ral?.i ~*-»t*7" it&tl?*** lr& i& 1UII1 TVNOIIVN 3NI3IQ3W JO A»V II8 IT TVNOIIVN JNI3IQJW JO A«Y«i IARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATI I /*w \ av 11 an tvnoiivn jnoicmw jo iivmn tvnoiivn inoioiw jo ahiiii tvnoiivn 3NI3 « ART OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATI «v A -s /V-^r f kA -s >v _✓? I < < %5 O liv«s n ■*»N JN 1310 3W JO A8VB8I1 TVNOIIVN 3 N I 3 I Q 3 W J O A 8 V 8 8 I T T V N O U V N 3N UIIART OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY^ MEDICINE IOII«III11«NOI1«N 3N I3IQ 3W JO A8VB8IT 1VNOUVN 3 N I 3 I 0 3 W J O A 8 V B 8 IT T V N O I 1 V N 3N 0 At B8IT 1VNOUVN 1NI3I03W JO ABV88IT TVNOIIVN 3NI3IQ3W JO ABVB8 IT TVNOIIVN 3NI ° 43x { Hi'm^} * - 5. S - S. e i LIHARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE N, NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRAS iOiBVBaiT TVNOIIVN 3NI3IQ3W JO ABVB8IT TVNOIIVN 3NI3I03W JO AII V 8 8 I T TVNOIIVN ;Nj C&rA IIIARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NA1 0ABVB8IT TVNOIIVN 3NI3I03W JO A8VB8IT TVNOIIVN 3NI3I03W JO A8VB8IT TVNOIIVN JNI t.j/K/ \ MARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NAT A DOMESTIC GUIDE TO MEDICINE, INDIVIDUALS, BOTH MALE AND FEMALE, ARE ENABLED TO TREAT THEIR OWN COMPLAINTS WITH PERFECT SAFETY. TO THIS IS PREFIXED A FAMILIAR TREATISE ON THE GENUINE HYGEIAN VEGETABLE PILLS, OR UNIVERSAL REMEDY OF DR. RAIjI^H, SHOWING ITS AGREEMENT WITH THE PREVAILING DOCTRINES OF THE Brit. College of Physicians and Surgeons, London. And pointing out the principle on which this remedy is applicable, in one degree or other, to evert disease, without exception, to which the human family is subject. BY DR. R-AXPH, •#• Graduate of the University of Edinburgh; Member of the RoyalI College Of Surgeons, London; and Lecturer on Midwifery m&f^ diseases of Women and Children, <&£<) 3&. *;;?..% ...... "Wcot i v^ a rtT *? Sold at the General Officeof the ^^^^^ZvtZS^ landt-st.; and by J. L.-av.ti, 182 Bo dvvaj J. Chatham-street, and Bartlett & Raynor, .7bR^rSs o^New Yort-also by many of the Drug- and elsewhere. 1834. V \%3 Entered, according to the Act of Congress, in the year 1834, by Joseph Ralph, in the Clerk's office of the District Court of the Southern District of New-York. INDEX. Page. CHAPTER I.---Introductory Remarks................................ 3 CHAPTER II.---Plates illustrative of the Organs of Digestion, showing that these with the Intestinal Canal, are the principal sources of the impurities which contaminate the blood, and produce diseases....... 9 CHAPTER III.---The process of healthy digestion explained............ 15 CHAPTER IV.----The manner in which a weak and disordered digestion supplies the blood with vitiated humors and impurities, and otherwise becomes a perpetual cause and aggravation of disease.............. 16 CHAPTER V.---On the composition of the No. 1, or alterative purgative pills, with directions for their management and doses.............• • • 18 CHAPTER VI.---On the composition of the No. 2, or gentle aperient pills, with directions for their management and doses..................... 20 A DOMESTIC TREATISE ON DISEASES, With more partticular directions for the use and management of the pills m e of the following disorders. CHAPTER I.---Dyspepsia, Indigestion, Bilious and Hypochondriacal af- fections .............................................. CHAPTER II.----Gout......................................... CHAPTER HI.---Rheumatism, Lumbago, and Rheumatic Gout......... ' CHAPTER IV.---Apoplexy, Giddiness, Headache, Confusion of Memory, and of the senses of sight and hearing, also feelings of numbness in various parts of the body.....• •................... ' CHAPTER V.---Intemperance,—its effects and remedy................. CHAPTER VI.____Fever and Ague, Bilious and Remittent Fevers, Yellow Fever, Scarlet, Typhus, Nervous and Common Fever-• • • • • • • •••••• CHAPTER Vn.---Scrofula, King's Evil, Tumors in the Neck, Enlarged Joints, Ulcers, Eruptions on the skin, Pimples in the face,|Salt Rheum, Nettle Rash, Prickly Heat, Boils, Itching of the Skin, Cutaneous dia- eases, &c.,&c."......-..-■ • ,,,-........»...... IV Page. CHAPTER VIII.----Consumption, Threatening Cough, Difficulty of Breath- ing, and Asthmatic Disease............................ CHAPTER IX.---Cholera, or Cholera Morbus........................ 50 CHAPTER X.---Inflammation, external and internal; Inflammation of the brain, of the lungs, and of the bowels; Opthalmia, Quinsy, Mumps, Inflammatory Swellings, Tumors, &c, &c........................ "^ CHAPTER XI.---Yellow Jaundice, Liver Disease, &c................. 72 CHAPTER XII.---Diarrhoea, or Summer Complaint.................. 76 CHAPTER XIII.---Dysentery, Chronic Dysentery, Bloody Flux, &c • • • • 79 CHAPTER XIV.---Dropsy, whether in the Chest, Belly, or Extre- mities.......................................................... °4 CHAPTER XV.---Sea Sickness..................................... 85 CHAPTER XVI.---Piles, Fistula, Stricture, Ruptures, &c.............. 86 CHAPTER XVII.----Stone, Gravel, and Diseases of the Urinary, and Ge- nital organs.................................................... 86 , DISORDERS OF FEMALES. 3 CHAPTER XVIII.---General observations on the Disorders of Females. 88 CHAPTER XIX.----Puberty, directions for treating certain irregularities and obstructions occurring at this crisis, and which Occasionally return in after periods of life........................................... 91 CHAPTER XX.---Pregnancy, and its attendant symptoms,—morning sickness, lowness of spirits, piles, swollen veins, &c, &c............. 95 CHAPTER XXI.---Sexual Weakness and Irregular Secretions......... 96 CHAPTER XXII.----Nervous Disorders, St. Vitus's Dance,- Epilepsy, Hysterical affections, Palpitations, and various other nervous feelings and complaints................................................. 98 CHAPTER XXIII.----Irregularities at later periods of life.............. 102 DISORDERS OF CHILDREN. CHAPTER XXIV.---General observations on tho Disorders of Children • • 104 CHAPTER XXV.---Small Pox, Chicken Pox, Cow Pox, and Swine Pox........................................................... 108 CHAPTER XXVI.---Measles....................................... 109 CHAPTER XXVII.---Hooping Cough............................... U0 CHAPTER XXVIII.---Fever, Scarlet Fever.......................... m CHAPTER XXIX.---Summer Complaint............................ 112 CHAPTER XXX.---Worms........................................ m CHAPTER XXXI.---A Wasting and Flabby state of the body, enlarge- ment of the Belly, often with Rickets and Low Fever.............. 113 CHAPTER XXXII.---Conclusion................................... 115 THE FAMILIAR TREATISE. CHAPTER I. INTRODUCTORY REMARKS. It is now about thirty years since the first rays of light wei-e thrown upon the subject of the connection of diseases with the or- gans of digestion. These interesting views were published by that learned and venerable physician, Dr. Hamilton of the University of Edinburgh ; but it was not until a few years ago that they began to find their way into any thing like general practice. Mr. Abernethy, Senior Surgeon to Bartholomew's Hospital, London, contributed much by his successful practice and publications to prove the truth and importance of this doctrine, and since that time these views have been gaining upon the common consent of the British College of Physicians and Surgeons, as well as of most of the eminent practi- tioners of England and other countries, so that the treatment of dis- ease is daily becoming in consequence more simple and efficacious. The application of these truths, however, has not even yet been Carried out in practice to the extent that their usefulness demands ; it is, therefore, the intention of the author in these few pages to point out in the clearest manner that this doctrine is not only applicable to diseases generally, but that there is not a single disorder, without exception, to which it may not be applied with safety and advantage. But whether medical men have, or have not made so much ad- vantage of this principle as they should have done, one thing is quite certain, which is,—that the public, those to whom this simple, safe, and efficacious plan of treating their own complaints is so ex, ceedingly adapted, have received as yet no benefit at all, for, as far as the writer is acquainted, there has been no familiar treatise, or popular explanation given on the subject. Such omission is the more remarkable as this plain and rational doctrine forms the only ground on which a private or domestic plan of medicine can with any jus, tice or propriety be recommended. Take, for instance, Buchanan's book, the only one of such a kind in general use, and it will be 4 clearly seen that such is the number and complicated forms of me« dicine, and such the nice and varying shades of disease for which they are directed, that it is next to impossible that any private indi- vidual should escape mistakes, and those often of a serious nature ; but on the simple and undeviating principle which is here set forth, such errors are totally avoided ;—the name of a disease, indeed, may be mistaken, but the nature of it cannot be. Suppose, for example, that a person takes these pills under the impression that he is labor- ing under any one complaint, but that it really is another which he is treating ; still he is equal/y benefitted, for he has attacked the na- ture, not the name of his complaint. By the means which are here directed the blood is purified ; the intestinal passages are cleansed ; the circulation regulated, and the general strength supported ;—now, what is that disease which is not benefitted by these measures, or which can by any possibility be injured by them?—the name of a disease is of very little consequence, if the mode of treatment be cor- rect and suitable. Another great advantage of this plan of treatment is, that you give to nature the full enjoyment of her powers of cure, and these are more numerous and efficient than is generally believed. Many and often secret are the laws of nature with respect to disease, and the best physician sometimes counteracts by his prescriptions those na- tural efforts which would have proved effectual to overcome the disorder but for such an interference. It is astonishing to witness the hopeless cases of disease in which the powers of nature prove successful, when her steps are rather followed than directed. Here, therefore, we have perfect safety, for while we thus support the natural functions of the body, we are co-operating with the best of all physicians, and thus assist those efforts of nature for the remov- al of disease, which but for such assistance might prove inadequate. Many of those complaints which are apt to settle upon important structures of the body, and form incurable diseases, might be pre- vented, or brought to a speedier termination by the safe and simple means which are recommended in this treatise ; such, for example, as consumption ; this in many cases is nothing more at first than a common cough, which might never settle on the lungs if early and proper steps were taken for its removal. Considering, therefore, that the connection of diseases with the organs of digestion, together 5 •with the impurities of the blood, form the only safe and proper basis of domestic medicine, it became an anxious undertaking to contrive a remedy in every way agreeable to this simple doctrine, and one at the same time universally safe and efficacious. It is well known that in most of the common remedies, advertised in the newspapers, &c, Mercury, in some shape or other, is a con- stant ingredient; now, it is true that this mineral was prescribed by the two eminent individuals already spoken of, but the process of separating the vegetable principle, so lately discovered by the French chemists, was not known to them, and it should also be remembered, that mercury may be very safe and useful in the hands of a skilful physician, but exceedingly unsafe and pernicious as a common and domestic medicine. In the composition of these pills the inventor has availed himself of these discoveries for the happiest purposes. The subject, however, of these vegetable principles cannot be fully entered into in this work, but an example may be cited by way of illustration ; let the Quinine be fixed upon, for this is now in common use. No one would think at this time of taking a tea-spoonful of Pe- ruvian bark for the cure of fever and ague, or any other disease, for it is well known that all the virtues of this quantity of bark can be obtained in a pure and simple state, and in a bulk not larger than a pea, in the form of Quinine. In the same manner the active vir- tues of most of our vegetable remedies may be obtained, and these, being separated from their useless and injurious parts, are brought to act upon diseases with a precision and effect that was never former. ly expected. With this advantage the author has succeeded to the utmost extent of his wishes, and has invented a remedy in every way suited to these views ; it is one that is entirely free from all mercury, perfectly safe in all diseases, may be continued for any length of time, and is eminently fitted for the purpose of private and domestic use. But, having been successful in finding a remedy of universal ap- plication to disease, and having also shown ihe general principle on which its use and operation should be conducted, the author felt that he was further called upon to show the particular manner in which this remedy should be applied under the varying circumstances of particular diseases. With this intention he has added to this little work a separate Treatise on those diseases which are included in 6 the Index; and although the remarks on some of these are very short, still he believes he has given all the information that is really necessary to conduct their management and cure with safety. This also gave him an opportunity of pointing out those peculiar circumstances in which this medicine should not be relied upon alone ; as well as what those other measures are which would give to this its best effect. No one possessed of common sense can really believe that any single remedy, without the occasional assistance of other means, should be relied on under every various circumstance of distress and danger. The author is aware that attempts are made to ridicule every means of such a kind,—except the one they sell,—even such as blood-letting in cases of inflammation of the bowels or the like. It is not necessary that he should show the dreadful loss of human life, and the moral guilt which these base attempts involve ; for he con.' ceives that the common sense and common rectitude of feeling which inhabits every human bosom, more or less, must point it out. In this little Treatise therefore, the author has anxiously availed himself of every circumstance which could render it in his opinion a safe and complete guide to medicine for private and domestic pur' poses ; and, moreover, in its various directions and remarks he has endeavored to be so plain that none can possibly mistake them In the constant aim to make this little work as interesting as pos- stble to every class, the author cannot forbear the pleasure of hoping, that, to certain classes of society, it will be found particular. ly so. To those, for instance, who reside in country places, away from medical assistance, it must prove a valuable treasure. Not only will such possess a general remedy, but will also understand the nature of disease, and the principle on which its cure should be conducted. For the same reason it will be found a valuable guide to those who go to sea; especially if bound to warm climates in which the liver is so apt to be-affected. In this little voW he , pecuhar circumstances of want are carefully anticipated and p ov ded for; so that diseases may be treated as wpII a P even better, at sea, than on L^^""^ lea..port without afew packages of^J^^^ s ft^r Wm ^ " ^ mediCi-Ch- --fold deg'reet 7 But there is another class to whom this little Treatise^ together with the pills, will prove at once a physician and a friend; we al- lude to female sufferers. Many of their complaints are of a nature so delicate as to be far more properly treated by themselves than any other person. To such it will be satisfactory to know that the hints which are delicately conveyed in these pages are yet sufficient to enable them to undertake the treatment of many complaints which it would be painful to mention to another. Now, in what has been said, the author trusts that he shall not be charged with a design of depreciating the usefulness' and character of medical men ; very far from this, no man has a higher consciousness * of their general merit and integrity ; and those who prefer it, and have the means, he would even advise to consult their friend and physician, in preference to a reliance on this, or any other private guide ; and those who are thought to be in danger should by all means obtain their personal assistance, where it can be done conve- niently. But, on the other hand, there are those who have not the means, nor the opportunity ; and there are many whose complaints are of long standing, and of a chronic kind, and do not stand in need of personal attendance; and there are also those to whom it is not convenient to submit to professional injunctions, and who themselves prefer to undertake the treatment of their own complaints. To all these in an especial manner, this little volume is addressed, and while the simple doctrine it sets forth, is true and rational, its practi; cal directions are so plain and efficacious that they cannot be mistaken. With regard to the remedy to which this Treatise continually re- fers, it is proper to observe, that it consists of two kinds of pills, and that these are compounded of imported ingredients of the most genuine kind which London and Paris can supply. At the same time it is cheaper than others, in as much as the boxes contain a greater number of pills, and being more efficacious, such large doses are rendered unnecessary. In point of fact, therefore, families will find this a convenient and economical method of preserving life and health ; and it is believed that at no distant period these pills will be preferred to any other advertised medicine at present in public, pri- vate or domestic use. It should be repeated that "they contain no mercury, they may be continued for any length of time, and are eminently calculated for general and extensive usefulness. 8 It is expedient in conclusion to guard the public against attempts which may be made to introduce a spurious and deceitful remedy. The cruelty of such an act is evident, for the pills of Dr. Ralph are prescribed in accordance with the essential doctrines contained in this domestic treatise; and with regard to their ingredients, their pro- portion, and particular composition, these are known only to the author. It will be the care therefore of every one to inquire for and see that he obtains The new and improved Hygeian Vegetable pills, or Universal Remedy of Dr. Ralph, Graduate of the University of Edinburgh ; Member of the Royal College of Surgeons, London ; Lecturer on Midwifery, and the dis- eases of women and children, &c, &c. 38 Courtlandt Street, New-York. N. B. Every package of the pills is signed by the doctor's own hand, and countersigned by the agent of the district in which they are sold : they may be obtained, wholesale, at the general office, 38 Courtlandt Street, and retail, at most of the respectable Drug Stores of New-York, also in most of the cities and principal towns of the United States. Agencies in vacant districts may be obtained, and will be supplied upon liberal terms, a satisfactory reference being given. Those who experience remarkable cures, or especial benefit from this plan of medicine, particularly in cases which have long withstood the effects of other remedies, would confer an obliging favor on the author, if they should feel disposed to transmit a statement of such cases to him or any of the agents. A volume of cases in which the cure of diseases is practically proved by the experience of others is thus collecting from their communications, and he who adds his faith- Jul testimony to this record, will enjoy the satisfaction of liaving con- tributed his ^share to the cause of suffering humanity. 9 CHAPTER II. Plates illustrative of the organs of digestion, showing that these with the intestinal canal, are the principal sources of the impurities which contaminate the blood and produce diseases. Before we begin to explain the process of digestion, and show in what manner its weak and disordered condition supplies the blood with vitiated humors and impurities, it is thought necessary first to give a representation of these organs themselves, in order to ren- der the subject as clear as possible. This with the aid of two or three plates will be very easily accomplished, and will further give an opportunity of explaining a few professional terms which it will be convenient to use in the after pages of the work. The use of the plates, it should be mentioned, is intended chiefly for those who are desirous of obtaining a more particular knowledge of diseases and of the principle on which the New and Improved Hygeian Veget- able Pills are so universally beneficial; by far the greater number of those who take them begin upon the recommendation they have received from others, but the ground on which they are induced to persevere in using them, is that of their own personal experience, —the best of testimony. These plates, therefore, may be examined or passed over at the reader's pleasure. Plate I. presents a view of the digestive organs, sometimes called the first passages ; while the bowels alone are called the In- testinal canal.—These consist of A, the stomach ; B, the small in- testines; C, the large intestine, or Colon ; D, the Rectum ; and E, the liver and Gall-duct. 10 Plate 1. THE ORGANS OF DIGESTION. A. The stomach, in which digestion is partly performed B. J lie small intestines, in which digestion is completed tV h!!e large imest>»e, «r colon, in winch the residue of food collects. D. lherectnm. E The liver which secretes, and the gall-duct, which conveys the bile into the email intestines; these are the seat of bilious diseases, &c. 11 Plate 11. shows a portion of the small intestines into which the bile and other secretions are conveyed for the purpose of complet- ing the digestive process. It is while in these intestines that the food imparts it nourishment to the body ; but if the process of diges- tion be imperfect, or deranged, then, instead of bland and proper nu- triment, a mass of crude impurities and vitiated humors is supplied. Further, these intestines are seen to abound with absorbent tubes, called lacteal vessels (A,) which take up such vitiated fluids and con- vey them through the mesenteric glands (B,) into the blood and circu- lating system. There is also seen a large supply of blood-vessels, (C,) of which the use will presently be shown, when speaking of the operation of the pills in purifying the blood, and carrying off its humors. 12 Plate 2. A PORTION OF THE SMALL INTESTINES. A.- Laeteal vesseli, having moutha by which they absorb the vitiated matter »fcorrupt and undigested food. B. Mesenteric glands. C. Large blood-vessels. 13 Plate III. represents the large intestine or colon; from its figure and dimensions some idea may be formed of the quantity of putrid refuse of undigested food which is apt to be accumulated therein. It begins on the lower part of the right side of the bowels, and pass- ing upwards crosses under the stomach, and then passes downward on the left side. This explanation of its direction will serve to ac- count for many of those pains and uneasy feelings which are fre- quently the subject of complaint, but which are not always suspected to arise from a disordered state of this intestine. It is also to be ob- served that the colon is divided into little cells, or pouches, by a number of bands which run across it (A). It is in these cells that the ill-digested food accumulates, and from which it can not be expelled by the ordinary purgatives in use. u Plate 3. THE COLON. A. The cells which collect and retain the hardened refuse of the food, and are the seat of cholic, dysentery, &c. &c. ,.,*,,_ B. The rectum, the termination of the colon, the seat of piles, fistula, thread- worms, &c, &.C. These, therefore, are the principal organs of digestion, and the manner in which their important office is performed is explained in the following chapter. l"j CHAPTER III. the process of healthy digestion explained. Having endeavored in the foregoing chapter to furnish the reader with a familiar description of the form of the various organs of di- gestion, it now becomes an easy task to explain what part each of these various organs performs in accomplishing this process,—it is as follows. The food, being received into the stomach, is there re- tained for a certain time, and by the action of the gastric juice be- comes changed into a soft and uniform mass ; this is all that the stomach has to do, and is termed < the first stage in the digestive process.' The food being, as we have stated, reduced into this pulpy state, during its retention in the stomach, is now passed on into the small intestines, and undergoes a second change by the action of the bile and other secretions which here mix with it, and when this mix- ture is perfected the process of digestion is complete. The meaning of digestion is this; that the nutritious portion of the food, of whatever kind it maybe, is, by the means detailed above, converted into a milky fluid, which is intended by nature to supply the growth and wasting of the body, the refuse of the food passing on into the colon, (plate III.) In order to convey this extracted fluid to the various parts of the bodv, which arc constantly needing supply, a means of communica- tion must be provided, and thus we find an innumerable quantity of little vessels, whose mouths open upon the inner surface of the in- testinal passage, and there suck up this fluid, and convey it to the blood, where it becomes fitted for its various purposes. These little absorbent vessels are named «lacteals," and the mesenteric glands, through which they pass, are beautifully exhibited in Plate II. ' But the nutriment of the food having been extracted, the residue becomes a useless mass, and must be disposed of. tor this purpose, the colon or large intestine, which is shown in Plate II ., is pecu- y adapted, h is large and divided into cells or pouches andin these the residue of the food collects, and after remaining there a certain period of time, is then expelled by a natural and easy effort of the bowels. 16 CHAPTER IV. The manner in which a weak and disordered digestion supplies the blood with vi- tiated humors and impurities, and otherwise becomes a perpetual cause and aggra- vation of disease. The separate organs of digestion and their natural uses having been so clearly explained in the foregoing chapters, it becomes no hard matter to understand how universal is the general connection of diseases with a disordered condition of these organs. So long, indeed, as these perform their office in a natural and regular manner, we hear but little complaint, but as soon as either of them becomes enfeebled or deranged, disease arises as a necessary consequence. Nor can it be expected otherwise, for the digestion of the food being incomplete, the blood is loaded with impure and half-digested parti- cles and humors, and these as they pass through the tender structures of the body, in which the blood must circulate, produce diseases in them. It cannot be foreseen at all times, what part will be the seat of such diseases, but whether it be the brain, or the lungs, the skin, or any of the other numerous and delicate structures of the frame, which these humors happen to obstruct and irritate, there disease originates; and this will be inflammatory, or of any other kind, just as the age, sex, constitution, or some other accidental circumstance shall direct and modify. There are also many instances in which the vitiated humors of the body render those disorders dangerous and fatal which would otherwise be harmless or light. This is remarkably the case in small-pox ; two individuals taking this from the same person ;__one of them shall have but few pustules, with very little fever, and soon get well;—while the other shall be loaded with pustules and corrup- tion, have a putrid fever and die of a malignant disease. So again with regard to consumption; two persons having a cough from taking cold ;—in one, whose constitution is good, the cough shall cease in a few days, and nothing more be heard of it;—but in ano- ther, whose constitution is imbued with scrofula, or other humors the cough continues, or if it abates, does not go off entirely, and is increased on every slight occasion ; at length, invited to the lungs by frequent coughing, such humors settle there, generally in the form of tubercles, and these may now continue in a dormant state for a certain time, but, sooner or later these tubercles inflame and ulcerate. 17 and their humors thus discharged into the air-cells, are brought up from thence by frequent and long-continued fits of coughing, until the substance of the lungs themselves is quite consumed. Thus, therefore, while impurities of the blood are shown to be a general source from which disease proceeds, we account at the same time for the great variety in which diseases constantly appear. But not only does disease proceed from the various humors of the blood which a weak and depraved digestion supplies, for, indepen- dently of this, there is a certain disordered action of the intestinal passage, which of itself alone originates, as well as aggravates disease. For instance, who has not sometimes experienced imme- diate relief from the operation of an aperient medicine ? now, this is not from having purified the blood ;—there has been no time for that;—it has arisen from having carried off a quantity of acrid and offensive material from the bowels, which had established disordered action in them. It is a fact which no man disputes, that disorder originating in one part of the body is transmitted through the medium of the nervous system to another, even to a distant part; thus in children, the irrita- tion of the bowels from worms is transmitted to the head, and the child is seized with fits, or has water in the brain.—So also in adults, the irritation of the colon is transmitted to the head, and may termi- nate in apoplexy ; at any rate it never fails to be a source of aggra- vation and of danger in those who are disposed to apoplexy from other causes. Innumerable instances of such a kind might be ad- duced to prove that irritation and deranged action in one part of the body may, and often does become the cause of disorder in distant parts The author is the more anxious to be as plain as possible on this subject, because of a very fatal mistake which prevails with some people;—it is the error of supposing that every complaint, without exception, arises from impurities of the blood, and from no other cause whatever—Now, this is quite contrary to the fact;-it is true, as has been clearly shown, that the impunties of the blood comprise a very general cause of disease, but it is not true that this is the only one. It is for this reason that persons who run away with this mistake, never get thoroughly well of many prevailing and dangerous complaints; such is the case with those who are apoplectic, or gouty, or dyspeptic ; and the same applies to all hys- 18 terical complaints, epilepsy, St. Vitus's dance, and all the class of nervous disorders, as well as to many others;—they may, indeed, feel somewhat benefitted by purifiers of the blood, but in as much as they overlook another and co-operating cause, they are never likely to be cured, and are, therefore, for ever taking pills or something of the kind. Now, the distinguishing peculiarity of this simple plan of medi- cine is this,—that it embraces the two principal causes of disease* viz. 1st. the impurities of the blood, and 2d. that disordered action of the organs of digestion which supplies those humors that are the foundation and support of many obstinate complaints. Thus the operation of the new and improved Hygeian Vegetable pills is to clear and purify the blood, while at the same time, by correcting the disorders of the stomach, liver and bowels, and restoring the organs of digestion to a natural and healthy state, they cut off the supply of injurious materials, and thus prevent the recurrence of disease. CHAPTER V. On the composition of tho No. 1, or alterative purgative pills, with directions for their management and doses. The alterative purgatives, or No. 1, compose an active, searching, and dcobstruent medicine, which is effectual in carrying off the vitiated secretions from every part of the body. The slime and bilious humors they separate and bring away from the intestinal canal and liver, are frequently so acrimonious as to give a scalding sensation as they pass by stool. But their operation is not only to purify, and remove obstructions, they have also the effect of regulating the circulation of the blood, by which its impetus is drawn away from distant parts and directed to the bowels;—hence it is, that in disorders of the head, in Apoplexy, iu Fevers, and obstinate tumors in various parts of the body, their effi- cacy has been so much experienced and acknowledged. In many instances a free evacuation of the bowels is all that is re- quired, but there are other cases which call for something more than this in the operation of cathartic medicine ; such is the case in Fe- vers, in St. Vitus's dance, and in diseases of a nervous kind : in all these, the great secret of cure consists in keeping up the same pur- gative action in a moderate degree even after the bowels have been thoroughly cleansed, and this must be continued throughout the whole course and duration of such diseases. For this purpose nothing can be more proper than the purgative pills No. 1, and as they contain no mercury, so no hurtful consequences need be anticipated from their continuation and repetition. The dose and management of No. 1, or alterative purgative. With regard to the dose of the alterative purgatives, it is usual to begin with three or four, but as these are generally given to pro- duce an active effect upon the bowels, the dose should be increased or diminished so as to produce the desired action. If they are given in continued fevers, nervous diseases, or any of those cases in which a constant impression of the bowels is required; then of course the dose must be diminished, and the interval of time between taking them lengthened, so as to moderate their effect. This interval may be four, six, twelve, or tvventy-four hours, as the patient using them may find their operation more or less powerful. If the object is to reduce the quantity of blood, and they are used instead of bleeding, as in apoplexy, or general fulness of the habit, the period between their repetition should be more protracted still; every fourth day, or once a week, may be frequent enough, and in such cases, a low diet, and a vigorous exercise of body should be subjoined. The best time to take them is on going to bed, as they do not usually operate until the morning at the time of rising; but if they should not operate before breakfast, another dose should then be taken; and cases may occur of particular constitutions, in which the dose should be repeated continually, at intervals of three or four hours, until the desired effect has been obtained. Another observation may be added; these pills do not in general gripe, but there are exceptions; indeed, in some constitutions, this 20 consequence cannot be entirely avoided; as, for instance, in those pa- tients whose passages are loaded with viscid and obstructing mucus, nothing but a searching medicine can be of service in stirring up and purging off such humors, and this will now and then produce a grip- ing pain; this much, however, may be said, that those who have occasionally found them gripe have thought them of more than or- dinary service. If these, or any other medicine should produce griping, the best of all remedies is plentiful draughts of some warm or mucilaginous drinks, such as water gruel, rice milk, panada, &c, a little warm wine and water, with cloves, or any other spice in it is also very proper. CHAPTER VI. On the composition of the No. 2, or gentle Aperient Pills, with directions for their management and doses. The gentle aperient pills, or No. 2, are a composition of a different kind from that of the No. 1, their effect being gentle, and their operation slow ; in some cases indeed, they do not cause the evacuations to be more frequent, but only more free and healthful; and they are therefore taken by many, rather to prevent a costive habit, than to produce an active purging of the bowels. This is a matter of very considerable importance, for there are many persons who have a daily movement of the bowels, and therefore conclude that their action is healthful, although the evacuations are scanty, of a black color, and costive ; such persons are laboring under great deception, and little think that many of the complaints they suffer, especially those of the head, arise from this circumstance ; the dry and hard masses they pass by stool have always been accu! mulating in the large intestine or colon for several days, so that the fluid humors with which they were at first charged, have been ab- sorbed and carried to the blood. Few persons are aware of the evils arising from a costive habit of the bowels, or that this is the cause, in their own persons, of many of the complaints under which they suffer. Even apoplexy 21 and many serious diseases of the head are among this number; so also is dyspepsia, and where costiveness is not the only cause of this distressing malady, it is always an aggravating one. The same remark applies to diseases of the liver, the lungs, the kidneys and urinary passages; the blood, loaded with impurities, has to circulate through these tender structures, which it cannot do long without pro- ducing obstruction and disease in them. It is true that those who labor, and thus support a copious per- spiration, escape, in some degree, these consequences; but those, whose occupations are more sedentary, are subject to perpetual dis- eases from this cause. This is remarkably the case with clerks in Banking Houses, and other offices; and still more with tailors, shoe- makers, watchmakers, milliners, and with those of other occupations of the same sedentary character; in these, as the perspiration is scanty, the blood is more readily loaded with impurity. With respect to piles, costiveness is almost the only cause of them, though in a different manner ; here it acts by pressure ; the hardened lumps of stool, which fill the lower bowels, prevent the blood from passing upwards, so that the veins swell, inflame, and sometimes burst, thus occasioning what are termed the bleeding piles. But the consequences of a costive habit do not stop here, and it is fit that they should be known in order to be obviated; an inward and constant fever is often attendant npon an accumulation in the lower bowels or colon ; the tongue is foul, particularly in the morn- ing, the sleep is unrefreshing, and the breath putrid and offensive ; the nervous system too, as well the parts subservient to the powers of intellect, as those of sense and motion, is also greatly influenced by torpor of the bowels; -hence it is, that literary people as well as nervous and hysteric patients, are so much benefitted by the gentle operation of the aperient pills, or No. 2. They will not be Efficient of themselves in every instance to clear ou the loaded bowels, but when this has been done by a dose or two of No. 1, or the d rative purgative, it is then that their good effects are seen in keeptg up the nlral action of the bowels, by which a reaccumu- lation is prevented. The dose and management of No. 2, or Gentle aperient. The dose of this gentle aperient varies from three to five or six, more, and these may be taken either at bed-time, in the morning, or 22 or night and morning; when taken in cases of habitual costiveness, they should be continued as often and as long as the occasion de- mands. They may, however, be discontinued at intervals, in order fo ascertain whether this necessity has been removed. As individual constitutions require different doses, the patient may begin with four pills, and increase or diminish the quantity accordingly, as he finds their operation more or less than is desirable. When they are prescribed for fever and ague they should be re- peated oftener; as often even as every four or five hours, beginning after the shaking fit is over ;—the more that can be taken between the shaking fits the speedier is the cure, so that in a case of fever and ague, five or six may be taken for a dose, and if this number should prove too laxative, it may be checked by a teaspoonfui of paregoric in a little wine and water, or the number be diminished. Children require doses, large in proportion to their age;—as a general rule, a child of seven years old will take half the dose of either of the pills, that an adult would require. In ordinary cases they are taken once a day, either night or morn- ing ;—some prefer them immediately before or after a meal, and this is a good time when taken as a corrector or sweetener of the blood. It is not often desirable to increase the appetite in cases of dyspepsia, for such persons generally eat more than the stomach can digest; but where the appetite is deficient and they are used as a dinner pill,—they should be taken 15 or 20 minutes before the meal,—in this empty state of the stomach they excite the secretion of the gastric juice and provoke the appetite accordingly. It is observed that the operation of this pill with most people is pretty regular, at a certain period from the time of taking them. Many take advantage of this circumstance, and use them at such an hour as to operate at the most convenient part of the day. For the general purposes of health, their operation should take place either in the morning or evening; but in those whose sleep is unre- freshing, it is better to have it in the evening or before bedtime. It is observed that a peculiar calm and refreshing sleep succeeds their operation in the evening, while a pleasing calmness and command of thought succeeds to it in the morning following. It may be also justly added, that nothing is more calculated to counteract the effects of over-repletion; and those who have been 23 tempted to partake too freely at the table of hospitality, should never omit to take a laxative dose of them on going to bed. These aperients are composed of three ingredients, each of which is capable of acting only upon separate parts of the alimentary pas- sages ; the first, being soluble in the stomach, imparts vigor and tone to it; hence its value in cases of Dyspepsia, Gout, Apoplexy, and all the diseases in which a peculiar weakness of this organ is a prominent feature : the second, dissolving in the small intestines, ex- erts its influence on the liver and biliary secretions, and is efficacious in removing all obstructions of the gall-duct, and in the various dis- eases of the liver : the third ingredient is reserved to operate on the lower bowels, and having entered with the refuse of the food into the colon, it there dissolves, and communicates an invigorating stimulus to this large intestine which affects it throughout its whole extent, thus exciting a natural and free evacuation. In the remarks which have been now concluded, every thing has been reverted to which has appeared requisite with regard to the high authority of this medicine, its composition, properties and general use and management. The leading and fundamental principles which are applicable, more or less to all diseases have also been explained ; and the manner in which diseases take their origin, and become relieved or aggravated through the medium of the organs of digestion have been clearly pointed out. It therefore now remains that something more descriptive and particular should be said on such diseases as are of most general occurrence, so that the most plain and perfect understanding may be attained, with regard to the particular use and management of the Pills, in these diseases individually. This, therefore, leads to the domestic treatise on particular dis- eases,—the catalogue of which will be found in the Index. A DOMESTIC TREATISE On those Particular Diseases, for which the Improved Hy- geian Pills are especially intended, in which are pointed out such other remedial measures as are adapted to the peculiar circumstances of Constitution, Sex, &c. &c, so as to give more entire efficacy to this medicine. It will be observed that in the following treatise, the writer has included several diseases in one Chapter ; the reason for doing this is, that these diseases are so nearly alike in character, although having different aames, or require a mode of treatment so precisely similar, that it would only have tended to produce confusion, if he had treated of them separately. 4 26 CHAPTER I. Dyspepsia, Indigestion, Bilious and Hypochondriacal Affec- tions. These are complaints of one and the same nature, and are there- fore properly treated of together. In all of them the organs of diges- tion are in a disordered state, but the stomach, generally, is most affected : it is weak, and cannot perform its proper office ; hence the food ferments, rather than digests, in the stomach, and thus pro- duces wind, acidity, and oppression, after eating. But these are only the first effects, for the imperfectly digested food passing along the intestinal canal, (see Plate the 1st,) supplies the blood with every kind of humor and impurity ; and these again are ready to produce a variety of disorders in the different parts through which they are to circulate. So also, when the refuse of this ill-digested food arrives at the large intestine or colon, it is not removed in a due and natu- ral manner, but is there retained, until it parts with every portion of its putrid humors, and after this a dry and hard evacuation passes off By stool. The consequences of such a state are very numerous, and they extend even to the mind;—lowness of spirits, the spleen and hy- pochondriacal imaginations, as well as melancholy, are frequently among their number. In these complaints the Improved Hygeian Pills are found to pro- duce the best effects, but for the particular manner of their operation the reader is referred to pages 18 & 20, on the subject of the composi- tion of the Pills. In Dyspepsia, and in all the affections above enume- rated, it is proper to begin with number 1. Three or four of them may be taken at bedtime, and if they should not operate sufficiently in the morning, the same dose should then be repeated. The bowels being thus effectually unloaded, a peculiar elasticity of feeling and tranquillity of mind succeeds their operation;—the gross impurities and vitiated bile which would have circulated through the tender structures of the body, are now carried off, while their direct impres- 21 sion on the bowels, transmitted through the medium of the nervous system to the brain, has also been removed. But there is something more than this to be effected in the treat- ment of Dyspepsia, or its various symptoms, though much alleviated, will certainly return. It is on this account that the mild and steady operation of the aperients, No 2, is so beneficial; these maintain a gentle action of the bowels, and being designed to be continued a cer- tain time, they impart a natural tone and vigor to these organs, by which the digestive function is permanently re-established. For this purpose from three to five or six of No. 2, are to betaken ,every night, or in the morning. These may be made to operate a little on the bowels, by varying the dose, but it should be remembered that their general effect is rather to prevent a costive, than to excite a purgative condition of the bowels. Thus is the stomach strength- ened, the bile promoted, and the hurtful accumulations of the large intestines effectually prevented. But there are yet some other points to be attended to in the cure of this disease. The first relates to diet, for if certain and very common errors are persisted in, on this particular department, we shall fail in all our efforts. The diet of a dyspeptic person should be animal, rather than vegetable ; not that the latter kind of food is to be entirely excluded, but it should make a smaller proportion in his daily food, than he himself might ordinarily choose. Neither should it by any means consist of soups, or broth, or of any fluid kind. These are gener- ally recommended where the digestion is thought to be weak, but it is a most unfortunate mistake. Animal foodin this form is far more disposed to become acid, and to generate wind in the stomach, than in a solid form. Indeed, fluid of any kind, should be [partaken of but sparingly, even though the meat be solid. The stomach can- nlo welf be" brought to act upon the solid part, when it is floating in so much of a liquid kind;-moreover, the gastric juices of he stomach, so necessary in the office of digestion, are too much weak, ened when thus diluted. It is advised, therefore, to take but little "^"pular error regards the quantity to be taken at any £ivt time. Now, I would not by any means promote an ove ; fo mg of the stomach, but 1 see a material error, winch has crept 28 into general belief on this subject. " Take a little and often," is the usual advice; but this is quite wrong in dyspepsia. Such persons do not consider what they are saying, and I am sure such ad- vice will never be taken by those who shall have perused atten- tively what has been already said in these pages on the digestive process. In that short chapter this subject is clearly stated:—It is there seen that digestion is a two-fold process; one part only of which is performed in the stomach, the other in the small intestines ; and that the food undergoes as much, or even more elaboration in the small intestines than in the stomach. Now, if you are perpetually taking a little and a little into the stomach, you commit two grand errors: in the first place, you interrupt the process which should be going on in the small intestines, by drawing off the nervous energy from them to be expended upon the fresh supply of food taken into the stomach, by this means the whole digestive process is deranged; — and in the next, by keeping the stomach in perpetual exercise, you deny it that repose, which every organ needs in order to recruit its powers. Be advised, therefore, to take meat, certainly not more than twice a day, and let it be boiled, broiled, or roasted, and with very little fat; let the quantity also be moderate; in short, let your concern be to " take a little and good," rather than, a " little and often." Another error which should not be overlooked in this place, relates to exercise. This is often directed to be used before dinner or meals, and thus persons who are engaged in the sedentary occupa- tions of the counting-house, and jaded by severe attention, are per- suaded to take a ride or a walk, or otherwise fatigue themselves before a meal, to get an appetite for eating. Nothing can be worse. Such persons do not recollect that dyspepsia is a disease of weak- ness, in which the stomach has the largest share. Now, if the body be fatigued by exercise, the stomach is so too, and this must surely be improper, just at the moment when its feeble powers are to be em- ployed in the office of digestion. Exercise, especially in the open air, is very necessary, either by walking or riding ; but it should never be used to any extent, immediately before or after a meal, neither should it ever be persevered in so as to induce great fatigue. As to the fatal effects of intemperance to the dyspeptic, they are supposed by the writer to be so well known as to render it alto- 29 gether superfluous to allude to them in this place, especially as they are noticed in the chapter on intemperance. These are the remarks which it has been thought advisable to make, in connexion with the Improved Hygeian Pills, on the treatment of dyspepsia. They embrace all that is really important on this subject, and those who adopt this course of treatment will find dys- pepsia to be a disease much more controlable, and much more fre- quently admitting of cure than is generally supposed. CHAPTER II. Gout. The new and Improved Hygeian Pills are found to be the most convenient and efficacious remedy for Gout, that has ever been con- trived, and this disease, which has generally been considered an in- curable constitutional malady, is now experienced to be as certainly prevented, relieved, or cured, as many other diseases which are peculiar to advancing life. Under every former plan, it is well known, that when once the gout appeared, uniformly, its attacks became more and more fre- quent, and every repetition more severe, until, at length, an interval of perfect ease was scarcely ever enjoyed. But, under a proper use of this medicine, with a due attention to the hints which are sub- joined, the returning fits of gout become less and less frequent, and each attack generally less severe. And not only is there now a better remedy at hand for gout, but the disease itself is better understood. It is not, however, said that there is nothing left to be discovered of its nature but that its con- nection with the derangement of the organs of digestion, is better understood than formerly, and its treatment on this prmciple more rational and effective. Indeed, the word hereditary having been "plied to gout, seems to have precluded every rational mvestigation TfrrJL, and certainly quite forbidden every expectation of re Uef so that persons laboring under the tortures of a gouty fit, 30 could obtain but little more assistance, than that which nursing and patience could administer. Now, with regard to its hereditary nature, it is true, that if an individual of a gouty family indulge in habits of intemperance of any kind, whether it be in eating or drinking, or in intellectual pur- suits, he will probably have the gout himself; but these habits will also bring it on in many other persons, in whom no hereditary claim to this disease, can possibly be traced. Is it not, therefore, certain that it depends on something more than hereditary constitution 1 Again, in every instance of the gout, a train of symptoms clearly pointing out derangement of the organs of digestion, appear first, and these generally continue for a certain time before the gout is seen. Further, it is observed that when a fit of gout abates, the symptoms of dyspepsia also disappear at the same time, and the digestive organs are restored, in some measure, to a healthy state. It was in reflecting on these truths, that the writer first conceived the propriety of letting the question of the hereditary nature of the gout quite alone, and was led to inquire whether this disease could not actually be prevented, even in gouty families, and cured or modified in others, from what cause soever it had sprung. This, as might be supposed, he attempted by means calculated to restore the organs of digestion to a healthy state, and keep them so; and he may safely add, that the result of his practice has amply proved these views to be substantially correct. This also further led to a better practice in the treatment of dys-. pepsia itself; for he found that the ordinary means of securing a diurnal movement of the bowels, so essential in dyspeptic persons, were, for the most part, weakening ; — the very thing to be avoided ; and it was under this impression, together with the conviction that the essential nature, both of gout and dyspepsia, was a state of weak- ness, that he composed his Alterative Aperient Pill, for the proper- ties of which see page 20. From what has been said, it will be perceived that the object of the writer is to prevent the gout, or prevent its gaining on the con- stitution of any individual when it has once appeared, rather than to produce any great effect upon any single gouty fit, when it has actually commenced. For the purpose of shortening, and very materially lessening the agony of gout, there are powerful means; 31 but as these are of a nature altogether unsafe for private and domestic hands, he thinks it better to omit the mention of them entirely. With a view therefore of preventing the gout, or with the inten- tion of saving an individual from that faulty state of the constitution from which a fit of gout bursts forth, the Aperient Pills, or No. 2, are chiefly to be relied ujpon, and their management is so precisely the same as in dyspepsia, that it will be requisite to say but very little on this subject. It should be remembered that they are not to purge, but rather to prevent a costive state, or to prove a little lax- ative. If at any time the general habit has become too full, a dose or two of No. 1, is to be preferred, which may be repeated at inter- vals of a few days. Many persons take their daily dose of Aperients, just before or after meals. In this case, they are hardly considered to be a medi- cine but rather as a part of food. They do not, indeed, nourish the body, but by mixing with the food, they give to it that strengthening and recruiting quality, which it does not possess without. In this manner, their operation also, as aperient, is pretty regular, and many take advantage of this circumstance so as to procure an evacuation towards evening ; for, the sleep which follows upon the emptying of the colon before bed-time, is always more refreshing and tranquil. No person need apprehend the slightest evil from their continued effect; indeed, such is the general comfort of body, and serenity of mind which accompanies their continued and habitual use, that many persons are not disposed to leave them off at all. With regard to food, the same remarks which were made upon dyspepsia are applicable here, but those who are most disposed to gout, are commonly persons who indulge too much in eating, and fall into habits of inactivity. These habits, at a certain period of life, are inseparable from that weakness which engenders this disease, and it must therefore be stated, that those who wish to avoid, or to cure the gout, must strictly regulate themselves in these two parti- culars. Without a regulated plan of diet and bodily exercise, the gout may be greatly benefitted by this plan of medicine, but not entirely cured. . , . , There is also an intemperance in the exercise of mind which oftener leads to gout than many are aware of. This disorder, espe- 32 cially in its more irregular forms, is very common in literary and studious persons. When literary people are troubled with undefined and irregular complaints, they should be aware of this, and relax in their pursuits; in the mean while, they will find that nothing in the form of medicine is more suited to relieve the effects of mind upon the body, or to bring the powers of the body to react upon the jaded faculties of mind, than these aperient pills. Should an absolute fit Of gout come on, two or three doses of the fever purgatives, or No. 1, should be taken,— the affected part should be kept cool, (not wrapped up in flannel,) and the diet should be low. These means will greatly lessen the pain and fever, and- shorten the fit materially. CHAPTER HI. Rheumatism, Lumbago, and Rheumatic Gout. These most commonly arise from cold, or irregular clothing and are more of an inflammatory nature; still the utmost good is ob- tained by an attention to the digestive organs, and by guarding against a costive habit. For this purpose, the aperients, No. 2, should be taken for a week or two together, and now and then a dose of No. 1. By this plan, in conjunction with a due regard to clothing, the most obstinate rheumatic affections are removed. Rheumatic Gout is nothing more than Rheumatism engrafted upon a gouty constitution, and should be treated as the gout. 33 CHAPTER IV. Apoplexy, Giddiness, Headache, Confusion of Memory, and of the Senses of Sight and Hearing, also feeling of Numbness in various parts of the Body. These are complaints of the utmost danger, and the safety of every one afflicted with them, depends much more upon the patient's own knowledge of their real nature than on the skill of his physi- cian. For this reason it will be an object of much care to make this subject as plain as possible, and it will be no small encourage^ ment to those to whom it may relate, to be assured that these dis- eases are greatly under the control of proper management. Apoplexy is not that sudden complaint which many suppose it to be • on the contrary, it is slow and very deceiving in its approach. Even in those sudden and fatal strokes we hear of, there are always premonitory symptoms, and these, if they were but known and pro- perly treated, would generally lead to measures of relief and safety. The complaints at the head of this chapter, are of this premonitory kind ; they are all of one nature, and under different circumstances lead to apoplexy. In this disease it is essential to keep in mind two things;—first, that there is a certain weakness in the blood-vessels of the head j and next, that too great a quantity of a rich and heavy blood is cir- culating through them. The plan of cure is therefore plain and rational ;-it is, to strengthen the vessels, and to reduce and purify the vital fluid. Now, every one agrees to this but every one * not acquainted with the means by which it is best accomplished. In aU Lse complaints, for instance, the common practice of repeat- dtood-letting is adopted, but nothing can be more unfortunate han such a practice. This is not the way to lessen circulatton,- than a p ^ ^^ M tQ mcrease 5^ of bTod, rJown to every Grazier. On this account t s that he always bleeds his cattle once or twice- before he puts h m to fatten for the market He does not always know the 34 reason why it is so, nor is it necessary here to point it out, but he knows the fact. In Apoplectic symptoms, therefore, except in circumstances threat- ening an immediate stroke; and in all diseases in which too much blood is a principal cause,—bleeding is a dangerous remedy, and very often fatal in its consequences. In all these cases, the repeat- ed operation of the alterative purgatives, or No. 1, is decidedly to be preferred. By these the blood is diminished in quantity, as well as purified in quality; and this is brought about by means that do not lead to its reproduction, which bleeding always does. In all the cases we have mentioned above as circumstances of an apoplectic tendency, the proper use of the purgatives No. 1, is, therefore, to supply the place of blood -letting; and these, in con- junction with the rules which are to follow, will relieve many an anxious sufferer from the fear and risque of sudden death. The importance of this subject is felt to be very great, and the writer would fain endeavor to impress it on the minds of all who have an interest in it by another word or two. If any one should doubt the truth that the proper use of the Pill No. 1, can lessen as well as purify the blood, he is requested to turn to plate the 2d, and observe the prodigious size and number of the blood vessels which ramify over the inner surface of the in- testinal passage. Now, over all these vessels this pill exerts a full command, and by their judicious use the quantity of blood can be reduced as certainly as by the lancet. But this is not all, for the reduction thus made is gradual, and therefore permanent;. while the effect of general bleeding is to arouse the system to a fresh supply of blood, and when this habit of re-supplying blood has once become established, an increasing fulness of the vessels is a constant consequence ; so that the danger of a rupture of the ves- sels in the head is increased, instead of being diminished, by repeated bleeding—It may not be improper just to mention in this place that the same remark applies to those distressing cases of pal- pitation which frequently occur in elderly people, particularly in those who are inclined to corpulence, and in whom the little vessels on the face are of a bluish cast. Such persons are very apt to fall into this error, but it is a dangerous and very often a fatal one, and therefore cannot be too plainly pointed out. It is certainly true 35 that those who adopt this practice most commonly find relief to be the immediate result; but this is the more to be regretted ; for it is that circumstance which leads to a repetition of a practice which directly involves the dangerous consequences already stated. De- pend upon it, if no other means can be devised,—none which have a more permanent effect in lessening the quantity of blood in con- stitutions of this kind, (which are called plethoric,) such individuals live from day to day upon a very slender tenure. But, in returning to the treatment of apoplectic constitutions, it may be further added, that while the quantity of blood is certainly and permanently reduced by the operation of this Purgative Pill, its current and determination is likewise altered by the same means. In the apoplectic, not only is the blood too abundant in quantity, but the proportion of it which circulates through the vessels of the head is also too great. There is a certain irritation in the blood vessels of the head, in apoplectic subjects, which perpetually invites the circulation to the brain. It has been shown already whence this arises, and to what extent the diseases of the stomach, the liver and the bowels, especially accumulations in the colon, produce and maintain this irritation ; and the reader who is desirous of further information on this subject, is referred to what has been said on the composition of the Aperients No. 2, Chapter VI. In this place it is only necessary to mention this additional ad- vantage of these Pills, and to show that while their immediate ope- ration is upon the bowels, and the circulation is determined to this part in consequence, so it is diverted from the head in the same proportion, and those vessels are allowed to recover their natural tone accordingly. . The use and management of this medicine ,s the following .- It will be observed there are two kinds of Pills ; the first » pre- scribed with the intention of reducing and regelating the emulation of the blood, and must therefore be had recourse to just as the system stands in need of absolute depletion or reduction, and of bourse must be continued and repeated according to the emergency and he effect which is seen to be produced. One person form- stance will require a repetition of the Pills every second or ttard day anl will find his strength, both of mind and ho y, greatly in, ™ved in consequence-while another might feel weakened by 36 such frequent doses, and should therefore repeat them but once a week. Again, one individual will be found to require a greater number for a dose than another, so that the dose must be regulated on the score of their activity. From three or four to six or eight evacuations of the bowels can generally be sustained, but the dose may be so regulated as to act as may be found desirable. Let three or four Pills of No. 1, be taken to begin with, and this quan- tity may be increased agreeably to the end proposed. When the habit of the body is found to be reduced, and the un- comfortable sensations of the head, and the premonitory symptoms are relieved, then leave them off, to be returned to only in the event of a relapse. The second kind of Pill, or mild aperient, is also of great utility in every stage of these complaints. In the first place, their mild effect is called for on the intervening days between the more active doses of No. 1, and when the occasion for the stronger pills has oeased, nothing will more contribute to preserve a healthy state of the organs of digestion, and of the colon in particular, than their occasional and judicious use. With regard to diet and exercise,—much which has been said upon this matter, both in dyspepsia and gout, is applicable here. Bodily exercise, however, is still more called for, and if the habit is gross and corpulent it must be carried on so as to promote a free and copious perspiration. It should also be as regular as can be commanded. The diet too, should not consist so much of animal food, and if the constitution be still disposed to become plethoric, the diet must consist almost entirely of vegetable articles. A life of regularity and temperance is known by all to be absolutely called for. 37 CHAPTER V. Intemperance,—its Effects and Remedy. The object of the following paragraphs is to point out a remedy for some of those effects which render it so difficult to abandon the use of intoxicating liquors when once established. Many an individual has made attempts to conquer this habit, alike destructive to health and happiness, but in these endeavors he has had to contend with such a host of disordered feelings, the effects of long continued inebriety, that he has given up the task, under the impression that he could not live without stimulating drink. The habit of intemperance, in many cases, is begun without the slightest suspicion of impropriety or danger ; even moral persons of the highest intellectual order, have been seduced unconsciously by this specious and deceitful agency. For instance, many of the complaints for which the pills would prove a certain remedy, are attended with a languor and depression of the spirits, for which the use of wine or something which exhilarates proves, unfortunately, a temporary soother; this may even be in the form of medicine, such as a few drops of the red spirits of lavender, upon a lump of sugar ; but, in what form or shape soever it be taken, its temporary relief is very soon dearly paid for. The first effect of this unhappy practice, is to quicken the returns of languor and depression ; but these return not under the same circumstances as at first; for they now require a greater force of stimuli, or a more abundant supply to counteract them. . . . . Invariably, the consequence of habitual wine or spirit drinkmgis to increase in its demand upon you ; and the climax of the drunk- ard's scale of graduation, is generally the strongest brandy, and every hour or two the usual interval between its repetitions. But, the various diseases which await the intemperate can scarcely be enumerated, yet there is not one for which this med^ine, if nghrty managed, is not a remedy. The first consptcuous effect is gener- 38 ally on the stomach, in the form of indigestion; then follows either emaciation, or a bloated fulness, unsteadiness of the hands and limbs, headache, loss of memory, and a state of dejection. There is usually, also, a peculiarly irritable state of temper, even in those who for- merly were amiable and patient, hence the meal becomes embittered, the social tie is weakened, and the very basis of domestic happiness at length is broken up. But, if the symptoms which have been enumerated are not enough to serve as warning, then there will soon follow, pain in the right side, extending to the shoulder; jaundice ; occasional bleedings from the nose, the intestines or other parts; dropsy of the belly and legs, and delirium. Under all these circumstances how important is it to know that the habit may be discontinued ' all at once.' It is a great mistake to think it is to be attempted by degrees. The popu- lar advice, to add a drop of sealing wax to your glass after every dram, and thus gradually lessen the measure, is bad advice;—it has more of wit than wisdom in it. If this advice be ever appli- cable at all, it is in those cases only in which the constitution is broken down by long indulgence. With the exception of such a case I know of none in which a total and sudden abstinence from every kind of spirituous potation, is not the safest and the easiest method to be adopted. In every instance of disease from drinking, the stomach and organs of digestion are first affected, and this is the only medium through which the constitution can be repaired and re-invigorated. On this principle it is that these pills are recommended and relied on. If they are taken as directed, although the languor • and craving of the accustomed stimuli should return, they will be of short duration ; while those false and spurious feelings of vigor, excited for a few moments by exhausting stimulants, will be succeeded by an abiding energy of mind and body, such as health alone produces. The aperients, No. 2, are chiefly used in these cases,—and, for the manner in which they operate, the reader is referred to page 20. Let from three to four of the mild aperients be taken evey night, or every morning at breakfast time, and these should be continued until the appetite and general strength of body is established. It is best to increase the dose, if they should not happen to be gently lax- ative, for it is worthy of remark, that those who suffer least from 39 habits of intemperance, are they who are subject to moderate loose- ness of the bowels, similar to that produced by the pills, which serves to carry off, in some degree, the poisonous effects of what is swal- lowed. CHAPTER VI. Fever and Ague, Bilious and Remittent Fever, Yellow Fe- ver, Scarlet, Typhus, Nervous and Common Fever. Although there is something peculiar to each of the febrile diseases above enumerated, and a great difference in some of them with re- gard to their rapidity and danger ; yet there is a striking similarity in their general treatment; and it will be found, that that part of the treatment of fever which is of more importance than any other, is requisite and necessary in them all, without exception. The most essential point in the treatment of fever consists, first, in evacuating the intestinal canal of all its putrid contents and hu- mors, and afterwards in maintaining a certain action of the bowels, by which the regeneration of such putrid humors is prevented. For the first purpose the composition of No. 1,—the febrile purga- tive, possesses the most specific virtue ; while, for the remaining purpose, the same pill in smaller doses, or repeated at longer inter- vals, is most remarkably adapted. Fevers, therefore, as it would appear, have much of one common nature, which is peculiar to them all; and it is the vitiated humors of the body, and the state in which the intestinal canal is found, which makes the principal difference in them. Indeed, by far the greatest number of fevers, arise spontaneously from the disordered condition of the intestinal canal alone, and then become nervous, putrid or malignant, just as these vitiated secretions happen to de- termine; very generally, those which arise from any other cause, as from cold, would speedily go off if they were not fed and con. cocted into different kinds from this common source of pestilence and diseae. 40 But, when this very general cause of fever is so fully stated, it is not pretended that there is no other cause of fever whatever. It is fully acknowledged that there are other causes which give rise to fevers, and those of peculiar and malignant character; and it is a knowledge of this truth which has given occasion for considering fever under the various names which are given at the head of this chapter. One observation, however, may be made, and should excite peculiar gratitude, viz. that while the dangerous and pestilential kinds of fever are few in number comparatively, by far the greatest number of febrile diseases are of a milder character, and are ag- gravated by causes which it is in our own power to regulate and remove. It is proposed, therefore, to consider the subject of fever in the order already stated, and to point out what other means of treat- ment are required, in order to give the utmost degree of usefulness to the fever purgative, as well as to show the proper use of the mild aperient in each disease. Fever and Ague. Every one knows this form of fever by the perfect intervals of all the symptoms which occur between the fits. This interval may be a day, or two, or even three days, and the fever is termed accord- ingly, a second or a third day ague. The best way to attack this disorder, is to wait for the usual time of the returning cold fit, and the moment it is found to be coming on, then to take a vomit. Thirty grains of ipecacuanha powder is a very good one, but it does not matter greatly what the vomit is; half a table spoonful of the flour of mustard, in a pint of warm water, is as good as any, and very safe and certain. Two or three hours after this, begin with the fever purgative or No. 1.—and after the bowels have been unloaded, then begin with No. 2., which must be repeated and continued until the disease is cured. The dose of No. 2, in this disorder, is from three to five, or more; and these must be repeated every four or six hours. The more that can be taken between the usual period of the shaking fit, the 41 more certain and quicker is the cure. If it should happen that these large doses excite the bowels too much, a tea spoon full of pa- regoric in a little wine and water, once or twice a day, will check it, or the dose may be lessened. This is the course which is to be pursued for several days, or un- til the ague ceases to return, when the pills are to be diminished by degrees, and in a day or two more may be laid aside. It is remark- able that Fever and Ague, which has continued long, is liable to return at the period of the changes of the moon, and on this account it is desirable.that a dose or two of the pills should be taken, before and after the first or second lunar changes. If it should happen that a sufficient quantity of pills cannot be taken for the cure of Ague, in consequence of the laxative effect, this inconvenience must be remedied by taking them in conjunction with the Quinine, or the Peruvian Bark. It is known that there are many cases of Fever and Ague, which resist the efficacy of the quinine or bark alone; but it has never yet been known that the fever and ague has ever resisted the efficacy of the quinine or bark, when taken in conjunc- tion with these pills. By this means those obstructions which pre- vent the curative operation of the bark, are removed by the pills, and no fever and ague, however obstinate, can withstand this com-- pound. In such cases the following will be found to be the most conve- nient and efficacious method of combining them. To one bottle of Madeira or Malaga wine, add sixty grains of sulphate of quinine, or one ounce and a half of Peruvian bark may be used in lieu Of the quinine. Shake the bottle, and take of this two or three table spoon- fuls, or a wine glass full, every two or three hours, having cleared the stomach and the bowels as before advised. With each dose, take two or three of the pills, No. 2, or just as many, and as often as may be necessary to keep the bowels moderately relaxed. It will seldom be necessary to continue this plan beyond a day or two so that the quantity may be diminished, and by degress the use ot the medicine left off. It is found very useful to continue a mild dose of the aperients for a week or two after, both with a view of re- cruiting the general strength and health, as well as preventing a return of the ague fit. 6 42 BILIOUS AND REMITTENT FEVER. What is meant by this fever is indeed expressed in the name. It means a fever in which the symptoms come on and run high at some particular period of every day, and after some hours duration they abate, but do not go entirely off. If the symptoms were to go off entirely, and return on the next day, or day after, then it would not be a remittent, but an intermittent fever, or fever and ague, which we have just been speaking of. The difference then between re- mittent fever, and intermittent ague is this ; that in remittent fever the symptoms only very much abate for a time, while in intermittent or ague, they go entirely off. In both cases the symptoms return pretty regularly at a certain hour on the following day; but while the remittent returns regularly every day, the intermittent or ague, sometimes returns only every second or third day. The common remittent fever then will be known by the daily abatement of all its symptoms. It is very often a mild disorder, and is more commonly seen in persons of a weak and delicate form, and those of sedentary occupations, and is very apt to prevail in the fall of the year. This fever is almost always preceded by a costive state of bowels, or some irregularity of the intestinal passage, and often by dyspeptic symptoms. There are some cases in which these symptoms do not at first appear, but in these they never fail to show themselves in the course and duration of the disease ; and always prove a cause which continues and greatly aggravates it.— It is on this account that the treatment of bilious and remittent fever, is so simple and successful. Nothing is really necessary but to un- derstand the proper use of the purgatives, No. 1, by which you first unload the intestinal passage, and afterwards continue them at cer- tain intervals, until every symptom disappears. It is proper to be- gin with three or four, and these should be repeated every four or six hours, until the intestinal contents are thoroughly dislodged.__ When the evacuations of the bowels cease to be unnatural and of- fensive, or become thin and watery, the first object is then obtained, and now the use of the medicine should be moderated, but must not be wholely discontinued. It is upon a judicious repetition of the same pill, that the removal of this disease depends, and by which 43 healthy secretions of the liver and; bowels will be re-established. The dose of the pills may be the same, but the intervals of their re- petition may be six, 12, or 24 hours ; and at this time it will be necessary to supply the patient with chicken or beef tea, arrow- root, panada, and the like bland and supporting things, and to these it is often very proper to add a little wine or any other cordial.— Under this plan of treatment, sooner or later, this fever will abate, and convalescent symptoms return; with a view of accelerating this return of strength and health, the mild aperients will produce the best effect. From three to four or five should be taken either at night or morning, and, now and then, a dose of the former medi- cine, or No. 1, should be substituted in their place. It should also be observed, that throughout the whole course of the disease, the freest ventilation of fresh cool air should always be insisted on. This is of more consequence than persons are gene- rally aware of. It is also very useful to enjoy the advantage of change of air, when the convalescent stage begins; and if the fever has continued long, and much general weakness has been the con- sequence, this will be greatly advantageous, only care must be ob- served that too much exposure be not allowed. If any form of fever and ao-ue should follow this disease, and that is not uncommon when it happens in the fall of the year, then take the quinine or Peruvian bark, as directed in that disorder. THE YELLOW FEVER. This is a disorder which is frequently so rapid and fatal, that it would always be advisable to obtain the personal assistance of a physician when it can be done. For the benefit of those, however, who have not the opportunity, and with a view to public good in case the yellow fever should ever become again epidemic m this country, or any other, the most simple and successful kind of treat- ment shall now be given. . This fever, like the former, is also of the remittent kmd ; but, owing to a great degree of heat and certain other circumstances, a Zw and then assumes this peculiar and mahgnaut character. In to ZL there is always great debdity, and the fiver becomes so exceedmgly irritable as to produce an overflowing quantity of bile , 44 it is this which gives the skin and surface of the body, its yellow color. In the beginning of the fever there is always, more or less, a high degree of inflammatory action ; and therefore, whenever it can be had recourse to, a free and copious bleeding is the first step which should be taken in its treatment. Those physicians and surgeons who have had the most experience in this disorder, either in this country, the West and East Indies, or in those parts of Europe in which it has ever been an epidemic, are all agreed on the propriety of bleeding. The quantity of blood which should be taken, or the repetition of it, are points which can only be determined by the high degree of heat and fever which are present, and the natural strength and fulness of habit of the individual patient. As a gene- ral rule it may be observed, that the bleeding should be bold and copious,—not sparing. When the patient has been blooded, or, in cases where no person is at hand to perform this operation, then immediately begin with me- dicine. Take three or four of the fever purgative pills, or No. 1, and repeat the dose every three, six, or eight hours, so as to keep the gall duct and intestinal passage free from accumulations of every kind. Both the liver and intestinal glands are under the im- mediate influence of this disease, and are continually pouring forth acrid and malignant humors. Now, the most important point in the treatment of the yellow, as well as of other fevers, consists in car- rying off such morbid secretions as fast as they are formed, and no better means on earth can be devised for this purpose than the fever purgative pill, or No. 1. There is however, one circumstance to be mentioned in connection with their use in this disease : it is, that an irritable state of the sto- mach and bowels sometimes presents itself which causes them and every thing else which is taken, immediately to be rejected by vomit- ing ;—or, if they pass into the bowels, they do not remain there long enough to produce their good effect upon the liver and intestinal glands. To allay the vomiting, and obviate these effects, some opi- ate or other quieting ingredient should be given with them ; and the most convenient and excellent form of medicine for this purpose, is the paregoric. In such cases, therefore, let a tea spoonful of this 45 be given in a little water with every dose, or every other dose of the pills as it may be required. The next object in the treatment of yellow fever, is to subdue the raging heat of the body as much as possible. For this purpose no- thing is better than sponging the limbs and surface of the body with cold water, or vinegar and water. This must never be omitted.— Let a person sit by the bed side, and continue his work steadily.— First begin with the feet and hands, then go up the limbs and then over the whole surface ; afterwards begin again with the feet, or where the heat is greatest, and do the like. It is astonishing how much the heat is to be subdued by this simple means, and how grate- ful and supporting it is to the suffering patient. It is also the best of all means to bring out a perspiration. This salutary action cannot take place under great febrile heat of body ; but if you can reduce this heat to a certain point by any means, then sweating will break out to the great relief of the patient. Sleep also is brought about by reducing the heat of the skin ; and the author has often known a calm and refreshing sleep to succeed this cooling process, espe- cially in children with the scarlet fever, when no medicine could procure it; he therefore, lays great stress on this simple means. Another and co-operating measure which must always be insisted on is ventilation. The importance of a free current of fresh cool air cannot be told. Every contrivance for this purpose is invalua- ble Let the bed be removed to the coolest room in the house, and so placed between the door and windows as to make the utmost of the change. If ever yellow fever should become again an epidemic in this country, it will be found that removing every patient as soon as possible to an encampment formed on this principle, wtll prove the happiest means of saving life and extinguishing the raging pes- ^Thl'beverage also should be cold ; cold water, or water acidu- latecl with lemon juice, or any kind of acid, may be drunk without measure or limitation,—the more the better. # When the fever abates and marks of convalescence begm to aolr a light and nourishing diet, jus, as in the convalescence of ler feverj will be demanded. Bark and cordia,s are somefimes called for. 4G The treatment of yellow fever then, whenever it occurs, may be condensed in a few words.—Bleeding at the onset, if it can be done; Repetition of the fever purgative pills, or No. 1, assisted with the paregoric when vomiting and irritation of the bowels are pre- sent ;—sponging the surface of the body, and free and constant ven- tilation. Scarlet, Typhus, Nervous and common Fever. It is not necessary to say much on the treatment of the fevers above mentioned, as one common principle is applicable to them all, and this has been plainly described in what has been already said. If a common fever continue in a person whose constitution is suf- fering from impurities of blood, disorders of the digestive organs, anxiety of mind, bad diet, impure air, or any such cause,—then it becomes a low fever, or what is called nervous ;—or, it may become lower still, when it is called typhus, or putrid. Now in all these, a like treatment is required, and this consists in a well regulated use of the fever purgative, or No. 1, just as it has been pointed out in speaking of yellow fever. The object is to clear the constitution of humors and vitiated secretions, and then continue their use in such a manner as to maintain a certain moderate action on the bowels. Thus a link is broken in that chain of morbid action, on which the existence of disease depended,—the resources which supplied ma- terials for its typhus character, are quite destroyed, while the ner- vous system is left at liberty to exert the powers of nature in the re-establishment of health. The same remarks which have been made upon the utility of the cooling process, are equally correct in fevers of every kind; but as the heat does not run so high, and the danger is not so great, such measures, are not often required to the extent which has been men- tioned in the previous article. The means of cooling the body, how- ever, by sponging or otherwise, is proper in all fevers, and when the heat arises above the ordinary standard, and the patient is sensi- ble of it, it can never in any instance be hurtful, and scarcely ever can be useless. With respect to scarlet fever, too much cannot be said to urge 47 the practice of sponging the body. Indeed, the author, for many years, has laid'a greater stress upon cooling ablutions in the scarlet fever, than on any other means, and not without the happiest results. With regard to other remedies but little may be said ; for, if the proper use of the fever purgatives be secured, and the heat of the body be reduced by the united efforts of sponging, and constant ventilation, but little else will be required. In the course of fevers, however, of any kind, local symptoms will sometimes happen. The brunt of the fever in such cases seems to fall in the form of inflammation, on some one or other part of the body, and this is known by great heat and pain in such part. These local affections must always be treated on the common principle of inflammations, and sometimes a general blood-letting is required. When this part happens to be the brain, or lungs, or any part of the belly, it must never be neglected. The head must be shaved; clothes wet with cold water, or vinegar and water, applied, and leeches to the temples-sometimes a blister to the nape of the neck. If it happen in any part of the belly, which is known by pressure of the hand, then leeches, warm fomentations, and after- wards a blister will be necessary. These are always safe steps, and in some cases absolutely required. A blister to the throat in scarlet fever is always safe. , With regard to beverage and supporting regimen, this must be regulated by the low or typhus symptoms which appear. Every fever differs in the degree of weakness or prostration of the vital powers, and therefore calls for different degrees of supporting be- Vera-e. Wine and water is the general and most proper drink. Thisls only called for on the score of support, and therefore is only necessary when symptoms of debility, or prutrescence are seen such as! dry brown or blackish tongue, the teeth covered with adhei humors, and the breath and evacuations offensive. In ^Teases wine alone, and even wine and brandy are required, and must be given liberally. 48 CHAPTER VII. Scrofula, Kings-evil, Tumors in the neck, Enlarged Joints, Ulcers, Eruptions on the Skin, Pimples in the Face, Salt Rheum, Nettle Rash, Prickly heat, Boils, Itching of the Skin, Cutaneous Diseases, &c. &c, The whole of the above diseases are so much of the same class that they may be advantageously spoken of in the same chapter, more especially as the method of treatment which is proper for one is proper for the whole. All of them are complaints in which the blood is poor as well as foul, and great mischief is constantly done by injudiciously purging to excess with calomel and weaken- ing drugs, while the diet allowed is frequently too poor and scanty. It is certainly proper to begin in all these cases with a briskly operating purge,—say with a dose of No. 1;—but when the bow- els are once cleared, they should then be only gently, though con- stantly moved by No. 2. It will sometimes be necessary to give a dose of these pills every day, and sometimes every other day, and where the habit is very gross and full, No. 1, may be repeated once or twice a week. It is, however, the No. 2, gentle aperients, that must be relied upon for sweetening the blood, and by their use the digestion will be so much improved, and the appetite so sharpened that the strength, activity and spirits will become abundant; and it is only in propor- tion as this result is obtained, which is a proof of general health, that all these eruptions, tumors, swellings, and ulcerations will heal and disappear. The diet, also, is to be a matter of your care, it should consist of good animal food twice a day, under-done, with a little wine, or beer;—pure air and moderate exercise are also absolutely necessary. The clothing too, must be adapted to the change of weather. Many of these complaints are seen in weak and delicate young . persons, and those parents who have lost their children under simU 49 lar affections will be astonished at the health, strength and pre* servation of life, which will ensue from the treatment here laid down. Children that cannot be induced to swallow pills, may have them powdered and dissolved in boiling water, and made a syrup of. CHAPTER VIII. Consumption, Threatening Cough, Difficulty of Breathing, and Asthmatic Disease. To prevent consumption in those affected with a threatening or suspicious cough, and as a remedy for all the various affections of the lungs mentioned above, it may be confidently affirmed that no me- dicine will be found more safe and efficacious than these pills* There is not a more insidious and fatal evil than a trifling cough, which sometimes improves, but never goes off entirely. If a cough continue much over a week, there is a sufficient ground for care and watchfulness, and if there should happen to be a taint of scro- fula in the constitution, or a vitiated state of the blood from indi- gestion, or an inactive state of the bowels, especially aUhe growing stage of life, the danger multiplies exceedingly. In such cases the humors seem attracted to the lungs, by the frequent irritation of coughing, and are there deposited in the form of tubercles;—this is the origin of tuberculated lungs ; "these tuber- cles continued to enlarge on every slight occasion, such as change of weather, &c, until at length they suppurate by continual inflam- mation, and the matter and corruption they contain escapes into.the air-cells, and is thence expelled by expectoration. This is a state of things more easily prevented than cured, and in a great majority of cases this fatal termination of the disease might have been obviated by the timely use of proper measures. The treatment which is recommended under the circumstances which have just been detailed, is the following : ' In a common cold accompanied by a cough, there is generally 7 50 a little fever, begin therefore with the No. 1, purgative pills, and repeat the dose in a day or two. If there are slimy and offensive materials in the bowels, they will be certainly removed, and if not, the blood will be cleansed, and its circulation determined to the bowels, and thus the irritation and obstruction in the lungs will be relieved. If pain about the chest, with considerable fever should attend the cough, a moderate bleeding from the arm is advisable, and it may be laid down as an axiom, that a blister, or mustard poultice upon the chest is always a safe and advisable application in severe affec- tions of the lungs. The diet should at the same time be low, and the patient must avoid unnecessary exposure to cold and all excess- ive bodily exertion. In long-continued coughs, in shortness of breath and asthma, the aperients, No. 2, are more particularly useful. These should be taken as in dyspepsia, and now and then a dose of No. 1, to purge away the accumulated humors from the system, and so prevent their disposition to settle on the lungs. CHAPTER IX. Cholera, or Cholera. Morbus. The disease which is to be the subject of this section, having so lately raged in this and many other countries, in the form of a severe and very fatal epidemic, it seems a matter greatly to be desired that every individual should be so far instructed with regard to the na- ture and treatment of this awful malady, as to be able from his own knowledge, immediately to attack it where and whensoever it may make its appearance, and to conduct its cure upon some plain and correct principle. There is no particular reason to apprehend that this disease will again return in the same rapid and fearful form in which we have so lately seen it; yet such" an event is by no meaas impossible; and, moreover, we are at all times liable to the 51 milder attacks of Cholera; and, indeed, in the months of July and August, as also in the fall of the year, this disease is very apt to become more or less an epidemic. For this reason, as well as that the life of the sufferer very often depends upon the prompt and decisive measures which are adopt- ed, the writer is anxious to render this disease and the treatment of it as plain as possible; and with this intention he proposes to ar- range the remarks he has to make upon the subject of cholera, in the following order :- The nature of the disease termed Cholera, or Cholera morbus. How'to distinguish cholera from disorders which in some degree resemble it. > The causes of cholera. Objects to be aimed at in the treatment of cholera, also, a list of materials which should be kept in readiness for their accom- plishment. On the different kinds of cholera ;—the symptoms which mark them ;—and the particular manner of administering the reme- dies already mentioned in each variety of the disease. Bilious cholera, or cholera morbus. Flatulent cholera. Spasmodic, or Asiatic cholera, its symptoms and treatment. The treatment of the premonitory symptoms of cholera. ' Means for securing general health during the" prevalence of cholera. The Nature of the Disease termed Cholera, or Cholera Morbus. It is to be remarked, that in this complaint, the liver is the organ which is always first affected, and from this source proceeds every circumstance which is observed subsequently to take place. In what this altered state of the liver consists, has not hitherto been ascertained, but the consequence of it is, that the secretion of this organ, that is to say the bile, becomes of an irritating and poisonous quality In common cholera morbus the bile is generally very much increased in quantity, but this is not the case m all the vane- 52 ties of cholera, on the contrary, in some it is even deficient, and again at other times, though not deficient, it is nevertheless shut up by spasm in the liver and gall-duct, so that there is no appearance of, bile in what is thrown off by the stomach and bowels. With regard to the color of the fluid evacuated, this also varies ; in the milder and common cases of cholera morbus, this is yellow and looks like an overflowing of pure, unmixed bile, but in the more severe forms of this disease, the evacuations both of the stomach and bowels are watery, or like water in which fresh meat or rice has been washed. Further, we observe a striking tendency to spasm. Cramp in the limbs, with spasmodic affections, more or less universal, and which sometimes extend to every organ of the body, is a peculiar charac- teristic of this disease. Much of this spasmodic affection may be ac- counted for on the principle of the irritating acrimony of the bile, occurring in a weak and excitable condition of the body, but, inde- pendently of this and other causes, there is in cholera a tendency to spasmodic affection which is peculiar to the disease! It does not seem that there is any essential difference in the nature of cholera, under whatsoever form it appears, and if we examine . ' "and compare the common cholera morbus with those severe and "*" fatal cases of spasmodic cholera "which occurred in the late epi- demic, it will be seen that the difference consisted more in the violence and rapidity of the circumstances attending each, than in any peculiarity' in the nature of the disease itself. In every case the liver is the seat and centre of all that follows, while the violence and fatality of every attack depends chiefly on the following cir- cumstances :—the doncentrated poisonous quality of the bile ;—the ease or difficulty with which it is carried off from the body, and the natural resources of each individual to supply the exhausting vital power. s With regard to the nature of cholera, therefore, it. may be stated in few words ;—it is a disease in which the liver is disordered, and secretes an acrid and poisonous bile ; this quickly disturbs the stomach and intestinal passages, and through them the nervous system ;—i hence, vomiting, purging and spasms. Such are the symptoms which are characteristic of cholera, and they are violent and fatal in pro, portion to the intensity of the disease of the liver. In the most 53 severe attacks, the spasm is so extreme and universal, as to shut up_ the poisonous bile in the .liver, and the gall-bladder, and the vital power becomes most - rapidly exhausted ; when this takes place, the patient is said to be in a state of collapse,' and death is then gener- ally near at hand. Some severe cases have thus, proved fatal in less than six hours. ■■ * How to distinguish Cholera from other disorders which in. SOME DEGREE RESEMBLE IT. During the panic of mind which prevails at the time of an epi- demic, almost every disorder which occurs, especially those which relate to the state of the stomach and bowels, are construed into a case of cholera, and much confusion and unnecessary alarm is frequently the consequence. The disorders which are most likely to be mistaken for cholera, are, dysentery, cholic, and common diar- rhoea, or summer complaint; but if what has been said on the nature of cholera, be kept in mind, it will generally be an easy matter to distinguish it from these disorders. For instance, dysentery may be known by the stools being slimy, not bilious or watery, and often streaked with blood.. ' Further, these evacuations are generally mixed with portions of common stool, and in the intervals of griping, there is more or less of a constant pain, about the fundament. These symptoms, together with' the absence of cramp and spasm, will be a sufficient guide to distinguish the disease of dysentery from that of cholera. In Cholic, and particularly in the painter's cholic, it is true that there is frequently a copious vomiting of bile, while the bowels al- ways remain obstinately costive ; nothing whatever can be made to pass by stool; and this striking circumstance will afford a distinctive mark between the cholic and the cholera. In Diarrhcearor common summer complaint, the evacuations are more or less watery, but they are not bilious. Neither is there fever, vomiting, or cramp and spasms. THE CAUSES OF CHOLERA. With regard to the remote cause, or the reason why the cholera ,should sometimes become an Epidemic-thisf is a matter perfectly 54 unknown to every one. Certain circumstances, such as heat alone, or heat combined with moisture, seem to favor its appearance ; but there is something more than these, and that which no person has yet been able to dtetect, which gives existence to the Epidemic form of cholera. It has prevailed even in cold and dry, as well as in hot and swampy districts. As to the question of its contagious nature,—that is to say, whe- ther cholera is communicated from person to person, or only by the agency of some peculiar, but unknown state of the atmosphere, this has been a subject of much debate. Those who have seen most of the disease, and are therefore by far the most capable of judging, are decidedly of opinion that cholera is not contagious, and in this opi- nion the writer perfectly agrees. In his judgment the disease can- not be taken by ,any one, in consequence of attending upon, and nursing those that are affected with it, and those who withhold their personal assistance from their friends or neighbours on this ground, are under a delusion. But if little or nothing is known with regard to the nature of that cause, which gives the cholera an epidemic character, this cannot be said of the immediate causes which produce it. Much that is important and very practical is known on this subject, and it is the duty of every individual to become acquainted with such causes, and earefully to avoid them. Amongst the most important of this kind, may be mentioned,—intemperance, and irregularities of any kind ; perspiration suddenly suppressed, particularly by cold and damp applied to the feet, as by long standing on cold, damp bricks or stones; —cold drink, especially if taken when heated by exercise ;—cold, indigestible fruits, as unripe apples and pears, cucumbers, melons, &c;—also, any violent purgative medicine ;—a state of costiveness ; —a neglected bowel complaint, or such a state mistreated by laudanum or astringents. Fear also may be considered to be a cause, as well as every thing which has a tendency to depress the spirits and ex- haust the strength of the body. Objects to be aimed at in the treatment of Cholera, and also a list of materials which shauld be kept in readiness for their accomplishment. The objects to which your endeavours are to be directed in the case of an attack of chqjera, are, to dilute, evacuate, and wash out 55 the acrid bile from the passages, both by the stomach and bowels;— to moderate the vomiting and purging;—to allay the cramp and • spasm,—and to prop up and support the sinking powers of life. Now to effect these purposes, especially in the time of cholera, every one ought to have in his house, or carry with him on a journey, the fol- lowing articles :— 1st. Some pearl barley, oatmeal grits, or some gum arabic, or all of these. 2th. A box of five grain calomel pills. 3d. A bottle of castor oil. 4d. A two-ounce bottle of laudanum. 5d. A box of one grain opium pills. 6th. A packet of Dr. Ralph's improved Hygeian Pills. 7th. An instrument for giving an injection, or a common glyster pipe and bladder. On the different kinds of cholera, the symptoms which mark them, and the particu- lar manner of administering the remedies already mentioned, in each variety of the disease. There are three kinds or species of cholera,—the Bilious, com- monly called Cholera Morbus,—the Flatulent Cholera,—and the Spasmodic, or Asiatic Cholera. BILIOUS CHOLERA, OR CHOLERA MORBUS. This is the first species, and is the mildest. It is the common cholera of our summer months. At such times it frequently becomes more or less an Epidemic, but it seldom gives occasion to much alarm, being usually mild and tractable. The manner in which this disease comes on, is as follows : a person complains, perhaps for a day or two or more, of uneasiness about the stomach and bowels; he is flatulent and feels some griping pains ;—at length he is sud- denly seized with vomiting and purging, and after the first few eva- cuations, the discharges consist of pure yellow bile, both upwards and downwards. To this pretty quickly succeeds cramps in the le