IF it should be asked, why I address my­self to the Patient, rather than to the Physician, I answer, that, having offended the Doctor in my title-page, I presume he will give but little attention to my reason­ing; for we listen very unfavourably to the advice of a man who begins by asserting, that we are fundamentally wrong. But with the Patient, the case is different: recollect­ing that consumptions, in the present mode of practice, are very rarely cured, he al­most assents to the truth of my assertion, even before he has heard the arguments upon which it is founded. I speak, there­fore, not immediately to the Physician, be­cause I do not like that a man should turn his back on me when I am talking to him. If the Doctor chuses, whilst I am conver­sing with my Patient, to look another way, yet squint an ear to my babbling, he is very welcome; provided he will not condemn my [Page 4]practice, till he hath proved its futility by experience.

Now, though I write not directly to Me­dical Gentlemen, I esteem it nevertheless necessary to proceed methodically, and ac­cordingly shall premise as much of the ana­tomical and physiological description of the lungs, as will be sufficient to enable those, who have not had a medical education, to comprehend my arguments. I shall then enquire into the predisposing and imme­diate causes of Consumptions; shall indicate the symptoms by which the patient may be certain of his disorder; and shall lastly proceed to consider the cure, upon rational principles.

The trunk of the human body is divided, by a remembrane called the Diaphragm, into two distinct cavities, the lower of which is called the abdomen, or belly, and the up­per, the thorax, or chest. The latter of these cavities contains the heart and the lungs. The lungs are divided into two principal lobes, which are inclosed in two distinct bags, formed by a membrane called the pleura; so that the right and left lobe of the lungs have not the least communi­cation. The adhesion of these bags near the middle of the chest, forms of perpen­dicular membrane called the mediastinum; but receding from each other as they go lower down, they form a third bag, called [Page 5]the pericardium, which contains the heart: so that the chest is divided into three sepa­rate cavities.

The lungs are composed of blood vessels, air vessels, lymphatic or water vessels, nerves and callular membrane.

The blood vessels are arteries and veins; but these are of two distinct kinds: the first receive and return the whole mass of blood, which circulates through the lungs, before it is thrown into the other parts of the body; and the second were intended only for the support and nourishment of the lungs themselves.

The air vessels are infinitely small branches continued from the wind-pipe, with which, in a sound state, they have a free commu­nication, so as at every inspiration to be filled with air.

The lymphatic vessels are distributed on the surface of the lungs, and convey the lymph, which they imbibe, to a certain duct, whence it is returned to the mass of blood.

The nerves are exceeding small branches, which proceed chiefly from what is called the eighth pair.

The cellular membrance, which fills the intermediate parts between the vessels, is composed of fibres or laminae, which are neitheer vascular, nor endowed with sensi­bility.

The aspera arteria, or wind-pipe, is that tube which conveys the air, passing through the mough or nose, to and from the lungs. It is composed of alternate cartilaginous and fleshy rings, behind which are an infi­nite number of small glands, which sup­ply the wind-pipe with a thin pellucid mu­cus lining its internal surface, which con­sists of a membrance of exquisite sensibility.

Thus much being premised, we shall now proceed to the office and utility of the lungs, which are necessary to be understood, be­fore we speak of its diseases.

The organs of respiration are so indis­pensibly necessary to our existence, it is no wonder that physiologists should have taken uncommon pains to discover the real design of Nature in their formation. Various have been the conjectures of authors on this sub­ject. Some have supposed, that the blood in passing through the lungs acquired its red colour; others have been of opinion, that the intention of respiration is to receive a certain quantity of air, which they ima­gined necessary to be mixed with the vital fluid; with many other suppositions equal­ly without foundation. That Nature, by first circulating the blood through the lungs, after the reception of fresh chyle, intended some necessary preparation, may be con­cluded without farther examination; and that this preparation is effected by throw­ing [Page 7]off a certain quantity of noxious mat­ter, imbibed by the air with is received by the lungs, seems evident from the ex­periments which prove that air, once satu­rated with this noxious matter, is unfit for respiration. The notion that animals, when confined to breathe the same air, die be­cause the elasticity of the air is destroyed, is entirely without foundation; it being very easy to prove, that the elasticity of the air is not in the least diminished. The use therefore of respiration, is to relieve the body from a certain matter, perspirable only from the lungs, which, if entirely retained, is incompatible with existence, and, when retained in part, is productive of disease. It is separated from the blood by means of small ducts passing from the pulmonary arteries to the air vessels, where it is dissolved and carried off by the air. The existence of these ducts is easily de­monstrated, by injecting almost any liquor into the pulmonary artery, which liquor may, without much difficulty, be made thus to fill the branches of the wind-pipe.

Supposing that we are now pretty well acquainted with the fabric and office of the lungs, we may, I think, with safety pro­ceed to the more immediate object of our attempt.

The general predisposing causes of a con­sumption of the lungs are to be sought for [Page 8]in the original formation of the body, the acrimony of the juices, or the age of the patient. As to the first of these causes, without reasoning about the matter, it is sufficient for our purpose to observe, that people of a slender and delicate frame, whose skin appears remarkably transparent, whose chest is flat and narrow, and shoul­ders high, are in general more subject to this disease than people of a contrary make; because, say the learned, the vessels of the lungs are, in such bodies, too fine, and too weak, to resist the impetus of the blood, flowing with great rapidity through the or­gan of respiration: a rupture of the vessels, a spitting of blood, &c. are the consequence. The same effects may be produced by an extraordinary acrimony in the fluids, which may corrode the vessels; and as to the third cause, it is attributed to the fervor of the blood, which is supposed to be greatest at the age when people are most liable to con­sumptions. To a sagacious reader, part of this reasoning will appear plausible, and part otherwise. But these are remote causes, which are equally applicable to all coun­tries, and which do not in the least assist us in accounting for the peculiar consump­tive propensity in the inhabitants of this island.

This propensity must be accounted for, not by any predisposition in the make of [Page 9]our bodies, but by what is called a Pro­catarctic or occasional cause, namely, the instability of our climate, or rather its im­mediate effect, a Cold, to which, I am con­vinced, the frequency of Consumptions in this kingdom is chiefly to be attributed.

What is a cold, and what are its effects?

The questions are of importance; let us not, therefore, be too precipitate. Expe­rience, our best instructor, hath taught us, that nothing is so detrimental to the human body, as sudden transitions from one ex­treme to another; but it is particularly true in regard to heat and cold. The natural effects of warm air is to relax the skin, con­sequently to open our pores, and conse­quently to increase our perspiration; an effect which may reasonably be supposed to take place equally in the lungs, as on the surface of the body. When the body, in this state, is suddenly exposed to a cold air, the consequence is an immediate spasm over its whole surface. The pores are obstinately closed, and the perspirable matter is gra­dually returned into the mass of blood.

That this perspirable matter is of an ex­ceeding acrid nature, is evident from its effects. By irritating the vessels, it in­creases their oscillations, which, increasing the circulation, produces fever. Its acri­mony appears even in the very first symp­tom of a Cold. The pores of the head have [Page 10]scarcely been closed a moment, before the perspirable matter, falling upon the mem­brane which lines the nose, causes, by its irritation, that convulsive motion which we call Sneezing. It returns upon the glands about the wind-pipe, and issuing thence excites another convulsive motion, called a Cough; which are different efforts of Na­ture to rid herself of the offending cause. In oozing down the wind-pipe, it destroys the mucus, therefore we are hoarse; and by inflaming the membrane which lines the trachia, occasions that sensation of soreness in the breast, which we feel in a few hours after taking cold. Thus continually de­scending, it enters the branches of air ves­sels, and diffusing itself to every part of the lungs, occasions the cough, which we so easily distinguish from that which proceeds from an irritation in the upper part of the wind-pipe, and which we call a Tickling cough.

We are not however to imagine, that this acrid lymph, which falls from above, is the sole cause of irritation in the lungs. On the contrary, it is more probable, that they are principally offended by the acri­mony of that which issues from their own peculiar glands; for in severe colds, that is, when the obstruction of perspiration is almost universal, (for it is never entirely so) in such cases, I say, every humour in the [Page 11]body is contaminated; and that very mucus, which in health prevents irritation in the air vessels of the lungs, is now the princi­pal cause.

Inflammation is the natural consequence of this continued irritation, which as na­turally produces a superabundant secretion of mucus, and which, if not constantly spit up, suffocates the patient. When these symptoms are violent, the disease is called a Peripneumony: but if this inflamma­tion continues beyond a certain time, the vessels are destroyed, and become dissolved in a kind of matter called pus.

Thus we are arrived at the immediate, or proximate, cause of a Consumption of the substance, of the lungs. But here it may naturally be asked, how it happens, when a part of an organ, so indispensibly necessary to life, is destroyed, that the pa­tient does not immediately die? I answer, that Nature, in this instance, has been par­ticularly kind to us; for the two lobes of the lungs, having no communication, are not immediately affected by each other's dis­eases; besides, every minute branch of the same lobe is so contrived, as to perform its office independent of the rest; therefore every single vessel continues to receive and return its portion of air, till it be actually destroyed. Hence it is, that in dissecting of bodies which have died consumptive, we [Page 12]frequently find a considerable part of the lungs entirely destroyed. Indeed the ap­pearance of the lungs, in those who have died of this disease, is so various, that, though it may be but of one genus, the number of species are extremely numerous, if we may conclude from the diversity of phoenomena upon dissection. Sometimes we find a texture of a part of the lungs en­tirely destroyed, and nothing but a collec­tion of purulent matter in its place, com­municating with the wind-pipe, so as to fill it on laying the head downward. At other times we discover a quantity of matter inclosed in a kind of bag. Sometimes this matter is contained in a number of small follicles, and at others, it may be squeezed from every part, and the texture of the lungs but little injured. In some cases, we find a number of small hard lumps; in others, large indurations, and sometimes tumours that are absolutely cancerous. In short, as I have before observed, the variety of ap­pearances is infinite, especially if we in­clude colour.

However, notwithstanding this great di­versity, the proximate cause of that species of Consumption which is so frequent, and so fatal, in this kingdom, is an ulcer in the lungs, in consequence of inflammation, oc­casioned by a cold, or, in other words, by a greater flux of acrid perspirable matter to [Page 13]the lungs, than can be absorbed and car­ried off by the air. It is also possible, that a part of this matter may be confined near the extremities of the air vessels, by a spas­modic constriction in the upper part, occa­sioned by the sudden admission of cold air. When this is the case, an inclosed ulcer, or vomica, is the consequence.

Having proceeded thus far in the consi­deration of our subject, and, I think, with­out straining our text, we are now naturally led from the cause, to the cure of our dis­ease. And first it may not be amiss to en­quire a little into the foundation of the ge­neral practice.

The first thought, which naturally oc­curs, is, that this general practice is gene­rally unsuccessful; and we thence as natu­rally conclude, that it must be fundamen­tally wrong.

If the inflammation be violent, compa­ring it with inflammations in other parts of the body, and reasoning from analogy, the first thing we do is to bleed; and so far we are right, as, by lessening the quantity of blood, we lessen the impetus of the remain­ing part, and thereby retard the progress of the disease for a time: but alas! the time is very short: the pulse soon recovers its velocity and strength. Well; but then we administer a quantity of saccharine, oily and mucilaginous medicines, in the form [Page 14]of an emulsion, or otherwise, intending, no doubt, thereby to sheathe and obtund the acrimony which causes the irritation in the lungs. The intention is certainly lau­dable; but it happens unfortunately that these balfamics go down, not into the lungs, but into the stomach, where they imme­diately undergo such a change, as to carry but little of their balsamic qualities even into the intestines, where they are still far­ther mixed and adulterated, particularly by the addition of a certain quantity of bile, immediately on quitting the stomach.

But to proceed. Let us suppose these demulcents already in the intestines. What becomes of them? They must either be received by the lacteal vessels, or pass off per anum; the latter of which is the way chosen by the greatest part of them, con­trary to the intention of the physician. Happily for mankind, these lacteal vessels are endowed with a kind of mechanical sagacity, which enables them to select from that heterogeneous mass of food and medi­cines, constantly presented to them by the stomach, such matter only, under the de­nomination of chyle, as is fit to be assimi­lated with the blood.

Here I shall be interrupted with an ob­jection, that the lacteals are capable of ad­mitting poisonous matter, and conveying it to the heart, to the immediate destruction [Page 15]of the body. To this objection, (having first hinted, that most poisons are destruc­tive from their immediate action on the nerves in the stomach) I answer, that Na­ture acts, not by partial, but by general laws. Those who are incapable of apply­ing this argument, deserve no other reply.

Let us now suppose, that a small portion of our balsamics has gained admittance through the mouths of the lacteals. Thence it is conveyed into the glands of the me­sentery, and having been secerned through several of these, it rises into a certain re­ceptacle whence it is conducted into a vein under the left arm, and thus mixes with the blood. It now soon reaches the heart, and from thence thus mingled with blood, it passes through the lungs. I say through the lungs; because it is immediately return­ed to the heart, thence to be distributed through the rest of the body.

Now it must be remembered, that the seat of the disorder which, by these heal­ing medicines, we are endeavouring to cure, is not in the blood vessels, but in the air vessels of the lungs; and that these air ves­sels have no communication with the arte­ries, except by means of tubes or pores so extremely small, as not to admit the red globules of the blood; consequently the constituent particles of our medicine must be smaller than these, otherwise no part of [Page 16]it can possibly be thus applied to the part injured. But we have said, that a liquor may, by injection through the pulmo­nary artery, be forced into the bronchia: true; but this liquor passes colourless, al­ways depositing in its passage the matter with which it was tinged.

These things being properly considered, let me now ask the reader, whether he thinks it probable, that even the lead be­nefit can rationally be expected from sac­charine, oily, mucilaginous, or balsamic medicines thus applied?

What then is to be done? Has Nature been so unkind, particularly to the inhabi­tants of this island, as to afflict us with a disease for which there is no remedy? I verily believe she has not been so unkind. The fault is not in Nature, but in ourselves; or, perhaps, rather in the difficulty of the task: for we cannot suppose, in the present improved slate of chemistry and anatomy, that all thinking men are not perfectly sen­sible of the improbability, I had almost said impossibility, of applying demulcents to the lungs through the alimentary canal: nor is it more reasonable to suppose them forget­ful, that the only possible way of applying medicines directly to the lungs, is through the wind-pipe. But, as I have before ob­served, they have been prevented from at­tempting [Page 17]this obvious method, by the dif­ficulties which occurred in the execution.

To convey any palpable solid or liquid substance through the wind-pipe into the lungs, we know to be impossible; for that, if the least crumb of bread, or drop of any liquor, happens by accident to enter the glottis, a violent cough is immediately ex­cited, till the offending matter be rejected. But we also know, that impalpable volatile matter is incessantly carried to and from the lungs, along with the air; every substance therefore that can be volatilized, may be conveyed directly to the lungs. Aqueous liquors may be easily converted into vapour, and vapour may be impregnated with great variety of medicinal substances.

On these considerations, it should now seem, that the whole mystery is at once discovered, and that we have nothing more to do, than to convert our proper medicines into vapour, and so convey them directly to the diseased part. Alas! there are many considerable obstacles yet to surmount, as will appear from a chemical view of the medicines in question.

Let us suppose, that our patient, having caught a severe cold, labours under an in­flammation of that membrane or skin which is continued from the mouth, down the wind-pipe, into the bronchia; and that this [Page 18]inflammation is chiefly in the lungs. Or let us suppose, that the irritating matter is not sufficiently acrid to produce much in­flammation, but only a superabundant se­cretion of acrid mucus. Or, let us farther suppose, that the lungs are actually ulce­rated. In these several stages, or degrees of the disorder, what are the indications?

Our endeavours to restore the obstructed perspiration, are undoubtedly rational; but our medicines, given with this intention, commonly fail. They excite indeed a co­pious sweat; but the fluid thus determined to the surface of the body, is totally dif­ferent from that volatile matter which, in a sound state, exhales particularly from the lungs, and to the diminution of which ex­halation, the disease in question is solely to be attributed. But what is the present danger? It is, that the inflammation may end in suppuration; or that the acrid mat­ter may be obstructed by mucus, or spasm, and so corrode, indurate, or destroy the substance of the lungs. The immediate indication therefore is, if possible, to pre­vent these consequences; which I presume can only be effected by the application of antiseptic, (that is, medicines which resist putrefaction) antispasmodic, attenuating, and balsamic medicines, directly to the part affected.

With regard to the first, viz. antiseptics, there is no difficulty, the most powerful of them (I speak from experience) being in their nature volatile. Antispasmodics and attenuants are equally easy of conveyance; so that the sole difficulty lies in our balsa­mic medicines, which are very refractory, but of great importance.

Gums, mucilages, and exprest oils, are by no means volatile: nor would I, in the present case, give one farthing to find them otherwise; as they would, at any rate, be totally unfit for our present purpose. Our whole attention therefore is fixed on the resinous native balsams, but not indiscri­minately. Those who have bestowed so much attention on them as myself will find them extremely different in their che­mical properties and effects on the human body. Besides, they are rarely to be met with genuine; and a thorough knowledge of them is only to be acquired by long ex­perience and frequent examination.

The chief of the liquid balsams are, Bal­sam of Gilead, of Copaiba, of Peru, of To­lu, of Canada; and the dry balsams are Benjoine, Storax, Labdanum, Myrrh and Mastich, and the Terpentines. But though these several substances are much alike in their chemical properties, yet they differ es­sentially in their medical virtues; which is easily accounted for, from the difference in [Page 20]quantity and quality of the etherial oil which they contain.

The chemical properties, as far as they are commonly known, of these fragrant resins or balsams, are, that they are inflam­mable, dissoluble in rectified spirits, but not in water. Now, this being the case, supposing, even after a thousand experi­ments, that we have fixed upon those whose oils are least acrid, and which, in every respect, are best fitted for our purpose, how shall we possibly contrive to convey them to the lungs in a proper vehicle? They will not dissolve in water, and the vapour of spirit of wine is much too ardent and in­flammatory.

If indeed we had remained satisfied with these general properties, without farther enquiry, we should still have believed, with our neighbours, that the attempt was im­practicable; that it was impossible to apply an efficacious remedy directly to the lungs, and consequently that consumptions were incurable.

Ever since I was capable of enquiry, it hath been a constant maxim with me to take nothing for granted upon any autho­rity whatsoever. Upon this principle, I be­gan my experimental disquisitions relative to the subject in question, being fully per­suaded, for reasons which will hereafter appear, that if I could find means to con­vey [Page 21]the best of these native fragrant bal­sams to the lungs in a mild and truly bal­samic state, the consumptive people of this island might expect considerable benefit from my success.

Were I to relate the many fruitless ex­periments I have made since I first en­gaged in this enquiry, the reader would be surprized at my patience and perseve­rance; but it would answer no other pur­pose. Let it suffice therefore to tell him, that I, at last, hit upon a certain chemi­cal liquor, which, to my great astonish­ment, dissolved at least double the quan­tity of the balsamic resins which I had se­lected, to any menstruum which I had ever tried or heard of. The pleasure I felt upon this discovery can only be conceived by those who have had the happiness to extend, in any degree, the path of know­ledge. It immediately occurred to me, that the discovery of so powerful a men­struum would not only be a considerable step in my present pursuit, but might pro­bably prove of singular advantage to me­dicine in general. But what added greatly to my expectations was, that this liquor happens to be of exceeding volatility, not at all inflammatory, and remarkably anti­septic and antispasmodic.

Thus far I had obtained every thing that I could wish. My solution, however, was too strong for the purpose I intended. [Page 22]I therefore, by way of experiment, drop­ped a few drops of it into boiling water, and found, beyond all possibility of a doubt, that the steam was richly impregnated, both with the antispasmodic and antiseptic qua­lities of the menstruum, and also with the balsamic and salubrious principles of the fragrant resins. This vapour I drew in with my breath, for a considerable time, and found it not in the least irritating; but, on the contrary, extremely mild and agreeable. Being now desirous to ascertain the quanti­ty of the dissolved resins, which thus rose with the vapour, I poured half an ounce of my solution into a quantity of hot water, and after evaporating the whole I found remaining in the vessel a very small propor­tion of t e weight of balsam which had been dissolved in that quantity, and conse­quently by much the greatest part had risen with the vapour.

Let me now ask the reader, whether he is not of opinion, that the happiest effects may rationally be expected from such a medicine thus applied, by means of the steam of hot water, directly to the injured lungs? Whether he does not think it pro­bable, that the acrimony of the irritating fluid will be thus obtunded, either in a recent cold, or more advanced state of the disease? Whether the spasmodic constric­tion of the vessels will not thus be relaxed, [Page 23]and the consequence of obstructions pre­vented? Whether the progress of putre­faction may not thus be stopped; and whe­ther, in that case, even in the advanced stage of a consumption, we may not hope for a cure?

When a considerable part of the substance of both lobes of the lungs is destroyed, the disease is doubtless incurable; but we know from dissection, that commonly one lobe only is principally affected. If there­fore we can thus stop the progress of pu­trefaction in the diseased lobe, the other may continue to perform its office, and the patient suffer but little inconveniency.

There remains yet another argument in favour of this new method of applica­tion, which, I think, will appear to be a powerful one. We know that many peo­ple, who have been far gone in a consump­tion, have recovered by removing to hap­pier climates. We cannot rationally attri­bute their recovery to any other cause than a difference in the air they breathe, which difference must arise from its being impregnated with certain salubrious, anti­septic, or balsamic effluvia. Since there­fore this natural application of salutiferous air to the part affected will produce that which medicines taken into the stomach had attempted in vain, are we not thereby naturally led to conclude, that the best way [Page 24]of administering to the lungs is by means of the air? It were ridiculous to attribute the recovery of consumptive people, on their migration to a milder climate, mere­ly to increase of heat, which might be in­creased to any degree in the patient's cham­ber at home. On the contrary, we know that heat remarkably accelerates putrefac­tion; so that in a putrid state of the lungs, if it were not for some powerful counter­acting cause, the disease, by travelling southward, must necessarily be increased.

With regard to the manner of applying this medicine, it is extremely easy. I usu­ally drop 30 or 40 drops into about half a pint of boiling water immediately after it is taken from the fire, ordering the patient to hold his mouth over the vessel, so as to draw in with his breath as much as possible of the vapour, continuing the operation as long as the steam will rise. I then or­der him to drink the water as soon as it is cold enough for that purpose: for, though I depend entirely on the vapour for the cure of the lungs, yet, as all the juices in the body may be in some degree affected by the matter absorbed from the lungs, this balsamic water, received into the stomach, will be of some advantage.

This simple method of application will be adundantly sufficient in common colds, hoarseness, &c. but when there is reason [Page 25]to suspect, that the lungs are dangerously affected, and that the disease is actually verging towards a consumption, a more copi­ous application is necessary. For this pur­pose I have contrived a simple machine, by means of which a much greater quantity of the balsamic effluvium is received into the lungs. The figure of this vessel may be seen in the plate facing the title-page. It holds about a pint. Half a pint of boiling water must be poured in, and the medicine immediately dropped into the water. The head being then fixed upon it, the patient applies his mouth to the pipe, and thus draws in the steam with his breath, removing the pipe from his lips at every expiration. The vessel is made of pewter. Those who are ac­quainted with the nature of evaporation will not be at a loss to account for the conic form of the vessel.

The reader now naturally expects, that I should tell him the ingredients and man­ner of preparing the medicine; otherwise, he is determined to pronounce me a quack, and, notwithstanding all I have said, to believe that my book is intended merely to promote the sale of a medicine for my own emolument. I must intreat him, however, to hear the reasons which have determined me to keep this preparation a secret.

Give me leave to suppose for a moment, that this medicine, thus applied, may be [Page 26]of infinite service to a considerable number of people in this kingdom. If I were to make it public, so as that it might be prepared by every apothecary in the nation, what would be the consequence? The con­sequence would be, that, notwithstanding its excellence, it would be neglected, and a number of people thereby deprived of a benefit which, so long as it remains a se­cret, they may reasonably expect; nothing being more certain, than that mankind na­turally despise those things which are com­monly known, and too easily obtained. Of this truth I could produce a thousand ex­amples. Some of the best medicines that ever were contrived have sunk into obli­vion, for no other reason than because their composition was made known. Does any one believe that Dr. Jame's powder would have been so universally beneficial, if he had published his secret to the world?

If this answer be thought insufficient, I confess that I have no better to give. With regard to the medicine in question, I think I have said enough to convince the patient, that his hopes of relief from its effects are rationally founded; and that, though it will not perform miracles, he may nevertheless expect from its balsamic quality, that it will destroy the acrimony of the irritating fluid; from its attenuating and antispasmodic principles, that it will remove obstructions; [Page 27]and from its antiseptic power, that it will prevent putrefaction, or stop its progress when begun, and thus preserve the sound part of the lungs, and give an opportunity to nature to regenerate the parts that were already destroyed.

What! says the sagacious reader, do you imagine, if a part of the lungs be ac­tually destroyed, that it can ever be re­stored? —Sir, it is a maxim with me, ne­ver to affirm any thing which I cannot prove; but I know no reason why nature should not as easily restore a part of the lungs as a part of an external muscle, or a part of the external skin, which is con­tinued into the lungs, and which is as vascular as the lungs themselves.

I shall now beg leave to add a few words concerning the diet, &c. of consumptive people; for, though our opinion of a me­dicine be ever so great, it were certainly imprudent to neglect such other means as may contribute to its success; and indeed, if the disease be far advanced, little is to be expected from any medicine whatsoever, unless the patient will adhere implicitly to the rules prescribed by his physician, rela­tive to his diet and manner of living.

First, with regard to exercise. Our im­mortal Sydenham was so strongly prepos­sessed in favour of riding on horse-back, that he constantly recommended that exer­cise [Page 28]in every stage of a consumption. It is, however, with this, as with most effi­cacious medicines; if it does no good, it certainly does harm. The patient himself will be able to determine whether its ef­fects be salutary or otherwise, by observing the following directions. First, unless the weather be hot, let his clothing be some­what warmer than usual, as he will other­wise grow chilly. Let him ride not more than an hour at a time, and that every gent­ly. If it be in spring or autumn, he must ride from eleven to twelve, or from twelve to one. If in the hotter months, let it be from nine to ten in the morning. But in moist or cold weather let him not ride at all. If, after this gentle exercise, he find himself in better spirits, his appetite in­creased, his breathing easy, and his skin cool and soft, he may certainly conclude that riding is of service to him, and ought therefore to be continued as often as the weather will permit. If, on the contrary, he find himself fatigued, his breathing more frequent and more difficult, his skin parched and dry, the palms of his hands hot, his cheeks flushed, his tongue dry, and in himself an inclination to drink rather than eat, he may then conclude that ri­ding is improper in the present state of his disorder, and that taking the air in a car­riage will have better effects. If never­theless [Page 29]he find no alteration for the bet­ter, I advise him, by all means, to have recourse to a sea voyage, from which, with the continuance of the medicine here re­commended, I venture to promise him every thing that human art can possibly sup­ply. It may not be improper to observe, that though I have above, in speaking of riding, limited the patient to an hour at a time, I mean that, in proportion to his in­crease of strength, and benefit received, the time should be prolonged, and the de­gree of exercise augmented.

We come now to aliment, which is of infinite importance. The first general rule which I give to my consumptive patients is, that, regardless of all stated hours, he is to eat as often as he has an appetite, but never much at a time. If, when he rises in a morning, he find no appetite for his breakfast, let him walk a little into the air, and wait an hour or two before he takes any food. As to tea, I absolutely forbid it, because it is an enemy to weak nerves, but more especially on account of the warm water, which greatly relaxes the stomach. A sea biscuit with a pint of cold almond milk, made with barley water or whey, is a good breakfast for a consumptive person; or a few almonds blanched and ground in a mortar with a little cold water, and then mixed, by little at a time, with two [Page 30]thirds of milk from the cow, is still bet­ter, where more nourishment is required. This admixture of almonds renders the curd, which separates in the stomach, much less tenacious, and easier of digestion. I mention cows milk, because it is most ea­sily obtained; otherwise, asses milk is cer­tainly preferable, because it contains much less of curd, which is both difficult of di­gestion, and putrescent. Goat's milk con­tains even a greater proportion of curd than cows milk, and is therefore highly impro­per, though frequently prescribed.

Eggs are by no means to be allowed, on account of their putrefactive tendency. In short, animal food is in general to be a­voided; though, if the patient be weak, I allow a little boiled white meat once or twice a week, and now and then a little veal or chicken broth, with a small quanti­ty of lemon juice squeezed into it. Po­tatoes, turnips, carrots, parsneps, beans, spinach, broccoli, sallets, bread and rice, constitute our general bill of fare.

As to drink, if the patient has much hectic fever, I confine him entirely to al­mond milk, barley water, or milk and wa­ter; otherwise, besides these, he is per­mitted to drink one or two glasses of mountain wine every day; or, in case that cannot be afforded, now and then a draught of ale, porter, or table beer.

If the patient complain of a nausea, weight, or uneasiness at his stomach, or­der him ten grains of Ipecacoanha, with chamomile tea, to be repeated once in ten days, or a fortnight, if the symptoms re­turn.

With regard to bleeding, as I expect no­thing more from it than a little present relief, I never order it, unless when the fever runs too high, and then I seldom ex­ceed five ounces.

If the patient be costive, I order him a solution of manna, with a little soluble tartar; if the contrary, I give him occasionally a few drops of the Thebaic tincture in a little simple cinnamon water.

If he sweat towards morning, which is often the case, I order him to go to bed in good time, to rise very early, and to re­pose a little after dinner. If his sweat still continue, I give him 20 or 30 drops of the acid elixir of vitriol in a glass of cold water twice a day. As to the Peruvian bark on this occasion, I believe it to be an excellent medicine; but I dislike it in sub­stance for many reasons, and am no less dissatisfied with all the known preparations of it. I have lately begun a course of te­dious experiments, with an intention to discover the parts in which its virtues actu­ally reside, and to divest it of those which are inert. If I am not much mistaken in [Page 32]my conjectures, it is possible to condense its active principles into a very small compass, and thereby to render it a much more agreeable and efficacious medicine. If I succeed, possibly the public may in some future t [...]me expect to be made acquainted with the result of my enquiries.

There remains yet one piece of advice, to which the patient, if he regard his own s [...]f [...]ty, will be particularly attentive. It concerns the position of his body. Con­sumptive people, from an indolence pecu­liar to their disorder, are very apt, whether sitting, w [...]lking, or riding, to suffer the body to b [...]nd forward, for want of a pro­per exertion of those muscles by which it should be kept erect. In this drooping position the chest is never sufficiently en­larged, nor the lungs fully expanded. I therefore con [...]antly advise my patients to keep themselves upright, and, especially when in the open air, to endeavour to bring their breast as forward as possible. In this, my intention is, to expand the small ramifications of the bronchus to their extre­mities, and to open a free passage for the blood from and to the heart; both which will assist our endeavours to remove ob­structions, and prevent those adhesions of the lungs to the pleura which are gene­rally found on dissection of consumptive ^*.

My asthmatic patients, no doubt, begin to think me tedious, or rather imagine that I have quite forgot them. That, however, is not the case. By an asthma we mean that disorder, the chief symptom of which is a difficulty of breathing. It is either continued, or by fits. Now, though the cause of this disease is frequently in the lungs, yet it is sometimes owing to a morbid af­fection of some of the other organs of respiration, as the diaphragm, the inter­costal muscl [...]s, or the wind-pipe, or some of the neighbouring viscera. How it hap­pens that the balsamic medicines, which are recommended as a cure for consump­tions, are at the same time recommended in asthmatic complaints, is amazing, and must proceed either from a consummate ig­norance, or unpardonable dishonesty. If, as we have seen above, these balsamies, taken into the stomach, can do nothing towards the cure of a consumption, how much less likely are they to relieve an asth­matic patient? For if they could even be ap­plied immediately to the part affected, they possess no one virtue that might authorize such expectation.

Hold! cries the reader, if that be the case, how comes it that you recommend your balsamic vapour for the cure of an asthma? I answer, that unless the asthma be a symptom of a consumption, I expect [Page 34]no advantage from the b [...]lsamic quality of this vapour. But when the cause of the asthma is a spasmodic contraction of the lungs, or wind-pipe, which is very fre­quently the case, especially when the dis­ease returns by fits, I then expert consider­able advantage from the antispasmodic pow­er of this vapour, and when in a continu­ed difficulty of breathing the cause of the disorder is an infarction of the lungs from viscid mucus, my hopes are then built on the attenuating power of the vapour ex­hibited in the manner I recommend. Let those who are capable of reasoning judge whether my expectations are well founded.

I have said, that the peculiar consump­tive disposition observable in the people of this kingdom is to be attributed to the instability of our climate, which renders us so frequently liable to take cold. Now, as it is always better to prevent a disorder than to cure it, and as colds do no injury to the lungs, except in their remote effects, I thought it rational to suppose, if imme­diately after taking cold I could dilute or obtund the acrimony of the humour which irritates and inflames the lungs, I should probably prevent the bad consequences of obstructed perspiration, at least as far as it concerned the lungs. Having myself late­ly taken a violent cold, I immediately be­gan to use the balsamic vapour, by hold­ing [Page 27]my head over a common pint vessel, keeping my mouth generally shut, that the steam might pass through my nose, and repeating the operation several times a day, for two or three days. The consequence of this was, that I very soon got rid of my cold, without the least cough or diffi­culty of breathing; which was really a re­markable circumstance, because my lungs are naturally so irritable, that I hardly re­member ever to have had the least degree of cold which did not end in a cough. This, however, is but a single experiment; but I have another of greater weight.

Having founded my expectations, in the cure of consumptions which are far ad­vanced, chiefly on the antiseptic quality of this Aether, in order to try its power, I suspended from two nails, at the distance of about four feet from each other, two pieces of fresh beef. Under one of these I held a vessel of hot water, into which fifteen drops of the medicine were drop­ped, repeating the operation three or four times every day, and continuing it about five minutes each time. To the other piece nothing was applied. I carefully ex­amined each piece every day, and was great­ly surprised to find, at the expiration of a month, that neither of them was, in the least, tainted or discoloured. That the piece to which the vapour was applied [Page 28]continued sweet did not at all surprise me; but I own, I did not expect, that the antiseptic power of this vapour was so great, as to prevent putrefaction in the other piece of beef, by only mixing with the air in the room. Indeed the room was small. This unexpected event, however, gave me great pleasure, as it immediately suggested to me the evident advantage that might be expected, in all putrid disorders, from im­pregnating the air in the chamber with this vapour. For this purpose, it is my constant practice to order 30 or 40 drops to be dropped into a quart of boiling water, and the vessel to be placed near the bed of the patient, to be repeated three or four times a day; or the water to be kept boiling over a lamp, in any part of the room, till it is entirely evaporated, if the disorder be of a very putrid nature, and especially in the small-pox. It were cer­tainly needless to mention the use of this vapour in sore throats, whether inflam­matory or putrid.

The medicine is entitled Dr. Stern's Bal­samic Aether, and may be had, for six shil­lings the bottle, of Mr. ALMON, in Picca­dilly, Mr. COOK, near the Royal Exchange, Mr. BLADON, in Pater-noster Row, Messrs. CURTIS, in Fleet-street, Mr. WOODFALL, Charing Cross, and Mr. WHITE, Lincoln's Inn Fields, Booksellers.

I shall now, by way of conclusion, beg leave to give a few general rules to the reader, which may enable him to judge properly of medicines which are exposed to sale. These rules seem the more neces­sary, in an age when almost every week produces a new medicine.

The first general rule is, never to pay the least regard to the canting of those who pretend, that the good of mankind is their sole motive for offering their medi­cine to sale.

Secondly, disregard all assertions concern­ing the excellency of a medicine, which are mere assertions, without any founda­tion in reason and experiment.

Thirdly, conclude the advertiser to be either a knave, or a fool in physic, who pretends, that his medicine will cure seve­ral disorders which have not the least ana­logy to each other.

And lastly, when the doctor writes a pam­phlet, with an intention to recommend his medicine, if it betray a manifest ignorance of his subject, of style, and grammar; in short, when his language is evidently that of a porter; conclude him to be some illi­terate, ignorant person, whose medicine and opinions deserve no attention.

Concerning myself, and the medicine I recommend, I do not expect, that the reader should have any dependence on what I [Page 30]may have asserted in the preceding pages; because, if he has any knowledge of man­kind, he has reason to suppose that I have sacrificed truth to interest and a fa­vourite hypothesis. My assertions however are very few, except what relates to the experiment to prove the antiseptic quality of this vapour; but as it is in every one's power to repeat the experiment, it will be an easy matter to convict me of falsehood, or confirm the truth. All I expect of the reader is, that he will impartially consider the reasons upon which I have founded my expectations of curing disorders of the lungs by means of this balsamic vapour. If he be of opinion, that I have reasoned justly, he will certainly think it adviseable for those whose lungs are injured to try the experiment, especially as it cannot possibly be attended with any danger; and as to the expence, it will certainly be thought most inconsiderable, when compared with the fees of a physician, and the bills of an apothecary.