,, and repeated as may be necessary.. [f the tongue be foul, the appetite destroyed, and a dis- agreeable taste in the mouth, shoAvring that the stomach is foul, a good dose of calomel would be necessary.— The diet should be light. The- affected part ought, dur- ing the above treatment, to be frequently Avashed with a strong solution of sugar of lead, or a soft cloth, fre- quently wet with the solution, may be kept constantly applied to the part. When suppuration cannot be pre- vented, it should by all means be promoted. This can be done by poulticing with a warm poultice of flax- seed, or light wheat bread and SAA'eet milk. When suppuration is complete, or in common language,, when the swelling has come to a head, a free incision must be made into it, at the most prominent pointy or at that part, at which matter can be discovered, by fluctu- ation. The lancet should be pushed in sufficiently deep„ and the external opening be of sufficient size, for the matter to flow out freely. It is quite common among females, to apply warm poultices to a swelling of this kind at the onset. Reason should dictate a contrary course 10 any one. The heat being already too great," means might to be resorted to, to lessen this heat—therefore the coldest applications ought to be used.. When,, however, PHYMOSIS. 199 as before stated, suppuration will take place, it should* by all means be promoted. PHYMOSIS. This is an affection in which the prepuce adheres to the glans penis, so that it cannot be drawn back to un- coAer the end of the p*enis. It is sometimes natur&l, at others accidental. The irritation, from severe gonorrhoea, may produce phymosis j but a more frequent cause, is a chancre. Children are sometimes born Avith a phymosis, so as to prevent to some extent, the free passage of urine. Very disagreeable symptoms may sometimes arise from phymosis, such as urinary concretions betAveen the prepuce and glans penis, and in the urethra; disease of the bladder and urethra; a profuse puriform discharge, with sores on the prepuce, and glans penis; warty ex- crescences, &c. Treatment.^-In recent cases, injections of warm milk and Avater, should be resorted to. A male syringe must be used for this purpose, and the milk and Avater throAvn in betAveen the glans and prepuce, four or five times a day. The penis ought also to be frequently bathed in warm water, with the end up. Attempts in moderation ought to be often made to draAv the prepuce back.— When a phymosis is of long standing, especially Avhen matter is formed beneath the prepuce, the injection of :t solution of sugar of lead, Avould be advisable. In se- vere cases, a good physician should by all means be called in Avithout delay, 200 PARAPHYMOSIS--RICKETS OR RACKETS-. PARAPHYMOSIS. In this affection, the prepuce is retracted and drawn tight around the neck of the penis behind the glans, and cannot be brought forward so as to cover the head of the penis. The glans become SAvelled, also the in- teguments behind, while the stricture caused by the pre- puce, is between them. Inflammation of the Cellular tissue soon takes place, lymph is formed; ulceration, and of- ten sloughirig of the parts, is "the consequence. Treatment.—This affection is attended Avith some dan- ger, and should be removed with all possible despatch. All external applications Avill proATe utterly useless, and ought not to be resorted to. The parts should be im- mediately replaced, if possible, by grasping the glans with the fingers of the right hand, and pressing firmly, so as to lessen the dimensions of that part, While with the left, the prepuce must be steadily pulled until it be drawn OArer the glans. At the same time that the op- erator attempts to diminish the volume of the glans, he should be endeavoring to push it back within the prepuce Avhich he is attempting to draAv over Avith the left hand* If these attempts fail, a physician must be called, as de-- 3.ay would be dangerous. RICKETS, OR RACKETS. This is a disease incident to children, and seems to be a want of firmness in the bones. Symptoms.—Children affected with rickets, exhibit signs >f general bad health. The bones of the limbs are so soft- ened as to become bent in various directions, by the action SPINA BIFIDA. 201 of the muscles. The spine becomes shorter, and curved in different places. The breast-bone projects, the bones of the pelvis sink in the os pubis, or front bone of the krwer part of the body, approaching the sacrum." In fact, almost every bone of the system in some cases, becomes distorted. Treatment.—The application of a mechanical apparatus to a bone, to prevent distortion in this affection, though re- commended by some of the old Avriters, is certainly produc- tiATe of no permanent benefit. The medicines that have been given with any decided benefit, are tonics, such as quinine, different preparations of iron, peruvian bark, &c. Many cases considered rickets, by medical men, are strictly cases of spinal irritation ; and the opinion entertained by some of the ancient medical writers, that the disease depen- ed on disease of the spinal cord, I am inclined to believe Avas correct. For information respecting the treatment of such cases, see " Spinal Irritation." A good physician should ahvays }xj employed to attend to such cases. SPINA BIFIDA, This is an affection of the spine, in which some of the bones of that part Tire deficient. Symptoms.—The disease is characterized by a -considera- ble tumor immediately over the spine, generally in the lumber region, or small of the back. The size is not uni- form, but varies in different cases. Fluctuation is percep- tible on applying the hand to the affected part. The con- tents of the tumor are sometimes colorless ; at others, the matter is of a dark color. The loAver extremities are apt to be Aveak, and dropsy of the brain often occurs. Chil- dren are born affected Avith this dreadful disease. 202 RUPTURE OF A TENDON. Treatment.—-Spina bifida is generally incurable, as we find hut tAvo or three cases in the records of surgery that have been successfully managed. Gentle, uniform, and continued pressure, Avill sometimes prevent an increase of the tumor, and prolong the life of the patient a short time. A child affected with this disease seldom lives more than three or four years, and often only a few days. No open-* ing should be made in the tumor, as this only hastens the patient out of existence ; and in some cases, death has been: knoAvn to take place instantly, on opening the tumor., RUPTURE OF A TENDON. The rupture of a tendon is quite a rare occurrence, but as it sometimes happens, I have thought proper to make a. few remarks upon the subject. The tendens liable to be torn asunder, are that of the loAA^er part of the leg; (commonly called the healstring,) that which is most in action in extending the leg; and a tendon of the arm.. As a rupture of that- tendon usually called the healstring is attended Avith the most difficulty, I Avill endeavor to giATe an explanation of it.. When this tendon is ruptured, the patient hears a sound,. similar to that of the crack of a whip. Immediately an incapacity, or extreme difficulty to Avalk, or even stand, lakes place. A depression may also be found between, the ends of the broken tendon. Treatment.—The ends of the tendon can be brought into contact by bending die leg in a moderate degree at the knee, and extending fche foot, and in order to effect a cure, it should be thus kept until union takes place. The hollow on each side of the tendon must be filled with soft lint. mi that a bandage afterwards applied, may press equally on those parts, and prevent the tendon, from, being pressed too, i POLYPUS.. 203 much inwards, towards the ancle bone.. A tolerably strong piece of cloth, two inches Avide,, must be placed along the bottom of the foot, commencing at the toes, and extending it along the back part of the leg, as far as the middle of the thigh. A bandage must then be wrapped around the foot and leg, begining at the toes, and wrapping the entire foot, including the strip of cloth first applied. After the foot is completely wrapped, the bandage must be carried under the foot, and up over the part ruptured, and afterwards continued to be carried around the limb until it is Avrapped as high as the strip fiist placed upon it. Care must be taken not to bind any part of the limb sufficiently tight, to interrupt the circulation of the blood. This plan will be apt to succeed in keeping the foot extended, and the limbs should be kept, as above directed, from three to six Aveeks, or until! entire union of the tendon takes place. The reader will discover, that the object is to bring the ends of a ruptured tendon together, and retain them in that situation ; his own good sense Avill, therefore, dictate to him what plan to adopt for this purpose.. It matters not Avhat tendon is ruptured, the limb should be placed in that situation the least calculated to bring such tendon into ac- tion, and kept so until the cure is complete. POLYPUS. This is a kind of tumor growing in the nose, womb, or vagina, having roots similar to the polypus. There- are va- rious kinds of this peculiar tumor.. Some are of a reddish color, and attended Avith no pain; some yellowish and pain- ful; others malignant, some fungus, and some cancerous. The plan adopted for the cure of polypus, is extraction, eith- er by a pair of forceps, made expressly foi the purpose,. 01 204 POLYPUS. with a ligature. Sometimes the polypus has a small neck-, around which a ligature can be ..placed, and by being tight- ened occasionally, the tumor Avill separate and come away. Care should be taken, to place the ligature at the origin of the tumor, that all may be removed. With all possible care in extracting a polypus, the tumor will often re-appear in-a short time. None but a physician or surgeon, should at- tempt the management of a polypus, as it is -attended with danger, and requires skill. In order to show the necessity of the aid of a good physi- cian, I will give a-description of the progress of the disease, as given by the celebrated surgeon, John Bell. This emin- ent surgeon seems to differ from 'the most of writers about the nature of the polypus, saying, that time and the natural ■groAvth of the tumor, its pressure on other parts, &c, "will bring every polypus to one invariable form, in its last and fatal stage." He goes on to say, "the more easily it is ex- tracted, the more easily does it return; and Avhether care- lessly extracted, or altogether neglected, it soon returns.— But Avhen it does return, it has not really changed its na- ture, it has not ceased to be in itself mild; «it is then to be (cared, not from its malignity, but from its pressure among ihe delicate cells and membranes of the nose. It soon fills the nostrils, obstructs the breathing, and causes mdescriba- ^ -hie anxieties. The tears are obstructed, and the eyes be- come Avatery from the'pressure on the lachrymal sack ; the hearing is in like manner injured, by the pressure of the tu- mor against the month of the Eustachian tube ; the voice is changed, and its resonance and tone entirely lost, by the sound no longer passing through the cells of the nose and face. The swallowing is in some degree affected by the soft palate being depressed by the tumor. The pains -arisine from such sIoav .and irresistible pressure, are unceasing.__ From the same pressure, the bones become carious, and the -adls-ofthe face and nose are destroyed by the sIoav the joints, is sometimes attacked with inflammation. Symptoms.-—Great pain is experienced in the part af- fected. There is considerable SAvelling around the joint; and the skin is apt to be red, and very tender to the touch. Sometimes the whole system is much, out of order, being affected Avith fever, loss of appetite the pulse full and frequent, tongue furred, bowels consti- pated, &c. INFLAMMATION OF THE SCALP. 2Q9 Causes.—Wounds, bruises, and sprains, may produce inflammation of the synovial membrane; but the most usual cause, is cold acting upon the system. Treatment.—If the pulse be full and frequent, bleeding may be resorted to in the early stage of the disease. An active dose of calomel and rhubarb, must be imme- diately administered. The volatile liniment, must be fre- quently applied to the affected part. After the operation of the purgative, sweating may be induced, by giving fifteen or twenty grains of Dover's powder, following it with an occasional drink of Avarm hyssop tea, for four hours; and if sweating does not take place in that time, the dose of powder may be repeated. In some cases, this plan will speedily remove the disease; but should it fail, or if the attack be violent at the commencement, a physician should by all means be called, as delay might prove very injurious. A dropsy, or a stiffness of the joint, may be the result of an inflammation of the synovial membranes, if mismanaged. INFLAMMATION OF THE SCALP, Symptoms.—In slight inflammation of the skin cover- ing the cranium, there is but little SAvelling or fever. The pain is but trifling. If, however, the entire scalp becomes inflamed, the symptoms are very violent. The swelling is considerable, and extends to the eyelids, and even over the whole of the face. The constitutional symptoms are some- times so seA^ere, that the patient soon sinks into a comatose state, and dies, Wlien the disease is suffered to go on with- out any treatmfrit, and the patient does not die, an abscess is apt to form, Avhich often covers one half of the head. Treatment.-—'The treatment must vary according to the N "210 ENLARGEMENT OF THE UVULA, &C. state of the system. If the excitement be high, evinced by a full strong pulse, high fever, &c, it may be proper U> reduce the system, by bleeding and purging. If on tin- nlherhand, universal debility prevail, as is sometimes the ease, the system must be supported Avith tonics, &c. In >light cases, a ftnv punctures made in the ailecied part, so ;ts to let out the effused scrum, and the application of AAraim fomentations, will generally ansAver. When tlie case is vi- olent,,the swelling very extensive, and an evidence of much matter collected under the skin, a free incision ought to be made early, so as to give free passage to the matter. The opening must be deep, in proportion to the depth of the matter, as there is danger of an injury to the bone, by the matter being retained long. In a case of this kind, a good physician ought to be called. ENLARGEMENT OF THE UVULA, OR FALLING OF THE PALATE. Symptoms.—Falling of the palate as it is generalb termed, is an enlargement and elougation of that organ Which causes it to fall doA\ n. On examination the palate will be found considerably SAvelled and inflamed. It is apt to produce coughing and nausea. The patient cannot articulate plainly, or at least some Words cannot be spoken distinctly. Treatment.-^Generally speaking the use of astringent car- gles, will'be sufficient to relieA'e the patient. If the patient have fever, he ought to take a purgative, and such cooling remedies as are usually used in ordinary fevers. As a gargle, the infusion of peruvian bark will be found benefi cial: a solution of alum is also good. The muriated tine ture of iron has been used with success. It can be applied FOREIGN BODIES IN THE WINDPIPE, &C 21 1 by dipping a piece of sponge in it, and touching the palate with the sponge. Should the above remedies fail, a good physician should be called, as it is sometimes necessary to cut off a part oi the uvula with a pair of scissors. FOREIGN BODIES IN THE WINDPIPE. Children in playing Avith peas, beans, or any small round substance, are sometimes so unfortunate as to get a substance of such kind into the Avindpipe. As soon as any thing is thus introduced into the windpipe, violeni coughing is apt to take place. The patient breaths with extreme difficulty, and is in great agony. The coun- tenance is expressive cf great terror; the face appears SAvelled and of a lived color. Nature makes strong but ineffectual efforts to expel the substance. After a few minutes the coughing intermits, and the patient is easy fur a short time, but the coughing soon returns Avith great violence. The only remedy in a case of this kind is tra- cheotomy or opening of the windpipe, and extracting the substance ; a skillful physcian should therefore be immedi- ately called. FOREIGN BODIES IN THE ESOPHAGUS. Foreign substances sometimes get into the gullet so large as to lodge and obstruct the passage completely. By suffer- ino" such a substance to remain long, great irritation and ultimately, inflammation is the consequence. If the sub- tance be small and of a digestible nature, as a piece of meat or bread, it should be pusru-d down with a probang or a 212 LUMBAR ABSCESS. bougie made for the purpose. If it be very large it can best be pulled up Avith a pair of long curved forceps, or a blunt hook attached to a Avhale bone probe. Pins, needles, and other sharp pointed instruments or substances, often lodge about the palate and may be discovered and removed with forceps. Should you apprehend any difficulty, how- ever, in removing the substance, the attempt ought not to be made, but a physician called in speedily. LUMBAR ABSCESS. Symptoms.—Pain in the loins, accompanied Avith chills is one of the first symptoms of lumbar abscess. As the di- sease progresses the patient experiences pain Avhenever he is erect, and the pain is much increased by extending the thigh. The glands in the groin become enlarged, and sAvelling takes place on the inside. The SAvelling appears larger Avhen the patient is standing, and an impulse is given to it by coughing. As the disease advances fluctua- tion is preceded. The location of the abcess varies, being sometimes high- er up, and sometimes loAver doAvn in the thigh. Some- times the affection is confined to the soft parts, but general- ly speaking, the lumbar vertebrae or bones of the back situ- ated in what is usually termed " the small of the back ;1 are diseased, and the matter found in a lumbar abscess, has its origin in ulceration in this part of the system. The pa tient is apt to experience much tenderness on pressure being made on that part of the back. He also complains of weakness of the back, and loAver extremities. Striking some parts of the back bone is apt to produce acute pain, and sometimes there is a slight curvature of the spine. : Treatment.—absolute rest is generally necessary. If the FRACTURE OF THE RIBS. 213 Tertebrae be affected, a seton should be introduced near the diseased part of the spine. When the abscess is form- ed, an early and free opening ought to be made, so that the matter may be discharged speedily. The strength is apt to require support as the matter is from time to time dis- charged. This can be clone with Avine, quinine, &c, as may be required. A good physician should be con- sulted. FRACTURE OF THE RIBS. A rib or ribs may be broken by injuries from a bloAV Avith ■a stick, or even with the fist; by falling on some hard sub- stance, or by pressure by heavy bodies being throAvn upon the breast, &c. A rib is most apt to give way at the most convex point, but they are also sometimes broken, near the back-bone or breast-bone. When a rib is broken the patient is apt to experience pain when he makes a full inspiration, or coughs. He also feels the ends of the bone passing each other.. The situation of the fracture can be discovered by the surgeon passing his hand over the ribs. Treatment.—In slight cases, it will be sufficient to ap- ply a large broad bandage around the chest, and hav- ing straps passed over the shoulders, and attached to such bandage to keep it to its place. If the patient be strong and plethoric, he should be bled freely. If fever should come on, the breathing become difficult, and the counten- ance expressive of great anxiety, the patient ought to be bled, and take a cathartic, and pursue a similar course to that laid doAvn for ordinary fever. If the patient groAV worse under such treatment, a skilful physician must be called in without too much delay. 211 FRACTURE OF THE ARM. FRACTURE OF THE ARM. In fracture of the arm, there is no difficulty in recogniz- ing the accident, as the limb is shortened considerably, and the natural appearance of it altogether changed. The-arm is useless, and bent towards the body. Great pain is pro- duced, by pressure upon the nerves, by the end of the bone. Treatment.—Extension should be made as soon as possi- ble, sufficiently to bring the ends of the broken bone in con- tact. In order to keep the bone properly situated, until union takes place, different plans have been proposed. A broad bandage of tolerable strong cloth, may first be applied around the limb, from the elbow up to the shoulder. A thin Avhite-oak splint, tAvo inches wide, may then be placed on the upper side of the arm, to extend from the upper end iif the arm, doAvn below the elbow, and another from the axilla, or arm pit, down beloAV the elboAv also, on the under side of the arm. These splints ought to be avrapped Avell with strips of cloth, and cotton or toAv interposed between them and the bandage, or roller, round the arm. Care must be taken not to bind the limb too tight, so as to interrupt the circulation of the blood. * Another mode is, to take paste-board, (such as book-bind- ers use, is best,) cut tAvo pieces of sufficient length, to ex- tend from the arm pit, down a little below the elbow,, and sufficiently broad to nearly surround the arm Avhen both are' applied—moisten them so as to make them soft, then apply i.hem to the arm, and retain them with a bandage. When the Avooden splints are used, they can be retained by pass- ing a strip of cloth around from one end to the other or w ith pieces of tape. The forearm must, be bent at right an- gles, and the fractured bone be kept close to the bodv. If the limb increrse by swelling after the bandages are applied, I FRACTURE OF THE FOREARM. 21f> Lhey must be loosened from time to time, to prevent undue pressure. The arm may be frequently Avet Avith vinegar, or if inflammation should take place, a solution of sugar oi lead, Avould be better. In from two to six Aveeks, agreeabl\ to the age and constitution of the patient, a cure will be ef- fected. FRACTURE OF THE FOREARM. Fracture of the forearm may take place partially, or com pletely; or in other Avoids, one bone only may be broken, or both, WTnen only one is broken, there is but little dis- placement, but the situation of the fracture can easily be as- certained, by tracing the bone Avith the fingers from one end to the other. When both bones are broken, the limb is much shortened and deformed. Treatment.—-When one bone only is fractured, it can !><■ very easil)' replaced, and retained Avith paste-board, as re- commended in fracture of the arm. When both bones ar.> broken, considerable force is required to extend the limb, so as to bring" the bones into contact. Care m st be taken in reducing a fracture of this kind, to place the hand in its na- tural position. Bandages and splints can be applied, as ad- vised in fracture of the arm, but it is of considerable advan- tage to have in addition, a box for the arm to lie in, a few days. The external application can be such as before pre. M.-ribod. 216 Fracture of The Thigh* FRACTURE OF THE THIGH. In fractures of the thigh, considerable difficulty attend? the diagnosis,-on account of the thickness of the muscles covering the bone. Careful examination must be made Avith the hands, rotating the limb at the same time, to as- » in a strait line with the Cap of the knee, as it is usually call- ed. A broad bandage must iioav be applied to the thigh, as recommended in fracture of the arm. Two strong splints must next be applied, one on the outside to extend from the armpit, to a few inches below the foot, while that on the in- side, must reach from as high as it can be placed on the in- side of the thigh, to as far below the foot as the former splint. The upper end of each of these splints, must be cut out and padded, so as to be agreeable, and they must be wrapped and applied as directed for other splints. Holes should be made in each splint, and a pin introduced two inches beloAV the sole of the fooL A handkerchief must be applied around the ankle, and fastened to the pin, so as to keep the limb from becoming shortened. All other treatment should be similar to that already pointed out. FRACTURE OF THE LEG. 217 FRACTURE OF THE LEG. A fracture of one or both bones of the leg, can generally be discovered by careful examination. In reducing the fracture, all that is necessary, is to place the foot in its nat- ural posture, (having the ends ©f the bones in contact at the same time,) and keeping it properly situated by the appli- cations recommended above. In conclusion, suffer me to impress upon the mind of the reader, the importance of seeking the aid of a physi- cian in all unusual fractures, as incalculable mischief has been done by those beings, called "bone setters," Avho knoAV nothing about the proper treatment to be pursued in cases CHILDREN. INTRODUCTORY REMARKS. The following - treatise, on the diseases peculiar to fe- males anc! child:en. is intended for the use of mothers;. and I do hope that gentlemen in Avhose hands this lit- tle volume may fall, especially young gentlemen, will have sufficient delicacy, and sufficient self-respect, to nmit perusing ibis part of the work. I hope so with the utrnc:-:.. confidence, as I am avc.11 aAvare that all men who are entitled to the appellation of gentlemen, will act. as become tle-ni. Feeling as I do, a deep interest in the welfare of the human family, and conscious that many a fire amiable young lady, has been hurried from time to eternity, in consequence of her notions of deli- cacy having prevented her from applying to a phy- sician fov medical aid, I consider myself imperiously hound to lay doAvn some hints for their special benefit; hut at t; ■■ same time, it is my wish that -ladies onlv should make use of this part of this little work. 1 have endeavored to make out plain prescriptions for mothers, to enable them to treat successfully some dis- eases to which their daughters are liable, and children -cm-rally. I have also tried to point out the symptoms of those affections, in such a manner, that mothers mav ON DISEASES, &C. 219 not be mistaken as to their nature. If the mother be satisfied of the true nature of any disease under which a daughter may be laboring, immediate treatment ought to be resorted to; but if not, a skilful physician should by all means be immediately consulted. Suffer me here to impress upon the minds of my fair young readers, the importance of throAving aside all false modesty, and con- sulting a good physician, whenever the health is much. impaired, or in danger of being thus impaired. It is true, there are many physicians, who are too mean and despicable to merit the confidence of a respectable lady, and I would advise you not to lay your case be- fore anv physician, who has no regard for the feehngs of a female, or respect for himself. When I speak of a good physician, I wish you to understand me as mean- inn- A good man, possessing medical information. Such. a man will treat you with becoming respect, and will never utter a word calculated to cause a blush on the cheek of modesty, or that would detract in the smallest degree from the dignity of a gentleman. To such an one, you need not hesitate to make known your true situation. Be plain and candid Avith him, describing eve- ry symptom of your disease, to that extent, that Tie may not be mistaken in your situation. With these brief remarks, I lay this part of my fee- hie labors before my female readers, with the hope that it may enable mothers to manage successfully the plain- er cases in their families, and that it will cause then- im call upon a physician, when convinced of the nec-s. sity of so doing. 220 DISEASES OF FEMALES, &C. DISEASES OF FEMALES. MENSTRUATION. By menstruation, I mean that discharge that takes place from the Avomb of a female once in a month, called by the good old mothers, ''1116 00111868." The age at which this first takes place, varies in different climates. In Aery hot climates, it happens as early as from 10 to 12 years of age: in temperate latitudes, from 12 to 14, and in cold regions, 19 or 20. In our own country, from 12 to 14, is the most usual age, at which menstruation takes place. The dis- charge continues from 2 to 7 or 8 days—and the quantity varies from four to ten ounces, in different individuals. The constitution of the girl, undergoes a considerable change on the first appearance of the menses, and the future health of the individual, depends much upon the course pursued at this time. She should use gentle exercise in the open air. avoiding at the same time, exposure to cold or damp air. She should use light, but nutritious diet, and taking moder- ate Avalks, or riding on ;a horse, or in a carriage, would be very proper exercise. She should by all means avoid hav- ing any of her clothes tight. I avill here take occasion to speak of the dangerous and fashionable practice of tight lacing. The motions of the body depend upon the actions of the muscles, and whatever places any artificial restraint upon any muscle of the sys- tem, destroys the activity of such muscle in proportion to :he force with which it is applied, and the length of time it remain. Hshence the cause of the ungraceful movements of a female accustomed to tight lacing, and the necessity of a continuance of the same pernicious practice among those Avho have been long accustomed to it. By undue pressure -upon the muscles of the body, they lose in a degree their AMENORRIICEA. &C 221 poAver to aet, and the poor deluded girl is obliged to contin- ue the use of her corsets, to keep the body erect. A greater injury still resulting from tight lacing, is the effect produced upon the stomach, liver and lungs. The pressure upon the liver and stomach, prevents the former from performing its necessary functions, and consequently imperfect digestion of the food taken into the stomach, is the result. Undue pres- sure upon the chest, prevents also the free expansion of the lungs—and consumption, that most fatal of all maladies, is often the consequence. Young ladies have been Avarned from time to time, of the disastrous consequences of tight lacing; and it is hoped, that the time is not far distant,when such a course will be abandoned. AMENORRHEA. RETENTION, OR SUPPRESSION OF THE MENSES. When a young girl passes the usual time for the men- ses to appear, and there is no appearance of the same, it is termed "retention of the menses." The patient soon becomes pale and languid. The appetite is im- paired, and the entire system becomes weakened, result- ing in chlorosis, or green sickness. The patient some- times has a severe cough; she often has A^olent attacks of pain in the head and breast, and across, the lower part of the abdomen, about once a month. A retention of the menses, is caused by exposure to great cold, about the time it should appear, by general disease oi the system, dyspepsia, &c. When menstruation has come on, and afterwards stopped, it is called suppression.— This is generally produced by the causes enumerated above. In retention of the menses, the first object should be 222 AMENORRHOEA, &C to attempt a restoration of the general health ; and af- terwards, some active emmenagogue or medicine, to act directly upon the uterus or womb, would be desirable. If the patient be feeble,* the system should be prepared for the administration of tonics, o:- strengthening medi- cines, by first cleansing the stomach and bowels; but if she be strong and plethoric, bleeding should be resorted to, before purging. My-usual practice has been to give a dose of calomel and rhubarb, or one or. two doses uf Cook's pills, Avhich are made by combining equal quan- tities in Aveight of calomel, rhubarb and aloes, and mak- ing the mass into common size pills. Of these, I give from 3 to 6 for a dose at bed time. Two doses given two nights apart, generally answers the pv. re-c^j for which they are given. The day following the operation of the last dose of Cook's pills, I commence giving the follow- ing pills, giving one of them before each meal in the day: (one in' the morning, one at noon, and one at night,) and continue the use of them until the general health is restored. Take sulphate of iron, five grains— gum myrrh and aloes, of each, two grains; mix. and make into tAventy pills. During the administration of these pills, if the patient complain of much pain in the head, in the evening, I give but two in the day, one in the morning, and one at night. If the patient be costive, it should be removed, by giving small doses of salts, of- ten repeated, so as to procure one or two stools per day. After the health and strength seem to be tolerably well restored, I stop the use of the pills, and commence using powdered savin, in doses of 15 grains three times a day, giving, two or three times a week at bed time, the hip bath thus : let the patient be seated in a tub of warm water, 15 or 20 minutes, so as for the water to cover the hips. In obstinate eases, I have generally given stre gthening pills three or four months, and the savin MENORRHAGIA, &C 22.5 and hip bath, from three to four weeks. During the Avhole course of treatment, the patient should use gentle exercise in the open air, live on light diet, and avoid exposure to cold and wet. In suppression of the men ses, the object should be to restore the health as above directed, and give the hip bath, until the secretion be restored. If the above means do not suffice, and tin1 patient appear on the decline, a >>, Ifiul physician should be called in without delay. MENORRHAGIA, EXCESSIVE FLOW OF THE MENSES. Profuse menstruation is genarally produced by any thing that tends to relax the system, such as a severe cold, ex- cessive fatigue, &c.; though females of a robust consti- tution, are sometimes attacked with too great a Aoav of the menses. During an attack of excessive flow of the menses, give 30 drops of tincture of cinnamon every two hours, applying cloths frequently clipped in cold spring water to the pubes, or lower part of the abdomen, and keep her on her back constantly. If those means do not arrest the. flow, and it be very profuse, call upon a phy- sician, as a feAV hours delay may prove fatal. In order to prevent these attacks in weak, patients, every thing should be resorted to in the intervals, to restore the health and strength. Half a grain of quinine, and 7 or £ drops of elixir vitriol, in 3 or 4 table spoonfuls of w itey, giv- en three times a day before eating, answers very well in common cases. In fleshy patients, bleeding, practiced just before the expected discharge, will be beneficial. If these remedies fail, call in a physician by all ineans. I •221. PREGXANCY, &C. PREGNANCY—MANAGEMENT PROPER IN THIS STATE. The dress of a female in a state of pregnancy, should lie perfectly free in eveiy part. That part around the chest and Avaist, especially, should be loose. Suffer me to impress this point upon the lady, who Avishes to ayoid much suffering during her pregnancy, and is desirous of living birth to a healthy infant. Were mothers aAvare of the danger they incur, by wearing tight clothes while; pregnant, they Avould Avillingly provide themselves Avith loose habits, regardless of the fashions of the day. Ex- ercise should be regular, but of the most gentle kind. Walking fast, running, dancing, jumping off a horse, and other unnecessary fatigue, should be carefully, avoid- ed. The diet should be light and Avholesome—avoiding wine, spirits, coffee, and every thing of a heating nature. The boAvels should be kept regular throughout the Avhole course of pregnancy, but ATiolent purging avoided. DISEASES OF PREGNANCY. CARDIALGIA— HEARTBURN. This is quite a common affection among pregnant fe- males, commencing within the first month, and some- times continuing many weeks, or even months, annoy ing the patient very much. The remedy most usually resorted to in this disease, is calcined magnesia. I pre- fer giving it in tea-spoonful doses, three or four times a day, in sweet milk, if the stomach will retain it given in that way. Prepared cha'lk, given in doses of fifteen or twenty grains as often, is also good. The patient SICKNESS, &c. • 225 should live on a milk and bread diet, avoiding the use of all indigestible articles of food, and not use tea or coffee, SICKNESS AND VOMITING, The mind of a pregnant Avoman afflicted Avith vomit- ing, should be easy and quiet. Her diet should be light, and she should not suffer her stomach to become empty —yet, her meals should be small, taking care not to overload the stomach at any time. She should drink cold water, and if vomiting be frequent, a little mint julep Avould be found of advantage. When much acid- ity of the stomach prevails, magnesia or prepared chalk, taken as directed under the head of Cardialgia, to cor, rect the acidity, Avould be beneficial, ODONTALGIA—TOOTH-ACHE. Females in a state of pregnancy, are often distressing- ly affected Avith tooth-ache, In such cases, the usual remedies for this affection, should be resorted to. All exciting causes, such as cold, wet feet, sitting with the head in a current of air, &c, should be carefully avoid ed. 0 226 ABORTION—-MISCARRIAGE, &,& ABORTION—MISCARRIAGE. Under this head, I shall only speak of the course to be pursued to prevent miscarriage, as I deem it neces- sary in all cases Avhere it is actually about to take place, to call in a skilful mid-wife* The general causes of ab- ortion, are death of the child, weakness of the mother, ex- cessive evacuations, violent exercise, lifting great Aveights, jumping off an eminence, fevers, excess of blood, high living, &c. In order to prevent an occurrence of thia kind, all the causes should be avoided. Women who are Aveak, should use solid food, avoiding the excessive use of teas and coffee. She should rise early and go to bed soon; shun damp houses; use gentle exercise and avoid fatigue. Women who are strong and robust, should live upon a light vegetable diet, and avoiding any thing of a heating nature. Should the immediate symptoms of abortion appear, a physician should immediately be called in. PROLAPSUS UTERI, OR FALLING OF THE WOMB. As falling doAvn of the womb sometimes occurs in pregnant women, I shall here mention the symptoms of such an accident, that any one placed in such a con dition, may be aAvare of her real state, and apply to some physician for relief. WThen there is a slight prolapsus, the patient experiences a sense of heaviness in the pel- vis or loAver part of the abdomen, with a dragging pain in the loins, aggravated on sitting up or walking about She is apt to have difficulty in passing her urine, and cos- tiveness generally prevails. In complete, prolapsus the RETROVERSION OF THE WOMB, &.C. 227 ', pain and dragging sensation increases, and the womb ofte n protrudes so as to be seen. In either of the above cases, a skilful physician should be consulted at an early day. No dependance should be placed in a female michvife in such eases, unles she should have studied Avell the anatomy of the human system, and have had experience. Oar good old mothers generally do more harm than good in cases of this kind. RETROVERSION OF THE WOMB. This condition of the Avomb is characterized by great forcing or bearing doAvn pains, Avith entire stoppage of urine and obstinate costiAreness. Those symptoms are caused by the fundus or upper part of the Avomb falling backAvards and downwards, and Avhenever an accident of this kind happens there should he no delay in calling a physician, as great danger always attends a case of this kind. OBLIQUITIES OF THE UTERUS. By obliquities of the uterus Ave mean displacement of the womb, by its moving from its position in the ab- domen to the right or left, or anterioty tOAvards the forepart of the abdomen. This latter obliquity is attended Avith oreat inconvenience, such as severe pain in the back and loins, with a forcing and bearing doAvn, urging the patient to pass her urine, or go to stool. In any case of obliquity, a physician should be consulted in due time. In order to prevent any displacement of the Avomb in pregnancy, a woman should avoid all unnecessary fatigue ©r ex- » 228 * CHILD BED. ertion, such as lifting, running, jumping off of an emi- nence, riding a hard trotting horse, or in a rough going carriage, &c, &x, CHILD BED. This is a subject that I approach Avith trepidation, though a subject upon which I have reflected long and seriously. One upon which I have studied more than any other connected with the science of medicine, A part of the practice o( our profession, upon which I have often been called to act as that of an accoucher or midwife, and this subject has engaged, and yet does engage my most earnest attention. In performing my duty in Avriting on this sub- ject, I can but be awaie that I shall be liable to much anim- aoversion from a small portion, (and I may add a verv respectable portion too,) of my female friends. Doubtless some will accuse me of sinister motives, and be ready to heap >upon me, their vindictive abuse, for my candour in expressing my* vieAvs on the present subject. Shall I hesitate ] Shall I be deterred from raising my humble voice against a practice, but too common in this country ; and from warning my female friends of the danger to which they are often exposed ? Shall the fear of producing displeasure in the minds of a few, deter me from actino- that part, upon which I feel myself imperiously called to act? Shall I vieAV the disastrous results of a practice, when pursued even by some of the most respectable of my female acquaintances, and refuse to Avield my feeble quill against such a practice 1 Certainly not. I feel my- self bound by every principle of philanthropy and human- ity, to use every laudable exertion to alleviate the suffer- ings of my fellow beings and to " cry out and spare not " i CHILD BED. 22,h against a practice often resulting in extreme anguish and even in loss of life ; regardless of the darts of calumny that may be hurled at my devoted head. The practice to which I allude, is that of a female en- gaging in the practice of midAvifery, Avithout the least knowledge of even the rudiments of the art. I shall in this little Avork, lay down no directions to be pursued in child birth$ as the limits of the work Avill not admit of any such course. It Avould require a large volume to- make any one of my female friends acquainted Avith the first principles of midwifery. In this small work I could only lay down the course to be pursued after labour commenced, and heaven forbid that I should take such a step. There is sufficient injury already sustained by the community by the ignorance of michvives. Already have I beheld too many suffering mothers, and loo many infants born only to suffer a few hours of mis- ery, and fall to the tomb, like a blasted floAver falling to the ground, to be willing to lay down any plan to l>e pursued in delivery, unless 1 had time, space, and suf- ficient intelligence, to lay before the reader a full treatise on the ait of midAvifery. In order to become a skilful midwife, a female should acquaint herself Avith physiolo- gy, and anatomy, and afterwards learn the properties oi those medicines used in midAvifery, and the practical pari of the same. This would require several months of close study.- How preposterous Avould it appear for a man to select Avorks on the practice of medicine, and read them and commence practice Avithout a knoAvledge of medi- cines, or of the human system! No rational individual would trust to such an one to treat diseases; yet how many females go into the practice of midAvifery, and even spend years in that business, Avithout reading a single pa«"e on the subject! Hoav many mothers fall a sacrifice to such ignorance! Hoav many infante are brought into 2:50 CHILD BED. the world lifeless, by too much interference of the mid- life ! How many mothers are doomed to drag out a miserable existence, from an injury sustained by the con- duct of some ignorant old lady! In my practice, I have been called to several cases of inflammation of the per- ritoneum, or child bed fever, and I can safely assert, that 1 have had but one case that Avas not caused by the mis- management of some old woman, and I am at this time attending a poor woman that has received an irrepara- ble injury, by a vain woman using something as a sub- stitute for obstetrical instruments, at the same time de- stroying the life of the infant. In order to show my female readers the dreadful consequences resulting from die conduct of old women, I will here give a feAV cases related by Dr. Bard, and other respectable practitioners of midAvifery : ■• I was sent for, to attend a woman well advanced in life, in labor of her first child. I found a midwife with her, who had been in Avaiting two days and nights, and had got her in one of the most uncommon positions which I believe a woman Avas ever placed in; her breech was elevated upon the side of the bed, which was don- ih-d up, with several pilloAArs to laise it, her head hung down behind, and in the time of a pain, Avas supported bv two Avomen, avIio sat behind her; one of Avhom, by The muhvife's direction, clapped a handkerchief over her mouth and face, Avith intent, as I understood, to keep in her breath, and prevent her crying out; Avhich the midwife observed, she had done so much already, as to 'iurl her pains, and prevent their being of use to her, which i hey otherwise Avould have been; her legs ■ were wide expanded, and supported on the backs of iavo- chairs, between which and underneath the patient, in a low chair, was placed the old woman, Avho at every little pain, and frequently oftener, had endeavored to deliver CHILD BED. 231 the child, which she said had been as near coming into the world as it was possible, for several hours past; but in spite of her having made all the way for it she was able, she could get it to come no further; and that it had so benumbed her hands and fingers in trying to *pen the womb, that she could scarcely feel them. From those fruit- less and unnecessary endeavors, and other mismanage- ment of the labor, I concluded it to have been protract- ed, and that the force of the natural pains had been in- terrupted. For, instead of waiting with patience, com- forting the Avoman, and keeping her cool and easy, the very opposite conduct had been pursued. I did not im- mediately alter the position of the woman; but examin- ed during a pain, and found a great dryness, and con- striction of the vagina, much tenderness of the parts, the anterior part of the uterus pushed down before the head bedoAV the pubes, and the os tinea tilting back- wards toAvards the sacrum, (a situation in Avhich I haA'e always found it sIoav to dilate,) but sufficiently open to admit the tip of my finger, and so prodigiously tight, that it felt like a ring. The woman had no other than small grinding pains, and upon enquiry, I found no vtool for several days. The posture was changed to one more decent and proper; an emollient clyster Avas administered, as soon as it could be got ready, which relieved the intestines from the' accumlated foeces they contained, and as the scooping, by being used with so much force, and continued so long, as to benumb the fingers, had produced a great deal of pain and inflam- mation, I ordered an emollient poultice, and Avarm stupes to the external parts; and after Avaiting several hours, and perceiving the pains weak, and returning seldom, I dismissed the greater part of her attendants, desired that she might be kept cool, and that the poultice and warm stupes might be renewed eA'ery six hours, I gave 232 CHILD BED* her an opiate, and retired; in. about twelve hours after ? I called on her again, and found she had been refresh- ed by sleep, that her pains Avere rather stronger, but recurred at. long intervals; the, os tincce Avas not quite so callous, and spread to the breadth of a shilling, and the smooth body of the membranes, Avas easily to be felt through it, upon Avhich I ..renewed my former di- rections, and gave her a second opiate, and left her, till I received a call about ten hours after. I Avas then . a- greeably surprised to find the os, tincce soft, and receding on all sides ; the pains strong and thundering, and the vertex as Ioav down as the os externum; the membrane;- soon broke, and the head, which was uncommonly large, was. delivered Avith the face to the sacrum, AAfithout in- juring the fourchette in the least; the child Avas alive, and the mother under a suppression of urine, Avhich be- ing relieved, she. recovered, and did AvelJ."—Perfect's, ca^ scs0 vol. 1, p. 305. , , " A lady about the begining of the eighth month of her pregnancy, Avas taken, as she supposed, in labour.by the breaking of the membranes Avithout any evident cause.— She sent for a niidAVife, and by her, Avas advised to stir about, in order to bring on labor pains the sooner, in Avhich she unhappily succeeded, the labor came on, Avas more tedious than the first, and the child was born a- live, but never breathed freely, nor did any regular cir- culation take place. Its color became livid, and it died on the third day. The same circumstance happened to this lady in her fourth labor, but she was hoav directed to keep herself perfectly quiet, to loose blood, and to keep her bowels open. In this A\ray she Avent on for twelve or fourteen days, the Avater continually dribbling aAvay, and seldom passing a night Avithout severe pain. Her labor then came on, and,she Avas delivered after an easy labor, of a very fine and healthy child."—Bard CHILD BED. 233 - "A yong Avomati, big Avith her first child, had been at- tended, many hours before my arrival, by a midAvife, Avho informed me, that the child's breech presented, and that Avith her utriiost endeavors, she coxdd not make way for it; the pains were still very good, but the Avaters had escaped the day before. The face from its confined situation, and the rough handling of the midwife, so extremely tumefied, that it was hard to distinguish it; but after some time I discover- ed the chin to the sacrum; I endeavored to change the posi- tion of the face, and bring down the vertex with the face to the sacrum ; but it Avas in vain, and as the symptoms were not pressing, I Avas unwilling to apply the forceps, I there- fore encouraged and supported the patient, and waited the issue with patience, Avhich proved fortunate, for in about four hours, the expulsion Avas affected by nature, and the child Avas bora alive, but never in my life had I seen an in- fant so frightfully disfigured. The face'was horribly black, and much swelled, the eyelids inflated, inflamed, and so pro- tuberant, as to*appear ready to bolt out of their sockets, the nostrils wide enough distended to admit the tip of the finger; the upper lip swollen, and puffed up; the lower lip torn, and laying-down on the chin; all which proved the ex- treme ignorance, and rough and injurious treatmet of the midwife. There is not a case in midwifery, which requires more gentle and tender tuching, than a face presentation." —Perfect's cases, vol. 1., p. 218, « A parson, in the practice of midwifery was sent for to a young woman in labor with her first child; it was a preternatural case; the feet prsenting, violence and hurry, was used, the body was delivered, with much difficul- ty and by being pulled with too great a degree of force, was separated from the head, which was left st.cking in the pelvis. I was sent for, and in about six hours after the accident happened, arrived at the house.— 234 CHILD .BED The woman had lost but"[little blood, yet was very faint, and suffered much anxiety of mind ; there had been entire cessation of labour pains for sometime. I gave her all encouragement in my poAver, and upon examining, found the head in the vagina at the bottom of the pelvis; one ear of the child being under ramus of the ischium, de- termined the situation of the head. I therefore proposed to use the forceps, Avhich was ap- proved of, and the patient being placed on the left side, near the edge of the bed; having lubricated one blade, I carefully conducted it betAveen the head of the child and the hand previously introduced ; the second blade of the forceps I then applied in the same cautious manner; having locked them, began gently to extract, by intervals inclining the handles to the abdomen, till the head began to extend the external orifice; then supporting the perineum, to pre^ vent its being lacerated ; within the space of tAventy min- utes entirely effected the delivery.—Perfect's cases, vol 11,;?. 74. A lady, after a labour rather severe, Avas delivered of her first child j the placenta did not folloAv in less than two hours, and was then delivered with so much pain,, that from circumstances, as well as from what followed, there is reason to believe much mismanagement occured. From sometime before the delivery, a suppression of urine took place, which continued above three days, during which time, in addition to much pain, she complained of a contin- ual nisus, as if something was to come away. On the fourth day, while sitting on the pan, and endeavoring to pass her urine, the whole womb was suddenly thrown out of the vagina. It was eight or ten hours hefore medical assistance could be procured, to replace it,; and actually saved his patient's life, by preventing the midwife from rudely attempting to bring it away ; which- she insisted on doing, asserting it to be a paet of the pfotenta left behind. CHILD BE3. 235 By the time the physician arrived, the nurse had so far succeeded, as to replace the womb Avithin the vagina; the urine was immediately drawn off by the catheter, but it was then found, to be impossible to revert the womb. For upwards of thirty years this lady remained subject to profuse hemorrhage, and consequently endured a very feeble state of health, but has survived until her. menses have ceased, and enjoys a perfect state of health."—Bard,. To these miserable details of the unhappy results of ignorance among females, I might add some similar cir- cumstances that have occurred in my immediate neigh- borhood, but I shall forbear to give any relation, of the circumstances^ as I might be accused of motives of interest m bringing such things before the public. I will only say that I have beheld scenes irv practicing midwifery, the bare recollection of Avhich at this moment makes me shudder. I hope the time is near at hand Avhen the peo- ple will awake to their (rue interest, and by refusing to call upon those females who attempt the practice of midAvifery Avithout the necessary qualifications, cause all those Avho Avish to engage in a practice of such vital im- portance, to first prepare themselves for the faithful per- formance of the duties involved in the same. Imagine not my fair readers that I wish all females to be pre- vented from pursuing the practice of midwifery. Far from it. Were an intelligent Avoman to take the ne- cessary steps to acquaint herself Avith anatomy, physi- ology, and every thing pertaining to the art, she of course would be qualified in a greater degree than any man of sim- ilar acquirements, to act as an accoucher. Let females study sufficiently, previous to engaging in practice, and I would say, let them monopolize the practice of obstetrics, to the entire exclusion of men. A female attendant in whom the patient in child bed could place the most implicit con- fidence, would surely be the most agreeable, but as the 236 CHILD BED. practice is now pursued, I tremble at the anticipated results, to many an affectionate mother'-and'her infant. Only look around you and see the effects of ignorance among midivives that you have knowledge of, and take warning by the same. Although most of my aged female readers know something of the injury1 society has sustained, from the errors of female midAvives, yet none of you I presume, has a most distant idea of the mischief that has been done. Ask the physician who has been in practice some thirty or forty years, and he can tell of many mothers and infants that have been sacrificed to the unskilful' con- duct of midAvives. Should not such results be sufficient to arouse mothers to a sense of their clanger!? Should no! every physician in Avhose breast a feeling of philanthropy exists, raise his voice against such conduct? I feel it my duty to do so, and suffer me to warn you my fair readers, as mothers, as daughters, as Avives, to discountenance such dangerous practice among your female friends. If any one of you feel that your duty requires you to become mid- Avives, for humanity's sake, for the sake of suffering moth- ers, for the sake of poster-it)-., recollect, at tlie same time that you are bound to qualify yourself for such an important undertaking. Think not for a moment that I Avould AA'ish to indulge in .any to mark that would tend to disparage the private Avoith of any female. As worthy old ladies as ever lived, pursue the practice of midwifery, without the proper qualifications; arid I freely, and with candor declare, that I have derived some information in medicine from unlettered females, arid even from the uncultivated children of the forest. If in any remarks I may have made upon this subject, I nave injured the feelings of any individual, I hope it will not be attributed to a disregard for the feelings of oth- ers, but to a sincere desire to promote the public o-ood. CHILD BED. 237 I Avill here remark, that ignorance in midwifery, is not * confined to female practitioners. Many physicians are quite ignorant of the principles of midAvifery, and even some who are extensively em- ployed ■ in . this particular branch of practice, and have a considerable reputation as "grannies," (in consequence of. not having been called to any one difficult case,) are men of too limited abilities, and too small a share of scientific attainments, to be depended on in any case attended with the least difficulty. There is nothing by Avhich the community can be imposed upon more, than practitioners of midAvifery, male or female; and there are too many characters who Avish to be called "doctor," now engagad in the practice, Avhose empty craniums and athletic frames, qualify them much better for making rails, and cultivating the soil, than for performing the delicate task of a midwife. To show that ignorance may be found among my pro- fessional brethren, I will give an instance. I Avas some- time since called to a lady with whom a female mid- wife had been three days, and a physician one. On ioy» arrival, I found the doctor busily engaged with the patient, and the female midwife gone home greatly a- I armed about the poor woman's condition. On entering the room, the doctor arose and asked me to walk out with him; I did so, and on my enquiring the difficul- ty attending the case, he replied that he could not tell. I asked him if the mouth of the uterus Avas much di- / lated—he answered that the dilation Avas considerable. 1 then enquired if she had proper pains, and was in- formed that she had. "What then," said I, "is the difficulty'? Is the pre- sentation unnatural?" He replied, that it was a breech presentation. I returned to the patient's room, and on examination, 238 CHILD BED. found a face presentation! I informed him of his mis- take, and after a re-examination, he acknowledged that ke was wrong. I discovered that too much interference had put an entire stop to the natural pains, and all that was necessary, was a dose of ergot, to produce sufficient pain. I proposed this plan to the doctor, but he stren- uously opposed it, saying that there was too great danger. I endeavored to reason with him, speaking of the ex- tensive dilatation of the mouth of the uterus, but he Avas inflexible. I accordingly told the husband of the lady we differ ed, and enquired which should take the responsibility. He said that he Avished me to do it. I then informed the doctor that I should assume the responsibility of act- ing as I thought best, and requested him to administer the infusion of ergot, as I directed, and if the patient died, the blame must fall on rne. He did so, while I attended to the lady, and in twenty minutes I delivered , her of a dead foetus, with its face mangled most shock ingly. In conclusion, I will say, that the female who is. a- bout to call for assistance in midAvifery at any time, and in any section of country, should be guided by reason and common sense, and if a female be in her neigh borhood, engaged in the practice of midwifery, who ru'j qualified herself, call upon her in preference to any man, but if she be unqualified, call upon a good physician by all means. DISEASES OF CHILDBED, &C. 239 DISEASES OF CHILDBED. PUERPERAL PERITONITIS—CHILDBED FEVER. This affection is ushered in by slight chills, alternating with flashes of heat; severe pain is generally felt at the lower part of the abdomen, Avhich is very tender to the touch. The pulse becomes full and frequent, and fever prevails throughout the disease. Although this disease is usually termed childbed fever, it is strictly an inflamma- tion of the peritoneum, or lining of the abdomen. The disease generally runs its course in five or six days, when it terminates in resolution, or death. Too great exposure to cold, is the most freqxient cause of this com plaint—females in childbed, should therefore be very care ful not to get out of bed, without being well wrapped, so as to be protected from cold. An equal degree of warmth should be maintained, as near as possible, dur ing confinement. Sometimes the disease is occasioned by local injury to the peritoneum; hence it often results from the mismanagement of midAvives. Upon an attack of this kind, the patient should be bled freely, suffering the blood to Hoav from a large orifice, until it be reduc- ed in fulness. This should be done in twenty-four hours from the commencement. After bleeding, an active ca- thartic should be administered. Two table spoonfuls of castor oil, with three tea-spoonfuls of spirits of turpen- * tine, are highly recommended; but my usual plan is, to give twenty grains of calomel, with ten or fifteen grains of rhubarb, and if this should not operate in four hours, I give a table spoonful of castor oil, and repeat every • hour, until purging is produced. Some stimulating lini- ments should be rubbed over the part, that is painful and tender. Equal parts of spirits of hartshorn/ and sweet oil combined, ansAvers well for this purpose. Sweating L 240 PHLEGMASIA DOLENS. after the purging ceases, is of much benefit. A tea- spoonful of spirits of nitre, and antimonial Avine com- bined equally, given every hour in some Avarm hyssop, sage, or balm tea, until sAveating is induced, ansAvers the purpose Avell. In any attack of this disease, I would ad- vise you to call in a physician, if one can be had. PHLEGMASIA DOLENS. This peculiar disease is confined to females in child bed and is knoAvn by a pale, tense, tender sAArelling of one of the loAver limbs. The patient from five to ten days after having a child, feels pain and stiffness in one groin, ac- companied Avith chills, Avhich are soon folloAved by fever. The entire limb soon becomes much SAvelled and very painful to the touch. Upon rubbing the hand over the skin, you will find a number of hard ridges, and the skin, though very hot, is Avhiter than usual. The duration of the disease is variable, continuing from tAvo to five or six Aveeks or more. Sometimes it terminates in suppura- tion, Avhich is ahvays attended Avith great danger. Treatment.—In the commencement of the attack, blood should be freely draAvn from the arm. From a pint to a quart should be taken, agreeably to the situation of the patient, and the impression made upon the pulse by the bleeding. An active purgative should be given and re- peated agreeably to the effect. A drachm of magnesia should be given every t\vo hours until purging ensues. Diaphoretics should next be given. Seven or eight grains of Dover's poAvders with three or four of ippecacuanha, giv- en every two hours, until sweating is produced, ansAvers Avell for the purpose. Flannel wrung out of hot vinegar and water, should be applied to the affected limb, and re. COLIC OR GRIPING—JAUNDICE, &C. 241 peated often in the day. The diet must be light. If con yenient, a skilful physician should be had by all means. DISEASES OF INFANTS, COLIC OR GRIPING. In slight colic of infants, ten or twelve drops of paregoric m a little sweetened water is sufficient to afford relief— In more severe cases, a tea-spoonful of castor oil, Avith live or six drops of paregoric, must be given and the child put into warm water. Should this fail, apply to a physi cian, JAUNDICE, Infants are sometimes affected with this disease. The skin becomes yelloAV, and the stools are of a dark green colour. Two or three grains of calomel should be given 10 a child a week or tAvo old., and this should be repeated m three or four days, if the situation of the child demand- it. The warm bath should also be used. SORE EYES. When an infant has sore eyes, it should be kept with the eyes excluded from the light, as much as possible. and the <7'.s Avashed with a Aveak solution of sugar of lead, tAvo or three times a day. Two grains of sugar of lead dissolved in an ounce of water, will answer a en well for the purpose. 242 APHTHA, Oft THRUSH, &C< APHTtLE, Ok THRUSH* This well known disease in its simple form, requires nothing more, generally, than the use of a solution of borax, as a wash for the mouth, or mixing powdered borax with honey, and putting a small quantity into the mouth occasionally* There is, however, a form of thrush that requires more active measures. The whole intesti- nal canal is sometimes affected. The little patient has high fever, pain in the bowels, &C, and the eruption within the mouth becomes yellow, or even black. In such cases, a small dose of rhubarb and magnesia should be given, the child put into a Avarm bath, and the borax used as above directed. Should this fail, apply to a physician. INFLAMMATION OF THE NOSTRILS. Though this is generally a trifling affection, it sometimes becomes very dangerous; the inflammation extending to the throat, giving rise to extensive suppuration, eventualh destroying life. The disease prevails mostly in cold wea- ther, the patient first sneezing—aid if you will examine the nostrils, you will find them much sAvelled. The voice becomes hoarse, the breath:::g difficult, and a co- pious discharge of a thin Avatery fluid takes place from the nostrils, Avhich in a few days changes to a thick mucous. The child is dull, and sometimes sleeps much. In consequence of the nostrils being stopped up, the in- fant is often unable to suck. A gentle dose of calomel and magnesia should be giveri at the commencement of this affection, and the bowels be kept open with castor vUl; rg-'/ated as often, as occasion may require afterwards; BOWEL COMPLAINT, OR DIARRHCEA, &C 243 Hyssop tea should be given after the first active purging, so as to produce sweating. In severe cases a blister should be applied to the back of the neck. Should this plan fail to releive in a few days, call in a skilful physician. BOWEL COMPLAINT, OR DIARRHOEA. Most infants are affected sooner or later Avith this af- fection. Disordered condition of the mothers milk, cutting teeth, exposure to cold or damp air, and improper diet, are among the causes of this disease. In severe cases ac- companied with high fever, three or four grains of calomel. with two or three of Dover's poAvder, should be givcn^ fol- lowed Avith castor oil. In more mild cases, a dose of cas- tor oil with ten or twelve drops of paregoric, Avould perhaps answer. A mucilage of gum arabic or slippery elm bark should be freely given. Should these measures fail, call a physician. CHOLERA INFANTUM, OR SUMMER COMPLAINT. The summer complaint of infants, or vomiting and purg- ing, is well knoAvn in every section of the southern country, and needs no discription from me. The treatment is simil- ar't» that pursued in diarrhoea, but a physician should al- ways be consulted if it is practicable. ,...-.' /vv .-■--„ PART FOURTH, A HISTORY OF MEDICINES, CALOMEL. This being quite the most important of our medicines, t place it at the head of the list. As a purgative it is used in doses of from 20 to 40 grains in almost all diseases in Avhich an active cathartic is necessary. In congestive fever it is certainly the only article upon which we can depend with any certainty as an evacuant of the boAvels,. In this disease, from thirty to forty grains should be given for a dose, and repeated in quantity and frequency, agreeably to the consti- tution of the patient, and violence of the disease. In con- gestive fever the liver is gorged Avith'bile, and Ave have no remedy as good to remove this engorgement as calomel. In the ordinary billious fevers of our country,, it is also our chief purgative, and in fact it is used in almost all febrile and inflammatory diseases, by all skilful physicians Avith the happiest effect. True, this, as well as all other valuable medicines, is capable of doing mischief Avhen in the hands of empirics, and even in the hands of good phy^ sician, it is sometimes attended with unfavorable results, in consequence of some peculiarity in the constitution of the patient, against which he cannot possibly guard. Is this any argument against the use of it? Almost any blessing can be converted into a curse by mismanagement. We know the stomach is often disordered in such a manner, that / CALOMEL. 245 any article of food will produce violent sickness and vomit- ing. Should Ave on this account discard all the luxuries that Heaven has bestowed upon us? Any rational mart will say at once "no." As a matter of course, we must not lay aside a medicine which has had the most decided ben- eficial effects in one thousand instances, and a deleterious effect in only a single case. I have used this article ex- tensively in a practice of-seven years^ and have seen no unhappy effect in but one instance. This Avas in conse- quence of a peculiarity of constitution, which I could not possibly foresee. The system was entirely insusceptible to the ordinary effect of mecury, and the patient doubt- less suffered more, (though life Avas prolonged a few days) than she would have done Avithout the use of calomel. Though this Avas the only case in all my practice in Avhich I, in the least regreted the use of calomel, some of- the people Avere loud in their cries against me for us- ing "marcury" (as they pleased to term it) urged and no doubt by a few ungenerous, ungentlemanly, interested physicians. I venture to assert that I have resorted to salivation less than any physician of my acquaintance, having -salivated but three or four patients in my life. Though salivation has snatched-many an individual from the jaws of death, I have ever been opposed to it only as a last resort in severe diseases. It is evident that*the popular voice is against the use of mercury, hence a few individuals in the United States have siezed the propi- tious moment, (as they think,) and under the names of "Botanic Doctors," "Thompsonians" &c, are going over the country pouring their empirical remedies into those who are sufficiently infatuated to employ them, to the manifest injury of the community among Avhom they practice. These men are loudly declaiming against all minerals, as poisons, and at the same time using indiscrim- • inately, lobelia, and many more of the most virulent poisons k 246 CALOMEL. of the materia medica. This is not to be wondered at. When Ave see the prejudice that exists against mineral medicines, we need not be surprised that indolence and avarice should influence some men to try to impose upon the credulity of the people. Can it be possible that these wonderful "-life preser- vers" are aware of the minerals that exist in their vege- tables, Avhen they are crying out so lustily against the medi- cal profession. These are not all who are exclaiming against calomel. Even seme of our profession, in order to sail with the popular current, with that disingenuousnes* characteristic of grovelling mindsr join with the general cry against mercury. Occasionally, a self important for- eigner will come among us, and finding that calomel is unpopular with the great mass of the people, will shrug bis shoulders, and with a knowing wink tell the people that these young doctors are killing them with calomel, when at the same time, he is himself disguising the article, by puting it into pills and boluses, and pouring it into his patients perhaps to a greater extent than those Avhom he denounces. While coming out in sweeping denuncia- tions against the physicians of the country, whom they are pleased to call "• quacks," they are guilty of more em- piricism themseh'es, and combining many medicines to- gether to prevent an easy exposure of their practice. Some of these foreigners seem to suppose because they were horn under a monarch, have crossed the "big waters, can imitate the actions of a monkey, and utter broken English, that they should have the decided preference over a native horn American. Such want of candor, such selfishness, Mich ungenerous conduct towards the medical men of our own country, and such despotic feeling, deserve the public censure: but it seems that the multitude delight in some- riling novel. When a foreigner comes into our country .ailing himself a physician, how soon will some one say CALOMEL. 247 ,kOh, he is a great doctor, he come from France, England or Germany, he Avas seven years in the Hospital, he is a well read man, a classical scholar, pursues a new plan in fever" &c &c, without the slightest evidence of his having any medical knowledge, or even a common good educa- tion, more than his OAvn boasting. How infatuated, people are! can any one suppose that a physician born in a far country, in a climate entirely different from ours, can be as Avell qualified for managing diseases of this country, as one brought up in our own clim- ate, and practicing in the same? Surely any person Avill set at once that our OAvn citizen has the advantage. Then why encourage a foreigner in preference to one brought up and educated Avith you? Why cause the intelligent med- ical man, Avho received his medical information Avithin your own knoAvledge, to abandon the home of his youth, and fly to a land of strangers to seek that encouragement that you withhold from him? Imagine not that I Avisb real Avorth to be overlooked, because it is beheld in the garb of a foreigner, I have no such Avish. Judge a tree by its fruit, and suffer not envy or prejudice to sway your judge- ment about a physician of your immediate section of country. To return to the subject of calomel, I Avill say that I detest that hypocrisy, dishonesty, and downrigpht meanness, that will cause a member of our oavii profession to abuse his brethren for using calomel, and at the same lime disguising it with other medicines, and giving it to a> great an extent as any other. As to myself, I say with that candor that I hope will ever characterize my life, that I have used it extensively and Avith the happiest effect. I here say without hesitation, and fearless of successful contradiction, that calomel is one of the best remedial agents of Avhich we have any knoAvl- rdge. Where is the medical man, where is the modern Paracelsus, who dares to lift his pen against this important •248' RHUBARB--JALAP. medicine? The experience of the ,best physicians of thi> and all other countries, has proven the truth of my asser- tion respecting this highly important article. RHUBARB. This is] also a cathartic, given in doses of-from 20 to 40 grains, combined with calomel in 10 or 15 grain doses.— I use it extensively in almost all febrile and inflammatory diseases, but seldom use it alone. Given in doses of from 4 io 10 grains, it has a good effect in dyspepsia as it is gently tonic. From one to two grains of rhubarb, with 4 or o grains magnesia, ansAvers well for the griping bowel com- plaints of children. It is sometimes applied in powder to ulcers. JALAP. This is a more drastic purgative thai! rhubarb; the dos*-- i> from 20 to 40 grains. It is used by some physicians in this country, in combination Avith calomel, in fevers I seldom use it except in dropsical diseases. Combined with cream of tartar^ one part of jalap, with three parts of i-ream of tartar, and given in tearspoonful doses, twice a day, it has a happy effect in dropsy, bringing away .copious watery discharges from the bowels. SENNA LEAVES—ALOES--CASTOR OIL. 249 SENNA LEAVES. This is sometimes used as a purgative in infusion. I have sometimes used it after a dose of calomel, by put- ting a small handful of the leaves into half a pint of boiling Avater, and after infusing a feAV minutes, tak- ing a table spoonful or two every hour until purging com- mences. I also use the infusion with children, in doses proportionate to the age, in consequence of the ease with which we can administer it. In making the infusion care must be taken to keep the vessel covered. ALOES. This given in from five to fifteen grains acts as a cath- thartic, though it is seldom used alone in this manner. Krom one to two grains giAren once or twice in twenty-foyn' hours answers Avell to obviate habitual costiveness, and i> especially beneficial in persons Avhose digestion is impaired, or Avhose liver is in a torpid condition. Combined Avith other medicines as in Cook's pills &c, it is valuable in various diseases. The habitual use of aloes is apt to pro- duce piles. CASTOR OIL. This is an article well knoAvn in domestic practice giv- en in doses of from one to tAvo table spoonfuls as a gen- tle cathartic. Two table spoonfuls of this oil with 25 or 30 drops laudanum, ansAvers Avell in dysentery and other boAvel affections. To remove bilious matter from the stomach, it is of no use, but given after a dose of calomel 250 FLOUR OF SULPHUR—MAGNESIA, &C it answers very well. In the colic of infants it can be given in 5 dose of a tea-spoonful or more agreeably to the age of the patient. FLOUR OF SULPHUR. This I seldom use. only as a laxative combined with cream of tartar. These two articles combined in equal quantities, I have used in piles with good effect, in doses of a tea-spoonful two or three times a day. I also use it in this way to obviate costiveness, and keep up a regular action of the boAv^els, MAGNESIA. This I seldom use, only as before mentioned in combina- tion Avith rhubarb. It serves to correct acidity of the stomach, and is very useful, given occasionally in doses of a tea-spoonful, to Avomen in a state of pregnancy, who are troubled Avith heart-burn. CREAM OF TARTAR. This is a pleasant article to take as a laxative, in warm weather especially. I sometimes use it Avhile usin«- oth- er medicines in fevers, letting the patient have a small quantity in a cup of water occasionly. , It is cooling to the system, and promotes the discharge of urine. Com- bined with epsom salts, it is sometimes used in doses of a tea-spoonful twice a day, to prevent costiveness. EPSOM SALTS--1PPECACL^W$&MeMETIC TARTAR. 251 III*" ,' EPSOM SALTS. This well known medicine is of little benefit in any way, except given in small and repeated doses, to cool the system and prevent costiveness. People often use salts in bowel affections to their manifest injury, as it is decidedly deleterious in such cases. IPPECACUANHA This I consider one of the most A'aluable emetics. The dose for an emetic is about tAventy grains, but I prefer put- ting from 25 to 30 grains into four table spoonfuls of warm water, and giving one fourth of the mixture every 15 min- utes, until vomiting takes place. I give all emetics which I usein this Avay. This is certainly the safest plan, as dou- ble the quantity is required to operate on one individual as an emetic that is upon another. I find ippecacuanha, twenty grains to one pint of cold water, an excellent ar- ticle as a cooling diaphoretic in feATers. My plan is to give a table-spoonful of this mixture once in two hours. If it produce vomiting, the dose must be lessened. You will find this medicine in several combinations hereafter. EMETIC TARTAR. This is used as an emetic in doses of from two to four or five grains. It seems te be placed as the most impor- tant emetic by the most of writers, but OAving to its vio- lence I am opposed to it except in cases attended with im- mediate danger, and an active emectic much needed. I L 252 ^INK ROOT--OIL OF WORM SEED. have used it only in a few cases of croup as an emetic. One grain of emetic tartar dissolved in a quart of Avater and used in Iavo days, continuing the use for several days is an excellent plan, for removing an enlargement of the spleen arising from intermitting fever. PINK ROOT. This vetctable which grows in our OAvn country, is cer- tainly one of our most valuable remedies for removing Avorms from the intestinal canal; though some of our physicians from an aversion to every thing "com■mon,, neglect the use of it. Fearing that the people will become acquainted with the importance of the article, and obtain it themselves, thereb}' avoiding the necessity of calling a physician, some of the profession are so selfish as to en- deavor to keep the people ignorant of its qualities. I usu- ally take a small handful of the herb (root, stem and leaves) to which I put a pint of water, and after boiling it a few minutes and letting it cool, it is fit for use. Of this decoction I give one tenth every hour until it is all ta- ken, to a child from two to six years old. Immediately after I give the last of the decoction, I give a good dose of calomel. This plan has generally succeeded in mv h an els. OIL OF WORM SEED, The oil of Avorna seed is used for worms also. From three to eight drops mixed Avith sugar can be given to a child tAvo or three years old, twice a day for three or four days followed by an active dose of calomel. This is a good plan., but I seldom resort to it. PERUVIAN BARK—COLUMBO—GENTIAN. 253 PERUVIAN BARK. This is a valuable tonic and has been much used in in- termittents, in doses of from one to tAvo drachms every hour during the intermission ; but since quinine has been in use, the barks are seldom used, except among some of the old physicians who seem to suppose their OAvn plans better than any other, because they resorted to them forty years ago. Quinine is the active principle of the bark, and one grain of it is equal to a drachm of the barks, then, why give the bark so disagreeable to the stomach ? One grain of the quinine given every hour during the in- termission is sufficient to arrest an ague in a few days, pro- vided the system is prepared for the administration. COLUMBO. This is a good tonic to be used during convalescence from fevers and other cases of debility, three times a day. IVom 15 to 30 grains of the poAArdered root, or from one and a half ounces to three ounces of the infusion may be taken for a dose. The infusion can be made by pouring a pint of water to a half ounce of the root, and letting it stand a feAV hours when it will be fit for use. GENTIAN This root which can be procured at any of the shops, is similar in property to columbo and can be used in like manner* 254 WILD CHERRY—DOG-WOOD—RUST OF IRON. WILD CHERRY. The bark of this tree is a very strengthening medicine, and answers Avell in debility. In jaundice it is particu- larly beneficial. Infuse an ounce of the bark in a pint of cold Avater 24 hours, and take a Avine-glassful three or four times a day. DOGWOOD. The bark of this tree is similar to the peruvian bark : and thirty five grains of the dogAvood bark are equal to thirty of the peruvian. It can be used in infusion either alone or with the wild cherry bark in a similar manner to remove debility and restore the strength. RUST OF IRON. This is an excellent tonic in feeble and cachectic con- ditions of the system. In the green sickness of females. suppressed menses, and other diseases attended Avith debili- ty it is a very good remedy. It is also used with great benefit with those children who are pale and dropsical, la boring under what our good mothers call "cachexy." It should be given in doses of from ten to thirty grains three times a day. There are other preparations of iron un- necessary to mention. OAK BARK—-KINO—-SUGAR OF LEAD, 255 OAK BARK. The oak bark used in medicine is the bark of the black oak. A decoction of this bark has been used successfulIv in intermittent fever, but is certainly an inferior article. I have used the decoction when cold as an injection iri prolapsus uturi and uterine hemorrhage with good effect. The oak bark powdered and made into a poultice, or the decoction made into a poultice, is a good application to mortified or gangrenous parts. The decoction for in- ternal use can be made by boiling two pints of water with an ounce of the poAvdered bark down to one pint. The dose is from one to two ounces, KINO. This gum is an active astringent. From 20 to 40 drops of the tincture is a dose. In the advanced stages of diar- ihoea and dysentery, I have used it with good effect; but I prefer combining it with other medicines, as prepared chalk, &c. Among the compounds you will find a for- mula for such cases. It is recommended in watery so- lution as an injection in fluor albus and gonorrhoea. SUGAR OF LEAD. Sugar of lead is a valuable astringent in many cases. It is nevertheless attended with some danger, and persons should not use it without the advice of a physician, as an internal remedy at least. I have used this article m the debilitating night sweats of consumption with dee- ded advantage, in doses of three grains with one gram ol 256 ALUM.\ opium. Two or three grains of sugar of lead Avith halt a grain of opium, given three or four times a day, has proved effectual in arresting a discharge of the blood from the bladder in a short time. Five or six grains of the former with one or tAvo of the latter, is our surest remedy in uterine hemmorrhage, or flooding. My plan is to repeat it every hour until it has the desired effect. The inter- nal use of this article is recommended in some other di- seases. As an external application, a solution of sugai of lead is good to apply to any inflamed part. Any re- cent swelling, highly inflamed, would be benefited by it, It is also useful as an application to hemorrhoidal tumors or the piles. A weak solution is very good for inflam- mation of the eye or sore eyes. ALUM. This is an article so well knoAvn that it is unnecessary to say much about it. It can be used in inflamation of the throat, and affections of the palate, dissolved in some' cargle with decided benefit. Half a.drachmn of alum dis- solved in a pint ©f an infusion of peruvian baifc, forms a good gargle in putrid sore throat, or that quantity dis- solved in a pint of sage tea ansAvers Avell in sore throat, or relaxation of the palate of the mouth. As an internal remedy 1 have ne\Ter used it, though it is recommended in some diseases. Dr. Eberle has used it with ippecacuanha in fluor albus, with advantage. He gave from six to ten grains of alum Avith four or five grains of the ipecac two or three times a day. Dr. DeAvees also used it in this. SAVIN LEAVES-T-.SENEKA SNAKE ROOT. 25T? SAVIN LEAVES. 1 wish to speak of this as an emmenagogue. Medical wri- ters seem to differ in their opinions about its powers in this. respect. As to myself, I can say that in every case of long letention of the menses that has come under my care, I have used it Avith unequivocal benefit. After having first paid some attention to the general health, I gave it in doses of from 15 to 20 grains three times a day until menstruation came on. In robust, plethoric patients, the system must first be placed in a proper situation by bleeding, purging, &c, and in weak relaxed females, I use preparations of iron and other tonics, until the system is renovated, and then; resort to the use of the powdered, savin leaves. SENEKA SNAKE ROOT, This is highly recommended by Dr. Chapman of Piladel- phia as an emmenagogue. I have never used it in but one case of amenorrhoea, and that without any effect, but the testimony in its favor is good, and I would advise a fair trial of it. A decoction made by boiling an ounce of the bruised root in a pint of water, until it is reduced oja.e third^ should be used* Three or four ounces of this should be used in a day, and gradually increased to as much as the stomach will bear. Q 258 OPIUM—CAMPHOR—ASAFCETIDA. OPIUM. This though a dangerous medicine, is one of our most powerful remedies. It is employed in a variety of diseases. I have given from one to tAvo grains of it one hour before an expected paroxysm of ague, and prevented the attack completely. It should not however be given until the sys- tem has been reduced by purging. It is recommended in locked jaw, St. vitus' dance, gravel, neuralgia, violent cramp colic, rheumatism, &c. I have used it in almost all of the most painful diseases, when no feAer exists, Avith the most happy effects. A grain of opium, or 30 drops of Jaudanum, is a common dose* , CAMPHOR. This is also a medicine much used in painful, spasmod- ic, and convulsive affections. It is recommended in mania, chorea, puerperal convulsions, rheumatism, painful men- struation, catarrh, typhus fever, and other diseases. The dose is from two grains to a scruple. ASSAFGETIDA. This is one of our most valuable antispasmodics,and ap- plicable to almost all nervTous affections. It is used in hysteria, typhus fever, chorea, and other diseases. I have used it in watery solution in asthma, Avith the happiest effect. The dose, in substance, is from three to thirty grains, SULPHURIC JETHER, &C 259 SULPHURIC .ETHER. This is a diffusible stimulant, and antispasmodic, given m hysteria and other spasmodic affections. I have gener- ally used it in combination Avith laudanum in severe colic, in paroxysms of gravel, to check vomiting, &c. Dose from one to three tea-spoonfuls. CARBONATE OF AMMONIA, OR HARTSHORN. This is one of the most valuable stimulants. In the sinking stage of typhus fever, and other diseases it is our principal stimulant. It is also recommended in chronic rheumatism, flatulent colic, hysteria, and other cases.— It is certainly our safest remedy, used both externally and internally, for the bite of the rattlesnake and other poisonous reptiles. The dose of the carbonate, is from five to tAventy grains; and of the spirit, from 10 to 30 drops. NITRE. This is a diaphoretic sometimes used in fevers, in doses of from ten to fifteen grains. I seldom use it only in combination Avith other medicienes. A solution of nitre >n vinegar is recommended in scurvy. Eight ounces of nitre, are disolved in sixty ounces of vinegar, and from three to eight ounces of the solution taken in the course of the day. 2S0 EUPETORIUM PERFOLIATUM, OR BONE-SET, &.C. EUPATORIUM PERFOLIATUM, OR BONE-SET. This is a valuable medicine growing plentifully in our bottoms. In large doses it proves emetic, in small doses it is diaphoretic and tonic. It has been successfully used in ague. A weak infusion, taken ai bed time so as to produce sweating, is good in catarrhal affections, acute rheumatism, &c. Dose of the powdered leaves, from ten to twenty grains as a tonic or diaphoretic. An infusion made by pouring a quart of boiling water to two drachms of the leaves may be used, a gill once in three hours, until sweating is produced. GUM GUYACUM, This medicine has been much used in rheumatism, gout, &,c. It is also recommended in chronic catarrh, and painful menstruation. Dose of the powdered gum, from ten to thir- ty grains; and of the tincture, from one to two tea-spoon- fuls, given three times a day. SARSAPARILLA. This plant, growing in various parts of the United States, is a valuable medicine in many diseases. It is recommend- ed in the venereal affections, in scrofula, rheumatism, and chronic diseases of the skin. A gill of the decoction of the root, ».iay be taken three times a day. Ik* SPANfSH FLY--SQUILL ROOT—BALSAM COPAIVA. 261 SPANISH FLY. This article is knoAVn as the blistering fly. Besides being used for blistering, the tincture of the Spanish fly is used in diseases. I have used it in immoderate flow of urine, and in painful menstruation, with good effect. From twenty- five to -sixty drofps of the tincture, should be given th re- times a day, observing to lessen the dose, or omit the use of k for a time, when any difficulty of making water occurs. SQUILL ROOT. This is a valuable diuretic and expectorant. It is used in dropsy, inflammation of the bronchia, whooping cough, and other coughs, generally Avhen the system is free from fever. The dose in substance, from one to four grains, the tincture and vinegar, from thirty to sixty drops. The honey of squills can be taken for coughs, a tea-spoonful or two ic a 'dose, three or four times a day. BALSAM COPAIVA. This is a diuretic much used in several diseases of the urinary 'organs. In gonorrhoea, or clap, it is a valuable remedy, combined with spirits of nitre, in equal quantities,, and given in tea-spoonful doses three times a day; using at the same time a tea-spoonful of salts, night and mor- ning, and living on a mild diet, will generally perform a cure in a short time. In fluor albus, I have used it with success. Thirty drops should be given three times a day. It is recommended in similar doses in diarrhoea ©.£ long standing. i 262 SPIRITS OF NITRE—AGRIMONY, &C* SPIRITS OF NITRE. This is a mild diuretic, and diaphoretic. As a diuretic- it can be used with children,, in doses of from ten to fif- teen drops* As a cooling diaphoretic, I have used it Avith the best effects in fever. A tea-spoonful should be given every hour Avhen the fever is high. AGRIMONY.. AGRIMONJA.. This vegetable groAvs in hedges, to the height of tAvo or three feet. The blossoms Avhich appear in July are }'eIloAv. Cuckold is the name by Avhich this herb is known, in con- sequence of the seed in the fall of the year adhering to the clothes. Two handfuls of the root put into a quart of boiling Avater, forms an infusion much recommended by some in diarrhoea, scurvy, and jaundice. The dose is half a pint, to be taken three times a day. It may be SAveetened with honey or sugar to suit the taste.. BLACK ALDER. ALNUS NIGRA. This bush so Avell known in this country,, groAvs in moisc ground, springing up in clusters eight or ten feet high, and bearing a red berry. The bark is some times used in ague, and diseases attended with debility, and seems to possess a similar property to the Peruvian bark. It can be taken in decoction, a handful or tAvo of the bark beino put into tAvo or three pints of water, and boiled until it is strong, and a tea-cupful taken three times a day. BARBERRY. RERBERIS VULGARIS--DEWBERRY, &C. 26; BARBERRY. BERBERIS VULGARIS. This shrub grows in hedges, and along roadsides. Th> leaves are very tender, of an oblong shape, and much liable to the rust. A decoction of the berries, made by putting a double handful, to three pints of water, ana boiling doAvn to two pints, is much used, by some, for jaundice, and is also used in dysentery, and other boAve! affections. Dose, a tea-cupful four or five times a day. DEWBERRY AND BLACKBERRY. These fruits, though found on different kinds of briars, are Avholesome, when ripe. A decoction of the root of the dewberry especially, is an excellent remedy, in dysentery. Tavo handfuls of the root should be put into three pints of water, and boiled down to a quart. Milk however Avould be better than water. Dose for an adult, is a tea-cupful, once in three hours. I haAre myself prescribed this with benefit. PUCCOON ROOT. SANGINARIA CANADENSIS. This plant groAvs about one foot high in rich places. The flowers are white, and appear in the month of April on naked stems. The leaves are some round, and indent- ed like those of the white oak. From tAventy to thiitv grains of the" root in powder, is an active emetic, and one grain of the same taken once in two or three hours pro- duces SAveating. Dr. Smith of NeAV Hampshire, is said to have cured polypus, by having the poAvder of puccoon root snuffed up the nostrils. It has been used with ben- 264 BEECH DROP—SWEET FLAG. efit in inflammation Of the lungs. From twenty to thirty grains of the powdered root, should be infused in half a gill of hot water, and one or two tea-spoonfuls taken every half hour or hour, agreeably to the violence of the disease, until some abatement of the symptoms occur. It is re- commended by some in dropsies, consumptions, hooping cough, &&, BEECH DROS>. OROBANCHE VIRGINIANA. This grows in every part of the Uirited States, or nearly so, and is usually found under the beech tree. It has con- siderable reputation in cancerous affections. The powder of the root has been applied to cancers, arid indolent ulcers, with decided benefit. It has been, used in infusion in dys- entery, but I know nothing Of its beneficial effects in this disease. A decoction has been applied to the skin in er- ysipelas, with some benefit. sweet Flag, acorus calamus This article is found in shallow Avater, and low marshy places. The leaves are long, and in the shape of a sword. The root bas a strong, aromatic smell, especially when dry. This part of the plant, taken in infusion, promotes digestion, has a tendency to prevent flatulent colic, &c. Added to wild cherry bark, dogwood, or peruvian, and made into bitters, it answers well to take once, or twice a day, to prevent ague, &c CINqueFoil—COMFREY—CRANES' BILL. 265 CINQUEFOIL. POTENTILLA RETTANS. This grows in our pastures, and resembles the straw- berry vine. "The vine runs along on the ground, having five leaves together, and a yellow flower. A decoction made by boiling a handful of the root, in a quart of water, is an excellent remedy in dysentery, and other affections of the bowels. Dose for an adult, a tea-cupful three or four times a day. COMFREY. CONSOLIDA. Phis Avell knoAvn plant, is cultivated in our gardens, the leaves are large, and of a pale blue color, the root black on the outside, but white internally. A handful of the roots, boiled in a^uart of milk, and used as the infusion of cinquefoil, is a good remedy in dysentery, gonorrhoea, and lucorrhoea, or Avhites; though, it should not be depen- ded on to cure gonorrhoea, but used as an auxiliary. CRANE'S BILL. GERANIUM MACULATCM. Crane's bill grows in the Avoods and meadoAvs, five or six inches high, has slender stalks, and seven leaves at •a joint. The root, Avhich is of a dark, knotty appear- ance, has a rough taste, and an aromatic smell. The powdered root in doses of a tea-spoenful three times a day, is a good remedy to check immoderate flow of the men- ses the whites, gleet, &c. Among all the medicines used as stypticks, to stop bleeding, this article has acquired with some of the medical profession, the highest repu- tation. I have never used it; but we have authority in 266 ELDER—SLIPPERY ELM. favor of it as a powerful medicine to arrest bleeding from Avounds; and though it originated as a styptic AA'ith the uncultivated children of the forest, it deserves the no- tice of every medical man ; and should be cultivated in our gardens, as it is in ether sections of the United States. The powdered or bruised root, should be ap- plied to the bleeding surface, in order to stop bleeding. ELDER.. SAMBUCUS NIGAR. The elder is well knoAvn in this country; it grows to a considerable height in hedges about meadows. When voung, the stalk is full of peth, and as it gets old,, it becomes entirely hollow. The flowers appear in July, and the beisry when ripe, is of a purple eolor. The juice of the eMer berry, evaporated by putting it inta a broad dish, and placing it in the sun until it becomes of the consistence of a conamon extract,, is a mild laxa- tive, and answers well to obviate costiveness. It should be takes m doses from a tea-spoonful, to a table spoon- ful,, sufficiently often, to keep> up, a regular action of the ! owels.. An infusion of a handful of the leaves to a quart of boiling Avater, answers the same purpose, and is said to promote perspiration also. The flowers stewed in lard, form a good ointment for burns.. SLIPPERY ELM. ULMUS RUBRA. I have found the mucilage of slippery elm bark to be one of the liwosti useful artioles in dysentery and diarrhoea,. that we can use During my attendance in the Cher- okee Hospital, the dysentery prevailed to a great extent, and finding many of the Cherokees opposed to taking TNDIAN TOBACCO. LOBELIA XNFLATA. 267 i any medicines with which I could supply them, I di- rected to take slippery elm bark, make an infusion, and drink freely. This pleased them,, and they would get the bark, make decoctions^ and use it in large quantities —and many cases AA'ere cured in a short time with this remedy alone. I have used this mucilage in almost all febrile diseases, with good effect. There is no necessity to. be particular about the quantity used, so> that it is not immoderate. A decoction made so. as to form a jelly, to which is added a little sugar and nutmegs ansAvers as a substitute for arrow root. A poultice made of the bark, Ls a good application for burns, Avounds,. ulcers,. Sac. INDIAN TOBACCO. LOBELIA INFLATA. Lobelia grows in dry fields, is about two feet high, floAvers in July and August, with cups filled Avith man) seeds. There are several stems to each plant, and the floAvers are of a pale blue color. The leaves are oblong, and have a similar taste to common tobacco'. The leaves are used as a medicine—and though a valuable remedy, lobelia is a most violent narcotic poison, and should be prescribed only by those acquainted with medicine. This is the principal emetic used? by those Steamers, infesting some portions of the United States, calling themselves doctors, a large proportion of whom- know as little c the modus operandi of lobelia itself, as they do of the human system,. an<2 as little of the human system as the ordinary farmers of the conn-try,, who have more honor and humanity, than to tamper thus Avith the live3 of their fellow creatures.. Some intelligent individuals, it is tr. e have been known to practice the Thomsonian system of humbuggery and empiricism, fee pecuniary 268 INDIAN TOBACCO. LOBELIA INFLATA. gain, but they are "few and far between." Many val- uable lives Irave doubtless been lost by the use of lo- belia in unskilful hands. The leaves should be collect- ed in August, and dried. From ten to twenty grains of the powdered leaves, answers as an emetic—or it may be given in tincture from a 'tea-spoonful to a table spoon- ful. As it is certainly a most poAVerfnl medicine, a sa- fer Avay, -and one I avo and ERRY TREE. MORUS NIGRA--MUSTARD SEED. 275 the under side of a lighter colour, and doAvny. The Avhole plant is someAvhat bitter. As medicine, it is recommended in ague, jaundice, difficult menstruation, dropsy, and dys- pepsy. It can be used in infusion, a handful of the tops to a quart of boiling water ; of this a tea-cupful can be taken three or four times a day. It is also used by some, to remove worms from children. I am induced to believe, that the use of it in the spring of the year, Avould tend to prevent children from becoming so weakly. MULBERRY TREE, MORUS NIGRA. The mulberry tree is well known in the United States, it bears a fruit at once pleasant to the taste, and wholesome. A syrup made of the juice of this fruit, is a useful gargle in inflammation of the throat. The bark of the root in powder has been successfully used as a cathartic, and also to destroy worms. The dose of the poAvdered bark is half a tea-spoonful. MUSTARD SEED. SINAPIS. Both the black and the white mustard seed are used in medicine. Used with food, mustard seed promotes diges- tion, increases the appetite, and is especially beneficial to persons who are generally weak. The seed can be used as an emetic by putting a table-spoonful of the poAvdered seed into a pint of Avarm water, and drinking it. A table spoonful of the seed not bruised, taken two or three times a day, is useful in chronic rheumatism, palsy, asthma, dropsy and dyspepsy. Sometimes a tea-spoonful of the flour of mustard, added to the peruvian bark or quinine, will prove successful in ague, Avhen the bark alone may 276 PEACH TREE. AMYGDALUS PERSICA. fail. Mustard Avhey can be made by boiling three table spoonfuls of the bruised seed in milk and Avater, a half pint each, until the curd separates, then to the Avhey add a little sugar. Of this a tea-cupful may be taken three or four times a day in Ioav stages of disease, especially ner- vous affections. Mustard seed mixed with flour and a little vinegar added so as to form a poultice, is an excllent application to the soles of the feet, to the ancles, and Avrists in low stages of fever, Avhen the blood does not circulate freely in the extremities. PEACH TREE. AMYGDALUS FERSICA. The bark, the leaves, floAver, and kernel of the fruit of this tree have been used medicinally. An infusion of leaves taken in doses of a table-spoonful, repeated once in tvvo hours until it operates on the boAvels, is quite a useful purgative. I have knoAvn this preparation with a feAV drops of essence of peppermint or paiegoric, to a dose, to have a powerful effect in diarrhoea and dysentery ; aud when a boy, I was repeatedly cured of a mild form of St. Anthony's fire, by using an infusion of the peach leaves freely. We also read of some cases of billious fever having been cured by perseverance in taking from a gill to a half pint of an infusion of peach leaves, every two or three hours foi' a feAV days. It is likewise recommended in diseased jridneys and gravel. The kernel of the peach has been used Avith good effect in asthma. They should be taken two or ihree times a day in as large quantities as the stomach will bear. Should disagreeable symptoms occur, such as tremors, giddiness, vomiting, or any thing of this kind, the dose must be omitted for a time, apd re- *nnj#d .in smaller doses, PENNYROYAL—PEPPERMINT. 277 PENNYROYAL. MENTHA PULEGIUM. This is an article frequentty used by our good old moth *ts, in obstruction of the menses. It doubtless possesses some such property, but it should not be indiscriminately used. In females of relaxed constitutions, it will answer, but those of a different state should avoid it, as it is highly stimulating. I must here Avarn females in childbed, who labor under a suppression of the lochial discharge, not to use pennyroyal. Generally speaking, Avhere an entire sup- pression of that discharge takes place, inflammation of the peritoneum also takes place, or Avhat is commonly termed childbed fever; and I have seen tAvo or three females brought very near the gate of death by the use of penny royal tea, given, as the dear ignorant old ladies will tell us. " to bring on her courses." In this state of affairs, every thing of a stimulating nature should be avoided. The in- fusion of pennyroyal can be made by putting a handful of the herb to a quart of boiling Avater. Of this, a tea-cupful can be taken three times a day. PEPPERMINT. MENTHA PIPERITA. This species of mint is used in colic, flatulence, languor, vomitino- &c. The infusion made by putting a handful of the mint into a pint of boiling Avater, can be taken in half tea-cupful doses, ev^ery tAAro hours in colic, until relief is ob- tained. Of the essence, from a half, to a tea-spoonful, can be taken in like manner. Peppermint infused in brandy as hot as can be borne, and applied to the stomach, is good in nausea or vomiting, particularly in cholera morbus. I have checked vomiting in a few minutes by applying mint to the stomach. It is also good thus applied in colic, or any spas- modic affection of the stomach or bowels. 278 CAYENNE PEPPER--PLANTAIN, &C. CAYENNE PEPPER. CAPSICUM ANNUUM. This species of pepper is cultivated in our gardens to a considerable degree. It is highly stimulating, and has been used Avith benfit in colic, attended with cramp of the stom- ach, and in chronic rheumatism. It can be given in infu- sion, tAvo pods to half a pint of brandy, and given in doses of half a wine-glassful, repeated in two or three hours, if necessary. Red pepper, steeped in brandy, is good to ap- ply to parts affecri'd Avith rheumatism—and the extremities, in Ioav stages of fever. It is a medicine much used by those life preserving steaming machines in our country, called steam doctors, Thompsonians, Botanic doctors, &c. ; and en- ters into several of their nostrums, which they give to break afeverfff This is one of the many absurdities practiced by these empirics. PLANTAIN. PLANTAGO. The plantain growing so plentifully about our yards, has long been used as an antidote against the bite of the spider, snake, &c. The leaves are considered gootl to be applied to any fresh wound, as Avell as to a bitten part. They should be bruised. The juice is the part exhibited inter- nally, for the bite of the snake. It should be given in doses of tAvo table spoonfuls every hour, until some relief be obtained. The juice of the plantain is sometimes given in conjunction with that of horehound, or rue. PLEURISY ROOT. ASCLEPIAS DECUMBENS. This is a plant sometimes called fluxroot, that grows about our fences, and even in the Avoods, about tAvo feet hi<*-h having yelloAV flowers which appear in July and Auo-ust, POKE WEED. PHYTOLACCA DECANDRA. 279 succeeded by long pods Avith a kind of silk attached to them. This plant appears to be much relied upon by many in this section of country, and doubtless possesses valuable prop- erties. In colds and pleurisies, it is held in high repute as a poAverful diaphoretic, producing copious SAveating with- out heating the system. In pleurisy, as a diaphoretic, fifteen or twenty grains of the powdered root should be given every hour until sweating ensues. It can also be given m infusion, a handful to a qnart of water, of which a tea-cupful can be given once in two hours until sweating comes on. POKE WEED. PHYTOLACCA DECANDRA, The juice of the poke berries (well knoAvn in this coun- try) spread upon a cloth, is said to be an excellent appli- cation to scrofulous tumors. It should be pressed out of the berries, and evaporated by a moderate heat until it becomes tolerably thick previous to spreading it. Anointment made by simmering the leaves in lard, is used as an application to ulcers. The root bruised is ap- plied by some to the hands and feet of patients in fever. An infusion of the leaves is useful as an external appli, cation in piles. A tincture made by filling a bottle Avith the ripe berries, and pouring on them as much brandy as the bottle will hold, is very good in rheumatism, a wine-glass full three times daily. There are other cases in Avhich this plant is sometimes used. Some persons make use of the young leaves for sallad, and also pickle them. This should never be done as the Avhole plant is poison. When a boy, I used freely of the young leaves and stalks pickled, which produced distressing sickness and violent vomiiino-; and though many years have elapsed since that time- if on taking my seat at a table on Avhich pickles of 280 POPLAR—PRICKLY ASH—CHINA TREE. any kind are placed, I happen to think of the pickled poke, the mere thought produces nausea, and I am unable to taste a pickle. I am convinced that I was poisoned by the use of such pickle. POPLAR. LIRIODENDRON TULIPIFERO, The bark of the common poplar of our country, both of the body and root, is an excellent tonic, being but little inferior to the peruvian bark in ague, and the Ioav stages of different diseases requiring strengthening rem- edies. The dose of the powdered bark is the same as that of the peruvian bark or it may be made into a strong decoction, and a tea-cup half full taken frequently. PRICKLY ASH. ZANTHOXYLUM. The bark of this tree is much relied upon in chronic rheumatism. The decoction should be made by boiling an ounce of the bark in one quart of water, and using ;i pint of this in the course of the day. It is also somtimes used in colic. CHINA TREE. MELIA AZEDARACH. The bark of this tree is good to destroy worms; but bein* a most virulent poison, it should be used with caution. The decoction can be made by boiling a handful of the fresh bark in three pints of water down to a quart. Of this half a wine-glassful, can be giA?en to a child once in three hours, until it operates on the bowels. I have never used the china bark or root in pratice, having been poisoned se- SKUNK CABBAGE—TANSY. 281 verely when a child six years of age, by an over dose of an infusion of the root. I Avas speechless twenty-four hours, and had I not receiA'ed an antidote from a physician at a distance, it is likely that I should not have survived an- other day. I Avould not advise the common use of this article among children. SKUNK CABBAGE. DRACONTIUM FCETIDUM. The skunk cabbage groAvs in swamps and has a disa greeable scent, similar to that of the polecat. The povu- dered root has considerable reputation in several diseases. Given in doses of thirty or forty grains, it has had good effects in asthma. It should be given during the parox- ism, and repeated agreeably to the violence of the disease, and continued sometime after the paroxysm shall have subsided. In rheumatism and some other painful and spasmodic diseases, it has been used by some practitioners with benefit. TANSY. TANACETUM VULGARE. , An infusion of tansy, which is cultivated in our gardens, is used by families as a common bitter. It is certainly good to promote digestion, by its tonic effect, and shorn J be used in the morning, especially by those having fee- ble appetites, &c. It is also recommended in obstructed menses, and worms, and is very safe for children. 282 BLACK SNAKE ROOT—WHITE WALNUT--WILLOW. BLACK SNAKE ROOT.—Serpentaria Virginiana. This is a powerful diaphoretic, but should not be given when fever exists in consequence of its stimulating effects, In ague, it is an admirable remedy combined with peru- vian bark. As a diaphoretic, it can be giAren in infusion made by boiling a handful of the root in a quart of wa- ter, and taking a tea-cupful every two hours until sweat- ing is produced. It is valuable in rhematism used in this way. » WHITE WALNUT. JUGLANS ALBA. The inner bark of this tree poAvdered and made into common pills is an excellent cathartic, given in doses of four, five, or six such pills. One or tAvo pills taken at bed- time proves serviceable in habitual costiveness. In full doses it is higiy recommended in bilious fever, dysentery, &c. The bark of the root poAvdered, answers very well to raise blisters. WILLOW. SALIX. The bark of the Avhite willovv possesses similar proper ties to the peruvian bark, and is an useful tonic in ague, and low stages of other diseases. A decoction should be made by boiling a. handful of the bark in one quart of water. Of this a Avine-glassful should be taken in inter- mittent fever every three hours, until three or four doses are given during the intermission every day, when practi- cable. In the Ioav stage of other diseases, three closes a dav will be sufficient. SASSAFRAS--RED CEDAR--WILD POTATOE. 283 SASSAFRAS. LAURUS SASSAFRAS. A tea of the bark of the root of this tree, is an excellent drink for persons to use in the spring season, particularly those Avho arc subject to diseases of the skin. An oil made from the buds, is used externally in rheumatism. The pith put into water, forms a mucilage that is used for sore eyes, with good effect. RED CEDAR. JUNIPERUS VIRGINIANA. The leaves of the common cedar of this country, possess similar properties to that of savin, and can be used as that article. For information respecting the manner of using the cedar leaves, see the article on savin. WILD POTATOE. CONVOLVULUS PENDURATUS. This plant groAvs in sandy and moist lands, having a vine something like the common SAveet potatoe, though running to much greater lengths. The flowers are white with some purple, and bellshaped, the loot large and white. It is used as a cathartic in doses of from a tea- spoonful, to a table-spoonful of the powdered root. A de- coction made, by boiling a handful of the sliced root in three pints of Avater, has been recommended in gravel. 284 POPPY--ONIONS--HORSE KAD1SH. POPPY. PAPAVER SOMNIFERUM. This article affording the opium spoken of in this work, is sometimes used as an external application, &c. The heads made into a poultice, can be applied to painful swell ings with good effect. A syrup made by putting the dried heads into half the quantity of sugar, and simmering it slowly for one hour, is very useful in coughs, and corn plaints of the breast. It can be given in doses of a table spoonful three or four times in twenty-four hours. ONIONS, ALLIUM CEPA. The onion possesses similar property as a remedial agent, to the garlic, Avhich article see. As an. article of diet, the onion is generally considered very Avholesome, but is stimulating, and should not be freely used in billions habits, or those predisposed to fever. Persons of a phleg- matic temperament, would do well to use this article heeiy as food. HORSE RADISH. This article frequently used as an article of diet in this country, is certainly excellent, to prmote digestion, and should be used by those affected Avith dyspepsy.— As a medicine, it is recommended in dropsy, scurvy, rheu- matism, and other affections. I have never used it as a medicine, but doubt not its efficacy in some cases. The dose is a table-spoonful of the root, cut into small pieces, and may be taken three or four times a day. COMPOUND CAMPHOR--OPODELDOC, &C 285 A LIST OF COMPOUNDS. COMPOUND CAMPHOR. LINIMENT. Take gum camphor tAvo ounces, Avater of ammonia six ounces, spirits of lavender, sixteen ounces; mix, and form a liniment. This is a useful application in rheumatism, and other painful affections of the joints. OPODELDOC. Take Avhite soap one ounce, rectified spirits one pint, gum camphor three and a half ounces, water of ammonia six drachms, oil of rosemary half a drachm, oil of origan- um one drachm ; mix all together. This as is Avell knoAvn, is also used as an external application in painful affections. COOK'S PILLS. Take of calomel, rhubarb, and aloes, of each one drachm —water sufficient to form a mass. ' Divide into common siae pills. This is a valuable cathartic to remove bilious, offensive matter from the stomach and boAvels. Its frequent use is calculated to prevent fevers, Sac. Dose, from three to seven, REMEDY FOR DYSPEPSIA. Take hickory ashes, one quart; soot, half a pint; boiling water, one gallon; mix, and let it stand twenty-four hours, then pour off the water. Dose, a wine-glassful after each sneal. 286 VOLATILE LINIMENT—TOOTH AVASH, &C. VOLATILE LINIMENT. Take olive oil, and Avater of ammonia; of each four oun- ces, and mix. This is an excellent stimulating application in diseases of the joints, those of the spine, and palsy of the limbs, TOOTH WASH. Take tincture of myrrh, tincture of peruvian bark, and water of cinnamon, of each four ounces; gum arabic, two drachms. Mix, and wash the teeth three times a day. WINE OF IRON. Take rust of iron, one and a half ownces; orange peel, and gentian root, of each half an ounce; Lusitan wine, two pounds. Put them into a glass vessel, exposed three days to a gentle heat, and it will be fit for use. Dose, from half an ounce to an ounce. This is a good tonic in diseases of debility. ASTRINGENT FOR DYSENTERY, &c, Take tincture of kino, and prepared chalk, of each, four drachms; laudanum, forty drops; water, four ounces, and mix. Dose, a table spoonful every two or three hours.__ This is a good remedy to check discharges from the bowels after the irritation subsides. MIXTURE FOR RHEUMATISM, &C. 2S7 MIXTURE FOR RHEUMATISM. Take gum guiacum, one drachm; poAvdered rhubarb, two drachms; flour of sulphur, two drachms; cream of tartar, one ounce; one nutmeg poAvdered; strained honey, one pound. Mix, and take tAvo table spoonfuls night and morn- ing. An excellent remedy in rheumatism. MIXTURE FOR THE GOUT. Take dried soda, half an ounce; poAvdered rhubarb, eie ven drachms; powdered cinnamon bark, one drachm; pow- dered ginger, one drachm; and two drachms of powdered columbo. Mix, and divide into thirty-six powders, and take one in water every night. MIXTURE FOR ASTHMA. Take carbonate of ammonia, one scruple; carbonate of iron, one scruple; and one scruple of powdered rhubarb- mix, and divide into tweh^e doses—and take one occasion ally, agreeably to the violence of the disease. RECEIPT FOR A BURN. Take oil of turpentine, and oil of rosin, of each one lb.— Mix together, and rub; oil the part affected. ^88 ITCH LOTION—MIXTURE FOR SPASMODIC ASTHMA, &C. ITCH LOTION Take corrosive sublimate, onq drachm; ^ajammoniac, three drachms ; Avater, one a hajf, pounds. Dissolve the *avo former in the Avater, and wash Avith the solution. MIXTURE FOR SPASMODIC ASTHMA. Take tincture of squills, ten drops; nitric acid, six drops; extract of hyoscianeus, three grains; Avater, one and a half ounces. Mix, one dose to be taken every third hour, MIXTURE FOR DYSENTERY. Take castor oil, one ounce; poAvdered gum arabic, and white sugar, of each one drachm; laudanum, eleven drops; water of peppermint, four ounces. Mix, and take a table spoonful two or three times daily. COUGH MIXTURE, NO. 1. Take vinegar of squills, one ounce; antimonial Avine, one drachm ; spirits of nitre, two drachms; gum arabic, two - drachms; and Avater, three ounces. Mix, and take a table spoonful three or four times a day. GARGLE FOR QUINSY. Take poAvdered peruvian bark, two drachms; sulphate of copper, one scruple; and water, three ounces. Mix, and gargle the throat. * MIXTURE FOR COLIC OF INFANTS, &C 289 MIXTURE FOR COLIC OF INFANTS. Take calcined magnesia, thirty grains; powdered rhu- barb, six grains ; white sugar, one drachm; oil of aniseed, three drops ; laudanum, four drops; and vvater, one and a half ounces. Mix, and give a tea-spoonful two or three times daily.. ANTIDOTE FOR ARSENIC. Take carbonate of magnesia, one ounce; Avater, fifteen ounces; Avine of opium, one and a half drachms; comr pound spirits of lavender, three drachms; and white sugar, half an ounce. Mix, and take tAvo table spoonfuls fre- quently. MIXTURE FOR INFLAMMATION OF THE KIDNEYS. Take powdered uva ursi, and peruvian bark, of each one scruple; opium, half a grain. Mix, and take the dose four times a day, drinking two ounces of lime water after each dose. POWDER FOR DROPSY. Take calomel, one grain; powdered squills, tAvo grains, and mix for one dose. To be taken night and morning, or oftener agreeably to the effect on the bowels, and the vio- lence of the disease. 290 COOLING REMEDY FOR FEVER, &C. COOLING REMEDY FOR FEVER. Take ipecacuanha, tAventy grains; cold water, one pint, and mix. Dose, a table spoonful once in (avo, three or four hours, increasing or lessening the dose, so as to produce slight nausea and sweating. MIXTURE FOR TINEA CAPITIS, OR SCALD HEAD. Take sulphur, three drachms; Spanish soap, one drachm; lime Avatei, eight ounces; and alcohol, two drachms. Mix, and wash the part affected, three times a day. DOVERS' POWDER. Take poAvdered opium and ipecacuanha of each one drachm, poAvdered sulphate of potash one ounce, and mix. Dose from ten to tAventy grains given once in three or four hours to produce sweating. This is an excellent article to produce sweat, in rheumatism and other painful diseases, after the fever is allayed. ANTIMONIAL WINE. Take emetic tartar one drachm, boiling Avater tAvo ounces^ Teneriffe Avine one pint. Dissolve the emetic tartar in the Water, and after it becomes-cold, add the wine. Dose frcni half an ounce to an ounce to produce vomiting. It is best to put it in half a tea-cupful of warm Avater, and give one fourth every fifteen minutes until vomiting takes place. COOLING DIAPHORETIC—COUGH MIXTURE, NO. 2, &C. 291 COOLING DIAPHORETIC. Take antimonial Avine and svAreet spirits of nitre, of each half an ounce, mix, and take a tea-cupful every hour in some Avarm tea, until SAveating is produced, some warm tea, such as hyson or balm, every fifteen minutes betAveen the doses of drops. This is good for producing gentle SAveating, and can be given in fevers. COUGH MIXTURE, NO. 2. Take honey of squills one ounce, sweet spirits of nitre two drachms, antimonial Avine one drachm, laudanum forty drops, and gum arabic tAvo drachms. Mix, and take a table spoonful three or four times a day. NITROUS POWDERS. Take nitre one drachm, calomel twelve grains, poAvdered ipecacuanha tAvelve grains, and mix. Divide into six doses, and take one every two, three, or four hours, in bilious fe- ver when the fever is up. This I find a most excellent remedy in our fevers in this country, after the bowels have been freely evacuated. The powders should be given so as to produce tAvo or three stools a day, and keep the skin soft and moist. Care should be taken, and if the gums and teeth become affected, the poAvders should be stopped forthwith. 292 T0&TIC PILLS-—BASILICCN OINTMENT, &C TONIC PILLS. Take extract of gentian, two drachms, poAvdered rheu- barb and sulphate of potash, of each ore drachm; oil of peppermint thirty drops, and water sufficient, to form a mahs. Make it into pills of ordinary size, take three or four night and morning, in weakness of the digestive pow- ers, and loss of appetite. BASILICON OINTMENT. Take yelloAV wax and yelloAV resin, of each one pound; sweet oil one pint, melt the Avax and resin OA'er a fire, and add the oil; strain through a cloth while hot. This is a good application for wounds and ulcers. ELECTUARY FOR THE PILES. Tahe flour of sulphur, one ounce, cream of tartar, half an ounce, and molasses sufficient to make it easily swal- Ioav d; and take a table spoonful of the mixture four times a day. LINIMENT FOR BURNS. Take lime water and olive oil of each four ounces, and ,mix. Rub the part that is burnt d with this three or four times.a day, WORM POWDER--INFUSION FOR PALSY, &C. 293- WORM POWDER. Take one scruple of poAvdered rhenbarb, scammony, and calomel, of each five grains, and mix. This is a full dose for a grown person, which can be divided for children, and given in molasses or honey. INFUSION FOR PALSY. Take horse radish and mustard seed bruised, of each four ounces, orange peel one ounce, boiling AVater tAvo quarts, mix, infuse twenty-four hours and strain. Dose, a tea-cupful three or four times a day. ■> MULBERRY SYRUP. Take mulberry juice one pint, sugar tAvo and a half pounds. Dissolve the sugar in the juice with a gentle heat, let it stand twenty- four hours, and pour off the syrup. This is a pleasant drink in fevers. BLAKE'S TOOTH-ACHE DROPS. Take poAvdered alum, tAvo drachms, SAveet spirits of nitre, eight drachms. Dissolve the alum in the spirits of nitre, and apply to any tooth1 that may be painful. ANDERSON'S PILLS. Take poAvdered aloes and jalap, of each three drachms. oil of aniseed thirty drops and water sufficient to form a mass, make sixty pills. Dose from three to six pills for a purgative. 294 MIXTURE FOR GONORRHOEA--STOMACH WINE, &C MIXTURE FOR GONORRHCEA. Take balsam copavia and tincture of cubebs, of each one ounce, SAveet spirits of nitre half an ounce, laudanum one drachm, sugar one ounce, gum arabic one drachm, and Avater eight ounces. Mix and take a table-spoonful three or four times a day. STOMACH WINE. Take poAvdered peruvian bark one ounce, gentian root two drachms, cinnamon bark one drachm, port wine one quat; mix and infuse five or six days. Dose, a Avine-glass full twice or three times a da)' for dyspepsia and other diseases of debility. PLASTER FOR WHITE SWELLING. Take gsm ammoniac three ounces, vinegar of squills sufficient to dissolve the gum; then add extract of hem- lock, two drachms, and solution of sugar of lead one drachm. Mix, and boil, to form a plaster, spread it upon leather and apply to the affected part. CERATE OF SPERMACETI. Take spermaceti one ounce, white Avax two ounces, sweet oil six ounces. Melt the tAvo former together and add the oil. This is a good application for blisters, burns, ulcers, &c. MIXTURE FOR SICKNESS OF THE STOMACH, &C. 295 MIXTURE FOR SICKNESS OF THE STOMACH. Take lime Avater and new milk, of each three ounces. Mix, and take two table spoonfuls for a dose, as occasion may require. LEAD OINTMENT. Take wax ointment one pound, white lead poAvdered two ounces, Mix Avith a gentle heat over the fire, and use for burns. SYRUP OF GINGER. Take ginger bruised four ounces, boiling water three pints and mix. Let it stand four hours and strain, then add sufficient sugar to form a syrup. This is a pleasant drink, good in dyspepsia, &c. MIXTURE FOR SPRAINS. Take soft soap and good vinegar, of each one f int, salt a handful, nitre a table-spoonful, and mix together. Ruh ihe affected part as occasion may require. STIMULATING MIXTURE. Take carbonate of ammonia tAvo scruples; sugar and gum arabic, of each one dracdm; oil of cinnamon five drops; water four ounces. Mix, and give a table-spoonful every hour or tAvo, as may be requisite. This is used when the system is sinking after fever, or any other diseases, to keep up the excitement. 296 PILLS EOR DYSPEPSIA—rlLLS OF RHEUBARB, &C. PILLS FOR DYSPEPSIA. Take poAvdered aloes one scruple; powdered ipecacu arrha half a drachm ; extract of hyoscyamus one scruple.— Make into a mass, and divide into twenty pills, one of which must be taken at bed time. PILLS OF RHUBARB AND SULPHATE OF IRON. Take powdered rhubarb one and a half drachms; suh phate of iron half a drachm; and white soap tAvo scruples. Mix, and add Avater sufficient to form a mass, and divide it into forty pills. Take three or four at bed time. These pills are excellent to obviate costiveness, and impart strength to the bowels. POWDER FOR DISEASED KIDNEYS OR BLADDER. Take powdered uva ursi, one and a half drachms, sub carbonate of soda, one drachm. Mix, and divide info twelve powders. Take one of these three times a day in a little sugar and water. COMPOUND OPIUM LINIMENT. Take laudanum, ether, and spirits of camphor, of each two ounces, and mix. To be applied to parts affected with rheumatism and other pains. turner's CERATE—WORM WIND, Sac. 297 TURNER'S CERATE. Take olive oil one pint, yelloAV wax and calamine, of each half a pound : melt the Avax over a fire, add the oil, afterAvards the calamine, stir until the mixture becomes cold. This is a good application for burns, Avounds, -&c. WORM WINE. Take rheubarb rOot half an ounce; Worm seed One ounce, port Avine one quart. Bruise the ingredienLs, and infuse in the Avine three or four days. Dose, a Avine glass- ful two or three times a day. OINTMENT FOR THE PILES. Take powdered galls two drachma; lard half an ounce. Mix, and apply externally. RHEUMATISM MIXTURE. lake flour of sulphur and powdered mustard seed, of each one ounce, honey sufficient to form an electuary. Dose, a piece the size of a nutmeg, three or four times a day. This is a prescription of Dr. Johnson, and said to > be excellent* FORMULAR FOR FLUOR ALBUS. Take red oxyde of iron two grains; gum aloes one grain; gum opium half a grain. Mix, and take this quantity four times a day. This is a remedy that I have never 298 .SAVIN CERATE--PAREGORIC ELIXER, &C. tried in fluor albus, but from the well known properties of the several ingredients, I doubt not the efficacy of it, especially when the patient is very feeble. SAVIN CERATE. Take savin leaves bruised, one pound ; beeswax, half a pound ; and lard, two pounds. Melt the wax and lard to- gether; boil the savin therein, and afterwards strain. This ointment is applied to blisters, to keep them open as lo»g as may be desired. PAREGORIC ELIXER. Take camphor, tAvo scruples; opium, one diachm; ben- zoic acid, one drachm ; and proof spirits, one quart.. Mix, and let it stand two days. Dose, from one to Iavo drachms. TURLINGTON'S BALSAM. Take benzoic acid, three ounces; thorax balsam, two ounces ; balsam of tolu, one ounce ; extract of aloes, half an ounce; and proof spirits, one quart. Mix, and let it stand fourteen days, and it will be fit for use. Dose, from half a drachm to two. This is an excellent remedy for coughs, pains in the chest, diarrhoea, Sac, and is applied externally to ulcers and wounds. GODFREY'S CORDIAL. Take opium, half an ounce; oil e.r sassafras, one drachm; molasses, four pounds ; boiling Avater, one gallon; spirits of wine, tAvo drachms. Dissolve the opium and oil in the spi- BALSAM OF HONEY--GALL OPODELDOC, &C 299 rits of Avine, then mix the molasses and water, and after it becomes cold, add the other ingredients. The use of this. nostrum is Avell known. BALSAM OF HONEY. Take balsam of tolu, two ounces ; storax, two drachms; opium, two drachms ; honey, half a pound. Mix, and add one quart of spirits of wine. Dose, a tea-spoonful or two^ used in coughs. It should be taken in Avater. GALL OPODELDOC. Take camphor gum, Javo ounces ; castile soap, Iavo oun- ces; spirits of Avine, half a pint. Dissolve the camphor and soap in the spirits of Avine in a quart bottle, then add one ounce of laudanum, and one ounce of water of ammonia, and fill up with beef's gall. This is a good external appli- cation in rheumatism, and other painful affections of the joints, Sac COMPOUND CAMPHOR. LINIMENT. Take gum camphor, tAATo ounces ; Avater of ammonia, six ounces ; and spirits lavender, sixteen ounces. Mix to- gether, and form a liniment. This is useful in rheumatic pains, &c. TONIC MIXTURE FOR AGUE. Take peruvian bark powdered, half an ounce; Virginia snake root, one drachm ; and carbonate of potash, twenty trains. Mix, and divide into four powders, to be taken du- ring the day in time of the intermission. 300 COOLING SWEAT FOR FEVERS—SOLUTION, &C< COOLING SWEAT FOR FEVERS. Take spirit of mindererus, four ounces ; SAveet spirits of -nitre, two drachms; antimonial Avine, one drachnr; le- mon syrup, one ounce, and mix. Dose, a table spoonful every hour, when the fever is high. SOLUTION OF QUININE. Take quinine, six grains ; elixir vitriol, ten drops ; pow- dered liquorice, one and a half drachms ; and Avater, two ounces, then mix. This is an excellent mode of preparing quinine for children, Avho have the ague. Dose, a tea- spoonful every hour, to a child from one to five years old, during the intermission. The dose for an adult, is a tabls 'Spoonful. MIXTURE OF SULPHATE OF ZINC. Take sulphate of zinc, tAvo grains ; cinnamon Avater and fountain Avater, of each one and a half ounces. Tincture of columbo, one ounce, and mix. This is a valuable remedy for ague. A table spoonful should be giv<>n every three or four hours, until the paroxysm is-arrested. MIXTURE OF SAL AMMONIAC. Take salxunmoniac, half an ounce ; powdered liquorice, one ounce ; emetic tartar, one grain ; water, eight ounces, and mix. A useful remedy to remove enlargement of the spleen, (commonly called ague cake.) A table spoonful can be taken every four hours throughout the day, until the swelling is removed. APERIENT MIXTURE, Sac 301 APERIENT MIXTURE. Take epsom salts, tAvo ounces ; emetic tartar, one grain, and dissolve in ten ounces of wafer. This solution ansAvers tolerably Avell to keep the boAvels loose in fevers/ Dose, a wine-glassful every hour, until purging takes place. MIXTURE OF SPIRITS OF TURPENTINE; Take spirits of turpentine, tA'o drachms ;. castor oil, one ounce, and mix. A combination that answers Avell in the sinking stage Of typhus fever, U a purgative be required.— It should be divided into four doses, and given half an hour apart, until all is taken, or an effect produced on the bow- els.. COMPOUND BLUE MASS PILLS. Take blue mass, one drachm; extract of hemlock, half st drach.m; powdered ipecacuanha, one scruple. Mix, and make into thirty pills. This piil ansAvers Avell to keep up a gentle salivation in diseased liver,, and other cases in which mercury is needed. One pill can be given three times a. day. MIXTURE OF EMETIC TARTAR, &c. Take emetic tartar, two grains; salt of tartar, six drachms ; water, two and a half ounces ; and strained hon- ey, tAvo and a half ounces. Mix.. A valuable expe torant for coughs, when the system is also affected Avith fever. A table spoonful can be given once in four hours to a grown person. 302 CAMPHORATED EXPECTORANT, &C. CAMPHORATED EXPECTORANT. Take poAvdered gum camphor, two scruples ; powdered gum arabic, two drachms; syrup of squills, one ounce; mix well in a mortar, and add forty drops of laudanum, and six ounces of Avater. Mix. A table spoonful may be given every hour or tAvo, agreeably to the state of the system, for coughs, when the patient is feeble, and the pulse Aveak. PILLS OF CALOMEL AND OPIUM, &c. Take calomel, eight grains ; poAvdered opium, six grains; emetic tartar, two grains. Mix, and make sixteen pills.— These are useful in acute rheumatism, after the system has been reduced by bleeding and purging. One of the pills should be given every tAvo hours. DRAUGHT FOR RHEUMATISM. Take spirits of mindererus, half an ounce ; Avine of mea doAV saffron, twenty drops ; syrup of poppy, one drachm ; camphor mixture, one ounce. Mix. This draught is re- commended by Scudamore, in rheumatism, Avhen little in- flammation exists. It is to be taken at once, and repeated in six oi eight hours. REMEDY FOR EPILEPSY. Take one drachm of Valeriana, and three drops of cajeput oil. This is a dose to be taken four times a day for epilep- tic fits. Richter is said to have cured a case of four years standing Avith this remedy, used for six weeks. PILLS OF LUNA CAUSTIC FOR EPILEPSY, &C 303 PILLS OF LUNA CAUSTIC FOR EPILEPSY. Take luna caustic, tvAelve grains ; opium, twenty grains; extract of gentian, tAvo drachms ; extract of aloes, two scru- ples. Mix, and make into ninety-six pills. One of these pills taken morning, noon and night, is said to be good in the above disease. It should not be used Avithout the advice of a physician acquainted Avith the case on hand. FORMULA FOR ASTHMA. " Take tincture of squills, thirty drops; nitric acid, eigth- teen drops ; extract of henbane, nine grains ; Avater, four oances and a half. Mix, and divide into three doses, all of which must be taken in the course of the day, viz: morn- ing, noon and night. It serves to palliate the distress in a paroxysm of asthma. PILLS FOR INDIGESTION. Take powdered rheubarb, forty grains ; powdered aloes, ten grains; poAvdered cayenne pepper, twenty grains.— - Mix, and divide into twenty pills. A combination used to promote digestion, and obviate costiveness in dyspepsia.— One of the pills should be taken before each meal. PILLS FOR COSTIVENESS. Take blue mass, two scruples ; powdered aloes, twelve grains; emetic tartar, one grain. Mix, and make tAA7elve pills. One of these is a dose, to be taken sufficiently often, to produce regular action of the bowels. 304 PILLS FOR THE PILES, &C. PILLS FOR THE PILES. Take powdered aloes, tAventy grains ; poAvdered ipecacu- anha, thirty grains. Mix, and make forty pills. Take one eveiy morning} noon and night. ' PILLS FOR DIABETES. Take extract of henbane, and powdered gum camphor, of each tAvo drachms. Mix, and make one hundred and tAven- ty pills. Of these, one can. be-taken- four times a day. PILLS FOR SPASMODIC RETENTION OF URINE.. Take asafcetida, one ounce; powdered ipecacuanha, and powdered opium, of each eight grains; oil of peppermint-, eight drops. Mix, and divide into tAvo hundred and fifty pills. Ten of these pills must be taken three or four times a day for suppression of urine coming on suddenly, and at- tended Avith much pain. MIXTURE FOR CHLOROSIS. Take phosphate of iron, tAvo drachms; powdered'orange- peel, six drachms. Mix, and divide into tAventy equal parts, one of which can be given three times a day for chlo- rosis,, after the bowels have been thoroughly acted upon.. MIXTURE FOR GONORRHOEA, Take balsam copaiva, one ounce; tincture of cub-bes, one ounce; sweet spirits of nitre, half an onn^e; laudarum, one drachm; Avhite sugar, one ounce; poAvdered on u arable, PILLS FOR AMENORRHEA. 305 one drachm; Avater,. eight ounces, and mix. A table spoon- ful of this taken three or four times a day, is useful in gon- orrhoea, commonly called clap. PILLS FOR AMENORRHEA. Take aloes poAvdered, two scruples ; poAvdered cayenne pepper, tAvo drachms ; poAvdered rheubarb, eight scruples. Mix, and make thirty pills. Tavo of these may be taken at bed-time every night, in suppression of the menses, when the patient is very Aveak and relaxed. T GLOSSARY, OR Explanation of Avoids, not in common use, and not de- fined elseAvhere in this work; ■Abortion. Miscarriage. Acid. Sour. Acute. Severe. Adult. Of full age. Antiphlogistic. To counteract inflammation. Antispasmodic. A medicine to remove spasms. Atmosphere. The air that Ave breathe, &c. Bile. A fluid found in the gall blader, secreted by the liver, poured out into the stomach and intestines. Bolus. Medicine mixed up in a considerable mass. Capsule. A dry pod or A'essel, containing seed. Carious. -A term used to denote rottenness of bones and teeth. Catarrh. A common cold. Cathartic-. A purge. Catheter. An instrument to draAv off the urme. Caustic. A buring application. Cutaneous. Relating to the skin. Chronic. A lingering complaint, not acute. Circulation. Relating to the passage of blood through ^the body. Coagulum. Curd. 'Comatose. Disposed to sleep. Confluent. Running together. Constipated. Costive. Contusion. A bruise. 'Convalescence* A state of recovery from disease. Debility. Weakness. Decoction* Made by boiling. GLOSSARY, 307 Deleterious. Injurious, deadly. Dentition. Teething Delirium. Light-headed. Diaphoretic. Medicines to promote -sweating. Diuretic. Medicines to promote urine. Effluvia, Exhalation. Emaciation. Lean, a Avant of flesh. Empiricism. Quackery. Epidemic. General disease, produced by the situation of the atmosphere. Eructation. A belch. Expectorants. Medicines to promote a discharge from the respiratory organs. Extremities. The limbs of the human system. Febrile. Feverish. Flatulent. Windy. Flooding. Copious discharge of blood from the womb, Fcetus. A child in the womb. Fomentation. Bathing a part by applying cloths &c. dipped into some liquid. Fracture. Broken bone. Gangrene. The first stage of mortification. Gargle. A Avash for the mouth and throat. Hectic. A sIoav fever, sndi as attends consumption. Hemorrhage. A Aoav of blood. Hepatic. Relating to the liver. Induration, Hardening. Infectious* Contagious. Infusion, Steeping in water Avithout boiling. Inhale, To draAv in by breathing. Languor. Weakness. Lateral. On, or towards one side. Ligature. A bandage. Mastication. The act of chewing. Membrane. A Aveb of fibres, such as the fleura, &.c. SOS GLOSSASY, Menses. The monthly discharge of females. Miasma. Morbid vapours. Mucilaee. A glutinous substance. Mucous. Any matter resembling that which is discharg- ed from the nose in colds. Narcotic. A medicine inducing sleep or stupor. Nausea. Sickness of the stomach. Nostrum. A patent, or secret medicine. Opiate. A medicine producing stupor as opium. Ophthalmia. An affection, or inflammation of the-eye.. Paroxysm. A periodical, or sudden attack. Placenta. The after-birth. Plethoric. Full of blood, full habit. Predisposition. Peculiar liability to any disease. Primary. The first. Pulmonary. Relating to the lungs. Purulent. Good matter, or pus. Pustule. A small SAvelling. Rectum. The large gut. Regimen. The regulation of the air, food, Sae, Respiration. Breathing. Saliva. The spittle. Secretion, Seperation of fluids from the solids. Sinapism. A poultice, or plaster of mustard sefd- Spasm, cramp, &c* Spine. The back bone. Stupor. Profound sleep, or partial loss of sensibilty. Syncope. Fainting. Temperament. A peculiar habit of body. Tonic. A strengthening medicine. Tumor. Wen or swelling Ulcer. A bad sore. Uterus. The womb. Uvular. The palat Vagina. The passage to ih? uterus, GLOSSARY. 3 ■,-'« n i jo Aavaan ivnouvn jnijiqiw jo Aavaan ivnoiivn inoiqjw jo Aavaan ivnouv 3 V. * 1^9 5. 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