OF CHILDREN.

TO avoid diseases, it is necessary we should know their causes. These indeed are numerous; but we shall endeavour to point out such only as have the most general influence, as too great minute­ness in this respect would tend rather to perplex than in­struct the generality of readers.

THE better to trace diseases from their original causes, we shall take a view of the common treatment of mankind in the state of infancy. In this period of our lives, the foundations of a good or bad constitution are generally laid; it is therefore of importance, that parents be well ac­quainted with the various causes which may produce dis­eases in their offspring. It must be owing either to the ig­norance or carelessness of parents, that so many of the hu­man species perish in infancy. This, we presume, will appear from the following observations.

THE annual registers of the dead shew, that at least one half of the children born in Great Britain die under twelve years of age. To those who do not reflect, this appears to be a natural evil, and therefore they think it their duty [...]o submit to it. But whoever accurately examines the mat­ter, will find that it is an evil of our own making, and, in a great measure, owing to mismanagement. Were the death of infants a natural evil, other animals should be as liable to die young as man; but that we see is not the case.

IT may seem strange, that man, notwithstanding his superior reason, should fall so far short of other animals [Page 2] in the management of his young: But our surprise will soon cease, if we consider that brutes, guided by instinct, never err in this respect; while man, trusting solely to art, is seldom right. Were a catalogue of those children who perish annually by art alone, exhibited to public view, it would astonish most people.

WHEN parents are above taking care of their children, others must be employed for that purpose: These will al­ways endeavour to recommend themselves by the appear­ance of extraordinary skill and address. By this means so many unnecessary and destructive articles have been intro­duced into the diet, cloathing, &c. of children, that it is no wonder so many of them perish.

NOTHING can be more preposterous than for a mother to think it below her to take care of her own child, or to be so ignorant as not to know what is proper to be done for it. If we search nature throughout, we cannot find a parallel to this. Every other creature is the nurse of its own young, and they thrive accordingly. Were the brutes to bring up their young by proxy, they would share the same fate with those of the human species.

WE mean not to impose it as a task upon every mother to [...]ckle her own child. This, whatever speculative writers may say to the contrary, is in many cases imprac­ticable, and would inevitably prove destructive both to the mother and child. Women of delicate constitutions, sub­ject to low spirits, hysteric fits, or other nervous disorders, make very bad nurses: But these complaints are now so common, that it is rare to find a woman of fashion free from them; for which cause few women of better station, suppose them willing, are really able to suckle their own children.

DID mankind live as nature directs, almost every mother would be in a condition to give suck: But, whoever con­siders how far we have deviated from her dictates, will not be surprised to find many of them unable to perform that necessary office. Mothers, who do not eat enough of solid food, nor enjoy the benefit of free air and exercise, can neither have wholesome humours themselves, nor afford proper nourishment to an infant. Children who are suck­led by delicate women, either die young, or are weak and sickly all their lives. Nor is this at all to be wondered at. If children suck in nervous diseases with their mother's milk, What have we to expect?

[Page 3] WHEN we say, that every mother is not able to suckle her own child, we would not be understood as discouraging that practice. Every mother who can, ought certainly to perform that tender office. But suppose it to be out of her power, she may, nevertheless, be of great service to her child. The business of nursing is by no means con­fined to giving suck. To a woman who abounds with milk, that is the easiest part of it. Numberless other offices are necessary for a child, which the mother at least ought to see done. A mother, who abandons the fruit of her womb, as soon as it is born, to the sole care of an hireling, hardly deserves that name. A child, by being brought up under the mother's eye, not only secures her affection, but may reap all the advantages of a mother's care, though it be suckled by another. How can a mother be better em­ployed, than in superintending the nursery? This is at once the most delightful and important office! yet the most trivial business or insipid amusements are often preferred to it. A strong proof both of the bad taste and wrong edu­cation of modern females.

IT is much to be regretted, that more pains is not be­stowed in teaching the proper management of children to those whom nature has designed for mothers. This, in­stead of being made the principal, is seldom considered as any part of female education. Is it any wonder, when females, so educated, come to be mothers, that they should be quite ignorant of the duties belonging to that station? However strange it may seem, it is certainly true, that many mothers, and those of fashion too, are as ignorant, when they have brought a child into the world, of what is proper to be done for it, as the infant itself. Indeed, the most ignorant part of the sex are generally reckoned most knowing in the business of nursing. Hence, sensible people become the dupes of ignorance and superstition; and the nursing of children, instead of being conducted by reason, is the result of whim and caprice.

ONE great design of females, no doubt, is to propagate the species. But to bring forth a child, is the least part of that important business. Were the care of a parent to stop here, the whole human race would soon be extinct. Na­ture has made it necessary, that a child should depend on its parents during the state of infancy; and those parents who neglect the proper care of their offspring, not only violate one of the first and strongest principles of nature, [Page 4] but actually endeavour to extinguish the human race. An infant may be as certainly murdered by neglect, as by any act of violence whatever; and, for one child that loses its life by the latter, a thousand perish by the former, without being regarded.

WERE the time that is generally spent by females in ac­quiring useless knowledge, employed in learning how to bring up their children; how to dress them so as not to hurt, cramp, or confine their motions; how to feed them with wholesome and nourishing food; how to exercise their tender bodies, so as best to promote their growth and strength: Were these the objects of female instruction, mankind would derive the greatest advantage from it. But, while the education of females implies little more than what relates to dress and public show, we have nothing to ex­pect from them but ignorance, even in the most important concerns. But ignorance can be no excuse, where people have it in their power to be better informed; and, if chil­dren perish by the negligence of mothers, they must be accountable.

DID mothers know their importance, and lay it to heart, they would embrace every opportunity of informing them­selves of the duties which they owe to their infant-offspring. It is theirs, not only to form the body, but also to give the mind its most early cast. They have it very much in their power to make men healthy or valetudinary, useful in life, or the bane of society.

BUT the mother is not the only person concerned in the management of children. The father has an equal interest in their welfare, and ought to assist in every thing that re­spects either the improvement of the body or mind.

IT is pity that men pay so little regard to this matter. Their neglect is one reason why females know so little of it. Women will ever be desirous to excel in such accom­plishments as recommend them to the other sex. But men generally keep at such a distance from even the smallest ac­quaintance with the affairs of the nursery, that many would esteem it an affront, were they supposed to know any thing of it. Not so, however, with the kennel or the stables: A gentleman of the first rank is not ashamed to give di­rections concerning the management of his dogs or horses; but would blush, were he to be surprized in performing the same office for that being, who derived its existence from himself, who is the heir of his fortunes, and the future hope [Page 5] of his country. Few fathers indeed run any hazard of being surprized in this situation; yet, certain it is, that man needs culture more than any other creature, and that both his body and mind are capable of the greatest im­provement. Nature has left so much in the power of pa­rents, that children are, in a great measure, what they please to make them.

PHYSICIANS themselves have not been sufficiently atten­tive to the management of children: That has been gene­rally considered as the sole province of old women, while men of the first rank in physick have even refused to visit infants when sick. Such conduct in the faculty has not only caused this branch of medicine to be neglected, but has also encouraged the other sex to assume an absolute title to prescribe for children in the most dangerous diseases. The consequence is, that a physician is seldom called till the good women have exhausted all their skill; when his attend­ance can only serve to divide the blame and appease the dis­consolate parents.

WE would have nurses do all in their power to prevent diseases; but, when a child is taken ill, some person of skill should immediately be consulted. The diseases of children are generally acute, and the least delay is dan­gerous.

WERE physicians more attentive to the diseases of chil­dren, they would not only be better qualified to treat them properly when sick, but likewise to give useful directions for their management when well. The diseases of chil­dren is by no means such a difficult study as many imagine. It is true, children cannot tell their complaints; but the causes of them may be pretty certainly discovered, by put­ting proper questions to the nurses and such as are about them. Besides, the diseases of infants, being less compli­cated, are easier cured than those of adults.

IT is really astonishing, that so little attention should in general be paid to the preservation of infant-lives! What labour and expence are daily bestowed to prop an old rotten carcase for a few years, while thousands of those, who might be useful in life, perish without being regarded, and prove no better than an untimely birth! Mankind are apt to value things not according to their future but their pre­sent utility. This is of all others the most erroneous me­thod of estimation; yet, upon no other principle is it pos­sible [Page 6] to account for the general indifference with respect to the death of infants.

OF DISEASED PARENTS.

DISEASED parents cannot beget healthy children. It would be as reasonable to expect a rich crop from a barren soil, as that strong and healthy children should be born of delicate parents, worn out with intemperance or disease.

AN ingenious writer observes *, that on the constitution of mothers depends originally that of their offspring. No one who believes this, will be surprised, on a view of the female world, to find diseases and death so frequent among children. A delicate female, brought up within doors, an utter stranger to exercise and open air, who lives on tea and other slops, may bring a child into the world, but it will hardly be fit to live. The first blast of a disease will nip the tender plant in the bud: Or, should it struggle through a few years existence, its feeble frame, shook with convul­sions from every trivial cause, would be unable to sustain the common functions of life, and prove a burden to so­ciety.

IF to the delicacy of mothers we add the irregular lives of fathers, we shall see further cause to believe, that chil­dren are often hurt by the constitution of their parents. A sickly frame may be originally induced by hardships or in­temperance, but chiefly by the latter. It is impossible that a course of vice should not spoil the best constitution: And did the evil terminate here, it would be a just punishment for the folly of the sufferer; but when once a distemper is contracted and rivetted in the habit, it is entailed on all posterity. What a dreadful inheritance is the gout, the scurvy, or the kings-evil, to transmit to our offspring! How happy had it been for the heir of many a great estate, had he been born a beggar, rather than to inherit his father's fortunes at the expence of likewise inheriting his diseases!

NO person who labours under any incurable malady, ought to marry, as he thereby both shortens his own life, and transmits misery to others: But when both parties are deeply tainted with the scrophula, the scurvy, or the like, the effects must be still worse. Such will either have no issue at all, or those whom they have, must be miserable in­deed. Want of attention to these things, in forming con­nections [Page 7] for life, has rooted out more families than the plague, famine, or the sword; and while these connections are formed from mercenary views, that must be the case.

IN our matrimonial contracts, it is amazing so little re­gard is had to the health and form of the object. Our sportsmen know, that the generous courser cannot be bred out of the foundered jade, nor the sagacious spaniel out of the snarling cur. This is settled upon immutable laws. The man who marries a woman of a sickly constitution, and descended of unhealthy parents, whatever his views may be, cannot be said to act a prudent part. A puny scrophulous woman may prove fertile; should this be the case, the family must become an infirmary. What prospect of happiness the father of such a family has, we shall leave any one to judge.

THE Jews, by the positive direction of the Almighty, were forbid to have any manner of commerce with the diseased; and indeed to this all wise legislators ought to have a special regard. In some states, the marriage of morbid people has actually been prohibited. This is an evil of a complicated kind, a natural deformity, and political mischief; and therefore requires a public con­sideration.

SUCH children as have the misfortune to be born of dis­eased parents, will require to be nursed with greater care than others. This is the only way to make amends for the defects of constitution; and it will often go a great length. A healthy nurse, wholesome air, and enough of exercise, will do wonders. But, when these are neglect­ed, little is to be expected from any other quarter. The defects of constitution cannot be supplied by medicine.

THOSE who inherit any family-disease, ought to be very circumspect in their manner of living. They should con­sider well the nature of such disease, and guard against it by a proper regimen. It is certain, that family-diseases have often, by proper care, been kept off for one genera­tion; and there is great reason to believe, that, by persist­ing in the same course, such diseases might at length be wholely eradicated. This is a subject very little regarded, though of the last importance. Family-constitutions are as capable of improvement, as family-estates; and the li­bertine, who impairs the one, does greater injury to his posterity, than the prodigal who squanders away the other.

OF THE CLOATHING OF CHILDREN.

THE cloathing of an infant is so simple a matter, that it is surprising, how any person should err in it; yet many children lose their lives, and others are deformed, by errors of this kind.

NATURE knows no other use of cloaths to an infant, but to keep it warm. All that is necessary for this pur­pose, is to wrap it in a soft, loose covering. Were a mo­ther left to the dictates of nature and reason, this is cer­tainly the method that she would follow. But the business of dressing an infant has long been out of the hands of mo­thers, and has at last become a secret, which none but adepts pretend to understand.

FROM the most early ages it has been thought necessary, that a woman in labour should have some person to attend her. This in time became a business; and, like all others, those who were employed in it, strove to outdo one ano­ther in the different branches of their profession. The dressing of a child came of course to be considered as the midwife's province, who no doubt imagined, that the more dexterity she could show in this article, the more her skill would be admired. Her attempts might be seconded by the vanity of parents, who wanting to make a show of the in­fant as soon as it was born, were ambitious to have as much finery heaped upon it as possible. Thus it came to be thought as necessary for a midwife to excel in bracing and dressing an infant, as for a surgeon to be expert in applying bandages to a broken limb; and the poor child, as soon as it came into the world, had as many rollers and wrappers applied to its body, as if every bone had been fractured in the birth; while these were often so tight, as not only to gall and wound its tender frame, but even to obstruct the motion of the heart, lungs, and other organs necessary for life.

IN several parts of Britain the practice of rolling chil­dren with so many bandages is now, in some measure, laid aside; but it would still be a difficult task to persuade the generality of women, that the shape of a child does not in­tirely depend on the midwife's care. So far, however, are all their endeavours to mend the shape of children, from being successful, that they constantly operate the contrary way, and mankind become deformed just in proportion to [Page 9] the means used to prevent deformity. How little deformi­ty of body is to be found among uncivilized nations? So little indeed, that it is vulgarly believed they put all their deformed children to death. The truth is, they hardly know such a thing as a deformed child. Neither should we, if we followed their example. Savage nations never think of manacling their children. They allow them the full use of every organ, carry them abroad in the open air, wash their bodies daily in cold water, &c. By this ma­nagement their children become so strong and hardy, that, by the time our puny infants get out of the nurse's arms, theirs are able to shift for themselves.

AMONG brute animals no art is necessary to procure a fine shape. Though many of them be extremely delicate, when they come into the world, yet we never find them grow crooked for want of swaddling-bands. Is nature less generous to the human kind? No: But we take the business out of nature's hands.

NOT only the analogy of other animals, but the very feelings of infants tell us, that they ought to be kept easy and free from all pressure. They cannot indeed speak their complaints; but they can shew signs of pain; and this they never fail to do, by crying, when pinched by their cloaths. No sooner are they freed from their bracings, than they seem pleased and happy; yet, strange infatuation! The moment they hold their peace, they are again committed to their chains.

IF we consider the body of an infant as a bundle of soft pipes, replenish'd with fluids in continual motion, the dan­ger of pressure will appear in the strongest light. Nature, in order to make way for the growth of children, has form­ed their bodies soft and flexible; and, lest they should re­ceive any injury from pressure in the womb, has surrounded the foetus every way with fluids. This shews the care which nature takes to prevent all unequal pressure on the bodies of infants, and to defend them against every thing that might in the least cramp or confine their motions.

EVEN the bones of an infant are so soft and cartilaginous, that they readily yield to the slightest pressure, and easily take on a bad shape, which can [...]ver after be remedied. Hence it is, that so many people appear with high shoul­ders, crooked spines and flat breasts, who were born with as good a shape as others, but had the misfortune to be [Page 10] squeezed into monsters by the application of stays and bandages.

PRESSURE, by obstructing the circulation, prevents the equal distribution of nourishment to the different parts of the body, by which means the growth becomes unequal. One part of the body grows too large, while another re­mains too small, and thus in time the whole frame becomes disproportioned and misshapen. To this we must add, that when a child is cramped in its cloaths, it naturally shrinks from the parts affected, and by putting its body into unna­tural postures, it becomes deformed by habit.

DEFORMITY of body may proceed from weakness or diseases; but, in general, it is the effect of improper cloathing. Nine tenths, at least, of the deformity amongst mankind must be imputed to this cause. A deformed body is not only disagreeable to the eye, but injurious to the health. By a bad figure both the animal and vital func­tions must be impeded, and of course health impaired. Hence, few people remarkably misshapen are strong or healthy.

THE new motions which commence at the birth, as the circulation of the blood through the lungs, respiration, the peristaltic motion, &c. afford another strong argument for keeping the body of an infant free from all pressure. These organs, not having been accustomed to move, are easily stopped; but when that happens, death must ensue. Hardly any method could be devised more effectually to stop these motions than bracing the body too tight with ^* rol­lers, &c. Were these to be applied in the same manner to the body of an adult, for an equal length of time, they could hardly fail to hurt the digestion and make him sick. How much more hurtful they must be to tender infants, we shall leave any one to judge.

WHOEVER considers these things, will not be surprised, that so many children die of convulsions soon after the birth. These fits are generally attributed to some inward cause; but, in fact, they oftener proceed from our own imprudent conduct. I have known a child seized with convulsion-fits, soon after the midwife had done swaddling it; but, upon taking off the rollers and bandages, it was [Page 11] immediately relieved, and never had any convulsion-fits af­terwards. Numerous examples of this sort might be brought, were they necessary.

IT would be safer to fix on the cloaths of an infant with strings than pins, as these often gall and irritate their tender skins, and occasion convulsions. Instances have been known, where pins were found sticking above half an inch into the body of a child after it had died of con­vulsion-fits, which, in all probability, proceeded from that cause.

CHILDREN are not only hurt by the tightness of their cloaths, but also by the quantity. Every child has some degree of fever after the birth; and, if it be loaded with too many cloaths, the fever must be increased. But that is not all; the child is generally laid in bed with the mo­ther, who is likewise feverish; to which we may add the heat of the lying-in-bed-chamber, and the wines, and other heating things too often given to children immediate­ly after the birth. When all these are combined, which does not seldom happen, they must increase the fever to such a degree as will endanger the life of the infant.

THE danger of keeping infants too hot, will further ap­pear, if we consider, that, after being for some time in the situation mentioned above, they are often sent into the country to be nursed in a cold house *. Is it any wonder, if a child, from such a transition, catches a mortal cold, or contracts some other fatal disease? When an infant is kept too hot, its lungs not being sufficiently expanded, are apt to remain weak and flaccid for life; from whence pro­ceed coughs, consumptions, and other diseases of the breast.

IT would answer little purpose to specify the particular pieces of dress proper for an infant. These ever will vary in different places according to custom and the humour of parents. The great rule to be observed is, That a child have no more cloaths than are necessary to keep it warm, and that they be quite easy for its body.

STAYS are the very bane of children. A volume would not suffice to point out all the ill effects of this useless piece of dress. The madness in favour of stays seems, however, to have been at a height; and it is to be hoped the world will, in time, become wise enough to know, that the hu­man [Page 12] shape does not solely depend upon whale-bone and bend leather ^*.

WE shall only add, with respect to the cloaths of chil­dren, that they ought to be kept very clean. Children perspire more than adults; and, if their cloaths be not frequently changed, they become very hurtful. Dirty cloaths not only gall and fret the tender skins of infants, but likewise occasion ill smells; and, what is worse, tend to produce [...] and cutaneous diseases.

CLEANLINESS is not only agreeable to the eye, but tends greatly to preserve the health of children. It pro­motes the perspiration; and, by that means, frees the body from superfluous humours, which, if retained, could not fa [...]l to occasion diseases. A nurse can have no excuse for allowing a child to be dirty. Poverty may oblige her to give it coarse cloaths; but, if she does not keep them clean, it must be her own fault.

OF THE FOOD OF CHILDREN.

NATURE not only points out the food proper for an in­fant, but actually prepares it. This, however, is not suf­ficient to prevent some who think themselves wiser than nature, from attempting to bring up their children with­out her provision. Nothing can show the disposition which mankind have to depart from nature more than their en­deavouring to bring up children without the breast. The mother's milk, or that of a healthy nurse, is unquestion­ably the best food for an infant. Neither art nor nature can afford a proper substitute for it. A child may seem to thrive for a few months without the breast; but when teething, the small-pox, and other diseases incident to childhood come on, they generally fall a victim. An evi­dent proof, that their food is unwholesome, and their hu­mours bad.

A child soon after the birth shews an inclination to suck; and there seems to be no reason why it should not be gra­tified. It is true, the mother's milk does not always come immediately after the birth; but is not this the way to bring it? The first milk that the child can squeeze out of the breast, answers the purpose of cleansing better than all the drugs in the apothecary's shop, and at the same time [Page 13] prevents inflammations of the breast, fevers, and other dis­eases incident to mothers.

IT is strange how people came to think, that the first thing given to a child should be drugs. This is beginning with medicines by times, and no wonder that they generally end with it. It sometimes happens, that a child does not pass the meconium so soon as could be wished. This has in­duced physicians in such cases to give something of an open­ing nature to cleanse the first passages. Midwives have im­proved upon this hint, and never fail to give syrups, oils, &c. whether they be necessary or not. Cramming an in­fant with such indigestible stuff as soon as it is born, can hardly fail to make it sick, and is more likely to occasion diseases, than prevent them. Children are seldom long af­ter the birth without having passage both by stool and urine; though these evacuations may be wanting for some time without any danger.

WERE a child permitted to suck its mother as soon as it shows an inclination for the breast, it would need no other physic; but if it must have something before it be allowed the breast, let it be a little simple water-pap, to which may be added an equal quantity of new milk. If this be given without any wines, sugars, or spiceries, it will neither heat the blood, load the stomach, nor occasion gripes.

UPON the first sight of an infant, almost every person is struck with the idea of its being weak, feeble, and wanting support. This naturally suggests the need of cordials. Accordingly we find wines universally mixed with the first food of children. Nothing can be more fallacious than this way of reasoning, or more hurtful to infants than the conduct founded upon it. Children need very little food for some time after the birth; and what they receive, should be thin, weak, light, and of a cooling quality. A very small quantity of wine, or even sugar, is sufficient to heat and inflame the blood of an infant; but every per­son, conversant in these matters, must know, that most of the diseases of infants proceed from the heat of their hu­mours, as the thrush, &c.

IF the mother or nurse has enough of milk, the child will need little or no other food before the third or fourth month. It will then be proper to give it, once or twice a day, a little of some food that is easy of digestion; as wa­ter-pap, milk-pottage, weak broth with bread in it, or the like. This will ease the mother; it will accustom the child [Page 14] by degrees to take food, and render the weaning both less difficult and dangerous. All great and sudden transitions are to be avoided in nursing. For this purpose the food of chil­dren ought to be simple, as near as possible resembling the properties of milk. Indeed milk itself should make a princi­pal part of their food, not only before they be weaned, but for a long time after.

NEXT to milk, we would recommend good light bread. Bread may be given to a child as soon as it shows an in­clination to chew, and it may at all times be allowed as much as it pleases. The very chewing of bread will help to cut the teeth and promote the discharge of saliva, while by mix­ing with the nurse's milk in the stomach, it will afford an excellent nourishment. Children show an early inclination to chew whatever is put into their hands. Parents observe the inclination, but generally mistake the object. Instead of giving the child something which may at once exercise its gums and afford it nourishment, they commonly put into its hand a piece of hard metal or impenetrable coral. A crust of bread is the best gum-stick. It not only answers the pur­pose better than any thing else, but has the additional pro­perties mentioned above, of nourishing the child and car­rying the saliva down to the stomach, which is too valuable a liquor to be lost.

BREAD, besides being used dry, may be many ways pre­pared into food for children. One of the best methods of preparing it, is to boil it in water, afterwards pouring the water off, and mixing with the bread a proper quantity of new milk unboiled: Milk is both more wholesome and nourishing this way than boiled, and is less apt to occasion costiveness. For a child farther advanced, bread may be mixed in veal or chicken broth, made into puddings or the like. Bread is a proper food for children at all times, pro­vided it be plain, made of wholesome grain, and well fer­mented; but when enriched with fruits, sugars, or such things, it becomes very unwholesome.

IT is soon enough to allow children animal food when they have got teeth to eat it. They should never taste it till after they are weaned, and even then they ought to use it very sparingly. Indeed, when children live wholely on vegetable food, it is apt to sour on their stomachs; on the other hand, too much flesh heats the blood and occasions fevers and other inflammatory diseases. This plainly points out a proper mixture of animal and vegetable food as most fit for children.

[Page 15] FEW things are more hurtful to children, than the com­mon method of sweetening their food. It not only makes them grow fat and bloated, but entices them to take more food than they ought to do. It is pretty certain, if childrens' food were quite plain, that they would never take more than enough. Thus the excesses of children are entirely owing to nurses. If a child be gorged with food at all hours, and enticed to take it, by making it sweet and agreeable to the palate, is it any wonder if such a child comes in time to crave more food than it ought to have?

CHILDREN may be hurt by too little as well as too much food. After a child is weaned, it ought to be fed four or five times a-day; but should never be accustomed to eat in the night; neither should it have too much at one time. Some lay it down as a rule, that no child ought to be fed above three times in twenty-four hours; whereas, most adults eat four times in the same space. The food of chil­dren is generally lighter than that of adults; their digestion is likewise more quickly performed: If to these we add the power of habit, we will be inclined to think, that children should be fed oftener than up-grown persons. If a child, who has been accustomed to suck its nurse at all hours, be suddenly deprived of that, and restricted to three meals a-day, bad consequences must follow. I have often seen the scheme of bringing children to live on three regular meals a-day tried, but never knew it succeed. Children thrive much better with small quantities of food frequently given. This neither overcharges the stomach, nor hurts the di­gestion, and is certainly most agreeable to nature.

WRITERS on nursing, have inveighed with such vehe­mence against too much food, that one would be apt to imagine two thirds of those who die in infancy were actu­ally crammed to death. This has induced many parents to ruin the constitutions of their children, by running into the other extreme. The error of pinching children in their food, is more hurtful than its opposite. Nature has many ways of relieving herself when overcharged; but a child who is pinched with hunger will never become a strong or healty man. That errors are frequently committed on both sides, we are ready to acknowledge; but where one child is hurt by the quantity of its food, ten suffer from the qua­lity. That is the principle evil, and claims our strictest at­tention.

MANY people imagine, that food which they love them­selves cannot be bad for their children: But this notion is [Page 16] very absurd. In the more advanced periods of life we often acquire an inclination for food which when children we could not bear to taste. There are many things that may agree very well with the stomach of an up-grown person, which would be very hurtful to a child; as high-seasoned, salted, and smoke-dried provisions, &c. It would also be improper to feed children with fat meat, strong broths, rich soups, gravies, or the like.

ALL strong liquors are hurtful to children. Some parents teach their children to guzzle ale, and other strong liquors at every meal; but such a practice cannot fail to do mis­chief. These children seldom escape the violence of the small-pox, measles, hooping-cough, or some other feverish disorder. Milk, water, butter-milk, or whey, make the most proper drink for children. If they have any thing stronger, it may be fine small bear, or a little wine mixed with water. The stomachs of children can digest well enough without the assistance of warm stimulants. Young people are naturally hot, and consequently are easily hurt by every thing of a heating quality: Their blood has a con­stant tendency to inflammation, which all strong liquors must increase.

FEW things are more hurtful to children than unripe fruits. These not only sour the stomach, but relax it and weaken the digestion; by which means it becomes a pro­per nest for worms of all kinds. Children indeed show the greatest inclination for fruit, and I am apt to believe, that if good ripe fruit were allowed them in proper quantity, it would have no bad effects. We seldom find a natural incli­nation wrong, if directed to its proper objects. Fruits are generally of a cooling nature, and correct the heat and acri­mony of the humours. This is what most children want; only care should be taken lest they exceed. Indeed the best way to prevent children from going to excess in the use of fruit, or eating that which is bad, is to allow them a proper quantity of what is good.

ROOTS which contain a crude viscid juice should be spa­ringly given to children. They fill the body with gross hu­mours, and tend to produce eruptive diseases. This caution is peculiarly necessary for the poor; being glad to get what will fill their children's bellies for a little money, they stuff them two or three times a-day with potatoes and the like. Children had better eat a small quantity of such food as would yield a wholesome nourishment, than be crammed with what their digestive powers are unable properly to assimulate.

[Page 17] BUTTER ought likewise to be sparingly given to children. It both relaxes the stomach, and produces gross humours. Indeed, most things that are fat or oily, have the same ef­fect. Butter, when salted, becomes still more hurtful. In­stead of butter, so plentifully eat by children in most parts of Britain, we would recommend honey. Honey is not only more wholesome than butter, but likewise cheaper. It is cooling, cleansing, and tends to sweeten the humours; whereas butter is just the reverse. Children who eat honey are seldom troubled with worms. They are also less subject to the common cutaneous diseases, as itch, scabbed-head, &c.

MANY people err in thinking the diet of children should be always moist. When children live entirely upon slops, it relaxes their solids, renders them weak, and predisposes them to rickets, scrophulas, and other glandular disorders. Relaxation is one of the most general causes of the diseases of children. Every thing therefore which tends to unbrace their bodies ought to be carefully avoided.

WE would not be understood as confining children to any particular kind of food. Their diet may be frequently varied, provided regard be had to simplicity. Whatever food we are most accustomed to in youth, we generally love during life. For this reason children should have a little of any kind of food that is plain and wholesome, lest they should contract an aversion for it, and afterwards be under the necessity of using it.

OF THE EXERCISE OF CHILDREN.

OF all the causes which conspire to render the lives of children short and miserable, none has greater influence than the want of proper exercise: Healthy parents, whole­some food, and proper cloathing, will avail little where i [...] is neglected. Enough of exercise will make up for several other defects; but nothing can supply the want of it. It is absolutely necessary to the health, the growth, and the strength of children.

THE desire of exercise is almost co-eval with life itself. Were this principle attended to, many diseases might be prevented. But while indolence and sedentary employ­ments keep two thirds of mankind from either taking ex­ercise themselves, or giving it to their children, what have we to expect but diseases and deformity among their off­spring? The rickets, so destructive to children, never ap­peared [Page 18] in Britain till manufactures began to flourish, and people, attracted by the love of gain, left the country to follow sedentary employments in great towns. It is amongst these people that this disease chiefly prevails, and not only deforms, but kills many of their offspring.

THE analogy of other animals shews that children re­quire exercise. Every creature endeavours to make use of its organs as soon as it can, and many of them, even when under no necessity of moving in quest of food, cannot be re­strained without force. This is evidently the case with the calf, the lamb, and many other young animals. If these creatures were not permitted to frisk about, and take ex­ercise, they would soon die. The same inclination appears very early in the human species; but as they are not able to take exercise themselves, it is the business of their parents or nurses to assist them.

CHILDREN may be exercised various ways. The best me­thod, while light, is to carry them about in the nurse's arms. This gives the nurse an opportunity of talking to the child, and of pointing out every thing that may please and delight its fancy. It is much safer than swinging an infant in a machine, or lea [...]g it [...] the care of such as are not fit to take care of themselves. Nothing can be more foolish than to set on [...] child to keep another; that has proved fatal to many infants, and has rendered others lame for life.

WHEN children begin to walk, the safest and best method of leading them about is by the hands. The common way of swinging [...] children by strings fixed to their backs, has many bad consequences. It makes them throw their bo­dies foreward, and press with their whole weight upon the breast: by that means the breathing is obstructed, the breast flattened, and [...] [...]owels compressed. This hurts the di­gestion, and occasions consumptions of the lungs, and other diseases.

IT is a common notion, that if children be set upon their feet too soon, their legs will become crooked. There is reason to believe, that the very reverse of this is true. Eve­ry member acquires strength in proportion as it is exercised. The limbs of children are weak indeed, but their bodies are proportionably light; and had they skill to direct them­selves, they would soon be able to support their own weight. Who ever heard of any other animal that became crooked by using its legs too soon? Indeed if a child be not permit­ted to make use of its legs till a considerable time after the [Page 19] birth, and be then set upon them with its whole weight at once, there may be some danger of hurting it; but this proceeds intirely from the child's not having been accustom­ed to use its legs from the beginning.

MOTHERS of the poorer sort think they gain a great deal by making their children lie or sit while they work. In this they are greatly mistaken. By neglecting to give their chil­dren exercise, they are obliged to keep them a long time before they can do any thing for themselves, and to spend more on medicine than would have paid for proper care, while it can never supply its place. To take care of their children, is the most profitable business in which even the poor can employ themselves: But alas! it is not always in their power. Poverty often obliges them to neglect their offspring, in order to procure the necessaries of life. When that is the case, it becomes the interest as well as the duty of the public to assist them. Ten thousand times more be­nefit would accrue to the state, by enabling the poor to bring up their own children, than from all [...] ^* hospitals that ever can be erected for that purpose.

WHOEVER considers the structure of the human body, will soon be convinced of the necessity of exercise for the health of children. The body is composed of an infinite number of vessels, whose contents cannot be pushed on with­out the action and pressure of the muscles. But if the fluids remain inactive, obstructions must happen, and the humours will of course be vitiated, which cannot fail to occasion dis­eases. Nature has furnished both the vessels which carry the blood and lymph with numerous valves, in order that the action of every muscle might push forward their contents; but without action this admirable contrivance can have no effect. The final cause of this part of the animal oeconomy proves the necessity of exercise for the preservation of health.

ARGUMENTS to shew the importance of exercise might be drawn from every part of the animal oeconomy: With­out [Page 20] exercise the circulation of the blood cannot be properly carried on, nor the different secretions duly performed; without exercise the humours cannot be properly prepared, nor the solids rendered strong or firm. The action of the heart, the motion of the lungs, and all the vital functions are greatly assisted by exercise. But to point out the man­ner in which these effects are produced, would lead us far­ther into the oeconomy of the human body, than most of those for whom this treatise is intended, would be able to follow. We shall therefore only add, that where exercise is neglected, none of the animal functions can be duly per­formed; and when that is the case, the whole constitution must go to wreck.

CERTAINLY our first object in the management of chil­dren ought to be a good constitution. This lays a founda­tion for their being useful and happy in life; and whoever neglects it, not only [...]ails in his duty to his offspring, but to society.

ONE very common error of parents, by which they hurt the constitutions of their children, is sending them too young to school. This is often done solely to prevent trouble. When the child is at school, he needs no keeper. Thus the schoolmaster is made the nurse; and the poor child is nailed to a seat seven or eight hours a-day, which ought to be spent in exercise and diversions. Sitting so long cannot fail to produce the worst effects upon the body; nor is the mind less injured. Early application weakens the fa­culties, and often fixes in the mind such an aversion from books as can never be removed.

BUT suppose this were the way to make children scholars, that ought not to be done at the expence of their constitu­tions. Our ancestors, who seldom went to school before they were men, were not less learned than we. But we imagine the boy's education will be quite lost unless he be carried to school in his nurse's arms. No wonder if such hot bed plants seldom become either scholars or men!

NOT only the confinement in public schools, but the number often proves extremely hurtful. Children are much injured by being kept in crowds within doors; their breath­ing not only renders the place unwholesome; but if any one of them happens to be diseased, the rest catch the infection. A single child has been often known to communicate the bloody-flux, the hooping-cough, the itch, or other diseases, to almost every individual in a numerous school.

[Page 21] BUT if fashion will prevail, and infants must be sent to school, we would earnestly recommend to teachers, as they value the interests of society, not to confine them too long at a time; but to permit them to run about and play at such active diversions as may promote their growth and improve their constitutions. Were boys, instead of being whipped, for stealing an hour to run, ride, swim, or the like, encou­raged to employ their time in these manly and useful ex­ercises, it would have many excellent effects.

IT would likewise be of great service to boys, if at a pro­per age, they were all taught the military exercise. This would improve their strength, courage, and agility; and, when their country called for their assistance, it would enable them to act in her defence, without being obliged to under­go a tedious and troublesome course of instructions, at a time when they are less fit to learn new motions, gestures, &c.

AN effeminate education will infallibly spoil the best na­tural constitution; and, if boys are brought up in a more delicate manner than even girls ought to be, they never will be men.

BUT the common education of girls is no less hurtful to the constitution than that of boys. Miss is set down to her frame, before she can put on her cloaths; and is taught to believe, that to excel at the needle is the only thing that can intitle her to general esteem. It is unnecessary here to in­sist upon the dangerous consequences of obliging girls to sit too much. They are pretty well known, and are too often felt at a certain time of life. But suppose this critical pe­riod to be got over, greater dangers still await them when they come to be mothers. Women who have been early accustomed to a sedentary life, generally run great hazard in childbed; while those who have been used to romp about, and take enough of exercise, are seldom in any danger.

ONE hardly meets with a girl who can, at the same time, boast of early performances by the needle, and a good con­stitution. Close and early confinement generally occasions indigestions, headachs, pale complexions, pain of the sto­mach, loss of appetite, coughs, consumptions of the lungs, and deformity of body. The latter indeed is not to be wondered at, considering the aukward postures in which girls sit at many kinds of needle-work, and the delicate flexible state of their bodies in the early periods of life.

WOULD mothers, instead of having their daughters in­structed in many useless accomplishments, teach them plain [Page 22] work and housewifery, allowing them enough of time to run about, they would both make them better mothers and more useful members of society. I am no enemy to gen­teel accomplishments, but would have them only con­sidered as secondary, and always disregarded when they impair health.

MANY people imagine it a great advantage for children to be early taught to gain their bread. This opinion is certainly right, provided they be so employed as not to hurt their health or growth; but, when these suffer, so­ciety, in place of being gainers, are real losers by their labour. There are few employments, except sedentary ones, by which children can earn a livelihood; and, if they be set to those too soon, it ruins their constitutions. Thus, by gaining a few years from childhood, we generally lose twice as many in the other periods of life, and even render the person less valuable while he does live.

IN order to be satisfied of the truth of this observation, one needs only look into the great manufacturing towns, where he will find a puny degenerate race of people, weak and sickly all their lives, seldom exceeding the middle pe­riod of life; or, if they do, being unfit for business, they become a burden to society. Thus, arts and manufactures, though they may increase the riches of a country, are by no means favourable to the health of its inhabitants. Good policy would therefore require, that such people as labour during life, should not be set too early to work. Every person conversant in the breeding of horses, or other work-animals, knows, that, if they be set to hard labour too soon, they never will turn out to advantage. This is equally true with respect to the human species.

THERE are nevertheless various ways of employing young people, without hurting their health. The easier parts of gardening, husbandry, or any business carried on without doors, are most proper. These are employments that most young people are [...]ond of, and some parts of them may al­ways be adapted to their age, taste and strength.

SUCH parents, however, as are under the necessity of employing their children within doors, ought to allow them enough of time for active diversions. This would both encourage them to do more work, and prevent their con­stitutions from being hurt.

SOME imagine, that exercise within doors is sufficient; but they are greatly mistaken. One hour spent in running, [Page 23] or any other exercise without doors, is worth ten within. When children cannot go abroad, they ought indeed to be exercised at home. The best method of doing this, is to make them run about in a long room, or dance. This last kind of exercise, if not carried to excess, is of ex­cellent service to young people. It cheers the spirit, pro­motes perspiration, strengthens the limbs, &c. An eminent physician used to say, that he made his children dance, in­stead of giving them physic. It were well, if more people followed his example.

AS many of the chronic diseases of children might be prevented by the prudent use of the COLD BATH, we shall point out some of those mistakes which commonly prevent its having the desired effect.

THE Cold Bath may be considered as an aid to exercise. By it the body is braced and strengthened, the circulation and secretions promoted, and, were it conducted with pru­dence, many diseases, as the rickets, scrophula, &c. might thereby be prevented. The antients, who took every me­thod to render children hardy and robust, were no stran­gers to the use of the cold bath; and, if we may judge from the great number of consecrated wells in this island, many of which possess no other virtues but those of cold water, yet are said to have been famous for curing the dis­eases of children, we will see cause to believe, that the practice of immersing children in cold water must have been very common amongst our ancestors.

SO far as I have been able to observe, the cold bath does as much mischief as good; but that is owing to the want of due care in using it. Children born of delicate parents are not suddenly to be plunged over the head in cold wa­ter. They must be gradually brought to it by using tepid water at first, and making it a little cooler every time they are bathed, till by degrees they be able to bear it quite cold. Children afflicted with internal diseases, as inflam­mations or obstructions of the breast, bowels, &c. ought not to be bathed in cold water. No child should be put into the cold bath, when its body is hot, nor immediately after a meal.

IT is next to impossible to bring nurses to make a proper use of the cold bath: Their prejudices are so strong and deep-rooted, that no reasoning is able to bring them off their own way. I have known some of them, who would not dry a child's skin after bathing it, lest it should destroy [Page 24] the effect of the water. Others will even put cloaths dipt in the water upon the child, and either put it to bed, or suffer it to go about in that condition. Some nurses be­lieve, that the whole virtue of the water depends upon its being dedicated to some particular saint. These will carry a child 40, 50, or 100 miles to have it once dipt in a cer­tain well; and this is to cure it of whatsoever disease it la­bours under. Others place their confidence in a certain number of dips, as three, seven, nine, or the like, and the world could not persuade them, if these do not suc­ceed, to try it a little longer.

THUS, by the whims and caprice of nurses, a valuable medicine is lost, and the physician is often disappointed in his hopes by their misconduct. When the cold bath is used as a medicine, it ought always to be by the advice of a phy­sician, and the nurse should adhere strictly to his directions. I have seen wonderful cures in the most obstinate scrophu­lous cases performed by the cold bath. The salt water in this case is always to be preferred. That will succeed where all other medicines have failed.

EVERY child, when in health, ought to have its extre­mities at least washed with cold water daily. This is a partial use of the cold bath, and is better than none. In winter this may suffice; but in the warm season, if a child be relaxed, or seem to have a tendency to the rickets or scrophula, its whole body ought to be daily immersed in cold water. Care however must be taken not to do this when the body is hot, or the stomach full. The child should be dipt only once at a time, should be taken out immediately, and have its skin well rubbed with a dry cloth.

OF THE BAD EFFECTS OF UNWHOLESOME AIR UPON CHILDREN.

FEW things are more destructive to children than con­fined or unwholesome air. This is one reason why so few of those infants live who are put into hospitals, or parish-workhouses. These places are generally crowded with old, sickly and infirm people. By that means the air is ren­dered so extremely pernicious, that it becomes a poison to infants.

WANT of wholesome air is likewise destructive to many of the children born in great towns. There the poorer sort [Page 25] of inhabitants live in low, dirty, confined houses, where the fresh air has no access. Though up-grown people, who are hardy and robust, may live for a number of years in such situations, yet they generally prove fatal to their off­spring, few of whom arrive at maturity, and those who do, are weak and deformed. Such people, not being able to carry their children abroad into the open air, we must lay our account with losing the greater part of their progeny. But the rich have not that excuse. It is their business to see that their children be daily carried abroad, and that they be kept in the open air for a sufficient time. This will suc­ceed better, if the mother goes along with them. Servants are often negligent in these matters, and allow a child to sit or lie on the damp ground, in place of leading or carry­ing it about. The mother surely needs air as well as her children; and how can she be better employed than in at­tending them? Some may think this office below their dignity; but I know no situation in which a mother ap­pears to such advantage, as when surrounded by a circle of healthy children.

A very bad custom prevails of making children sleep in small apartments, or crowding two or three beds into one chamber. In place of that, the nursery ought always to be the largest and best aired room in the house. When children are confined in small apartments, the air is not only unwholesome, but such places being generally too hot, their bodies are relaxed, and this disposes them to catch cold when they go abroad, and has many other bad effects.

CHILDREN who are kept within doors all day, and sleep all night in warm close apartments, may, with great pro­priety, be compared to plants nursed in a hot-house, in place of the open air. Though such plants, by extraor­dinary care, may be kept alive for some time; yet they never will arrive at that degree of strength, vigour and magnitude, which they would have done in the open air, nor would they be able to bear it afterwards, should they be exposed to it.

CHILDREN brought up in the country, who have been accustomed to fresh open air, should not be too early sent to great towns, where the air is confined and unwhole­some. This is frequently done with a view to forward their education, but proves very hurtful to health. Those who are grown up, do not suffer near so much from bad [Page 26] air as young persons. All schools and seminaries of learn­ing ought to be so situated as to have fresh, dry, whole­some air, and should never be too much crowded.

WITHOUT entering into a detail of the particular ad­vantages of wholesome air to children, we shall only ob­serve, that when they enjoy that blessing, they generally sleep well, eat well, and thrive accordingly. It braces and strengthens their bodies, enlivens their spirits, and every way promotes their growth and health.

OF NURSES.

NURSES are guilty of many faults, which prove fatal to infants. It is therefore the duty of parents to watch over their conduct with the greatest care, and to be extremely cautious in the choice of them.

ONE of the most common faults of nurses is to dose children with stupifactives, or such things as lull them asleep. An indolent nurse, who does not give a child enough of exercise in the open air to make it sleep, and does not chuse to be disturbed by it in the night, will sel­dom fail to procure for it a dose of laudanum, diacodium, saffron, or, what answers the same end, a dram of spirits, or other strong liquors. These, though they be certain poison to children, are every day administered by many who bear the character of very good nurses.

A nurse who has not enough of milk, is apt to imagine, that she can supply that defect by giving the child wines, cordial waters, or other strong liquors. This is an egre­gious mistake. The only thing that has any chance to supply the place of the nurse's milk, must be somewhat nearly of the same quality, as cow's milk, ass's milk, or the like, with good bread. It never can be done by the help of strong liquors. These, in place of nourishing an infant, never fail to produce the contrary effect.

CHILDREN are often hurt by nurses permitting them to cry long and vehemently. This strains their tender bo­dies, and frequently occasions ruptures, inflammations of the throat, lungs, &c. The nurse who can hear an infant cry till it has almost exhausted itself, without endeavouring to please it, must be cruel indeed, and is unworthy to be trusted with the care of a human creature.

NURSES who deal much in medicine, are always to be suspected. They trust to it, and neglect their duty. I [Page 27] never knew a good nurse who had her Godfrey's cordials, Daffy's elixirs, &c. at hand. Such generally imagine, that a dose of these will make up for all defects in food, air, exercise, cleanliness, &c.

A very pernicious custom of indolent nurses is the al­lowing of children to continue long wet. This is not only disagreeable, but it galls and frets the infant, and by relaxing the solids, occasions scrophulas, rickets, and other fatal diseases.

NATURE often attempts to free the bodies of children from bad humours, by throwing them out upon the skin: By that means fevers, and other diseases are prevented. Nurses are apt to mistake such critical eruptions for an itch, or some other infectious disorder. Accordingly they take every method to drive them in. In this way many children lose their lives; and no wonder, as nature is opposed in the very method that she took to relieve them. It ought to be a rule which every nurse should observe, never to stop any eruption without proper advice, or being well assured, that it is not of a critical nature. At any rate it is never to be done without previous evacuations.

LOOSE stools is another method by which nature often prevents the diseases of infants. If these proceed too far, no doubt they ought to be checked; but this is never to be done without the greatest caution. Nurses, upon the first appearance of loose stools, frequently fly to the use of astringents, or such things as bind the belly. Thus in­flammations, fevers, and other fatal diseases are brought on. A dose of rhubarb, a gentle vomit, or some other evacua­tion, should always precede the use of astringent medicines.

ONE of the greatest faults of nurses is concealing the diseases of children from their parents. This they are extremely ready to do, especially when the disease is the effect of their own negligence. Every person must have seen instances of people who were lame for life, by a fall out of the nurse's arms, while she, through fear, conceal­ed the misfortune till it was past cure. Every parent who intrusts a nurse with the care of a child, ought to give her the strictest charge not to conceal the most trifling dis­order or misfortune that may befal it. Parents, instead of being angry, when a nurse informs them of such accidents, ought to reward her for her honesty; this would encourage her to do the same upon other occasions. We can see no reason why a nurse should not be punished who conceals [Page 28] any disorder or misfortune that happens to a child under her care, till it loses its life. A few examples of this would save many infant lives; but as there is little reason to expect, that it ever will be the case, we would earnestly recommend it to all parents to look carefully after their children, and not to trust so valuable a treasure entirely in the hands of an hireling.

THESE, and many other faults, being daily committed by those who have the care of children, it ought surely to rouse the attention of all parents who have any regard for their offspring, and to make them very circumspect in the choice of those into whose hands they commit them. They ought at least to take care that a nurse be sober, cleanly, honest, healthy, not too young, nor the contrary; that she have the necessaries of life, and a comfortable ha­bitation, &c.

WERE it practicable to have all children nursed and educated in the country, we should lose very few of them. One seldom sees a country-farmer without a numerous off­spring, most of whom arrive at maturity. Many things conspire to that end. The children of these people are generally nursed by their mothers; they eat plain whole­some food, enjoy the benefit of fresh air, and have enough of proper exercise; they have rural sports and pastimes suited to their age, and as they grow up, find employments adapted to their strength, agreeable to their inclinations, and conducive to their health. They learn industry and so­briety from their parents, and seldom fail to practise these virtues for life. In fine, we cannot help joining with the learned Mr. Locke ^*, in recommending the example of these people as a model to all in the management of their children.

As many people can understand the meaning of a short rule, who are not able to attend to a chain of reasoning, we shall reduce the leading principles of nursing under the following general heads.

1. EVERY mother ought to suckle her own child, if she can do it with safety.

2. A weak, consumptive, nervous, or hysteric mother ought not to give suck, where a healthy nurse can be had.

[Page 29] 3. No child should be brought up without the breast, if it be possible to obtain a proper nurse.

4. The cloaths of an infant should be soft, light, loose and easy for its body. They ought to be fastened on with strings rather than pins.

5. The cloths of children ought to be kept very clean.

6. A new born infant should not be kept too hot.

7. AN infant should be permitted to suck as soon as it shows an inclination for the breast.

8. AN infant should neither be crammed with food nor physic as soon as it is born; but permitted to lie quiet for some time, in order to recover the fatigue of the birth, &c.

9. IF an infant must have food before it sucks, let it be water-pap mixed with new milk, free of all wines, sugars, spiceries, or the like.

10. WHILE the child sucks, it seldom needs much of any other food. It will however be right, about the third or fourth month, to begin to give it once or twice a-day a little of some food that is light and easy of digestion. This will make the weaning both less troublesome and dangerous.

11. A child should not be weaned all at once, but by degrees; as all sudden changes in the diet of children are dangerous.

12. THE food of children ought at all times to be simple, but nourishing. It should consist of a proper mix­ture of animal and vegetable substances.

13. CHILDREN should not be permitted to eat too much fruit, or roots of any kind; but all sorts of green trash ought to be kept from them with the greatest care.

14. CHILDREN ought not to be pinched in their food. They require to eat oftener than adults.—If their food be simple, and they know that they can have it when hungry, they will seldom or never eat more than enough.

15. As soon as children can take exercise, they ought to be allowed as much as they please; till then it is the busi­ness of the nurse to carry and toss them about.

16. A nurse ought not only to carry an infant about, but to divert and amuse it so as to keep it in good humour.

17. AN infant should never be suffered to cry long and vehemently.

18. ERUPTIONS, or looseness in children, ought not to be stopt, but with the greatest caution.

[Page 30] 19. NURSES should use no means to force children to sleep; but they may always be permitted to take as much as they please.

20. CHILDREN ought never to have medicine unless they are diseased.

21. CHILDREN should neither be too early set to school, nor confined to any mechanical employment within doors.

22. SCHOOLMASTERS, and all who have the care of youth, should allow them plenty of time for exercise and diversions.

23. ALL children should be nursed and educated in the country, if possible. When that cannot be done, they ought to be carried abroad every day, and kept for a suffi­cient time in the open air.

24. THE children of delicate and diseased parents must be managed with more care than those of the hardy and robust.

25. A mother should never abandon her child solely to the care of a mercenary nurse.

LET no one imagine these matters unworthy of his at­tention. On the proper management of children depend not only their health and usefulness in life, but likewise the safety and prosperity of the state to which they be­long. Effeminacy ever must prove the ruin of any king­dom; and when its foundations are laid in infancy, it can never afterwards be wholely eradicated. We would therefore recommend to all who wish well to their country, to study every method to render their offspring strong and healthy.

OF ADULTS.

HAVING endeavoured to point out some of the sources from which the diseases and mortality of in­fants proceed, we shall next take a view of the more ge­neral causes of diseases, or such things as endanger the health of mankind in the more advanced periods of life.

NO man, however careful, can at all times avoid dis­eases; yet nothing is more certain than that many of them, and those too of the most dangerous nature, are often ow­ing to the want of care. The smallest causes, when ne­glected, generally produce the greatest effects. This is strictly true with respect to diseases. A little care would often prevent what no medicine can cure.

THE most common cause of diseases in this island is an obstructed perspiration, or what commonly goes by the name of CATCHING COLD. The perspiration is by far the most considerable discharge from the body; and so long as it goes on properly, we have seldom any complaints; but when it is obstructed, the health must suffer. Men being less sensible of this than of the other evacuations, are consequently not so attentive to the various causes which obstruct it: We shall therefore point out some of the most considerable of them, in order to put people upon their guard.

COMMON CAUSES OF CATCHING COLD.

COLDS are often occasioned by sudden changes in the atmosphere. There is no country where such changes hap­pen more frequently than in Britain. The degrees of heat and cold are not only various in the different seasons of the year, but often change from the one extreme to the other in a few days, and sometimes even in the course of one day. As these changes cannot fail to increase or diminish the perspiration, they must of course affect the health.

THE best method of fortifying the body against the changes of the weather, is to be abroad every day. Those who keep much within doors, are most liable to catch cold. [Page 32] Such people feel even the slightest changes in the atmos­phere, and by their coughs, pains and oppressions of the breast, &c. become a kind of living barometers.

THE frequent changes of the weather ought to make us cautious in changing our apparel. All persons, but especially the valetudinary, should be careful not to put off their winter-garments too soon, nor to wear their summer ones too long. The commencement of our warm season is so uncertain, that a few hot days in April or May often make us believe summer is arrived; when all of a sudden the weather sets in more intensely cold than at Christmas. The like sudden changes frequently happen in September or October; and where no care is taken to guard against their influence, the gout, rheumatisms, fluxes and fevers often ensue.

LABOURERS frequently suffer by not attending to the changes of the weather. They strip to work while it is warm, but neglect to put on their cloaths when it grows cold; some are even thoughtless enough to disregard being wet; such however, in the end, generally find cause to re­pent their fool-hardiness.

NOTHING more certainly obstructs the perspiration than WET CLOATHS. Nor is the most robust constitution proof against their effects. The perspiration is not only ob­structed by wet cloaths, but the moisture is likewise ab­sorbed, which greatly encreases the danger.

It is impossible for people who go abroad, always to avoid being wet. But the danger might generally be les­sened, if not wholely prevented, by changing their cloaths soon; when that cannot be done, they should keep in mo­tion till they dry. So far are many from observing this rule, that they will sit, or even lie down in the fields with their cloaths wet, and frequently sleep whole nights in that condition. Every person must have known instances of fevers, rheumatisms, and even consumptions, brought on in this way. Though these happen daily, yet they are not sufficient to deter others from the like conduct.

EVEN wet feet often occasion fatal diseases. Coughs, in­flammations of the breast, and ulcers in the lungs, frequent­ly proceed from that cause. The cholic, a fit of the gout, the iliac passion, and cholera morbus, are likewise often oc­casioned by wet feet. Habit will, no doubt, render this less dangerous; but it ought, as far as possible, to be avoided. The delicate, and those who are not accustomed [Page 33] to have their cloaths or feet wet, should be peculiarly care­ful in this respect.

THE perspiration is often obstructed by NIGHT-AIR; the absence of the sun renders it damp and foggy. Even in summer the night-air ought to be avoided. The dews which fall plentifully after the hottest day, make the night more dangerous than when the weather is cool. Hence, in warm countries the dews are more hurtful than where the climate is more temperate.

IT is very agreeable indeed, after a warm day, to be abroad in the cool evening; but this is a pleasure to be avoided by all who value their health. The effects of evening dews are gradual and almost imperceptible; but they are not the less to be dreaded: We would therefore advise travellers, labourers, and all who are much heated by day, carefully to avoid them. When the perspiration has been great, these become dangerous in proportion: By not attending to this, in flat marshy countries, where the exhalations and dews are copious, labourers often catch intermitting fevers, quinsies, and the like.

DAMP BEDS seldom fail to obstruct the perspiration. Beds become damp, either from want of use, standing in damp houses, or in rooms without fire. Nothing is more to be dreaded by travellers than damp beds, which are very common in all places where feuel is scarce. When a tra­veller cold and wet arrives at an inn, he may by means of a good fire, and a dry bed, have the perspiration restored; but if he be put into a cold room, and laid on a damp bed, it will be more obstructed, and the worst consequences must ensue. Travellers should avoid inns which are noted for damp beds, as they would a house infected with the plague; as no man, however robust, is proof against the danger arising from them.

BUT inns are not the only places where damp beds are to be met with. Beds kept in private families for the re­ception of strangers, are no less dangerous. All kinds of linen and bedding, when not frequently used, become damp. How then is it possible, that beds which are not slept in above two or three times a-year, should be other­wise? Nothing is more common than to hear of people having caught cold by changing their bed. The reason is obvious. Were they careful never to sleep on a bed but what was frequently used, they would seldom find any ill consequences from a change.

[Page 34] NOTHING is more to be dreaded by a delicate person, when on a visit, than being laid in the guest-chamber. That ill-judged piece of complaisance becomes a real in­jury. All the bad consequences from this quarter might be easily prevented in private families, by causing their ser­vants to sleep in the spare beds, and to resign them to stran­gers when they come. This is the custom of many families in London, and we would earnestly recommend it to all who value the health of their friends. In inns where the beds are used almost every night, nothing else is necessary than to keep the rooms well seasoned by frequent fires, and the linen dry.

DAMP houses frequently produce the like ill conse­quences. For this reason those who build, should be care­ful to chuse a dry situation. A house which stands on a damp marshy soil, must be hurtful to the health of the in­habitants. Not only a marshy soil, but being situated in the neighbourhood of large woods, lakes, or standing wa­ter, must make a house damp. Large woods both prevent the free current of air, and send forth great quantities of moist exhalations, which render all places near them un­wholesome. This is one reason why new discovered coun­tries commonly prove unhealthy, till they be cleared of their woods. Even in England, at this day, there is great­ly more planting in several parts than is either conducive to the fertility of the soil, or the health of its inhabitants. This taste, instead of being any improvement, is the way to reduce the country back to its original state, and to render the climate less healthy than it otherwise would be.

COLD is not near so hurtful to the health as moisture. Cold, in a moderate degree, braces and strengthens the body; but moisture relaxes and pre-disposes it to diseases. That is the reason why intermittents and other fevers are so frequent in low, damp, marshy countries abounding with woods and standing water. This likewise shews the danger of inhabiting new houses before they be thoroughly dry. Nothing is more common than for people, merely to avoid some trifling inconveniency, to hazard their lives, by in­habiting a house almost as soon as the masons, plaisterers &c. have done with it. Such houses are not only dangerous from their dampness, but likewise from the smell of lime, paints, &c. The asthma's, consumptions, and other dis­eases of the lungs, so common to people who work in these articles, are a plain proof of their being unwholesome.

[Page 35] HOUSES are often rendered damp by an unseasonable piece of cleanliness, I mean the ridiculous custom of washing rooms immediately before company is put into them. Many people are sure to catch cold, if they sit but a short while in a room that has been lately washed. The delicate ought carefully to avoid such a situation, and even the robust would run less hazard by sitting without doors. People who are accustomed to live in dry houses, ought, as far as possible, to shun damp ones, and by all means not to continue long in rooms that have been lately washed.

ALL houses, unless where the ground is extremely dry, should have the first floor a little raised. Such servants as are obliged to live for the most part in cellars and sunk sto­ries, seldom continue long in health; and surely masters ought to pay some regard to the health of their servants as well as to their own.

EVEN houses which are built for the poor, ought to be dry. These people generally live on the ground-floor, and if it be damp, they must suffer. This is one cause of the aches, cramps and rheumatic pains, which poor people are so subject to in the decline of life.

BUT nothing so frequently obstructs the perspiration as SUDDEN TRANSITIONS from heat to cold. Colds are seldom caught, unless when people have been too much heated. Heat rarifies the blood, quickens the circulation, and in­creases the perspiration; but when these are suddenly checked, the consequences must be bad. It is indeed im­possible for labourers not to be too hot upon certain occa­sions; but it is generally in their power to put on their cloaths when they leave off work, to make choice of a dry place to rest themselves in, and to avoid falling asleep in the fields. These easy rules, if observed, would save many useful lives.

NOTHING is more common than for people, when hot, to drink freely of cold small liquors. This conduct is ex­tremely dangerous. Thirst indeed is hard to bear, and the inclination to gratify that appetite, frequently gets the bet­ter of reason, and makes us do what our judgment disap­proves. Every peasant knows, if his horse be permitted to drink his belly full of cold water after violent exercise, and be immediately put into the stable, or suffered to remain at rest, that it will kill him. This they take the utmost care to prevent. It were well, if they were equally atten­tive to their own safety.

[Page 36] THIRST may be quenched many ways without swallow­ing large quantities of cold liquor. The fields afford variety of acid fruits and plants, the very chewing of which would abate thirst. Water kept in the mouth for some time, and spit out again, if frequently repeated, will have the same effect. If a bit of bread be eat along with a few mouth­fuls of water, it will both quench thirst more effectually, and make the danger less. When a person is extremely hot, a mouthful of brandy, or other spirits, ought to be preferred to any thing else, if it can be obtained. But if any one has been so foolish, when hot, as to drink freely of cold liquor, he ought to continue his exercise at least, till what he drank be thoroughly warmed upon his sto­mach.

IT would be tedious to enumerate all the bad effects which flow from drinking cold thin liquors when the body is hot. Sometimes this has occasioned immediate death. Hoarseness, quinseys, and fevers of various kinds, are its common consequences. Neither is it safe, when warm, to eat freely of raw fruits, sallads, or the like. These indeed have not so sudden an effect on the body as cold liquors, but they are notwithstanding dangerous, and ought to be avoided.

SITTING in a warm room, and drinking hot liquors till the pores are quite open, and immediately going into the cold air, is extremely dangerous. Colds, coughs, and in­flammations of the breast, are the usual effects of this conduct: Yet how common is it? Many people, after having drank warm liquors for several hours, walk or ride a number of miles in the coldest night; while others sit up at their bottle all night, or ramble about in the streets. Such conduct is one cause why coughs and colds are so common in the winter-season.

PEOPLE are very apt, when a room is hot, to throw open a window, and to sit near it. This is a most ready way to catch cold. A delicate person had better sit with­out doors than in such a situation, as the current of air is directed against one particular part of the body. Inflam­matory fevers and consumptions have often been occasioned by sitting or standing thinly cloathed near an open window. Nor is sleeping with open windows less to be dreaded. That ought never to be done even in the hottest season. I have known mechanics frequently contract fatal diseases, by [Page 37] working stript at an open window, and would advise all of them to beware of such a practice.

NOTHING exposes people more to catch cold than keep­ing their own houses too warm; such persons may be said to live in a sort of hot-houses; they can hardly stir abroad to visit a neighbour, but at the hazard of their lives. Were there no other reason for keeping houses in a mode­rate degree of warmth, that alone is sufficient. But no house that is too hot, can be wholesome. Heat destroys the spring and elasticity of the air, and renders it less fit for expanding the lungs, and other purposes of respiration. Hence it is, that consumptions and other diseases of the lungs prove so fatal to people who work in forges, glass­houses, and the like.

SOME are even so fool-hardy, as to bathe themselves, when hot, in cold water. Not only fevers, but madness itself, has frequently been the effect of this conduct. In­deed it looks too like the action of a madman to deserve a serious consideration.

WE shall conclude these observations on the common causes of catching cold, by recommending it to every one to avoid, with the utmost attention, all sudden transitions from heat to cold, and to keep the body in as uniform a temperature as possible; or, where that cannot be done, to take care to cool gradually.

IT may be thought, that too strict an attention to these things would tend to render people delicate. So far how­ever is this from being our design, that the first rule laid down for preventing colds, is to harden the body, by enur­ing it daily to bear the open air.

It is a true saying, that colds kill more than plagues. On examining patients, one finds most of them impute their dis­eases either to violent colds, or to slight ones which had been neglected. This shows the importance of guarding against every thing that may obstruct the perspiration, and likewise of using proper means immediately to remove such obstruc­tion when it does happen. The want of due attention to these costs Britain annually some thousands of useful lives.

UNWHOLESOME FOOD.

AS our bodies consist of what we eat and drink, un­wholesome food must be dangerous. There is no question but the whole constitution of body may be changed by [Page 38] diet. This is often done more quickly than people would imagine. A diet consisting too much of alkaline substances will soon render the humours putrid. On the other hand, if acids be used too freely, they will receive a taint of an opposite nature. The solids may be relaxed or weakened by the use of oily or watery substances, or they may be too much constricted by eating spiceries, austere vegetables, &c.

IT is not easy to ascertain the exact quantity and quality of food proper for every age, sex and constitution: But a scrupulous nicety here is by no means necessary. The best rule is to avoid all extremes. Mankind were never intend­ed to weigh and measure their food. Nature teaches every creature when it has enough of food, and a very small de­gree of reason is sufficient for the choice of it. Men sel­dom err in this respect through ignorance. The most knowing are generally the most guilty.

THOUGH moderation be the only rule necessary with re­spect to the quantity of food, yet the quality of it merits further attention. Many people, if they can satisfy the appetites of hunger and thirst, are very indifferent what they eat or drink. The following observations will show the danger of such conduct.

PROVISIONS may be rendered unwholesome various ways. Bad seasons may either prevent the ripening of grain, or damage it afterwards. Wet and cold summers seldom bring the fruits of the earth to maturity; and if the harvest like­wise prove rainy, they are often so damaged as to be very hurtful. These indeed are acts of Providence; it is there­fore our duty to submit to them. But surely no punishment can be too severe for those who suffer provisions to be spoilt, by hoarding them on purpose to enhance the price. The soundest grain, if kept too long, must become unfit for use.

THE poor are generally the first who suffer by unsound provisions: But the lives of the labouring poor are of the greatest importance to the state. Besides, diseases occa­sioned by unwholesome food often prove infectious, and by that means reach people in every station. The poor judge ill in buying low-priced and coarse provisions. They had better have a smaller quantity of what is sound and good; as that would both afford more nourishment, and be at­tended with less danger.

ANIMAL as well as vegetable food becomes unwholesome when kept too long. All animal substances have a constant tendency to putrefaction, and when that has proceeded too [Page 39] far, they not only become offensive to the senses, but hurt­ful to health. Diseased animals, and such as die of them­selves, ought not to be eaten. It is common enough in grasing countries for servants and poor people to eat such animals as die of any disease in the spring or winter, or are killed by accident. I have been frequently told by people who live in places where this is done, that when much flesh of that kind is eaten, it never fails to occasion fevers.

THE injunctions given to the Jews, not to eat any crea­ture which died of itself, seem to have a strict regard to health, and ought to be observed by Christians as well as Jews. Animals never die of themselves without some pre­vious disease; but how a diseased animal should be whole­some food, is inconceivable. Even those which die by ac­cident, must be hurtful, as their blood is mixed with the flesh, and soon turns putrid.

ANIMALS which feed gross, as tame ducks, swine, &c. are neither easily digested, nor afford wholesome nourish­ment. No animal can be wholesome food which does not take sufficient exercise. Most of our stalled cattle, hogs, &c. are crammed with gross food, but not allowed exercise nor free air, by which means they indeed grow fat, but their humours not being properly prepared or affimulated, they must remain crude. The flesh of an animal which has not properly digested its own food, can never be easily digested by another: Yet such are the delicacies of modern luxury, and such the animals daily devoured even by the weak and valetudinary. Is it any wonder, that such should complain of crudities, indigestions, and oppression of the spirits? Let them eat the same quantity of an animal which runs wild, and they will not feel any load on their stomach, or difficulty of digestion. We would not have people live on carrion; but surely the opposite extreme of eating animals which are gorged with gross food till they are unfit to live, must be as pernicious.

ANIMALS may likewise be rendered unwholesome by being over-heated. Heat causes a fever, exhalts the salts of the animal, and mixes the blood so intimately with the flesh, that it cannot be seperated. For this reason people ought not to eat freely of such animals as are hunted down, their flesh being apt to occasion putrid fevers. But­chers should also be careful not to over-drive their cattle. No person would chuse to eat the flesh of an animal which had died in a high fever; yet that is the case with all over­drove [Page 40] cattle, and the fever is often raised even to the degree of madness.

NO people in the world eat such quantities of animal food as the English. That is one reason why they are so generally tainted with the scurvy, and its numerous train of consequences, as indigestion, low spirits, hypochon­driacism, &c. Animal food was surely designed for man, and with a proper mixture of vegetables, it will be found the most wholesome; but to gorge beef, mutton, pork, fish and fowl twice or thrice a-day, is certainly too much. All who value health, ought to be contented with making one flesh-meal in the twenty-four hours, and this ought to consist of one kind only.

THE most obstinate scurvy has often been cured by a vegetable diet; nay, milk alone will frequently do more in that disease than any medicine. From hence it is evi­dent, that if vegetables and milk were more used in diet, we should have less scurvy, and likewise fewer putrid and inflammatory fevers.

OUR aliment ought neither to be too moist, nor too dry. Moist aliment relaxes the solids, and renders the body feeble. Thus we see females who live much on tea and other watery diet, generally become weak, and unable to digest solid food; from whence proceed hysterics, and all their dreadful consequences. On the other hand, food that is too dry, renders the solids in a manner rigid, and the humours viscid, which predisposes the body to inflamma­tory fevers, scurvies, and the like.

THE arts of cookery render many things unwholesome, which are not so in their own nature. By jumbling to­gether a number of different ingredients, in order to make a poignant sauce, or rich soup, the composition proves al­most a poison. All high-seasoning, pickles, &c. are only incentives to luxury, and never fail to hurt the stomach. It were well for mankind, if cookery, as an art, were in­tirely prohibited. Plain rosting or boiling is all that nature points out, and all that the stomach requires. These alone are sufficient for people in health, and the sick have still less need of a cook.

THE liquid part of our aliment likewise claims our at­tention. Water is not only the basis of most liquors, but also composes a great part of our solid food. Good water must therefore be of the greatest importance in diet. The best water is that which is most pure, and free from any [Page 41] mixture of foreign bodies. Water takes up parts of every body with which it comes in contact; by which means it is often impregnated with metals and minerals of a hurtful or poisonous nature.

THE inhabitants of some hilly countries have peculiar diseases, which in all probability proceed from the water. Thus the people who live near the Alps in Switzerland, and the inhabitants of the Peak of Derby in England, have large tumours or wains on their necks. This disease is generally imputed to the snow-water; but there is more reason to believe it is owing to the minerals in the moun­tains through which the waters pass. Were it owing to the snow-water, it should happen to the inhabitants of all mountainous countries, where snow lies long; but there are many parts of Britain where the snow lies much longer than in the Peak of Derby; yet the inhabitants have no such disease. The Peak of Derby is well known to be a bed of minerals of different kinds; and, as far as what is called the mineral country extends, these tumours are com­mon, and generally go by the name of Derby [...].

WHEN water is impregnated with foreign bodies, it ge­nerally appears by its weight, colour, taste, smell, heat, or some other sensible quality. Our business therefore is to chuse such water, for common use, as is lightest, and without any particular colour, taste or smell. In most places of Britain the inhabitants have it in their power to make choice of their water, and [...]ew things would contri­bute more to health than a due attention to this article. But mere indolence often induces people to make use of the water that is nearest them, without considering its qualities.

BEFORE water be brought into great towns, the strictest attention ought to be paid to it's qualities, as epidemic dis­tempers are often occasioned by bad water; and when it has been procured at a great expence, we are unwilling to give it up.

THE common methods of rendering water clear by fil­tration, of soft by exposing it to the sun and air, &c. are so generally known, that it is unnecessary to spend time in explaining them. We shall only in general advise all to avoid waters which stagnate long in small lakes, ponds, or the like. Such waters often become putrid with insects and other [...], which breed and die in them. Even cattle frequently suffer by drinking, in dry seasons, water which [Page 42] has stood long in small reservoirs, without being supplied by springs, or freshened with showers. All wells ought to be kept clean, and to have a free communication with the air. When either animal or vegetable substances are suf­fered to lie at the bottom of wells, they corrupt and taint the water. Even the air itself, when confined in wells, becomes poisonous, and must of course render the water unwholesome.

MUCH noise has been made about the use of fermented liquors. They notwithstanding still continue to be the common drink of almost every person who can afford them. As this is, and in all probability will be the case, we shall rather endeavour to assist people in their choice of these liquors, than pretend to condemn what custom has esta­blished. It is not the moderate use of sound fermented liquors which hurts mankind; i [...] is excess, or the abuse of them, and using such as are ill-prepared or vitiated.

FERMENTED liquors which are too strong hurt digestion, instead of assisting it, by which means their intention is lost, and the body, in place of being strengthened by them, is weakened and relaxed. Many imagine, that hard labour could not be supported without drinking strong liquors: This, though a common, is a very erroneous notion. Men who never taste strong liquors, are not only able to endure more fatigue, but also live much longer than those who use them daily. But suppose strong liquors did enable men to do more work, they must nevertheless waste the powers of life, and of course occasion premature old age. They keep up a constant fever, which wastes the spirits, heats and inflames the blood, and predisposes the body to number­less diseases.

BUT fermented liquors may be too weak as well as too strong: When that is the case, they must either be drank new, or they become sour and dead. When such liquors are drank new, the fermentation not being over, they ge­nerate air in the bowels, and occasion flatulencies; and when kept till stale, they sour on the stomach, and greatly hurt digestion. For this reason all malt-liquor, cyder, &c. ought to be of such strength as will make them keep till they be ripe, and then they should be used. When such liquors are kept too long, though they should not become sour, yet they generally contract a hardness, which renders them unwholesome. Hence it is, that bottled ale hurts the stomach, occasions the gravel, &c.

[Page 43] ALL families, who can, ought to prepare their own li­quors. Since preparing and vending of liquors became one of the most general branches of business, every me­thod has been tried to adulterate them. The great object both of the makers and venders of liquor is, to render it intoxicating. But it is well known, that this may be done by other ingredients than those which ought to be used for that purpose. It would be imprudent even to name those things which are daily made use of to render liquors heady. It is sufficient to observe, that the practice is very common, and all the ingredients used for that purpose, are of an opiate or stupifactive nature. But as all opiates are of a poisonous quality, it is easy to see what must be the consequence of their general use. Though they do not kill suddenly, yet they hurt the nerves, relax and weaken the stomach, and of course spoil the digestion.

WERE fermented liquors faithfully prepared, not too strong, nor too weak, kept to a proper age, and used in moderation, they would prove real blessings to mankind. But while they are ill prepared, various ways adulterated, and taken to excess, they must have many bad consequences. These however we shall not mention at present, as they will be pointed out under another article.

TO specify the different kinds of aliment, to explain their nature and properties, and to point out their effects in different constitutions, would far exceed the limits of our design. Instead of a detail of this kind, which in all probability would be very little attended to, and would not be generally understood, we shall only mention the follow­ing easy rules with respect to the choice of aliment.

THOSE whose solids are weak and relaxed, ought to avoid all viscid food, or such things as are hard of digestion; and to take plenty of exercise in a dry open air.

SUCH as abound with blood, should be sparing in the use of every thing that is highly nourishing, as fat meat, rich wines, strong ale, &c. Their food should consist mostly of bread and other vegetable substances, and their drink ought to be milk, whey, and the like.

FAT people should not eat freely of oily nourishing diet. They ought frequently to use raddish, garlic, spices, or such things as are heating, and promote per­spiration and urine. Their drink should be water, coffee, tea, or the like; and they ought to take much exercise and little sleep.

[Page 44] THOSE who are too lean, must follow an opposite course.

SUCH as abound with acidities, or whose food is apt to sour on their stomach, should live much on flesh-meats; and those who are troubled with alkaline eructations, or heat of the stomach, ought to use a diet consisting chiefly of acid vegetables.

PEOPLE who are affected with the gout, low spirits, hy­pochondriac or hysteric disorders, ought to avoid all flatu­lent food, every thing that is viscid or hard of digestion, all salted or smoke-dried provisions, and whatever is au­stere, acid, or apt to sour on the stomach. Their food should be light, spare, cool, and of an opening quality.

THE diet ought not only to be suited to the age and con­stitution, but also to the manner of life. A sedentary or studious person should live more sparingly than one who labours hard without doors. Food will nourish a peasant very well, which would be almost indigestible to a citizen; and the latter will live upon a diet on which the former would starve.

DIET ought not to be too uniform. The constant use of one kind of food might have bad effects. Nature points out this by the great variety of aliments which she has pro­vided for man, and likewise by giving him an appetite for different kinds of food.

THOSE who labour under any particular disease, ought to avoid such aliments as have a tendency to increase it. For example, a gouty person should not use rich wines, strong soups, or gravies, and should avoid all acids. One who is troubled with the gravel, ought to shun all austere and astringent aliments; and those who are scorbutic, should not indulge in animal food, &c.

IN the first period of life our food ought to be light, nourishing, and of a diluting nature, but frequently used. Food that is solid, with a sufficient degree of tenacity, is most proper for the state of manhood. The diet suited to the last period of life, when nature is upon the decline, approaches near to that of the first. It should be lighter, and more diluting than that of vigorous age, and likewise more frequently taken.

IRREGULARITIES IN DIET, SLEEP, &c.

IT is not only necessary for health, that our diet be wholesome, but also that it be taken at regular periods. [Page 45] Some imagine, that long fasting will atone for excess; but that, instead of mending the matter, never fails to make it worse. When the stomach and intestines are over dis­tended with food, they lose their proper tone, and by long fasting they become weak, and inflated with wind. Thus either gluttony or fasting destroys the powers of digestion.

THE frequent repetition of aliment is not only necessary for repairing the continual waste of our bodies, but like­wise to keep the humours sound and sweet. Our humours, even in the most healthy state, have a constant tendency to become putrid, which can only be prevented by frequent supplies of fresh nourishment: When that is wanting too long, the putrefaction often proceeds so far, as to occasion very dangerous fevers. From hence we may learn the ne­cessity of regular meals. No person can enjoy a good state of health, whose vessels are either frequently over­charged, or the humours long deprived of fresh supplies of chyle.

LONG fasting is extremely hurtful to young people; it vitiates their humours, and prevents their growth and strength. Nor is it less injurious to the aged. Many in the decline of life are afflicted with wind: That com­plaint is not only increased, but even rendered dangerous, and often fatal, by long fasting. Old people, when their stomachs are empty, are frequently seized with giddiness, headachs and faintness. These complaints may generally be removed by a bit of bread and a glass of wine, or taking any other solid food; which plainly points out the method of preventing them. It is more than probable, that many of the sudden deaths which happen in the advanced periods of life, are occasioned by fasting too long, as it exhausts the spirits, and fills the bowels with wind; we would therefore advise people, in the decline of life, never to al­low their stomachs to be too long empty. Many take no­thing but a few cups of tea and a bit of bread, from nine o'clock at night till two or three next afternoon. Such may be said to fast almost three fourths of their time. This can hardly fail to ruin the appetite, vitiate the humours, and fill the bowels with wind; all which might be pre­vented by a solid breakfast. That would tend more to strengthen the nerves, and expel wind, than all the cor­dial or carminative medicines which can be administered.

THE strong and healthy do not indeed suffer so much from fasting as the weak and delicate; but they run great [Page 46] hazard from its opposite, viz. repletion, Many diseases, especially fevers, are the effect of a plethora, or too great fulness of the vessels. Strong people, in high health, have generally a great quantity of blood and other humours. When these are suddenly increased by an overcharge of rich and nourishing diet, the vessels become distended, and being unable to contract themselves, obstructions and in­flammations ensue. Hence so many people are seized with inflammatory and eruptive fevers, after a feast or debauch. This shows the danger of all sudden transitions from a spare to a full and luxurious diet.

EXCESS in diet is not peculiar to the rich and opulent; the poor are often guilty of it, and frequently feel its bad effects. The poor seldom lose an opportunity of gorging themselves either with meat or drink, when they can obtain it, and the less they are accustomed to it, the danger is the greater.

WHEN we recommend regularity in diet, we would not be understood as condemning every small deviation from it. It is next to impossible for people at all times to avoid some degree to excess, and living too much by rule might make even the smallest deviation dangerous. It may therefore be prudent to vary a little, sometimes taking more, sometimes less than the usual quantity of meat and drink, provided al­ways that regard be had to moderation.

SLEEP as well as diet ought to be duly regulated. Too little sleep exhausts the spirits, weakens the nerves, and oc­casions diseases; and too much renders the mind dull, the body gross, and disposes it to apoplexies, lethargies, &c. A medium therefore ought to be observed; but that is not easy to fix. The you [...]g require more sleep than those who are grown, the laborious than the idle, and such as eat and drink freely than those who live abstemiously. Besides, the real quantity of sleep cannot be measured by time; as one per­son will be more refreshed by five or six hours of sleep, than another by eight or ten. The best way to make sleep [...]ound and refreshing is to rise by times. The indolent custom of lolling a-bed for nine or ten hours relaxes the body, un­braces the nerves, and greatly hurts the constitution.

CHILDREN may be allowed as much sleep as they chuse; but for adults six or seven hours is certainly enough, and none ought to exceed eight. Those who lie more than eight hours a-bed may slumber, but they can hardly be said to sleep; such generally toss and dream away the fore-part of the night, sink to rest towards morning, and dose till [Page 47] noon. Instead of encouraging a habit of this kind, rising early would make them fall into a [...]ound sleep as soon as they went to bed, and they would seldom wake till morn­ing, when they would find themselves sufficiently refreshed.

NATURE points out night as the proper time for sleep. Those who think it too vulgar to sleep in that season, seldom enjoy health. Nothing more certainly destroys the con­stitution than night-watching. It is great pity that a prac­tice so destructive to health should be so much in fashion. How quickly the want of rest in due season will blast the most blooming complexion, or ruin the best constitution, is evident from the ghastly countenances of those who, as the phrase is, turn day into night, and night into day.

TO make sleep refreshing, the following things are ne­cessary. First, that we take enough of exercise in the open air, through the day; next, to eat a light supper; and last­ly, to lie down with a mind chearful and serene.

IT is certain, that too much fatigue will prevent sleep, as well as too little. We seldom, however, hear the active and laborious complain of restless nights. It is the indolent and slothful who generally have these complaints. Is it any wonder, that a bed of down should not be refreshing to a person who lolls all day in an easy chair? A great part of the pleasure of life consists in alternate rest and motion; but they who neglect the latter can never relish the former. The labourer enjoys more true luxury in plain food and [...]ound sleep, than is to be found in sumptuous tables and downy pillows, where exercise is wanting.

THAT light suppers cause sound sleep, is true even to a proverb. Many, if they exceed the least at that meal, are sure to have uneasy nights; and if they drop asleep, the load and oppression on their stomach and spirits occasion frightful dreams, broken and disturbed repose, with night­mares, &c. Were the same persons to go to bed with a light supper, or [...]it up till what they eat were pretty well digested they might enjoy [...]ound sleep, and rise refreshed and chearful.

NOTHING more certainly disturbs our repose than anxie­ty. When the mind is not at ease, we seldom enjoy [...]ound sleep. That greatest of human blessings often flies the wretch who needs it most, and visits the happy, the chear­ful, and the gay. This is a good reason why every man should endeavour to be as easy in his mind as possible, when he goes to rest. Many, by neglecting this rule, and by in­dulging [Page 48] grief and anxious thoughts, have banished sleep so long, that they could never afterwards enjoy it.

FEW things contribute more to health than keeping the belly regular. When the foeces lie too long in the bowels, they become acrid, and spoil the humours; and when they are discharged too soon, the body is not properly nourished. Regular stools depend greatly upon regularity in eating and drinking, and proper exercise; people have reason to su­spect a fault in one or other of these, whenever the belly is not regular.

TO prevent costiveness, one good rule is, to rise betimes and go abroad in the open air. Not only the posture in bed is unfavourable to regular stools, but likewise the warmth. This, by promoting the perspiration, cannot fail to lessen all the other discharges. Mr. Lock's advice, to solicit na­ture by going regularly to stool every morning, is a very good one, and has more effect than most people would ima­gine. Any habit will in time become natural. It is always more safe to keep the belly regular by proper diet, exercise, &c. than by the use of drugs. Those who have frequent recourse to medicine for that purpose, seldom fail to ruin their constitutions. But if opening medicines must be used, the safest is fine rhubarb, which may either be taken in small doses in powder, or a little of it chewed daily. Cus­tom will render this sufficiently agreeable.

SUCH as are troubled with habitual looseness, ought to suit their food to the nature of their complaint. Looseness may often be removed by a change of diet: For example, boiled milk may be used in place of raw, wheat bread in­stead of that which is mixed, red wine, or brandy and wa­ter may be drank in place of malt-liquor, white broths may be eat instead of flesh, and [...] or sago gruels, with light flour puddings, in place of barley or oat meal. An habitual looseness is often occasioned by an obstructed perspiration. In that case as flannel vest and thick shoes are the best me­dicines.

BAD AIR.

BAD air is a very common cause of diseases. Few are aware of the danger arising from it; people generally pay some attention to what they eat and drink, but seldom re­gard what goes into the lungs, though the one often proves fatal as well as the other.

[Page 49] PERHAPS no air is perfectly pure; that, however, which has fewest noxious particles in it, is no doubt the best. Air as well as water takes up parts of most bodies with which it comes into contact, and is often so replenished with those of a noxious quality, as to occasion immediate death. But such violent effects seldom happen, as people are generally on their guard against them. The less perceptible influ­ences of bad air prove more hurtful to mankind; we shall therefore endeavour to point out some of these, and to show wherein the danger consists.

AIR may become noxious many ways. Whatever destroys its spring or elasticity, renders it unfit for respiration: Wherever therefore great numbers of people are crowded into one place, if the air has not a free current, it soon be­comes unwholesome. Hence it is that delicate persons are so apt to faint or be sick, in crowded churches, assemblies, or any place where the air is exhausted by breathing, fires, candles, or the like.

IN great cities so many things tend to pollute the air, that it is no wonder it proves so fatal to the inhabitants. The air in cities is not only breathed over and over by thou­sands, but is likewise exhausted by fires, loaded with sul­phur, smoke, and other exhalations, besides the vapours continually arising from innumerable putrid substances. All possible care should be taken to keep the streets of large towns open and wide, that the air may have a free current. They ought likewise to be kept very clean. Nothing tends more to pollute and contaminate the air than dirty streets, dunghills, slaughter-houses, &c.

IT is very common in this country to have church-yards in the middle of populous cities. Whether that be the ef­fect of ancient superstition, or owing to the increase of such towns, is a matter of no consequence. Whatever gave rise to the custom, it is a bad one. It is habit alone which re­conciles us to these things; by means of it, the most ridi­culous, nay, pernicious customs, often become sacred. Cer­tain it is, that thousands of putrid carcases, so near the sur­face of the earth, in a place where the air stagnates, cannot fail to taint it; and that such air being breathed into the lungs, and mixed with the blood, must occasion diseases ^*.

WHEREVER air stagnates long, it becomes unwholesome. Hence the unhappy inmates of jails not only contract ma­lignant [Page 50] fevers themselves, but often communicate them to others. Nor are many of the holes, for we cannot call them houses, possessed by the poor in great towns, much better than jails. These low dirty habitations are the very lurk­ing places of bad air and contagious diseases. Such as live in them seldom enjoy good health; and their children com­monly die young. In the choice of a house, the greatest at­tention ought always to be paid to free air.

THE various methods which luxury has invented to make houses close and warm, contribute not a little to render them unwholesome. No house can be wholesome unless the air has a free passage through it. For which reason, houses ought daily to be ventilated by opening opposite win­dows, and admitting a current of fresh air into every room. This would expel any noxious vapour, and could not fail to promote the health of the inhabitants. In hospitals, jails, ships, &c. where that cannot be conveniently done, venti­lators should be used. The method of expelling foul, and introducing fresh air, by means of ventilators, is a most sa­lutary invention, and is indeed the most useful of all our modern medical improvements. We wish, for the benefit of mankind, it were more generally regarded. It is capable of universal application, and fraught with numerous advan­tages, both to those in health and sickness.

AIR not only loses its spring, and becomes unwholesome from heat and stagnation, but likewise from moisture. Thus, in low marshy countries, the air is generally bad, as also in countries over-run with wood, or any thing that sends forth moist exhalations.

AIR that stagnates in mines, wells, cellars, &c. must be noxious. That kind of air is to be avoided as the most deadly poison. It often kills almost as quick as lightening. For this reason, people should be very cautious in opening cellars that have been long shut, or going down into deep wells, especially if they have been close covered.

MANY people who have splendid houses, chuse to sleep in small apartments. This conduct is very imprudent. A bed-chamber ought always to be well aired; as it is gene­rally occupied in the night only, when all doors and win­dows are shut. If a fire be kept in it, the danger becomes still greater. Many have been stifled when asleep by a fire in a small apartment. Some are even so inconsiderate as to make fires in bed-chambers which have no chimneys, and imagine by using that kind of coal which has little or no [Page 51] smoke, that they are safe; whereas the danger becomes thereby the greater, such coal generally abounding with sulphur. The most fatal consequences are always to be dreaded from every attempt of this nature.

THOSE who are obliged, on account of business, to spend the day in close towns, ought, if possible, to sleep in the country. Breathing good air in the night will, in some measure, make up for the want of it through the day. This practice would have a greater effect in preserving the health of citizens than is commonly imagined.

CARE should be taken to admit a constant stream of fresh air into all crowded places, as churches, assembly-rooms, colleges, courts of justice, &c. The neglect of this has had so many fatal consequences, that it is sufficient only to men­tion it.

IT was necessary in former times, for safety, to surround cities, colleges, and even single houses, with high walls. These, by obstructing the current of air, never fail to ren­der such places damp and unwholesome. As such walls are now, generally speaking, become useless, they ought to be thrown down, and every method taken to admit a free pas­sage to the air. Were proper attention paid to AIR and CLEANLINESS, it would tend more to preserve the health of the inhabitants of great towns than all the endeavours of the Faculty.

IF fresh air be necessary for those in health, it is still more so for the sick, who often lose their lives for the want of it. The notion that sick people must be kept very hot, is so common, that one can hardly enter the chamber where a patient lies, without being ready to faint, by reason of the hot suffocating smell. How this must affect the sick, any one may judge. No medicine is so beneficial to the sick as fresh air. It is the most reviving of all cordials, if it be ad­ministred with prudence. We are not, however, to throw open doors and windows at random upon the sick. Fresh air is to be let into the chamber gradually, and, if possible, by opening the windows of some other apartment.

THE air of a sick person's chamber may be greatly fresh­ened, and the patient much revived, by sprinkling the floor, bed, &c. frequently with vinegar, juice of lemon, or any other strong vegetable acid.

IN places where numbers of sick are crowded into the same house, or, which is often the case, into the same apart­ment, fresh air becomes absolutely necessary. Infirmaries, [Page 52] hospitals, &c. often become so noxious for want of proper ventilation, that the sick run more hazard from them than from the disease; this is particularly the case when dysen­teries, putrid fevers, or other infectious diseases prevail.

PHYSICIANS, surgeons, and others who attend hospitals, ought, for their own sake, to take care that they be proper­ly ventilated. They are obliged to spend much of their time amongst the sick, and run great hazard of being them­selves infected when the air is bad. All hospitals, and places for the sick, ought to have an open situation, at some dis­tance from any great town.

WANT OF CLEANLINESS.

THE want of cleanliness is a fault which admits of no excuse. Where water can be had for nothing, it is surely in the power of every person to be clean. The continual dis­charge from our bodies by perspiration renders frequent changes of apparel necessary. Change of apparel greatly pro­motes the secretion from the skin, so necessary for health. When that matter which ought to be carried off by perspi­ration, is either retained in the body, or re-absorbed from dirty cloaths, it is apt to occasion fevers and other diseases.

MOST diseases of the skin proceed from want of cleanli­ness: These indeed may be caught by infection; but they will seldom continue long where cleanliness prevails. To the same cause must we impute the various kinds of vermine which infest the human body, houses, &c. These may ge­nerally be banished by cleanliness alone. Perhaps, the in­tention of nature in permitting such vermine to annoy man­kind, is to induce them to the practice of this virtue.

ONE common cause of putrid and malignant fevers is the want of cleanliness. These fevers commonly begin among the inhabitants of close, dirty houses, who breathe bad air, take little exercise, use unwholesome food, and wear dirty cloaths. There the infection is generally hatched, which often spreads far and wide, to the destruction of many. Hence cleanliness may be considered as an object of public attention. It is not sufficient that I be clean myself, while the want of it in my neighbour affects my health as well as his own. If dirty people cannot be removed as a common nuisance, they ought at least to be avoided as infectious. All who regard their health should keep at a distance even from their habitations.

[Page 53] IN places where great numbers of people are collected, cleanliness becomes of the utmost importance. It is well known, that infectious diseases are communicated by taint­ed air. Every thing, therefore, which tends to pollute the air, or spread the infection, ought, with the utmost care, to be avoided. For this reason, in great towns, no filth of any kind should be permitted to lie upon the streets. Nothing is more apt to convey infection than the excrements of the diseased. These, in many cases, are known to be highly in­fectious. The streets in many great towns are little better than dunghills, being frequently covered with ashes and nastiness of every kind. How easily might this be prevented by active magistrates, who have it always in their power to make proper laws relative to things of this nature, and to enforce the observance of them?

WE are sorry to say, that the importance of general clean­liness does by no means seem to be sufficiently understood. It were well if the inhabitants of Britain would imitate their neighbours the Dutch in the cleanness of their streets, houses, &c. Water, indeed, is easily obtained in Holland; but the situation of most towns in Britain is more favourable to cleanliness. Nothing can be more agreeable to the senses, more to the honour of the inhabitants, or conducive to their health, than a clean town; nor does any thing impress a stranger sooner with a disrespectful idea of any people than its opposite.

THE peasants in most countries seem to hold cleanliness in a sort of contempt. Were it not for the open situation of their houses, they would often feel the bad effects of this disposition. One seldom sees a farm-house without a dung­hill before the door, and frequently the cattle and their mas­ters lodge under the same roof. Peasants are likewise ex­tremely careless with respect to change of apparel [...] keeping their skins clean, &c. These are merely the effects of indo­lence and a dirty disposition. Habit may indeed render them less disagreeable; but no habit can ever make it salutary to wear dirty cloaths, or breathe unwholesome air.

IN camps the strictest regard should be paid to cleanliness. By negligence in this matter, infectious diseases are often spread amongst a whole army; and frequently more die of these than by the sword. The Jews, during their encamp­ments in the wilderness, received particular instructions with [Page 54] respect to cleanliness ^* The rules enjoined them ought to be observed by all in the like situation. Indeed the whole system of laws delivered to that people, has a manifest ten­dency to promote cleanliness. Whoever considers the na­ture of their climate, and the diseases to which they were liable, will see the propriety of such laws.

IT is remarkable, that in most eastern countries clean­liness makes a great part of their religion. The Maho­metan, as well as the Jewish religion, enjoins various ba­things, washings and purifications. No doubt these were designed to represent inward purity; but they are at the same time calculated for the preservation of health. How­ever whimsical these washings may appear to some, few things would tend more to prevent diseases than a proper attention to many of them. Were every person, for ex­ample, after handling a dead body, visiting the sick, &c. to wash before he went into company, or sat down to meat, he would run less hazard either of catching the infection himself, or communicating it to others.

FREQUENT washing not only removes the filth and [...]ordes which adhere to the skin, but likewise promotes the per­spiration, braces the body, and enlivens the spirits. Even washing the feet tends greatly to preserve health. The sweat and dirt with which these parts are frequently co­vered, cannot fail to obstruct the perspiration. This piece of cleanliness would often prevent colds and fevers. Were people careful to bathe their feet and hands in warm water at night, after being exposed to cold or wet through the day, they would seldom experience any of the fatal effects which often proceed from these causes.

A proper attention to cleanliness is no where more ne­cessary than on shipboard. If epidemical distempers break out there, no one can be safe. The best way to prevent them is to take care that the whole company be cleanly in their cloaths, diet, &c. When infectious diseases do break out, cleanliness is the most likely means to prevent their spreading. Above all things, the cloaths, bedding, &c. of the sick ought to be carefully washed, and fumigated with brimstone, or the like. Infection will lodge a long [Page 55] time in dirty cloaths, and will afterwards break out in the most terrible manner.

IN places where great numbers of sick people are kept, cleanliness ought most religiously to be observed. The very smell in such places is often sufficient to make one sick. It is easy to imagine what effect that is likely to have upon the diseased. A person in perfect health has a greater chance to become sick, than a sick person has to get well, in an hospital or infirmary, where cleanliness is neglected.

THE brutes themselves set us an example of cleanliness. Most of them seem uneasy, and thrive ill, if they be not kept clean. A horse that is kept thoroughly clean, will thrive better on a smaller quantity of food, than with a greater, where cleanliness is neglected. Even our own feelings are a sufficient proof of the necessity of cleanli­ness. How refreshed, how chearful and agreeable does one feel on being shaved, washed and dressed; especially when these offices have been long neglected? Most people esteem cleanliness; and even those who do not practise it themselves, often admire it in others. Superior cleanliness sooner attracts our regard than even finery itself, and often gains esteem where the other fails.

TO point out the numerous advantages arising from cleanliness of person, houses, streets, &c. would be a very useful and agreeable task; but as our plan only permits us to name things, we must conclude this article by recom­mending the practice of that virtue to people of all stations and conditions in life. We do not indeed pretend to rank cleanliness amongst the cardinal virtues; but we would re­commend it as necessary for supporting the dignity of hu­man nature, as useful and agreeable to society, and as highly conducive to health.

INTEMPERANCE.

A modern author ^* observes, that temperance and ex­ercise are the two best physicians in the world. He might have added, that if these were duly regarded, there would be little occasion for any other. Temperance may justly be called the parent of health; but numbers of mankind act as if they thought diseases and death too slow in their progress, and by intemperance and debauch seem, as it were, to sollicit their approach.

[Page 56] THE danger of intemperance appears from the very con­struction of the human body. Health depends on that state of the solids and fluids which fits them for the due perform­ance of the vital functions; and so long as these go regular­ly on, we are sound and well; but whatever disturbs them, necessarily impairs health. Intemperance never fails to dis­order the whole animal oeconomy; it spoils the digestion, relaxes the nerves, renders the different secretions irregular, vitiates the humours, and of course occasions diseases.

THE analogy between the nourishment of plants and animals affords a strong proof of the danger of intemper­ance. Moisture and manure greatly promote vegetation; but an over-quantity of either will entirely prevent it. The best things become hurtful, nay destructive, when carried to excess. From hence we learn, that the greatest pitch of human wisdom consists in regulating our appetites and pas­sions so as to avoid all extremes. 'Tis that alone which en­titles us to the character of rational beings. The slave of appetite will ever be the disgrace of human nature.

THE Author of nature hath endued us with various pas­sions, for the propagation of the species, the preservation of the individual, &c. Intemperance is the abuse of these pas­sions; and in the proper regulation of them moderation con­sists. Men, not content with satisfying the simple calls of nature, create artificial wants, and are perpetually in search after something that may gratify them; but imaginary wants can never be gratified. Nature is content with a little; but luxury knows no bounds. The epicure, the drunkard and the debauchee seldom stop in their career till cash or con­stitution fails: Then indeed they generally see their error, when too late.

IT is impossible to lay down determined rules of tem­perance, on account of the different constitutions of man­kind. The most ignorant person however certaily knows what is meant by excess; and it is in the power of every man to avoid it, if he chuses. The great rule in regulat­ing our diet, is to study simplicity. Nature delights in the most plain and simple food, and every animal, except man, follows her dictates. Man alone riots at large, and ransacks the whole creation in quest of luxuries, to his own destruction. An elegant writer ^* of the last age speaks thus of intemperance: ‘For my part, when I behold a fashionable table set out in all its magnificence, I fancy [Page 57] that I see gouts and dropsies, fevers and lethargies, with other innumerable distempers, lying in ambuscade among the dishes.’

INTEMPERANCE does not hurt it's votaries alone; the innocent too often feel the direful effects of it. How many wretched orphans are to be seen embracing dunghills, whose parents, regardless of the future, spent in riot and debauch what might have served decently to feed and cloath their offspring? How often do we behold the miserable mo­ther, with her helpless infants, pining in want, while the cruel father is indulging even at the expence of their lives!

FAMILIES are not only reduced to misery, but extirpated by means of intemperance. Nothing tends so much to pre­vent propagation, and to shorten the lives of children. The poor man who labours all day, and at night lies down contented with his humble fare, can boast a numerous off­spring, while his pampered lord, sunk in ease and luxury, has neither son nor nephew. Even states and empires feel the influence of intemperance, and rise or fall as it prevails.

INSTEAD of mentioning the different kinds of intem­perance, and pointing out their influence upon health, we shall confine our observations to one particular species of that vice, viz. the abuse of intoxicating liquors.

EVERY act of intoxication puts nature to the expence of a fever, in order to discharge the superfluous load; but when that is repeated almost every day, it is easy to foresee the consequences. That constitution must be strong indeed which is able long to hold out under a daily fever! But fevers occasioned by drinking do not always go off in a day; they frequently end in an inflammation of the breast, liver or brain, and produce fatal effects.

THOUGH the drunkard should not fall by an acute dis­ease, he seldom escapes those of a chronic nature. Intoxi­cating liquors, when used to excess, weaken the bowels and spoil the digestion; they destroy the power of the nerves, and occasion paralytic and convulsive disorders; they heat and inflame the blood, destroy it's balsamic qua­lity, render it unfit for circulation, and the nourishment of the parts, &c. Hence obstructions, atrophies, dropsies, and consumptions of the lungs. These are the common ways in which drunkards make their exit. Diseases of this kind, when brought on by hard drinking, seldom ad­mit of a cure.

[Page 58] MANY people injure their health by drinking, who sel­dom get drunk. The continual habit of soaking, as it is called, though its effects be not so violent, is no less per­nicious. When the vessels are kept constantly full and upon the stretch, the different digestions can neither be duly performed, nor the humours properly prepared. Hence most people of this character are afflicted with the gout, the gravel, ulcerous sores in the legs, &c. If these dis­orders do not appear, they are seized with low spirits, hypochondriacal disorders, and other symptoms of indi­gestion.

ALL intoxicating liquors may be considered as poisons. However disguised, that is their real character, and sooner or later they will have their effect. Consumptions are now so common, that it is thought one tenth of the inhabitants of great towns die of that disease. Drunkenness is one of the causes to which we must impute the increase of con­sumptions. The great quantities of viscid malt-liquor drank by the common people of England, cannot fail to render the blood [...]izy and unfit for circulation; from whence pro­ceed obstructions and inflammations of the lungs. There are few great ale-drinkers who are not phthisical; nor is that to be wondered at, considering the glutinous and almost indigestible nature of strong ale. Those who drink ardent spirits or strong wines, do not run less hazard; these liquors heat and inflame the blood, and tear the tender vessels of the lungs in pieces.

THE habit of drinking proceeds frequently from mis­fortunes in life. The miserable fly to it for relief. It af­fords them indeed a temporary ease. But alas, this solace is short-lived, and when it is over, the spirits sink as much below their natural pitch, as they had before been raised above it. Hence a repetition of the dose becomes necessary, and every fresh dose makes way for another, till the un­happy wretch becomes a slave to the bottle, and at length falls a sacrifice to what nature intended only as a medicine. No man is so dejected as the drunkard when his debauch is gone off. Hence it is, that those who have the greatest flow of spirits while the glass circulates freely, are of all others the most melancholy when sober, and often put an end to their own miserable existence in a fit of spleen or ill humour.

DRUNKENNESS not only proves destructive to health, but likewise to the faculties of the mind. It is strange, [Page 59] that creatures who value themselves on account of a su­perior degree of reason to that of brutes, should take plea­sure in sinking so far below them. Were such as volun­tarily deprive themselves of the use of reason, to continue ever after in that condition, it would seem but a just pu­nishment. Though that be not the consequence of one act of drunkenness, it seldom fails to succeed a course of intoxication. By a habit of drinking, the greatest genius is often reduced to a mere dunce.

INACTIVITY.

MANY look upon the necessity man is under of earning his bread by labour as a curse. Be that as it may, it is evident from the structure of the body, that exercise is not less necessary for the preservation of health, than food. Those whom poverty obliges to labour for daily bread, are not only the most healthy, but generally the most happy. Industry seldom fails to place such above want, and activity serves them instead of physic. This is peculiarly the case with those who live by the culture of the ground. The great increase of inhabitants in infant-colonies, and the common longevity of such as follow agriculture every where, evidently prove it the most healthful as well as the most useful employment.

THE love of activity shows itself very early in man. So strong is this principle, that a healthy youth cannot be restrained from exercise, even by the fear of punish­ment. Our love of motion is surely a strong proof of its utility. Nature implants no disposition in vain. Some imagine, that the love of motion was implanted in man, because without it he could not obtain the necessaries of life; but suppose the necessaries of life could be universally obtained without motion, it would nevertheless be indis­pensable. It seems to be a catholic law throughout the whole animal creation, that no creature, without exercise, can enjoy health. Every creature, except man, takes as much exercise as is necessary. He alone, and such animals as are under his direction, deviate from this original law, and they suffer accordingly.

INACTIVITY never fails to bring on universal relaxation of the solids, which occasions innumerable diseases. When the solids are relaxed, neither the digestion, nor any of the secretions, can be duly performed. In this case the [Page 60] worst consequences must ensue. How can those who loll all day in easy chairs, and sleep all night on a bed of down, fail to be relaxed? Nor do such greatly mend the matter, who never stir abroad but in a coach, or sedan, &c. These elegant pieces of luxury are become so common, that the inhabitants of great towns seem to be in some danger of losing the use of their limbs altogether. 'Tis now below any one to walk who can afford to be carried. How ridi­culous would it seem to a person unacquainted with modern luxury, to behold the young and healthy swinging along on the shoulders of their fellow-creatures! or to see a fat carcase, over-run with diseases occasioned by inactivity, dragged through the streets by half a dozen horses.

GLANDULAR obstructions generally proceed from in­activity. These are the most obstinate of all maladies. So long as the liver, kidnies, and other glands, duly perform their functions, health is seldom impaired; but when they fail, nothing can preserve it. Exercise is almost the only cure we know for glandular obstructions; indeed it does not always succeed, but there is reason to believe, that it would seldom fail to prevent these complaints. One thing is certain, that amongst those who take enough of exercise, glandular diseases are very little known; whereas the indolent and inactive are seldom free from them.

WEAK nerves are the constant companions of inactivity. Nothing but exercise and open air can brace and strengthen the nerves, or prevent the endless train of diseases which proceed from a relaxed state of these organs. We seldom hear the active or laborious complain of nervous diseases; these are reserved for the sons of ease and affluence. Many have been compleatly cured of nervous disorders by being reduced from a state of opulence to labour for their daily bread. This plainly points out the sources from whence such diseases flow, and the means by which they may be prevented.

IT is absolutely impossible to enjoy health without a free perspiration; but that necessary discharge never goes pro­perly on where exercise is wanting. When the matter which ought to be thrown off by perspiration, is retained in the body, it cannot fail to vitiate the humours. Hence proceed the gout, fevers, rheumatism, &c. In a word, none of the vital or animal functions can be duly per­formed when exercise is neglected. It alone would pre­vent [Page 61] many diseases which cannot be cured, and would re­move others where medicine proves ineffectual.

A late author ^*, in his excellent treatise on health, says, that the weak and valetudinary ought to make exercise a part of their religion. We would recommend this, not on­ly to the weak and valetudinary, but to all whose business does not oblige them to take sufficient exercise, as sedentary artificers, shop-keepers, studious people, &c. Such ought to take exercise as regularly as they take food. This, were people careful to husband their time well, might be done without any interruption to business or study.

No piece of indolence hurts the health more than the modern custom of lolling a-bed too long in a morning. This is universally the case in great towns. The inhabitants of cities seldom do much business before breakfast; but that is the best time for exercise, while the stomach is empty, and the body refreshed with sleep. Rising early would not on­ly give those who cannot leave their business through the day, an opportunity of taking exercise, but it would prevent the bad effects of loitering in bed too long. The morning air braces and strengthens the nerves, and, in some measure, answers the purpose of a cold bath. Let any one who has been accustomed to lie a-bed till eight or nine o'clock, rise by six or seven, spend a couple of hours in walking, riding, or any active diversion without doors, and he will find his spirits chearful and serene through the day, his appetite keen, and his body braced and strengthened. Custom soon ren­ders early rising agreeable, and nothing contributes more to the preservation of health.

EXERCISE, if possible, ought always to be taken in the open air. When that cannot be done, various methods may be contrived for exercising the body within doors, as dan­cing, fencing, the dumb bell, playing at tennis, &c. It is not necessary to adhere strictly to any particular kind of exercise. The best way is to take them by turns, and to use that longest which is most suitable to the strength and con­stitution. These kinds of exercise which give action to most of the bodily organs, are always to be preferred, as riding, walking, running, digging, swimming, and such like.

IT is much to be regretted, that active and manly diver­sions are now so little regarded. Diversions make people take more exercise than they otherwise would do, and are of the greatest service to such as are not under the necessity [Page 62] of labouring for their bread. As active diversions lose ground, those of a sedentary kind seem to prevail. Sedentary diversions are of no other use than to consume the time which might be employed in exercise: Instead of relieving the mind, they often require more thought than either stu­dy or business. Every thing that induces people to sit still, unless it be some necessary employment, ought to be avoided.

THE diversions which afford the best exercise are, hunt­ing, shooting, playing at cricket, hand-ball, golff ^*, &c. These exercise the limbs, promote perspiration, and the other secretions. They likewise strengthen the lungs, and give firmness and agility to the whole body.

SUCH as can, ought to spend two or three hours a-day on horseback; those who cannot, should employ the same time in walking. The best time for taking exercise is in the morning, or at least before dinner; but it should never be continued too long. Over fatigue prevents the benefit of exercise, and weakens instead of strengthening the body.

EVERY man should lay himself under some sort of necessi­ty to take exercise. Indolence, like all other vices, when in­dulged, gains ground, and at length becomes agreeable. Hence, many who were fond of exercise in the early part of life, become quite averse to it afterwards. This is the case of most hypochondriac and gouty people, which ren­ders their diseases in a great measure incurable.

IN some countries laws have been made, obliging every man, of whatever rank, to learn some mechanical employ­ment. Whether such laws were designed for the preserva­tion of health, or encouragement of manufacture, is a que­stion of no importance. Certain it is, that if gentlemen were frequently to amuse and exercise themselves in this way, it might have many good effects. They would, at least, derive as much honour from a few masterly specimens of their own workmanship, as from the character of having ruined most of their companions by gaming or hard drink­ing. Besides, men of leisure, by applying themselves to the mechanical arts, might improve them, to the great benefit of society. This would afford a more comfortable reflec­tion at the close of life, than the consciousness of having lived in the world for no other purpose than to eat and drink.

[Page 63] INDOLENCE not only occasions diseases, and renders men useless to society, but promotes all manner of vice. To say a man is idle, is perhaps, in the strongest terms, to call him vicious. The mind, if not engaged in some useful pursuit, is constantly in quest of ideal pleasures, or impressed with the apprehension of some imaginary evil. From these sources proceed most of the miseries of mankind. Sure man never was intended to be idle. Inactivity frustrates the very de­sign of his creation. An active life is the best guardian of virtue, and the greatest preservative of health.

INFECTION.

MOST diseases are infectious. Every person ought, there­fore, as far as he can, to avoid all communication with the diseased. The common practice of visiting the sick, though well meant, has many ill consequences. Far be it from us to discourage any act charity or benevolence, especially towards those in distress; but we cannot help blaming such as endanger their own or neighbours lives by a mistaken friendship, or an impertinent curiosity.

THE houses of the sick, especially in the country, are gene­rally crowded from morning till night with idle visitors. It is customary, in such places, for servants and young people to wait upon the sick by turns. It would be a miracle indeed should such always escape. Experience teaches us the dan­ger of this conduct. People often catch fevers in this way, and communicate them to others, till at length they be­come epidemic.

IT would be thought highly improper for one who had not had the small-pox, to wait upon a patient in that disease; yet many other fevers are almost as infectious as the small­pox, and not less fatal. Some imagine, that fevers prove more fatal in villages than in great towns, for want of pro­per medical assistance. How far that is true, we will not pretend to say; but we are inclined to think, that it rather proceeds from the cause above mentioned.

WERE a plan to be laid down for communicating infec­tion, it could not be done more effectually than by the common method of visiting the sick. Such visitors not only endanger themselves and their connections, but likewise hurt the sick. By crowding the house, they render the air un­wholesome, and by their private whispers and dismal coun­tenances, disturb the imagination of the sick and depress [Page 64] his spirits. Sick persons, especially in fevers, ought to be kept as quiet as possible. The sight of strange faces, and every thing that disturbs the mind, hurts them.

THE common practice in country places of inviting great numbers of people to funerals, and crowding them into the same apartment where the corpse lies, is another way of spreading infection. The infection by no means dies with the patient. In many cases it rather grows stronger as the body becomes putrid. This is peculiarly the case of those who die of malignant fevers, or other putrid diseases. Such ought not to lie long unburied; and people should keep at a distance from them. It is very common for people, after attending the funeral of a friend, to be seized with the same disease of which he died, and to share the same fate.

IT would tend greatly to prevent the spreading of infec­tious diseases, if those in health were kept at a proper dis­tance from the sick. The Jewish Legislator, among many other wise institutions for preserving health, has been pecu­liarly attentive to the means of preventing infection, or de­filement, as it is called, either from a diseased person or a dead body. In many cases the diseased were to be separated from those in health; and it was deemed a crime even to ap­proach their habitations. If a person only touched a dead body, he was appointed to wash himself in water, and to keep for some time at a distance from society.

INFECTIOUS diseases are often communicated by cloaths. It is extremely dangerous to wear apparel which has been worn by the diseased, as infection will lodge in it a long while, and afterwards produce very tragical effects. This shows the danger of buying at random the cloaths which have been used by other people.

INFECTIOUS disorders are frequently imported. Com­merce, together with the riches of foreign climes, brings us also their diseases. These do often more than counterbalance all the advantages of that trade, by means of which they are introduced. It is to be regretted that so little care is com­monly taken, either to prevent the introduction or spreading of infectious diseases. Some attention, indeed, is generally paid to the plague; but other diseases pass unregarded.

INFECTION is often spread by jails, hospitals, &c. These are frequently situated in the very middle of cities, or po­pulous towns; and when infectious diseases break out in them, it is impossible for the inhabitants to escape. Were magistrates to pay any regard to the health of the people, this evil might be easily remedied.

[Page 65] MANY are the causes which tend to diffuse infection through populous cities. The whole atmosphere of a large town is one contaminated mass, abounding with every kind of infection, and must be pernicious to health. The best advice that we can give to such as live in cities, is to choose an open situation; to avoid narrow, dirty, crowded streets; to keep their own houses and offices clean; to admit the fresh air every day into their apartments; and to be as much abroad as their time will permit.

IT would tend greatly to prevent the spreading of infec­tious diseases, were proper nurses every where employed to take care of the sick. This might often save a family, or even a whole town, from being infected by one person. We do not mean that people should abandon their friends or relations in distress, but only to put them on their guard against being too much in company with those who are af­flicted with diseases of an infectious nature.

SUCH as wait upon the sick in infectious diseases, ought to stuff their noses with tobacco, or some other strong smel­ling herb, as rue, tansy, or the like. They ought likewise frequently to sprinkle the room where the patient lies with vinegar, or other strong acids; and to avoid the patient's breath as much as they can.

HOWEVER easy these hints may seem; yet a proper atten­tion to them would save many lives. A fever, or other in­fectious disease, seldom breaks out in a family, but it affects the most of them, and frequently seizes every individual. The scenes of calamity and distress produced by this means, are too often witnessed by those who attend the sick.

YOUNG people are peculiarly liable to catch infection; and therefore ought to be kept at the greatest distance from the diseased. Their minds are easily affected with scenes of distress, and they often catch diseases even by the force of imagination.

WE would not only recommend it to magistrates, to take proper measures to prevent the spreading of infectious dis­eases, but also to masters of families. A single servant may spread a disease amongst a whole family, which may prove fatal to many of them. For this reason, when a servant is seized with a fever, or other infectious disease, he ought to be kept in some separate apartment, or rather sent to an hos­pital or infirmary. Servants would not only be taken better care of in this way, but fatal diseases might be often pre­vented.

[Page 66] INFECTION is often caught by sleeping with the diseased. Every person knows that this is the case in consumptions of the lungs; but other diseases are infectious as well as consumptions: Nay, we hardly know any disease that is not so in some degree. If a sound person communicates health, surely a diseased one must have the contrary effect. Were this attended to in the choice of companions for life, it would save many from a premature end.

NOT only the diseases of the body, but also those of the mind are infectious. For this reason, our companions ought to be of a sound mind, as well as a sound body. A melancholy person, for example, diffuses a gloom all around him, and generally taints the minds of his companions with the temper of his own. Those who would be healthy and happy, ought therefore to associate with the young, the chearful, and good humoured.

THE PASSIONS.

THE passions have great influence both in the cause and cure of diseases. How mind acts upon matter, will, in all probability, ever remain a secret. It is sufficient for us to know, that there is established a reciprocal influence be­twixt the mental and corporeal parts, and the whatever dis­orders the one likewise hurts the other.

THE passion of anger ruffles the mind, distorts the coun­tenance, hurries on the circulation of the blood, and disor­ders the whole vital and animal functions. It often occa­sions fevers, with other acute diseases; and sometimes brings on sudden death. This passion is peculiarly hurtful to the delicate, and those of weak nerves. I have known a hysteric woman lose her life by a violent fit of anger; all such ought to guard against the excess of this passion with the utmost ca [...]e.

IT is not always in our power of prevent being angry; but we may surely avoid harbouring resentment in our breast. Resentment preys upon the mind; it occasions the most ob­stinate chronical disorders, and gradually wastes the con­stitution. Nothing shows true greatness of mind more, than to forgive injuries: It promotes the peace of society, and greatly conduces to our own ease, health, and felicity.

SUCH as value health should avoid violent gusts of anger, as they would the most deadly infection. They ought never to indulge resentment, but to endeavour at all times to keep [Page 67] their minds calm and serene. Nothing tends so much to the health of the body as a constant tranquillity of mind.

THE influence of fear, both in occasioning and aggra­vating diseases, is very great. No man ought to be blamed for a decent concern about life; but too great a desire to preserve it, is often the way to lose it. Fear and anxiety, by depressing the spirits, pre-dispose us to diseases, and often render those fatal, which an undaunted mind would overcome.

SUDDEN fear has generally violent effects. Epilectic fits, and other convulsive disorders, are often occasioned by it. Hence the danger of that practice, so common among young people, of frightening one another. By this many have lost their lives, and others have been rendered useless ever after. It is dangerous to tamper with the human pas­sions. They may easily be thrown into such disorder as never again to act with regularity.

BUT the gradual effects of fear prove more generally hurtful. The constant dread of some future evil, by dwell­ing upon the mind, often occasions the very evil itself. Hence it comes to pass, that so many die of these diseases, of which they long had a dread, or which some accident, or foolish prediction, had impressed on their minds. This often happens to women in childbed. Many of those who die in that situation, are impressed with the notion of their death a long while before it happens; and there is reason to believe, that such impressions are often the cause of it.

THE methods taken to impress the minds of women with apprehensions of the great danger and peril of child­birth, are very hurtful. Few women die in labour, though many lose their lives after it; which may be thus accounted for. A woman after delivery finding herself weak and ex­hausted, immediately apprehends she is in danger; but fear seldom fails to obstruct the necessary evacuations, upon which her recovery depends. Thus the sex often fall a sacrifice to their own imaginations, when there would be no danger, did they apprehend none.

IT seldom happens, that two or three women, who are generally known, die in child-bed, but their death is fol­lowed by many others. Every woman of their acquaint­ance who is with child, dreads the same fate, and the dis­ease becomes epidemical by the mere force of imagination. This should induce pregnant women to dispise fear, and [Page 68] by all means to avoid those tattling gossips, who are con­tinually telling them the misfortunes of others. Every thing that may in the least alarm a pregnant or child-bed woman, ought with the greatest care to be guarded against. Many women have lost their lives in child-bed by the old superstitious custom, still kept up in most parts of Britain, of tolling the parish-bell for every person who dies. People who think themselves in danger, are very inquisitive; and if they come to know, that the bell tolls for one who died in the same situation, what must be the consequence?

BUT this custom is not pernicious to child-bed women only. It is hurtful in many other cases. When low fe­vers in which it is difficult to support the patient's spirits, prevail, what must be the effect of a funeral peal sound­ing five or six times a day in his ears? His imagination will no doubt suggest, that others died of the same dis­ease, which he labours under. Nor will the matter be at all mended by endeavouring to persuade him of the contrary. This will tend rather to confirm than remove his suspicions.

IF this childish custom cannot be abolished, we ought to keep the sick as much from hearing it as possible, and from every thing else that may tend to alarm them. So far is this from being attended to, that many make it their busi­ness to visit the sick, on purpose to whisper dismal stories in their ears. Such may pass for sympathizing friends, but they ought rather to be reckoned enemies, and ranked amongst murderers. All who wish well to the sick, ought to keep such persons at the greatest distance from them.

A custom has long prevailed among physicians of prog­nosticating, as they call it, the patient's fate, or foretelling the issue of the disease. Vanity no doubt introduced this practice, and still supports it, in spite of common sense and the safety of mankind. I have known a physician barbarous enough to boast, that he pronounced more sen­tences than all his Majesty's judges. Would to God that such sentences were not often equally fatal! It may be alledged, that the doctor does not declare his opinion be­fore the patient. So, much the worse. A sensible patient had better hear what the doctor says, than learn it from the disconsolate looks, the watery eyes, and the broken whispers of those about him. It seldom happens, when the doctor gives an unfavourable opinion, that it can be [Page 69] concealed from the patient. The very emberassment which generally appears in disguising what he has said, is sufficient to discover the truth.

WE do not see what right any man has to announce the death of another, especially if such a declaration has a chance to kill him. Mankind are indeed very fond of prying into future events, and seldom fail to importune the physician for his opinion. A doubtful answer, however, or one that may tend to encourage the hopes of the patient, is surely the most safe. This conduct could neither hurt the patient nor the physician. Nothing tends more to de­stroy the credit of physic than those bold prognosticators, who, by the by, are generally the most ignorant. The mistakes which daily happen in this way, are so many standing proofs of human vanity, and the weakness of science.

THE vanity of foretelling the fate of the sick is not peculiar to the Faculty. Others follow their example, and those who think themselves wiser than their neighbours, often do much mischief, in this way. Humanity surely calls upon every one to comfort the sick, and not to add to their affliction, by alarming their fears. A physician may often do more good by a mild and simpathizing be­haviour than by medicine, and should never neglect to ad­minister that greatest of all cordials, HOPE.

GRIEF is the most destructive of all the passions. Its effects are permanent, and when it sinks deep into the mind, it generally proves fatal. Anger and fear being of a more violent nature, seldom last long; but grief often changes into a fixed melancholy, which preys upon the spirits, and wastes the constitution. We should beware of the indulging this passion. It may generally be conquered at the beginning; but when it has gained strength, all our attempts become vain.

NO person can prevent misfortunes; but it shows true greatness of mind to bear them with serenity. Many make a merit of indulging grief, and when misfortunes happen, they obstinately refuse all consolation, till the mind, over­whelmed with melancholy, sinks under the load. Such conduct is not only destructive to health, but inconsistent with reason, religion and common sense.

CHANGE of ideas is as necessary for health as change of posture. When the mind dwells long upon one object, especially of a disagreeable nature, it hurts the whole func­tions [Page 70] of the body. Thus grief indulged spoils the digestion, and destroys the appetite. By that means the spirits are de­pressed, the nerves relaxed, the bowels inflated with wind, and the humours, for want of fresh supplies of chyle, vi­tiated. Thus many an excellent constitution has been ruined by a family-misfortune, or any thing that occa­sioned excessive grief.

IT is utterly impossible, that any person of a dejected mind should enjoy health. Life may indeed be dragged on for a few years: But whoever would live to a good old age, must be good humoured and chearful. This indeed is not altogether in our own power; yet our temper of mind, as well as actions, depends greatly upon ourselves. We can either think of agreeable or disagreeable objects, as we chuse; we can go into chearful or melancholy com­pany; we can mingle in the amusements and offices of life, or [...]it still and brood over our calamities. These, and many such things, are certainly in our power, and from these the mind generally takes its cast.

THE variety of scenes which present themselves to the senses, were certainly designed to prevent our attention from being too long fixed upon any one object. Nature abounds with variety, and the mind, unless fixed down by habit, delights in contemplating new objects. This at once points out the method of relieving the mind in dis­tress. Turn the attention to other objects. Examine them with accuracy. When the mind begins to recoil, shift the scene. By this means a constant succession of new ideas may be kept up, till the disagreeable ones entire­ly disappear. Thus travelling, the study of any art or science, reading or writing on such subjects as engage the attention, will sooner expel grief than the most sprightly amusements.

IT has already been observed, that exercise is absolutely necessary for the health of the body; but it is no less so for that of the mind. Indolence nourishes grief. When the mind has nothing else to think of but calamities, no wonder that it dwells there. Few people who pursue busi­ness with attention, are hurt by grief. Instead of abstract­ing ourselves from the world or business, when misfortunes happen, we ought to engage in it with more than usual at­tention, to discharge with double diligence the functions of our station, and to mix with friends of an easy social temper.

[Page 71] INNOCENT amusements are by no means to be neglected. These, by leading the mind insensibly to the contemplation of agreeable objects, help to dispel the gloom which mis­fortunes cast over it. They make time seem less tedious, and have many other happy effects.

SOME, when overwhelmed with grief, betake themselves to drinking. This is making the cure worse than the dis­ease. It seldom fails to end in the ruin of fortune, cha­racter and constitution.

THE best way to counteract the violence of any passion is to encourage its opposite. Thus, under the most pres­sing calamities, HOPE is always to be kept in view. Hope is the very support of life, and absolutely necessary to the happiness of a rational being.

SHOULD all other means of comfort fail, the Christian religion affords an inexhaustible source of consolation. It teaches us, that the sufferings of this life are designed to prepare us for a future state of happiness, and that all who pursue the paths of virtue, shall at last arrive at complete felicity.

OF ARTIFICERS, LABOURERS, &c.

THAT men are exposed to particular diseases from the occupations which they follow, is a fact well known; but to remedy that evil, is a difficult matter. People are under a necessity of pursuing the employments in which they are bred, whether they be favourable to health or not. Hence all that we can propose, under this article, is to point out those diseases to which men are more immediately exposed from their particular occupations; and to shew how far such diseases, by due care, may be avoided.

THE first cause of the diseases of artificers that we shall mention, is the unwholesome smells and noxious exhala­tions which often proceed from those materials in which they are employed. Thus tallow-chandlers, boilers of oil, [...]ssers of leather, and all who work upon putrid animal [Page 72] substances, are afflicted with diseases of the stomach and lungs. Ill smells not only create a nausea and hurt the di­gestion, but even taint the humours themselves, and fre­quently prove the cause of fevers, consumptions, &c.

THESE occupations are not only hurtful to those as are employed in them, but likewise to those who live in the neighbourhood of the places where they are carried on; for which reason they ought always to be at a proper dis­tance from any town.

THE best advice that we can give to such as are em­ployed in this way, is, to pay the utmost attention to clean­liness. They are indeed obliged to wear dirty cloaths while at work; but the moment they leave off, they ought to wash themselves, strip of their dirty cloaths, put on clean ones, and remove at a proper distance from the smell of their work­shops, &c. No one who has not made the trial, can imagine how far an attention to these, and other pieces of cleanli­ness, will go in preserving the health of those artificers who are obliged to follow such employments.

CHYMISTS, founders, glass-makers, &c. besides the noxious exhalations from those bodies in which they work, are forced to breathe an air that is in a manner burnt, or at least too much rarified to expand the lungs, or answer the important purposes of respiration. Such people are ge­nerally thin, pale, and of a weak consumptive habit. They are melted down with sweat, in order to supply which eva­cuation, large quantities of liquor become necessary. Thus by hard working and fast living their constitutions are worn out in a few years.

SUCH artists ought to work by turns, and should never continue long near the furnace at a time. They should be careful, when they leave off work, to cool gradually, avoid­ing every thing that may suddenly check the perspiration. The places where these occupations are carried on, should be properly constructed for discharging the smoke and other exhalations, and admitting a free current of fresh air; otherwise the people who work in them, can never enjoy health.

THE exhalation from metals and minerals is not only hurtful to founders, chymists, and others who manufacture them for particular purposes, but likewise to miners, or those who dig them out of the earth. Fallopius observes, that such as work in mines of mercury, seldom live above three or four years. They are generally affected with pals [...], [Page 73] vertigos, and other diseases of the nerves, which soon put an end to their miserable lives. Those also who work in lead-mines are very liable to paralytic disorders, with gripes, cholics, and other complaints of the bowels.

MINERS suffer from their situation as well as from the me­tals in which they work. The air in mines being totally excluded from the sun's rays, by stagnation loses its spring, and often becomes damp. This kind of air is to be avoided as the most deadly poison: Besides, mines are often wet, which renders them still more hurtful. This is one reason why miners are very subject to aches, cramps, and rheumatic pains, &c.

MINERS should never continue too long under ground at a time; neither ought they at any time to go to work fast­ing, nor to suffer their stomachs to be empty while they continue in the mines. They ought not to live too low; and their liquor should be generous. They should by all means avoid costiveness, by either taking food of an open­ing nature, or, when that does not succeed, a gentle purge. Oils are found to be a good preservative against gripes from the affluvia of metals. Oils both open the belly, and sheath the coats of the intestines, which prevents their be­ing hurt by the poisonous particles of the metal.

MINERS should by all means take care that the air have a free current through the mines, and that neither it nor the water be suffered to stagnate. All who work in mines or metals ought to wash when they leave off work, and to change their cloaths. Those parts of the metal which ad­here to the skin or the cloaths, being continually absorbed into the body, must necessarily do hurt. People are too apt to look upon such circumstances as unworthy their at­tention; but these small causes, by being neglected, never fail to produce the most dreadful effects.

PLUMBERS, painters, gilders, and all who work in me­tals, are subject to the same diseases as those who dig them. They are afflicted with colics, asthmas, palsies, &c. and should observe the same precautions as miners. It is impos­sible for people thus employed, at all times to avoid some degree of danger; but it consists with observation, that, by [...]e care, they may prolong their lives to a good old age, [...]th a tolerable share of health. We have seldom seen a person in danger from any of the above causes, but it pro­ceeded from his own foolhardiness or want of care.

[Page 74] AS it would greatly exceed our bounds to specify the disorders peculiar to every occupation, we shall therefore consider mankind under the following general classes, viz. Laborious, Sedentary and Studious.

The LABORIOUS.

THOUGH those who follow laborious employments are in general the most healthy. yet the nature of their occupati­ons, and the places where they are carried on, expose them to many diseases. Husbandmen, for example, are exposed to all the vicissitudes of the weather, which are often very great and sudden. They are likewise forced to work hard, and often to carry loads above their strength, which by overstraining the vessels, occasion ma­ny diseases, as asthmas, fevers, ruptures, &c.

INTERMITTENT fevers, or agues, are very common a­mongst those who labour without doors. These are occasi­oned by the frequent vicissitudes of heat and cold to which they are exposed, by the bad water which they are often obliged to drink, by the low marshy situation of their hou­ses, and by their frequent exposure to the evening dews, night-air, &c.

ASTHMAS and inflammations of the breast are very inci­dent to the laborious. These are occasioned by the violent exercise and the frequent extremes of heat and cold to which they are exposed. Those who bear heavy burdens, as porters, &c. are obliged to draw in the air with much greater force, and also to keep their lungs distended with more violence than is necessary for common respiration: By this means the tender vessels of the lungs are over distended. and often burst, insomuch that a spitting of blood or fevers en­sues. Hippocrates mentions an instance to this purpose of a man. who, upon a wager, had carried an ass. The man, he says, was immediately seized with a fever, a vo­miting of blood, and a rupture.

CARRYING very heavy burdens is often the effect of mere indolence, which prompt people to do at once, what should be done at twice. It likewise proceeds frequently from bravado, or an emulation to outdo others. Hence it is that the strongest men are most generally hurt by heavy burdens, hard labour, or feats of activity. It is rare to find one who excels in this way, without a hernia, a haemoptoe, or some other disease, which he enjoys as the fruit of his fol­ly. [Page 75] One would imagine, that the daily instances we have of the fatal effects of carrying great weights, running, wrestling, &c. should be sufficient to put a stop to such practices.

THERE are indeed some employments which necessarily require a violent exertion of strength, such as blacksmiths, carpenters, &c. None ought to follow these occupations but men of a strong body; and they should never exert their strength to the utmost, nor work too long. When the muscles are violently strained, frequent rest is necessary, in order that they may recover their tone; where that is ne­glected, the strength and constitution will soon be wore out, and a premature old age brought on.

THE quinsy and erisipelas, or St. Anthony's fire, are likewise diseases very incident to the laborious. These are occasioned by whatever gives a sudden check to the perspi­ration, as drinking cold liquor when the body is warm, keeping on wet cloaths, sitting or lying on the cold ground, damp houses, wet feet, &c. As the great dan­ger of these practices has already been pointed out, it is un­necessary to insist upon them here.

THE laborious are often afflicted with the iliac passion, the colic, and other complaints of the bowels. These are often occasioned by wet feet, or wet cloaths; but they more generally proceed from flatulent and indigestable food. Labourers eat unfermented bread made of peas, beans, rye, and other windy ingredients. They also eat great quanti­ties of unripe fruits, baked, stewed, or raw, with various kinds of roots and herbs, upon which they drink sour milk, stale small beer, &c. Such a composition cannot fail to fill the bowels with wind, and occasion diseases. Ac­cordingly we find these people in the decline of life univer­sally complaining of flatulencies; a disorder which renders many of them very unhappy, and for which no cure is yet known. The best advice that we can give them is to avoid windy food as far as possible.

INFLAMMATIONS, whitlows, and other diseases of the ex­tremities, are very common amongst them who labour without doors. These diseases are often attributed to ve­nom, or some kind of poison; but they generally proceed either from sudden heat after cold, or the contrary. When such people come from the fields cold and wet, they run to the fire, and often plunge their hands in warm water, by which means the blood and other humours in these parts are suddenly expanded, the vessels not yielding so quickly, [Page 76] a strangulation happens, and an inflammation or mortificati­on ensues.

WHEN labourers come home cold, they ought to keep at a distance from the fire for some time, to wash their hands in cold water, and to rub them well with a dry cloth. It sometimes happens that people are so benumbed with cold, as to lose the use of their limbs altogether. In such a case the only remedy is to rub the parts affected with snow, or, failing it, with cold water. If they be held near the fire, or plunged into warm water, a mortification will certainly en­sue.

LABOURERS in the hot season are apt to lie down and sleep in the sun. This practice is so dangerous, that they often rise in a high fever. The burning fevers which prove so fatal about the end of summer, and beginning of autumn, are often occasioned by this means. When la­bourers leave off work, which they ought always to do du­ring the heat of the day, they should go home, or, at least, get under some cover, where they may repose themselves in safety.

THE different seasons of the year expose those who la­bour without doors to different diseases. Thus in the spring agues are frequent: in summer, as has been observed, burning fevers abound; and in autumn, dysenteries and fluxes prevail. The latter proceed not only from the per­spiration being, at that time, obstructed, but also from the green trash, or unripe fruits, which country people eat in great quantities. Indeed if fruit be ripe, and eat in mode­ration, it rather prevents than occasions dysenteries; but it is equally certain, that much bad fruit will bring on a flux.

LABOURERS are often hurt by long fasting. They fre­quently follow their employments in the fields from morn­ing till night, without eating any thing. This cannot fail to hurt their health. However homely their fare be, they ought to have it at regular times, and the harder they work, the more frequently should they eat.

LABOURERS likewise suffer from the nature of their food. They are extremely careless with respect to what they eat or drink, and often through mere indolence, eat unwholesome food, when they might, for the same expence, have that which is wholesome. The poor often hurt their health for want of a proper method of living, and in the end save nothing by it. In many parts of Britain, the pea­sants are too careless to take the trouble of dressing their [Page 77] victuals, though they have feuel for nothing. Such peo­ple will live upon one meal a-day in indolence, rather than labour, though it were to procure them the greatest afflu­ence.

POVERTY is doubtless a very general cause of diseases a­mong the labouring part of mankind. Few of them have [...]ch foresight; and if they had, it seldom is in their power to lay any thing up against hard times. They are glad to make a shift to live from day to day; and when any disease renders them unfit for work, their families are ready to starve. Here the God-like virtue of charity ought ever to exert herself. To relieve the industrious poor when in dis­tress, is surely the most exalted act of religion, and can never lose its reward. They alone who witness those scenes of calamity, can form a notion of what numbers pe­rish in diseases for want of proper assistance, and even for want of the necessaries of life. It were to be wished, for the honor of human nature, as well as for the good of society, that these things were more looked into.

FEVERS of a very bad kind are often occasioned by what is called poor living. When the body is not sufficiently nourished, the humours become bad, and the spirits sink; from whence the most fatal consequences must ever ensue. Poor living is likewise productive of cutaneous diseases. It is remarkable that cattle, when pinched in their food, are generally affected with diseases of the skin. These diseases seldom fail to disappear when they are put upon good pa­sture: which shews how much a good state of the humours depends upon a sufficient quantity of proper nourishment.

LABOURERS often suffer from a foolish emulation, which prompts them to vie with one another, till they drop down dead, or over-heat themselves to such a degree as to occasi­on a fever. As this is the effect of vanity, it ought always to be checked by those who have the superintendance of them. Such as wantonly throw away their lives in this manner, deserve to be looked upon in no better light than self-murderers. It is pity that poor widows and father­less children should suffer by such childish conduct: Could we speak to the passions of men, we would bid them think of these, and then consider of how great importance their lives are.

THE office of a soldier in time of war, may be ranked amongst laborious employments. Soldiers suffer many hardships from the inclemency of seasons, long marches, [Page 78] hunger, bad provisions, &c. These occasion fevers, flux­es, rheumatisms, and other fatal diseases, which often do more execution than the sword, especially when campaigns are continued too late in the season. One week of cold rainy weather will kill more men than many months when it is dry and warm.

EVERY commander should take care that his soldiers be well clothed and well fed. He ought also to endeavour to put an end to the campaign in due season, and to provide his men with winter quarters that are dry and well-aired. These easy rules, with taking care to keep the sick at a pro­per distance from those in health, will go a great length in preserving the lives of the soldiery.

IT is indeed to be regretted, that soldiers suffer no less by indolence and intemperance in time of peace, than from hardships in time of war. When men are idle, they will be vicious. It would therefore be of the greatest importance, could a scheme be formed for rendering the military in time of peace less vicious, more healthy, and more useful to society. All those desirable objects might certainly be promoted by only employing them five or six hours every day, and advancing their pay in proportion. By this means idleness, the mother of vice, would not only be pre­vented, but the price of labour might be lowered. Public works, as harbours, canals, turn-pike roads, &c. might be made without hurting manufactures; and soldiers might be enabled to marry, and bring up children.

A SCHEME of this kind might be so conducted as to raise instead of depressing the martial spirit, provided the men were never allowed to work above a certain number of hours, and obliged always to work without doors. No soldier should ever be allowed to work too long, nor per­mitted to follow any sedentary employment. Sedentary employments render men weak and effeminate, and quite unfit for the hardships of war; whereas working a few hours daily without doors would innure them to the wea­ther, brace their nerves, and promote their strength and courage.

SAILORS may also be numbered amongst the laborious. They undergo great hardships from change of climate, the violence of weather, hard labour, bad provisions, &c. Sai­lors are of so great importance both to the trade and safety of this kingdom, that too much pains can never be bestowed in pointing out the proper means of preserving their lives.

[Page 79] EXCESS is one great source of the diseases of sea-faring people. When they get on shore, after being long at sea, without regard to the climate, or their own constitutions, they plunge headlong into all manner of riot, and often per­sist till a fever puts an end to their lives. Thus intemperance, and not the climate, is often the cause why so many of our brave sailors die on foreign coasts. We would not have sea-faring people live too low; but they will find tempe­rance the best defence against fevers, and many other ma­ladies.

SAILORS when on duty are often exposed to cold and wet. When that happens, they should change their cloaths as soon as they are relieved, and take every proper method to restore the perspiration. In this case they should not have recourse to spirits, or other strong liquors, but should rather drink such as are weak and diluted, of a proper warmth, and go immediately to bed, where a sound sleep and a gentle sweat will set all to rights.

THE health of sailors suffers most from unwholesome food. The constant use of salted provisions vitiates the whole humours, and occasions the scurvy, and other obsti­nate maladies. It is no easy matter to prevent this disease in long voyages; yet we cannot help thinking, that much might be done towards effecting so desirable an end, were due pains bestowed for that purpose. For example, various roots, greens, and fruits might be kept a long time at sea, as potatoes, cabbages, lemons, oranges, tamarinds, apples, &c. When fruits cannot be kept the juices of them either fresh or fermented, may. With these all the drink, and even the food of the ships company, ought to be acidulated in long voyages. But suppose the vegetable acids should fail, yet the chymical, as cream of tartar, elixir of vitriol, &c. may be kept for any length of time; and as they are attended with no expence, it is in the power of every sailor to lay in enough of these for the longest voyage. These, though not so good as vegetable acids, are still better than none, and should always be used when the others fail.

STALE bread and beer likewise contribute to vitiate the humours. Meal will keep for a long while on board, of which fresh bread might frequently be made. Malt too might be kept on board, and infused with boiling water at any time. This liquor, when drank even in the form of wort, is very wholesome, and is found to be an excellent antidote against the scurvy. Small wines and cyder might [Page 80] likewise be plentifully laid in, and should they turn sour, they would still be useful, as vinegar. Vinegar is a very great antidote against diseases, and should be used by all travellers, especially at sea.

SUCH animals as can be kept alive ought likewise to be carried on board, as hens, ducks, pigs, &c. Fresh broths made of portable soup, and puddings made of peas, or other vegetables, ought to be used frequently. Many o­ther things will occur to people conversant in these matters, which would tend to preserve the health of that brave and useful set of men. Pity it is that so little attention should be paid to these things by such as have it in their power to rec­tify them; but interest binds the eyes of some, while others, totally regardless of the future, will make no provision a­gainst diseases till they feel them.

THERE is reason to believe, if care were taken with re­spect to the diet, air, cloathing, &c. of sea-faring people, that they would be the most healthy set of men in the world; but when these are not duly regarded, the very reverse must happen.

PERUVIAN bark is the best medical antidote that we can recommend to sailors or soldiers on foreign coasts. This will often prevent fevers, and other fatal diseases. A dram or so of it may be chewed every day, or if this should prove disagreeable, an ounce of bark, with half an ounce of orange-pill, and two drams of snake-root coarsely pow­dered, may be infused for two or three days in an English quart of brandy, and half a wine glass of it taken twice or thrice a-day, when the stomach is most empty. This has been found to be an excellent antidote against fluxes, putrid, intermitting, and other fevers, in unhealthy climates. It is not material in what form this medicine be administred. It may either be infused in water, wine, or spirits, as re­commended above, or made into an electuary with syrup of lemons, oranges, or the like.

The SEDENTARY.

THOUGH nothing can be more contrary to the nature of man than a sedentary life, yet the far greater part of the human species are comprehended under this class. Almost the whole female world, and, in manufacturing countries, the major part of the males, may be reckoned sedentary.

AGRICULTURE, the first and most healthful of all em­ployments, is now followed by few who are able to carry on any other business. Those who imagine that the culture of the earth is not sufficient to employ all its inhabitants, are greatly mistaken. An ancient Roman, we are told, could maintain his family from the produce of one acre of ground. So might a modern Briton, if he could be con­tented to live like a Roman. This shows what an immense increase of inhabitants Britain might admit of, and all of them live by the culture of the ground. Agriculture is the great source of domestic riches. It is of all employments the most favourable to health and population. When it is neglected, whatever wealth may be imported from abroad, poverty, wretchedness, and misery will abound at home. Such is, and ever will be, the fluctuating nature of manu­factures, that ten thousand people may be in bread to-day, and in beggary to-morrow. This can never happen to those who cultivate the ground. They can eat the fruit of their labour, and can always by industry obtain, at least, the necessaries of life.

THO' sedentary employments be necessary, yet there seems to be no reason why any person should be confined for life to these alone. Were such employments intermixed with the more active and laborious, they would never do hurt. It is constant confinement that ruins the health. A man many not be hurt by sitting four or five hours a-day, who, were he obliged to sit ten or twelve, would soon con­tract diseases.

BUT it is not want of exercise alone which hurts sedenta­ry people; they often suffer from the unwholesome air which they breathe. It is very common to see ten or a do­ [...] taylors, or stay-makers, for example, crouded into one small appartment, where there is hardly room for one [...]gle person [...] freely. In this situation they gene­rally [Page 82] continue for many hours at a time, with often the ad­dition of sundry candles, which help to waste the air, and render it less fit for respiration. Air that is breathed over and over, loses its spring, and becomes unfit for expanding the lungs. This is one cause of the phthisical coughs, and other complaints of the breast, so incident to sedentary ar­tificers.

EVEN the perspiration from a great number of bodies pent up together, renders the air unwholesome. The danger from this quarter is greatly increased, if any of them hap­pens to have bad lungs, or to be other ways diseased. Those who sit near him, being forced to breathe the same air, can hardly fail to be infected. It would be a rare thing indeed to find a dozen of sedentary people all sound. The danger of crouding them together must therefore be evident to eve­ry one.

MANY of those who follow sedentary employments are constantly in a bending posture, as shoemakers, taylors, cutlers, &c. Such a situation is extremely hurtful. A bending posture obstructs all the vital motions, and of course must ruin the health. Accordingly we find such artificers generally complain of indigestions, flatulencies, headaches, pains of the breast, &c. In such people the first concoction is generally bad, and as that fault can never be mended in any of the subsequent ones, it cannot fail to induce a total vitium of the humours, which paves the way to innumerable diseases.

THE aliment in sedentary people, instead of being push­ed forwards by an erect posture, the action of the muscles, &c. is in a manner confined in the bowels. Hence costive­ness, wind, and other hypocondriacal symptoms, the never failing companions of the sedentary. Indeed none of the secretions can be duly performed where exercise is wanting, and when any one of these is retained too long in the body, it must have bad effects, as it is again taken up into the mass of humours.

A bending posture is very hurtful to the lungs. When this organ is compressed, the air cannot have free access in­to all its parts, so as to expand them properly. Hence tu­bercles, adhesions, &c. are formed, which often end in consumptions. The proper action of the lungs is like­wise necessary for making good blood. When that organ fails, the humours soon [...] universally de­praved, and the whole constitution go [...] to wreck. [...] fine, both the pectoral and abdominal viscera ought to be kept as free and easy as possible. Their continual action [Page 83] is absolutely necessary to life, and being of a soft texture, their functions are easily obstructed by any sort of pressure.

THE sedentary are not only hurt by pressure on the bow­els, but also on the inferior extremities, which obstructs the circulation in these parts, and renders them weak and feeble. Thus taylors, shoemakers, &c. frequently lose the use of their legs altogether; besides the blood and other humours, by stagnating in these parts, are vitiated; from whence proceed the scab, ulcerous sores, foul blotches, and other cutaneous diseases, so common among sedentary artificers.

A bad figure of body is a very common consequence of close application to sedentary employments. The spine, for example, by being continually bent, puts on a crooked shape, and generally remains so ever after. But a bad fi­gure of body has already been observed to be hurtful to health, as the vital functions, &c. are thereby impeded.

A sedentary life never fails to occasion an universal relax­ation of the solids. This is the grand source from whence most of the diseases of sedentary people flow. The scro­fula, consumption, rickets, and many other maladies which now abound, were little known in this country before se­dentary artificers became so numerous; and they are very little known still among such of our people as follow active employments without doors, though in the great manufac­turing towns, at least two thirds of the inhabitants are af­flicted with them.

IT is the more difficult to remedy those evils, because many who have been accustomed to a sedentary life, like rickety children, lose all inclination for exercise; we shall however give a few hints with respect to the most likely means for preserving the health of this useful set of people, which some of them, we hope, will be wise enough to ob­serve.

IT has been observed, that sedentary artificers are often hurt by their bending posture. They ought therefore to stand or sit as erect as the nature of their employments will permit. They should likewise change postures frequently, and should never sit too long at a time, but leave off work and walk, ride, run, or do any thing that will promote the vital functions.

SEDENTARY artificers are allowed too little time for ex­ercise; yet, short as it is, they seldom employ it properly. A journeyman taylor or weaver, instead of walking abroad [Page 84] for exercise and fresh air, at his hours of leisure, chooses often to spend them in a publick house, or in pursuing some sedentary diversion, at which he generally loses both his time and money.

THE awkward postures in which many sedentary artifi­cers work, seem rather to be the effect of custom than ne­cessity. For example, a table might surely be contrived for ten or a dozen taylors to sit round it, with liberty for their legs either to hang down, or rest upon a foot-board, as they should choose. A place might be cut out in the table for every person to sit in, by which means his work would lie as ready to his hand, as in the present mode of sitting cross-legged.

WE would recommend to all sedentary artificers the most religious regard to cleanliness. Both their situation and oc­cupations render this highly necessary. Nothing would contribute more to preserve sedentary artificers in health, than a strict attention to this rule; and such of them as ne­glect it, not only run the hazard of losing their health, but of becoming a nuisance to society.

SEDENTARY people should live spare. They ought like­wise to avoid food that is windy, or hard of digestion, and should pay the strictest regard to sobriety. A person who works hard without doors will soon throw off an overcharge of liquor, but one who sits has by no means an equal chance. Hence it often happens, that sedentary people are seized with fevers after hard drinking. When such people feel their spirits low, instead of running to the tavern for relief, they should ride, or walk into the fields. This would remove the complaint more effectually than strong li­quor, and would never hurt the constitution.

INSTEAD of multiplying rules for preserving the health of the sedentary, we shall recommend the following general plan, viz. That every person who follows a sedentary em­ployment should cultivate a piece of ground with his own hands. This he might dig, plant, sow, and weed at his leisure-hours, so as to make it both an exercise and amuse­ment, while it produced many of the necessaries of life. After working an hour in a garden, a man will return with more keenness to his employment within doors, than if he had been all the while idle.

LABOURING the ground is every way conducive to health. It not only gives exercise to every part of the body, but the very smell of the earth and fresh [...]bs, revive and [Page 85] chear the spirits, whilst the perpetual prospect of some­thing coming to maturity, delights and entertains the mind. We are so made as to be always pleased with some­what in prospect, however distant or however trivial. Hence the happiness that most men feel in planting, sowing, building, &c. These seem to have been the chief employ­ments of the early ages; and when kings and conquerors cultivated the ground, there is reason to believe, that they knew as well wherein true happiness consisted as we do.

IT may seem romantic to recommend gardening to ma­nufacturers in great towns; but observation proves, that the plan is very practicable. In the town of Sheffield, in Yorkshire, where the great iron manufacture is carried on, there is hardly a journeyman cutler who does not occupy a piece of ground which he cultivates as a garden. This practice has many salutary effects. It not only induces these people to take exercise without doors, but also to eat many greens, roots, &c. of their own produce, which they would not think of purchasing. There seems to be no reason why manufacturers in any other town in Great-Britain should not follow this example.

MECHANICS are too much inclined to crowd into great towns. This situation may have some advantages, but ma­ny disadvantages. All mechanics who live in the country, have it in their power, and indeed most of them do, occupy a piece of ground, which not only gives them exercise, but enables them to live more comfortably. So far at least as our observation reaches, mechanics who live in the country are far more happy than those in great towns. They enjoy better health, live in greater affluence, and seldom fail to rear a healthy and numerous-offspring.

IN a word, exercise without doors, in one shape or other, is absolutely necessary to health. Those who neglect it, though they may for a while drag out life, can hardly be said to enjoy it. Their humours are generally vitiated, their solids relaxed and weak, and their spirits low and de­pressed.

The STUDIOUS.

INTENSE thought is so destructive to health, that few in­stances can be produced of studious persons who live to an extreme old age. Hard study always implies a sedentary life; and when [...]ant of exercise is joined to intense think­ing, [Page 86] the consequences must be bad. We have frequently known even a few months intense study ruin an excellent constitution, and bring on a train of nervous complaints, which never could be removed. Man is evidently not form­ed for continual thought more than for perpetual action, and would be as soon worn out by the one as by the other.

SO great is the power of the mind over the body, that by its influence the whole vital motion may be accelerated or retarded, to almost any degree. Chearfulness and mirth quicken the circulation, and promote all the secretions; whereas sadness and profound thought never fail to retard them. Thus even a degree of thoughtfulness is necessary to health. The perpetual thinker seldom enjoys either health or spirits; while the person who can hardly be said to think at all, seldom fails to enjoy both. The mind, by a habit of thinking, in some measure, loses the power of unbending itself. This may be called a disease of the mind, and should be as carefully guarded against as any o­ther malady.

PERPETUAL thinkers, as they are called, seldom think to much purpose. Such people, in a course of years, ge­nerally become quite stupid, and exhibit a melancholy proof how readily the greatest blessings may be abused. Thought, like all other things, when carried to extreme, becomes a vice. Hence nothing can afford a greater proof of wisdom than for a man frequently and seasonably to un­bend his mind. This may always be done by a chearful company, active diversions, music, or the like.

THE gout is the common companion of the studious. This excruciating disease generally proceeds from indigesti­ons, and an obstructed perspiration. It is impossible that the man who [...]its all day in a closet should either digest his food, or have any of the secretions in due quantity. When that matter, which should be thrown off by the skin, is re­tained in the body, it cannot fail to vitiate the humours, and of course to produce the gout, or some other malady.

THE studious are often afflicted with the stone and gra­vel. Motion greatly assists the secretion and discharge of urine; consequently a sedentary life must have the contra­ry effect. Of this any one may be sensible by observing, that he passes much more urine by day than in the night, and also when he walks or [...]ides than when he [...]its. A f [...]e discharge of urine not only prevents the gravel and stone, but many other diseases. When the [...] or other hu­mours [Page 87] are disordered, nature generally attempts to free her­self of the offending cause, by the urinary passages; but when these become unfit for performing their proper func­tions, this attempt must fail, and consequently diseases will ensue.

OBSTRUCTIONS of the liver prove often fatal to the stu­dious. Diseases of that organ are very obstinate, and gene­rally complicated. The circulation in the liver being slow, obstructions can hardly fail to be the consequence of inactivity. Hence sedentary people are frequently afflicted with schirrous livers, the jaundice, &c. The proper secre­tion and discharge of the bile is so necessary a part of the animal oeconomy, that where it is not duly performed, the health must needs be impaired. Indigestion, loss of appe­tite, and a wasting of the whole body, seldom fail to be the consequences of a vitium, or obstructions of the bile.

FEW diseases prove more fatal to the studious than con­sumptions of the lungs. It has already been observed, that this organ cannot be duly expanded in those who do not take proper exercise, and where that is the case, obstruc­tions, adhesions, &c. must ensue. Not only want of ex­ercise, but the posture in which studious people often sit, is very hurtful to the lungs. Those who read or write much are apt to contract a habit of bending forwards, and often press with their breast upon a table or bench, &c. It is impossible this posture should fail to hurt the lungs. It ought therefore to be avoided with the utmost care.

THE studious are often afflicted with want of appetite and indigestions. These lay the foundation of numerous diseases. When the digestions fail, the humours must soon be depraved, to which succeed low spirits, weak nerves, with the whole train of hysteric and hypochondriac mala­dies.

HEADACHES often afflict the studious. These proceed from long and intense thinking, and sometimes they are ag­gravated by costiveness. The best way to prevent them is never to study too long, and to keep the belly regular ei­ther by proper food, or taking frequently a little of some o­pening medicine.

Diseases of the eyes often afflict the studious. Such therefore as read or write much should early accustom themselves to use preserves. Night-study is most destructive to the [...]ight, and should never be prolonged too late. In­deed late studi [...] [...]e not only hurtful to the eyes, but to [Page 88] the whole body. Nothing more certainly ruins the health, than the practice of spending those hours in the closet which should be allotted to sleep. Studious persons will find their eyes greatly strengthened by bathing them frequently in cold water, or brandy and water mixed.

THE dropsy is another of those diseases which commonly affect the studious, and very often puts an end to their lives. It has already been observed, that the secretions are gene­rally defective in the studious, and that various diseases, a­mong which is the dropsy, are occasioned by the retention of these humours which ought to be thrown off in that way. Any person may observe, that sitting makes his legs swell, and that this will go off by exercise; which clearly points out the method of prevention to all who can take it. To those who cannot take exercise, we would recommend the use of the flesh-brush, cold bathing, and such food as is of a bracing and strengthening nature.

FEVERS, especially of the nervous kind, are often the effect of study. Nothing is so destructive to the nerves as intense thought. It is able, in a manner, to unhinge the whole machine. It not only hurts the vital motions, but disorders the mind itself. Hence a delirium, melancholy, and even madness, are often the effect of close application to study. There is no disease which can proceed either from a bad state of the humours, a defect of the usual secreti­ons, or a debility of the nervous system, which may not be brought on by intense thinking.

BUT the most afflicting of all the diseases which attack the studious, are the hypochondriacal. These seldom fail to be the companions of deep thought, and may rather be call­ed a complication of maladies than a single one. To what a wretched pass are the best of men often reduced by these maladies? Their strength and appetite fail. A per­petual gloom hangs over their minds. They live in the constant dread of death, and are continually in search of relief from medicine, where, alas! it is not to be found. This disease far exceeds all description, and those who la­bour under it, though they be often made the subject of ridicule, justly claim our highest sympathy and compassi­on.

NOTHING can be more preposterous than for any man to make study his sole business. A mere student is seldom a [...] useful member of society. Indeed it rarely happens, th [...] an useful invention is the effect of study. The farther that [Page 89] men dive into profound researches, they generally deviate the more from common sense, and too often lose sight of it altogether. Hence it is that profound speculations, instead of making men wiser or better, generally render them mere sceptics, and overwhelm them in doubt and uncer­tainty. All that is necessary for man to know, in order to be happy, is easily obtained, and the rest, like the forbid­den tree, serves only to increase his misery.

STUDIOUS people, in order to relieve their minds; must not only discontinue to read and write, but engage in some employment or amusement, that will so far occupy the thought as to make them forget the business of the closet. A solitary ride or walk are so far from relieving the mind, that they rather encourage thought. Nothing can divert the mind, when it gets into a train of serious thinking, but an attention to subjects of a more trivial nature. These, when compared with the other, prove a kind of play to the mind, and consequently relieve it.

THINKING men are apt to contract a contempt for what they call trifling company. They are ashamed to be seen with any but philosophers. This however is no proof of their being philosophers themselves. No man deserves the name of a philosopher who is ashamed to unbend his mind by associating with the cheerful and gay. Even the society of children will relieve the mind, and expel the gloom which application to study is too apt to occasion. It is re­markable, that such as have numerous families; whatever hardships they may labour under, are generally the most cheerful and happy.

AS studious people are necessarily much within doors, they should make choice of a large and well-aired place for study. That would not only prevent the bad effects which attend confined air, but would cheer the spirits, and have a most happy influence both on the body and mind. It is said of Euripides, the Tragedian, that he used to re­tire to a dark cave to compose his tragedies; and of De­mosthenes, the Grecian orator, that he chose a place for study where nothing could either be heard or seen. With all deference to such venerable names, we cannot help con­demning this taste. A man may surely think to as good purpose in an elegant apartment as in a cave; and may have as happy ideas where the all-cheering rays of the sun [...]der the air wholesome, as in places where they never reach.

[Page 90] THOSE who read or write much should be very attentive to their posture. They ought to sit and stand by turns, always keeping as near an erect posture as possible. Those who dictate may do it walking. It has an excellent effect frequently to read or speak aloud. This not only exercises the lungs, but almost the whole body, Hence studious people are greatly benefited by delivering discourses in pub­lic. Such indeed sometimes hurt themselves by over-act­ing their part; but that is their own fault. The man who dies a martyr to mere vociferation merits not our sympa­thy.

THE morning has by all medical writers been reckoned the best time for study. It is so. But it is also the most proper season for exercise, while the stomach is empty, and the spirits refreshed with sleep. Studious people should therefore frequently spend the morning in some manly diver­sion abroad. This would make them return to study with greater alacrity, and would be of more service than twice the time after their spirits are worn out with fatigue. It is not sufficient to take diversion only when we can think no longer. Every studious person should make it a part of his business, and should let nothing interrupt his hours of re­creation more than those of study.

MUSIC has a most happy effect in relieving the mind. It would be well if every studious person were so far ac­quainted with that science as to amuse himself after severe thought, by playing such airs as have a tendency to rouse the spirits, and inspire cheerfulness and good humour.

STUDIOUS persons generally spend their mornings in the closet, and their evenings in company. It were better to invert this rule. It is the reproach of learning, that so ma­ny of her sons, to relieve the mind after study, betake themselves to the use of strong liquors. This indeed is a remedy; but it is a desperate one, and always ends in de­struction. Would such persons, when their spirits are low, get on horse-back, and gallop ten or a dozen miles, they would find it a more effectual remedy than all the strong liquors in the world. A good horse is the best preventive medicine that we can recommend to the studious. This is better than all the nervous antidotes of the shops, and will in the end be found much cheaper.

IT is really to be regretted that men, while in health, pay so little regard to these things! How common is it to see a wretch, over-run with nervous diseases, bathing, [Page 91] walking, riding, and in a word, doing every thing for health after it is gone; yet if any one had recommended these things by way of prevention, his advice would have been treated with contempt, or, at least, with neglect. Such is the weakness of human nature, and such the folly and want of foresight, even of those who ought to be the wisest of mankind!

OF DISTINGUISHING DISEASES.

BEFORE we proceed to the particular treatment of diseases, it will be necessary to lay down some gene­ral rules for distinguishing one disease from another, as the danger of mistaking the disease often deters people from at­tempting to relieve the sick.

TO distinguish diseases is the most difficult part of the practice of physic. So near a resemblance do the symptoms of one disease often bear to those of another, that they may deceive the most skilful physician. We do not mean in this place to give the distinguishing marks of every par­ticular disease, but only to put the reader upon his guard by pointing out a few of those diseases which have the nearest resemblance to one another, and which the unwary and inattentive may be most apt to mistake.

THE small-pox and measles are both preceded by chil­ness and shivering, with heat and cold by turns, a quick pulse, great thirst, and other symptoms of a fever. In both the eruption appears about the third or fourth day in little spots resembling flea-bites. Thus far the disease cannot be certainly known; but on the second or third day from the eruption, the small-pox begin to rise and to fill with matter; which plainly shows the nature of the disease.

THE petechial or spotted fever, may be known from the miliary by this mark, that in the former the spots never rise above the skin; whereas in the latter the skin is rough, and before the eruption appears the patient complains of chil­ness, itching in the skin, and oppression of the breast.

THOUGH there be a great similarity in the first symptoms of all fevers, yet an attentive observer may generally disco­ver to what class they belong. Thus a burning fever may [Page 93] be known by the intense heat of the whole body, a dry parched skin, a chapt tongue, and unquenchable thirst. An inflammatory fever generally affects one particular part, as the lungs, the stomach, the brain, &c. This kind of fever has a natural tendency to a mortification. Malignant fevers are generally owing to infection. They may be known by the patient's sudden loss of strength, perpetual watching, &c. A catarrhal fever is known by a running at the nose, a hoarseness, and a sense of [...]ulness in the breast.

THE peripneumony and pleurisy may be distinguished by this, that in the latter the pain is more acute, and in the former the oppression of the breast, and difficulty of breathing are greater, and the spittle is generally tinctured with blood.

INTERMITTENT fevers or agues are known by their leaving the patient, and returning at certain periods, as once a day, once in two days, three days, or the like. They are denominated from the space between the fits, as quotidian, or every day agues, tertian, or such as return every other day, quartan, &c.

A hectic fever may be known by its supervening to some other disorder, as the dropsy, consumption, scurvy, &c. It differs from a slow fever in this, that the pulse is always quick, but remarkably so in the morning; whereas the pulse in a slow fever is more natural in a morning, and be­fore meals, though it be more quick after eating: Besides, in a slow fever the weakness is not so great as in a hec­tic.

AN inflammation of the stomach may be distinguished from a cardialgia, an inflammation of the liver, &c. by a sense of the most intense heat in the stomach, a fever at­tended with a quick, unequal and weak pulse, and a prodigious uneasiness upon taking any thing into the stomach.

AN inflammation in the concave part of the liver may be distinguished from the bastard pleurisy, by the fever be­ing less violent, the breathing easier, and the pain lower down. Besides, the bastard pleurisy generally goes off on the seventh day; whereas the inflammation of the liver is a tedious disease, and often ends in an abs [...]ss, which occasi­ons a hectic fever or a dropsy, &c.

A phrenzy, or inflammation of the membranes of the brain, may be distinguished from madness, a common de­lirium, the hydrophobia, &c. by the burning [...]ever, the continual watching, and the violent pulsation of the arte­ries [Page 94] about the head and temples, which always attend it. It differs from a delirium in being more violent, from mad­ness in being an accute disease, and from the hydrophobia in this, that the patient has no aversion from liquids.

A nephritis, or inflammation of the kidneys, may be distinguished from a fit of the gravel, by a fixed, dull, pressing pain in the loins, which continues long; whereas the pain in a fit of the gravel is more violent, less fixed, and generally extends downwards.

EXTERNAL inflammations are easily distinguished. An erysipelas, or St. Anthony's fire, only affects the skin with redness, tumour and pain; whereas a phlegmon reaches to the subjacent muscles, and a gangrene penetrates not only the muscles, but even the tendinous and nervous parts, and is attended with great heat, pain, and redness, which at length change into a livid or black colour.

A stone descending by the uriters may easily be mistaken for a fit of the colic, as both are attended with violent pain, vomiting, &c. In the former, however, the pain is more fixed in the loins, is attended with shiverings, and as the stone descends, the pain reaches downwards, and occasions a numbness of the thigh on the side affected; there is also a frequent inclination to pass water, with some degree of strangury; whereas in the colic the pain is chiefly about the navel, and the belly is generally distended with wind.

THE gout may be distinguished from the rheumatism by its attacking the extremities chiefly, and being attended with a greater inflammation, and more violent pain. It may likewise be distinguished from venereal pains, by its being more violent in the day; whereas they are most severe in the night.

THE piles may be mistaken for a dysentary, as both tinge the stools with blood, though the one be a dangerous disease, and the other in many cases a salutary evacuation. In the piles however the blood flows without pain or gripes; whereas in the dysentary the stools are attended with the most violent gripes, spasms, &c.

COUGHS may be owing to cold, an ulcer in the lungs, an asthma, &c. The best way to distinguish them is to examine into the cause, to observe what the patient spits, and to mark the continuance of the disease. A cough occa­sioned by catching cold is generally attended with a dis­charge of phlegm, and is seldom of long continuance. That [Page 95] which is owing to an ulcer of the lungs is generally attend­ed with an hectic fever, and the spittle is mixed with matter. An asthmatic cough is generally owing to wind or spasms, and seldom admits of relief from medicine.

A headach, which proceeds from too great a quantity of blood being forced into the vessels of the brain, is gene­rally attended with heat, redness, and a swelling of the face, a great pulsation of the arteries of the neck, &c. That kind of headach, which is the effect of venereal con­tageon, may be known by its being generally worst in the night. When the headach is owing to an effusion of serum or blood into the sinuosities of the bones of the forehead, the pain is obstinate, sharp and fixed; it is generally situated in the bottom of the forehead, and above the eyes. When the head is disordered from crudities in the stomach or wind, it may be known from belching, and the increase of the disorder upon using flatulent food, &c.

AN apoplexy may be distinguished from a syncope or fainting fit, by the colour of the face, the breathing, and the pulse continuing much the same as in health; whereas in a syncope the pulse and breathing are imperceptible, the face is pale, and the body grows cold. An apoplexy may be distinguished from a catalepsy, because the latter comes on suddenly, and keeps the member quite rigid, and in the same posture as at the time of the attack

A proper attention to the age, sex, constitution, temper of mind, &c. of the patient would greatly assist us in find­ing out and distinguishing diseases. Thus, in children the fibres are lax and soft; in adults, rigid and tense. In young people the nerves are extremely irritable, and the flu­ids thin. In old age the nerves become almost insensible, and many of the vessels imperviable. These, and number­less other peculiarities, render the diseases of the young and those of the aged very different; and of course they must re­quire different treatment.

NOT only the age, but also the sex of the patient, claims our attention. Females are liable to many peculiar diseases. Their nervous system being weak and delicate, they are easier affected with spastic or convulsive disorders than males. This is the true source of most of the diseases of the fair sex, and ought always to be kept in view in the treat­ment of their disorders.

[Page 96] WE ought likewise to attend to the particular constituti­on. This not only predisposes persons to peculiar diseases, but likewise makes it necessary, that their diseases be treat­ed in a very different manner. For example, a delicate person with weak nerves, can neither bear bleeding, nor any other evacuation, to the same extent as one whose con­stitution is hardy and robust.

THE temper of mind ought likewise to be attended to in diseases. Fear, anxiety, and a fretful temper both occasi­on and aggravate diseases. The medicine of the mind is too little regarded. In vain do we apply medicines to the body to remove diseases which proceed from the mind. When that is the case, the best medicine is to sooth the passions, divert the mind from anxious thought, and to cherish the hopes of the patient.

ATTENTION ought likewise to be paid to the place where the patient lives, the air he breathes, his diet, occu­pation, &c. Such as live in low marshy countries, are subject to many diseases which are unknown to the inhabi­tants of the high countries. Those who breathe the im­pure air of cities have many maladies, to which the more happy rustics are strangers. Such as feed gross, and indulge in strong liquors are liable to diseases which do not affect the temperate and abstemious. The situation of life, as has been observed, likewise predisposes men to peculi­ar diseases. Thus the laborious, the sedentary, the studi­ous, &c. are liable to particular maladies from the very oc­cupations which they follow.

IT is necessary to enquire whether or not the patient has been guilty of any excess in eating or drinking, if he has overstrained himself, has drank cold liquor when he was warm, lain on the damp ground, changed his usual cloathing, or, in a word, done any thing that might ob­struct the perspiration. It will also be proper to inquire, if any usual evacuation, as sweating of the feet, issues, &c. has been stopped. The state of the belly should likewise be enquired into. Costiveness alone will occasion diseases, and the removing of it will cure them.

IT is likewise necessary to inquire what diseases the pati­ent has formerly been most liable to, and what medicines were most beneficial. If medicines have been administered, it will be proper to enquire into their effect. It will like­wise be necessary to inquire, what kind of medicines are [Page 97] most agreeable to the patient, or if he has an aversion to any particular drug, &c.

IT is also necessary to inquire whether the patient can perform with ease all the animal and vital functions, or which of them gives him pain; and also to inquire, if all the different secretions go duly on, as the perspiration, dis­charge of urine, &c.

THE nature of the disease is likewise to be inquired into, as whether it be primary or secondary; whether simple or complicated with some other disease; whether it be exter­nal or internal▪ whether epidemic or not; whether it be the effect of age, intemperance, infection, or owing to a vitiated state of the humours, &c. &c.

OF FEVERS IN GENERAL.

A Fever is the most general disease incident to mankind. It attacks every age, sex, and constitution, and effects every part of the body; nor is the mind itself free from its influence. A fever is known by a quick pulse, an increased heat, and a difficulty in performing some of the vital or ani­mal functions, as breathing, walking, &c.

FEVERS are divided into continual, remitting, and inter­mitting. By a continual fever is meant that which never leaves the patient during the whole course of the disease, or which shews no remarkable increase or abatement in the symptoms. This kind of fever is likewise divided into acute, flow, and malignant. The fever is called acute, when its progress is quick, and the symptoms violent; but when these are more gentle, it is generally denominated flow. When livid or petechial spots, show a putrid state of the humours, the fever is called malignant, putrid, or pete­chial.

A remitting fever differs from a continual, only in de­gree. It has frequent increases and decreases, or exacerba­tions and remissions, but never wholly leaves the patient during the course of the disease. Intermitting fevers, or agues, are those which, during the time that the patient may be said to be ill, have evident intervals or remissions of the symptoms.

AS a fever is nothing else but an effort of nature to free herself from an offending cause, it is the business of those who have the care of the sick, to observe with diligence [Page 98] which way nature points, and to endeavour to assist her ope­rations. Our bodies are so framed as to have a constant ten­dency to expel or throw off whatever is injurious to health. This is generally done by urine, sweat, stool, expectoration, vomit, or some other evacuation.

THERE is reason to believe, if the efforts of nature, at the beginning of a fever, were duly attended to and pro­moted, it would seldom continue longer than twenty-four hours; but when her attempts are either neglected, or counteracted, it is no wonder if the disease be prolonged. There are daily instances of persons, who, after catching cold, have all the symptoms of a beginning fever; but by keeping warm, drinking diluting liquors, bathing their feet in warm water, &c. the symptoms in a few hours disappear, and the danger is prevented. In a word, almost every fever proceeding from an obstructed perspiration, might be car­ried off, or its danger prevented, by timely care.

OUR design is not to enter into a critical inquiry into the nature, causes, &c. of fevers, but to mark their most ob­vious symptoms, and to point out the proper treatment of the patient with respect to his diet, drink, air, warmth, &c. in the different stages of the disease. In these articles the inclinations of the patient will, in a great measure, direct our conduct.

ALMOST every person in a fever complains of great thirst, and calls out for drink, especially of a cooling nature. This at once points out the use of water, which we may venture to call the greatest febrifuge in nature. What is so likely to abate the heat, attenuate the humours, remove spasms and obstructions, promote perspiration, increase the quan­tity of urine, and, in short, produce every salutary effect in an ardent or inflammatory fever, as drinking plentifully of warm water, thin gruel, or any other weak, diluting liquor, of which water is the basis? The necessity of diluting li­quors is pointed out by the dry tongue, the parched skin, and the burning heat, as well as by the unquenchable thirst of the patient.

MANY cooling liquors, which are extremely grateful to patients in a fever, may be prepared from fruits, roots, and acid vegetables, as decoctions of tamarinds, apple-tea, orange-whey, and the like. Mucilaginous liquors might also be prepared from marsh-mallow roots, linseed, lime-tree-buds, and many other vegetables. These liquors, espe­cially [Page 99] when acidulated, are highly agreeable to the patient, and should never be denied him.

AT the beginning of a fever, the patient generally com­plains of great lassitude or weariness, and has no inclination to move. This evidently shows the propriety of keeping him easy, and, if possible, in bed; that relaxes the spasms, abates the violence of the circulation, and gives nature an opportunity of exerting all her force to overcome the dis­ease. The bed alone would often remove a fever at the beginning; but when the patient struggles with the dis­ease, instead of driving it off, he only fixes it the deeper, and renders it more dangerous. This observation is often veri­fied in travellers, who happen, when on a journey, to be seized with a fever. Their anxiety to get home, induces them to travel with the fever upon them, which conduct seldom fails to render it fatal.

IN fevers, the mind as well as the body should be kept easy. Company is seldom agreeable to the sick. Indeed, every thing that disturbs the imagination increases the dis­ease▪ for which reason, every person in a fever ought to be kept perfectly quiet, and neither allowed to see nor hear any thing that may in the least affect or discompose his mind.

THO' the patient in a fever has the greatest inclination for drink, yet he seldom has any appetite for solid food; from whence we may see the impropriety of loading his stomach with victuals. Much solid food in a fever is every way hurtful to the patient. It oppresses nature, and instead of nourishing the patient, serves only to feed the disease. What food the patient takes should be in small quantity, light, and easy of digestion. It ought to be chiefly of the vegetable kind, as water-pap, roasted apples, groat-gruel, and such like.

POOR people, when any of their family are taken ill, run directly to their rich neighbours for cordials, and pour wines, spirits, &c. into the patient, who perhaps never had been accustomed to taste such liquors when in health. If there be any degree of fever, this conduct must increase it, and if there be none, this is the ready way to raise one. Stuffing the patient with sweat-meats and other delicacies, is likewise very pernicious. These are always harder to di­gest then common food, and cannot fail to hurt the stomach.

NOTHING is more desired by a patient in a fever than fresh air. It not only removes his anxiety, but cools the blood, revives the spirits, and proves every way beneficial. [Page 100] Many patients are in a manner stiffled to death in fevers, for want of fresh air; yet such is the unaccountable infa­tuation of many people, that the moment they think a per­son in a fever, they imagine he should be kept in a close chamber, into which not one particle of fresh air must be admitted. There ought to be a constant stream of fresh air into a sick person's chamber, so as to keep it always in a temperate degree of warmth, which ought never to be greater than is agreeable to one in perfect health.

NOTHING spoils the air of a sick person's chamber, or hurts the patient more than a number of people breathing in it. When the blood is inflamed, or the humours in a putrid state, air that has been breathed over and over will greatly increase the disease. Such air not only loses its spring, and becomes unfit for the purposes of respiration, but acquires a noxious quality, which renders it in a man­ner poisonous to the sick.

IN fevers, when the patient's spirits are low and depressed, he is not only to be supported with cordials, but every method should be taken to cheer and comfort his mind. Many, from a mistaken zeal, when they think a person in danger, instead of solacing his mind with the hopes and consola­tions of religion, fright him with the views of hell and damnation, &c. It would be unsuitable here to dwell upon the impropriety and dangerous consequences of this con­duct; it often hurts the body, and there is reason to be­lieve, seldom benefits the soul.

AMONGST common people, the very name of a fever ge­nerally suggests the necessity of bleeding. This notion seems to have taken its rise from most fevers having been formerly of an inflammatory nature; but true inflammatory fevers are now seldom to be met with. Sedentary occupa­tions, and a different manner of living, has so changed the state of diseases in Britain, that there is now hardly one fe­ver in ten where the lance [...] is necessary. In most low, ner­vous, and putrid fevers, which are now so common, bleed­ing is really hurtful, as it weakens the patient, and sinks his spirits, &c. We would recommend this general rule, never to bleed at the beginning of a fever, unless there be evident signs of an inflammation. Bleeding is an excellent medi­cine when necessary, but should never be wantonly per­formed.

IT is likewise a common notion, that it is always ne­cessary to raise a sweat in the beginning of a fever. As fe­vers [Page 101] often proceed from an obstructed perspiration, this no­tion is not ill founded. If the patient only lies in bed, bathes his feet and legs in warm water, and drinks freely of water-gruel, or any other weak, diluting liquor, he will seldom fail to perspire freely. The warmth of the bed, and the diluting drink, will relax the universal spasm, which generally affect the solids at the beginning of a fever; it will open the pores, and promote the perspiration, by means of which the fever may often be carried off. But in­stead of this, the common practice is to heap cloaths upon the patient, and to give him things of a hot nature, as spi­rits, spiceries, &c. which fire his blood, increase the spasms, and render the disease more dangerous.

IN all fevers a proper attention should be paid to the pa­tient's longings. These are the calls of nature, and often point out what may be of real use. Patients are not to be wantonly indulged in every thing that the sickly appetite may crave; but it is generally right to let them have a lit­tle of what they eagerly desire, though it may not seem al­together proper. What the patient longs for, his stomach will generally digest; and such things have sometimes a very happy effect.

WHEN a patient is recovering from a fever, great care is is necessary to prevent a relapse. Many persons, by too soon imagining themselves well, have relapsed, or contract­ed some other disease of an obstinate nature. As the body after a fever is weak and delicate, it is necessary to guard against catching cold. Moderate exercise in the open air will be of use; agreeable company will also have a good effect. The diet must be light, but nourishing. It should be taken frequently, but in small quantities. It is very dangerous at such a time to eat as much as the sto­mach craves.

OF INTERMITTING FEVERS OR AGUES.

INTERMITTING fevers afford the best opportunity both of observing the nature of a fever, and also the effects of medicine. No person can be at a loss to distinguish an in­termitting fever from any other disease, and the proper me­dicine for it is now almost universally known.

THE several kinds of intermitting fevers, as has been ob­served, take their names from the period in which the fit returns, as quotidians, tertians, quartans, &c.

[Page 102] CAUSES.—Agues are occasioned by moist air. This is evident from their abounding in rainy seasons, and being most frequent in countries where the soil is marshy, as in Holland, the fens of Cambridgeshire, the Hundreds of Essex, &c. This disease is also occasioned by eating too much stone-fruit, a poor watery diet, damp houses, even­ing dews, lying upon the wet ground, &c. When the inhabitants of a high country remove to a low one, they seldom fail to catch an intermitting fever, and to such the disease is most apt to prove fatal. In a word, whatever relaxes the solids, diminishes the perspiration, or obstructs the circulation in the capillary or small vessels, predisposes the body to agues.

SYMPTOMS.—An intermitting fever gene­rally begins with a pain of the head and loins, weariness of the limbs, coldness of the extremities, stretching, yawning, with sometimes great sickness and vomitting; to which succeed shivering and violent shaking. Afterwards the skin becomes moist, and a profuse sweat breaks out, which ge­nerally terminates the fit or paroxysm. Sometimes, indeed, the disease comes on suddenly, when the person thinks him­self in perfect health; but it is more commonly preceded by listlessness, loss of appetite, and the symptoms mention­ed above.

REGIMEN.—While the fit continues, the patient may drink feely of water-gruel, orange-whey, weak camomile-tea; or, if his spirits be low, small wine-whey, sharpened with the juice of lemon. His drink ought to be a little warm, as that will assist in bringing on the sweat, and consequently shorten the paroxysm.

BETWEEN the paroxysms the patient must be supported with food that is nourishing, but light and easy of digestion, as veal or chicken broths, sago-gruel, with a little wine, light puddings, &c. His drink may be small negas, acidu­lated with the juice of lemons or oranges, and sometimes a little weak punch. He ought also to drink infusions of bit­ters, as camomile, wormwood, or water trefoil tea, and may now and then take a glass of small wine, in which gentian root, centaury, or some other bitter, has been infused.

AS the chief intentions of cure in an ague are to brace the solids, and promote perspiration, the patient ought to take as much exercise between the fits as he can bear. If he be able to go abroad, riding on horseback, or in a machine, will be [Page 103] of great service. But if he cannot bear that kind of exer­cise, he ought to take such as his strength will permit. No­thing tends more to prolong an intermitting fever, than in­dulging a lazy, indolent disposition.

INTERMITTING fevers, under a proper regimen, will generally cure of themselves; and when the disease is mild, in an open dry country, there is seldom any danger from allowing it to take its course; but when the patient's strength is exhausted, and the paroxysms are so violent, that his life is in danger, medicine ought immediately to be administered. This however should never be done till the disease be properly formed, that is to say, till the pati­ent has had several fits of shaking and sweating.

MEDICINE.—The first thing to be done in the cure of an intermitting fever, is to cleanse the first pas­sages. This not only renders the application of other me­dicines more safe, but likewise more efficacious. In this disease the stomach is generally overcharged with cold vi­scid phlegm, and frequently great quantities of bile are discharged by vomit; which plainly points out the necessity of such evacuations. Vomits are therefore to be admini­stered before the patient takes any other medicine. A dose of ipecacuanha will generally answer this purpose very well. Half a dram of the powder will be sufficient for an adult, and for a younger person the dose must be less in proportion. After the vomit begins to operate, it may be wrought off by drinking plentifully of weak camomile tea. The vomit should be taken two or three hours before the coming on of the fit, and may be rep [...]ed two or three times at the distance of three or four days from each other. Vomits not only cleanse the stomach, but increase the per­spiration, and all the other secretions, which render them of such importance, that they often cure intermitting fevers without the assistance of any other medicine. Of this I have seen many instances, and remember myself to have been compleatly cured of a regular tertian, by taking two vomits of ipecacuanha, and observing proper regimen.

PURGING medicines are likewise useful, and often ne­cessary, in intermitting fevers. A smart purge has been known to cure an obstinate ague, after the Jesuits bark and other medicines had been used in vain. Vomits, how­ever, are more suitable in this disease, and render purging less necessary; but if the patient be afraid to take a vomit, [Page 104] he ought in this case to cleanse the bowels by a dose or two of Glauber's salts, jalap, or rhubarb, &c.

BLEEDING may sometimes be proper at the beginning of an intermitting fever, when excessive heat, a delirium, &c. give reason to suspect an inflammation; but as the blood is very seldom in an inflammatory state in intermit­ting fevers, this operation is rarely necessary.

AFTER proper evacuations, the patient may safely use the Jesuits bark, which may be taken in any way that is most agreeable to him. As it would answer no purpose to mul­tiply forms, we shall only mention the following.

Two ounces of the best Jesuits bark, half an ounce of Virginian snake-root, and a quarter of an ounce of ginger, all fine powdered, may be divided into twenty-four doses. These may be either made into bolusses, as they are used, with a little syrup of lemon, or mixed in a glass of red wine, a cup of camomile-tea, water-gruel, or the like.

IN an ague which returns every day, a dose of the above may be taken every two hours during the interval of the fit. By this method the patient will be able to take five or six doses between each paroxysm. In a tertian, or third-day ague, it will be sufficient to take a dose every third hour, during the interval, and in a quartan every fourth. If the patient cannot take so large a dose of the bark, he may di­vide each of the powders into two parts, and take one every hour. For a young person, a smaller quantity of this me­dicine will be sufficient, and the dose must be adapted to the age, constitution, &c.

THE above will seldom fail to remove an ague; but the patient ought not to leave off taking the medicine so soon as the paroxysms are stopped, but should continue to use it till such time as there is reason to believe the disease is in­tirely overcome. Most of the failures in the cure of this disease are owing to the patients not continuing to use the medicine long enough. They are generally directed to take it till their fits are stopped, then to leave it off, and begin again at some distance of time; by which means the disease gathers strength, and often returns with as much violence as before. A relapse may always be prevented by the pa­tient's continuing to take small doses of the medicine for sometime after the symptoms disappear. This is both the most safe and effectual method of cure.

THOUGH the bark alone will generally cure intermitting fevers; yet it may be assisted by alkaline salts, acid and [Page 105] astringent vegetables, &c. Many have been cured of an intermitting fever, after the bark had failed, by taking twice or thrice a-day a dram of the salt of wormwood in water-gruel. Some have stopped an ague by eating a boil­ed lemon, with the rind, immediately before the coming on of the fit. We would rather recommend a medicine which is the result of these two when joined together, than either of them separately. Thus, a dram of salt of wormwood may be dissolved in an ounce and half of fresh lemon juice, to which may be added three or four ounces of boiling water, and half a glass of brandy. These will make an agreeable medicine; a tea cupful of which may be taken three or four times a-day.

AN ounce of gentian root, calamus aromaticus, and orange-peel of each half an ounce, with three or four handfuls of camomile flowers, and an handful of coriander seed, all bruised together in a mortar, may be used in form of infusion or tea. About half an handful of these ingre­dients may be put into a tea-pot, and an English pint of boiling water poured on them. A cup of this infusion may be drank three or four times a-day. This strengthens the stomach, rectifies the blood, and greatly promotes the cure. Such patients as cannot drink the watery infusion, may put two handfuls of the same ingredients into a bottle of white wine, and take a glass of it twice or thrice a-day. If pa­tients drink freely of the above, or any other proper infu­sion of bitters, a much smaller quantity of bark than is ge­nerally used, will be sufficient to cure an ague.

THERE is reason to believe, that sundry of our own plants or barks, which are very bitter and astringent, would succeed well enough in the cure of intermitting fe­vers, especially when assisted by aromatics. But as the Je­suits bark has been long approved in the cure of this dis­ease, and is now to be obtained at a very reasonable rate, it is of less importance to search after new medicines. We cannot however omit taking notice, that the Jesuits bark is very often adulterated, and that it requires considerable skill to distinguish between the genuine and the false. This ought to make people very cautious of whom they purchase it.

THOSE who cannot swallow the bark in substance, may take it in decoction or infusion. An ounce of bark in pow­der may be infused in a bottle of white wine for four or five days, frequently shaking the bottle, afterwards let the [Page 106] powder subside, and pour off the clear liquor. A wine­glass may be drank three or four times a-day, or oftener, as there is occasion. If a decoction be more agreeable, an ounce of the bark, and two drams of snakeroot bruised, with a dram of salt of wormwood, may be boiled in a pro­per quantity of water, into half an English pint. To the strained liquor may be added an equal quantity of red wine, and a glass of it taken thrice a-day, or oftener, if necessa­ry.

IN obstinate agues the bark will be found much more ef­ficacious when assisted by warm cordials, than if taken alone. This I have had frequently occasion to observe in a country where intermitting fevers were endemical. The bark seldom succeeded unless assisted by snakeroot, ginger, canella alba, or some other warm aromatic. When the fits are very frequent and violent, in which case the fever often approaches towards an inflammatory nature, it will be safer to leave out the ginger, and to add in its place half a [...] ounce of salt of wormwood. But in obstinate tertians or quartans, in the end of autumn, or beginning of winter, warm and cordial medicines are absolutely necessary.

AS autumnal and winter agues generally prove much more obstinate than those which attack the patient in spring or summer; it will be necessary to continue the use of medicines longer in the former than in the latter. A person who is seized with an intermitting fever in the be­ginning of winter, ought frequently, if the season proves rainy, to take a little medicine, although the disease be cured, to prevent a relapse, till the return of the warm sea­son. He ought likewise to take care not to be much abroad in wet weather, especially in cold, moist, easterly winds.

WHEN agues are not properly cured, they often degene­rate into obstinate chronical diseases; as the dropsy, jaun­dice, &c. For this reason, all possible care should be taken to have them radically cured, before the humours be vitiat­ed, and the constitution spoiled.

THOUGH nothing is more rational than the method of treating intermitting fevers, yet, by some strange Infatua­tion, more charms and whimsical remedies are daily used for removing this than any other disease. There is hardly an old woman who is not possessed of a nostrum for stopping an ague; and there is reason to fear, that many by trusting to them lose their lives. Those in distress eagerly grasp at any thing that promises sudden relief; but the shortest way [Page 107] is not always the safest in the treatment of diseases. The only method to obtain a safe and lasting cure, is gradually to assist nature in removing the cause of the disease.

SOME people try bold, or rather fool-hardy experiments to cure agues, as drinking strong liquors, jumping into a river, &c. These may sometimes have the desired effect, but must always be attended with danger. When there is any degree of inflammation, or the least tendency to it, such experiments may prove fatal. The only person whom I remember to have seen die in an intermitting fever, evidently killed himself by drinking strong liquor, which some person had persuaded him would prove an infallible remedy.

MANY out of the way things are extolled for the cure of intermitting fevers, as cobwebs, snuffings of candles, &c. Though these may sometimes succeed, yet their very nasti­ness is sufficient to set them aside, especially when cleanly medicines will answer the purpose better. The only medi­cine that can be depended upon, for thoroughly curing an intermitting fever, is the Jesuits bark. It may always be used with safety: And I can honestly declare, that in all my practice I never knew it fail, when properly applied, and duly persisted in.

WHERE agues are endemical, even children are often afflicted with that disease. Such patients are very difficult to cure, as they can seldom be brought to take the bark, or any other disagreeable medicine. One method of ren­dering this medicine more palatable is, to make it into a mixture with distilled waters and syrup, and afterward to give it an agreeable sharpness with the elixir of spirit of vi­triol. This both improves the medicine, and takes off the nauseous taste. The bark may be administered to children in form of clyster when they will not take it by the mouth. Wine whey is a very proper drink for a child in an ague; to half an English pint of which may be put a tea-spoonful of the spirit of hartshorn. Exercise is likewise of consider­able service; and when the disease proves obstinate, the child ought, if possible, to be removed to a warm dry air. Their food ought to be nourishing, and they should some­times have a little generous wine.

WE have been the more full upon this disease, because it is very common, and because few patients in an ague apply to physicians unless in extremities. There are, however, many cases in which the disease is very irregular, being [Page 108] complicated with other diseases, or attended with sypmtoms which are both very dangerous, and difficult to understand. All these we have purposely passed over, as they would on­ly bewilder the generality of readers. When the disease is very irregular, or the symptoms dangerous, the patient ought immediately to apply to a physician, and strictly to follow his advice.

TO prevent agues, people must avoid their causes. These have been already pointed out in the beginning of this section; we shall therefore only add one preventive medicine, which may be of use to such as are obliged to live in low marshy countries, or who are liable to frequent at­tacks of this disease.

TAKE an ounce of the best Jesuits bark, half an ounce of Virginian snake-root, and half an ounce of orange-peel, bruise them all together, and infuse for five or six days in a bottle of brandy, Holland-gin, or any good spirit; afterwards pour off the clear liquor, and take a wine glass of it twice or thrice a day. This indeed is recom­mending a dram; but the bitter in a great measure takes off the ill effects of the spirit. Those who do not choose it in brandy may infuse it in wine; and such as can bring them­selves to chew the bark, will find that method succeed very well. Gentian-root, or calamus aromaticus, may also be chewed by turns for the same purpose. All bitters seem to be antidotes to agues, especially those that are warm and astringent.

OF AN ACUTE CONTINUAL FEVER.

THIS fever is denominated acute, ardent, or inflamma­tory. It most commonly attacks the young, or those about the prime or vigour of life, especially such as live full, abound with blood, and whose fibres are strong and elastic. It seizes people at all seasons of the year; but is most fre­quent in the spring and beginning of summer.

CAUSES.—An ardent fever may be occasioned by any thing that overheats the body, as violent exercise, sleeping in the sun, drinking strong liquors, eating spiceries, &c. It may likewise be occasioned by any thing that obstructs the perspiration, as lying on the damp ground, drinking cold liquor when the body is hot, night-watching, or such like.

[Page 109] SYMPTOMS.—A rigor or chillness generally ushers in this fever, which is soon succeeded by great heat, a frequent and full pulse, a pain of the head, dry skin, redness of the eyes, a florid countenance, pains in the back, loins, &c. To these succeed difficulty of breathing, sick­ness, with an inclination to vomit. The patient complains of great thirst, has no appetite for solid food, is restless, and his tongue generally appears black and rough.

A delirium, excessive restlessness, great oppression of the breast, with laborious respiration, starting of the tendons, hiccup, cold, clammy sweats, and an involuntary discharge of urine, are generally the forerunners of death.

AS this disease is always attended with danger, the best medical assistance ought to be procured as soon as possible. A physician may be of use at the beginning, but his skill is often of no avail afterwards.

WE cannot here omit, once for all, taking notice▪ of the unaccountable conduct of those who have it in their power, at the beginning of a fever, to procure the best medical assistance, yet put off till things come to an extremity. When the disease, by delay or wrong treatment, has be­come incurable, and has exhausted the strength of the pa­tient, it is in vain to hope for relief from medicine. Phy­sicians may indeed assist nature; but their attempts must ever prove fruitless, when she is no longer able to co-ope­rate with their endeavours.

REGIMEN.—From the symptoms of this dis­ease, it is evident, that the blood must be thick and viscous, by which its circulation thorough the small vessels is imped­ed; that the perspiration, urine, and all the other secretions, are in too small quantity; that the vessels are too rigid, and the heat of the whole body too great: All these clearly point out the necessity of a regimen, calculated to dilute the blood, allay the excessive heat, remove the spasmodic stricture of the vessels, and promote the secretions.

THESE important purposes may be greatly promoted by drinking plentifully of diluting liquors, as thin water-gruel, oat-meal tea, clear whey, barley-water, balm-tea, apple-tea, &c. These should be sharpened with juice of orange, jelly of currants, raspberries, and such like: Orange-whey is likewise an excellent cooling drink. It is made by boil­ing a bitter orange, sliced, among milk and water, till the curd separates. If no orange can be had, a lemon, a little cream of tartar, or a few spoonfuls of vinegar, will have [Page 110] the same effect. Two or three spoonfuls of white wine may be occasionally added to the liquor when boiling.

IF the patient be costive, an ounce of tamarinds, with two ounces of stoned raisins of the sun, and a couple of figs, may be boiled in three English pints of water to a quart. This makes a very pleasant drink, and may be used at dis­cretion. The common pectoral decoction is likewise a very proper drink in this disease. It is made by boiling barley, stoned raisins and figs, of each two ounces, with half an ounce of liquorice-root sliced, in two English quarts of water, till one half be consumed. The barley should be boiled some time before the other ingredients are put in. This, with the addition of two or three drams of purified nitre, or sal-prunel, will not only be a proper drink, but prove an exceeding good medicine. A tea-cupful of it may be taken every two hours, or oftener, if the patient's heat and thirst be very great.

THE above liquors must all be drank a little warm. They may be used in smaller quantities at the beginning of a fe­ver, but more freely afterwards, in order to assist in carry­ing off the morbid matter by the different excretions. We have mentioned a variety of liquors, that the patient may have it in his power to choose that which is most agreeable; and that, when tired of one, he may have recourse to an­other.

THE patient's diet must be very spare and light. All sorts of meat, and even chicken-broths, are to be avoided. He may be allowed groat-gruel, panada, or light bread boil­ed in water, and afterwards strained; to which may be add­ed a few grains of common salt, and a little sugar, which will render it more palatable. He may eat roasted apples with sugar, toasted bread with jelly of currants spread upon it, boiled prunes, &c.

IT will greatly relieve the patient, especially in an hot season, to have fresh air frequently let into his chamber, This, however, must always be done in such a manner as not to endanger his catching cold.

IT is a common practice to load the patient with bed-cloaths, under the pretence of making him sweat, or de­fending him from the cold. This custom has many ill ef­fects. It increases the heat of the body, fatigues the pa­tient, and retards, instead of promoting, the perspiration.

SITTING upright in bed, if the patient be able to bear it, will often have a good effect. It relieves the head, by re­tarding [Page 111] the motion of the blood to the brain. But this pos­ture ought never to be continued too long: And if the pa­tient be inclined to sweat, it will be more safe to let him lie still, only raising his head with pillows, &c.

SPRINKLING the chamber with vinegar, juice of lemon, or vinegar and rose-water, with a little nitre dissolved in it, will greatly refresh the patient. This ought to be done fre­quently, especially if the weather be hot.

THE patient's mouth should be often washed with warm water, mixed with honey, and a little vinegar; or a de­coction of figs in barley-water, &c. His feet and hands ought likewise frequently to be bathed in lukewarm water; especially if the head be effected.

THE patient should be kept as quiet and easy as possible. Company, noise, and every thing that disturbs the mind is hurtful. Even too much light, or any thing that affects the senses, is to be avoided. His attendants should be as few as possible, and they ought not to be too often changed. His inclinations ought rather to be soothed than contradicted; even the promise of what he craves will often satisfy him as much as its reality.

MEDICINE.—In this and all other fevers arising from too great a quantity, and too rapid a motion of the blood, bleeding is of the greatest importance. This opera­tion ought always to be performed as soon as the symptoms of an inflammatory fever appear. The quantity of blood to be let must be in proportion to the strength of the pa­tient, and the violence of the disease. If after the first bleed­ing the fever seems to rise, and the pulse feels hard, there will be a necessity for repeating it a second, and perhaps a third time, which may be done at the distance of twelve, eighteen, or twenty-four hours, as the symptoms require. If the pulse continues soft, and the patient is tolerably easy after the first bleeding, it ought not to be repeated till ne­cessary.

THE cooling febrifuge draught, recommended in the in­termitting fever, page 105, will likewise be very proper here; only the brandy must be left out, and half a dram of purified nitre added in its stead.

IF the above cannot be conveniently obtained, forty or fifty drops of the dulcified or sweet spirit of vitriol may be made into a draught, with an ounce of rose-water, two ounces of common water, and half an ounce of simple sy­rup, or a bit of loaf-sugar. This draught may be given to [Page 112] the patient every three hours while the fever is violent; af­terwards, once in five or six hours will be sufficient.

IF the patient be afflicted with reaching or an inclination to vomit, it will be right to assist nature's attempts, by giving him weak camomile tea or lukewarm water to drink.

IF the belly be bound, the patient ought daily to receive a clyster of milk and water with a little salt, and a spoonful of sweet oil or fresh butter. If this has not the desired effect, a tea-spoonful of magnesia alba, or cream of tartar, may be frequently put into his drink. He may likewise eat tama­rinds, boiled prunes, roasted apples, and the like.

IF about the 10th, 11th, or 12th day, the pulse becomes more soft, the tongue moister, and the urine begins to let fall a reddish sediment, there is reason to expect a favourable issue to the disease. But if, instead of those symptoms, the patient's spirits grow languid, his pulse sinks, and his breath­ing becomes difficult; with a stupor, tremors of the nerves, starting of the tendons, &c. there is reason to fear that the consequences will be fatal. In this case, blistering plaisters must be applied to the head, ancles, inside of the thighs, &c. and the patient must be supported with cordials, as strong wine-whey, negas, sago-gruel, and such like.

A proper regimen is not only necessary during the fever, but likewise after the patient begins to recover. By ne­glecting that, many relapse, or fall into other diseases, and continue valetudinary for life, Tho' the body be weak after a fever, yet the food for some time ought to be rather cleansing than of too nourishing a nature. The person should take great care not to exceed in any thing. Too much food, drink, sleep, exercise, company, &c. are care­fully to be avoided. The mind ought likewise to be kept easy, and the person should not attempt to pursue study, or any thing that requires intense thinking.

IF the digestion be bad, or the person b [...] troubled at times with feverish heats, an infusion of the Jesuits bark in cold water will be o [...] use. It will strengthen the stomach, and help to subdue the remains of the fever.

WHEN the patient's strength is pretty well recovered, he ought to take some gentle laxative. An ounce of tamarinds and a dram of senna, may be boiled for a few minutes in an English pint of water, and an ounce of manna dissolved in the decoction; afterwards, it may be strained, and a tea­cupful drank every hour till it operates. This dose may be [Page 113] repeated twice or thrice, five or six days intervening be­twixt each dose.

THOSE who follow laborious employments ought not to return too soon to their labour after a fever, but should keep easy till their strength and spirits be recruited.

OF THE PLEURISY.

THE true pleurisy is an inflammation of that membrane, called the pleura, which lines the inside of the breast. It is distinguished into the moist and the dry. In the former, the patient spits freely; but in the latter, little or none at all. There is likewise a species of this disease, which is called the spurious or bastard pleurisy, in which the pain is more exter­nal, and chiefly affects the muscles between the ribs. This disease abounds among labouring people, especially such as work without doors, and are of a sanguine constitution. It is most frequent in the spring-season.

CAUSES.—The pleurisy is occasioned by whatever obstructs the perspiration; as cold northerly winds, drinking cold liquors when the body is hot, sleeping without doors on the damp ground, wet cloaths, plunging the body into cold water, or exposing it to the cold air when covered with sweat, &c. It may likewise be occasioned by drinking strong liquors; by the stoppage of usual evacuations, as old ulcers, issues, sweating of the feet or hands, &c. the sudden striking in of any eruption, as the itch, the measles, or the small-pox. Those who have been accustomed to bleed at a certain sea­son of the year, are apt, if they neglect it, to be seized with a pleurisy. Keeping the body too warm by means of fire, cloaths, &c. renders it more liable to this disease. A pleu­risy may likewise be occasioned by violent exercise, as run­ning, wrestling, leaping, or by supporting great weights, especially on the breast. The very make of the body some­times predisposes persons to this disease, as a narrow chest, a straitness of the arteries of the pleura, &c.

SYMPTOMS.—This, like most other fevers, be­gins with chillness and shivering, which are followed by heat, thirst, and restlessness. To these succeed a violent pricking pain in one of the sides amongst the ribs. Some­times the pain extends towards the backbone, sometimes to­wards the forepart of the breast, and at other times towards the shoulder-blades. The pain is generally most violent when the patient draws in his breath.

[Page 114] THE pulse in this disease is generally hard, the urine high coloured; and if blood be let, it is covered with a tough crust, or buffy coat. The patient's spittle is at first thin, but afterwards it becomes grosser, and is often streaked with blood

REGIMEN.—Nature endeavours to carry off this disease either by a critical discharge of blood from the nose, &c. or by expectoration, sweat, loose stools, thick urine, &c. When the violence of the fever is not broken by these, or other evacuations, it often ends in an abscess o [...] suppuration; to which ensues an ulcer, mortification, and death.

THE violence of this disease may generally be checked by lessening the force of the circulation, relaxing the ves­sels, diluting the humours, and promoting expectoration, &c.

FOR these purposes, the diet, as in the former disease, must be cool, slender, and diluting. The patient must avoid food that is viscid, hard of digestion, or that affords much nourishment, as flesh, butter, cheese, eggs, milk, and also every thing that is of a heating nature. His drink must be sweet whey, or decoctions and infusions of the pectoral and balsamic vegetables.

TAKE a table spoonful of linseed, a quarter of an ounce of liquorice-root sliced, and half an ounce of the leaves of coltsfoot. Put these ingredients in a close vessel, pour on them a quart of boiling water, and let them stand near a fire for eight or ten hours; afterwards strain off the liquor; of which the patient may take a cupful frequently for his ordinary drink.

BARLEY-WATER sweetened with honey, or sharpened with the jelly of currants, is likewise a very proper drink in this disease. It is made by boiling an ounce of pearl-barley in three English pints of water to two, which must afterwards be strained. The decoction of figs, raisins, and barley, &c. recommended in the continual fever, p. 110. is here likewise very proper. These, and other diluting li­quors, are not to be drank in large quantities at a time; but the patient ought, in a manner, keep continually sip­ping them, so as to render his mouth and throat always moist. All his food and drink must be taken a little warm.

THE patient should be kept quiet, cool, and every way ea­sy, as directed under the foregoing disease. His feet and hands [Page 115] ought daily to be bathed in warm water; and he may sometimes [...]it up in bed for a short space, in order to re­lieve his head.

MEDICINE.—Almost every person knows when a fever is attended with a violent pain of the side, and a quick, hard pulse, that bleeding is necessary. When these symptoms appear, the sooner this operation is per­formed the better; and the quantity at first must be pretty large, provided the patient be able to bear it. A large quantity of blood let at once, in the beginning of a pleuri­sy, has a much greater effect than several repeated small bleedings. An adult person may lose ten or twelve ounces of blood as soon as it is certainly known that he is seized with a pleurisy. For a younger person, or one of a delicate con­stitution, the quantity must be less.

IF after the first bleeding, the stitch, with the other vio­lent symptoms, should continue, it will be necessary, at the distance of twelve or eighteen hours, to let eight or nine ounces more. If the symptoms do not then abate, and the blood shows a strong buffy coat, a third or even a fourth bleeding may be requisite. If the pain of the side abates, the pulse becomes softer, or the patient begins to spit free­ly of a brown or reddish colour, bleeding ought not to be repeated. This operation is seldom necessary after the third or fourth day of the fever, and ought not then to be performed without the advice of a physician, unless in the most urgent circumstances.

THE blood may be many ways attenuated without let­ting it off. There are likewise many things that may be done to ease the pain of the side besides bleeding. Thus, after the first or second bleeding, emollient fomentations may be applied to the part affected. These may be made by boiling a handful of the flowers of elder, camomile, and common mallows, or any other soft vegetables, in a proper quantity of water. The herbs may be either put into a bag, and applied warm to the side, or flannels may be dip­ped in the decoction, afterwards wrung out, and applied to the part affected, with as much warmth as the patient can easily bear. As the cloths grow cool, they must be chan­ged, and great care taken that the patient do not catch cold: An ox's bladder may be half filled with warm milk and wa­ter, and applied to to the side, if the above method of fo­menting be found inconvenient. Fomentations not only [Page 116] ease the pain, but by relaxing the vessels, prevent the stag­nation of the blood and other humours.

THE side may likewise be frequently rubbed with a little of the following liniment. Take two table spoonfuls of the oil of sweet almonds, olives, or any other sweet oil, and two tea spoonfuls of spirit of hartshorn: Shake them well together, and rub about a tea spoonful upon the side, with a warm hand, three or four times a-day.

SOME recommend dry applications to the affected side, as burnt oats, toasted bread, &c. But these, though they may be useful, are not so proper as moist ones. Could it be properly conducted, we would recommend putting the patient into a bath of warm milk and water, in which emol­lient vegetables had been boiled; but as this cannot always be obtained, we shall recommend what is in every person's power, viz. to apply soft poultices, or cataplasms to the part affected. These may be made of wheat bread and milk, softened with oil or fresh butter.

LEAVES of various plants might likewise be applied to the patient's side with advantage. We have often seen, and even felt, the benefit of young cabbage leaves applied warm to the side in a pleurisy. These not only relax, but likewise draw off a little moisture, and may prevent the ne­cessity of blistering plaisters; which, however, when other things fail, must be applied.

IF the stitch continues after repeated bleedings, fomenta­tions, &c. a blistering plaister must be laid upon the part affected, and suffered to remain for two days. This not only procures a discharge from the side, but actually thins the blood, and by that means assists in removing the cause of the disease.

TO prevent a stranguary when the blistering plaister is on, the patient may drink freely of the following emulsion: take an ounce of sweet almonds blanched, and beat them well in a mortar, with an equal quantity of fine sugar; then dissolve half an ounce of gum arabic in an English quart of barley water warm. Let it stand till cool, and afterwards pour it by little and little upon the almonds and sugar, continually rubbing them till the liquor becomes uniformly white or milky. Afterwards strain it, and let the patient use it for ordinary drink. A quart bottle, at least, may be drank daily.

IF the patient be costive, a clyster of warm water, or of barley water, in which a handful of mallows, or any [Page 117] other emollient vegetable, has been boiled, may be daily administered. This will not only empty the bowels, but have the effect of a warm fomentation applied to the infe­rior viscera, which will help to make a derivation from the breast.

THE expectoration, or spitting, may be promoted by sharp, oily, and mucilaginous medicines. For this purpose, an ounce of the oxymel or vinegar of squills may be added to six ounces of the pectoral decoction, and two table spoonfuls of it taken every two hours.

SHOULD the squill disagree with the stomach, two oun­ces of the oil of sweet almonds, or oil of olives, and two ounces of the syrup of violets, may be mixed with as much sugar-candy powdered as will make an electuary of the con­sistence of honey. The patient may take a little of this frequently, when the cough is troublesome.

SHOULD oily medicines happen to prove nauseous, which is sometimes the case, two drams of gum ammoniac may be dissolved in half an English pint of barley water, in the following manner: The gum must be well rubbed in a mortar, and the water gradually poured upon it till it be quite dissolved. Three or four ounces of simple pennyroy­al water may be added to the above quantity, and two table spoonfuls of it taken three or four times a-day.

IF the patient does not perspire, but has a burning heat upon his skin; and passes very little water, some small do­ses of purified nitre and camphire will be of use. Two drams of the former may be rubbed with five or six grains of the latter in a mortar, and the whole divided into six do­ses, one of which may be taken every five or six hours, in a little of the patient's ordinary drink.

BUT the best medicine, which some indeed reckon al­most a specific in the pleurisy, is the decoction of the Sene­ca rattlesnake root. Two ounces of the root, grossly pow­dered, must be boiled in two English pints and an half of water, till one half the water be consumed. It must not be boiled quickly, but gradually simmered over a slow fire. After bleeding, and other evacuations have been premised, the patient may take two, three, or four table spoonfuls of this decoction, according as his stomach will bear it, three or four times a-day. If it should occasion vomiting, two or three ounces of simple cinnamon water, may be mixed with the quantity of decoction above mentioned, or it may be taken in smaller doses. As this medicine at once pro­motes [Page 118] perspiration, urine, and keeps the belly easy, it bids the fairest of any thing yet known to answer all the in­tentions of cure in a pleurisy, or any other inflammation of the breast.

NO one will imagine, that these medicines are all to be used at the same time. We have mentioned different things, on purpose that people may have it in their power to choose; and, likewise, that when one thing cannot be obtained, they may make use of another. Different medicines are no doubt necessary in the different periods of a disor­der; and where one fails of success, or disagrees with the patient, it will be proper to try another.

WHAT is called the crisis, or height of the fever, is sometimes attended with very alarming symptoms; as diffi­culty of breathing, an irregular pulse, convulsive motions, &c. These are apt to f [...]ight the attendants, and induce them to do improper things, as bleeding the patient, giving him strong stimulating medicines, or the like. But they are only the struggles of nature to overcome the disease, in which she ought to be assisted by plenty of diluting drink, which is then peculiarly necessary, as the febrile matter is now ready to be discharged. If the patient's strength, however, be much exhausted by the disease, it may be ne­cessary, at this time, to support him with frequent small draughts of wine whey, or the like.

WHEN the pain and fever are gone, it will be proper, after the patient has gathered sufficient strength, to give him some gentle purges, as those directed under the acute, continual fever, page 112. He ought likewise to use a light diet, of easy digestion; and, his drink should be butter-milk, whey, and other things of a cleansing na­ture.

THAT species of pleurisy, which is called the bastard, or spurious, generally goes off by keeping warm for a few days, drinking plenty of diluting liquors, and observing a proper regimen.

IT is known by a dry cough, a quick pulse, and a dif­ficulty of lying on the affected side, which last does not always happen in the true pleurisy. Sometimes, indeed, this disease proves obstinate, and requires bleeding, with cupping, and scarifications of the affected side. These, together with the use of nitrous, and other cooling medi­cines, seldom fail to effect a cure.

[Page 119] THE paraphrenitis, or inflammation of the diaphragm, is so nearly connected with the pleurisy, and resembles it so much in the manner of treatment, that it is scarce necessary to consider it as a separate disease.

IT is attended with a very acute fever, and an extreme pain of the part affected, which is generally augmented by coughing, sneezing, drawing in the breath, taking food, going to stool, making water, &c. Hence the patient breathes quick, and draws in his bowels to prevent the mo­tion of the diaphragm, is restless, anxious, has a dry cough, a hiccup, and often a delirium. A convulsive laugh, or ra­ther a kind of involuntary grin, is no uncommon symptom of this disease.

EVERY method must be taken to prevent a suppuration, as it is impossible to save the patient's life when that hap­pens. The regimen and medicine are in all respects the same as in the pleurisy. We shall only add, that in this disease emollient clysters are peculiarly useful, as they relax the bowels, and by that means draw the humours from the part affected.

OF A PERIPNEUMONY, OR INFLAM­MATION OF THE LUNGS.

AS this disease affects an organ which is absolutely neces­sary to life, it must always be attended with danger. Those who abound with thick blood, whose fibres are tense and rigid, who seed upon gross aliment, and drink strong viscid liquors, are most liable to this disease. It is generally fatal to persons of a [...]lat breast, or narrow chest, and to such as are afflicted with an asthma, especially in the decline of life. Sometimes the inflammation reaches to one lobe of the lungs only, at other times the whole of that organ is affected; in which case the disease can hardly fail to prove fatal.

WHEN the disease proceeds from a viscid pituitous matter, obstructing the vessels of the lungs, it is called a spurious or bastard peripneumony. When it arises from a thin acrid de­ [...]uction on the lungs, it is denominated a catarrhal peripneu­mony, &c.

CAUSES.—An inflammation of the lungs is some­times a primary disease, and sometimes it succeeds to other diseases, as a quinsy, a pleurisy, &c. It arises from the same causes as pleurisy, viz. an obstructed perspiration from [Page 120] cold, wet cloaths, &c. or from an increased circulation of the blood by violent exercise, the use of spiceries, ardent spirits, and such like. The pleurisy and peripneumony are often complicated; in which case the disease is called a pleuro-peripneumony.

SYMPTOMS.—Most of the symptoms of a pleu­risy, likewise attend an inflammation of the lungs; only in the latter, the pulse is more soft, and the pain less acute; but the difficulty of breathing, and oppression of the breast, are generally greater.

REGIMEN.—As the regimen and medicine are in all respects the same in the true peripneumony as in the pleurisy, we shall not here repeat them, but refer the reader to the treatment of that disease. It may not, however, be improper to add, that the aliment ought to be more slender and thin in this than in any other inflammatory disease. The learned Dr. Arbuthnot asserts, that even common whey is sufficient to support the patient, and that decoctions of barley, and infusions of fennel-roots in warm water with milk, are the most proper both for drink and nourishment. He likewise recommends the steam of warm water taken in by the breath, which serves as a kind of internal fomenta­tion, and helps to attenuate the impacted humours. If the patient has loose stools, but is not weakened by them, they are not to be stopped, but rather promoted by the use of emollient clysters.

IT has already been observed, that the spurious or bastard peripneumony is occasioned by a viscid pituitous matter ob­structing the vessels of the lungs. It commonly attacks the old, infirm, and phlegmatic, in winter or wet seasons.

THE patient, at the beginning, is cold and hot by turns, has a small quick pulse, feels a sense of weight upon his breast, breathes with difficulty, and sometimes complains of a pain and giddiness of his head. His urine is commonly pale, and his colour very little changed.

THE diet in this, as well as in the true peripneumony, must be very slender, as weak broths sharpened with the juice of orange or lemon, &c. His drink may be thin wa­ter-gruel sweetened with honey, or a decoction of fennel-root, liquorice, and roots of quick grass. An ounce of each of those may be boiled in three English pints of water to a quart, and sharpened with a little cu [...]rant-jelly, or the like.

BLEEDING and purging are generally proper at the be­ginning of this disease; but if the patient's spittle be pretty thick, or well concocted, neither of them are necessary. It [Page 121] will be sufficient to assist the expectoration by some of the soft balsamic medicines, recommended for that purpose in the pleurisy. Blistering plaisters have generally a good ef­fect, and ought to be applied pretty early. They may either be applied to the neck or ancles, or both, if necessary.

IF the patient does not spit, he must be bled, if his strength will permit, and have a gentle purge administered. Afterwards his belly may be kept open by clysters, and the expectoration promoted, by taking every four hours two table spoonfuls of the solution of gum ammoniac, recom­mended in the pleurisy, page 117.

WHEN an inflammation of the breast does not yield to bleeding, blistering, and the other means mentioned above, it commonly ends in a suppuration, which is more or less dangerous, according to the part where it is situate. When this happens in the pleura, it sometimes breaks outwardly, and the matter is discharged by the wound.

SOMETIMES the suppuration happens within the sub­stance or body of the lungs; in which case the matter may be discharged by expectoration; but if the matter floats in the cavity of the breast, between the pleura and the lungs, it can only be discharged by an incision made betwixt the [...].

IF the patient's strength does not return after the inflam­mation is to all appearance removed; if his pulse continues quick, tho' soft, his breathing difficult and oppressed; if he has cold shiverings at times, his cheek▪ flushed, his lips dry; and if he complains of thirst, and want of appetite; there is reason to fear that a suppuration is going on, and that a phthisis or consumption of the lungs will ensue. We shall therefore proceed to consider the proper treatment of that disease.

OF CONSUMPTIONS.

A consumption is a wasting or decay of the whole body, from an ulcer, tubercles, or concretion of the lungs; from an empyema, a nervous atrophy, &c.

DR. Arbuthnot observes, that in his time consumptions made up above one tenth part of the bills of mortality about London. There is reason to believe, they have rather in­creased since that time; and we know for certain, that they are not less fatal in several other towns in England than in London.

[Page 122] YOUNG persons betwixt the age of fifteen and thirty, of a slender make, long neck, high shoulders, and flat breasts, are most liable to this disease.

CONSUMPTIONS prevail more in England than in any other part of the world, owing, perhaps, to the great use of animal food, and strong liquors, the general application to sedentary employments, and the great quantity of pit-coal which is there burnt; to which we may add, the perpetual changes in the atmosphere, or variableness of the weather.

CAUSES.—It has already been observed, that in­flammations of the breast often end in an imposthume: Consequently, whatever predisposes to those diseases, must likewise be considered as a cause of consumptions.

MANY other diseases, by vitiating the humours, may likewise occasion consumptions; as the scurvy, the scro­phula or king's evil, the venereal disease, the asthma, small-pox, measles, &c.

As this disease is seldom cured, it will be necessary to point out its causes more particularly, in order that people may be the better enabled to avoid it. These are:

—WANT of exercise. Hence it comes to pass, that this disease is so common amongst the inhabitants of great towns, who follow sedentary employments, and likewise amongst the rich, who are not under the necessity of la­bouring for their bread.

—CONFINED or unwholesome air. Air which stag­nates, or is Impregnated with the fumes of metals or mine­rals, is extremely hurtful to the lungs, and often corrodes the tender vessels of that necessary organ.

—VIOLENT passions or affections of the mind; as grief, disappointment, anxiety, or close application to the study of abstruse arts or sciences, &c.

—EXCESSIVE evacuations; as sweating, diarrhoeas, diabetes, excessive venery, the flour albus, an over-discharge of the menstrual flux, giving suck too long, &c.

—THE sudden stoppage of customary evacuations; [...] the bleeding piles, sweating of the feet, bleeding of the nose, the menses, issues, ulcers, or eruptions of any kind.

—CHANGING suddenly from a hot to a very cold cli­mate, or whatever greatly lessens the perspiration.

—FREQUENT and excessive debaucheries. Late watch­ing, and drinking of strong liquors, which generally go to­gether, can hardly fail to destroy the lungs. Hence the bon companion generally falls a sacrifice to this disease.

[Page 123] —INFECTION. Consumptions are often caught by sleeping with the diseased; for which reason this should be carefully avoided. It cannot be of great benefit to the sick, and must hurt [...]ose in health.

—OCCUPATIONS in life. Those artificers who sit much, and are constantly leaning forward, or pressing upon their stomachs and breasts, as cutlers, taylors, shoemakers, &c. often die of consumptions.

—COLD. More consumptive patients date their dis­orders from wet feet, damp beds, night air, wet cloaths, and such like, than from all other causes.

SHARP, saline, and aromatic aliments, which heat and inflame the blood, are likewise frequently the cause of con­sumptions.

WE shall only add, that this disease is often owing to an hereditary taint; in which case, it is generally incurable.

SYMPTOMS.—This disease generally begins with a dry cough, which often continues for some months. If a disposition to vomit after eating be excited by it, there is great reason to fear an approaching consumption. The patient complains of a more than usual degree of heat, a pain and oppression of the breast, especially after motion; his spittle is of a saltish taste, and sometimes mixed with blood. He is apt to be sad; his appetite is bad, and his thirst great. There is generally a sense of weight on the breast, with a quick, soft, small pulse; though sometimes the pulse is pret­ty full, and rather hard. These are the common symptoms of a beginning consumption.

AFTERWARDS the patient begins to spit a greenish, white, or bloody matter. His body is extenuated by the hectic fever and colliquative sweats, which mutually succeed one another, viz. the one towards the night, and the other in the morning. A looseness, and excessive discharge of urine, are often troublesome symptoms at this time, and greatly weaken the patient. There is a burning heat in the palms of the hands, and the face generally flushes after eating; the fingers become remarkably small, the nails are bent inwards, and the hairs fall off.

AT last, the swelling of the feet and legs, the total loss of strength, the sinking of the eyes, the difficulty of swallow­ing, and the coldness of the extremities, show the immedi­ate approach of death, which, however, the patient seldom believes to be so near. Such is the usual progress of this [Page 124] fatal disease, which, if not early checked, commonly sets all medicine at defiance.

REGIMEN.—On the first appearance of this disease, if the patient lives in a large town, or any place where the air is confined, he ought immediately to quit it, and to make choice of a situation in the country, where the air is pure, dry and free. Here he must not remain inac­tive, but take every day as much exercise as he can bear.

THE best method of taking exercise is to ride on horse­back, as this gives the body a great deal of motion without much fatigue. Such as cannot bear this kind of exercise, must make use of a machine. A long journey, as it amuses the mind by a continual change of objects, is greatly pre­ferable to riding the same ground over and over. Care, however, must be taken to avoid catching cold from wet cloaths, damp beds, or such like. At any rate, the patient must ride; his life depends upon it; and it is almost an in­fallible remedy, if begun in time, and duly persisted in.

IT is pity those who attend the sick seldom recommend riding in this disease, till the patient is either unable to bear it, or the malady is become incurable. Patients are always apt to trifle with every thing that is in their own power. They cannot see how one of the common actions of life should prove a remedy in an obstinate disease, and therefore they reject it, while they greedily hunt after relief from me­dicine, merely because it is unknown.

THOSE who have strength and courage to undertake a pretty long voyage, may expect great advantage from it. This has frequently cured a consumption after the patient was thought to be in the last stage of that disease, and where medicine had proved ineffectual. It is reasonable from hence to conclude, that if a voyage were undertaken in due time, it would seldom [...]il to perform a cure.

SUCH as try this method of cure, ought to carry as much fresh provisions along with them as will serve for the whole time they are at sea. As milk is not to be obtained in this situation, they ought to live upon fruits and the broth of chickens, or other young animals which can be kept alive on board. It is scarce necessary to add, that such voyages should be undertaken, if possible, in the mildest season, and that they ought to be towards a warmer climate.

THOSE who have not courage for a long voyage may travel into a more southern climate, as the south of France, Spain, or Portugal; and if they find the air of these countries [Page 125] agree with them, they should continue there, at least till their health be confirmed.

NEXT to proper air and exercise, we would recommend a due attention to the diet. The patient must eat nothing that is either heating or hard of digestion, and his drink must be of a soft and cooling nature. All the diet must be calculat­ed to lessen the acrimony of the humours, and abate the rapid motion of the blood. For this purpose the patient must keep strictly to the use of vegetables and milk. Milk, alone, is of more value in this disease, than the whole ma­teria medica.

ASSES milk is generally reckoned preferable to any other; but it cannot always be obtained; besides, it is generally taken as a medicine, whereas, to produce any considerable effects, it ought, in a manner, to make the principal part of the patient's food. It is hardly to be expected, that a gill or two of asses milk, drank in the space of twenty-four hours, should be able to produce any considerable change in the humours in a short time; but when people do not per­ceive its effects soon, they lose hope, and so leave it off. Hence it comes to pass, that this medicine, however valua­ble, very seldom performs a cure. The reason is obvious; it is commonly used too late, is taken in too small quanti­ties, and is not duly persisted in.

I have known very extraordinary effects from asses milk in obstinate coughs, which threatened a consumption of the lungs; and do verily believe, if used at this period, that it would seldom fail; but if it be delayed till an ulcer is formed, which is generally the case, how can it be expect­ed to succeed?

ASSES milk ought to be drank, if possible, in its natural warmth, and in the quantity of half an English pint at a time. Instead of taking this quantity night and morning only, the patient ought to take it four times, or, at least, thrice a-day, and to eat a little light bread along with it, so as to make it a kind of meal.

IF asses milk should happen to purge the patient, it may be mixed with old conserve of roses, which is itself a valu­able medicine in this disease. If that cannot be obtained, the powder of crabs claws may be used in its stead. Asses milk is usually ordered to be drank warm in bed; but as it generally throws the patient into a sweat, when taken in this way, it would be proper to give it after he rises.

[Page 126] SOME extraordinary cures in consumptive cases have been performed by breast milk. Could this be obtained in sufficient quantity, we would recommend it preferable to any other. It is better if the patient can suck it from the breast than to drink it afterwards. I knew a man who was reduced to such a degree of weakness in a consumption, as not to be able to turn himself in bed. His wife was that time giving suck, and the child happening to die, he sucked her breasts, not with a view to reap any advantage from the milk, but to make her easy. Finding himself however greatly bene­fited by it, he continued to suck her till perfectly recovered, and is at present a strong and healthy man.

SOME prefer butter-milk to any other, and it certainly is a very valuable medicine, if the stomach be able to bear it. It does not agree with every person at first; and is there­fore often laid aside without a sufficient trial. It should at first be taken sparingly, and the quantity gradually increas­ed, until it comes to be almost the sole food. I never knew it succeed, unless where the patient almost entirely lived upon it.

COWS milk is most readily obtained of any; and tho' it be not so easily digested as that of asses or mares, it may be rendered lighter, by adding to it an equal quantity of barley water, or allowing it to stand for some hours, and afterwards taking off the cream. If it should, notwith­standing, lie heavy on the stomach, a table spoonful of rum or brandy, and a bit of loaf-sugar, may be put into half an English pint.

IT is not to be wondered, that milk should, for some time, disagree with a stomach that has not been accustomed to digest any thing but flesh and strong liquors, which is the case of most of those who fall into consumptions. We do not, however, advise those who have been accustomed to animal food and strong liquors, to leave them off all at once. This might be dangerous. It will be necessary for such to eat a little once a-day of the flesh of some young animal, or rather to use the broth made of chickens, veal, lamb, or such like. They ought likewise to drink a little wine made into negas, or diluted with twice or thrice its quan­tity of water, and to make it gradually weaker till they can leave it off altogether.

THESE must be used only as preparatives to a diet con­sisting solely of milk and vegetables, which the sooner the patient can be brought to bear, the better. Rice and milk, [Page 127] or barley and milk boiled, with a little sugar, is very pro­per food. Ripe fruits, roasted, baked, or boiled, are like­wise proper; as goose or currant-berry tarts, apples roasted, or boiled in milk, &c. The jellies, conserves, and pre­serves. &c. of ripe subacid fruits, ought to be eat plenti­fully, as the jelly of currants, conserve of roses, preserved plumbs, cherries, &c.

WHOLESOME air, proper exercise, and a diet consisting solely of these and other vegetables, with milk, is the only course that can be depended on in the beginning of a con­sumption. If the patient has strength and sufficient resolu­tion to persist in this course, he will seldom be disappointed of a cure.

IN a populous town in England, where consumptions are very common, I have frequently seen consumptive pa­tients, who had been sent to the country with orders to ride, and live upon milk and vegetables, return in a few months quite plump, and free of any complaint. This, in­deed, was not always the case, especially when the disease was hereditary, or far advanced; but it was the only me­thod in which success was to be expected; where it failed, I never knew medicine succeed.

IF the patient's strength and spirits flag, he must be sup­ported by rich broths, jellies, &c. Some recommend shell-fish in this disorder, and we are inclined to think with reason; they are very nourishing, at the same time that they cool the blood, and blunt the acrimony of the hu­mours. All the food and drink ought to be taken in small quantities, lest an overcharge of fresh chyle should oppress the lungs, and too much accelerate the circulation of the blood.

THE patient's mind ought to be kept as easy and chear­ful as possible. Consumptions are often occasioned by a melancholy cast of mind; for which reason, music, cheer­ful company, and every thing that inspires mirth, are high­ly beneficial. The patient ought seldom to be left alone, as brooding over his calamities is sure to render them worse.

MEDICINE.—Though we know no medi­cine that will cure a confirmed consumption; yet the fol­lowing things may be of service, in abating some of the more violent symptoms.

IN the first stage of a consumption, the cough may some­times be appeased by bleeding; and expectoration promoted [Page 128] by the following medicines. Take fresh squills, gum am­moniac, and powdered cardamum seeds, of each a quarter of an ounce; beat them together in a mortar, and if the mass proves too hard for pills, a little of any kind of syrup may be added to it. This may be formed into pills of a moderate size, and four or five of them taken twice or thrice a-day, according as the patient's stomach will bear them.

THE lac ammoniacum, or milk of gum ammoniac, as it is called, is likewise a proper medicine in this stage of the dis­ease. It may be prepared and used, as directed page 117.

A syrup made of equal parts of lemon juice, fine honey, and sugar-candy, may likewise be used. Four ounces of each of these may be simmered together in a sauce-pan, over a slow fire, and a table spoonful of it taken at any time when the cough is troublesome.

IT is common, in this stage of the disease, to load the patient's stomach with balsamic medicines, and at the same time, to drench him with decoctions, infusions, &c. of the pectoral vegetables. The former of these, instead of re­moving the cause of the disease, tend rather to increase it, by heating the blood, while the latter pall the appetite, relax the solids, and prove every way hurtful to the pati­ent. Whatever is used for removing the cough, besides, riding, and other proper regimen, ought to be medicines of a sharp and cleansing nature.

FOR the patient's drink, we would recommend infusions of the bitter plants, as ground-ivy, the lesser centaury, camomile flowers, or water trefoil. These infusions may be drank at pleasure. They strengthen the stomach, pro­mote digestion, rectify the blood, and at the same time an­swer all the purposes of dilution, and quench thirst much better than things that are luscious or sweet.

BUT if the patient spits blood, he ought to use the fol­lowing decoction for his ordinary drink. Take an ounce of comfrey root, of liquorice and marsh-mallow roots, each half an ounce. Boil them in two English quarts of water to one. If a tea spoonful of the acid elixir of vitriol be add­ed to this decoction, when cold, it will be a very proper medicine. A tea cupful of it may be taken at pleasure.

THERE are many other mucilaginous plants and seeds, of a healing and agglutinating nature, from which decocti­ons or infusions may be prepared with the same intention; as the orches, the quince seed, coltsfoot, linseed, sarsaparilla, &c. It is not necessary to mention the different forms in [Page 129] which these may be used. Simple infusion, or boiling, is all that is necessary, and the dose may be at discretion.

THE conserve of roses is here peculiarly proper. It may either be put into the decoction above prescribed, or eat by itself. No benefit is to be expected from trifling doses of this medicine. I never knew it of any service, unless where three or four ounces at least were used daily. In this way I have seen it produce very extraordinary effects, and would recommend it wherever there is a discharge of blood from the lungs.

WHEN the spitting up of gross matter, oppression of the breast, and the hectic symptoms show that an imposthume is formed in the lungs, we would recommend the Jesuits bark, that being the only drug which has any chance to counteract the tendency which the humours then have to putrefaction.

AN ounce of the bark, in powder, may be divided into eighteen or twenty doses, of which one may be taken every three hours through the day, in a little syrup, or a cup of the patient's ordinary drink.

IF the bark should happen to purge, it may be made into an electuary, with the conserve of roses: thus; take old conserve of roses, a quarter of a pound; Jesuits bark, in powder, an ounce; syrup of orange, or lemon, as much as will make it of the consistence of honey. This quanti­ty will serve the patient four or five days, and may be re­peated as there is occasion.

SUCH as cannot take the bark in substance, may infuse it in cold water. This seems to be the best medium for ex­tracting the virtues of that drug. Half an ounce of bark, in powder, may be infused for twenty-four hours in half an English pint of water. Afterwards let it be passed through a fine strainer, and an ordinary tea cupful of it taken three or four times a-day.

WE would not recommend the bark while there are any symptoms of an inflammation of the breast; but when it is certainly known, that matter is collecting there, it is the only medicine upon which any stress can be laid. Few pa­tients have resolution enough to give the bark a fair trial, at this period of the disease; otherwise, we have reason to believe, that great benefit might be reaped from it.

WHEN it is evident, that there is an imposthume in the breast, and the matter can neither be spit up, nor carried off by absorption, the patient must endeavour to make it [Page 130] break inwardly, by drawing in the steams of warm water or vinegar with his breath, coughing, laughing, or bawl­ing aloud, &c. When it happens to burst within the lungs, the matter may be discharged by the mouth. Sometimes, indeed, the bursting of the vomica, occasions immediate death, by suffocating the patient. When the quantity of matter is great, and the patient's strength exhausted, this is apt to happen. At any rate, the patient is ready to fall into a swoon, and should have volatile spirits, or salts, held to the nose.

IF the matter discharged be thick, and the cough, and breathing, become easier, there may be some hopes of a cure. The diet, at this time, ought to be light, but re­storative; as, small chicken broths, sago gruel, rice-milk, &c. The drink, butter-milk, or whey, sweetened with honey. This is likewise a proper time for using the Jesuits bark, which may be taken as before directed.

IF the vomica, or imposthume, should discharge itself into the cavity of the breast, betwixt the pleura and the lungs, there is no way of getting the matter out, but by an incision, as has already been observed. As this opera­tion must always be performed by a surgeon, it is not ne­cessary for us to describe it. We shall only observe, that it is not so dreadful as people are apt to imagine, and that it is the only chance the patient has for his life. It is, indeed, a pity that this operation, like most others, is ge­nerally delayed till too late. When the whole mass of hu­mours is tainted, the body wasted, and the strength decay­ed, it is in vain to attempt to save the patient's life by an operation.

A NERVOUS CONSUMPTION, is a wasting, or decay of the whole body, without any consi­derable degree of a fever, cough, or difficulty of breathing. It is attended with indigestion, weakness, and want of ap­petite &c.

THOSE who are of a fretful temper, who indulge in spi­rituous liquors, or who breathe an unwholesome air, are most liable to this disease.

WE would chiefly recommend, for the cure of a ner­vous consumption, a light and nourishing diet; enough of exercise, in a free open air; and the use of such bitters, as brace and strengthen the stomach; as, the Jesuits bark, [Page 131] gentian root, camomile, &c. These may be infused in wine, and a glass of it drank frequently.

IT will greatly assist the digestion, and promote the cure of this disease, to take, twice a-day, twenty or thirty drops of the elixir of vitriol in a glass of wine or water.

THE chalybeate wine is likewise an excellent medicine in this case. It strengthens the solids, and powerfully as­sists nature in the preparation of good blood. It is made by putting three ounces of the filings of steel, or iron, into a bottle of Rhenish wine, and allowing it to digest for three weeks, frequently shaking the bottle. Afterwards the wine must be filtered for use. A table spoonful of it may be taken twice or thrice a-day.

AGREEABLE amusements, cheerful company, and riding about, are, however, preferable to all medicines in this dis­ease. For this reason, when the patient can afford it, we would recommend a long journey of pleasure, as the most likely means to restore his health.

WHAT is called a symptomatic consumption cannot be cured without first removing the disease by which it is oc­casioned. Thus, when a consumption proceeds from the scrophula, or king's evil, from the scurvy, the asthma, the venereal disease, &c. a due attention must be paid to the malady from whence it arises, and the regimen and medicine directed accordingly.

WHEN excessive evacuations, of any kind, occasion a consumption, they must not only be restrained; but the pa­tient's strength must be restored by gentle exercise, nou­rishing diet, and generous cordials, &c. Young and de­licate mothers, often fall into consumptions, by giving suck too long. As soon as they perceive their strength and ap­petite begin to fail, they ought immediately to wean the child, or give it to another nurse, otherwise they cannot ex­pect a cure.

BEFORE quitting this subject, we would earnestly recom­mend it to all who wish to avoid consumptions, to take as much exercise without doors as they can; to avoid un­wholesome air, and to study sobriety. Consumptions owe their present increase not a little to the fashionable mode of spending every evening over a punch-bowl, or a bottle of wine. These liquors not only spoil the appetite, and hurt the digestion, but heat and inflame the blood, and set the whole constitution on fire.

THE SLOW OR NERVOUS FEVER.

NERVOUS fevers have increased greatly of late years in this island, owing, doubtless, to the increase of luxury and sedentary employments; as this disease commonly attacks persons of a weak relaxed habit, who neglect exercise, eat little solid food, study hard, or indulge in spirituous liquors.

CAUSES.—Nervous fevers are occasioned by what­ever depresses the spirits, or impoverishes the blood; as grief, fear and anxiety, want of sleep, intense thought; living on poor watery diet, as unripe fruits, cucumbers, melons, mushrooms, &c. They are likewise occasioned by damp, confined, or unwholesome air. Hence they are very common in rainy seasons, and prove most fatal to those who live in dirty, low houses, crowded streets, hospitals, jails, or such like places.

PERSONS whose constitutions have been broken by ex­cessive venery, frequent salivations, too free an use of pur­gative medicines, or the like, are very liable to this disease.

KEEPING on wet cloaths, sleeping in the sun, lying on the damp ground, excessive fatigue, and whatever obstructs the perspiration, or causes a spasmodic stricture of the so­lids, may likewise occasion nervous fevers. We shall only add, frequent and great irregularities in eating and drinking. Too great abstinence, as well as excess, is hurtful. Nothing tends so much to preserve the humours in a sound state as a regular diet; nor can any thing contribute more to occa­sion fevers of the worst kind than its contrary.

SYMPTOMS.—Low spirits, want of appetite, weakness, weariness after motion, watchfulness, deep sigh­ing, and dejection of mind, are generally the forerunners of this disease. These are succeeded by a quick low pulse, a dry tongue, without any considerable thirst, chillness and flushing in turns, &c.

AFTER some time, the patient complains of a giddiness and pain of his head, has a nausea, with reachings and vo­miting; his pulse is quick, and sometimes intermitting; his urine pale, resembling dead small bear, and his breath­ing is difficult, with oppression of the breast, and slight alie­nations of mind.

IF towards the ninth, tenth, or twelfth day, the tongue becomes more moist, with a plentiful spitting, a gentle diarrhoea, or a moisture upon the skin; or if a suppuration happens in one or both ears, or large pustules break out [Page 133] about the lips and nose, there is reason to hope for a favour­able crisis.

BUT, if there be an excessive looseness, or wasting sweats, with frequent fainting fits; if the tongue, when put out, trembles excessively, and the extremities feel cold, with a fluttering or slow creeping pulse; if there be a starting of the tendons, an almost total loss of sight and hearing, and an involuntary discharge by stool and urine, there is great reason to fear that death is approaching.

REGIMEN.—It is highly necessary in this disease to keep the patient easy and quiet. The least motion will fatigue him, and will be apt to occasion weariness, and even faintings. His mind likewise ought not only to be kept easy, but soothed and comforted with the hopes of a speedy recovery. Nothing is more hurtful in low fevers of this kind, than presenting to the patient's mind gloomy or frightful ideas. These often occasion nervous fevers, and it is not to be doubted but they will likewise increase the danger.

THE patient must not be kept too low. His strength and spirits ought to be supported by nourishing diet and ge­nerous cordials. For this purpose, his gruels, panadas, or whatever food he takes, must be strengthened with wine, according as the symptoms may require. Pretty strong wine-whey, or small negas sharpened with the juice of orange or lemon, will be proper for his drink.

WINE, in this disease, if it could be obtained genuine, would be almost the only medicine that we should need. Good wine possesses all the virtues of the cordial medicines, while it is free from many of their bad qualities. I say, good wine; for, however common that article of luxury is now become, it is rarely to be obtained genuine, especially by the poor, or such as purchase it in small quantities.

I have seen a patient in a low nervous fever, whose pulse could hardly be felt, with a constant delirium, coldness of the extremities, and almost every other mortal symptom, recover by using, in whey, gruel, and negas, a bottle of strong wine every day. Good wine is not only the most proper cordial, but seems also to be an excellent antispas­modic medicine; and consequently it must be highly pro­per in all diseases arising from a poor vapid state of the blood, and too great a stricture of the solids.

MUSTARD whey is a very proper drink in this fever. It is made by tying in a linen rag a table spoonful of common [Page 134] mustard bruised, and boiling it a little in half an English pint of water, with an equal quantity of milk. Two or three spoonfuls of wine may be added to it when boiling, to make the curd separate more perfectly, and to render the whey more cordial. A tea cupful of this may be given fre­quently for the patient's ordinary drink.

IN a word, the great aim in this disease is to support the patient's spirits, by giving him frequently small quantities of the above, or other drinks of a warm and cordial nature. He is not, however, to be over-heated either with liquor or cloaths; and his food ought to be light, and given in small quantities.

MEDICINE.—Where a nausea, load, and sick­ness at stomach prevail at the beginning of the fever, it will be necessary to give the patient a gentle vomit. Fifteen or twenty grains of ipecacuanha will generally answer this purpose very well. This may be repeated any time before the third or fourth day, if the above symptoms continue. Vomits not only clean the stomach, but, by the general shock which they give, promote the perspiration, and have many other excellent effects in slow fevers, where there are no signs of inflammation, and nature wants rousing.

SUCH as dare not venture upon a vomit, may clean the bowels by a small dose of Turkey rhubarb, or an infusion of senna and manna.

IN all fevers, the great point is to regulate the symptoms, so as to prevent their going to either extreme. Thus, in fevers of the inflammatory kind, where the force of the cir­culation is too great, or the blood dense, and the fibres too rigid, bleeding and other evacuations are necessary. But where nature flags, where the blood is vapid and poor, and and the solids weak and relaxed, there the lancet is to be avoided. Hence, bleeding is never to be permitted in ner­vous fevers unless there be evident signs of an inflammation, which very seldoms happens.

IT is the more necessary to caution people against bleed­ing in this disease, as there is generally, at the beginning, an universal stricture upon the vessels, which even to the pa­tient himself often gives the idea of a plethora, or too great a quantity of blood. I have known some of the profession deceived by their own feelings in this respect, so far as to insist upon being bled, when it was evident that the opera­tion was improper.

[Page 135] I remember to have attended an apothecary in a nervous fever, who, at the beginning, was so fully persuaded of the existence of a plethora, and the necessity of bleeding, that when I objected to it, he told me he was so certain of the necessity of that operation from his own feelings, that if it was not performed he could not live; and that if no body else would bleed him, he was determined to do it himself. He was accordingly bled, but was soon convinced of his error. The blood shewed no signs of inflammation, and he was so remarkably worse after the operation, that he nar­rowly escaped with his life. His pulse and spirits sunk ex­ceedingly, so that he could hardly be supported by a bottle of strong wine in the day, besides other cordial medicines.

THO' bleeding be improper in this disease, yet blistering is highly necessary. Blistering plasters may be applied at all times of the fever with great advantage; we would, how­ever, advise people not to make too free with them at the beginning, le [...]t there should be more occasion for them after­wards. If the patient be delirious, he ought to be blistered on the neck, and it will be the safest course, while the fever continues; as soon as the discharge occasioned by one plaster abates, to apply another some where else, and by that means keep up a continual succession of them till the patient be out of danger.

I have been more sensible of the advantage of blistering in this disease, than of any other medicine. It not only pro­motes the circulation by stimulating the solids, but likewise occasions a continual discharge, which may, in some mea­sure, supply the want of critical evacuations, which seldom happen in this kind of fever.

IF the patient be costive through the course of the disease, it will be necessary to procure a stool, by giving him every other day a clyster of milk and water, with a little sugar, to which may be added a spoonful of common salt, if it be ne­cessary.

SHOULD a violent looseness come on, it may be checked, by giving the patient frequently a small quantity of Venice treacle, or any thing that will promote the perspiration.

THO' blistering and cordial liquors are the only medi­cines to be depended on in this kind of fever, yet, for those who may choose to use them, we shall mention one or two of the forms of medicine which are commonly prescribed in it.

THUS, when the patient is low, ten grains of Virginian snakeroot, and the same quantity of contrayerva root, with [Page 136] five grains of Russian castor, all in fine powder, may be made into a bolus, with a little of the cordial confection or syrup of saffron. One of these may be taken every four or five hours.

THE following powder may be used for the same inten­tion. Take wild Valerian root, in powder, one scruple; saffron and castor, each four grains. Mix these by rubbing them together in a mortar, and give it in a cup of wine whey three or four times a-day.

IN desperate cases, where the hiccup and starting of the tendons have already come on, we have sometimes seen ex­traordinary effects from large doses of musk frequently ex­hibited. This is doubtless a great antispasmodic, and may be given to the quantity of a scruple three or four times a-day. Sometimes, it may be proper to add to the musk a few grains of camphire, and salt of hartshorn, as these tend to promote perspiration and urine. Thus, fifteen grains of musk, with three grains of camphire, and six grains of salt of hartshorn, may be made into a dose and given as above.

IF the fever should happen to intermit, which it frequent­ly does towards the decline, or if the patient's strength should be wasted with colliquative sweats, it will be necessa­ry to give him an infusion of the Jesuits bark, with snake­root, in wine or brandy.

HALF an ounce of the bark, with a dram of Virginian snakeroot, half a dram of saffron, and half an ounce of orange-peel, all grossly powdered, may be infused in half an English pint of brandy for three or four days. Afterwards strain it, and give the patient two tea spoonfuls in a glass of water, or small wine, three or four times a-day.

SUCH as don't choose spirits, may infuse the above ingre­dients in a bottle of Lisbon wine, and take a glass of it fre­quently; this will restore the strength, prevent a relapse, and help to carry off the remains of the fever.

IT will likewise be proper, at this time, to interpose now and then a gentle dose of rhubarb, or some other mild open­ing medicine, taking care, at the same time, to support the patient's strength with chicken-broth, jellies, and such like.

OF THE MALIGNANT, PUTRID, OR SPOTTED FEVER.

THIS may be called the pestilential fever of Europe, as in many of its symptoms it-bears a great resemblance to that dreadful disease.

[Page 137] PERSONS of a lax habit, a melancholy disposition, and those whose vigour has been wasted by long fasting, watch­ing, hard labour, excessive venery, or frequent salivations, &c. are most liable to this disease.

CAUSES.—This fever is occasioned by an un­wholesome, putrid, or stagnating air. Hence it prevails in jails, hospitals and infirmaries, especially where such places are greatly crowded, and cleanliness is neglected.

A close constitution of the air, with long rainy or foggy weather, likewise occasions putrid fevers. Hence they often succeed great inundations in low and marshy countries, espe­cially when these are preceded or followed by a hot and sul­try season.

LIVING too much upon animal food, without a proper mixture of vegetables, or eating fish or flesh that has been kept too long, are likewise apt to occasion this kind of fe­ver. Hence, sailors on long voyages, and the inhabitants of besieged cities, are very often visited with putrid fevers.

CORN that has been greatly damaged by rainy seasons, or long keeping, and water that has become putrid by stagna­tion, will likewise occasion putrid fevers. The excessive use of alkaline salts will also have this effect.

DEAD carcases tainting the air, especially in hot seasons, are very apt to occasion putrid fevers. Hence this kind of fever often prevails in camps, and such countries as are the scenes of war and bloodshed. This shews the necessity of removing church-yards, slaughter-houses, &c. at a proper distance from great towns.

WANT of cleanliness is a very general cause of putrid fe­vers. Hence they prevail amongst the poor inhabitants of large towns, who breathe a confined, unwholesome air, ne­glect cleanliness, and are forced to live upon spoiled or un­wholesome provisions, &c. Such mechanics as carry on dirty employments, and are constantly confined within doors, are likewise very liable to putrid fevers.

WE shall only add, that all putrid, malignant, or spotted fevers, are very infectious; and are, therefore, often com­municated in this way. For which reason, all persons ought to keep at a distance from such as are affected with these dis­eases, unless those whose attendance is absolutely necessary.

SYMPTOMS.—The malignant fever is generally preceded by a remarkable weakness, or loss of strength, without any apparent cause. This is sometimes so great, [Page 138] that the patient can scarce walk, or even sit upright, with­out being in danger of fainting away. His mind too is greatly dejected; he sighs, and is full of dreadful appre­hensions.

THERE is a nausea, and sometimes vomiting of bile; a violent pain of the head, with a strong pulsation, or throbbing of the temporal arteries; the eyes often appear red and inflamed, with a pain at the bottom of the orbit; there is a noise in the ears, the breathing is laborious, and often interrupted with a sigh; the patient complains of a pain about the region of the stomach, and in his back and [...]oins; his tongue is at first white, but afterwards it appears black and chapped; and his teeth are covered with a black crust. He sometimes passes worms both upwards and downwards, is affected with tremors, or shaking, and often becomes delirious.

IF blood be let, it appears dissolved, or with a very small degree of cohesion, and soon becomes putrid; the stools smell extremely foetid, and are sometimes of a greenish, black, or reddish cast. Spots of a pale, purple, dun, or black colour, often appear upon the skin, and sometimes violent haemorrhages, or discharges of blood from the mouth, eyes, nose, &c. happen.

PUTRID fevers may be distinguished from the inflamma­tory, by the smallness of the pulse, the dejection of mind, the dissolved state of the blood, the petechiae, or purple spots, and the putrid smell of the excrements. They may likewise be distinguished from the low or nervous fever, by the heat and thirst being greater, the urine of a higher co­lour, and the other symptoms more violent.

IT sometimes, however, happens, that the inflamma­tory, nervous, and putrid symptoms, are so blended toge­ther, as to render it very difficult to determine to which class the fever belongs. In this case, the greatest caution and skill are requisite. All endeavours must be used to re­lieve the most urgent symptoms; and the efforts of nature are carefully to be watched, in order that we may give her what assistance we can in expelling the cause of the disease in her own way.

INFLAMMATORY and nervous fevers are often converted into malignant and putrid, by too hot a regimen, or im­proper medicines.

THE period of putrid fevers is extremely uncertain; sometimes they terminate betwixt the seventh and fourteenth [Page 139] day, and at other times, they are prolonged for five or six weeks. Their duration depends greatly upon the constitution of the patient, and the manner of treating the disease.

THE most favourable symptoms are, after the fourth or fifth day, a gentle looseness, with a warm, mild sweat. These, when continued for a considerable time, often carry off the fever, and should never be imprudently stopped. Small miliary pustules appearing between the petechiae, or purple spots, are likewise favourable; as also, hot scabby eruptions about the mouth and nose. It is a good sign when the pulse rises upon the use of wine, or other cordi­als, and the nervous symptoms abate; deafness coming on towards the decline of the fever, is likewise a favourable symptom, and so are abscesses in the groin, or parotid glands.

AMONGST the unfavourable symptoms may be reckoned an excessive looseness, with a hard swelled belly. Large black or livid blotches breaking out upon the skin, are a proof of the putrid dissolution of the blood, and shew the danger to be very great. Aphthae in the mouth, and cold clammy sweats▪ are unfavourable signs; as also, blindness, change of the voice, a wild staring of the eyes, difficulty of swallowing, an inability to put out the tongue, and a constant inclination to uncover the breast. When the sweat and saliva are tinged with blood, and the urine is black, or deposites a black, sooty sediment, the patient is in great danger. Starting of the tendons, and foetid, ichorous, involuntary stools, attended with coldness of the extremities, are generally the forerunners of death.

REGIMEN.—In the management of this disease, we are to endeavour, as far as possible, to counter­act the putrid tendency of the humours; to support the pa­tient's strength and spirits; and to assist nature in expelling the morbific matter, by gently promoting perspiration and the other evacuations.

IT has been observed, that putrid fevers are often occasi­oned by unwholesome air, and, of course, they must be aggravated by it. Care must, therefore, be taken to prevent the air from stagnating in the patient's chamber, to keep it cool, and renew it frequently, by opening the doors or windows of some adjacent apartment. The breath and perspiration of persons in perfect health, soon render the air of a small apartment noxious; but this will sooner [Page 140] happen from the perspiration and breath of a person whose whole mass of humours are in a putrid state. These fevers are often so heightened by the same infected air being breathed over and over, that the patient is, in a manner, suffocated by his own atmosphere.

BESIDES the frequent admission of fresh air, we would recommend the use of vinegar, verjuice, juice of lemon, Sevil orange, or any kind of vegetable acid that can be most rea­dily obtained. These ought frequently to be sprinkled up­on the floor, the bed, and every part of the room. They may also be evaporated with an hot iron, or by boiling, &c. The fresh skins of lemons or oranges ought likewise to be laid in different parts of the room, and they should be fre­quently help to the patient's nose. The use of acids in this manner would not only prove very refreshing to the patient, but would tend greatly to prevent the infection from spreading among those who attend him. Strong smelled herbs, as rue, tansy, rosemary, wormwood, &c. may likewise be laid in different parts of the house, and smelled by those who go near the patient.

THE patient must not only be kept cool, but likewise quiet and easy. The least noise will affect his head, and the smallest fatigue will be apt to make him faint away.

NOTHING is of so great importance in this disease, as the liberal use of acids. These are to be mixed with all the patient's food, as well as drink. Orange, lemon, or vinegar whey, are all very proper, and may be drank in turns, according to the patient's inclination. These may be ren­dered cordial, by the addition of wine, in such quantity as the patient's strength seems to require. When he is very low, he may drink negas, with only one half water, and sharpened with the juice of orange or lemon. In some cases, a glass of clear wine may now and then be allowed. The most proper wine is Rhenish; but if the belly be open, red Port, or claret, is to be preferred.

WHEN the belly is bound, a tea spoonful of the cream of tartar may be put into a cup of the patient's drink, as there is occasion; or he may eat a few tamrinds, which will both quench his thirst, and keep his belly easy.

IF camomile tea will sit upon the stomach, it is a very proper drink in this disease. It may be sharpened by add­ing to every cup of the tea fifteen or twenty drops of the elixir of vitriol.

[Page 141] THE food must be light, as panada, groat-gruel, and such like; to these a little wine may be added, if the patient be weak and low, and they ought all to be sharpened with the juice of orange, or the jelly of currants, raspberries, &c. The patient ought likewise to eat freely of ripe fruits, either baked, roasted, or raw, as roasted apples, currant, or goose­berry tarts, preserved cherries, plumbs, and such like.

THE patient must never be long without nourishment. Taking a little food or drink frequently, not only supports the spirits, but counteracts the putrid tendency of the hu­mours; for which reason, he ought constantly to be sipping small quantities of some of the acid liquors mentioned above, or any that may be more agreeable to his palate, or more readily obtained.

IF the patient be delirious, his feet and hands ought to be frequently fomented with strong infusions of camomile flowers. This, or an infusion of the bark, to such as can afford it, cannot fail to have a good effect. Fomentations of this kind not only relieve the head, by relaxing the ves­sels in the extremities, but as their contents are absorbed, and taken into the blood, they must, by their antiseptic qualities, assist in preventing the putrescency of the humours.

IF the patient be not able to put his feet and hands into the decoction, cloths dipt in it may be applied to them.

MEDICINE.—If a vomit be taken at the very be­ginning of this fever, it will hardly fail to have a good ef­fect; but if the fever has gone on for some days, and the symptoms are violent, vomits must not be taken without proper advice.

BLEEDING is seldom necessary in putrid fevers. If there be signs of an inflammation, it may sometimes be permitted at the first onset; but the repetition of it often proves fatal.

BLISTERING plasters are never to be used unless in the greatest extremities. If the petechiae, or spots, should sud­denly disappear, the patient's pulse sink remarkably, and a delirium, with other bad symptoms, come on, blistering may be permitted. In this case, the blistering plasters are to be applied to the head, and the insides of the legs or thighs. But as they are sometimes apt to occasion a gan­grene, we would rather recommend warm poultices or cata­plasms to be applied to the feet, having recourse to blisters only in the utmost extremities.

A very ridiculous notion has long prevailed, of expelling the poisonous matter of malignant diseases by strong doses [Page 142] of cordial or alexipharmic medicines. In consequence of this notion, the contrayerva root, the cordial confection, and the mithridate, &c. have been extolled as infallible re­medies. There is reason to believe, that these oftener do harm than good. Where cordials are necessary, we know none that is superior to good wine; and therefore again re­commend it both as the safest and best. Wine, with other acid and antiseptic medicines, are the only things to be re­lied on in the cure of malignant fevers.

WE have already recommended acids in various forms, and shall only add one more, viz. camphorated vinegar. This is made, by rubbing a dram of camphor, with a small quantity of spirits of wine in a mortar, till it becomes soft, then adding half an ounce of loaf-sugar, and rubbing the whole together till perfectly united. Afterwards, take an English pint of warm vinegar, and add it by little and little, still continuing the trituration, till they be uniformly mix­ed. Let it stand to cool, and afterwards strain it. This may be taken in the dose of a table spoonful or two, every two or three hours, according as it agrees with the stomach. If it should heat the patient, or occasion a nausea, it must be discontinued.

IN the most dangerous species of this disease, when it is attended with purple, livid, or black spots, the Jesuits bark is the only medicine that can be depended upon. I have seen it, when joined with acids, almost perform wonders, even in cases where the petechiae had the most threatening aspect. But, to answer this purpose, it must not only be given in large doses, but duly persisted in.

THE best method for administering the bark is certainly in substance. An ounce of it, in powder, may be mixed with half an English pint of water, and the same quantity of red wine, and sharpened with the elixir of spirit of vitriol, which will both make it sit easier on the stomach, and ren­der it more beneficial. Two or three ounces of the syrup of lemon may be added, and two table spoonfuls of the mix­ture taken every two hours, or oftener, if the stomach will bear it.

THOSE who cannot take the bark in substance may in­fuse it in wine, as recommended in page 136.

IF there be a violent looseness, the bark must be boiled in red wine, with a little cinnamon, and sharpened with the elixir of vitriol, as above. Nothing can be more beneficial [Page 143] in this kind of looseness than plenty of acids, and such things as promote the perspiration.

IF the patient be troubled with vomiting, a dram of the salt of wormwood dissolved in an ounce and an half of fresh lemon juice, and made into a draught with an ounce of simple cinnamon water, or peppermint water, and a bit of sugar, may be given to the patient, and repeated as often as it is necessary.

IF swellings of the glands appear, there suppuration is to be promoted by the application of poultices, ripening cata­plasms, &c. And as soon as there is any appearance of mat­ter in them, they ought to be laid open, and the poultices continued.

I have known patients, in the decline of this fever, have large ulcerous sores break out in various parts of the body, of a livid gangrenous appearance, and a most putrid cada­verous smell. These gradually healed, and the patient re­covered by the plentiful use of Jesuits bark mixed in wine, and sharpened with the spirits of vitriol.

ALL who would avoid this dreadful disease, should study universal cleanliness, and should live regularly, avoiding the extremes of too high or too low a diet with equal care.

INFECTION, above all things, is to be avoided. No con­stitution is proof against it. I have known persons seized with a putrid fever, by only making a single visit to a pa­tient in it; others have caught it by going through a town where it prevailed; and some by attending the funerals of such as died of it.

ANY one who is apprehensive of having caught the in­fection, ought immediately to take a vomit, and to work it off by drinking plentifully of camomile tea. This may be repeated in a day or two, if the apprehensions still continue, or any unfavourable symptoms appear.

THE person ought likewise to take an infusion of the bark and camomile flowers for his ordinary drink; and, be­fore he goes to bed, he may drink an English pint of pretty strong negas, or a few glasses of generous wine. I have been frequently obliged to follow this course when malig­nant fevers prevailed, and have likewise recommended it to others with constant success.

PEOPLE generally fly to bleeding and purging as antidotes against infection; but these are so far from securing them, that they often increase the danger.

[Page 144] PHYSICIANS, and such as attend the sick in putrid fevers, ought always to have a piece of spunge, or a handkerchief dipt in vinegar, or juice of lemon, to hold at their nose. They ought likewise to wash their hands, and, if possible, to change their cloaths, before they visit any other patient.

OF THE MILIARY FEVER.

THIS fever takes its name from the small pustules or bladders which appear on the skin, resembling, in shape and size, the seeds of millet. The pustules are either red or white, and sometimes both are mixed together.

SOMETIMES the whole body is covered with pustules; but they are generally more numerous where the sweat is most abundant, as on the breast, the back, &c. A gentle sweat, or moisture on the skin, greatly promotes the erup­tion; but where the skin is dry, the eruption is both more painful and dangerous.

SOMETIMES this is a primary disease; but it is much of­tener only a symptom of some other malady, as the small­pox, measles, ardent, putrid, or nervous fever, &c. In all these cases it is generally the effect of too hot a regimen or medicines.

THE miliary fever chiefly attacks the idle and the phleg­matic, or persons of a relaxed habit. The young and the aged are more liable to it than those in the vigour and prime of life. It is likewise more incident to women than men, especially the delicate, and the indolent, who, neglecting ex­ercise, keep continually within doors, and live upon weak, watery diet. Such females are extremely liable to be seiz­ed with this disease in child-bed, and often lose their lives by it.

CAUSES.—The miliary fever is often occasi­oned by violent passions or affections of the mind; as ex­cessive grief, anxiety, thoughtfulness, &c. It may like­wise be occasioned by excessive watching, great evacuations, a weak, watery diet, rainy seasons, eating too freely of cold, watery, unripe fruits, as plumbs, cherries, cucum­bers, melons, &c. Impure waters, or provisions which have been spoiled by rainy seasons, long keeping, &c. may likewise cause miliary fevers. They may also be occasion­ed by the stoppage of any customary evacuation, as issues, setons, ulcers, the bleeding piles in men, or the menstrual flux in women, &c.

[Page 145] THIS disease in childbed women i [...] sometimes the effect of great costiveness during pregnancy; sometimes it is oc­casioned by their excessive use of green, unripe fruits, and other unwholesome things, in which pregnant women are too apt to indulge. But its most general cause is in­dolence. Such women as indulge an easy, sedentary life, during pregnancy, and, at the same time, live gross and full, can hardly escape this disease in childbed. Hence it proves extremely fatal to women of fashion, and likewise to those women in manufacturing towns, who, in order to assist their husbands, sit close, within doors, for almost the whole of their time. But, among women who are active and laborious, who live in the country, and take enough of exercise without doors, this disease is very little known.

SYMPTOMS.—When this is a primary dis­ease, it makes its attack, like most other eruptive fevers, with a slight shivering, which is succeeded by heat, loss of strength, faintishness, sighing, a low quick pulse, difficul­ty of breathing, with great anxiety and oppression of the breast. The patient is restless, and sometimes delirious; the tongue appears white, and the hands shake, with often a burning heat in the palms; and, in childbed wo­men, the milk generally goes away, and the other dischar­ges stop.

THE patient feels an itching or pricking pain under the skin, after which innumerable small pustules of a red or white colour▪ begin to appear. Upon this the symptoms generally abate, the pulse becomes more full and soft, the skin grows moister, and the sweat, as the disease advances, begins to have a peculiar foetid smell; the great load on the breast, and oppression of the spirits, generally go off, and the customary evacuations gradually return. About the sixth or seventh day from the eruption, the pustules be­gin to dry and fall off, which occasions a very disagree­able itching in the skin.

IT is impossible to ascertain the exact time when the pu­stules will either appear or go off. They generally come out on the third or fourth day, when the eruption is criti­cal; but, when symptomatical, they may appear at any time of the disease.

SOMETIMES the pustules appear, and vanish, by turns. When that is the case, there is always danger; but when they strike in, all of a sudden, and do not appear again, the danger is very great.

[Page 146] IN childbed women, the pustules are commonly at first filled with clear water, afterwards they grow yellowish. Sometimes they are interspersed with pustules of a red co­lour. When these only appear, the disease goes by the name of a rash.

REGIMEN.—In all eruptive fevers, of what­ever kind, the chief point is to prevent the sudden striking in of the pustules. For this purpose, the patient must be kept in such a temperature, as neither to push out the eruption too fast, nor cause it to retreat prematurely. The diet and drink ought therefore to be in a moderate degree, nourishing and cordial; but neither strong nor heating. The patient's chamber ought neither to be kept too hot nor too cold; and he should not be too much covered with cloaths. Above all, the mind is to be kept easy and cheer­ful. Nothing so certainly makes an eruption strike in, as fear, or the apprehension of danger.

THE food must be weak chicken broth, with bread, wa­ter pap, with sago, and groat gruel, &c. to a gill of which may be added a spoonful or two of wine, as the patient's strength requires, with a few grains of salt and a little su­gar. Good apples, roasted or boiled, with other ripe fruits, of an opening, cooling nature, may be eat.

THE drink must be suited to the state of the patient's strength and spirits. If these be pretty high, the drink ought to be weak; as water gruel, balm tea, or the fol­lowing decoction:

TAKE two ounces of the shavings of hartshorn, and the same quantity of sarsaparilla, boil them in two English quarts of water. To the strained decoction add a little white sugar, and let the patient take it for his ordinary drink.

WHEN the patient's spirits are low, and the eruption does not rise sufficiently, his drink must be a little more ge­nerous; as wine whey, or small negas, sharpened with the juice of orange or lemon, and made stronger or weaker, as the circumstances may require.

SOMETIMES the miliary fever approaches towards a pu­trid nature; in which case the patient's strength must be supported with generous cordials, joined with acids; and if the degree of putrescency be great, the Jesuits bark must be administered. If the head be much affected, the belly must be kept open by emollient clysters.

IN the Commercium Literarium for the year 1735, we have the the history of an epidemical miliary fever, which reged [Page 147] at Strasburg in the months of November, December, and January; from which we learn the necessity of a temperate regimen in this disease, and likewise that physicians are not always the first who discover the proper treatment of dis­eases. "This fever made terrible havoc among men of robust constitutions, and all medicine proved in vain. They were seized in an instant with shivering, yawning, stretch­ing, and pains in the back, succeeded by a most intense heat; at the same time, there was a great loss of strength and appetite. On the seventh or ninth day the miliary eruptions appeared, or spots like flea-bites, with great anxie­ty, a delirium, restlessness, and tossing in bed. Bleeding was fatal. While matters were in this unhappy situation, a midwife, of her own accord, gave to a patient, in the height of the disease, a clyster of rain-water and butter, without salt, and for his ordinary drink a quart of spring-water, half a pint of generous wine, the juice of one lemon, and six ounces of the whitest sugar, gently boiled till a scum arose, and this with great success; for the belly was soon loosened, the grievous symptoms vanished, and the patient was restored to his senses, and snatched from the jaws of death." This practice was imitated by others with the like happy effects.

MEDICINE.—If the food and drink be properly regulated, there will be little occasion for medicine in this disease. Should the eruption, however, not rise, or the spirits flag, it will be necessary to support the patient with cordials, and to apply blisters. The most proper cordial, in this case, is good wine, which may either be taken in the patient's food or drink; and if there be any signs of putres­cency, which frequently happens, the bark and acids may be mixed with wine, as directed in the putrid fever.

SOME recommend blisters through the whole course of the disease; and where nature flags, and the eruption comes and goes, it may be necessary to keep up a stimulus, by a continual succession of small blisters; but we would not re­commend above one at a time. If, however, the pulse should sink remarkably, the pustules strike in, and the head be af­fected, it will be necessary to apply several blistering plasters to the most sensible parts, as the inside of the legs and thighs, &c.

BLEEDING is seldom necessary in this disease, and some­times it does much hurt, as it weakens the patient, and de­presses his spirits. It is, therefore, never to be attempted [Page 148] unless by the advice of a physician. We mention this, be­cause it has been customary to treat this disease in childbed women by bleeding, and other evacuations, as if it were highly inflammatory. But this practice is generally very unsafe. Patients, in this situation, bear evacuations very ill. And, indeed, the disease seems often to be more of a putrid than an inflammatory nature.

THOUGH this fever be often occasioned in childbed women by too hot a regimen, yet it would be dangerous to leave that off all of a sudden, and have recourse to a very cool regimen, and large evacuations. We have reason to believe, that supporting the patient's spirits, and promoting the natural evacuations, is here much safer than to have re­course to artificial ones, as every thing that tends to depress the patient's spirits constantly increases the danger.

IF this disease proves tedious, or the recovery slow, we would recommend the Jesuits bark, which may either be taken in substance, or infused in wine or water, as the pa­tient inclines.

THE miliary fever, like other eruptive diseases, after it is gone, requires purging, which should not be neglected as soon as the patient's strength will permit.

To avoid this disease, a pure dry air, plenty of exercise and wholesome food, are necessary. Pregnant women should guard against costiveness, and take daily as much exercise as they can bear, avoiding all green trashy fruits, and other unwholesome things; and when in childbed, they ought strictly to observe a cool regimen.

OF THE SMALL-POX.

THIS disease is so general, that very few escape it at one time of life or another. It is the most contagious malady in these parts; and has, for upwards of a thousand years, proved the scourge of Europe.

THE small-pox generally appear towards the spring. They are very frequent in summer, less so in autumn, and least of all in winter. Children are most liable to this dis­ease; and those whose food is unwholesome, who want pro­per exercise, and abound with gross humours, run the greatest hazard from it.

THE disease is distinguished into the distinct and conflu­ent kind; the latter of which is always attended with dan­ger. [Page 149] There are likewise other distinctions of the small-pox; as the lymphatic, the crystalline, the bloody, &c.

CAUSES.—The small-pox are commonly caught by infection. Since the disease was brought into Europe, the infection has never been wholely extinguished; nor have any proper methods, so far as we know, ever been taken for that purpose; so that now it has become in a manner con­stitutional. Children who have over-heated themselves by running, wrestling, &c. or adults after a debauch, are very apt to be seized with this disease.

SYMPTOMS.—This disease is so generally known, that a minute description of it is unnecessary. Children commonly look a little dull, seem listless and drowsy for a few days before the more violent symptoms of the small-pox appear. They are likewise more inclined to drink than usual, have little appetite for solid food, complain of weari­ness, and, upon taking exercise, are apt to sweat. These are succeeded by slight fits of cold and heat in turns, which, as the time of the eruption approaches, become more vio­lent, and are accompanied with pains of the head and loins, vomiting, &c. The pulse is quick, with a great heat of the skin, and restlessness. When the patient drops asleep, he wakes in a kind of horror, with a sudden start, which is a very common symptom of the approaching eruption; as are also convulsion fits in very young children.

ABOUT the third or fourth day from the time of sicken­ing, the small-pox generally begin to appear; sometimes, indeed, they appear sooner, but that is no advantage. At first they very nearly resemble flea-bites, and are most early discovered on the face, arms and breast.

THE most favourable symptoms are a slow eruption, and an abatement of the fever as soon as the pustules appear. In a mild distinct kind of small-pox, the pustules seldom ap­pear before the fourth day from the time of sickening, and they generally keep coming out gradually for several days after. Pustules, which are distinct, with a florid red basis, and which fill with thick purulent matter, first of a whitish, and afterwards of a yellowish colour, are the best.

A livid brown colour of the pustules is an unfavourable symptom; as also, when they are small and flat, with black specks in the middle. Pustules which contain a thin wa­tery ichor are very bad. A great number of pox on the face is always a bad sign, especially if they be confluent, or run into one another.

[Page 150] BUT the most unfavourable symptom is the petechiae, or purple, brown and black spots interspersed among the pustules. These are signs of a putrid dissolution of the blood, and show the danger to be very great. Bloody stools or urine, with a swelled belly, are bad symptoms; as is also, a continual strangury. When the urine is very pale, and there is a violent throbbing of the arteries of the neck, it portends a delirium or convulsion fits. When the face does not swell, or falls before the pox come to maturity, it is a very bad sign. If the face begins to fall about the eleventh or twelfth day, and the hands begin to swell, and afterwards the feet, the patient generally does well; but when these do not succeed, there is reason to apprehend danger. When the tongue is covered with a brown crust, it is an unfavourable symptom. Cold shivering fits coming on at the height of the disease, are likewise unfavourable. Grinding of the teeth, when it proceeds from an affection of the nervous system, is a bad sign; but, sometimes, it is oc­casioned by worms, or a disordered stomach.

REGIMEN.—When the first symptoms of the small-pox appear, people are ready to be alarmed, and often fly to the use of medicine, to the great danger of the pa­tient's life. I have known children, to appease the anxiety of their parents, bled, blistered, purged, and vomited, during the fever which preceded the eruption of the small-pox, to such a degree, that nature was not only disturbed in her operation, but rendered unable to support the pustules after they were out; so that the patient, exhausted by mere eva­cuations, sunk under the disease.

WHEN convulsions appear, they give a dreadful alarm. Immediately some nostrum is applied, as if this were a pri­mary disease; whereas, it is only a symptom, and far from being an unfavourable one, of the approaching eruption. As the fits generally go off before the actual appearance of the small-pox, it is attributed to the medicine, which, by this means, acquires a reputation without any merit.

ALL that is, generally speaking, necessary during the eruptive fever, is to keep the patient within doors, and to allow him to drink freely of some weak diluting liquors; as balm tea, barley water, clear whey, gruels, &c. He should neither be kept in too warm a room, nor confined to bed; but should sit up as much as he is able, and should have his feet and legs frequently bathed in lukewarm water. [Page 151] His food, if he takes any, ought to be very light; and he should be as little disturbed with noise and company as possible.

MUCH mischief is done at this period by confining the patient too soon to his bed, and plying him with warm cordials, or sudorific medicines. Every thing that heats and inflames the blood, increases the fever, and pushes out the pustules too fast. This has numberless ill effects. It not only increases the number of pustules, but likewise tends to make them run into one another; and when they have been pushed out with too great violence, they gene­rally fall in before they come to maturity.

THE good women, as soon as they see the small-pox begin to appear, commonly ply their tender charge with cordials, saffron or marygold teas, wines, punch, and even brandy itself. All these are given with a view to throw out the eruption, as they pretend, from the heart. This, like most other popular mistakes, is the abuse of a very just observation, That when there is a moisture on the skin, the pox rise better, and the patient is easier than when it continues dry and parched. But that is no reason for forcing the patient into a sweat. Sweating never relieves, unless where it comes spontaneously, or is the effect of drinking weak di­luting liquors.

THE patient ought to have no more covering in bed than is necessary to prevent his catching cold, and he should be frequently taken up, if it were only for a few minutes; this will both keep him cool, and prevent too great a flux of blood towards the head.

CHILDREN are often so peevish that they will not lie a-bed without a nurse constantly by them. This, we have reason to believe, has many bad effects. Even the natural heat of the nurse cannot fail to augment the fever of the child; but if she too proves feverish, the danger must be increased. I have known a nurse contract a malignant fe­ver, by lying in bed with a child the whole time of its be­ing ill of a bad kind of small-pox.

LAYING several children who have the small-pox in the same bed, has many ill consequences. They ought, if pos­sible, never to be in the same chamber, as the perspiration, the heat, and the smell, &c. all tend to augment the fever, and to heighten the disease. It is common, among the poor, to see two or three children lying in the same bed, with such a load of pustules, that their very skins stick to­gether. [Page 152] One can hardly view a scene of this kind without being sickened by the sight and smell. How much more must these affect the poor patients, many of whom perish by this usage?

THIS observation is likewise applicable to hospitals, workhouses, &c. where numbers of children happen to have the small-pox at the same time. I have seen above forty children cooped up in one apartment all the while they had this disease, without any of them being admitted to breathe the fresh air. No one can be at a loss to see the impropriety of such conduct, which generally proceeds from a piece of ill-judged oeconomy, to save the trifling ex­pence of a few nurses. It ought to be a rule, not only in hospi­tals for the small-pox, but likewise for other diseases, that no patient should be within sight or hearing of another. This is a matter to which too little regard is paid in most hospitals and infirmaries, where the sick, the dying, and the dead are often to be seen in the same apartment.

A very dirty custom prevails amongst the lower sort of people, of allowing children in the small-pox to keep on the same linen during the whole period of that loathsome disease. This is done lest they should catch cold, but it has many ill consequences. The linen becomes hard, by the moisture which it absorbs, and frets the tender skin. It likewise occasions a bad smell, which is very pernicious both to the patient, and those about him; besides the filth and sordes, which adhere to the linen, being absorbed, or taken up again into the body, greatly augment the disease.

A patient should not be kept dirty in any disease, espe­cially in the small-pox. Cutaneous disorders are often oc­casioned by nastiness alone, and are always increased by it. Were the patient's linen to be changed every day, it would greatly refresh him. Care, indeed, is to be taken that the linen be thoroughly dry. It ought, likewise, to be warm­ed, and put on when the patient is most cool.

SO strong is the vulgar prejudice in this country, notwith­standing all that has been said against keeping children too warm in the small-pox, that numbers still fall a sacrifice to that error. I have seen poor women travelling in the depth of winter, and carrying their children along with them in the small-pox; and have frequently observed others begging by the way-side, with infants in their arms, covered with the pustules; yet I could never learn that one of these chil­dren died by this sort of treatment. We would not, however, [Page 153] propose this as an example worthy of imitation; we only mention it to shew, that the danger of exposing children to the open air in this disease is not so great as people are apt to imagine.

STRONG prejudices, when got over, often produce the opposite extreme. We would, therefore, advise people, when they avoid one error, not to run into another. Some celebrated inoculators order their patients to walk about all the while they are under the disease, as if nothing were the matter. We should think it advisable, however, to keep within doors, at least during the eruption, as cold air is apt to check the perspiration, and to prevent the pox from rising, or filling with matter. I do not remember ever to have seen large, well-filled pustules where the patient was exposed to the external air. In winter the air of this coun­try is abundantly cool within doo [...]s, and in summer a patient may be kept more uniformly cool in the house than he can be out of it. For these, and other reasons, we should think it right to confine the patient to the house while the eruption is out; but never to allow the heat of his chamber to be greater than is agreeable to a person in perfect health.

THE food in this disease ought to be very light, and of a cooling nature, as water pap, rice, or bread, boiled with milk, good apples, roasted, or boiled with milk, and sweetened with a little sugar, or such like.

THE drink may be equal parts of milk and water, clear sweet whey, barley water, or thin gruel, &c. After the pox are full, butter-milk is an excellent drink, it being of an opening and cleansing nature.

MEDICINE.—This disease is generally divi­ded into four different periods, viz. the fever which pre­cedes the eruption, the eruption itself, the suppuration, or maturation of the pustules, and the secondary fever.

IT has already been observed, that little more is necessary during the primary fever, than to keep the patient cool and quiet, allowing him to drink diluting liquors, and bathing his feet frequently in warm water. Though this be gene­rally the safest course that can be taken with infants, yet adults of a strong constitution and plethoric habit some­times require bleeding. When a pulse, a dry skin, and other symptoms of inflammation, render this operation ne­cessary, it ought to be performed. But, unless these symptoms are urgent, it is safer to trust to fomentations; [Page 154] and, if the belly be bound, emollient clysters may be thrown in.

IF there be a great nausea or vomiting, weak camomile tea, or lukewarm water, may be drank, in order to clean the stomach. At the beginning of a fever, nature general­ly attempts a discharge, either upwards or downwards; which, if promoted by gentle means, would tend greatly to abate the force or violence of the disease.

THOUGH every method is to be taken during the prima­ry fever, by a cool regimen, &c. to prevent too great an eruption; yet, after the pustules have made their appear­ance, our business is to promote the suppuration, by gen­tle warmth, diluting drink, light food, and, if nature seems to flag, by generous cordials; but the latter ought never to be given unless where there is an absolute necessi­ty. When a low, creeping pulse, faintishness, and great loss of strength, render cordials necessary, we would re­commend good wine, which may be made into negas, with an equal quantity of water, and sharpened with the juice of orange, the jelly of currants, or the like. Wine whey, sharpened as above, is likewise a proper drink in this case; great care, however, must be taken not to overheat the pa­tient by any of these things. This would retard instead of promoting the eruption.

SOMETIMES the rising of the small-pox is prevented by the violence of the fever; in which case, the cool regimen is strictly to be observed. For example, the patient's chamber must be kept cool; he ought likewise frequently to be taken out of bed, and to be lightly covered with cloaths while in it.

EXCESSIVE restlessness often prevents the rising and fill­ing of the small-pox. When that happens, gentle opiates are necessary. These, however, ought always to be ad­ministered with the greatest caution. To an infant, a tea spoonful of the syrup of poppies may be given every five or six hours, till it has the desired effect. An adult person will require a table spoonful in order to answer the same pur­pose; and to others, the dose must be proportioned to their age, and the violence of the symptoms.

IF the patient be troubled with a strangury, or suppres­sion of urine, which often happens in the small-pox, he should be frequently taken out of bed, and, if he be able, should walk across the room with his feet bare. When he cannot do this, he may be frequently set on his knees in [Page 155] bed, and should endeavour to pass his urine as often as he can. When these do not succeed, a tea spoonful of the sweet spirits of nitre may be occasionally mixed in his drink. Nothing more certainly relieves the patient, or is more be­neficial in the small-pox, than a plentiful discharge of urine.

IF the mouth be foul, and the tongue dry and chapped, it ought to be frequently washed, and the throat gargled with warm water and honey, sharpened with a little vinegar or currant jelly.

DURING the rising of the small-pox, it frequently hap­pens that the patient is eight or ten days without a stool. This not only tends to heat and inflame the blood, but the foeces, by lodging so long in the body, become acrid and even putrid, from whence bad consequences must ensue. It will therefore be proper, when the belly is bound, to throw in an emollient clyster every second or third day, through the whole course of the disease. This will greatly cool and relieve the patient.

WHEN petechiae, or purple, black, or livid spots appear among the small-pox, the Jesuits bark must immediately be administered in as large doses as the patient's stomach can [...]ear. For a child, two drams of the bark in powder may be mixed in three ounces of common water, one ounce of simple cinnamon-water, and two ounces of the syrup of orange or lemon. This may be sharpened with the spirits of vitriol, and a table spoonful of it given every hour. If it be given to an adult in the same form, he may take at least three or four spoonfuls every hour. This medicine ought not to be trifled with, but must be thrown in as fast as the stomach can bear; in which case it will often produce very happy effects. I have frequently seen the petechiae disap­pear, and small-pox, which had a very threatening aspect, rise and fill with laudable matter, by the use of the Jesuits bark and acids.

THE patient's drink ought likewise, in this case, to be acidulated with the spirits of vitriol, vinegar, juice of le­mon, jelly of currants, or such like. His food must consist of apples, roasted or boiled, preserved cherries, plumbs and other sharp fruits.

CAMOMILE tea, if the patient's stomach will bear it, is likewise a very proper drink in this case. It may be sharpen­ed with any of the acids mentioned above, and drank at pleasure. When the pulse and spirits are low, red wine [Page 156] negas, or pretty strong wine whey, sharpened with the juice of lemon, must be given for the patient's ordinary drink.

THE bark and acids are not only necessary when the pe­techiae or putrid symptoms appear, but likewise in the lym­phatic or crystalline small-pox, where the matter is thin, and not duly prepared. The Jesuits bark seems possessed of a singular power to assist nature in preparing laudable pus, or what is called good matter; consequently it must be very beneficial, both in this and other diseases whose crisis depends on a suppuration. I have often observed, where the small-pox were flat, and the matter contained in them quite clear and transparent, and where they had the appearance of running into one another, that the use of a few drams of the Jesuits bark, acidulated as above, not only promoted the suppuration, but changed the colour and consistence of the matter, and produced the most happy effects.

WHEN the eruption subsides suddenly, or, as the good women term it, when the small-pox strike in, before they have arrived at maturity, the danger is very great. This is often the effect of a hot regimen, or medicines which at the beginning push out the matter before it has been properly prepared. When this happens, blistering plasters must be immediately applied to the wrists and ancles, and the pa­tient's spirits supported with cordials.

SOMETIMES bleeding has a surprising effect in raising the pustules after they have subsided; but it requires skill to know when this is proper, or to what length the patient can bear it. Sharp cataplasms, however, may be applied to the feet and hands, as they tend to promote the swelling of these parts, and by that means to draw the humour towards the extremities.

THE most dangerous period of the disease is what we call the secondary [...]ever. This generally c [...]mes on when the small-pox begin to turn on the face; and most of those who die of the small-pox are carried off by this fever.

NATURE generally attempts, at the turn of the small­pox to relieve the patient by loose stools. Her endeavours this way, are by no means to be counteracted, but promoted, and the patient at the same time supported by things of a light but nourishing nature. Patients have often been re­markably relieved at this time by a few loose stools, either brought on by nature or procured by art. That should [Page 157] encourage us to endeavour to assist nature in this way, espe­cially if the symptoms be threatening, and the belly con­tinues bound.

IF at the approach of the secondary fever, the pulse be very quick, hard, and strong, the heat intense, and the breathing laborious, with other symptoms of an inflamma­tion of the breast, the patient must immediately be bled, otherwise a fatal peripneumony will ensue. The quantity of blood to be let must be regulated by the patient's strength, age, and the urgency of the symptoms.

BUT, in the secondary fever, if the patient be faintish, the pustules become pale and shrink, and if there be great coldness of the extremities, blistering plasters must be ap­plied, and the patient must be supported with generous wine. Wine, and even spirits have sometimes been given in such desperate cases with amazing success.

AS the secondary fever is in great measure, if not whole­ly, owing to the absorption of the matter, it would seem highly consonant to reason, that the pustules, as soon as they come to maturity, should be opened. That is every day practised in other phlegmons which tend to suppura­tion; and there seems to be no reason why it should be less proper here. On the contrary, we have reason to believe, that by this means the secondary fever might always be lessened, and often wholely prevented.

THE pustules should be opened when they begin to turn of a yellow colour. Very little art is necessary for this operation. They may either be opened with a pair of scis­sors, or a needle, and the matter absorbed by a wet spunge, or a little lint. As the pustules are generally first ripe on the face, it will be proper to begin with opening these, and the others in course as they become ripe. The pustules generally fill again, a second, or even a third time, &c. for which cause the operation must be repeated, or rather continued so long as there is any considerable appearance of matter in the pustules.

WE have reason to believe, that this operation, rational as it is, has been neglected from a piece of mistaken tender­ness in parents. They believe, that it must be great pain to the poor child; and therefore would rather see it die than have it thus tortured. This notion, however, is en­tirely without foundation. It is only the scarf-skin that is cut, which, upon the top of the pustules, by the time they are ripe, becomes quite insensible. I have frequently open­ed [Page 158] the pustules when the patients did not see me, without their being in the least sensible of it; but suppose it were attended with a little pain, that is nothing in comparison to the advantages which arise from it.

OPENING the pustules not only prevents the absorption of the matter into the blood, but likewise takes off tension of the skin, and by that means greatly relieves the patient. It likewise prevents the pitting, which is a matter of no small importance. Acrid matter, by lodging long in the pustules, cannot fail to corrode the tender skin; by which many a handsome face becomes so deformed as hardly to bear a resemblance to the human figure.

IT is always necessary, after the small-pox are gone off, to purge the patient. If, however, the belly has been open through the whole course of the disease, or, if butter-milk, and other things of an opening nature, have been given, after the height of the small-pox, purging becomes less necessary; but it ought never wholely to be neglected.

FOR very young children, an infusion of [...]enna and prunes, with a little rhubarb, may be sweetened with manna or coarse sugar, and given in small quantities till it operates. Those who are farther advanced must take me­dicines of a sharper nature. For example, a child of four or five years of age, may take ten grains of fine rhubarb in powder over night, and the same quantity of jalap in powder next morning, with two or three grains of calomel, mixed in currant jelly, or made into a bolus with a little honey. He ought to keep the house all day, and to drink nothing that is cold. The dose may be repeated three or four times, five or six days intervening betwixt each dose. For children further advanced, and adults, the dose must be increased in proportion to the age and constitution.

WHEN imposthumes happen after the small-pox, which is not seldom the case, they are to be brought to suppurati­on as soon as possible, by means of ripening poultices; and, when they have been opened, or break of their own accord, the patient must be purged.

WHEN a cough, a difficulty of breathing, or other sym­toms of a consumption, succeed to the small-pox, the pa­tient must be sent to a well aired place, and put upon a course of a [...]e [...] milk, with such exercise as he can bear. For further directions in this case, see the article Consump­tions.

THOUGH no disease, after it is formed, baffles the pow­ers of medicine more than the small-pox, yet more may be [Page 159] done before hand to render this disease favourable than any one w [...]now, as almost all the danger from it may be pre­vented by inoculation. This salutary invention has been known in Europe about half a century; but, like most other useful discoveries, it has met with great opposition. It must, however, be acknowledged, to the honour of this country, that inoculation has met with a more favourable reception here than by any of our neighbours. It is still, however, far from being general, which we have reason to fear will ever be the case, so long as the practice continues in the hands of the faculty.

NO discovery can ever be of general utillity while the practice of it is kept in the hands of a few. Had the inocu­lation of the small-pox been introduced as a fashion, and not as a medical discovery, and had it been practised by the same kind of operators here as it is in those countries from whence we had it, it had long ago been universal. The fears, the jealousies, the prejudices, and the opposite inte­rests of the faculty, are, and ever will be, the most effectual obstacles to the progress of any salutary discovery. Hence it is, that the practice of inoculation never became, in any measure, general, even in England, till taken up by men not bred to physic. These have not only rendered the practice more extensive, but likewise more safe, and, by acting under less restraint than the regular practitioners, have taught them that the patient's greatest danger arose, not from the want of care, but from the excess of it.

THEY know very little of the matter, who impute the success of modern inoculators to any superior skill, either in preparing the patient or communicating the disease. Some operators indeed, from a sordid desire of ingrossing the whole practice to themselves, pretend to have extraordi­nary secrets or nostrums in preparing persons for inoculation, which never fail of success. But this is only a pretence calculated to blind the ignorant and inattentive. Com­mon sense and prudence alone are sufficient both in the choice of the subject, and management of the operation. Whoever is possessed of these may perform this office for his children whenever he finds it convenient, provided they be in a proper state of health; and may rest assured, that he will succeed as well as the most celebrated inoculator.

THIS sentiment is not the result of theory, but of observa­tion. Though few physicians have had more opportuni­ties of trying inoculation in all its different forms, so little [Page 160] appears to me to depend on these, generally reckoned im­portant circumstances, of preparing the body, communi­cating the infection by this or the other method, &c. that for several years past I have caused the parents or nurses perform the whole themselves, and have found that method followed with equal success, while it is free from many in­conveniencies that attend the other.

A critical situation, too often to be met with, first put me upon trying this method. A gentleman who had lost all his children, except one son, by the natural small-pox, was determined to have him inoculated. He told me his intention, and desired I would persuade the mother and grandmother, &c. of its propriety. But that was impossi­ble. They were not to be persuaded, and either could not get the better of their fears, or were determined against con­viction. It was always a point with me not to perform the operation without the consent of parties concerned. I therefore advised the father, after giving his son a dose or two of rhubarb, to go to a patient who had the small-pox of a good kind, to open two or three of the pustules, taking up the matter with a little cotton, and as soon as he came home to take his son into a private room, and give his arm a slight scratch with a pin, as if it had been by accident, afterwards to rub the place well with the cotton, and take no farther notice of it. All this he punctually performed; and, at the usual period, the small-pox made their appear­ance, which were of an exceeding good kind, and so mild as not to confine the boy an hour to his bed. None of the other relations knew but the disease had come in the natural way till the patient was well.

WE do not propose this as the only method in which the small-pox can be communicated. It appears from experience, that this may be done various ways with equal success. In Tur­key, from whence we learned the practice, the women commu­nicate the disease to children, by opening a bit of the skin with a needle, and putting into the wound a little matter taken from a ripe pustule. On the coast of Barbary, they pass a thread wet with the matter through the skin, between the thumb and fore-finger; and in Europe inoculation is generally performed by making a small incision through the cuticle of the arm or leg with a lancet, and laying a bit of thread wet with the matter upon the wound, which is co­vered with a piece of sticking plaster, and kept on for two or three days.

[Page 161] SOME of the people in England, who make a trade of inoculation, only open one of the ripe pustules with a lan­cet, and while it is wet with the matter, make a slight in­cision in the arm of the person to whom they want to com­municate the disease; afterwards they close up the wound, and leave it without any other dressing. This seems to be no real improvement. It frequently fails to communicate the disease, and is far less certain than when a scratch with a pin or needle is made, and a bit of thread wet with the matter kept on the wound for some days by a sticking pla­ster.

INDEED, if the matter be applied long enough to the skin, there is no occasion for any wound at all. Let a bit of thread, about half an inch long, wet with the matter, be applied to the arm, midway between the shoulder and elbow, and covered with a piece of the common black sticking plaster, and kept on for eight or ten days. This will seldom fail to communicate the disease. We mention this method, because many people are afraid of a wound; and, doubtless, the more easily the operation can be per­formed, it has the greater chance to become general. Some people imagine, that the discharge from a wound lessens the eruption; but there is not much stress to be laid upon this notion: Besides, deep wounds often ulcerate, and be­come troublesome.

WE do not find that inoculation is at all considered as a medical operation in those countries from whence we learn­ed it. In Turkey it is performed by the women, and in the East-Indies by the Brachmins or priests. In this coun­try the custom is still in its infancy; we make no doubt, however, but it will become so familiar, that parents will think no more of inoculating their own children than at present they do of giving them a dose of physic.

NO set of men have it so much in their power to render the practice of inoculation general as the clergy; the great­est opposition to it still arising from some scruples of con­science, which they alone can remove. We would recom­mend it to them, not only to endeavour to remove the re­ligious objections which weak minds may have to this salu­tary practice, but to enjoin it as a duty, and to point out the danger of neglecting to make use of a mean which Pro­vidence has put in our power for saving the lives of our offspring. Surely such parents as wilfully neglect th [...] means of saving their children alive, are as guilty as those who [Page 162] put them to death. We wish this matter were duly weigh­ed. No one is more ready to make allowance for human weakness and religious prejudices, yet I cannot help recom­mending it, in the warmest manner, to parents to consider how great an injury they do their children, by neglecting to give them this disease in the early period of life.

THE numerous advantages attending inoculation of the small-pox, have been pretty fully pointed out by the learn­ed Dr. McKenzie in his History of Health: "Many and great, says this humane author, are the dangers attending the natural infection, from all which the inoculation is quite secure. The natural infection may invade weak or distempered bodies, by no means disposed for its kindly reception. It may attack them at a season of the year either violently hot, or intensely cold. It may be commu­nicated from a sort of small-pox impregnated with the ut­most virulence. It may lay hold upon people unexpect­edly, when a dangerous sort is imprudently imported into a maritime place. It may surprize us soon after excesses committed in luxury, intemperance, or lewdness. It may likewise seize on the innocent, after indispensible watch­ings, hard labour, or necessary journies. And is it a tri­vial advantage, that all these unhappy circumstances can be prevented by inoculation? By inoculation numbers are saved from deformity as well as from death. In the na­tural small-pox, how often are the finest features, and the most beautiful complexions, miserably disfigured? Where­as inoculation rarely leaves any ugly marks or [...]ears, even where the number of pustules on the face have been very considerable, and the symptoms by no means favourable. And many other grievous complaints, that are frequently subsequent to the natural sort, seldom follow the artificial. Does not inoculation also prevent those inexpressible ter­rors that perpetually harrass persons who never had this dis­ease, insomuch, that when the small-pox is epidemical, in­tire villages are depopulated, markets ruined, and the face of distress spread over the whole country? From this terror it arises, that justice is frequently postponed, or dis­couraged, at sessions or assizes, where the small-pox ra­ges. Witnesses and juries dare not appear; and, by rea­son of the necessary absence of some gentlemen, our ho­nourable and useful judges are not attended with that reve­rence and splendor due to their office and merit. Does not inoculation, in like manner, prevent our brave sailors from [Page 163] being seized with this distemper on shipboard, where they must quickly spread the infection among such of the crew who never had it before, and where they have scarce any chance to escape, being half-stifled with the closeness of their cabbins, and but very indifferently nursed? Lastly, with regard to the soldiery, the miseries attending these poor creatures, when attacked by the small-pox on a march, is inconceivable, without attendance, without lodgings, without an [...] accommodations; so that one of three commonly perishes."

WE shall only add, that such as have not had the small-pox in the early period of life, are not only rendered un­happy, but likewise, in a great measure, unfit for sustain­ing many of the most useful and important offices. Few people would choose even to hire a servant who have not had the small-pox, far less to purchase a slave who had the chance of dying with this disease. How could a physician, or a surgeon, who had never had the small-pox himself, attend others under that malady? Thus, besides, the continual fears and anxiety which haunt those persons who have not had the small-pox, we might shew numberless in­conveniencies which arise from it. For example,

HOW deplorable is the situation of females, who arrive at mature age without having had the small-pox! A wo­man with child seldom survives this disease: And, if an infant happens to be seized with the small-pox upon the mother's breast, who has not had the disease herself, the scene must be distressing! If she continues to suckle the child, it is at the peril of her own life; and, if she weans it, in all probability, it will perish. How often is the af­fectionate mother forced to leave her house, and abandon her children, at the very time when her care is most neces­sary? But should parental affection get the better of her fears, the consequences will often prove fatal. I have known the tender mother and her insant child laid in the same grave, both untimely victims to this dreadful malady. But these are scenes too shocking even to mention. Let parents who run away with their children to avoid the small-pox, or who refuse to inoculate them in their infan­cy, consider to what deplorable situations they may be re­duced by this mistaken tenderness.

AS the small-pox has now become a constitutional dis­ease in most parts of the known world, no other choice re­mains, but to render the malady as mild as possible; that [Page 164] is the only manner of extirpation now left in our power; and, though it may seem paradoxical, this artificial method of planting the disease, could it be rendered universal, would amount to nearly the same thing as rooting it out. It is a matter of small consequence, whether a disease be entirely extirpated, or rendered so mild, as neither to de­stroy life, nor hurt the constitution; but that this may be done by inoculation, does not now admit of a doubt. The numbers who die under inoculation, hardly deserve to [...]e named. In the natural way, one in four or five generally die; but by inoculation, not one of a thousand. Na [...], some can boast of having inoculated ten thousand without the loss of a single patient.

I have often wished to see some plan established for ren­dering this salutary practice universal; but am afraid I shall never be so happy. The difficulties indeed are many; yet the thing is by no means impracticable. The aim is great; no less than saving the lives of one fourth of man­kind. What ought not to be attempted in order to accom­plish such an end?

THE first step towards rendering the practice universal, must be to remove the religious prejudices against it. This, as already observed, can only be done by the clergy. They must not only recommend it as a duty to others, but likewise practise it on their own children. Example will ever have more influence than precept.

THE next thing requisite is to put it in the power of all. For this purpose we would recommend it to the Faculty to inoculate the children of the poor gratis. It is hard that those who are certainly the most useful part of mankind, should, by their poverty, be excluded from such a bene­fit.

SHOULD this fail, it is surely in the power of any state to render the practice general, at least, as far as their do­minion extends. We do not mean, that it ought to be in­forced by a law: That, there is reason to believe, would rather tend to obstruct its progress. The way to promote it, would be to employ a sufficient number of operators at the public expence to inoculate the children of the poor. This would only be necessary, till the practice became general; afterwards custom, the strongest of all laws, would oblige every one to inoculate their children, to prevent reflecti­ons.

[Page 165] IT may be objected to this scheme, that the poor would refuse to employ the inoculators: That is easily removed. A small premium to enable mothers to attend their chil­dren while under the disease, would be a sufficient induce­ment; besides, the success attending the operation, would soon banish all objections to it. Even considerations of profit, would induce the poor to embrace this plan. They often bring up their children to the age of ten or twelve, and when they come to be useful, they are snatched away by this malady, to the great loss of their parents, and de­triment of the public.

THE British legislature has, of late years, shown great attention to the preservation of infant lives, by supporting the foundling hospital, &c. But we will venture to say, if one tenth part of the sums laid out in supporting that in­stitution, had been bestowed towards promoting the prac­tice of inoculation of the small-pox among the poor, that not only more useful lives had been saved, but the practice, before now, rendered quite universal in this island. It is not to be imagined, what effect example, and a little mo­ney, will have upon the poor; yet, if left to themselves, they will go on for ever in the old way, without thinking of any improvement. We only mean this as a hint to the humane and public spirited. Should such a scheme be ever put in practice, a proper plan might easily be laid down for the execution of it.

AS all public plans are very difficult to bring about, and, often, by the selfish views, or misconduct, of those intrust­ed with the execution of them, fail of answering the noble purposes for which they were designed: We shall, there­fore, point out some other methods by which the benefits of inoculation may be extended to the poor.

THERE is no doubt but inoculators will be daily more numerous. We would, therefore, have every parish in Britain, to allow one of them a small annual salary for inoculating all the children of the parish at a proper age. Though some refractory persons might for a while object to this method, they would soon be obliged to comply with it, or run the hazard of being reckoned the murder­ers of their own children.

TWO things chiefly operate to prevent the progress of inoculation. The one is a wish to put the evil day as far off as possible. This is a principle in our nature; and as inoculation seems rather to be anticipating a future evil, [Page 166] it is no wonder mankind are so averse from it. But this objection is sufficiently answered by the success. Who, in his senses, would not prefer a lesser evil to-day, to a greater to-morrow, provided it were equally certain?

THE other obstacle is the fear of reflections. This has very great weight with the bulk of mankind. Should the child die, they think the world would look down upon them. This they cannot bear. Here lies the difficulty which pinches, and till that be removed, inoculation will make but small progress. Nothing can remove it but custom. Make the practice fashionable, and all the ob­jections at once vanish. It is fashion alone that has led the multitude since the beginning of the world, and will lead them to the end. We must, therefore, call upon the more enlightened part of mankind, to set a pattern to the rest. Their example, though it may, for some time, meet with opposition, must, at length, infallibly prevail.

I am aware of an objection to this practice, from the expence with which it may be attended; this is easily ob­viated. We do not mean that every parish ought to employ a Sutton, or a Dimsdale, as inoculators. These have, by their success, already recommended themselves to crowned heads, and are beyond the vulgar reach; but have not others an equal chance to succeed? They certain­ly have. Let them make the same trial, and the difficulties will soon vanish. There is not a parish, and hardly a vil­lage in Britain, destitute of some person who can bleed. But this is a far more difficult operation, and requires both more skill and time than inoculation.

THE persons to whom we would chiefly recommend the performance of this operation are the clergy. Most of them know something of medicine. Almost all of them bleed, and can order a purge; which are all the qualifica­tions necessary for the practice of inoculation. The priests among the less enlightened Indians perform this office; and why should a Christian teacher think himself above it? Surely the bodies of men, as well as their souls, merit a part of the pastor's care; at least, the greatest Teacher who ever appeared among men seems to have thought so.

SHOULD all other methods fail, we would recommend it to parents to perform the operation themselves. Let them take any method of communicating the disease they please, provided the subject be healthy, and of a proper age; and we may venture to warrant their success. I have known [Page 167] many instances of parents performing the operation, and never so much as heard of one bad consequence. A plant­er in one of the West-India islands is said to have inocula­ted, with his own hand, in one year, three hundred of his slaves, who, notwithstanding the warmth of the climate, and other unfavourable circumstances, all did well. Common mechanics have often, to my knowledge, performed the ope­ration with as good success as physicians. We do not, how­ever, mean to discourage those, who have it in their power, from employing people of skill to inoculate their children, and attend them while under the disease, but only to shew, that where such cannot be had, the operation ought not, upon that account, to be neglected.

INSTEAD of multiplying arguments to this effect, I shall just beg leave to mention the method I took with my own child, an only son. After giving him two gentle purges, I ordered the nurse to take a bit of thread, which had been previously wet with fresh matter from a pock, and to lay it upon his arm, covering it with a piece of sticking plaster. This staid on six or seven days, till it was rubbed off by accident. At the usual time, the small-pox made their ap­pearance, and were exceedingly favourable. Sure this, which is all that is necessary, may be done without any skill in medicine.

THE best season of the year for inoculation, is towards the end of the spring, and in the beginning of summer. It may, however, be done at any time of the year, if circum­stances render it necessary.

THE most proper age for inoculation is betwixt two and five. Many disagreeable circumstances attend inoculating children upon the breast, which we have not time to enu­merate. Neither should the operation be too long delayed. When the [...]ibres begin to grow rigid, and children make use of grosser food, the small-pox become more danger­ous.

CHILDREN, who have constitutional diseases, must, ne­vertheless, be inoculated. It will often mend the habit of body; but ought to be performed at a time when they are most healthy. Accidental diseases should always be re­moved before inoculation.

THE most healthy state is always to be chosen, as that must be the best preparation. The next step is to regulate the diet for sometime before the disease is communicated. In children great alteration in diet is seldom necessary, their food being [Page 168] commonly of the the most simple and wholesome kind; as milk, water pap, small broths, bread, light pudding, mild roots, and white meats.

CHILDREN, however, who have been accustomed to a hotter diet, who are of a gross habit, or abound with bad humours, ought to be put upon a spare diet, before they be inoculated. Their food should be of a light cooling nature; and, their drink, whey, butter-milk, and such like.

WE would recommend no other medicinal preparation, but two or three mild purges, which ought to be suited to the age and strength of the patient. It is, no doubt, possi­ble, by purgative and mercurial medicines, to lessen the eruption; but it very seldom happens, that the eruption, in this way, proves too great, and, we have always observed, that those children who had a pretty free eruption, and where the pox filled well, enjoyed the best health after­wards.

THE regimen, during the disease, must be the same as under the natural small-pox. The patient must be kept cool, his diet must be light, and his drink weak and dilu­ting, &c. Should any bad symptoms appear, which seldom happens, they must be treated in the same way as directed in the natural small-pox. Purging is not less necessary, after the small-pox by inoculation, than in the natural way, and ought, by no means, to be neglected.

OF THE MEASLES.

THE measles appeared about the same time with the small-pox, and are nearly related to that disease. They both came from the East, are both infectious, and seldom attack people more than once. The measles are most com­mon in the spring season, and generally disappear in the summer. The disease itself, when properly managed, is seldom dangerous; but its consequences are often fatal.

CAUSE.—This disease, like the small-pox, proceeds from infection, and is more or less dangerous, ac­cording to the constitution of the patient, the season of the year, the climate, &c.

SYMPTOMS.—The measles, like other fevers, are preceded by alternate fits of heat and cold, sick­ness, and loss of appetite. The tongue is white, but ge­nerally moist. There is a short cough, a heaviness of the [Page 169] head and eyes, drowsiness, and running of the nose. Sometimes, indeed, the cough does not come before the eruption. The eye-lids frequently swell so as to occasion blindness. The patient generally complains of his throat; and vomiting or looseness often precedes the eruption. The stools in children are commonly greenish; they complain of an itching of the skin, and are remarkably peevish. Bleeding at the nose is common, both before and in the progress of the disease.

ABOUT the fourth day, small spots, resembling flea­bites, appear, first upon the face, then upon the breast, and, afterwards, on the extremities: These may be distin­guished from the small-pox, by their scarcely rising above the skin. The fever, cough, and difficulty of breathing, instead of being removed by the eruption, as in the small­pox, are rather increased; but the vomiting generally ceases.

ABOUT the sixth day, the measles begin to grow dry on the face, and, afterwards, upon the body; so that by the ninth day they entirely disappear. The fever, however, and difficulty of breathing, often continue, especially if the patient has been kept upon too hot a regimen. Petechiae, or purple spots, may likewise be occasioned by this error.

A violent looseness sometimes succeeds the measles, in which case the patient's life is in imminent danger.

SUCH as die of the measles generally expire about the ninth day, and are evidently carried off by a peripneumony, or inflammation of the lungs.

THE most favourable symptoms are, a moderate looseness, gentle sweats, and a plentiful discharge of urine.

WHEN the eruption suddenly falls in, and the patient is seized with a delirium, he is in the greatest danger. If the measles turn of a pale colour, it is an unfavourable symp­tom, as are also, great weakness, vomiting, restlessness, and difficulty of swallowing. Purple, or black spots, ap­pearing among the measles, are very unfavourable. When a continual cough, with hoarseness, succeeds the disease, there is reason to suspect an approaching consumption of the lungs.

OUR business in this disease is to assist nature, if her ef­forts be too languid, in throwing out the morbid matter, by proper cordials; but when they are too violent, they must be restrained by evacuations, and cool diluting liquors, &c. We ought, likewise, to endeavour to appease the [Page 170] most urgent symptoms, as the cough, restlessness, and dif­ficulty of breathing.

REGIMEN.—The regimen in this disease should be of the same kind with that recommended in the small-pox, viz. cooling and diluting. Acids, however, do not answer so well here as in the small-pox, as they tend to exasperate the cough. Small beer, likewise, though a good drink in the small-pox, is here improper. The most suitable liquors are decoctions of liquorice, with marsh-mallow roots, and sarsaparilla; infusions of linseed, or of the flowers of elder with milk, clarified whey, barley water, and such like. These, if the belly be bound, may be sweetened with honey; or, if that should disagree with the stomach, a little manna may occasionally be added to them.

MEDICINE.—The measles being an in­flammatory disease, without any critical discharge of mat­ter, as in the small-pox, bleeding is commonly necessary, especially when the fever runs high, with difficulty of breathing, and great oppression of the breast. But if the disease be of a mild kind, bleeding may be omitted.

BATHING the feet and legs in lukewarm water, both tends to abate the violence of the fever, and to promote the eruption.

THE patient is often greatly relieved by vomiting. When there is a tendency this way, it ought not to be stop­ped, but encouraged, by drinking lukewarm water, or weak camomile tea.

WHEN the cough is very troublesome, with dryness of the throat, and difficulty of breathing, it will greatly re­lieve the patient, if he holds his head over the steam of warm water, and draws the steam into his lungs.

HE may likewise lick a little spermaceti and sugar-can­dy pounded together; or take now and then a spoonful of the oil of sweet-almonds, with sugar-candy dissolved in it. These will soften the throat, and relieve the tickling cough.

IN case the measles should suddenly disappear, it will be necessary to pursue the same method which we have recom­mended when the small-pox fall in. The patient must be supported with wine and cordials. Blistering plasters must be applied to the extremities, and the body rubbed all over with warm flannels. Warm poultices may, likewise, be applied to the feet, and palms of the hands.

[Page 171] WHEN purple, or black spots appear, the patient's drink should be sharpened with spirits of vitriol; and, if the putrid symptoms run high, the Jesuits bark must be administered in the same manner as directed in the small-pox.

OPIATES are sometimes necessary, but should never be given except in case of extreme restlessness, a violent loose­ness, or when the cough is very troublesome. For chil­dren, the syrup of poppies is sufficient. A tea spoonful or two may be occasionally given, according to the patient's age, or the violence of the symptoms.

AFTER the measles are gone off, purging is absolutely ne­cessary. This may be conducted in the same manner as directed in the small-pox.

IF a violent looseness succeeds the measles, it may be checked by taking, for some days, a gentle dose of rhubarb in the morning, and an opiate over night; but, if these do not remove it, bleeding will seldom fail to have that effect.

PATIENTS recovering after the measles, should be very careful what they eat or drink. Their food, for some time, should be light, and in small quantities, and their drink diluting, and rather of an opening nature; as butter­milk, whey, and such like. They ought, also, to be­ware of exposing themselves to the cold air, lest a suffoca­ting catarrh, an asthma, or a consumption of the lungs should ensue.

SHOULD a cough, with difficulty of breathing, and other symptoms of a consumption, remain after the measles, we would recommend small quantities of blood to be fre­quently let at proper intervals, as the patient's strength and constitution will bear. He ought, likewise, to drink asses milk, to remove to a free air, if necessary, and to ride daily on horseback. He must keep close to a diet, con­sisting of milk and vegetables; and, lastly, if these do not succeed, let him remove to a warmer climate.

OF THE SCARLET FEVER.

THE scarlet fever is so called from the colour of the pa­tient's skin, which appears as if it were tinged with red wine. It happens at any season of the year, but is most common in the latter end of summer; at which time it of­ten seizes whole families, especially children.

[Page 172] IT begins with coldness and shivering, as in other fevers, without any violent sickness. Afterwards the skin is covered with red spots, which are broader, more florid, and less uni­form than the measles. They continue two or three days, and then disappear; after which the cuticle, or scarf-skin, falls off.

THERE is seldom any occasion for medicine in this dis­ease. The patient ought, however, to keep within doors, to abstain from flesh, strong liquors, and cordials, and to take plenty of cool diluting drink. If the fever be high, the belly must be kept gently open by emollient clysters, or small doses of nitre and rhubarb. A scruple of the for­mer, with five grains of the latter, may be taken thrice a-day, or oftener, if necessary.

CHILDREN, and young persons, are sometimes seized, at the beginning of this disease, with a kind of stupor, and epileptic [...]its. In this case, the feet and legs should be bathed with warm water, a large blistering plaster applied to the neck, and a dose of the syrup of poppies given every night till the patient recovers.

AFTER the fever is gone off, the patient ought to be purged once or twice.

OF THE ERYSIPELAS, OR ST. ANTHONY's FIRE.

THIS disease, which in many parts of Britain is called the rose, attack persons at all periods of life, but is most common between the age of thirty and forty. Persons of a sanguine or plethoric habit, are most liable to it. It often attacks young people, and pregnant women; and such as have once been afflicted with it, are very liable to have it again. Sometimes it is a primary disease, and, at other times only a symptom of some other malady. Every part of the body is liable to be attacked by an erysipelas, but it most frequently seizes the legs or face, especially the latter. It prevails most in autumn, or when hot weather is succeed­ed by cold and wet.

CAUSES.—The erisipelas is frequently occa­sioned by violent passions or affections of the mind; as, fear, anger, &c. It is likewise occasioned by cold. When the body has been heated to a great degree, and is immediately exposed to the cold air, so that the perspiration is suddenly checked, an erysipelas will often ensue. It [Page 173] may also be occasioned by excess of strong liquor, by con­tinuing too long in a warm bath, or by any thing that over­heats the blood. If any of the natural evacuations be ob­structed, or in too small a quantity, it may cause an ery­sipelas. The same effect will follow from a stoppage of ar­tificial evacuations; as, issues, setons or the like.

SYMPTOMS.—The erysipelas attacks with a violent shaking, heat, thirst, loss of strength, pain in the head and back, restlessness, and a quick pulse; to which may be added, vomiting, and sometimes a delirium. On the second, third, or fourth day, the part swells, be­comes red, and small pustules appear; at which time the fever generally abates.

WHEN the erysipelas seizes the foot, the parts contiguous swell, the skin shines; and, if the pain be violent, it will ascend to the leg, and will not bear to be touched.

WHEN it attacks the face, it swells, appears red, and the skin is covered with small pustules, filled with clear water. One or both eyes are generally closed with the swelling; and there is a difficulty of breathing. If the mouth or nostrils be very dry, and the patient drowsy, there is reason to expect an inflammation of the brain.

IF the erysipelas effects the breast, it swells, and becomes exceedingly hard, with great pain, and is apt to suppurate.

THERE is a violent pain in the armpit on the side affected, where an abscess is often formed.

THERE is a kind of erysipelas, which in some parts of Britain goes by the name of the ring worm. It frequently attacks children about the region of the navel, where it surrounds the body like a girdle, and is not without dan­ger.

THE event of this disease depends greatly upon the con­stitution of the patient. It is seldom dangerous; yet I have known it prove fatal to people in the decline of life, who were of a scorbutic habit, or whose humours were vitiated by irregular living, or unwholesome diet.

IF, in a day or two, the swelling subsides, the heat and pain cease, the rosy colour turns yellow, and the cuticle breaks and falls off in scales, the danger is over.

WHEN the erysipel as is large, deep, and affects a very sensible part of the body, the danger is great. If the red colour changes into black or blue, it will end in a mortifi­cation. Sometimes the inflammation cannot be discussed, but comes to suppuration; in which case, sistulas, a gan­grene, [Page 174] or mortification, generally ensue. Where the con­stitution was bad, I have frequently seen the leg swell to a prodigious size, and the cure prove extremely difficult.

SUCH as die of this disease, are mostly carried off by the [...]ever, which is attended with difficulty of breathing, some­times with a delirium, and great drowsiness. They gene­rally die about the seventh or eighth day.

REGIMEN.—In this disease the patient must neither be kept too hot nor cold, as either of these extremes will tend to make the disease retreat, which is always to be guarded against. When the disease is mild, it will be suffi­cient to keep the patient within doors, without confining him to his bed, and to promote the perspiration by diluting liquors, &c.

THE diet ought to be very spare, and of a moderately cool­ing and moistening quality; as groat gruel, panada, small chicken or barley broth, with cooling herbs and fruits, &c. avoiding flesh, fish, strong drink, spices, pickles, and all other things that may heat and inflame the blood; the drink may be barley water, an infusion of elder flowers, common whey, and such like.

BUT if the pulse be low, and the spirits sunk, the patient must be supported with small negas and other things of a cor­dial nature. His food may be sago gruel with a little wine, and nourishing broths, taken in small quantities, and often re­peated. Great care, however, must be had not to over­heat him.

MEDICINE.—In this disease much mischief is often done by medicine, especially external applications. People, when they see an inflammation, immediately think of some external applications. These, indeed, are necessa­ry in large phlegmons; but, in an erysipelas, the safer course is to apply nothing. Almost all ointments, salves and plasters, are of a greasy nature, and tend rather to ob­struct and repel, than promote any discharge from the part. At the beginning of this disease, it is neither safe to pro­mote a suppuration, nor to repel the matter too quickly. The erysipelas, in many respects, resembles the gout, and is to be treated with the greatest caution. Fine wool, or very soft flannel, are the safest applications to the part. These not only defend it from the external air, but likewise promote the perspiration, which has a great tendency to carry off the disease.

[Page 175] IT is a common thing to bleed in the erysipelas; but this likewise requires caution. If, however, the fever be high, the pulse hard and strong, and the patient vigorous, it will be proper to bleed; but the quantity must be regulated by these circumstances, and the operation repeated or not, as the symptoms may require. If the patient has been accu­stomed to strong liquors, and the disease attacks his head, bleeding is absolutely necessary.

BATHING the feet and legs frequently in lukewarm water, when the disease attacks the face or brain, has an excellent effect. It tends to draw the humours of the head towards the inferior extremities, and seldom fails to relieve the pati­ent. When bathing proves ineffectual, poultices, or sharp sinapisms, may be applied to the soles of the feet for the same purpose.

IN cases where bleeding is requisite, it is likewise necessa­ry to keep the belly gently open. This may be effected by emollient clysters, or small doses of nitre and rhubarb, such as are prescribed in the foregoing disease. Some, in­deed, recommend very large doses of nitre in this case; but nitre seldom sits easy on the stomach when taken in large quantities. It is, however, one of the best medicines in this case; and, when the fever and inflammation run high, half a dram of it may be taken in the patient's ordinary drink, three or four times a-day.

THE saline julep, as it is called, is likewise a very proper medicine in the erysipelatous fever. It may be made by dissolving two drams of salt of wormwood, or salt of tartar, in three ounces of fresh lemon juice, to which may be add­ed, two ounces of common water, and an ounce or two of peppermint water, with as much white sugar as will render it agreeable. Of this two table spoonfuls may be taken every two or three hours.

WHEN the erysipelas leaves the extremities, and seizes the head, so as to occasion a delirium, or stupor, it is ab­solutely necessary to open the belly. If clysters and mild purgatives [...]ail to have that effect, stronger ones must be given. Blistering plasters must, likewise, be applied to the neck, or behind the ears, and sharp cataplasms laid to the soles of the feet.

WHEN the erysipelas cannot be discussed, and the pain lies deep, and seems to reach to the membrane which co­vers the bones, and the part has a tendency to ulcerate, it will then be proper to promote suppuration, which may [Page 176] be done by the application of ripening poultices, with saf­fron, warm fomentations, and such like.

WHEN the black, livid, or blue colour of the part, shews a tendency to mortification, the Jesuits bark must be administered. It may be taken along with acids, as re­commended in the small-pox, or in any other form more agreeable to the patient. It must not, however, be trifled with, as the patient's life is at stake. Half a dram may be taken every two hours, or oftener, if the symptoms be threatening, and cloths dipped in warm camphorated spi­rits of wine, or the tincture of myrrh and aloes, may be applied to the part, and frequently renewed.

IN what is commonly the scorbutic erysipelas, which continues for a considerable time, it will only be necessary to give gentle laxatives, and such things as purify the blood. Medicines which promote the perspiration are likewise proper. Thus, after the inflammation has been checked by opening medicines, a decoction of the sudorific woods, as sassafras and guaiacum, with liquorice root, may be drank, and afterwards a course of bitters, which will both strengthen the stomach, and purify the blood.

SUCH as are liable to frequent attacks of the erysipelas, ought carefully to guard against all violent passions; to ab­stain from strong liquors, and all fat, viscid, and highly nourishing food. They should take abundance of exercise, carefully avoiding the extremes of heat or cold. Their food should consist chiefly of milk, and such fruits, herbs, and roots, as are of a cooling quality; and their drink ought to be small beer, whe [...], butter-milk, and such like. They should never suffer themselves to be too long costive. If that cannot be prevented by diet alone, it will be proper to take frequently a gentle dose of rhubarb and cream of tartar, the lenitive electuary, or some other mild purga­tive.

OF THE INFLAMMATION OF THE BRAIN.

THIS is sometimes a primary disease, but oftener only a symptom of some other malady; as the inflammatory, eruptive, or spotted fever, &c. It is very common, how­ever, as a primary disease in warm climates, and is most incident to persons about the prime and vigour of life. The passionate, the studious, and th [...]se whose nervous system is weak, are very liable to it.

[Page 177] CAUSES.—This disease is often occasioned by night-watching, especially when joined with hard study: It, likewise, proceeds from hard drinking, from anger, grief, or anxiety. It may, also, be occasioned by a seden­tary life, or the stoppage of usual evacuations; as the bleeding piles in men, the customary discharges of women, &c. Such as imprudently expose themselves to the heat of the sun, especially by sleeping without doors, in a hot season, with their heads uncovered, are often suddenly seiz­ed with an inflammation of the brain, so as to awake quite delirious. When repellents are imprudently used in an erysipelas, an inflammation of the brain is often the conse­quence. It may, likewise, be occasioned by external in­juries, as blows, or bruises upon the head, &c.

SYMPTOMS.—The symptoms which precede a true inflammation of the brain are, pain of the head, redness of the eyes, a violent flushing of the face, disturb­ed sleep, or a total want of it, great dryness of the skin, costiveness, a retention of urine, a small dropping of blood from the nose, singing of the ears, and extreme sensibility of the nervous system.

WHEN the inflammation is formed, the symptoms, in general are similar to those of the inflammatory fever. The pulse, indeed, is often weak, irregular, and trembling; but, sometimes, it is hard and contracted. When the brain itself is inflamed, the pulse is always soft and low; but when the inflammation only affects the integuments of the brain, it is hard. A remarkable quickness of hearing, is a com­mon symptom of this disease; but that seldom continues long. Another usual symptom is, a great throbbing or pul­sation in the arteries of the neck and temples. The tongue is often black and dry; yet the patient seldom complains of thirst, and even refuses drink. The mind chiefly runs after such objects as have before made a deep impression upon it; and, sometimes, from a sullen silence, the patient be­comes all of a sudden quite outrageous.

A constant trembling and starting of the tendons, is an unfavourable symptom, as also, a suppression of the urine; a total want of sleep; a constant spitting; a grinding of the teeth, which must be considered as a kind of convulsi­on. When this disease succeeds an inflammation of the lungs, of the intestines, or of the throat, &c. it is owing to a translation of the morbific matter from these parts to the brain, and generally proves fatal. Hence we learn the necessity of proper evacuations, and the danger of repellents in all inflammatory diseases.

[Page 178] THE favourable symptoms are, a free perspiration or sweating, a copious discharge of blood from the nose, the bleeding piles, a plentiful discharge of urine, which lets fall a copious sediment. Sometimes the disease is carried off by a looseness, and in women by an excessive flow of the menses.

AS this disease often proves fatal in a few days, it re­quires the most speedy applications. When it is prolong­ed, or improperly treated, it sometimes ends in madness, or a kind of stupidity, which continues for life.

IN the cure, two things are chiefly to be attended to, viz. to lessen the quantity of blood in the brain, and to re­tard the circulation towards the head.

REGIMEN.—The patient ought to be kept very quiet. Company, noise, and every thing that affects the senses, or disturbs the imagination, increases the disease. Even too much light is hurtful; for which reason, the pa­tient's chamber ought to be a little darkened, and he should neither be kept too hot nor cold. It is not, however, necessary to exclude the company of an agreeable friend, as this has a tendency to sooth and quiet the mind. Nei­ther should the patient be kept too much in the dark, lest it should occasion a gloomy melancholy, which is too often the consequence of this disease.

THE patient must, as far as possible, be soothed and hu­moured in every thing. Contradiction will ruffle his mind, and increase his malady. Even when he calls for things which are not to be obtained, or which might prove hurtful, he is not to be positively denied them, but rather put off with the promise of having them as soon as they can be obtained, or by some other excuse. A little of any thing that the mind is set upon, though not quite proper, will hurt the patient less than a positive refusal. In a word, whatever the patient is fond of, or used to be delighted with when in health, may here be tried, as plea­sing stories, soft music, or whatever has a tendency to sooth the passions, and compose the mind. Boerhaave pro­poses several mechanical experiments for this purpose; as the soft noise of water distilling by drops into a bason, and the patient trying to reckon them, &c. Any uniform sound, if low and continued, has a tendency to procure sleep, and, consequently, may be of service.

THE aliment ought to be light, of farinaceous substances; as panado, and water gruel, sharpened with jelly of cur­rants [Page 179] or juice of lemons, ripe fruits roasted or boiled, jellies, preserves, &c. The drink small, diluting, and cooling, as whey, barley water, or decoctions of barley and tamarinds; which latter, not only renders the liquor more palatable, but likewise more beneficial, as they are of an opening cooling nature.

MEDICINES.—In an inflammation of the brain, nothing more certainly relieves the patient than a free discharge of blood from the nose. When this comes of its own accord, it is by no means to be stopped, but promoted, by applying cloths dipped in warm water to the part. When bleeding at the nose does not happen sponta­neously, it may be provoked by putting a straw, or any other sharp body up the nostril.

BLEEDING in the temporal arteries greatly relieves the head; but as this operation cannot be generally performed, we would recommend in its stead bleeding in the jugular veins. When the patient's pulse and spirits are so low, that he cannot bear bleeding with the lancet, leeches may be applied to the temples. These not only draw off the blood more gradually, but by being applied nearer to the part affected, generally give more immediate relief.

A discharge of blood from the haemorrhoidal veins is like­wise of great service, and [...], by all means, to be pro­moted. If the patient has been subject to the bleeding piles, and that discharge has been stopped, every method must be tried to restore it; as the application of leeches to the parts, sitting over the steams of warm water, sharp cly­sters, or suppositories made of honey, aloes, and rock salt.

IF the inflammation of the brain be occasioned by the stoppage of any evacuation, either natural or artificial, as the menses, issues, setons, or such like, all means must be used to restore it as soon as possible, or to substitute some other in its stead.

IF the patient be costive, his belly must be kept open by emollient clysters, or gentle purgatives; as manna, rhu­barb, cream of tartar, or such like. These may either be given separately or together in small doses, and repeated as there may be occasion.

SMALL quantities of nitre ought frequently to be mixed with the patient's drink. Two drams, or more, if the case be dangerous, may be used every twenty-four hours.

THE head should be shaven, and frequently rubbed with vinegar and rose water a little warm. Cloths dipped in it may likewise be applied to the temples.

[Page 180] IF the disease proves obstinate, and does not yield to these medicines, it will be necessary to apply a blistering plaster to the whole head.

OF THE INFLAMMATION OF THE EYES.

THIS disease may be occasioned by external injuries; as strokes, dust thrown into the eyes, &c. It is often caused by the stoppage of customary evacuations; as the healing of old sores, drying up of issues, or the like. Nothing more certainly brings on an inflammation of the eyes, than the suppression of gentle morning sweats, or the sweating of the feet. Long exposure to the night air, especially in cold northerly winds, or whatever suddenly checks the perspiration, especially after the body has been much heat­ed, is very apt to cause an inflammation of the eyes. View­ing snow or other white bodies for a long time, or looking stedfastly at the sun, a clear fire, or any bright object, will likewise occasion this malady. A sudden transition from darkness to very bright light, will often have the same effect.

NOTHING more certainly occasions an inflammation of the eyes than night watching especially reading or writing by candle light. Drinking [...]itous liquors, and excess of venery, are very hurtful to the eyes. The acrid fumes of metals, and of several kinds of fuel, are likewise very perni­cious. Sometimes an inflammation of the eyes proceeds from a venereal taint, and often from a scrophulous or gouty habit. It may likewise be occasioned by hairs in the eye-lids turning inwards, and hurting the eyes. Sometimes the disease is epidemic, especially after wet seasons; and I have frequently known it prove infectious, particularly to those who lived in the same house with the patient. It may be occasioned by moist air, or living in low, damp houses, especially where people are not accustomed to such situations. In children, it often proceeds from imprudent­ly drying up of scabbed heads, a running behind the ears, or any other discharge of the same nature [...] Inflammations of the eyes often succeed the small-pox, or measles, espe­cially in children of a scrophulous habit.

SYMPTOMS.—An inflammation of the eyes is attended with acute pain, heat, redness, and swelling. The patient is not able to bear the light, and sometimes he feels a pricking pain, as if his eyes were pierced with a [Page 181] thorn. Sometimes he imagines his eyes are full of motes, or thinks he sees flies dancing before him, the eyes are fill­ed with a scalding rheum, which rushes forth in great quantities, whenever the patient attempts to look up. The pulse is generally quick and hard, with some degree of fever. When the disease is violent, the neighbouring parts swell, and there is a throbbing or pulsation in the temporal arteries, &c.

A slight inflammation of the eyes, especially from an ex­ternal cause, is easily cured; but when the disease is vio­lent, and continues long, it leaves specks upon the eyes, or dimness of sight, and sometimes total blindness.

IF the patient be seized with a looseness, it has a good effect; and when the inflammation passes from one eye to another, as it were by infection, it is no unfavourable symptom. When the disease is accompanied with a vio­lent pain of the head, and continues long, the patient is in great danger of losing his sight.

REGIMEN.—The diet, unless in scrophulous cases, can hardly be too spare, especially at the beginning. The patient must abstain from every thing of a heating na­ture. His food must consist chiefly of mild vegetables, weak broths, and gruels. His drink may be barley water, balm tea, common whey, and such like.

THE patient's chamber must be darkened, or his eyes shaded by a green cover, so as to exclude the light, but not to press upon the eyes. He should not look at a candle, the fire, or any luminous object; and ought to avoid all smoke, as the fumes of tobacco, or any thing that may cause cough­ing, sneezing, or vomiting. He should be kept quiet, avoid­ing all violent efforts, either of body or mind, and encou­raging sleep, as much as possible.

MEDICINE.—This is one of those diseases wherein great hurt is done by external applications. Al­most every person pretends to be possessed of a remedy for the cure of [...]ore eyes. These remedies generally consist of eye-waters and ointments, with other external applications. All which do mischief twenty times for once they do good. People ought, therefore, to be very cautious how they use such things, as the very pressure upon the eyes often increa­ses the malady.

BLEEDING, in a violent inflammation of the eyes, is al­ways necessary. This should be performed as near the part affected as possible. An adult may lose ten or twelve ounces [Page 182] of blood from the jugular vein, and the operation may be re­peated according to the urgency of the symptoms. If it be not, however, convenient to bleed in the neck, the same quan­tity may be let from the arm, or any other part of the body.

LEECHES are often applied to the temples, or under the eyes with good effect. The wounds must be suffered to bleed for some hours, and if the bleeding stop soon, it may be promoted by the application of cloths dipt in warm water. In obstinate cases, it will be necessary to repeat this opera­tion several times.

OPENING and diluting medicines are by no means to be neglected. The patient may take a small dose of Glau­ber's salts and cream of tartar, every second or third day, or a decoction of tamarinds with senna. If these be not agreeable, gentle doses of rhubarb and nitre, a little of the lenitive electuary, or any other mild purgative, will answer the same end. The patient, at the same time, must drink freely of water gruel, tea, or any other weak diluting li­quor. He ought likewise to take, at bed-time, a large draught of very weak wine whe [...], in order to promote per­spiration. His feet and legs must frequently be bathed in lukewarm water, and his head shaved twice or thrice a-week, and afterwards washed in cold water. This has a remarkable good effect.

AFTER these evacuations have been continued for some time, if the inflammation does not yield to them, blistering plasters must be applied behind the ears, to the temples, or upon the neck, and kept open for some time by the mild blistering ointment. I never knew these, if long enough kept open, fail to remove the most obstinate inflammation of the eyes; but, for this purpose it is often necessary to con­tinue the discharge for several weeks.

WHEN the disease has been of long standing, I have seen very extraordinary effects from a seton in the neck, or be­twixt the shoulders, especially the latter. It should be put upwards and downwards, or in the direction of the spine, and in the middle between the shoulder-blades. It may be dressed twice a-day with yellow basilicon. I have known patients, who had been blind for several months, recover sight by means of a seton betwixt the shoulders. When the seton is put a-cross the neck, it soon wears out, and is both more painful and troublesome than between the shoulders; besides, it leaves a disagreeable mark, and does not discharge so freely.

[Page 183] WHEN the heat and pain of the eyes is very great, a soft poultice of bread and milk, with plenty of sweet oil or fresh butter, may be applied to them, at least all night; and they may be bathed with lukewarm milk and water every morn­ing.

IF the patient cannot sleep, which is sometimes the case, he must take ten or twelve drops or laudanum, or two spoon­fuls of the syrup of poppies, over night, more or less ac­cording to his age, or the violence of the symptoms.

AFTER the inflammation is gone off, if the eyes still re­main weak and tender, they may be bathed every night and morning with cold water and a little brandy, six parts of the former to one of the latter. A method should be con­trived by which the eyes can be quite immersed in the bran­dy and water, where they should be kept for some minutes. I have generally sound this as good a strengthener of the eyes as any of the most celebrated collyriums.

WHEN an inflammation of the eyes proceeds from a scro­phulous habit, it generally proves very obstinate. In this case the patient's diet must not be too low, and he may be allowed to drink small negas, or now and then a glass of wine. The most proper medicine is the Jesuits bark, which may either be given in substance, or prepared in the following manner:

TAKE an ounce of Jesuits bark in powder, with two drams of Winter's bark, and boil them in an English quart of water to a pint; when it has boiled nearly long enough, add half an ounce of liquorice root sliced. Let the liquor be strained. Two, three, or four table spoonfuls, according to the age of the patient, may be taken three or four times a-day. It is impossible to say how long this me­dicine should be continued, as the cure is sooner performed in some than others; but, in general, it requires a consi­derable time to produce any lasting effects.

DR. Cheyne says, "That aethiops mineral never fails in inflammations of the eyes, even scrophulous ones, if given in a sufficient dose, and persisted in for a sufficient time." Both this and other mercurial preparations, are no doubt proper when the disease proves obstinate; more especially, when there is reason to suspect that it may proceed from a venereal taint; but as these medicines can never be safely administered unless under the direction of a physician, we shall omit specifying their particular doses, &c.

[Page 184] IT will be proper frequently to look into the eyes, to see if any hairs be turned inwards, or pressing upon them, in order that they may be cut off without delay.

SUCH as are liable to frequent returns of this disease, ought constantly to have an issue in one or both arms. Bleeding or purging in the spring and autumn, will be very beneficial to such persons. They ought likewise to live re­gularly, avoiding strong liquor, and every thing of a heat­ing quality. Above all, l [...]t them avoid the night air and late studies.

OF THE QUINSEY, OR INFLAMMATION OF THE THROAT.

THIS disease is very common in Britain, and is fre­quently attended with great danger. It prevails in the win­ter and spring, and is most fatal to young people of a san­guine or plethoric habit.

CAUSES.—In general, it proceeds from the same causes as other inflammatory fevers, viz. an obstructed per­spiration, or whatever heats or inflames the blood. An in­flammation of the throat is often occasioned by omitting some part of the covering usually worn about the neck, by drinking cold liquor when the body is warm, by riding or walking against a cold northerly wind, or any thing that greatly cools the throat, and parts adjacent. It may like­wise proceed from the neglect of bleeding, purging, or any customary evacuation.

SINGING, speaking loud and long, or whatever strains the throat, may likewise cause an inflammation of that or­gan. I have often known the quinsey prove fatal to jovial companions, after sitting long in a warm room, drinking hot liquors and singing with vehemence; especially, when they were so imprudent as afterwards to go abroad in the cold night air. Sitting with wet feet, or keeping on wet cloaths, are very apt to occasion this malady. It is likewise frequently occasioned by continuing long in a moist place, sleeping in a damp bed, sitting in a room that has been newly plastered, &c. I know people who never fail to com­plain of their throat after sitting but a very short while in a room that has been lately washed.

ACRID or irritating food may likewise inflame the throat, and occasion a quinsey. It may also proceed from bones, pins, or other sharp substances sticking in the throat, or [Page 185] from the caustic fumes of metals or minerals, as arsenic, an­timony, &c. taken in by the breath. This disease is some­times epidemic and infectious.

SYMPTOMS.—The inflammation of the throat is evident from inspection, the parts appearing red and swelled; besides, the patient complains of pain in swallow­ing any thing. His pulse is quick and hard, with other symptoms of a fever. If blood be let, it is generally covered with a tough coat of a whitish colour, and the patient spits a tough phlegm. As the swelling and inflammation increase, the breathing and swallowing become the more difficult, the pain affects the ears; the eyes generally appear red, and the face swells. The patient is often obliged to keep himself in an erect posture, being in danger of suffocation; there is a constant nausea, or inclination to vomit, and the drink, in­stead of passing into the stomach, is often returned by the nose. The patient is frequently starved at last, merely from an inability of swallowing any kind of nourishment. When the breathing is performed with a hissing noise, and the pulse begins to intermit, death is at hand.

AS several of the organs necessary for life are affected by this disease, it can never be without danger; no time there­fore should be lost in attempting to remove it, as a little de­lay often renders it incurable.

WHEN the breathing is laborious, with straitness of the breast and anxiety, the danger is great. Though the pain of swallowing be very great, yet while the patient breathes easy, there is not so much danger. An external swelling is no unfavourable symptom; but if it suddenly falls, and the morbific matter is thrown upon the breast, the danger is very great. When a quinsey is the consequence of some other disease, which has already weakened the patient, his situation is dangerous. A frothing at the mouth, with a swelled tongue, a pale ghastly countenance, and coldness of the extremities, are fatal symptoms.

REGIMEN.—The regimen in this disease is in all respects the same as in the pleurisy or peripneumony. The food must be light, and in small quantity, and the drink plentiful, weak, and diluting, mixed with acids.

IT is highly necessary, in this disease, that the patient be kept easy and quiet. Violent passions of the mind, or great efforts of the body, may prove fatal. He should not even attempt to speak but in a low voice. Such a degree of warmth as to promote a constant gentle sweat is proper. When the [Page 186] patient is in bed, his head ought to be raised a little higher than usual.

IT is peculiarly necessary that the throat be kept warm; for which purpose several folds of soft flannel may be wrapt round the neck: That alone will often remove a slight complaint of the throat, especially if applied in due time. We cannot here omit observing the propriety of a custom which prevails amongst the peasants of this country; when they feel any uneasiness of the throat, they wrap a stocking about it all night. So effectual is this remedy, that, in many places, it passes for a charm, and the stock­ing is applied with particular ceremonies: The custom, however, is undoubtedly a good one, and should never be neglected. When the throat has been thus wrapt up all night, it must not be exposed to the cold air through the day, but a handkerchief, or a piece of flannel, kept about it, till the inflammation be gone.

THE jelly of black currants is a medicine very much in esteem for complaints of the throat; and indeed the whole materia medica cannot afford a better. It should be almost constantly kept in the mouth, and swallowed down leisure­ly. It may likewise be mixed in the patient's drink, or taken any other way. When it cannot be obtained, the red currant jelly, or the mulberry, may be used in its stead.

GARGIES for the throat are likewise very beneficial. They may be made by adding to half an English pint of the pectoral decoction mentioned in page 110, two or three spoonfuls of honey, and the same quantity of currant jelly. This may be used three or four times a-day; and, if the patient be troubled with tough viscid phlegm, the gargle may be made more sharp and cleansing, by adding to it a tea spoonful of the spirits of sal ammoniac. Some recom­mend gargles made of a decoction of the leaves or bark of the blackberry bush; but where the jelly can be had, these are unnecessary.

THERE is no disease wherein the benefits of bathing the feet and [...] in lukewarm water are more apparent. That practice [...], therefore, never to be neglected. If people were careful to keep warm, to wrap up their throats with flannel, to [...]he their feet and legs in warm water, and to use a spare diet, with diluting liquors, at the beginning of this disease, it would seldom proceed to any great height, [...] be attended with any danger; but when these precauti­ons [Page 187] are neglected, and the disease becomes violent, more powerful medicines are necessary.

MEDICINE.—An inflammation of the throat being one of the most acute and dangerous distempers, which sometimes takes off the patient in a few hours, the most early remedies are, with the greatest care and di­ligence to be administered. In the very first attack, there­fore, when it is violent, it will be proper to bleed in the arm, or rather in the jugular vein, and to repeat the ope­ration if the symptoms require.

THE belly should likewise be gently opened. This may either be done by giving the patient for his ordinary drink a decoction of figs and tamarinds, or small doses of rhu­barb and nitre, as recommended in page 172. These may be increased according to the age of the patient, and repeat­ed till they have the desired effect.

I have often known very good effects from a bit of sal prunel, or purified nitre, held in the mouth, and swllowed down as it melted. This promotes the discharge of saliva, by which means it answers the end of a gargle, while, at the same time, it cools the blood, by promoting the dis­charge of urine, &c.

THE throat ought, likewise, to be rubbed twice or thrice a-day with a little of the volatile liniment. This may be made by taking an ounce of oil of sweet almonds, and half an ounce of spirit of hartshorn, and shaking them together in a vial till they be united. I do not remember ever to have seen this fail to produce some good effects. The throat should be carefully covered with wool or flannel, to prevent the cold from penetrating the skin, as this application ren­ders it very tender. Many other external applications are recommended in this disease, as a swallow's nest, poultices made of the funges called Jews-ears, &c. But as we do not look upon any of these to be preferable to a common poultice of bread and milk, we shall take no farther notice of them.

BLISTERING upon the neck, or behind the ears, in vio­lent inflammations of the throat, is very beneficial. After the plasters are taken off, the part ought to be kept running by the application of sharp ointment, till the inflammation is gone; otherwise, upon their drying up, the patient will be in danger of a relapse.

WHEN the patient has been treated as above, a suppura­tion seldom happens. This, however, is sometimes the case, in [Page 188] spite of all our endeavours to prevent it. When the inflam­mation and swelling continue, and it is evident that a sup­puration will ensue, it ought to be promoted by drawing the steam of warm water into the throat through a tunnel, or the like. Soft poultices ought, likewise, to be applied outwardly, and the patient may keep a roasted fig constant­ly in his mouth.

IT sometimes happens, before the tumour breaks, that the swelling is so great, as entirely to prevent any thing from getting down into the stomach. In this case, the patient must inevitably perish, unless he can be supported in some other way. This can only be done by nourishing clysters of broth, or gruel with milk, &c. Patients have often been supported by these for several days, till the tumour has broke; and afterwards they have recovered.

NOT only the passage of the food, but the breathing is often prevented by the tumour. In this case, nothing can save the patient's life, but opening the trachea or windpipe, That has been so often done with success, that no person, in such desperate circumstances, ought to hesitate a mo­ment about the operation; but as it can only be performed by a surgeon, it is not necessary here to give any directions about it.

WHEN a difficulty of swallowing is not attended with an acute pain or inflammation, it is generally owing to an ob­struction of the glands about the throat, and only requires that the part be kept warm, and the throat frequently gar­gled with somewhat that may gently stimulate the glands, as a decoction of figs with vinegar and honey; to which may be added a little mustard, or a small quantity of spirits.

BUT this kind of gargle is never to be used where there are signs of an inflammation. This species of angina has various names among the common people, as the pap of the throat, the falling down of the almonds of the ears, &c. Ac­cordingly, to remove it, they pull the patient up by the hair of the head, and thrust their fingers under his jaws, &c. all which practices are, at best, useless, and often hurtful.

THOSE who are subject to inflammations of the throat, in order to prevent too great a fulness of blood and hu­mours, ought to live temperately. Such as do not choose to observe this rule, must have frequent recourse to purging and other evacuations, to discharge the superfluous hu­mours. They ought likewise to beware of catching cold, [Page 189] and should abstain from aliment and medicines of an astrin­gent or stimulating nature.

VIOLENT exercise, by increasing the motion and force of the blood, is apt to occasion an inflammation of the throat, especially if cold liquor be drank immediately after it, or the body suffered suddenly to cool. Those who would avoid this disease, ought, therefore, after speaking aloud, singing, running, drinking warm liquor, or doing any thing that may strain the throat, or increase the circu­lation of the blood towards it, to take care to cool gradu­ally, and to wrap plenty of coverings about their necks, &c.

I have often known persons who had been subject to sore throats, kept intirely free from that complaint by only wearing a ribband, or a bit of flannel, constantly about their necks, or by wearing a pair of thicker shoes, &c. These may seem trifling, but they have great effect. There is danger indeed in leaving them off, after persons have been accu­stomed to them; but surely the inconveniency of using such things for life, is not to be compared with the danger which may attend the neglect of them.

OF THE MALIGNANT QUINSEY, OR PUTRID, ULCEROUS SORE THROAT.

THIS kind of quinsey is but little known in the northern parts of Britain, though, for some time past, it has been very fatal in the more southern counties. Children are more subject to it than adults, females than males, and the delicate than those who are hardy and robust. It prevails most in autumn, or after a long course of damp, or fultry weather.

CAUSE.—This is evidently a contageous distem­per, and is generally communicated by infection. Whole families, and even entire villages often receive the infection from one person. This ought to put people upon their guard against going near such patients as labour under the disorder; as by that means they endanger not only their own lives, but likewise those of their friends and connecti­ons.

SYMPTOMS.—It begins with alternate fits of shivering and heat. The pulse is quick, but low and une­qual, and generally continues so through the whole course of the disease. The patient complains greatly of weakness [Page 190] and oppression of the breast; his spirits are low, and he is apt to faint away when set upright; he is troubled with a nausea, and often with a vomiting or purging. The two latter are most common in children. The eyes appear red and watery, and the face swells. The urine is at first pale and crude; but, as the disease advances, it turns more of a yellowish colour. The tongue is white, and generally moist, which distinguishes this from an in­flammatory disease. Upon looking into the throat it ap­pears swelled, and of a florid red colour. Pale, or ash-coloured spots, however, are here and there interspersed, and sometimes one broad patch or spot, of an irregular fi­gure, and pale white colour, surrounded with florid red only appears. These whitish spots, or sloughs, cover so many ulcers underneath.

AN efflorescence, or eruption upon the neck, arms, breast, and fingers, about the second or third day, is a common symptom of this disease. When it appears, the purging and vomiting generally cease.

THERE is often a slight degree of delirium, and the face frequently appears blotted, and the inside of the nostrils red and inflamed. The patient complains of a disagreeable, putrid smell, and his breath is very offensive.

THE putrid, ulcerous sore throat, may be distinguished from the inflammatory, by the vomiting and looseness, with which it is generally ushered in; by the foul ulcers in the throat, covered with a white or livid coat; and, by the excessive weakness of the patient; with other symptoms of a putrid fever.

UNFAVOURABLE symptoms are, an obstinate purging, extreme weakness, dimness of the sight, a livid or black colour of the spots, and frequent shiverings, with a weak, fluttering pulse. If the eruption upon the skin suddenly disappears, or becomes of a livid colour, with a dis­charge of blood from the nose or mouth, the danger is very great.

IF a gentle sweat breaks out about the third or fourth day, and continues with a slow, firm, and equal pulse; if the sloughs cast off in a kindly manner, and appear clean and florid at the bottom; and if the breathing be soft and free, with a lively colour of the eyes, there is reason to hope for a salutary crisis.

REGIMEN.—The patient must be kept quiet, and, for the most part, in bed, as he will be apt to faint when taken out of it. His food must be nourishing and [Page 191] restorative; as sago gruel with red wine, jellies, broths, &c. His drink ought to be generous, and of an antisep­tic quality; as red wine negas, white wine whey, and such like.

MEDICINE.—The medicine in this kind of quinsey is entirely different from that which is proper in the inflammatory. All evacuations, as bleeding, purging, &c. which weaken the patient, must be avoided. Cooling medicines, as nitre, and cream of tartar, are, likewise, hurtful. Strengthening cordials alone can be used with safety; and these ought never to be neglected.

IF, at the beginning, there be a great nausea, or incli­nation to vomit, the patient must drink an infusion of green tea, camomile flowers, or carduus benedictus, in order to clean the stomach. If these be not sufficient, he may take a few grains of the powder of ipecacuanha, or any other gentle vomit.

IF the disease be mild, the throat may be gargled with an infusion of sage and rose leaves, to a gill of which may be added a spoonful or two of honey, and as much vinegar as will make it agreeably sharp; but, when the symptoms are urgent, the sloughs large and thick, and the breath ve­ry offensive, the following gargle may be used.

TO six or seven ounces of the pectoral decoction, when boiling, add half an ounce of contrayerva root; let it boil for some time, and afterwards strain the liquor; to which add two ounces of white wine vinegar, an ounce of fine honey, and an ounce of the tincture of myrrh. This ought not only to be used as a gargle, but a little of it should frequently be injected with a syringe to clean the mouth, be­fore the patient takes any meat or drink. This method is pe­culiarly necessary for children, who cannot use a gargle.

IT will be of great benefit if the patient frequently re­ceives into his mouth, through an inverted funnel, the steams of warm vinegar, myrrh, and honey.

WHEN the putrid symptoms run high, and the disease is attended with danger, the only medicine that can be de­pended upon is the Jesuits bark. It may be taken in sub­stance, if the patient's stomach will bear it. If not, an ounce of bark grossly powdered, with two drams of Virgi­nian snakeroot, may be boiled in an English pint and an half of water, to half a pint; to which a tea spoonful of the elixir of vitriol may be added, and an ordinary tea cupful of it taken every three or four hours. Blistering plasters [Page 192] are very beneficial in this disease, especially when the pati­ent's pulse and spirits are low. They may be applied to the throat, behind the ears, or upon the back-part of the neck.

SHOULD the vomiting prove troublesome, it will be pro­per to give the patient two table spoonfuls of the saline ju­lep, recommended in page 175, every two hours, or oftener, if necessary. Tea made of mint and a little cinnamon, will likewise be a proper drink, especially if an equal quantity of red wine be mixed with it.

IN case of a violent looseness, the size of a nutmeg of diascordium, or the Japonic confection, may be taken two or three times a-day, or oftener, if necessary; and the pa­tient's drink must be red wine negas.

IF a discharge of blood from the nose happens, the steams of warm vinegar may be received up the nostrils fre­quently; and the drink may be sharpened with spirits of vitriol, or tincture of roses.

IN case of a strangury, the belly must be fomented with warm water, and emollient clysters given three or four times a-day.

AFTER the violence of the disease is over, the belly should be opened with mild purgatives; as manna, senna, rhubarb, or the like.

IF great weakness and dejection of spirits, or night sweats, with other symptoms of a consumption, should re­main after this disease, we would recommend it to the pati­ent to continue the use of the Jesuits bark, with the elixir of vitriol, and to take frequently a glass of generous wine. These, together with a milk diet, and riding on horseback, are the most likely means for recovering his strength.

OF COLDS.

IT has already been observed, that colds are the effect of an obstructed perspiration; the common causes of which we have likewise endeavoured to point out, and shall not here repeat them. Neither shall we spend time in enumerating all the various symptoms of colds, as they are pretty generally known. It may not, however, be amiss to observe, that almost every cold is a kind of fever, and only differs in degree from some of those which have already been treated of.

[Page 193] No age, sex, nor constitution, are exempted from this disease; neither is it in the power of [...] to prevent it. The inhabitants of every climate are [...]able to catch cold, nor can even the greatest circumspection defend them against its attacks. Indeed, if the human body could be kept constantly in an uniform degree of warmth, such a thing as catching cold would be impossible: But as that cannot be effected by any means, the perspiration must be liable to many changes. Such changes, however, when small, do not affect the health; but, when excessive, they must prove hurtful. Hence the great secret of preventing colds, lies in avoiding, as far as possible, all extremes ei­ther of heat or cold.

WHEN oppression of the breast, a stuffing of the nose, unusual weariness, or a pain of the head, &c. give ground to believe that the perspiration is obstructed, or, in other words, that the person has caught cold, he ought imme­diately to lessen his diet, at least, the usual quantity of his solid food, and to abstain from all strong liquors. Instead of flesh, fish, eggs, milk, and other nourishing diet, he may eat light bread pudding, veal, or chicken broth, paps, or gruels, and such like. His drink may be water gruel, sweetened with a little honey; an infusion of balm, or linseed, sharpened with the juice of orange or lemon; a decoction of barley and liquorice, with tamarinds, or any other cool, diluting acid liquor.

ABOVE all, his supper should be light; as small posset, or water gruel, sweetened with honey, and a little toasted bread in it. If honey should disagree with the stomach, the gruel may be sweetened with treacle, or coarse sugar, and sharpened with the jelly of currants. Those who have been accustomed to generous liquors, may take white wine whey instead of gruel, which may be sweetened as above.

THE patient ought to lie longer than usual in bed, and to encourage a gentle sweat, which is easily brought on towards morning, by drinking tea, or any kind of warm diluting liquor. I have often known this practice, in a day or two, carry off a cold, which, in all probability, had it been neglected, would have cost the patient his life, or have confined him for some months to his bed. Would people sacrifice a little time to ease and warmth, and prac­tice a moderate degree of abstinence when the first symptoms of a cold appear, we have reason to believe, that most of the bad effects which flow from an obstructed perspiration, [Page 194] might be prevented. But, after the disease has gathered strength by delay, all attempts to remove it, often prove in vain. A pleurisy, a peripneumony, or a fatal consumption of the lungs, are the common effects of colds that have ei­ther been totally neglected, or treated improperly.

MANY attempt to cure a cold, by getting drunk. But this, to say no worse of it, is a very hazardous and fool­hardy experiment. No doubt it may sometimes succeed, by suddenly restoring the perspiration; but when there is any degree of inflammation, which is frequently the case, strong liquors, instead of removing the malady, will in­crease it. By this means a common cold is often convert­ed into an inflammatory fever.

WHEN those who labour for their daily bread have the misfortune to catch cold, they grudge to lose a day or two, in order to keep themselves warm, and take a little medi­cine, by which means the disorder is often so aggravated, as to confine them for a long while, or even to render them ever after unable to sustain hard labour. Such of the labouring poor as can afford to take care of themselves, are often too hardy to do it; they affect to despise colds, and as long as they can crawl about, scorn to be confined by what they call a common cold. Hence it comes to pass, that colds destroy such numbers of mankind. Like an enemy despised, they gather strength from delay, till, at length, they become invincible. We often see this verifi­ed in travellers, who, rather than lose a day in the prose­cution of their business, throw away their lives, by pursu­ing their journey with this disease upon them, even in the coldest season.

BUT colds may be too much as well as too little indulged. When a person, for a slight cold, shuts himself up in a warm room, and drinks great quantities of warm liquor, it may bring on such a general relaxation of the solids as will not be easily removed. It will, therefore, be proper, when the disease will permit, and the weather is mild, to join to the regimen mentioned above, gentle exercise; as walking, riding on horseback, or in a machine, &c. An obstinate cold, which no medicine can remove, will yield to a pro­per course of exercise when duly persisted in.

BATHING the feet and legs every night in warm water, has a great tendency to restore the perspiration. But care must be taken that the water be not too warm, otherwise it will do hurt. It should never be warmer [...]n new milk, [Page 195] and the [...] should go immediately to bed after using it. Bathing [...] feet in warm water, lying in bed, and drink­ing warm water gruel, or other weak liquors, will sooner take off a spasm, and restore the perspiration, than all the hot sudori [...]ic medicines in the world. This is all that is necessary for removing a common cold; and if this course be taken at the beginning, and pursued for a few days, it will seldom fail.

BUT when the symptoms do not yield to abstinence, warmth, and diluting liquors, there is reason to fear the approach of some other disease, as an inflammation of the breast, an ardent fever, &c. If the pulse, therefore, be hard and frequent, the skin hot and dry, and the patient complains of his head and breast, &c. it will be necessary to bleed, and to give the cooling opening powders menti­oned in page 172, every three or four hours, till they give a stool.

IT will likewise be proper to put a blistering plaster on the back, to give two table spoonfuls of the saline mixture ordered in page 175, every three hours, and, in short, to treat the patient, in all respects, as for a slight fever. I have often seen this course, when observed at the begin­ning, remove the complaint in two or three days, when the patient had all the symptoms of an approaching ardent fever, or an inflammation of the breast.

OF COUGHS.

A cough is generally the effect of a cold, which has ei­ther been improperly treated, or intirely neglected. When it proves obstinate, there is always reason to fear the conse­quences, as this shews a weak state of the lungs, and is often the forerunner of a consumption.

IF the cough be violent, and the patient young and strong, with a hard quick pulse, bleeding will be necessary, to lessen the quantity of the humours, and prevent a rup­ture of the blood-vessels of the lungs, &c. but in weak and relaxed habits, bleeding rather prolongs the disease. When the patient spits freely, bleeding is unnecessary, and some­times hurtful, as it tends to lessen that discharge.

WHEN the cough is not attended with a fever, and the spittle is viscid and tough, sharp pectoral medicines are to be ad­ministered; as gum ammoniac, squills, &c. The solution of gum ammoniac may be prepared as directed in page 117, [Page 196] and two table spoonfuls of it taken three or four [...] a-day, more or less, according to the age and constitution of the patient. Squills may be given various ways; two ounces of the vinegar, the oxymel, or the syrup, may be mixed with the same quantity of spirituous cinnamon water, to which may be added, an ounce of common water, and an ounce of balsamic syrup. Two table spoonfuls of this mix­ture may be taken three or four times a-day.

A syrup made of equal parts of lemon juice, honey and sugar-candy, is likewise very proper in this kind of cough▪ A table spoonful of it may be taken at pleasure.

WHEN the defluxion is sharp and thin, these medicines rather do hurt. In this case, gentle opiates, oils, and mu­cilages are proper. A cup of the infusion of wild poppy leaves, with marsh mallow roots, or the flowers of coltsfoot, may be taken frequently; or a tea spoonful of the parego­ric elixir may be put into the patient's drink twice a-day. He may likewise take an emulsion made of an ounce and an half of olive oil, six ounces of water, one ounce of pec­toral syrup, and a tea spoonful of spirits of hartshorn. These must be well shaken together, and two table spoonfuls of the mixture taken every three or four hours. Fuller's Spanish infusion is also a very proper medicine in this case, and may be taken, if the above should disagree with the patient's sto­mach. It is made by infusing in an English quart of boil­ing water, two drams of salt of tartar, half a dram of saffron cut into small pieces, and an ounce of Spanish juice like­wise cut small. These must stand in a close vessel for twen­ty-four hours, in a gentle degree of warmth. Afterwards, let the infusion be strained, and a tea cupful of it taken three or four times a-day.

WHEN a cough is occasioned by acrid humours tickling the throat and fauces, the patient should keep some soft pectoral lozenges almost constantly in his mouth; as the Pontefract liquorice cakes, barley sugar, the Spanish juice, &c. These blunt the acrimony of the humours, and by taking off their stimulating quality, help to appease the cough.

IN obstinate coughs, proceeding from a flux of humours upon the lungs, it will often be necessary, besides expec­torating medicines, to have recourse to issues, setons, or some other drain. In this case, I have always observed the most happy effects from a Burgundy pitch plaster applied between the shoulders. I have ordered this simple remedy in the most obstinate coughs, in a great number of cases, and in many different constitutions, without ever knowing [Page 197] it fail, unless where there were evident signs of an ulcer in the lungs. About the bulk of a nutmeg of Burgundy pitch may be spread thin upon a piece of soft leather, about the size of the hand, and laid between the shoulder-blades. It may be taken off and wiped every three or four days, and ought to be renewed once a fortnight or three weeks. This is indeed a cheap and simple medicine, and consequently apt to be despised; but we will venture to affirm, that the whole materia medica does not afford an application more ef­ficacious in almost every kind of cough. It has not, indeed, an immediate effect; but, if continued long enough, it will succeed where most other medicines fail.

THE only inconveniency attending this plaster is the itch­ing, which it occasions in the part to which it is applied; but surely this may be dispensed with, considering the ad­vantage which the patient may expect to reap from the ap­plication; besides, when the itching becomes very uneasy, the plaster may be taken off, and the part rubbed with a dry cloth, or washed with a little warm milk and water. Some caution, indeed, is necessary in discontinuing the use of such a plaster; this, however, may be safely done by making it smaller by degrees, and at length quitting it al­together in a warm season.

BUT coughs proceed from many other causes besides de­fluxions upon the lungs. In these cases the cure is not to be attempted by pectoral medicines. Thus, in a cough pro­ceeding from a foulness and debility of the stomach, syrups, oils, mucilages, and all kind of balsamic medicines, do hurt. This cough may be known from one that is owing to a fault in the lungs by this mark, that in the latter the patient coughs whenever he inspires, or draws in his breath fully; but in the former that does not happen.

THE cure of this cough depends chiefly upon cleansing and strengthening the stomach; for which purpose gentle vomits and bitter purgatives are most proper. Thus, after a vomit or two, the sacred tincture, as it is called, may be taken for a considerable time, in the dose of a table spoonful or two twice a-day, or as often as it is found necessary to keep the belly gently open. People may make this tincture themselves, by infusing an ounce of hiera picra in an English pint of white wine, letting it stand a few days, and then straining it off for use.

IN coughs, which proceed from a debility of the stomach, the Jesuits [...]ark is, likewise, of considerable use. It may [Page 198] either be chewed, taken in powder, or made into a tincture along with other stomachic bitters.

A nervous cough can only be removed by change of air, and proper exercise; to which may be added the use of gentle opiates. A tea spoonful of the paregoric elixir, or two of the saponaceous pills may be taken twice a-day. If these prove too weak, ten, fifteen, or twenty drops of li­quid laudanum, more or less, as circumstances require, may be taken at bed-time, or when the cough is most troublesome. Putting the feet and hands in warm wa­ter, will often appease the violence of a nervous cough.

WHEN a cough is only the symptom of some other ma­lady, it is in vain to attempt to remove it without first cu­ring the disease from which it proceeds. Thus, when a cough is occasioned by the cutting of teeth; keeping the belly open, scarifying the gums, or whatever facilitates the teething, likewise appeases the cough. In like manner, when worms occasion a cough, such medicines as remove these, will generally cure the cough; as bitter purgatives, oily clysters, and such like.

WOMEN, during the last months of pregnancy, are often greatly afflicted with a cough, which is generally relieved by bleeding, and keeping the belly open. They ought to avoid all flatulent food, and to wear a loose easy dress.

A cough is not only a symptom, but is often, likewise, the forerunner of diseases. Thus, the gout is frequently ushered in by a very troublesome cough, which affects the patient for some days before the coming on of the fit. A pa­roxysm of the gout generally removes this cough, which should, therefore, be promoted, by keeping the extremities warm, drinking warm liquors, and bathing the feet and legs frequently in lukewarm water.

OF THE CHIN-COUGH.

THIS cough seldom affect adults, but is often epidemical among children. Such children as live upon thin watery diet, who breathe unwholesome air, and have too little ex­ercise, are most liable to this disease, and generally suffer most from it.

THE chin-cough is so well known, even to nurses, that no description of it is necessary. Whatever hurts the digest­ion, obstructs the perspiration, or relaxes the solids, pre­disposes [Page 199] to this disease; consequently its cure must depend upon cleaning and strengthening the stomach, bracing the solids, and, at the same time, promoting perspiration, and the different secretions.

THE diet in this disease must be light, and of easy digest­ion; for children, good bread made into pap or pudding, chicken broth, with other light spoon meats, are proper; but those who are farther advanced, may be allowed sago gruel, and, if the fever be not high, a little boiled chick­en, or other white meats. The drink may be pennyroyal tea, sweetened with honey or sugar-candy, small wine whey; or, if the patient be weak, he may sometimes be allowed a little negas.

THE most effectual remedy in this disease is change of air. This often removes the malady, even when the change seems to be from a purer to a less wholesome air. This may, in some measure, depend on the patient's being re­moved from the place where the infection prevails. Most of the diseases of children are infectious; nor is it at all uncommon to find the chin-cough prevailing in one town or village, when another, at a very small distance, is quite free from it. But, whatever be the cause, we are sure of the fact. No time ought, therefore, to be lost in removing the patient at some distance from the place where he caught the disease, and, if possible, into a more pure and dry air.

WHEN the disease proves violent, and the patient is in danger of being suffocated by the cough, he ought to be bled, especially if there be a fever with a hard full pulse. But, as the chief intention of bleeding is to prevent a rupture of the blood vessels of the lungs, and to render it more safe to give vomits, it will seldom be necessary to repeat the operation; yet, if there be symptoms of an inflammation of the lungs, a second, or even a third bleeding may be re­quisite.

IT is a favourable symptom when the patient vomits after the fit. This cleans the stomach, and greatly relieves the cough. It will, therefore, be proper to promote the dis­charge, either by camomile tea, or lukewarm water; and, when these are not sufficient, small doses of ipecacuanha may be given. A child of three or four years of age may take five or six grains; and to others, less or more must be given, according to their age and strength.

IT is very difficult to make children drink after a vomit. I have often seen them happily deceived, by infusing a scru­ple [Page 200] or half a dram, of the powder of ipecacuanha in a tea-pot, with half an English pint of boiling water. If this be disguised with a few drops of milk, and a little sugar, they will imagine it tea, and drink it very greedily. A small tea cupful of this may be given every quarter of an hour, or rather every ten minutes, till it operates. When they begin to puke, there will be no occasion for drinking any more, as the water already on their stomach will be suffi­cient.

VOMITS not only clean the stomach, which, in this dis­ease is generally loaded with viscid phlegm, but they like­wise promote the perspiration and other secretions; and ought, therefore, to be repeated, according to the obstina­cy of the disease. They should not, however, be too strong; gentle vomits, frequently repeated, are both less dangerous, and more beneficial than strong ones.

AS the patient is generally costive, it will be proper to keep his belly gently open. The best medicines for this purpose are rhubarb and its preparations, or the sacred tinc­ture, if the patient can be brought to take it. Of this a tea spoonful or two may be given to a young child twice or thrice a-day, as there is occasion. To such as are farther advanced, the dose must be proportionally increased, and repeated till it has the desired effect. Those who cannot be brought to take the bitter tincture, may have an infusion of senna and prunes, sweetened with manna, coarse sugar, or honey; or a few grains of rhubarb, mixed with a spoon­ful or two of syrup, or currant jelly, so as to disguise the taste. Most children are fond of syrups and jellies, and seldom refuse even a bitter medicine when mixed with them.

MANY people believe that oily, pectoral, and balsamic medicines, possess wonderful virtues for the cure of the chin-cough, and accordingly exhibit them plentifully to patients of every age and constitution, without considering that every thing of this nature must load the stomach, hurt the digestion, and, of course, aggravate the disorder.

THE millepedes, or woodlice, are greatly recommended for the cure of a chin-cough. Those who choose to make use of these insects, may infuse two ounces of them bruised in an English pint of small white wine for one night. Af­terwards the liquor may be strained through a cloth, and a table spoonful of it given to the patient three or four times a-day.

[Page 201] OPIATES are sometimes necessary to allay the violence of the cough. For this purpose, a little of the syrup of poppies, or ten, fifteen, or twenty drops, according to the age of the patient, of the paregoric elixir, may be taken in a cup of hyssop, or pennyroyal tea, three or four times a-day. An adult may take a table spoonful of the syrup, or a tea spoonful of the elixir.

THE garlic ointment is a well known remedy in North-Britain for the chin-cough. It is made by beating in a mortar garlic with an equal quantity of hogs lard, but­ter, or oil. With this the soles of the feet may be rubbed twice or thrice a-day, or it may be spread thin upon a rag, and applied as a plaster. It should be renewed every night and morning at least, as the garlic soon loses its virtue. This is an exceeding good medicine, both in the chin-cough, and in most other coughs of an obstinate nature. It ought not, however, to be used when the patient is very hot, or feverish, le [...]t it increase these symptoms.

THE feet should be bathed once every two or three days in warm water; and the Burgundy pitch plaster, mention­ed in page 196, may be applied betwixt the shoulders. But when the disease proves very violent, it will be necessary, instead of it, to apply a blistering plaster, and to keep the part open for some time with issue ointment.

WHEN the disease is prolonged, and the patient is free of a fever, the Jesuits bark, and other bitters, are the most proper medicines. The bark may either be taken in sub­stance, or in a decoction or infusion, as is most agreeable to the patient. For a child, ten, fifteen, or twenty grains may be given for a dose, according to the age of the patient. For an adult, half a dram, or two scruples, will be proper. Some give the extract of the bark with cantharides; but to manage this, requires some skill and attention. It is more safe to give a few grains of castor along with the bark. A child of six or seven years of age may take seven or eight grains of castor, with fifteen grains of powdered bark, for a dose. This may be made into a mixture, with two or three ounces of any simple distilled water, and a little syrup, and taken three or four times a-day.

INFLAMMATION OF THE STOMACH.

THIS is a dangerous disease, and requires the most speedy assistance, as it frequently ends in a suppuration; and sometimes in a mortification, which is certain death.

[Page 202] CAUSES.—It may proceed from any of the causes which produce an inflammatory fever; as cold li­quor drank while the body is warm, an obstructed perspi­ration, the sudden striking in of any eruption, &c. It may likewise proceed from the acrimony of the bile, or from acrid and stimulating substances taken into the sto­mach; as strong vomits or purges, corrosive poisons, and such like. When the gout has been repelled from the ex­tremities, either by cold or improper applications, it often occasions an inflammation of the stomach. Hard or indi­gestable substances taken into the stomach, as bones, the shells of nuts, &c. have likewise that effect.

SYMPTOMS.—It is attended with a fixed pain and burning heat in the stomach; great restlessness and anxiety; a small, quick, hard pulse; vomiting, or, at least, a nausea and sickness; excessive thirst; coldness of the extremities; difficulty of breathing; cold clammy sweats; and sometimes convulsions and fainting fits. The stomach is swelled, and often feels hard to the touch. One of the most certain signs of this disease is the sense of pain, which the patient feels upon taking any kind of food or drink, especially if too hot or cold, into his stomach.

WHEN the patient vomits every thing he eats or drinks, is extremely restless, has a hiccup, with an intermit­ting pulse, and frequent fainting fits, the danger is very great.

REGIMEN.—The patient must, with the greatest care, avoid all acrimonious, heating, and irrita­ting food and drink. His weakness may deceive the by­standers, and induce them to give him wines, spirits, or other cordials; but all these increase the disease, and of­ten occasion sudden death. The inclination to vomit, may likewise impose on the attendants, and make them think a vomit necessary; but that too is almost certain death.

THE food must be light, thin, cool, and easy of digest­ion. It must be given in small quantities, and should nei­ther be quite cold nor too hot. Thin gruel made of bar­ley or oatmeal, light toasted bread, dissolved in boiling water, or very weak chicken broth, are the most proper. The drink should be clear whey, barley water, or decocti­ons of emollient vegetables; or liquorice and marsh mal­low roots, &c.

[Page 203] MEDICINE.—Bleeding in this disease is ab­solutely necessary, and is almost the only medicine that can be depended on. When the disease proves obstinate, it will often be necessary to repeat this operation several times, nor must the low state of the pulse deter us from doing so. The pulse in this disease generally rises upon bleeding, and so long as that is the case, the operation is safe.

FREQUENT fomentations with warm water, or a decoc­tion of emollient vegetables, are likewise beneficial. Flan­nel cloths dipped in th [...]se, must be applied to the region of the stomach, and removed as they turn cool. They must neither be applied too warm, nor suffered to continue till they become quite cold, as either of these extremes would aggravate the disease.

THE feet and legs ought, likewise, to be frequently bathed in lukewarm water, and warm bricks, or poultices, may be applied to the soles of the feet.

THE only internal medicines which we shall venture to recommend in this disease, are mild clysters. These may be made of warm water, or thin water gruel, and, if the patient be costive, a little sweet oil, honey or manna, may be added. Clysters answer the purpose of an internal fo­mentation, while they keep the belly open, and, at the same time, nourish the patient, who is often, in this dis­ease, unable to retain any thing upon his stomach. For these reasons they must not be neglected, as the patient's life may depend on the application of them.

OF THE ILIAC PASSION.

THIS is one of the most painful and dangerous diseases that mankind are liable to. It proceeds from the same causes as the inflammation of the stomach; to which may be added costiveness, worms, eating unripe fruits, or great quantities of nuts, drinking hard windy malt liquors, as stale beer, bottled ale, or sour wine, cider, &c. It may, likewise, be occasioned by a rupture, scirrhous tumours of the intestines, or by their opposite sides growing together.

THE symptoms here are nearly the same as in the forego­ing disease; only the pain, if possible, is more acute, and is situate lower down about the region of the navel. The vomiting is likewise more violent, and sometimes even the excrements, together with the clysters and suppositaries, [Page 204] are discharged by the mouth. The patient is continually belching up wind, and has often an obstruction of his urine.

WHILE the pain shifts, and the vomiting only returns at certain intervals, and while the clysters pass downwards, there is ground to hope; but when the clysters and foeces are vo­mited, and the patient is exceeding weak, with a low fluttering pulse, a pale countenance, and a disagreeable, or stinking breath, there is great reason to fear, that the consequences will prove fatal. Clammy sweats, black foetid stools, with a small intermitting pulse, and a total cessation of pain, are the signs of a gangrene, and approaching death.

REGIMEN.—The regimen in this disease is in general the same as in an inflammation of the stomach. The patient must be kept quiet, avoiding cold, and all vi­olent passions of the mind. His food must be thin, weak, and given in small quantities; his drink weak and diluting; as clear whey, barley water, and such like.

MEDICINE.—Bleeding in this, as well as in the inflammation of the stomach, is the remedy most to be depended on. It should be performed as soon as the symp­toms appear, and must be repeated according to the strength of the patient, and the violence of the symptoms.

A blistering plaster applied immediately over the part where the most violent pain is, has often a very good effect. Even clysters, which before had no effect, will operate when the blister begins to rise.

FOMENTATIONS and laxative clysters are by no means to be omitted. The patient's feet and legs should fre­quently be bathed in warm water; and cloths dipped in it applied to his belly. Bladders, filled with warm water, may likewise be applied to the region of the navel, and warm bricks, or bottles filled with warm water, to the soles of the feet. The clysters may be made of barley wa­ter or thin gruel, and softened with plenty of sweet oil, or fresh butter. These may be administered every two or three hours, or oftener, if the patient continues costive.

IF common clysters have not the desired effect, we would recommend the smoke of tobacco. It may be blown into the bowels through an inverted pipe. This may be repeat­ed after some time, unless the effect of the first renders it unnecessary.

IF the disease does not yield to clysters and fomentations, recourse must be had to pretty strong purgatives; but as [Page 205] these, by irritating the bowels, often increase their contrac­tion, and, by that means, frustrate their own intention, it will be necessary to join them with opiates; these, by al­laying the pain, and relaxing the spasmodic contractions of the guts, greatly assist the operation of purgatives in this case.

WHAT often answers the purpose of purging very well, is a solution of the bitter purging salts. Two ounces of these may be dissolved in an English pint of warm water, or thin gruel, and two or three table spoonfuls given every half hour till it operates. At the same time, fifteen, twen­ty, or twenty-five drops of laudanum may be given in a glass of pepper mint, or simple cinnamon water, to appease the irritation, and prevent the vomiting, &c.

ACIDS have often a very happy effect in staying the vo­miting, and appeasing the other violent symptoms of this disease. It will, therefore, be of use to sharpen the pati­ent's drink with cream of tartar, juice of lemon; or, w [...]en these cannot be obtained, a little vinegar may be add­ed to it.

BUT it often happens, that no liquid whatever will stay on the stomach. In this case the patient must take pur­gative pills. I have generally found the following answer very well. Take jalep in powder, and vitriolated tartar, each half a dram, opium, one grain, Castile soap, as much as will make the mass fit for pills. These must be taken at one dose, and if they do not operate in six or seven hours, the dose may be repeated.

IF a stool cannot be procured by any of the above means, it will be necessary to immerse the patient in warm water up to the breast. I have often seen this succeed, when other means proved in vain. The patient must continue in the water as long as he can easily bear it without [...]aint­ing, and, if one emersion does not succeed, it may be re­peated after some time, when the patient's strength and spirits are recruited. It is more safe for him to go fre­quently into the bath, than continue too long at a time; and, it is often necessary, to repeat it several times before it has the desired effect.

IT has sometimes happened, after all other means of procuring a stool had been tried in vain, that this was brought about by immersing the patient's lower extremities in cold water, making him walk upon a wet pavement, and dashing his legs and thighs with the cold water, &c. This [Page 206] method, when others fail, at least merits a trial. It is, indeed, attended with some danger; but a doubtful reme­dy is better than none.

IN desperate cases it is common to give quicksilver. This may be taken to the quantity of several ounces, or even a pound, but should not exceed that. When there are evident marks of an inflammation, or any reason to suspect a mortification of the guts, this medicine ought not to be tried. In that case, it will only hasten the patient's death. But when the obstruction is occasioned by any cause that can be removed by force, quicksilver is not only a proper medicine, but the best that can be applied, as it is the fittest body we know for making its way through the intestinal canal.

IF the disease proceeds from a rupture, the patient must be laid with his head very low, and the intestines returned by gentle pressure with the hand. If this, with fomenta­tions and clysters, should not succeed, recourse must be had to a surgical operation, which may give the patient re­lief.

SUCH as would avoid this excruciating and dangerous disease, must take care never to be too long without a stool. Some who have died of it, have had several pounds of hard, dry foeces taken out of their guts. They should, likewise, beware of eating too freely of sour or unripe fruits, or drinking stale windy liquors, pricked wines, or the like. I have of­ten known it brought on by living too much on baked fruits, which are seldom good. It likewise proceeds fre­quently from cold caught by wet cloaths, &c. but especial­ly from wet feet.

OF THE COLIC.

THE colic has great affinity, both in its symptoms and method of cure, with the two preceding diseases. It is generally attended with costiveness and acute pain of the bowels; and requires diluting diet, evacuations, fomenta­tions, &c.

COLICS are variously denominated according to their causes, as the flatulent, the bilious, the hysteric, the nervous, &c. As each of these requires a particular treatment, we shall point out their most general symptoms, and the means to be used for their relief.

[Page 207] THE flatulent, or wind colic, is generally occasioned by an indiscreet use of unripe fruits, meats of hard digestion, windy vegetables, fermented liquors, and such like. It may likewise proceed from an obstructed perspiration, or catching cold. Delicate people, whose digestive powers are weak and debilitated, are most liable to this kind of colic.

THE flatulent colic may either affect the stomach or in­testines. It is attended with a painful stretching of the stomach, or that part of the bowels where it is lodged. The patient feels a rumbling in his guts, and is generally relieved by a discharge of wind either upwards or down­wards. The pain is seldom confined to any particular part, as the vapour wanders from one division of the bowels to an other, till such time as it finds a vent.

WHEN the disease proceeds from windy liquor, eating green fruit, sour herbs, or the like, the best medicine is to take immediately a dram of brandy, gin, or any good spi­rits, and to apply warm cloths to the stomach and bowels. The patient should likewise sit with his feet upon a warm hearth stone, or apply warm bricks to them; and he may drink camomile tea, or water gruel, with as much pepper in it as to render it moderately warm.

THIS is the only colic wherein ardent spirits, spiceries, or any thing of a hot nature, may be ventured upon. Nor, indeed, are they to be used here, unless at the beginning, before there be any symptoms of inflammation. We have reason to believe, that a colic occasioned by wind or fla­tulent food, might always be cured by spirits and warm li­quors, if they were taken immediately upon perceiving the first uneasiness; but when the pain has continued for a con­siderable time, and there is reason to fear an inflammation of the bowels is already begun, all hot things are to be avoid­ed, and the patient is to be treated in the same manner as for the iliac passion.

SEVERAL kinds of food, as honey, eggs, &c. occasion colics in some particular constitutions. I have generally found the best cure for th [...]se colics was to drink plentifully of small diluting liquors, as water gruel, small posset, toast and water, &c.

COLICS which proceed from excess and indigestions, ge­nerally cure themselves, by occasioning vomiting or pur­ging. These discharges are by no means to be stopped, but promoted, by drinking plenty of warm water, or weak [Page 208] posset. When their violence is over, the patient may take a dose of rhubarb, or any other gentle purge, to carry off the dregs of his debauch.

COLICS which are occasioned by wet feet, or catching cold, may generally be removed at the beginning, by bathing the feet and legs in warm water, and drinking such warm diluting liquors as will promote the perspiration, as weak wine whey, or water gruel, with a small quantity of spirits in it.

THESE flatulent colics, which prevail so much in the country, might generally be prevented, if people were careful to change their cloaths when they get wet. They ought, likewise, to take a dram, or to drink some warm li­quor after eating any kind of green trash. We do not mean to recommend the practice of dram drinking, but, in this case, ardent liquors prove a real medicine, and, in­deed, the best that can be applied.

THE bilious colic is attended with very acute pain about the region of the navel. The patient complains of great thirst, and is generally costive. He vomits a hot, bitter, yellow coloured bile, which being discharged, seems to afford some relief, but is quickly followed by the same vi­olent pain as before. As the distemper advances, the pro­pensity to vomit increases, in so much, that sometimes it becomes almost continual, and the proper motion of the intestines is so far perverted, that there are all the symptoms of an impending iliac passion.

IF the patient be young and strong, and the pulse full and frequent, it will be proper to bleed, after which cly­sters may be administered. Clear whey, or gruel, sharp­ened with the juice of lemon, or cream of tartar, must be drank freely. Small chicken broth, with a little manna dissolved in it, or a slight decoction of tamarinds, are, like­wise, very proper, or any other thin, acid, opening li­quor.

BESIDES bleeding, and plentiful dilution, it will be ne­cessary to foment the belly with cloths dipped in warm water, and if this should not succeed, the patient must be set in a warm bath up to the middle.

MILD purgatives are here likewise necessary, as the leni­tive electuary, manna, cream of tartar, or, what will an­swer very well, the bitter purging salts. These may be dissolved in water, and given in the same manner as direct­ed in page 205. If these medicines will not stay on the [Page 209] stomach, it will be necessary to join an opiate with them.

SUCH as are liable to frequent returns of the bilious colic should use flesh sparingly, and live chiefly upon a light ve­getable diet. They should, likewise, take frequently a dose of cream of tartar with tamarinds, or any other cool, acid purge.

THE hysteric colic bears a great resemblance to the bilious. It is attended with acute pains about the region of the sto­mach, vomiting, &c. But what the patient vomits in this case is commonly of a greenish colour. There is a great sinking of the spirits, with dejection of mind, and difficul­ty of breathing, which are the characteristic symptoms of this disorder. Sometimes it is accompanied with the jaun­dice, but this generally goes off of its own accord in a few days.

IN this colic all evacuations, as bleeding, purging, vo­miting, &c. do hurt. Every thing that weakens the pati­ent, or sinks the spirits, is to be avoided. If, however, the vomiting should prove violent, weak camomile tea, or small posset, may be drank to cleanse the stomach. After­wards the patient may take fifteen, twenty, or twenty-five drops of liquid laudanum in a glass of cinnamon water. This may be repeated every ten or twelve hours till the symptoms abate.

THE patient may likewise take four or five of the foetid pills, three times a-day, and drink a cup of pennyroyal tea after them. If asafoetida should disagree with the stomach, which is sometimes the case, a tea spoonful of the tincture of castor in a cup of pennyroyal tea, or thirty or forty drops of the balsam of Peru dropped upon a bit of loaf sugar, may be taken in its stead. The anti-hysteric plaster may also be applied to the region of the navel, which has often a good effect.

THE nervous colic prevails most among miners, smelters of lead, plumbers, the makers of white lead, &c. It is very difficult to cure, and often ends in a palsy.

No disease of the bowels is attended with more excru­ciating pain than this. Nor is it soon at an end. I have known it continue eight or ten days with very little inter­mission, the belly all the while continuing bound in spite of medicine, yet at length yield, and the patient recover.

THE general treatment of this disease is so nearly the same with that of the iliac passion, or inflammation of the guts, that we shall not insist upon it. The belly is to be [Page 210] opened by mild purgatives, given in small doses, and fre­quently repeated, and their operation must be assisted by soft oily clysters, fomentations, &c.

THE Barbados tar is said to be a proper medicine in this disease. It may be taken to the quantity of two drams threetimes a-day, or oftener if the stomach will bear it. This tar, mixed with an equal quantity of strong rum, is likewise proper for rubbing the spine, in case any tingling, or other symptoms of a palsy are felt. When this tar cannot be ob­tained, the back may be rubbed with strong spirits, or a little of the oil of nutmegs or rosemary.

IF the patient remains weak and languid after this disease, he must take exercise on horseback, and use an infusion of the Jesuits bark in wine. When the disease ends in a palsy, the Bath waters are found to be extremely proper.

To avoid this colic, people must shun all sour fruits, acid and austere liquors, &c. Those who work in lead ought never to go to their business fasting, and their food should be oily or fat. They may take a glass of sallad oil, with a little brandy or rum every morning, but should ne­ver take spirits alone. Liquid aliment is best for them; as fa [...] broths, &c. but low living is bad. They should now and then go a little out of the tainted air; and should, at least, take physic every spring and fall.

SUNDRY other kinds of this disease might be mentioned, but too many distinctions would [...]end only to perplex and bewilder the reader. These already mentioned are the most material, and should indeed be attended to, as their treat­ment is very different. But even those who are not in a condition to distinguish very accurately in these matters, may nevertheless be of great service to patients in colics, by only observing the following general rules: First, To bathe the patient's feet and legs in warm water; and next, To apply bladders filled with warm water, or cloths dipped in it, to his stomach and bowels. Afterwards, To make him drink freely of weak, diluting, warm liquors. And, lastly, To give him an emollient clyster every two or three hours.

INFLAMMATION OF THE KIDNEYS.

CAUSES.—This disease may proceed from any of those causes which produce an inflammatory fever. It is likewise occasioned by wounds, or bruises of the kidneys, and by small stones or gravel lodging within them. It may also proceed from strong diuretic medicines; as spirits of [Page 211] turpentine, tincture of cantharides, &c. Violent motion, as hard riding or walking, especially in hot weather, or whatever drives the blood forcibly into the kidneys, may occasion this malady. It may likewise proceed from lying too soft, or too much on the back, or from involuntary contractions, or spasms in the urinary vessels, &c.

SYMPTOMS.—There is a sharp pain about the region of the kidneys, with some degree of fever, and a stu­por, or dull pain in the thigh of the affected side. The urine is at first clear, and afterwards of a redish colour; but in the worst kind of the disease it generally continues pale, is passed with difficulty, and commonly small quantities at a time. The patient feels great uneasiness when he endea­vours to walk or sit upright. He lies with more ease on the affected side than on the sound; and has generally a nausea or vomiting, resembling that which happens in the colic.

THIS disease, however, may be distinguished from the colic by the pain being seated farther back, and by the dif­ficulty of passing urine, which is a constant symptom of this disease, but does nor always happen in the other.

REGIMEN.—Every thing of a heating or sti­mulating nature is to be avoided. The food must be thin and light; as water pap, small broths, with mild vegetables, and the like. Emollient and soft liquors must be plentifully drank; as clear whey, or balm tea sweetened with honey, decoctions of marsh mallow roots, with barley and liquo­rice, &c. The patient, notwithstanding the vomiting, must constantly keep sipping small quantities of these or other diluting liquors. Nothing so safely and certainly abates the inflammation, and expels the obstructing cause, as co­pious dilution. The patient must be kept easy, quiet, and free from cold, so long as any symptoms of inflammation appear.

MEDICINE.—Bleeding is here very necessary, especially at the beginning. Ten or twelve ounces may be let from the arm or foot with a lancet, and if the pain and inflammation continue, the operation may be repeated in twenty-four hours, especially if the patient be of a full ha­bit. Leeches may likewise be applied to the haemorrhoidal veins, as a discharge from these will greatly relieve [...] pa­tient.

CLOTHS dipped in warm water, or bladders [...] it, must be applied to the part affected, and [...] grow cool. If the bladders be filled with a [...] [Page 212] mallows and camomile flowers, to which a little saffron is added, and mixed with about a third part of new milk, it will be still more beneficial.

EMOLLIENT clysters are likewise frequently to be admi­nistered; and if these do not open the belly, a little honey or manna may be added to them.

THE same course is to be followed where gravel or a stone is lodged in the kidney; but when the gravel or stone is separated from the kidney, and lodges in any of the uri­nary passages, it will be proper, besides the fomentations, to rub the part with a little sweet oil, and to give gentle diu­retics; as juniper water sweetened with the syrup of marsh mallows, or a tea spoonful of the sweet spirits of nitre, now and then in a cup of the patient's drink. He ought likewise to take exercise on horseback, or in a coach, &c.

WHEN the disease is protracted beyond the seventh or eighth day, and the patient complains of a stupor and hea­viness of the part, has frequent returns of chillness, shiver­ing, &c. there is reason to suspect, that matter is forming in the kidney, and that an abscess or ulcer will ensue.

WHEN matter in the urine shews, that an ulcer is alrea­dy formed in the kidney, the patient must be careful to ab­stain from all acrid, sour, and salted provisions; and must live chiefly upon m [...]d mucilaginous herbs and fruits, toge­ther with the broth of young animals, made with barley and common pot herbs, &c. His drink may be whey, and butter milk that is not sour. The latter is reckoned a spe­cific remedy in ulcers of the kidneys. To answer this cha­racter, however, it must be drank for a considerable time. Chalybeat waters have likewise been found beneficial in this disease. This medicine is easily obtained, as it is found in every part of Great Britain. It must likewise be used for a considerable time, in order to produce any salutary effects.

THOSE who are liable to frequent returns of inflamma­tion, or obstruction of the kidneys, must abstain from wines, especially such as abound with tartar; and their food must be light, and of easy digestion. They should use moderate exercise, and should not lie too hot, nor too much on their back.

INFLAMMATION OF THE BLADDER.

THE inflammation of the bladder proceeds, in a great measure, from the same causes as that of the kidneys. It is known by an acute pain towards the bottom of the belly, [Page 213] and difficulty of passing urine, with some degree of fever, a constant inclination to go to stool, and a perpetual desire to make water.

THIS disease must be treated on the same principles as the immediately preceding. The diet must be light and thin, and the drink cooling and diluting. Bleeding is very proper at the beginning, and in robust constitutions, it will often be necessary to repeat it. The bottom of the belly must be frequently fomented with warm water, or a decoc­tion of mild vegetables; and emollient clysters must fre­quently be administered, &c.

THE patient should abstain from every thing that is of a hot, acrid, and stimulating nature; and should live entirely upon small broths, gruels, or mild vegetables.

A stoppage of urine may proceed from other causes be­sides an inflammation of the bladder; as a swelling of the haemorrhoidal veins, hard foeces lodged in the rectum; a stone in the bladder, excrescences in the urinary passages, a palsy of the bladder, hysteric affections, &c. Each of these requires a particular treatment, which does not fall under our consideration here. We shall only observe, that in all of them a mild and gentle treatment is the safest, as strong diuretic medicines, or things of an irritating nature, gene­rally increase the danger. Some persons have killed them­selves by introducing probes into the urinary passages, to remove, as they thought, somewhat that obstructed the passage of the urine; and others have brought on a violent inflammation of the bladder, by using strong diuretics for that purpose.

INFLAMMATION OF THE LIVER.

THE liver is less subject to inflammation than any of the other viscera, as, in it, the circulation is slower; but when an inflammation does happen, it is with difficulty re­moved, and often ends in a suppuration, or schirrhous.

CAUSES.—Besides the common causes of inflam­mation, we may here reckon the following, viz. excessive fatness, a schirrhous of the liver itself, violent shocks from strong vomits, when the liver was before un [...]ound, an adust or atrabillarian state of the blood, any thing that sud­denly cools the liver, after it has been greatly heated, stones obstructing the course of the bile, drinking strong [Page 214] wines or spiritous liquors, using hot spicy aliment, obstinate hypochondriacal distempers, &c.

SYMPTOMS.—This disease is known by a painful tention of the right side under the false ribs, attended with some degree of fever, a sense of weight, or fulness of the part, difficulty of breathing, loathing of food, great thirst, with a pale or yellowish colour of the skin and eyes.

THE symptoms here are various, according to the degree of inflammation, and likewise according to the particular part of the liver where the inflammation happens. Some­times the pain is so inconsiderable, that an inflammation is not so much as suspected; but when it happens in the up­per or convex part of the liver, the pain is more acute, the pulse quicker, and the patient is often troubled with a dry cough, a hiccup, and a pain extending to the shoulder, with difficulty of lying on the left side, &c.

THIS disease may be distinguished from the pleurisy by the pain being less violent, seated under the false ribs, the pulse not so hard, and by the difficulty of lying on the left side. It may be distinguished from the hysteric and hypo­chondriac disorders by some degree of fever, with which it is always attended.

THIS disease, if properly treated, is seldom mortal. A constant hiccupping, violent fever, and excessive thirst, are very bad symptoms. If it ends in a suppuration, and the matter cannot be brought to discharge itself outwardly, the danger is great. When a schirrhous of the liver ensues, the patient, if he observes a proper regimen, may live a num­ber of years tolerably [...]asy; but if he indulges in animal food and strong liquors, or takes medicines of an acrid or irri­tating nature, the schirrhous will be converted into a cancer, which must infallibly prove fatal.

REGIMEN.—The same regimen is to be ob­served in this as in other inflammatory disorders. All hot things are to be carefully avoided, and cool resolving li­quors, as whey, barley water, &c. drank freely. The food must be light and thin, and the body, as well as the mind, must be kept easy and quiet.

MEDICINE.—Bleeding is proper at the begin­ning of this disease, and it will often be necessary, even though the pulse should not feel hard, to repeat the operati­on. The belly must be kept gently open; but all violent purgatives are to be avoided. A decoction of tamarinds, [Page 215] with a little honey or manna, will answer this purpose ve­ry well. The side affected must be frequently fomented with warm water, in the manner directed in the foregoing diseases. Mild laxative clysters should be frequently admi­nistered; and, if the pain should, notwithstanding, con­tinue violent, a blistering plaster may be applied over the part affected.

MEDICINES which promote the secretion of urine, have a very good effect here. For this purpose, half a dram of purified nitre, or half a tea spoonful of the sweet spirits of nitre, may be taken in a cup of the patient's drink, three or four times a-day.

WHEN there is an inclination to sweat, it ought to be promoted, but not by warm sudorifics. The only thing to be used for that purpose, is plenty of diluting liquor drank about the warmth of the human blood. Indeed, the patient, in this case, as well as in all other topical inflammations, ought to drink nothing that is colder than the blood.

IF the stools should be loose, and even streaked with blood, nothing must be given to stop them, unless they be so frequent as to weaken the patient. Loose stools often prove critical, and carry off the disease.

IF the disorder, in spite of all endeavours to the contra­ry, should end in a schirrhous, the patient must be careful to regulate his diet, &c. in such a manner as not to aggra­vate the disease. He must not indulge in flesh, fish, strong liquors, or any poignant or salted provisions; but must, for the most part, live on mild vegetables, as fruits and roots, taking gentle exercise, and drinking wh [...]y [...] [...] water, or butter milk. If he takes any thing stronge [...] [...] should be [...]ne mild ale, which is much more safe than win [...] or spirits.

WE shall take no notice of inflammations of the other viscera. They must all be treated upon the same princi­ples as those already mentioned. The great rule, with re­spect to all of them, is to avoid every thing that is strong, or of a heating nature, to apply warm fomentations to the part affected, and to supply the patient with plenty of weak, warm, diluting drink.

OF THE CHOLERA MORBUS, OR VO­MITING AND LOOSENESS.

THIS is a violent purging and vomiting, attended with gripes, and a constant desire to go to stool. It comes on [Page 216] suddenly, and is most common in autumn. There is hard­ly any disease that kills more quickly than this, when proper means are not used in due time for removing it.

CAUSES.—It is occasioned by a redundency and putrid acrimony of the bile; by food that easily turns ran­cid or sour on the stomach; as butter, fat pork, sweet meats, cucumbers, melons, cherries, &c. It is sometimes the effect of strong acrid purges or vomits; or of poison­ous substances taken into the stomach. It may likewise proceed from violent passions of the mind; as fear, anger, &c.

SYMPTOMS.—It is generally preceded by a cardialgia, or heart burn, sour belchings, and flatulences, with pain of the stomach and intestines. To these succeed excessive vomiting, and purging of green, yellow, or black­ish coloured bile, with a distention of the stomach, and vi­olent griping pains. There is, likewise, a great thirst, with a very quick unequal pulse, and often a fixed acute pain about the region of the navel. As the disease advan­ces, the pulse often sinks so low as to become quite imper­ceptible, the extremities grow cold, or cramped, and co­vered with a clammy sweat, the urine is obstructed, and there is a palpitation of the heart. Violent hiccupping, fainting, and convulsions, are the signs of approaching death.

MEDICINE.—At the beginning of this dis­ease, the efforts of nature to expel the offending cause, must be assisted, by promoting the purging and vomiting. For this purpose the patient must drink plenty of diluting liquors; as whey, butter milk, warm water, thin water gruel, small posset, or, what is, perhaps, preferable to any of them, very weak chicken broth. This should not only be drank freely, to promote the vomiting, but a clyster of it given every hour, in order to promote the purging.

AFTER these evacuations have been continued for some time, a decoction of toasted oat bread, may be drank to stop the vomiting. The bread should be toasted till it is of a brown colour, but not burned, and afterwards boiled in spring water. If oat bread cannot be had, wheat bread, or oat meal, well toasted, may be used in its stead. If this does not put a stop to the vomiting, the saline mixture may be taken, as directed in page 175.

THE vomiting and purging, however, ought never to be stopped too soon. So long as these discharges do not [Page 217] weaken the patient they are salutary, and may be allowed to go on, or rather ought to be promoted. But when the patient is much exhausted by the evacuations, or has a small intermitting pulse, coldness of the extremities, with other symptoms of weakness, recourse must immediately be had to opiates, and generous cordial medicines. Ten or fifteen drops of liquid laudanum in half a glass of strong cinnamon water, may be taken every four or five hours, till the violent symptoms be removed. Warm negas, or strong wine whey, may likewise be taken to support the patient's spirits, and promote the perspiration. His legs may be rubbed with flannel cloths, or wrapped in warm blankets, and warm bricks applied to the soles of his feet.

WHEN the violence of the disease is over, to prevent a relapse, it will be necessary, for some time, to continue the use of small doses of laudanum. Ten or twelve drops may be taken in a glass of wine, at least twice a-day, for eight or ten days. The patient's food ought to be nourishing, but taken in small quantities, and he should use moderate exercise. As the stomach and intestines are generally much weakened, an infusion of the bark, or other bitters, in small wine may be drank for some time.

THOUGH physicians are seldom called in due time in this disease, they ought not, however, to despair of relieving the patient, even in the most desperate circumstances. Of this I lately saw a very striking instance in an old man and his son, who had been both seized with it about the middle of the night. I did not see them till next morning, when they had much more the appearance of dead than of living men. No pulse could be felt; the extremities were quite cold and rigid; the countenance was ghastly, and the strength quite exhausted. Yet from this deplorable condition they were both recovered by the use of opiates and cordial medicines, with the regimen mentioned above.

OF A DIARRHOEA, OR LOOSENESS.

A looseness, in many cases, is not to be considered as a disease, but rather as a salutary evacuation. It never ought to be stopped unless when it continues too long, or evidently weakens the patient. As this, however, some­times happens, we shall point out the most common causes of a looseness, with the method of treatment proper in each case.

[Page 218] WHEN a looseness is occasioned by catching cold, or an obstructed perspiration, the patient ought to keep warm, to drink freely of weak diluting liquors, to bathe his feet and legs frequently in lukewarm water, to wear flannel next to his skin, and to take every other method to restore the perspiration.

IN a looseness which proceeds from excess or repletion, a vomit is the proper medicine. Vomits not only clean the stomach, but promote all the secretions, which [...]enders them of great importance in carrying off a debauch. Half a dram of ipecacuanha in powder will answer the purpose very well. A day or two after the vomit, the same quan­tity of rhubarb may be taken, and repeated two or three times, if the looseness continues. The patient ought to live upon light vegetable food, of easy digestion, and to drink whey, thin gruel, or ba [...]ley water.

A looseness occasioned by the obstruction of any custom­ary evacuation, as the bleeding piles in men, the monthly discharges in women, &c. generally requires bleeding. If that does not succeed, other evacuations, as issues, setons, &c. may be substituted in the room of those which are ob­structed. At the same time, every method is to be taken to restore the usual discharges, as not only the cure of the disease, but the patient's life may depend on this.

A periodical looseness ought never to be stopped. It is always an effort of nature to carry off some offending mat­ter, which, if retained in the body, might produce fatal diseases. Children are very liable to this kind of looseness, especially while teething. It is, however, so far from be­ing hurtful to them, that such children generally get their teeth with least trouble. If these loose stools should at any time prove sour or griping, a tea spoonful of magnesia alba, with four or five grains of rhubarb, may be given to the child in a little pap or any other food. This, if repeated three or four times, will generally correct the acidity, and carry off the griping stools.

A diarrhoea, or looseness which proceeds from violent passions or affections of the mind, must be treated with the greatest caution. Vomits, in this case, are highly improper. Nor are purges safe, unless they be very mild, and given in small quantities. Opiates, and other antispas­modic medicines are most proper. Ten or twelve drops of liquid laudanum may be taken in a cup of valerian or pen­nyroyal tea, every eight or ten hours, till the symptoms [Page 219] abate. Ease, cheerfulness, and tranquillity of mind, are here of the greatest importance.

WHEN a looseness proceeds from acrid or poisonous sub­stances taken into the stomach, the patient must drink large quantities of diluting liquors, with oil or fat broths, to promote vomiting and purging. Afterwards, if the bowels are inflamed, bleeding will be necessary. Small do­ses of laudanum may likewise be taken to remove the spasms and the irritation of the bowels.

WHEN gouty matter, repelled from the extremities, oc­casions a looseness, it is, by no means, to be stopped, but promoted by gentle doses of rhubarb, or other mild purgatives. The gouty matter is likewise to be solicited to the extremities by warm fomentations, and cataplasms. And the perspiration ought to be promoted by warm diluting liquors; as wine whey, with spirits of hartshorn, or a few drops of liquid laudanum in it.

WHEN a looseness proceeds from worms, such medi­cines ought to be used as kill or carry off these vermin; as powder of tin, with purges of rhubarb and calomel, &c. The proper doses of these medicines will be pointed out when we come to treat of diseases occasioned by worms.

A looseness is often occasioned by bad water. When this is the case, the disease generally proves epidemical. When there is reason to believe that this, or any other disease, proceeds from the use of unwholesome water, it ought im­mediately to be changed, or, if that cannot be done, it may be corrected by mixing with it quicklime, chalk, or the like.

IN people whose stomachs are weak, violent exercise immediately after meals, will occasion a looseness. Though the cure of this is obvious, yet it will be proper, besides avoiding violent exercise, to use such medicines as tend to brace and strengthen the stomach; as infusions of the bark, with other bitter and astringent medicines, in white wine. The person ought, likewise, to take frequently a glass or two of old red port, or good claret.

PERSONS who, from a peculiar weakness, or too great an irritability of the bowels, are liable to frequent returns of this disease, should live temperately, avoiding crude summer fruits, all unwholesome food, and meats of hard digestion. They ought, likewise, to beware of cold, moisture, or whatever may obstruct the perspiration, and should wear flannel next their skin. All violent passions of [Page 220] the mind, as fear, anger, &c. are likewise carefully to be avoided.

OF THE DYSENTERY, OR BLOODY-FLUX.

THIS disease prevails in the spring and autumn. It is very infectious, and often epidemical. Those persons are most liable to it who are much exposed to the night air, or who live in places where the air is confined and unwhole­some. Hence it often proves fatal in camps, on shipboard, in jails, hospitals, and such like places.

CAUSES.—This disease may be occasioned by any thing that obstructs the perspiration, or renders the hu­mours putrid; as damp beds, wet cloaths, unwholesome diet, air, &c. But it is most frequently communicated by infection. This ought to make people extremely cautious in going near such persons as labour under the disease. Even the smell of the patient's excrements has been known to communicate the infection.

SYMPTOMS.—It is known by a flux of the belly, attended with a violent pain of the bowels, a con­stant inclination to go to stool, and generally less or more of blood in the stools. It begins, like other fevers, with chill­ness, loss of strength, a quick pulse, great thirst, and an inclinati­on to vomit. The stools are at first greasy or frothy, afterwards they are streaked with blood, and, at last, have frequently the appearance of pure blood, mixed with small filaments, or bits of skin, which is part of the internal coat of the in­testines abraded by the acrimony of the foeces. Sometimes, however, there is no blood in the stools through the whole course of the disease. When the patient goes to stool, he feels a bearing down, as if the whole bowels were falling out, and sometimes a part of the intestine is actually pro­truded, which proves exceeding troublesome, especially in children.

THIS disease may be distinguished from the diarrhoea, or looseness, by the acute pain of the bowels, and the blood which generally appears in the stools. It may be distin­guished from the cholera morbus, by its not being attended with such violent and frequent fits of vomiting, &c.

WHEN the dysentery attacks the old, the delicate, or such as have been wasted by scorbutic, consumptive, or other lingering diseases, it generally proves fatal. Vomiting and hiccupping are bad signs, as they shew an inflammation [Page 121] of the stomach. When the stools have an exceeding disa­greeable smell, are green, black, or mixed with small glandular substances, or bits of skin, the danger is great. It is an unfavourable symptom when clysters are immediate­ly returned; but still more so, when the passage is so obsti­nately shut, that they cannot be injected. A weak pulse, coldness of the extremities, with difficulty of swallowing, and convulsions, are signs of approaching death.

REGIMEN.—Nothing is of more impor­tance in this disease than cleanliness. It contributes great­ly to the recovery of the patient, and no less to the safety of such as attend him. In all contagious diseases, the dan­ger is increased, and the infection spread, by the neglect of cleanliness; but in none more than in this. Every thing about the patient should be frequently changed. The ex­crements should never be suffered to continue in his cham­ber, but removed immediately, and buried under ground. A co [...]nt stream of fresh air should be admitted into the chamber; and it ought frequently to be sprinkled with vi­negar, juice of lemon, or some other strong acid.

THE patient must not be discouraged, but his spirits kept up in hopes of a cure. Nothing tends more to render any putrid disease mortal than the fears and apprehensions of the sick. All diseases of this nature have a tendency to sink and depress the spirits, and, when that is increased by fears and alarms, from those whom the patient believes to be persons of skill, it cannot fail to have the worst ef­fects.

A flannel vest worn next the skin has often a very good effect in a dysentery. This promotes the perspiration with­out greatly heating the body. Great caution, however, is necessary in leaving it off. I have often known a dysentery brought on by imprudently throwing off a flannel vest be­fore the season was sufficiently hot. For, whatever pur­pose this piece of dress be worn, it should never be left off but in a warm season.

IN this disease the greatest attention must be paid to the patient's diet. Flesh, fish, and every thing that has a ten­dency to turn putrid or rancid on the stomach, must be abstained from. Apples boiled in milk, water pap, and plain light pudding, with broth made of the gelatinous parts of animals, may be eat. Jelly broth not only answers the purpose of food, but likewise of medicine. I have of­ten [Page 222] known dysenteries cured [...]y it, after pompous medi­cines had proved ineffectual ^*.

ANOTHER kind of food very proper in the dysentery, which may be used by such as cannot take the broth men­tioned above, is made by boiling a few handfuls of fine flour, tied in a cloth, for six or seven hours, till it be­comes as hard as starch. Two or three table spoonfuls of this may be grated down, and boiled in such a quantity of new milk and water as to be of the thickness of pap. This may be sweetened to the patient's taste, and taken for his ordinary food ^†.

THE patient may likewise be allowed to eat freely of most kinds of good ripe fruit; as apples, grapes, currant ber­ries, strawberries, &c. These may either be eat raw or boiled, with or without milk, as the patient chooses. The prejudice against fruit in this disease is so great, that many believe it to be the common cause of dysenteries. This, however, is an egregious mistake. Both reason and ex­perience shew, that good fruit is one of the best medicines, [Page 223] both for the prevention and cure of the most dangerous kind of dysentery. In a dysentery arising from a putrid state of humours, fruit is, in every respect, calculated to counteract that tendency to putrefaction, from whence all the danger proceeds. The patient, in such a case, ought, therefore, to be allowed to eat as much fruit as he pleases, provided it be good ^*.

THE most proper drink in this disorder is whey. The dysentery has often been cured by the use of clear whey alone. It may be taken both for drink, and in form of a clyster. When whey cannot be had, barley water, sharp­ened with cream of tartar, may be drank, or a decoction of barley and tamarinds; two ounces of the former, and one of the latter, may be boiled in two English quarts of water to one. Warm water, water gruel, or water where­in hot iron has been frequently quenched, are all very pro­per, and may be drank in turns. Camomile tea, [...] the stomach will bear it, is an exceeding proper drink. It both strengthens the stomach, and by its antiseptic quality, tends to prevent a mortification of the bowels.

MEDICINE.—At the beginning of this disease it is always necessary to cleanse the first passages. For this purpose, a vomit of ipecacuanha must be given, and wrought off with weak camomile tea. Strong vomits are seldom necessary here. A scruple, or at most half a dram of ipecacuanha, is generally sufficient for an adult, and, sometimes, a very few grains will suffice. The day after the vomit, half a dram, or two scruples of rhubarb, must be taken. This dose may be repeated every other day for two or three times. Afterwards small doses of ipecacuanha [Page 224] may be taken for some time. Two or three grains of the powder may be mixed in a table spoonful of the syrup of poppies, and taken three times a-day.

THESE evacuations, and the regimen prescribed above, will seldom fail to perform the cure. Should it, however, happen otherwise, the following astringent medicines must be used.

A clyster of starch or fat mutton broth, with twenty or thirty drops of liquid laudanum in it, may be administered twice a-day. At the same time, an ounce of gum Arabic, and half an ounce of gum tragacanth, may be dissolved in an English pint of barley water, over a slow fire, and a table spoonful of it taken every hour.

IF these have not the desired effect, the patient may take four times a day, about the bulk of a nutmeg of the [...]aponic confection, drinking after it a tea cupful of the decoction of logwood; which may be thus made: Boil three or four ounces of the shavings of logwood in two English quarts of water to one; towards the end, add two drams of cinna­mon bark. This decoction gives the stools a reddish co­lour, which is sometimes mistaken for blood. We menti­on this circumstance to prevent the patient from being alarmed at their appearance.

SOME have treated dysenteries very successfully, by giv­ing the patient white wax dissolved in milk. Others extol the virtues of the Cornessi root, the Simaruba bark, &c. for the cure of this disease. When other medicines fail, these strong astringents may be tried; but we hope they will seldom be found necessary. At any rate, astrin­gent, or binding medicines, never are to be used till proper evacuations have been premised, otherwise they will fix the disease instead of removing it.

PERSONS who have been cured of this disease are very li­able to a relapse; to prevent which, great circumspection with respect to diet is necessary. The patient must abstain from all fermented liquors, except now and then a glass of good wine; but he must drink no kind of malt liquor. He must, likewise, abstain from animal food, as fish and flesh, and must live principally upon milk and vegetables.

GENTLE exercise, and wholesome air, are likewise of importance. The patient should go to the country as soon as his strength will permit, and should take exercise daily on horseback, or in a machine. He may, likewise, use bitters infused in wine or brandy, and may drink twice [Page 225] a-day a gill of lime water, mixed with an equal quantity of new milk.

WHEN dysenteries prevail, we would recommend a strict attention to cleanliness, a spare use of animal food, and the free use of [...]ound ripe fruits, and other vegetables. The night air is to be carefully avoided, and all commu­nication with the sick. Bad smells are likewise to be shun­ned, especially those which arise from putrid animal substances. The office houses where the sick go are very dangerous. Nothing is more apt to occasion the disease than being greatly afraid of it.

WHEN the first symptoms of the dysentery appear, the patient ought immediately to take a vomit, to go to bed, and drink plentifully of weak, warm liquor, to promote a sweat. This, with a dose or two of rhubarb, would often carry off the disease at the beginning. In countries where dysenteries prevail, we would advise such as are liable to them, to take either a vomit or a dose of physic every spring and autumn, as a preventive.

THERE are sundry other fluxes of the belly, as the lien­tery and coeliac passion, which, though less dangerous than the dysentery, yet merit consideration. These diseases ge­nerally proceed from a relaxed state of the stomach and in­testines, which is sometimes so great, that the food passes through them, without almost any sensible alteration; and the patient dies merely from the want of nourishment.

WHEN the lientary or coeliac passion succeed a dysentery, they often prove fatal. They are always dangerous in old age, especially when the constitution has been broken by excess, or acute diseases. If the stools be very frequent, and quite crude, the thirst great, with little urine, the mouth ulcerated, and the face marked with spots of diffe­rent colours, the danger is very great.

THE treatment of the patient is in general the same as in the dysentery. In all obstinate fluxes of the belly, from whatever cause, the cure must be attempted, by first clean­ing the stomach and bowels with gentle vomits and purges. Afterwards, such a diet as has a tendency to brace and strengthen the bowels, with opiates and astringent medi­cines, will generally perfect the cure.

THIS observation, likewise, holds with respect to a tenes­mus, or frequent desire of going to stool. It resembles the dysentery so much, both in its symptoms and method of cure, that we think it needless to insist upon it.

OF A DIABETES, OR EXCESSIVE DISCHARGE OF URINE.

THE diabetes may be called a flux of the kidneys. It is seldom to be met with among young people; but I have often known it happen to labourers in the decline of life, especially those who followed the more violent employ­ments, and who had been hard drinkers in their youth.

CAUSES.—A diabetes is often the consequence of acute diseases, as fevers, fluxes, &c. where the patient has suffered excessive evacuations; it may also be occasion­ed by excessive fatigue, as riding long journies upon a hard trotting horse, carrying heavy burdens, running, &c. It may be brought on by the use of strong stimulating diuretic medicines, as tincture of cantharides, spirits of turpentine, and such like. It is often the effect of drinking large quantities of mineral waters. Many imagine that these will do them no service unless they be drank in large quan­tities, by which mistake it happens, that they often occasi­on worse diseases than those they were taken to cure. In a word, this disease may either proceed from too great a laxi­ty of the organs which secrete the urine, from something that stimulates the kidneys too much, or from a thin dis­solved state of the blood, which makes too great a quan­tity of it run off by the urinary passages.

SYMPTOMS.—In a diabetes the urine gene­rally exceeds in quantity all the liquid food and drink which the patient takes. It is thin and pale, of a sweetish taste, and an agreeable smell. The patient has a continu­al thirst, with some degree of fever; his mouth is dry, and he spits frequently a frothy spittle. The strength fails, the appetite decays, and the flesh wastes away, till the pa­tient is reduced to skin and bone. There is a heat of the bowels; and frequently the loins, testicles, and feet are swelled.

THIS disease may be cured at the beginning; but, after it has continued long, the cure becomes very difficult. In drunkards, and very old people, a cure is not to be ex­pected.

REGIMEN.—Every thing that stimulates the urinary passages, or tends to relax the habit, must be avoided. The patient should live chiefly on solid food. His thirst may be quenched with acids, or sorrel, juice of lemon, or vinegar. The mucilaginous vegetables, as rice, sago, [Page 227] and salop, with milk, are the most proper food. Of ani­mal substances, shell-fish are to be preferred, as oysters, crabs, &c.

THE drink may be Bristol water. When that cannot be obtained, lime water with milk may be drank. This will be better if an ounce of gum Arabic be dissolved in every pound of it. The white decoction, with isinglass dissolved in it, is likewise a very proper drink. It is made by boiling two ounces of calcined hartshorn, and half an ounce of gum Arabic, in three English pints of water to two, and afterwards straining it.

THE patient ought daily to take exercise, but it should be so gentle as not to fatigue him. He should lie upon a hard bed or matress. Nothing hurts the kidneys more than ly­ing too soft. A warm dry air, the use of the flesh brush, and every thing that promotes perspiration, is of service. For this reason, the patient ought to wear flannel next his skin. A large strengthening plaster may be applied to the back; or, what will answer the same end, a broad girdle may be worn about the loins.

MEDICINE.—Gentle purges, if the pati­ent be not too much weakened by the disease, have a good effect. They tend to promote a flux of the humours towards the intestines, and, of course, to lessen the discharge by the kidneys. They may consist of rhubarb, with cardamum seeds, or any other spiceries, infused in wine, and may be taken in such quantities as to keep the belly gently open.

THE patient must next have recourse to astringents and corroborants. Half a dram of powder, made of equal parts of allum and the gum called dragon's blood, may be taken four times a-day, or oftener if the stomach will bear it. The allum must first be melted in a crucible; afterwards they may both be pounded together. Along with every dose of this powder the patient may take a tea cupful of the tinc­ture of roses. It is made by infusing in a stone ware vessel, for four hours, an ounce of the dried leaves of red roses, with one dram of spirit of vitriol, in two English pints of boiling water. Afterwards the tincture may be filtered, and four or five ounces of white sugar added to it.

IF the patient's stomach cannot bear the allum in sub­stance, whey may be made of it, and taken in the dose of three or four ounces three times a-day. The allum whey is prepared by boiling two English quarts of milk over a [...]low [Page 228] fire, with three drams of allum, till it be turned into whey.

OPIATES are of service in this disease, even though the patient rests well. They take off spasms and irritation, and, at the same time, lessen the force of the circulation. Ten or twelve drops of liquid laudanum may be taken in a cup of the patient's drink two or three times a-day.

THE best corroborants which we know, are the Jesuits bark and wine. A dram of bark may be taken in a glass of red port or claret, three times a-day. The medicine will be more efficacious and less disagreeable, if fifteen or twenty drops of the acid elixir of vitriol be added to every dose. Such as cannot take the bark in substance, may use the decoction, mixed with an equal quantity of red wine, and sharpened as above.

THERE is a disease pretty incident to labouring people in the decline of life, called an incontinency of urine. This differs intirely from a diabetes, as the water passes off invo­luntarily by drops, and does not exceed the usual quantity. This disease is rather troublesome than dangerous. It is owing to a relaxation of the spincter of the bladder, and is often the effect of a palsy. Sometimes it proceeds from hurts, or injuries occasioned by blows, bruises, preternatural la­bours, &c. Sometimes it is the effect of a fever. It may, likewise, be occasioned by a long use of strong diu­retics, or of stimulating medicines, injected into the blad­der.

THIS disease may be mitigated by the use of astringent and corroborating medicines, such as have been mentioned above; but we do not remember ever to have seen it cured.

OF A SUPPRESSION OF URINE.

IT has already been observed, that a suppression of urine may proceed from various causes; as an inflammation of the kidneys, or bladder; small stones or gravel lodged in the urinary passages, hard foeces lying in the rectum, a spasm, or contraction of the neck of the bladder, clotted blood in the bladder, a swelling of the haemorrhoidal veins, &c.

SOME of these cases require the cathater, both to remove the obstructing matter, and to draw off the urine; but as this instrument can only be managed with safety by persons skilled in surgery, we shall say nothing further of its use.

[Page 229] WE would chiefly recommend, in all obstructions of urine, fomentations and evacuations. If the patient be young, of a full habit, and if his pulse be hard, frequent bleeding will be necessary, especially where there are symp­toms of a topical inflammation. Bleeding, in this case, not only abates the fever, by lessening the force of the circula­tion, but by relaxing the solids, takes off the spasm, or stricture upon the vessels, which occasioned the obstructi­on.

AFTER bleeding, fomentations must be used. These may either consist of warm water alone, or decoctions of mild vegetables; as mallows, camomile flowers, &c. Cloths dipped in these may either be applied to the part af­fected, or a large bladder, filled with the decoction, may be kept continually upon it. Some put the herbs them­selves into a flannel bag, and apply them to the part, which is far from being a bad method. These continue longer warm than cloths dipped in the decoction, and, at the same time, keep the part equally moist.

IN all obstructions of urine, the belly ought to be kept open. This is not, however, to be attempted by brisk purgatives, but by emollient clysters, or gentle infusions of senna and manna. Clysters, in this case, not only open the belly, but answer the purpose of an internal fomentati­on, and greatly assist in removing spasms of the bladder, &c.

THE food must be light, and taken in small quantities. The drink may be weak broth, or decoctions and infusions of mucilaginous vegetables, as marsh mallow roots, lime tree buds, &c. A tea spoonful of the sweet spirits of nitre, or a dram of Castile soap, may be frequently put into the patient's drink; and, if there be no inflammation, he may drink small gin punch, without acid.

IN a suppression of urine, nature often attempts to re­lieve the patient by a sweat, looseness, spitting, gulping up of clear water from the stomach, &c. These discharges ought not to be suppressed, but encouraged, as the patient's life often depends upon them.

PERSONS subject to a suppression of urine, ought to live very temperate. Their diet should be light, and their li­quor diluting. They ought to avoid all acids, and wines that abound with tartar; they should likewise t [...]lenty exercise, lie hard, and avoid study and sedentary [...]pati­ons.

OF COSTIVENESS.

NO person can long enjoy good health, who does not go regularly to stool. There is, however, a very great dif­ference of persons in this respect, some being able to bear costiveness much longer than others. We do not here mean to treat of those astrictions of the bowels, which are the symptoms of diseases, as in the colic, the iliac passion, &c. but only to take notice of that infrequency of stools which sometimes happens, and which, in some particular constitutions, may occasion diseases.

COSTIVENESS may proceed from an excessive heat of the liver; drinking rough red wines, or other astringent li­quors; too much exercise, especially on horseback: It may, likewise, proceed from a long use of cold insipid food, which does not sufficiently stimulate the intestines. Sometimes it is owing to the bile not descending to the in­testines, as in the jaundice; and, at other times, it pro­ceeds from diseases of the intestines themselves, as a palsy, spasms, tumours, a cold dry state of the intestines, &c.

WHEN costiveness is constitutional, it may be borne a long time without any bad effects; but when it proceeds from an inflammation or tumour in the intestines, it is dan­gerous. Costiveness, when long continued, is apt to oc­casion, pains of the head, vomiting, colics, &c. It is pe­culiarly hurtful to hypochond [...] and hysteric persons, as it generates wind and other grievous symptoms.

PERSONS who are liable to be costive should live upon a moistening and laxative diet, as roasted or boiled apples, pears, stewed prunes, raisins, gruels with currants, butter, honey, and sugar, &c. Green broths, with spinage, l [...]ks, and other soft pot-herbs, are, likewise, proper. Rye bread, or that which is made of a mixture of wheat and rye together, ought to be eat. No person troubled with costiveness should eat wheat bread alone, especially that which is made of fine flour. The best bread for keep­ing the belly soluble, is what the English call meslin. It is made of equal parts of wheat and rye; or, more com­monly, of two parts of the former, to one of the latter.

COSTIVENESS is increased by keeping the body too warm, and by every thing that promotes the perspiration; as wearing flannel, lying too long in bed, &c. Intense thought, and a sedentary life, are, likewise, hurtful. All the s [...]etions and excretions are promoted by moderate ex­ercise [Page 231] without doors, and, by a gay, cheerful, sprightly temper of mind.

THE drink should be of an opening quality. All ardent spirits, austere and astringent wines, as port, claret, &c. ought to be avoided. Malt liquor that is fine, and of a moderate strength, is very proper. Butter milk, they, and other watery liquors, are likewise proper, and may be drank in turns, as the patient's inclination directs.

^* THOSE who are troubled with costiveness ought, if possible, to remedy it by diet, as the constant use of medi­cines, for that purpose, is attended with many inconveni­encies, and often with bad consequences. I never knew any one get into a habit of taking medicine for keeping the belly open, who could leave it off. In time, the custom becomes necessary, and, generally, ends in a total relax­ation of the bowels, indigestion, loss of appetite, wasting of the strength, and death.

WHEN the belly cannot be kept open without medicine, we would recommend gentle doses of rhubarb to be taken twice or thrice a-week. This is not near so injurious to the stomach, as aloes, jalep, or the other drastic purgatives so much in use. Infusion of senna and manna may, like­wise, be taken; or, half an ounce of soluble tartar, dis­solved in water gruel. About the size of a nutmeg, of le­nitive electuary taken twice or thrice a-day, generally an­swers the purpose very well.

OF INVOLUNTARY DISCHARGES OF BLOOD.

SPONTANEOUS, or involuntary discharges of blood, of­ten happen from various parts of the body. They are sel­dom, however, attended with great danger, and prove of­ten salutary. When such discharges are critical, which is frequently the case i [...] fevers, they ought not to be stopped. Nor, indeed, is it proper, at any time, to stop them, unless they be so great as to endanger the patient's life. Most people, afraid of the smallest appearance of blood from any part of the body, fly immediately to the use of stiptic and astringent medicines, by which means an inflammation of the brain, or some other fatal disease, is occasioned, which, had the discharge been allowed to go on, might have been prevented.

PERIODICAL discharges of blood, from whatever part of the body they proceed, must not be stopped. These are always the efforts of nature to relieve herself, and fatal diseases have often been the consequence of obstructing them. It may, indeed, be sometimes necessary to check the violence of such discharges; but even this requires the greatest caution. Instances may be given where the stop­ping of a small periodical flux of blood, from one of the fingers, has proved fatal to the person's health.

IN the early period of life, bleeding at the nose is most common. Those who are farther advanced in life, are more liable to a haemoptoe, or discharge of blood from the lungs. After the middle period of life, haemorrhoidal fluxes are most common, and in the decline of life, dis­charges of blood from the urinary passages.

INVOLUNTARY fluxes of blood may proceed from very different, and often from quite opposite causes. Some­times they are hereditary, or owing to a particular con­struction of the body, as a sanguine temperament, a lax or plethoric habit, &c. Sometimes they proceed from a deter­mination of the blood towards one particular part, as the head, the haemorrhoidal veins. They may likewise proceed from an inflammatory disposition of the blood, in which case, there is generally some degree of fever; this, like­wise, happens when the flux is occasioned by an obstructed perspiration, or a stricture upon the skin, the bowels, or any particular part of the system.

[Page 233] BUT a dissolved state of the blood will, likewise, occa­sion haemorrhages. Thus, in putrid fevers, the scurvy, the malignant small-pox, &c. there are often very great discharges of blood from different parts of the body. They may, likewise, be brought on by the use of any medicines which tend to dissolve the blood, as mercury, cantharides, and the volatile alcaline salts, &c. Food of an acrid or ir­ritating quality, may, likewise, occasion haemorrhages; as also strong purges and vomits, or any thing that greatly sti­mulates the bowels.

VIOLENT passions, or agitations of the mind, will also occasion haemorrhages. These often cause bleeding at the nose, and I have known them sometimes occasion an haemorrhage in the brain. Violent efforts of the body, by overstraining or hurting the vessels, may, likewise, bring on haemorrhages, especially when the body is long kept in an unnatural posture, as hanging the head very low, &c.

THE cure of an haemorrhage must be adapted to its cause. When it proceeds from too much blood, or a tendency to inflammation, bleeding, with gentle purges, and other eva­cuations, will be necessary. It will, likewise, be proper for the patient, in that case, to live chiefly upon a vegeta­ble diet, to avoid all strong liquors, and food that is of an acrid, hot, or stimulating quality. The body should be kept cool, and the mind easy.

WHEN an haemorrhage is owing to a putrid or dissolved state of the blood, the patient ought to live chiefly upon acid fruits with milk, and vegetables of a nourishing na­ture, as sago, salop, &c. His drink may be wine diluted with water, and sharpened with the juice of lemon, vinegar, or spirits of vitriol. The best medicine, in this case, is the Jesuits bark. It may be taken as directed in page 228.

WHEN a flux of blood is the effect of acrid food, or of strong stimulating medicines, the cure is to be effected by such soft and mucilaginous diet as is recommended in the dysentery or bloody-flux. The patient may, likewise, take frequently about the bulk of a nutmeg of Locatelli's bal­sam, or the same quantity of spermaceti.

WHEN an obstructed perspiration, or a stricture upon any part of the system, is the cause of an haemorrhage, it may be removed by drinking warm diluting liquors, lying in bed, bathing the extremities in warm water, &c.

OF BLEEDING AT THE NOSE.

A bleeding at the nose is commonly preceded by some degree of quickness of the pulse, a flushing of the face, pul­sation of the temporal arteries, heaviness in the head, dim­ness of the sight, heat and itching of the nostrils, &c.

TO persons who abound with blood, this discharge is very salutary. It often cures a vertigo, the headach, a phrenzy, and even an epilepsy. In fevers, where there is a great determination of blood towards the head, it is of the utmost service. It is, likewise, beneficial in inflammations of the liver and spleen, and often in the gout and rheuma­tism. In all diseases where evacuations are necessary, a spontaneous discharge of blood from the nose, is of much more service than the same quantity let with a lancet.

IN a discharge of blood from the nose, the great point is, to determine whether it ought to be stopped or not. It is a common practice to stop the bleeding without considering whether it be a disease, or the cure of a disease. This con­duct proceeds from fear; but it has many bad, and some­times even fatal consequences.

WHEN a discharge of blood from the nose happens in an inflammatory disease, there is always reason to believe, that it may prove salutary; and, therefore, it should be suf­fered to go on, at least as long as the patient seems to bear it well.

WHEN it happens to persons in perfect health, who are full of blood, it ought not to be stopped; especially if the symptoms of a plethora, mentioned above, have pre­ceded it. In this case, it cannot be stopped without risking the patient's life.

IN fine, whenever bleeding at the nose relieves any bad symptom, and does not proceed so far as to endanger the patient's life, it ought not to be stopped. But when it re­turns frequently, or continues till the pulse becomes very low, the extremities begin to grow cold, the lips pale, or the patient complains of being sick, or like to faint, it must immediately be stopped.

THE patient should be set nearly upright, with his head inclining a little backwards, and his legs immersed in wa­ter about the warmth of new milk. His hands ought, like­wise, to be put in lukewarm water, and his garters may be tied a little tighter than usual, about three inches above the knee. Ligatures may, likewise, be applied to the arms, [Page 235] about the place where they are usually made for bleeding, and with nearly the same degree of tightness. These must be gradually slackened as the blood begins to stop, and re­moved intirely as soon as it gives over.

SOMETIMES, dry lint put up the nostrils will stop the bleeding. When this does not succeed, dossils of lint dipped in strong spirits of wine, may be put up the nostrils, or, if that cannot be had, they may be dipped in brandy. Roman vitriol dissolved in water may, likewise, be used for this pur­pose, or a tent dipped in the white of an egg well beat up, may be rolled in a powder made of equal parts of white su­gar, burnt allum, and white vitriol, and put up the nostril from whence the blood issues.

INTERNAL medicines can hardly take place here, as they have seldom time to operate. It may not, however, be amiss to give the patient half an ounce of Glauber's salt, and the same quantity of manna, dissolved in four or five ounces of barley water. This may be taken at a draught, and repeated if it does not operate in a few hours. Ten or twelve grains of nitre may be taken in a glass of cold water and vinegar every hour, or oftener, if the stomach will bear it. If a stronger medicine be necessary, a tea cupful of the tincture of roses, made as directed in page 227, with twen­ty or thirty drops of the small spirit of vitriol, may be taken every hour. When these things cannot be had, the patient may drink water, with a little common salt in it, or equal parts of water and vinegar.

IF the genitals be immersed in cold water, it will gene­rally stop a bleeding at the nose.—I have never known this fail.

SOMETIMES, when the blood is stopped outwardly, it continues to bleed inwardly. This is very dangerous, and requires particular attention, as the patient is apt to be suf­focated with the blood, especially if he falls asleep, which be is very ready to do after losing a great quantity of blood.

AFTER the bleeding is stopped, the patient ought to be kept as easy and quiet as possible. He ought not to pick his nose, nor to take away the tents or clotted blood, till they fall off of their own accord, and should not lie with his head too low.

THOSE who are affected with frequent bleeding at the nose, ought to bathe their feet often in warm water, and keep them warm and dry. They ought to wear nothing tight about their necks, to keep their body as much in an erect posture as possible, and never to view any object [Page 236] obliquely. If they have too much blood, a vegetable diet, with now and then a dose of physic, is the safest way to lessen it.

BUT when the disease proceeds from a thin dissolved state of the blood, the diet should be rich and nourishing; as strong broths with bread, sago gruel with wine and su­gar, &c. Infusions of the Jesuits bark in wine, ought like­wise to be taken, and persisted in for a considerable time.

OF THE BLEEDING AND BLIND PILES.

A discharge of blood from the haemorrhoidal vessels is called the bleeding piles. When the vessels only swell, and discharge no blood, but are exceeding painful, the disease is called the blind piles.

PERSONS of a loose spungy texture, of a bulky size, who live high, and lead a sedentary and inactive life, are most subject to this disease. It is often owing to a hereditary disposition. Where this is the case, it attacks persons more early in life than when it is accidental. Men are more liable to it than women, especially those of a sanguine plethoric habit, or of a melancholy disposition.

THE piles may be occasioned by an excess of blood, by strong aloetic purges, high seasoned food, drinking great quantities of sweet wines, the neglect of bleeding, or other customary evacuations, much riding, great costiveness, or any thing that occasions hard or difficult stools. Anger, grief, and other violent passions, will likewise occasion the piles. I have often known them brought on by cold, espe­cially about the anus. A pair of thin breeches will occasion the disorder in a person who is subject to it, and sometimes even in those who never had it before. Pregnant women are often afflicted with the piles.

A flux of blood from the anus is not always to be reckon­ed a disease. It is even more salutary than bleeding at the nose, and often prevents or carries off diseases. It is pecu­liarly beneficial in the gout, rheumatism, asthmas, and hy­pochondriacal complaints, and often proves critical in co­lics, and inflammatory fevers.

IN the treatment of this disease, regard must be had to the patient's habit of body, his age, strength, and manner of living. A discharge which might be excessive and prove hurtful to one, may be very moderate, and even salutary to another. That only is to be esteemed dangerous which

WHEN the piles are exceeding painful and swelled, but discharge nothing, the patient must [...]it over the steams of warm water. He may, likewise, apply a linen cloth dipped in warm spirits of wine to the part, or poultices made of bread and milk, or of leeks fried with butter. If these do not produce a discharge, and the piles appear large, leeches must be applied as near the piles as possible, or if they will fix upon the piles themselves so much the better. When leeches will not fix, the piles may be opened with a lancet. The operation is very easy, and is attended with no danger.

VARIOUS ointments, and other external applications, are recommended in the piles; but I do not remember ever to have seen any effects from these worth mentioning. Their principal use is to keep the part soft, which may be done equally well by a soft poultice or an emollient cataplasm.

SPITTING OF BLOOD.

WE only mean here to treat of that discharge of blood from the lungs, which commonly goes by the name of an haemoptoe, or spitting of blood. Persons of a slender make, and a lax fibre, who have long necks and strait breasts, are most liable to this disease. It is most common in the spring, and generally attacks people before they arrive at the prime or middle period of life. It is a common observation, that those who have been subject to bleeding at the nose when young, are afterwards most liable to an haemoptoe.

CAUSES.—An haemoptoe may proceed from ex­cess of blood, from a peculiar weakness of the lungs, or a bad conformation of the breast. It is often occasioned by excessive drinking, running, wrestling, singing, or speaking aloud. Such as have weak lungs ought to avoid all violent exertions of that organ, as they value life. They should, likewise guard against violent passions, and every thing that occasions a rapid circulation of the blood.

THIS disease may likewise proceed from wounds of the lungs. These may either be received from without, or they may be occasioned by hard bodies getting into the wind-pipe, and so falling down upon the lungs, and hurt­ing their tender vessels. The obstruction of any customa­ry evacuation, may occasion a spitting of blood; as the ne­glect of bleeding or purging at the usual seasons, the stop­page of the bleeding, piles in men, or the menses in women, &c. It may likewise proceed from a polypus, schirrhous [Page 239] concretions, or any thing that obstructs the circulation of the blood in the lungs. It is often the effect of a long and violent cough; in which case, it is generally the forerunner of a consumption. A violent degree of cold, suddenly ap­plied to the external parts of the body, will occasion an an haemoptoe. It may likewise be occasioned by breathing in air which is too much rarified to be able properly to ex­pand the lungs. This is often the case with those who work in hot places, as furnaces, glass houses, &c. It may likewise happen to such as ascend to the top of very high mountains, as the peak of Teneriff, &c.

SPITTING of blood is not always to be considered as a primary disease. It is often only a symptom, and, in some cases, not an unfavourable one. This is the case in pleu­risies, peripneumonies, and sundry other fevers. In a dropsy, scurvy, or consumption, it is a bad symptom, and shews that the lungs are ulcerated.

SYMPTOMS.—Spitting of blood is gene­rally preceded by a sense of weight, and oppression of the breast, a dry tickling cough, hoarseness, and a difficulty of breathing. Sometimes it is ushered in with shivering, cold­ness of the extremities, costiveness, great lassitude, flatu­lence, pains of the back and loins, &c. As these shew a general stricture upon the vessels, and a tendency of the blood to inflammation, they are commonly the forerunners of a very copious discharge. These symptoms do not at­tend a discharge of blood from the gums or fauces, by which means they may always be distinguished from an haemoptoe. Sometimes the blood that is spit up is thin, and of a florid red colour; and, at other times, it is thick, and of a dark or blackish colour; nothing, however, can be inferred from this circumstance, but that the blood has lain a longer or shorter time in the breast before it was dis­charged.

SPITTING of blood, in a strong healthy person, of a [...]ound constitution, is seldom dangerous; but when it at­tacks the tender and delicate, or persons of a weak lax fibre, it is not easily removed. When it proceeds from a schirrhous, or polypus of the lungs, it is bad. The danger is greater when the discharge proceeds from the rupture of a large vessel than of a small one. When the extrava­sated blood is not spit up, but lodges in the breast, it cor­rupts, and greatly increases the danger. When the blood [Page 240] proceeds from an ulcer in the lungs, it is generally fa­tal.

REGIMEN.—The patient ought to be kept cool, and perfectly at rest. Every thing that heats the blood, or quickens the circulation, increases the danger. The mind ought likewise to be soothed, and every occasion of exci­ting the passion avoided. The diet should be soft, cool­ing, and slender; as rice, boiled with milk, small broths, barley gruels, panada, &c. The diet, in this case, can scarce be too low. Even water gruel is sufficient to sup­port the patient for some days. All strong liquors must be avoided. The patient may drink milk and water, bar­ley water, whey, butter milk, and such like. Every thing should be drank cold, and in small quantities at a time. The patient must observe the strictest silence, or, at least, speak with a very low voice.

MEDICINE.—This, like the other invo­luntary discharges of blood, ought not to be suddenly stop­ped by astringent medicines. More mischief is often done by these than if it were suffered to go on. It may, how­ever, proceed so far as to weaken the patient, and even en­danger his life, in which case, proper means must be used for restraining it.

THE belly should be kept gently open by laxative diet; as roasted apples, stewed prunes, &c. If these should not have the effect, a tea spoonful of the lenitive electuary may be taken twice or thrice a-day, as is found necessary. If the bleeding proves violent, ligatures may be applied to the extremities, as directed for the bleeding at the nose.

IF the patient be hot or feverish, bleeding, and small do­ses of nitre, will be of use; a scruple, or half a dram, may be taken in a cup of his ordinary drink, twice or thrice a-day. His drink may likewise be sharpened with acids, as juice of lemons, or a few drops of the spirit of vitriol; or he may take frequently a cup of the tincture of roses, as di­rected in page 227.

BATHING the feet and legs in lukewarm water, by ta­king off spasms, has a very good effect in this disease. Opi­ates too are sometimes beneficial for that purpose; but these must be given with the greatest caution. Ten or twelve drops of laudanum may be given in a cup of barley water twice a-day, and continued for some time, provided they be found beneficial.

[Page 241] THE conserve of roses is likewise a very good medicine in this case, provided it be taken in sufficient quantity, and long enough persisted in. It may be taken to the ex­tent of three or four ounces a-day; and, if the patient be troubled with a cough, it should be made into an electuary with balsamic syrup, and a little of the syrup of poppies.

IF stronger astringents be found necessary, fifteen or twenty drops of the acid elixir of vitriol may be taken in a glass of water, three or four times a-day.

THOSE who are subject to frequent returns of this dis­ease, should be careful to avoid all excess. Their diet should be light and cool, consisting chiefly of milk and ve­getables. Above all, let them beware of vigorous efforts of the body, and violent agitations of the mind.

VOMITING OF BLOOD.

THIS is not so common as the other discharges of blood which have already been mentioned; but it is more dan­gerous, and requires the greatest attention.

VOMITING of blood is generally preceded by pains in the stomach, sickness and nausea, and is accompanied with great anxiety, and frequent fainting fits.

VOMITING of blood is sometimes periodical; in which case it is less dangerous. It often proceeds from an ob­struction of the menses in women; and sometimes from the stopping of the haemorrhoidal flux in men. It may be occasioned by any thing that greatly stimulates or wounds the stomach, as strong vomits or purges, acrid poisons, sharp or hard substances taken into the stomach, &c. It is often the effect of obstructions in the liver, the spleen, or some of the other viscera. It may likewise proceed from external violence, as blows or bruises, or from any of the causes which produce inflammation.

A great part of the danger in this disease arises from the extravasated blood lodging in the bowels, and becoming putrid, by which means a dysentery or putrid fever may be occasioned. The best way of preventing this, is to keep the belly gently open, by frequently exhibiting emollient clysters. Purges must not be given till the discharge is stopt, otherwise they will irritate the stomach, and increase the disorder. All the food and drink must be of a mild cooling nature, and taken in small quantities. Even [Page 242] drinking cold water has sometimes proved a remedy. When there are signs of an inflammation, bleeding may be neces­sary; but the patient's weakness will seldom permit it. Astringents can seldom be used, as they stimulate the sto­mach, and of course increase the disease. Opiates may be of of use; but they must be given in very small doses, as four or five drops of liquid laudanum twice or thrice a-day. Af­ter the discharge is over, as the patient is generally troubled with gripes, occasioned by the acrimony of the blood lodged in the intestines, gentle purges will be necessary.

OF BLOODY URINE.

THIS disorder is commonly called pissing of blood. It is a discharge of blood, with or without urine, from the vessels of the kidneys or bladder, which may be either enlarged, broken, or eroded. It is more or less dangerous according to the different circumstances which attend it.

WHEN pure blood is voided suddenly without interrup­tion and without pain, it proceeds from the kidneys; but if the blood be in small quantity, of a dark colour, and emitted with heat and pain about the bottom of the belly, it pro­ceeds from the bladder. When bloody urine is occasioned by a large rough stone descending from the kidneys to the bladder, which wounds the ureters, it is attended with a sharp pain in the back and difficulty of making water. If the coats of the bladder are hurt by a stone, and bloody urine follows, it is attended with the most acute pain, and a previous stoppage of urine.

BLOODY urine may likewise be occasioned by falls, blows, the lifting or carrying of heavy burdens, hard riding, or any violent motion. It may also proceed from ulcers or erosions of the bladder, from a stone lodged in the kidney [...], or from violent purges, or sharp diuretic medicines, especially cantharides.

BLOODY urine is always attended with some degree of danger; but it is peculiarly so when mixed with purulent matter, as this she [...] an ulcer somewhere in the urinary passages. Sometime [...] this discharge proceeds from excess of blood, in which case it is rather to be considered as a salu­tary evacuation than a disease. If the discharge, however, be very great, it may waste the patient's strength, and oc­casion an ill habit of body, a dropsy, or a consumption, &c.

THE treatment of this disorder must be varied according to the different causes from which it proceeds.

[Page 243] WHEN it is owing to a stone in the bladder, the cure [...]e­pends upon an operation, which it is not our business to de­scribe.

IF it be attended with a plethora, and symptoms of an inflammation, bleeding will be necessary. The belly must likewise be kept open by emollient clysters, or cooling pur­gative medicines; as crystals of tartar, rhubarb, manna, or small doses of lenitive electuary.

WHEN bloody urine proceeds from a dissolved state of the blood, it is commonly the symptom of some malignant dis­ease; as the small-pox, a putrid fever, or the like. In this case, the patient's life depends on the liberal use of the Je­suits bark and acids, as has already been shewn.

WHEN there is reason to suspect an ulcer in the kidneys or bladder, the patient's diet must be cool, and his drink of a soft, healing, balsamic quality, as decoctions of marsh­mallow roots with liquorice, solutions of gum Arabic, &c. Three ounces of marshmallow roots, and half an ounce of liquorice, may be boiled in two English quarts of water to one; two ounces of gum Arabic, and half an ounce of pu­rified nitre, may be dissolved in the strained liquor, and a tea cupful of it taken four or five times a-day.

THE early use of astringents, in this disease has often bad consequences. When the flux is stopped too soon, the grumous blood, by being confined in the vessels, may pro­duce inflammations, abscess, and ulcers. If, however, the case be urgent, or the patient seem to suffer from the loss of blood, gentle astringents may be necessary. In this case, the patient may take three or four ounces of ^* lime-water, with half an ounce of the tincture of Jesuits bark, three times a-day. Or, he may take an ounce or two of the con­serve of roses three or four times a-day, drinking a tea cup­ful of the tincture of roses after it. If stronger styptics be necessary, a dram of Armenian bole may be taken in a cup of whey three or four times a-day.

OF VOMITING.

VOMITING may proceed from various causes; as excess in eating or drinking; a foul stomach; the acrimony of [Page 244] the aliments; the translation of the morbific matter of ul­cers, the gout, the erysipelas, and other diseases, to the sto­mach. It may likewise proceed from a looseness, or flux of blood being too suddenly stopped, or from the stoppage of any customary evacuation, as the bleeding piles, the menses, &c. Vomiting may proceed from the weakness of the sto­mach, the colic, the iliac passion, a rupture, a fit of the gra­vel, worms, or from any kind of poison taken into the sto­mach. It is an usual symptom of hurts of the brain; as contusions, compressions, &c. It is likewise a symptom of wounds, or inflammations of the diaphragm, intestines, spleen, liver, kidneys, &c.

VOMITING may be occasioned by unusual motions; as riding backwards in a cart or coach, sailing, &c. It may likewise be excited by violent passions, or by the idea of nauseous objects, especially of such things as have formerly produced vomiting. Sometimes it proceeds from a regur­gitation of the bile into the stomach; in this case, what the patient vomits is generally of a yellow or greenish colour, and has a bitter taste. Persons who are subject to nervous affections are often suddenly seized with violent fits of vo­miting. Lastly, Vomiting is a common symptom of preg­nancy. In this case, it generally comes on about two weeks after the stopping of the menses, and continues during the first three or four months.

WHEN vomiting proceeds from a soul stomach or indi­gestion, it is not to be considered as a disease, but as the cure of a disease. It ought, therefore, to be promoted by drinking lukewarm water, or thin gruel. If this does not put a stop to the vomiting, a dose of ipecacuanha may be taken, and wrought off with weak camomile tea.

WHEN the retrocession of gouty matter, or the obstruc­tion of customary evacuations occasion vomiting, all means must be used to restore these discharges; or, if that cannot be effected, their place must be supplied by others, as bleed­ing, purging, bathing the extremities in warm water, opening issues, setons, perpetual blisters, &c.

WHEN vomiting proceeds from pregnancy, it may ge­nerally be relieved by bleeding, and keeping, the belly gently open. The bleeding, however, ought to be in small quantities at a time, and the purgatives should be of the mildest kind, as figs, stewed prunes, manna or senna. Preg­nant women are most apt to vomit in the morning, imme­diately after getting out of bed, which is owing partly to [Page 245] the change of posture, but more to the emptiness of the sto­mach. It may generally be prevented by taking a dish of tea, or some light breakfast in bed. Pregnant women, who are afflicted with vomiting, ought to be kept easy both in body and mind. They should neither allow their stomachs to be quite empty, nor should they eat much at once. Cold water is a very good drink in this case; if the stomach be weak, a little brandy may be added to it. If the spirits be low, and the person apt to faint, a spoonful of cinnamon water, with a little marmalade of quinces or oranges, may be taken.

IF vomiting proceeds from weakness of the stomach, bit­ters will be of service, as the Gentian root, camomile and snakeroot, infused in brandy or wine. To these may be added as much rhubarb as will keep the belly gently open. The Jesuits bark is likewise an excellent medicine for bracing and strengthening the stomach. It may be drank in form of tea, or infused in wine or brandy, &c. The elixir of vitriol is also a good medicine in this case. It may be taken in the dose of fifteen or twenty drops, twice or thrice a-day, in a glass of wine or water.

A vomiting which proceeds from acidities in the stomach is relieved by alkaline purges. The best medicine of this kind is the magnesia alba, a tea spoonful of which may be taken in a dish of tea or a little milk, twice or thrice a-day, or oftener, if necessary, to keep the belly open.

WHEN vomiting proceeds from violent passions, or affec­tions of the mind, all kind of evacuations must be avoided, especially vomits. These are exceeding dangerous. The patient, in this case, ought to be perfectly easy and quiet, to have the mind soothed, and to take some gentle cordial, as negas, or a little brandy and water. A few drops of li­quid laudanum may likewise be taken, to calm the spirits, and take off the irritation upon the nerves.

WHEN vomiting proceeds from spasmodic affections of the stomach, musk, castor, and other antispasmodic medi­cines are of use. Aromatic plasters have likewise a good effect. The stomach plaster of the London or Edinburgh dispensatory may be applied to the pit of the stomach, or rather a little towards the left side, so as to cover a part of the false ribs. Aromatic medicines may likewise be taken inwardly, as cinnamon tea, mint tea, wine with spiceries boiled in it, &c. The region of the stomach may be rubbed with aether, or, if that cannot be had, with strong brandy, [Page 246] or other spirits. The belly should be fomented with warm water, or the patient immersed up to the breast in a warm bath.

I have always found the saline draughts most effectual in stopping a vomiting, from whatever cause it proceeded. These may be made by dissolving a dram of the salt of tar­tar in an ounce and a half of fresh lemon juice, adding to it an ounce of peppermint water, and half an ounce of spi­ritous cinnamon water. This draught may be sweetened with a little white sugar, and taken in the act of efferve­scence. It must be repeated every two hours, or every hour, if the vomiting be very violent. I do not remember to have seen this medicine, when duly persisted in, fail to stop a vomiting.

AS the least motion will often bring on the vomiting again, even after it has been stopped, the patient must avoid all manner of action. His diet must be so regulated as to [...]it easy upon the stomach, and he should take nothing that is hard of digestion. We do not, however, mean that the patient is to live upon slops. Solid food, in this case, of­ten [...]its easier on the stomach than liquids.

OF THE HEADACH.

THE headach is produced by various causes, and attend­ed with different symptoms, according to its different degrees, and the part where it is situated. When it is [...]light, and affects a particular part of the head, it is called cephalaea; when the whole head is affected, cephalaea; and when one side only, hemicrania. A fixed pain in the forehead, which may be covered with the end of the thumb, is called clavis hystericus.

THERE are also other distinctions. Sometimes the pain is internal; sometimes external; sometimes it is an origi­nal disease, and at other times only symptomatic. When the headach proceeds from a hot bilious habit, the pain is very acute and throbbing, with a considerable heat of the part affected. When from a cold phlegmatic habit, the patient complains of a dull heavy pain, and has a sense of coldness in the part. This kind of headach is sometimes attended with a degree of stupidity or folly.

WHATEVER obstructs the free circulation of the blood through the vessels of the head, may occasion a headach. In persons of a full habit, who abound with blood, or [Page 147] other humours, the headach often proceeds from the sup­pression of customary evacuations; as bleeding at the nose, sweating of the feet, &c. It may likewise proceed from any cause that determines a greater flux of blood towards the head; as coldness of the extremities, hanging of the head, &c. Whatever prevents the return of the blood from the head, will likewise occasion a headach; as look­ing long at any object obliquely, wearing any thing tight about the neck, &c.

WHEN a headach proceeds from the stoppage of a run­ning of the nose, there is a heavy, obtuse, pressing pain in the forepart of the head, in which there seems to be such a weight, that the patient can scarce hold it up. When it is occasioned by the caustic matter of the venereal disease, it generally affects the skull, and often produces a caries of the bones.

SOMETIMES the headach proceeds from the repulsion, or retrocession of the morbific matter of the gout, the ery­sipelas, the small-pox, measles, itch, or other eruptive diseases. A hemicrania generally proceeds from crudities or indigestion.

THERE is likewise a most violent, fixed, constant, and almost intolerable headach, which occasions great debility both of body and mind, prevents sleep, disturbs digestion, destroys the appetite, causes a vertigo, dimness of sight, a noise in the years, convulsions, epileptic fits, and some­times vomiting, costiveness, coldness of the extremities, &c.

THE headach is often symptomatic in continual and in­termitting fevers, especially quartans. It is likewise a very common symptom of hysteric and hypochondriac com­plaints.

AN external pain of the head is seldom dangerous. When it attends an acute fever, with pale urine, it is an unfa­vourable symptom. In excessive headachs, coldness of the extremities is a bad sign. When the disease continues long, and is very violent, it often terminates in blindness, an apoplexy, deafness, a vertigo, the palsy, epilepsy, &c.

THE cool regimen in general is to be observed in this disease. The diet ought to consist of such emollient sub­stances as will correct the acrimony of the humours, and keep the belly open; as apples boiled in milk, spinage, turnips, and such like. The drink ought to be diluting; as barley water, infusions of mild mucilaginous vegetables, [Page 248] decoctions of the sudorific woods ^*, &c. The feet and legs ought to be kept warm, and frequently bathed in luke­warm water; the head should be shaved, and bathed with water and vinegar. The patient ought, as much as possi­ble, to keep an erect posture, and not to lie with his head too low.

WHEN the headach is owing to excess of blood, and in hot bilious constitutions, bleeding is necessary. The pati­ent may be bled in the jugular vein, and the operation re­peated if there be occasion. Cupping also, or the applica­tion of leeches to the temples, and behind the ears, may be of service. Afterwards a blistering plaster may be ap­plied to the neck, or behind the ears, or to any part of the head that is most affected. In some cases it will be proper to blister the whole head. In persons of a gross habit, is­sues, or perpetual blisters, will be of service. The belly ought likewise to be kept open by gentle laxatives.

BUT when the headach proceeds from a copious vitiated serum stagnating in the membranes, either within or with­out the skull, with a dull, heavy, continual pain, which will neither yield to bleeding nor gentle laxatives, then more powerful purgatives are necessary, as pills made of aloes, resin of jalap, or the like. It will also be necessary in this case to blister the whole head, and to keep the back part of the neck open for a considerable time by a perpetual blister.

WHEN the headach is occasioned by a stoppage of the running of the nose, the patient should frequently smell to a bottle of vol [...] salts; he may likewise take snuff, or any thing that will irritate the nose, so as to promote a dis­charge from it; as the herb mastich, ground ivy, &c.

A hemicrania, especially a periodical one, is generally owing to a foulness in the stomach, for which gentle vo­mits will be beneficial, as also purges of rhubarb. After the bowels have been sufficiently cleared, chalybeate wa­ters, and such bitters as strengthen the stomach, will be ne­cessary.

[Page 249] WHEN the headach arises from a vitiated state of the humours, as in the scurvy and venereal disease, the pati­ent, after proper evacuations, must drink freely of the de­coction of woods, recommended above, or the decoction of sarsaparilla with raisins and liquorice ^*. These promote perspiration, sweeten the humours, and, if duly persisted in, will produce very happy effects. When a collection of matter is felt under the skin, it must be discharged by an incision, otherwise it will render the bone carious.

WHEN the headach is so intolerable as to endanger the patient's life, or is attended with continual watching▪ de­lirium, &c. recourse must be had to opiates. These, af­ter proper evacuation by clysters, or mild purgatives, may be applied both externally and internally. The affected part may be rubbed with Bate's anodyne balsam, or a cloth dipped in it may be applied to the part. The patient may, at the same time, take twenty drops of laudanum, in a cup of valerian or pennyroyal tea, twice or thrice a-day. This is only to be done in case of extreme pain. Proper evacuations ought always to accompany and follow the use of opiates.

WHEN the patient cannot bear the loss of blood, his feet ought frequently to be bathed in lukewarm water, and well rubbed with a coarse cloth. Cataplasms with mustard or horseradish ought likewise to be applied to them. This course is peculiarly necessary when the pain proceeds from a gouty humour affecting the head.

WHEN the headach is occasioned by great heat, hard labour, or violent exercise of any kind, it may be allayed by cooling medicines; as the saline draughts with nitre, &c.

OF THE TOOTHACH.

THIS disease is so well known, that it needs no descrip­tion. It has great affinity with the rheumatism, and often succeeds pains of the shoulders and other joints.

IT may proceed from various causes; as obstructed per­spiration, or catching cold; or from any of the common causes of inflammation. I have often known the toothach [Page 250] occasioned by neglecting some part of the usual coverings of the head, by sitting with the head bare near an open window, or its being any how exposed to a draught of cold air. Food or drink taken either too hot or too cold, is ve­ry hurtful to the teeth. Great quantities of sugar, or other sweet-meats, are likewise hurtful. Nothing is more destructive to the teeth than cracking nuts, or chewing any kind of hard substances. Picking the teeth with pins, needles, or with any thing that may hurt the enamel with which they are covered, does great mischief; as the tooth is sure to be spoilt whenever the air gets into it. Pregnant women are very subject to the toothach, especially during the first three or four months of pregnancy. The tooth­ach often proceeds from scorbutic humours affecting the gums. In this case, the teeth are sometimes wasted, and fall out without any considerable degree of pain. The proximate or immediate cause of the toothach is a rotten or carious tooth.

IN order to relieve the toothach, we must endeavour to draw off or divert the humours from the part affected. This may be done by mild purgatives, bleeding and bath­ing the feet frequently in warm water. The perspiration ought likewise to be promoted, by drinking freely of weak wine whey, or other diluting liquors, with small doses of nitre. Vomits too have often an exceeding good effect in the toothach. It is seldom safe to administer opiates, or any kind of heating medicines, or even to draw a tooth till proper evacuations have been premised, and these alone will often effect the cure.

NEXT to evacuations we recommend fomenting the part with warm water, or decoctions of emollient vegetables. Bags filled with boiled camomile flowers, flowers of elder, or the like, may be applied to the part affected, with as great a degree of warmth as the patient can bear, and re­newed as they grow cool. The patient may likewise re­ceive the steams of warm water into his mouth, through an inverted funnel, or by holding his head over the mouth of a porringer filled with warm water, &c.

GARGLES are likewise of use to make a discharge from the part. Rob of elder dissolved in small beer makes a ve­ry proper gargle, or an infusion of sage or mulberry leaves.

SUCH things as promote the discharge of saliva, or cause the patient to spit, are always proper. For this pur­pose, bitter, hot, or pungent vegetables may be chewed; [Page 251] as gentian, calamus aromaticus, or pellatory of Spain. Allen recommends the root of yellow water flower-de-luce in this case. This root may either be rubbed upon the tooth or chewed. Brookes says, he hardly ever knew it fail to ease the toothach.

MANY other herbs, roots, and seeds, &c. are recom­mended for curing the toothach; as the leaves or roots of millefoil or yarrow chewed, tobacco smoaked or chewed, or the ashes put into the hollow tooth, staves acre, or the seeds of mustard chewed, &c. These bitter, hot, and pungent things, by occasioning a great flow of saliva, fre­ [...] [...] ease in the toothach.

OPIATES often relieve the toothach. For this purpose a little cotton wet with laudanum may be held between the teeth; or a piece of sticking plaster, about the bigness of a sixpence, with a bit of opium in the middle of it, of a size not to prevent the sticking of the other, may be laid on the temporal artery, where the pulsation is most sensible. De la Motte affirms, that there are few cases wherein this will not give relief. If there be a hollow tooth, a small pill made of equal quantities of camphire and opium, put into the hollow, is often beneficial. When this cannot be had, the hollow tooth may be filled with gum mastich, wax, lead, or any substance that will stick in it, and keep the external air out.

FEW applications give more relief in the toothach than blistering plasters. These may be applied betwixt the shoulders, but they have the best effect when put behind the ears, and made so large as to cover a part of the lower jaw. Burning the nerve within the affected tooth with a hot iron, has frequently given ease; but this operation ought to be done with care. Applying a hot iron to the antetragus, or what is called the inner bar of the ear, is like­wise a noted cure for the toothach. Blistering, however, is more safe than either of these, and is not less efficaci­ous.

HOFFMAN says, When every thing else failed, that he had often great success from the following pills.

TAKE of aromatic pill one dram, storax pill half a dram, extract of saffron six grains. Make them into nine pills; of which six or eight are to be taken at bed time for a dose.

AFTER all, when a tooth is carious, it is often impossi­ble to remove the pain, without drawing the tooth; and, [Page 252] as a spoilt tooth never becomes sound again, it is prudent to draw it soon, left it should affect the rest. Tooth drawing, like bleeding, is very much practised by mecha­nics as well as persons of the medical profession. The operation however is not without danger, and ought al­ways to be done with care. A person unacquainted with the structure of the parts, will be in danger of breaking the jaw-bone, or of drawing a [...]ound tooth instead of a rotten one, &c.

WHEN a sound tooth has been drawn, if it be replaced immediately, it will grow in again. It is now a common practice to draw a rotten tooth, and put a sound one, taken from the mouth of some other person, in its place. It is likewise an easy matter to fix artificial teeth so neatly, as to answer most of the purposes of the natural; but these are matters which do not properly fall under our consideration.

WHEN the toothach returns periodically, and the pain chiefly affects the gums, it may be cured by the bark.

SOME pretend to have found great benefit in the tooth­ach, from the application of an artificial magnet to the af­fected tooth. We shall not attempt to account for its mode of operation; but, if it be found to answer, though only in particular cases, it certainly deserves a trial, as it is attended with no expence, and cannot do any harm.

PERSONS who have returns of the toothach at certain seasons, as spring and autu [...], might often prevent it by taking a dose of physic at these times.

KEEPING the teeth clean has no doubt a tendency to prevent the toothach. The best method of doing this is to wash them daily with salt and water, or with cold water alone. All brushing and scraping of the teeth is dangerous, and, unless it be performed with great care, must do mis­chief.

OF THE EARACH.

THIS disorder chiefly affects the membrane which lines the inner cavity of the ear, called the meatus auditorius. It is often so violent as to occasion great restlessness and anxiety, and even delirium. Sometimes epileptic fits, and other convulsive disorders, have been brought on by ex­treme pain in the ear.

[Page 253] THE earach may proceed from any of the causes which produce inflammation. It often proceeds from a sudden suppression of perspiration, or from the head being exposed to cold when covered with sweat. It may also be occasion­ed by worms, or other insects getting into the ear, or be­ing bred there; or from any hard body sticking in the ear. Sometimes it proceeds from the translation of morbific mat­ter to the ear. This often happens in the decline of malig­nant fevers, and occasions deafness, which is generally reckoned a favourable symptom.

WHEN the earach proceeds from insects, or any hard body sticking in the ear, every method must be taken to remove them as soon as possible. The membranes may be relaxed by dropping into the ear oil of almonds, or olive oil. Afterwards the patient should be made to sneeze, by taking snuff, or some strong sternutatory. If this should not force out the body, it must be extracted by art. I have seen insects which have got into the ear, come out of their own accord upon pouring in oil upon them, which is a thing they cannot bear.

WHEN the pain of the ear proceeds from inflammation, it must be treated like other topical inflammations, by a cool­ing regimen and opening medicines. Bleeding at the be­ginning, either in the arm or jugular vein, or cupping in the neck, will be proper. The ear may likewise be fo­mented with steams of warm water, or flannel-bags filled with boiled mallows and camomile flowers may be applied to it warm; or bladders filled with warm milk and water. An exceeding good method of fomenting the ear is to apply it close to the mouth of a jug filled with a strong decoction of camomile flowers.

THE patient's feet should be frequently bathed in luke­warm water, and he ought to take small doses of nitre and rhubarb, viz. a scruple of the former, and ten grains of the latter three times a-day. His drink may be whey, or decoctions of barley and liquorice, with figs or raisins, &c. The parts behind the ear ought frequently to be rubbed with camphorated oil, or the volatile liniment; and a few drops of the camphorated spirit of wine may be put into the ear with wool or cotton.

WHEN the inflammation cannot be resolved, a poultice of bread and milk, or roasted onions, may be applied to the ear, and frequently renewed, till it breaks, or the abscess can be opened. Afterwards the humours may be diverted [Page 254] from the part by gentle laxatives, blisters, or issues; but the discharge must not be suddenly dried up by any exter­nal application. I have often known the sudden drying of a running of the ear produce fatal consequences.

OF THE HEART-BURN.

WHAT is called the heart-burn, is not a disease of that organ, but an uneasy sensation of heat or acrimony about the pit of the stomach, which is sometimes attended with anxiety, nausea, and vomiting.

IT may proceed from indigestion, from the acidity of the fluids, or contents of the stomach, or from bilious humours. Stale liquors, vinegar, greasy aliment, wind, &c. will cause the heart-burn. In some constitutions it is occasioned by the use of acids, and in others by aromatics. Pregnant wo­men are very subject to it.

WHEN the heart-burn proceeds from indigestion, or a [...]oul stomach, the patient ought to take a vomit, and after­wards a purge. After the stomach has been cleansed, he may drink twice or thrice a-day a cup of camomile tea, with fifteen or twenty drops of elixir of vitriol in it, in order to strengthen the stomach and promote digestion.

WHEN acidity or sourness of the stomach occasions the heart-burn, absorbents are the proper medicines. In this case, chalk and water, or what is called the chalk julep, often answers very well. It is made by mixing an ounce of powdered chalk, half an ounce of fine sugar, and a quarter of an ounce of gum Arabic, in two English pints of water. A tea cupful of this may be taken at pleasure. When the gum Arabic cannot be had, the chalk may be mixed with milk, or taken in water alone. The testacious powders are very proper here. A tea spoonful of prepared oyster shells, or the powder called crab's eyes, may be taken in a glass of peppermint water, or simple cinnamon water, as often as there is occasion.

BUT the safest absorbent which we know, is the magnesia alba. This not only acts as an absorbent, but by its purg­ing quality cleanses the bowels; whereas the chalk, and other absorbents of that sort, are apt to lie in the intestines, and occasion obstructions. This powder is no way dis­agreeable, and may be taken in a cup of tea, a little milk, or a glass of peppermint water. A large tea spoonful is the usual dose, but there is no danger in taking a much greater [Page 255] quantity, and it may be repeated as often as is found neces­sary.

WHEN the heart-burn proceeds from bilious humours, a tea spoonful of the sweet spirits of nitre in a glass of wa­ter, or a cup of tea or coffee, will generally give ease. If it be caused by fat or greasy aliments, a dram of brandy or rum may be taken.

IF wind be the cause of this complaint, the medicines called carminatives are proper; as aniseeds, juniper berries, cardamum seeds, &c. These may either be chewed, or a glass of their distilled waters taken at pleasure. These, and other warm aromatics, as ginger, canella alba, &c. give ease, but they ought never to be used unless when necessary. They are only drams in a dry form, and very pernicious to the stomach. One of the safest medicines of this kind is the tincture made by infusing an ounce of rhubarb, and a quarter of an ounce of the lesser cardamums, in an English pint of brandy. This must digest for two days; afterwards it should be strained, and four ounces of white sugar-candy in powder added to it. It must stand to digest again till the sugar be dissolved. A table spoonful may be taken for a dose.

I have frequently known the heart-burn cured by the patient chewing green tea.

PAIN OF THE STOMACH.

THIS may proceed from various causes; as indigestion, wind, the acrimony of the bile, or from sharp, acrid, or poisonous substances taken into the stomach. It may like­wise proceed from worms; the stoppage of customary eva­cuations, or from a translation of gouty matter to the sto­mach, &c.

WOMEN, in the decline of life, are very liable to this dis­ease, especially such as are afflicted with hysteric complaints. It is likewise very common to hypochondriac men of a se­dentary and luxurious life. In such persons it often proves so extremely obstinate, as to baffle all attempts of medicine.

WHEN the pain of the stomach is most violent after eat­ing, there is reason to suspect that it proceeds from some fault either in the digestion or the food. In this case, the patient ought to change his diet, till he finds what kind of food agrees best with his stomach, and should continue chiefly to use that. If a change of diet does not remove [Page 256] the complaint, the patient may take a gentle vomit, and afterwards a dose or two of rhubarb. He ought likewise to take an infusion of camomile flowers, or some other sto­machic bitter, either in wine or water. I have often known exercise remove this complaint, especially sailing, or a long journey on horseback, or in a machine.

WHEN a pain of the stomach proceeds from flatulencies, the patient is constantly belching up wind, and feels an un­easy distension of the stomach after meals. This is a most deplorable disease, and is seldom cured. In general, the pa­tient ought to avoid all windy diet, and every thing that sours on the stomach, as greens, roots, &c. This rule, how­ever, admits of some exceptions. I have known several in­stances of persons very much troubled with wind, who re­ceived great benefit from eating parched peas ^*, though that grain is well known to be of a windy nature. This com­plaint may likewise be greatly relieved by exercise, especi­ally digging, walking, or riding, &c. I have found the elixir of vitriol answer very well in flatulencies. It may be taken as directed in page 254.

WHEN a pain of the stomach is occasioned by the swal­lowing of acrid or poisonous substances, they must be dis­charged by vomit; this may be excited by butter, oils, or other soft things, which sheath and defend the stomach from the acrimony of its contents.

WHEN a pain of the stomach proceeds from a translation of gouty matter, warm cordials are necessary. Some have drank a whole bottle of brandy or rum, in this case, in a few hours, without being in the least intoxicated, or even feeling the stomach warmed by it. Generous wines, how­ever, are more safe, as genuine Madeira, &c. It is impos­sible to ascertain the quantities necessary upon these occa­sions. This must be left to the feelings and discretion of the patient. It is, however, the safest way not to go too far. When there is an inclination to vomit, it may be pro­moted by drinking an infusion of camomile flowers or car­duus benedictus.

IF a pain of the stomach proceeds from the stoppage of customary evacuations, bleeding will, in some cases, be ne­cessary, especially in sanguine and very full habits. It will [Page 257] likewise be of use to keep the belly gently open by mild purgatives; as rhubarb or senna, &c. When this disease affects women in the decline of life, after the stoppage of the menses, making an issue in the leg or arm will be of peculiar service.

WHEN the disease is occasioned by worms, they must be destroyed, or expelled by such means as are recom­mended in the following section.

OF WORMS.

THESE are chiefly of three kinds, viz. the taenia, or tape worm; the teres, or round and long worm, and the ascarides, or round and short worm. There are many other kinds of worms found in the human body; but as they proceed, in a great measure, from similar causes, have nearly the same symptoms, and require almost the same method of cure, we shall not spend time in enumera­ting them.

THE tape worm is white, very long, and all over joint­ed. It is generally bred either in the stomach or small in­testines. The round and long worm is likewise bred in the small guts, and sometimes in the stomach. The round and short worms commonly lodge in the rectum, or what is called the end gut, and occasion a disagreeable itching about the anus.

THE long round worms occasion squeamishness, vo­miting, an ill breath, gripes, looseness, swelling of the belly, swoonings, loathing of food, and, at other times, a voracious appetite, a dry cough, convulsions, epileptic fits, and sometimes a privation of speech. These worms have been known to perforate the intestines, and get into the cavity of the belly. The effects of the tape worm are nearly the same with those of the long and round, but ra­ther more violent.

ANDRY says, the following symptoms particularly at­tend the folium, which is a species of the tape worm, viz. swoonings, privation of speech, and a voracious appetite. The round worms called ascarides, besides an itching of the anus, cause swoonings, and tenesmus, or an inclination to go to stool.

CAUSES.—Worms may proceed from various causes; but they are seldom found but in weak and relaxed stomachs, where the digestion is bad. Sedentary persons [Page 258] are more liable to them than the active and laborious. Those who eat great quantities of unripe fruit, or who live much on raw herbs and roots, are generally subject to worms. Worms are often a symptom of fevers, and other acute diseases. There seems to be a hereditary disposition in some persons to this disease. I have often seen all the children of a fa­mily subject to worms of a particular kind. They seem likewise frequently to be owing to the nurse. Children of the same family, nursed by one woman, have often worms, when those nursed by another have none.

CHILDREN are more liable to this disease than adults, especially after two years of age. Infants while on the breast, are seldom troubled with worms. To this, how­ever, there are several exceptions. I lately saw an instance of a child who passed worms before it was three months old. They were indeed of a very particular kind, being real caterpillars. Some of them were above an inch long; they had red heads, and were so brisk as to jump about; they lived several days after the child had passed them. Another child suckled by the same woman, passed the same kind of worms when upon the breast, and both children suffered extremely before the worms came away.

SYMPTOMS.—The common symptoms of worms are, paleness of the countenance, and, at other times, an universal flushing of the face; itching of the nose, this however is doubtful, as children pick their noses in all diseases; starting, and grinding of the teeth in sleep; the appetite sometimes bad, at other times quite voracious; looseness, a sour or stinking breath, a hard swelled belly, great thirst, the urine frothy, and sometimes of a whitish colour, griping, or colic pains, an involuntary discharge of saliva, especially when asleep; frequent pains of the side, with a dry cough, and unequal pulse; palpitations of the heart, swoonings, drowsiness, cold sweats, palsy, epileptic fits, with many other unaccountable nervous symptoms, which were formerly attributed to witchcraft, or the influence of evil spirits. Small bodies in the excre­ments, resembling melon or cucumber seeds, are symptoms of the tape worm.

THOUGH this is a very common disease, yet it is less so than is generally imagined. Nurses impute most of the diseases of children to worms, and often give medicine to kill these vermin where they do not exist. Even physici­ans are often deceived with respect to worms. I have fre­quently [Page 259] opened children who were thought to have been killed by them, and found none. In short there is no certain proof of worms existing in the intestines, but their being passed; and that will sometimes happen where no previous symptoms appeared.

MEDICINE.—Though numberless medi­cines are extolled for killing and expelling worms ^*, yet no disease▪ more frequently baffles the physician's skill. In general, the most proper medicines for their expulsion are▪ strong purgatives; and to prevent their breeding, stoma-chic bitters, with now and then a glass of good wine.

THE best purge for an adult is jalap and calomel. Five and twenty or thirty grains of the former, with six or seven of the latter, mixed in syrup, may be taken for a dose. This should be taken early in the morning. It will be proper that the patient keep the house all day, and drink nothing cold. The dose may be repeated once or twice a-week, for a fortnight or three weeks. On the inter­mediate days the patient may take a dram of the powder of [...], twice or thrice a day, mixed with syrup, honey, or treacle.

THOSE who do not choose to take calomel, may make use of the bitter purgatives; as aloes, hiera picra, tincture of [...]enna and rhubarb, &c.

OILY medicines are likewise of use for expelling worms. An ounce of salad oil and a table spoonful of common salt, may be taken in a glass of red port wine thrice a-day, or oftener if the stomach will bear it. But the more com­mon form of using oil is in clysters. Oily clysters sweeten­ed with sugar or honey, are very efficacious in bringing away the short round worms called ascarides.

THE Harrowgate water is an excellent medicine for ex­pelling worms, especially the ascarides. As this water evi­dently abounds with sulphur, we may hence infer, that sulphur alone must be a good medicine in this case; this is found to be true in fact. Many practitioners give flour of sulphur in very large doses, and with great success. It may be made into an electuary with honey or treacle, and taken in such quantity as to purge the patient.

[Page 260] WHERE Harrowgate water cannot be obtained, sea water may be used, which is far from being a contempti­ble medicine in this case. If sea water cannot be had, common salt may be dissolved in water and drank. I have often seen this used by country nurses, when they suspect­ed their children were troubled with worms, with very good effect.

BUT worms, though expelled, will soon breed again, if the stomach remains weak and relaxed; to prevent this, we would recommend the Jesuits bark. Half a dram of bark in powder may be taken in a glass of red Port wine, three or four times a-day, after the above medicines have been used. Lime water is likewise good for this purpose, or a table spoonful of the chalybeate wine ^*, taken twice or thrice a-day. Infusions or decoctions of bitter herbs may likewise be drank; as the infusion of tansy, water trefoil, camomile flowers, tops of wormwood, the lesser centaury, &c.

THE above directions are calculated for adults; but for children the medicines must be more agreeable, and given in smaller doses.

FOR a child of four or five years old, ten grains of rhu­barb, five of jalap, and two of calomel, may be mixed in a spoonful of syrup or honey, and given in the morning. The child should keep the house all day, and have nothing cold. This dose may be repeated twice a-week for three or four weeks. On the intermediate days the child may take a scruple of powder of tin, and ten grains of aethiops mine­ral, in a spoonful of treacle twice a-day. These doses must be increased or diminished according to the age of the pa­tient.

I have frequently known those big bellies, which in children are commonly reckoned a sign of worms, quite removed by giving them white soap in their pottage, or other food. Tansy, garlic, and rue, are all good against worms, and may be used various ways. We might here mention many plants, both for external and internal use, but think the powder of tin, with aethiops mineral, and the purges of rhubarb and calomel, are much more to be de­pended on. It will not, however, be amiss to give a child [Page 261] who is troubled with worms a glass of red wine now and then, as every thing that braces and strengthens the stomach is good both for preventing and expelling these vermine.

PARENTS who would preserve their children from worms, ought to allow them plenty of exercise in the open air, to see that their food be wholesome and sufficiently solid, and, as far as possible, to prevent their eating raw herbs, roots, or green trashy fruits ^*.

OF THE JAUNDICE.

THIS disease is first observable in the white of the eye, which appears of a yellowish colour. Afterwards, the whole skin puts on a yellow, and sometimes a blackish appearance. The urine too is of a saffron hue, and dyes a white cloth, if put into it, of the same colour.

CAUSES.—The immediate cause of the jaundice is an obstruction of the bile. The remote or occasional causes are, the bites of poisonous animals, as the viper, mad dog, &c. the bilious or hysteric colic, violent passions, as grief, anger, &c. Strong purges or vomits will likewise oc­casion the jaundice. Sometimes it proceeds from obstinate agues, or from that disease being prematurely stopped by astringent medicines. In infants it is often occasioned by the meconium not being sufficiently purged off. Pregnant women are very subject to it. It is likewise a symptom in several kinds of fevers. Catching cold, or the stopping of customary evacuations, as the menses, the bleeding piles, issues, &c. will occasion the jaundice.

SYMPTOMS.—The patient at first complains [...] excessive weariness, and has great aversion to any kind of motion. His skin is dry, and he generally feels a kind of itching or pricking pain over the whole body. The stools are of a whitish or clay colour, and the urine, as was ob­served [Page 262] served above, is yellow. The breathing is difficult, and the patient complains of an unusual load or oppression on his breast. There is a heat in the nostrils, a bitter taste in the mouth, loathing of food, sickness at the stomach, vomiting, flatulency, and frequently all objects appear to the eye of a yellow colour.

IF the patient be young, and the disease complicated with no other malady, it is seldom dangerous; but in old people, where it continues long, returns frequently, or is complicated with the dropsy or hypochondriac symptoms, it generally proves fatal. The black jaundice is more dan­gerous than the yellow.

REGIMEN.—The diet should be cool, light, and diluting, consisting chiefly of ripe fruits and mild ve­getables; as apples boiled or roasted, stewed prunes, pre­served plumbs, boiled spinage, &c. Veal or chicken broth, with light bread, are likewise very proper. The drink should be butter milk, whey, sweetened with honey, or decoctions of cool opening vegetables; as marshmal­low roots, with liquorice, &c.

THE patient should take as much exercise as he can bear, either on horseback or in a machine; walking, run­ning, and even jumping, are likewise proper, provided he can bear them without pain, and there be no symptoms of inflammation. Patients have been often cured of this disease by a long journey, after medicines had proved inef­fectual.

AMUSEMENTS are likewise of great use in the jaundice. The disease is often occasioned by a sedentary life, joined to a dull melancholy disposition. Whatever therefore tends to promote muscular motion, and to cheer the spirits, must have a good effect; as dancing, laughing, singing, &c.

MEDICINE.—If the patient be young, of a full sanguine habit, and complains of pain in the right side about the region of the liver, bleeding will be necessa­ry. After this a vomit must be administered; and if the disease proves obstinate, it may be repeated once or twice. No medicines are more beneficial in the jaundice than vo­mits, especially where it is not attended with inflammati­on. Half a dram of i [...]ecacuanha in powder will be a suf­ficient dose for an adult. It may be wrought off with weak camomile tea, or lukewarm water.

THE belly must likewise be kept open by mild purga­tives. Castile soap, if taken in sufficient quantities, an­swers [Page 263] this purpose extremely well. It may be taken from half an ounce to an ounce daily, for a considerable time. As few people have resolution to swallow such large quan­tities of soap, I generally give pills made of soap, aloes, and rhubarb, which answer the same intention in a smaller dose. They may be prepared in the following man­ner:

TAKE socotrine aloes and Turkey rhubarb in powder, of each a dram, Castile soap an ounce. Beat them all to­gether, with a little syrup, into a proper consistence for pills. Let them be formed into pills of an ordinary size, and five or six of them taken three times a-day. They must be continued for some time, and the quantity regulated by the patient's stools, of which he ought at least to have one or two every day.

FOMENTING the parts about the region of the stomach and liver, and rubbing them with a warm hand or flesh-brush, are likewise beneficial; but it is still more so for the patient to [...]it in a vessel of warm water up to the breast. He ought to do this frequently, and should continue in it as long as his strength will permit.

MANY dirty things are recommended for the cure of the jaundice; as lice, the mill [...]pedes, &c. But these do more harm than good, as people trust to them, and ne­glect more valuable medicines; besides, they are seldom taken in sufficient quantity to produce any effects. Peo­ple always expect that these out of the way things should act as charms, and consequently seldom persist in the use of them. Vomits, purges, fomentations, and exercise, will seldom fail to cure the jaundice when it is a simple disease; and when complicated with the dropsy, or other chronic complaints, it is hardly to be cured by any means.

NUMBERLESS British herbs are extolled for the cure of this disease. Dr. Short, in his Medicina Britannica, men­tions near a hundred, all famous for curing the jaundice. The fact is, this disease often goes off of its own accord; in which case the last medicine is always said to have per­formed the cure. I have however seen considerable benefit in a very obstinate jaundice, from a decoction of hemp seed. Four ounces of the [...]eed may be boiled in two En­glish qua [...]ts of ale, and sweetened with coarse sugar. The dose is half an English pint every morning. It may be continued for eight or nine days.

[Page 264] I have known Harrowgate water cure a very obstinate jaundice. I have known patients, after taking many me­dicines without effect, go thither in the middle of winter, and in few weeks return quite well. They both drank the sulphur water, and bathed.

OF THE DROPSY.

THE dropsy is a preternatural swelling of the whole bo­dy, or some part of it, occasioned by a collection of watery humour. It is distinguished by different names, according to the part affected, as the anasarca, or a collection of wa­ter under the skin; the ascites, or a collection of water in the belly; the hydrops pectoris, or dropsy of the breast; the hydrocephalus, or dropsy of the brain, &c. There is likewise a species of dropsy called tympany, which is occa­sioned by ra [...]ified air pent up in the cavities or cells of the body.

CAUSES.—A very common cause of the drop­sy is a hereditary disposition. It may likewise proceed from drinking ardent spirits, or other strong liquors. It is true, almost to a proverb, that great drinkers die of a drop­sy. The want of exercise is also a very common cause of the dropsy. Hence it is justly reckoned among the diseases of the sedentary. It often proceeds from excessive evacua­tions, as frequent and copious bleedings, strong purges of­ten repeated, frequent salivations, &c. The sudden stop­page of customary or necessary evacuations, as the menses, the haemorrhoids, or fluxes of the belly, may likewise cause a dropsy.

I have often known the dropsy occasioned by drinking large quantities of cold, weak, watery liquor after violent exercise, while the body was hot. A low, damp, or marshy situation is likewise a frequent cause of it. Hence it is a common disease in moist, [...]lat, fenny countries. It may also be brought on by a long course of poor watery diet, or the use of viscous aliment, that is hard of digestion. It is often the effect of other diseases, as the jaundice, a schirrhous of the liver, a violent ague, of long continuance, a diarr­hoea, a dysentery, an empyema, or a consumption of the lungs. In short, whatever obstructs the circulation of the blood, or prevents its being duly prepared, may occasion a dropsy.

[Page 265] SYMPTOMS.—This disease generally begins with a swelling of the feet and ancles towards night, which for some time disappears in the morning. In the evening the parts, if pressed with the finger, will pit. The swell­ing gradually ascends towards the belly, which at length grows big. When it is struck with the hand, a fluctuation may be felt, and sometimes heard. Afterwards the breath­ing becomes difficult, the urine is in small quantity, and the thirst great, the belly is bound, and the perspiration is greatly obstructed. To these succeed torpor, heaviness, a slow wasting fever, and a troublesome cough. This last is generally a fatal symptom, as it shews the lungs to be affected. In a tympany, the belly when struck sounds like a drum.

WHEN the disease comes suddenly on, and the patient is young and strong, there is reason to hope for a cure, espe­cially if medicine be given early. But if the patient be old, has led an irregular or a sedentary life, or if there be reason to suspect that the liver, lungs, or any of the viscera are un­found, there is great ground to fear that the consequences will prove fatal.

REGIMEN.—The patient must abstain, as much as possible, from all drink, especially weak and wa­tery liquors, and must quench his thirst with acids, as juice of lemons, oranges, sorrel, &c. His aliment ought to be dry, of a heating and diuretic quality, as toasted bread, the flesh of birds, or other wild animals, roasted; pungent and aromatic vegetables, as garlic, mustard, onions, cresses, horseradish, rocambole, shalot, &c. They may also eat sea biscuit, dipt in wine or brandy. This is not only nou­rishing, but tends to quench thirst. Some have been actu­ally cured of a dropsy by a total abstinence from all liquids, and living entirely upon such things as are mentioned above. If the patient must have drink, the Spaw water, or Rhenish wine, with diuretic medicines infused in it, are the best.

EXERCISE is of the greatest importance in a dropsy. If the patient be able to walk, run, dance, or jump about, he ought to continue these exercises as long as he can. If he be not able to walk, &c. he must ride on horseback, or in a machine, and the more violent the motion so much the better, provided he can bear it. His bed ought to be hard, and the air of his apartments warm and dry. If he lives in a damp country, he ought to be removed into a dry one, [Page 266] and, if possible, into a warmer climate. In a word, every method must be taken to promote the perspiration and to brace the solids. For this purpose, it will likewise be proper to rub the patient's body two or three times a-day, with a hard cloth or the flesh brush, and he ought constantly to wear flan­nel next his skin.

MEDICINE.—If the patient be young, his constitution good, and the disease has come on suddenly, it may generally be removed by strong vomits, brisk purges, and such medicines as promote a discharge of sweat and urine. For an adult, half a dram of ipecacuanha in pow­der, and half an ounce of oxymel of squills, will be a pro­per vomit. This may be repeated three or four times, if necessary, three or four days intervening betwixt each dose. The patient must not drink much after the vomit, other­wise he destroys its effect. A cup or two of camomile tea will be sufficient to work it off.

BETWIXT each vomit, on one of the intermediate days, the patient may take the following purge. Take jalap in powder half a dram, cream of tartar two drams, calomel six grains. These may be made into a bolus with a little syrup of pale roses, and taken early in the morning. The less the patient drinks after it the better. If he be much griped, he may take now and then a cup of chicken broth.

THE patient may likewise take every night at bedtime the following bolus: Take four or five grains of camphire, one grain of opium, and as much syrup of orange peel as is sufficient to make them into a bolus. This will generally promote a gentle sweat, which should be encouraged by drinking now and then a small cup of wine whey, with a tea spoonful of the spirits of hartshorn in it.

THE patient may take, three of four times a-day, a tea cupful of the following infusion: Take juniper berries, mustard seed, and horse radish, of each half an ounce, ashes of broom half a pound; infuse them in a quart of Rhenish wine or strong ale for a few days, and afterwards strain of the liquor. Such as cannot take this infusion, may use the de­coction of Seneca root, which is both diuretic and sudorific. It may be prepared and taken as directed in page 119.

AS this disease is very apt to return; after the water has been drained off, to prevent its collecting again, the patient must continue to take exercise, to use a dry diet, and such medicines as strengthen and brace the solids, as wine with steel or bark infused in it; warm and aromatic bitters are [Page 267] likewise proper, as the Virginian snakeroot, canella alba, orange peel, &c. infused in wine or brandy: The patient must avoid all great evacuations, and ought, if he can, to make choice of a dry warm situation.

THE above course will often cure an incidental dropsy, if the constitution be good; but when the disease proceeds from a bad habit, or an unfound state of the viscera, strong purges and vomits are not to be ventured upon. In this case, the safer course is to palliate the symptoms by the use of such medicines as promote the secretions, and to support the patient's strength by warm and nourishing cor­dials.

THE discharge of urine may be greatly promoted by ni­tre. Brookes says, he knew a young woman who was cured of a dropsy by taking a dram of nitre every morning in a draught of ale, after she had been given over as incu­rable. The powder of squills is likewise a good diuretic. Six or eight grains of it, with a scruple of nitre, may be given twice a-day in a glass of strong cinnamon water. Ball says, a large spoonful of unbruised mustard seed taken every night and morning, and drinking half an English pint of the decoction of the tops of green broom after it, has produced a cure, after other powerful methods had proved ineffectual.

TO promote perspiration, the patient may use the de­coction of Seneca root, as directed above; or he may take two spoonfuls of ^* Mindererus's spirit, in a cup of wine whey, three of four times a-day. The saline draughts re­commended in page 105, are likewise very proper in this case. These medicines, with the regimen mentioned above, if they do not cure, will, at least, alleviate the disease, which, in worn out constitutions, is a safer course than at­tempting to extirpate it. When other means fail, re­course must be had to tapping, which is a safe and easy ope­ration, though it seldom produces a radical cure.

OF THE GOUT.

THERE is no disease which shews the imperfection of the medical art more than the gout. Nor does any malady [Page 268] shew the advantages of temperance and exercise in a stronger light. Few who pay a proper regard to these are troubled with the gout, unless when it is hereditary. This points out the true source from whence that pest originally sprung, viz. excess and idleness. Few persons are affected with the gout till the decline of life, except those who inherit it from their parents. Men are more liable to it than wo­men, especially those of a full, gross habit.

CAUSES.—One very common cause of the gout is a hereditary disposition. Persons who know themselves to be tainted this way, ought therefore to guard against its attack, by steadily pursuing a course directly opposite to that which occasions the disease. Full living, but especi­ally indulging in rich, pungent, or stimulating sauces and generous wines, has a great tendency to bring on the gout. Intense thought, or application of the mind to abstruse sub­jects, particularly night studies, has likewise this effect. The plentiful use of acids, as sour punch, prickt wines, &c. are also hurtful; but nothing more certainly induces this disease than excess of venery, especially in the early period of life.

SOMETIMES the gout has been known to prove infecti­ous; but this is rarely the case. It may proceed from an obstruction or defect of any of the usual discharges, as the perspiration, sweating of the feet, the menses, &c. A sudden chilling of the fe [...]t after sweat, or drying them at the fire after being wet and cold, are likewise bad. The modern custom of eating a hot flesh supper, drinking warm strong liquors after it, and sitting up the greater part of the night, is one very great cause of the gout, and indeed of many other diseases.

SYMPTOMS.—A fit of the gout is generally preceded by indigestion, drowsiness, wind, a slight head-ach, sickness, and sometimes vomiting. The patient com­plains of weariness and dejection of spirits, and has often a pain in the limbs, with a sensation as if wind or cold water were passing down the thigh. The appetite is often re­markably keen a day or two before the fit, and there is a slight pain in passing urine, and sometimes an involuntary shedding of tears. Sometimes these symptoms are much more violent, especially upon the near approach of the fit; and some observe, that as the fever which ushers in the gout is, so will the fit be; if the fever be short and sharp, the fit will be so likewise; if it be feeble, long, and lingering, [Page 269] the fit will be such also. But this observation can only hold with respect to very regular fits of the gout.

THE regular gout generally makes its attack in the spring, or beginning of winter, in the following manner: About two or three in the morning, the patient is seized with a pain in his great toe, sometimes in the heel, and at other times in the ancle or calf of the leg. This pain is accom­panied with a sensation, as if cold water were poured upon the part, which is succeeded by a shivering, with some de­grees of fever. Afterwards the pain increases, and fixing among the small bones of the foot, the patient feels all the different kinds of torture, as if the part were stretched, burnt, squeezed, gnawed, or torn in pieces, &c. The part at length becomes so exquisitely sensible, that the pa­tient cannot bear to have it touched, nor even suffer any person to walk across the room.

THE patient is generally in exquisite torture for twenty-four hours, from the time of the coming on of the fit: He then becomes easier, the part begins to swell, appears red, and is covered with a little moisture. Towards morning he drops asleep, and generally falls into a gentle breathing sweat. This terminates the first paroxysm, a number of which constitutes a fit of the gout; which is longer or shorter according to the patient's age, strength, the season of the year, and the disposition of the body to this dis­ease.

THE patient is always worse towards night, and easier in the morning. The paroxysms however generally grow milder every day, till at length the matter is discharged by perspiration, urine, and the other evacuations. In some patients this happens in a few days; in others it requires weeks, and in some months, to finish the fit. Those whom age and frequent fits of the gout have greatly debili­tated, seldom get free of it before the approach of summer, and sometimes not till it be pretty far advanced.

REGIMEN.—As there are no medicines, yet known, that will cure the gout, we shall confine our ob­servations mostly to regimen, both in and out of the fit.

IN THE FIT, if the patient be young and strong, his diet ought to be thin and cooling, and his drink of a diluting nature; but where the constitution is weak, and the pati­ent has been accustomed to live high, this is not a proper time to retrench. In this case, he must keep nearly to his usual diet, and should take frequently a cup of strong negas, [Page 270] or a glass of generous wine. Wine whey is a very proper drink in this case, as it promotes the perspiration without heating the patient. It will answer this purpose better, i [...] a tea spoonful of sal volatile oleosum, or spirits of hart [...]horn, be put into a cup of it twice or thrice a-day. It will likewise be proper for the patient to take at bed time a tea spoonful of the volatile tincture of guaiacum in a large draught of warm wine whey. This will greatly promote perspiration through the night.

AS we know no safe way of discharging the gouty matter but by perspiration, this ought to be kept up by all means, especially in the part affected. For this purpose, the leg and foot affected should be wrapt in soft flannel, for or wool. The last is most readily obtained, and seems to an­swer the purpose as well, if not better, than any thing else. The people of Lancashire look upon wool as a kind of spe­cific in the gout. They wrap a great quantity of it [...]b­ed about the leg and foot affected, and cover it [...] of shamoy leather. This they suffer to continue [...] eight or ten days, and sometimes for a fortnight or three weeks, or longer if the pain does not cease. I never knew any external application answer so well in the gout. I have of­ten seen it applied when the swelling and inflammation were very great, with violent pain; and have found all these symptoms relieved by it in a few days. The wool which they use is generally greased, and carded or combed. They choose the softest which can be had, and seldom or never remove it till the fit be entirely gone off.

THE patient ought likewise to be kept quiet and easy during the fit. Every thing that affects the mind [...] the paroxysm, and tends to throw the gout upon the [...] parts. For the same reason, all external applications that repel the matter are to be avoided as death. They do not cure the disease, but remove it from a safe to a more dangerous part of the body, where it often proves fatal. A fit of the gout is rather to be considered as Nature's me­thod of curing a disease than a disease itself, and all that we can do, with safety, is to promote her intentions, and to assist her in expelling the enemy in her own way. Evacu­ations by bleeding, stool, &c. are likewise hurtful. They do not remove the cause of the disease, and by weakening the patient, they generally prolong the fit.

MANY things will indeed shorten a fit of the gout, and some will drive it off altogether; but nothing has yet been [Page 271] found which will do this with safety to the patient. In pain we eagerly grasp at any thing that promises immediate ease, and even hazard life itself for a momentary relief. This is the true reason why so many infallible remedies have been proposed for the gout, and why such numbers have lost their lives by them. It would be as prudent to stop the small-pox from rising, and to drive them into the blood, as to attempt to repel the gout. The latter is as much an effort of Nature to free herself from an offending cause as the former, and ought equally to be promoted. In fine, there is no disease which Nature makes a greater effort to cure than the gout; nor is it difficult to see which way her endeavours tend. She always attempts to throw the disease upon the extremities, and when that is accom­plished, her work is half done. It may safely lodge there till it be gradually expelled by the vital powers, and it can­not lodge safely any where else, nor be expelled in any other way.

AFTER the fit is over, the patient ought to take a dose or two of the bitter tincture of rhubarb, or some other warm stomachic purge. He should also drink a weak in­fusion of stomachic bitters, in small wine or ale; as genti­an, with cinnamon, or Virginian snakeroot, and orange peel. The diet at this time should be light, but nourish­ing, and gentle exercise should be taken on horseback, or in a machine, &c.

OUT OF THE FIT, it is in the patient's power to do ma­ny things towards preventing a return of the disorder, or rendering the fit, if it should return, less severe. This, however, is not to be attempted by medicine. I have fre­quently known the gout kept off for several years, by the Jesuits bark, and other medicines; but in all the cases where I had occasion to see this tried, the persons died suddenly, and, to all appearance, for want of a regular fit of the gout. One would be apt, from hence, to con­clude, that a fit of the gout, to some constitutions, in the decline of life, is rather salutary than hurtful.

THOUGH it may be dangerous to stop a fit of the gout by medicine, yet if the constitution can be so changed by diet and exercise, as to lessen or totally prevent its return, there certainly can be no danger in following such a course. It is well known that the whole humours may be so altered by a proper course of diet, as quite to eradicate this disease; [Page 272] and those only who have resolution enough to persist in such a course have reason to expect a cure.

THE course which we would recommend for preventing the gout, is as follows: In the first place, universal tempe­rance. In the next place, plenty of exercise. By this we do not mean sauntering about in an indolent manner, but labour, sweat, and toil. These only can render the hu­mours wholesome, and keep them so. Going early to bed, and rising by times, are of great importance. It is like­wise proper to avoid night studies, and all intense thought. The supper should be light, and taken early. All strong liquors, especially generous wines and sour punch, are to be avoided. Above all, we would recommend a milk diet. The use of milk is not to be gone into all at once, but in­creased gradually, till it becomes the principal part of the diet.

WE would likewise recommend some doses of magnesia alba and rhubarb to be taken every spring and autumn; and afterwards a course of stomachic bitters, as tansy or water trefoil tea▪ an infusion of gentian and camomile flowers, or a decoction of burdock root, &c. Any of these, or an infusion of any wholesome bitter that is more agreeable to the patient, may be drank for two or three weeks twice a-day. An issue or perpetual blister has a great tendency to prevent the gout. If these were not ge­nerally used, in the decline of life, they would not only often prevent the gout, but also many other mala­dies. Such as can afford to go to Bath will find great be­nefit from bathing and drinking the water. It both pro­motes digestion and invigorates the habit.

WHEN the gout attacks the head or lungs, every me­thod must be taken to draw it towards the feet. They must be frequently bathed in warm water, and acrid cataplasms applied to the soles. Blistering plasters ought likewise to be applied to the ancles or calves of the legs. Bleeding in the feet or ancles is also necessary, and warm stomachic purges. The patient ought to keep in bed for the most part, if there be any signs of inflammation, and should be very careful not to catch cold.

IF it attacks the stomach with a sense of cold, the most warm cordials are necessary; as strong wine▪ cinnamon water, peppermint water, and even brandy or rum. The patient should keep in bed, and endeavour to promote a sweat by drinking warm liquors; and if he should be trou­bled [Page 273] with a nausea, or inclination to vomit, he may drink camomile tea or small posset.

WHEN the gout attacks the kidneys, and imitates gravel pains, the patient ought to drink freely of a decoction of marshmallows, and to have the parts fomented with warm water. An emollient clyster ought likewise to be given, and afterwards an opiate. If the pain be very violent, twenty or thirty drops of laudanum may be taken in a cup of the decoction.

PERSONS who have had the gout should be very attentive to any complaints that may happen to them about the time when they have reason to expect a return of the fit. The gout imitates many other disorders, and by being mistaken for them, and treated accordingly, is often diverted from its proper course, to the great danger of the patient's life.

THOSE who never had the gout, but who, from their constitution or manner of living, have reason to expect it, ought likewise to be very circumspect with regard to its first approach. If the disease by wrong conduct or im­proper medicines, be diverted from its proper course, the miserable patient has a chance to be ever after tormented with headachs, coughs, pains of the stomach and intestines; and generally falls, at last, a victim to its attack upon some of the more noble parts.

OF THE RHEUMATISM.

THIS disease has great affinity with the gout. It gene­rally attacks the joints with exquisite pain, and is some­times attended with inflammation and swelling. It is most common in the spring and towards the end of autumn. It is usually distinguished into acute and chronic; or the rheumatism attended with a fever, and that which is not.

CAUSES.—The causes of a rheumatism are fre­quently the same as those of an inflammatory fever, viz. an obstructed perspiration, the immoderate use of strong liquors, &c. Sudden changes of the weather, and all quick transitions from heat to cold, are very apt to occasi­on the rheumatism. The most extraordinary case of a rheumatism that I ever saw, where almost every joint of the body was distorted, was in a man who used to work one part of the day by the fire, and the other part of it in the [Page 274] water. Very obstinate rheumatisms have likewise been brought on by persons, not accustomed to it, allowing their feet to continue long wet. The same effects are of­ten produced by wet cloaths, damp beds, or lying upon the ground, especially in the night.

THE rheumatism may either be occasioned by excessive evacuations or the stoppage of usual discharges. It is often the effect of chronic diseases, which vitiate the humours; as the scurvy, the lues venerea, obstinate autumnal agues, &c.

THE rheumatism prevails most in low, damp, marshy countries. It is likewise very common amongst the poor­er sort of peasants, who are ill clothed, live in low, cold houses, and eat coarse unwholesome food, which contains but little nourishment, and is not easy assimilated.

SYMPTOMS.—The acute rheumatism com­monly begins with weariness, shivering, a quick pulse, restlessness, thirst, and other symptoms of fever. After­wards the patient complains of flying pains, which are in­creased by the least motion. These at length fix in the joints, which are often affected with swelling and inflam­mation. If blood be let in this disease, it has generally the same appearance as in the pleurisy.

IN this kind of rheumatism the treatment of the patient is nearly the same as in an acute or inflammatory fever. If he be young and strong, bleeding is necessary, which may be repeated according to the exigencies of the case.

THE belly ought likewise to be kept open by emollient clysters, or cool opening liquors; as decoctions of tama­rinds and liquorice, cream of tartar, whey, &c. The diet should be light, and in small quantity, consisting chiefly of roasted apples groat gruel, or very weak chicken broth. After the feverish symptoms have abated, if the pain still continues, the patient must keep his bed, and take such things as promote perspiration; as wine whey with spi­ritus Mendereri, in the manner directed in page 267. The patient may likewise take, for a few nights, at bed time, in a cup of wine whey, a dram of cream of tartar, and half a dram of gum guaiacum in powder.

WARM bathing, after proper evacuations, has often an exceeding good effect. The patient may either be put in­to a bath of warm water, or have cloths wrung out of it applied to the parts affected. Great care must be taken that he do not catch cold after bathing.

[Page 275] THE chronic rheumatism is seldom attended with any con­siderable degree of fever, and is generally confined to some particular part of the body, as the shoulders, the back, or the loins. There is seldom any inflammation or swelling in this case. Persons in the decline of life are most subject to the chronic rheumatism. In such patients it often proves extremely obstinate, and sometimes incurable.

IN this kind of rheumatism the regimen should be nearly the same as in the acute. Cool and diluting diet, consist­ing chiefly of vegetable substances, as stewed prunes, cod­dled apples, currants or gooseberries boiled in milk, is most proper. Arbuth [...]ot says, ‘If there be a specific in aliment for the rheumatism, it is certainly whey;’ and adds, ‘That he knew a person subject to this disease, who could never be cured by any other method but a diet of whey and bread.’ He likewise says, ‘That cream of tartar in water gruel, taken for several days, will ease rheumatic pains considerably.’ This I have often ex­perienced, but found it always more efficacious when join­ed with gum guaiacum, as directed above. In this case the pa­tient may take the dose mentioned above twice a-day, and likewise a tea spoonful of the volatile tincture of gum gu­aiacum at bed time in wine whey.

THIS course may be continued for a week, or longer, if the case proves obstinate, and the patient's strength will permit. It ought then to be omitted for a few days, and repeated again. At the same time, leeches or a blistering plaster may be applied to the part affected. What I have generally found answer better than either of these, in obsti­nate fixed rheumatic pains, is the warm plaster. It is made by melting over a gentle fire, an ounce of gum plaster, with two drams of blistering plaster. This may be spread upon soft leather, and applied to the part affected. It should be taken off and wiped every three or four days, and may be renewed once a fortnight. Cupping upon the part af­fected is likewise often beneficial, and is greatly preferable to the application of leeches.

THOUGH this disease may not seem in the least to yield to medicines for a long time, yet they ought still to be per­sisted in. Persons who are subject to frequent returns of the rheumatism, will often find their account in using me­dicines, whether they be immediately affected with it or not. The chronic rheumatism is similar to the gout in [Page 276] this respect, that the most proper time for using medicines to extirpate it, is when the patient is most free from it.

TO those who can afford to go thither, we would re­commend the warm baths of Buxton or Matlock in Der­byshire. These have often cured very obstinate rheuma­tisms, and are always safe either in or out of the fit. When the rheumatism is complicated with scorbutic com­plaints, which is not seldom the case, the Harrowgate wa­ters and those of Moffat are proper. They should both be drank and used as a warm bath.

THERE are several of our own domestic plants which may be used with advantage in the rheumatism. One of the best of them is the white mustard seed. A table spoon­ful of this may be taken twice or thrice a-day, in a glass of water or small wine. The water trefoil is likewise of great use in this complaint. It may be infused in wine or ale, or drank in form of tea. The ground-ivy, camo­mile, and several other bitters, are also beneficial, and may be used in the same manner. No benefit however is to be expected from these unless they be used for a consider­able time. Excellent medicines are often despised in this case, because they do not perform a cure instantaneously; whereas nothing would be more certain than their effect, were they duly persisted in. The want of perseverance in the use of medicines is one great cause why chronic disea­ses are so seldom cured.

COLD bathing, especially in salt water, often cures the rheumatism. We would also recommend riding on horseback, and wearing flannel next the skin. A flannel shirt, in an obstinate rheumatism, especially if the patient be old, is one of the best medicines we know. Issues are likewise very proper; they have often been known to cure a chro­nic rheumatism. If the pain affects the shoulders, an issue may be made in the arm; but if it affects the loins, it should be put in the leg or thigh. Rheumatic persons ought to make choice of a dry warm air, to avoid wet cloaths as much as possible, and make frequent use of the flesh-brush.

OF THE SCURVY.

THIS disease prevails chiefly in cold northern countries, especially in low damp situations, near large marshes, or [Page 277] great quantities of stagnating water. Sedentary people, of a dull melancholy disposition are most subject to it. It proves often fatal to sailors in long voyages, particularly in ships that are not properly ventilated, and have many peo­ple on board.

CAUSES.—The scurvy is occasioned by cold moist air, by the long use of salted or smoke-dried provisi­ons, or of any kind of food that is hard of digestion, and affords little nourishment. It may also proceed from ex­cessive evacuations, or the suppression of customary dis­charges; as the menses, haemorrhoidal flux, &c. It is sometimes owing to a hereditary taint, in which case a very small cause will excite the latent disorder. Grief, fear, and other depressing passions, have a great tendency to pro­duce this disease. It may likewise proceed from neglect of cleanliness, bad cloathing, the want of proper exercise, con­fined air, excess in eating or drinking, or from any dis­ease which greatly weakens the body, or vitiates the hu­mours.

SYMPTOMS.—This disease may be known by unusual weariness, heaviness of the body, and difficulty of breathing, especially after bodily motion; rottenness of the gums, which are apt to bleed on the slightest touch▪ a stinking breath, frequent bleeding of the nose, difficulty of walking; sometimes a swelling, and sometimes a falling away of the legs, on which there are livid, yellow, or vio­let coloured spots; the face is generally of a pale or leaden colour. As the disease advances, other symptoms come on; as rottenness of the teeth, haemorrhages, or dischar­ges of blood from various parts of the body, foul obstinate ulcers, which no applications will cure; the patient com­plains of pains in various parts of the body, especially about the breast, and his body is covered with dry scaly eruptions. At last a wasting or hectic fever comes on, and the mise­rable patient is often carried off by a dysentery, or diarr­hoea, a dropsy, the palsy, fainting fits, or a mortification of some of the bowels.

CURE.—We know no method of curing this disease, but by pursuing a course directly opposite to that which brought it on. It proceeds from a vitiated state of the humours, occasioned by errors in diet, air, or exer­cise; and this can be removed no other way than by a pro­per attention to these important articles.

[Page 278] IF the patient has been obliged to breathe a cold, damp, or confined air, he should be removed, as soon as possible, to a dry, open, and moderately warm one. If the disease proceeds from a sedentary life, or depressing passions, as grief, fear, &c. the patient must take daily as much exer­cise in the open air as he can bear, and his mind should be diverted by cheerful company and other amusements. No­thing has a greater tendency either to prevent, or remove this disease, than constant cheerfulness and good humour. But this, alas, is seldom the lot of persons afflicted with the scurvy; they are generally surly, peevish, sour, mo­rose, and dull.

WHEN the scurvy has been brought on by a long use of salted provisions, the proper medicine is a diet consisting chiefly of fresh vegetables; as oranges, lemons, apples, tamarinds, water cresses, scurvy grass, brooklime, &c. The use of these with milk, pot herbs, new bread, and fresh beer or cider, will seldom fail to remove a scurvy of this kind, if taken before it be too far advanced; but to have this effect they must be persisted in for a considerable time. When fresh vegetables cannot be had, pickled or preserved ones may be used; and if these cannot be obtained, the chymical acids may be taken in their stead. All the pati­ent's food and drink must be sharpened with cream of tar­tar, elixir of vitriol, vinegar, or the spirit of sea salt, &c.

THESE things, however, will more certainly prevent than cure the scurvy; for which reason seafaring people, especially on long voyages, ought to lay in plenty of them. Cabbage, onions, gooseberries, and many other vegetables, may be kept a long time by pickling, preserv­ing, &c. When these fail, the chymical acids, mention­ed above, which will keep for any length of time, may be used. We have reason to believe, if ships were well venti­lated, good store of fruits, greens, and portable soup, &c. laid in, and a proper regard paid to cleanliness and warmth, that sailors would be the most healthy people in the world, and would seldom suffer either from the scurvy or putrid fevers, which are so fatal to that useful set of men; but it is too much the temper of such people to despise all precau­tion; they will not think of any calamity till they find it, when it is too late to ward off the blow.

IT must indeed be owned, that many of them have it not in their power to make the provision we are speaking of; but in this case it is the business of their employers to [Page 279] make it for them; and no man ought to engage in a long voyage without having this article secured.

I have often seen very extraordinary effects in the scurvy from a milk diet. This preparation of nature is a mixture of animal and vegetable properties, which of all others is the most fit for restoring a decayed constitution, and re­moving that particular acrimony of the humours, which seems to constitute the very essence of the survy, and many other diseases. But men despise this wholesome and nou­rishing food, because it is cheap, and guzzle down flesh, and fermented liquors, while milk is only deemed fit for their hogs.

THE most proper drink in the scurvy is whey or butter­milk. When these cannot be had, sound cider or perry may be used. Wort has been found to be a proper drink in the scurvy, and may be used at sea, as malt will keep during the longest voyage. A decoction of the tops of the spruce fir is also good. It may be drank in the quantity of an English pint twice a-day. Tar water may likewise be used for this purpose, ordecoctions of any of the mild mucila­ginous vegetables; as sarsaparilla, marshmallow roots, &c. Infusions of the bitter plants, as ground-ivy, the lesser cen­taury, marsh trefoil, &c. are likewise beneficial. I have seen the peasants in some parts of Britain express the juice of the last mentioned plant, and drink it with good effect in those foul scorbutic eruptions with which they are often troubled in the spring season.

THE Harrowgate water is certainly an excellent medi­cine in the scurvy. I have often seen patients in the most deplorable condition from that disease, greatly relieved by drinking the sulphur water, and bathing in it. The cha­lybeate water may also be used with advantage, especially with a view to brace the stomach after drinking the sul­phur water, which, though i [...] sharpens the appetite, never fails to weaken the power of digestion.

A slight degree of scurvy may be carried off by frequent­ly sucking a little of the juice of a bitter orange, or lemon. When the disease affects the gums only, this practice, if continued for some time, will generally carry it off. We would, however, recommend the bitter orange as greatly preferable to lemon. It seems to be as good an acid, and is not near so hurtful to the stomach. Perhaps our own sorrel may be little inferior to either of them. All kinds of salad are good in the scurvy, and ought to be eat in great [Page 280] plenty; as spinage, lettuce, parsley, celery, endive, ra­dish, dandelion, &c. It is amazing to see how soon fresh vegetables in the spring cure the brute animals of any scab or foulness which is upon their skins. Is it not natural to suppose that their effects should be as great upon the human species?

THE LEPROSY, which was so common in this country long ago, seems to have been near akin to the scurvy. Perhaps its appearing so seldom now, may be owing to the inhabitants of Britain eating more vegetable food than for­merly, living more upon tea and other diluting diet, using far less salted meat, and being greatly more cleanly and better cloathed, &c.—Where this disease happens, we would recommend the same course of diet and medicine as in the scurvy.

OF THE SCROPHULA, OR KING's EVIL.

THIS disease chiefly affects the glands, especially those of the neck. Children and young persons of a sedentary life are most subject to it. It is one of those diseases that may be removed by proper regimen, but seldom yields to medi­cine. The inhabitants of cold, damp, marshy countries, are most liable to the scrophula.

CAUSES.—This disease may proceed from a hereditary taint, infection, a scrophulous nurse, &c. Children who have the misfortune to be born of sickly pa­rents, whose constitutions have been worn out by the French-pox, or other chronic diseases, are apt to be affect­ed with the scrophula. It may likewise proceed from such diseases as weaken the habit or vitiate the humours, as the small-pox, measles, &c. External injuries; as blows, bruises, compressions, &c. sometimes produce scrophulous ulcers; but there is reason to believe, when this happens, that it is owing either to a predisposition in the habit to this disease, or to the confinement of the patient. In short, whatever tends to vitiate the humours, or relax the solids, predisposes to this disease; as the want of exercise, too much heat or cold, confined air, unwholesome food, bad water, the use of poor, weak, watery aliments, the neglect of cleanliness, or suffering children to continue long wet, &c.

[Page 281] SYMPTOMS.—At first small knots appear under the chin or behind the ears, which gradually increase in number and size, till they form one large hard tumour. This often continues for a long time without breaking, and when it does break, it only discharges a thin sanies or watery humour. Other parts of the body are likewise lia­ble to its attack, as the arm-pits groins, feet, hands, eyes, breasts, &c. Nor are the internal parts exempt from it. It often affects the lungs, liver or spleen; and I have fre­quently seen the glands of the mesentery greatly enlarged by it.

THESE obstinate ulcers which break out upon the feet and hands with swelling, and little or no redness, common­ly called the spina ventosa, are of the scrophulous kind. They seldom discharge good matter, and are exceeding dif­ficult to cure. The white swellings of the joints seem like­wise to be of this kind. They can seldom be brought to a suppuration, and when opened they only discharge a thin ichor. There is not a more general symptom of the scrophu­la than a swelling of the upper lip and nose. It likewise frequently begins in a single toe or finger, which continues long swelled, with no great degree of pain, till at length the bone becomes carious.

REGIMEN.—As this disease proceeds, in a great measure, from relaxation, the diet ought to be generous and nourishing, but at the same time light and of easy digestion, as good light bread, the flesh and broth of young animals, with now and then a glass of generous wine, or good ale. The air ought to be open, dry, and not too cold, and the patient should take as much exercise as he can bear. Ex­ercise is here of the utmost importance. Children will sel­dom be troubled with the scrophula who have enough of exercise, and if they be, it alone has the greatest chance to cure them.

MEDICINE.—The vulgar are remarkably credulous with regard to the cure of the scrophula, many of them be­lieving in the virtue of the royal touch, that of the seventh son, &c. The truth is, we know but little either of the nature or cure of this disease, and where reason or medi­cines fail, superstition always comes in their place. Hence it is, that in diseases which are the most difficult to under­stand, we always hear of the greatest number of miracu­lous cures being performed. Here, however, the decepti­on [Page 282] on is easily accounted for. The scrophula at a certain pe­riod of life, often cures of itself; and, if the patient hap­pens to be touched about this time, the cure is imputed to the touch, and not to nature, who is really the physician. In the same way the insignificant nostrums of quacks and old women often gain applause when they deserve none.

THERE is nothing more pernicious, than the custom of dosing children with strong purgative medicines in the scro­phula. People imagine, that it proceeds from humours which must be purged off, without considering, that these purgatives increase the relaxation and aggravate the disease. It has indeed been found that keeping the belly gently open, especially with sea-water, has a good effect; but this should only be given in such quantity as to procure one, or at most two stools every day. Bathing in the salt water has like­wise a very good effect, especially in the warm season. I have often known a course of bathing in salt-water, and drinking it in such quantities as to keep the belly gently open, cure a scrophula, after many medicines had been tried in vain. When salt-water cannot be had, the patient may be bathed in fresh-water, and his belly kept open by small quantities of salt and water, or some other mild pur­gative.

NEXT to cold bathing and drinking the salt-water, we would recommend the jesuits bark. The cold bath may be used in summer, and the bark in winter. It may either be taken in substance mixed with wine, or if the patient cannot be brought to use it in that form, a decoction of it may be drank. An ounce of the jesuits bark, and a dram of Winter's bark grossly powdered, may be boiled in an English quart of water to a pint; towards the end, half an ounce of sliced liquorice-root, and a handful of raisins may be added, which will both render the medicine less disagreeable and make it take up more of the bark. The liquor must be strained, and two, three, or four spoon­fuls, according to the age of the patient, taken three times a day. The patient ought at the same time to take, twice or thrice a day, a glass of good wine, with ten, twenty, or thirty drops of volatile tincture of guaiacum in it. I have often given the bark in obstinate scrophulous cases with very good effect. An adult may take at least two drams of it daily, and must continue to use it for several months.

[Page 283] THE Moffat and Harrowgate waters are likewise very proper medicines in the scrophula, especially the latter. They ought not however to be drank in large quantities, but should be taken so as to keep the belly gently open, and must be used for a considerable time.

AS to external applications, they are of little avail. Be­fore the tumour breaks, nothing ought to be applied to it, unless a piece of flannel, or something to keep it warm. After it breaks, the sore may be dressed with some digestive ointment. What I have always found to answer best, was the yellow basilicon mixed with about a sixth or eighth part of its weight of red precipitate. The sore may be dressed with this twice a day; and if it be very fungous, and does not digest well, a larger proportion of the preci­pitate may be added.

MEDICINES which mitigate this disease, tho' they do not cure it, are not to be despised. If the patient can be kept alive by any means till he arrives at the age of puberty, he he has a great chance to get well; but if he does not reco­ver at this time, in all probability he never will. Persons afflicted with this disease ought not to marry. There is no malady which parents are so apt to communicate to their offspring as the scrophula, and surely it is a cruel thing to entail misery on posterity.

FOR the means of preventing this disease, we must re­fer the reader to the observations on nursing, at the begin­ning of the book.

OF THE RICKETS.

THIS disease generally attacks children betwixt the age of nine months and two years. It appeared first in Eng­land, about the time when manufactures began to be in­troduced, and still prevails most in towns where the inha­bitants follow sedentary employments, and by that means neglect either to take proper exercise themselves, or to give it to their children. It has a great resemblance to the foregoing disease both in its causes and method of cure.

CAUSES.—One cause of the rickets in children is diseased parents. Mothers of a weak relaxed habit, who neglect exercise, and live upon weak watery diet, can nei­ther be expected to bring forth strong and healthy children, nor to be able to nurse them, after they are brought forth. [Page 284] Accordingly we find, that the children of such women ge­nerally die of the rickets, the scrophula, consumptions, &c. Children begotten by men in the decline of life, who are afflicted with the gout, the gravel, or other chronic dis­eases, or who have been often affected with the venereal dis­ease in their youth, are likewise liable to the rickets.

ANY disorder that weakens the constitution, or relaxes the habit of children, as the small-pox, measles, teething, the hooping-cough, &c. predisposes them to this disease. It may likewise be occasioned by improper diet, as food that is either too weak and watery, or so viscid that the stomach cannot digest it. Too great a quantity of rich and nourishing diet may likewise vitiate the humours and occa­sion the rickets. Bad nursing is often the cause of this dis­ease. When the nurse is either diseased, or has not enough of milk to nourish the child, it must suffer. But children suffer oftner by want of care in nurses than want of food. Allowing an infant to continue long wet, or not keeping it thoroughly clean in its cloaths, &c. has the most pernici­ous effects. Wet shoes, stocking, and other cloaths, re­lax the bodies of children, and greatly obstruct their growth. The want of free air, is likewise very hurtful to children in this respect. A nurse who lives in a close, small house, where the air is damp and confined, and who is too in­dolent to carry her child abroad into the open air, will hardly fail to give it the rickets. But want of exercise is the chief cause of this disease. A healthy child should al­ways be in motion, unless when asleep; but if it be suffer­ed to lie, or sit, instead of being tossed and dandled about, it can hardly escape this baneful malady.

SYMPTOMS.—At the beginning of this disease the child's flesh grows soft and flabby; its strength is diminish­ed; it loses its wonted cheerfulness, looks more grave and composed than is natural for its age, and does not care to be moved. The head and belly become too large in pro­portion to the other parts; the face appears full, and the complexion florid. Afterwards the bones begin to be affect­ed, especially in the more soft and spungy parts, or to­wards the ends. Hence the wrists and ancles become thick­er than usual; the spine or back-bone puts on an unnatu­ral shape; the breast is likewise often deformed; and the bones of the arms and legs grow crooked. All those symp­toms vary according to the violence of the disease. The [Page 285] pulse is generally quick, but feeble; the appetite and di­gestion, for the most part, bad; the teeth come slowly and with difficulty, and they often rot and fall out after­wards. Ricketty children generally have great acuteness of mind, and an understanding above their years. Whether this be owing to their being more in the company of adults than other children, or the enlargement of the brain, we shall not pretend to determine.

REGIMEN.—As this disease is always attended with evident signs of weakness and relaxation, our chief aim in the cure must be to brace and strengthen the solids, and to promote the digestion and due preparation of the fluids. These important ends will be best promoted by wholesome nourishing diet, suited to the age and strength of the patient, and often repeated; by open dry air, and plenty of exercise. If the child has a bad nurse, who ei­ther neglects her duty, or has not enough of milk, she should be changed. If the season be cold, the child ought to be kept warm; and when the weather is hot it ought to be kept cool; as sweating is very apt to weaken it; and too great a degree of cold has the same effect. The limbs should be rubbed frequently with a warm hand, and the child should be kept as cheerful as possible.

THE diet ought to be light and dry, as good bread, roasted flesh, &c. Biscuit is generally reckoned the best bread; and pigeons, pullets, veal, rabbets, or mutton roasted or minced, are the most proper flesh. If the child be too young for flesh meats, he may have rice, millet, or pearl barley boiled with raisins, to which may be added a little wine and spice. His drink may be good claret, of which he may take half a glass three or four times a day. Those who cannot afford claret, may give the child now and then a wine glass of fine mild ale.

MEDICINE.—Medicines are here of little avail. The disease may often be cured by the nurse, but seldom by the physician. In children of a gross habit, gentle pur­ges or vomits may sometimes be of use; but they will never carry off the malady. That must depend upon bracing a­lone: For which purpose, besides the regimen mentioned above, we would recommend the cold bath, especially in the warm season. It must however be administred with prudence, as some ricketty children cannot bear it. The best time for using the cold bath is in the morning, and [Page 286] the child should be well rubbed with a dry cloth immedi­ately after. If the child should be weakened by the use of the cold bath, it must be discontinued.

SOMETIMES issues have been found beneficial both in this and the foregoing disease. They are peculiarly necessa­ry for children who abound with gross humours. An infu­sion of the jesuits-bark, in wine or ale, is likewise of use; but it is scarce possible to bring children to take it. We might here mention many other medicines which have been recommended for the rickets; but, as there is far more danger in trusting to these than in neglecting them altoge­ther, we chuse rather to pass them over, and to depend en­tirely on regimen.

OF THE ITCH.

THE ITCH is a disease of the skin, and is generally com­municated by infection. It seems originally to proceed from the want of cleanliness, bad air, or unwholesome diet; as the inmates of jails, hospitals, and such as live upon salted and smoke dried provisions are seldom free from it.

IT generally appears in form of small watery pustules, first about the wrists, or betwixt the fingers, and afterwards it affects the arms, legs, and thighs, &c. These pustules are attended with an intolerable itching, especially when the patient is warm in bed, or sits near the fire. Sometimes the skin is covered with large blotches or scabs, and at o­ther times with a white scurf, or scaly eruption. This last is called the dry itch, and is the most difficult to cure.

THE itch is seldom a dangerous disease, unless when it is rendered so by neglect or improper treatment. If it be suffered to continue too long, it may vitiate the whole mass of humours; and, if it be suddenly drove in, without proper evacuations, it may occasion fevers, inflammations of the viscera, or other internal disorders.

THE safest medicine for the itch is sulphur, which ought to be applied both externally and internally. The parts most affected may be rubbed with an ointment made of common sulphur and flower of brimstone, each an ounce; crude sal ammonia [...], finely powdered, two drams; hog's lard, or butter, four ounces. A scruple, or half a dram of of the essence of lemon may be added, to take away the disagreeable smell. About the bulk of a nutmeg of this [Page 287] may be rubbed upon the extremities; at bed-time, twice or thrice a week. It is seldom necessary to rub any part but the extremities, and even these ought not all to be rubbed at the same time, but by turns, as it is dangerous to stop too many pores at once.

BEFORE the patient begins to use the ointment, he ought, if he be of a full habit, to bleed and take a purge or two. It will likewise be proper, during the use of it, to take e­very night and morning as much of the flower of brim­stone, in a little treacle or new-milk, as will lie upon a shilling. He should beware of catching cold, should wear more cloaths than usual, and take every thing warm. The same cloaths, the linen excepted, ought to be kept on all the time of using the ointment; and such cloaths, as have been worn while the patient was under the disease, are not to be used again, unless they have been fumigated with brimstone, and thoroughly cleaned, otherwise they will communicate the infection anew.

I never knew brimstone, if used as directed above, fail to cure the itch; and I have reason to believe, that, if du­ly persisted in, it never will fail: but if it be only used once or twice, and cleanliness be neglected, it is no won­der if the disorder returns. The great secret both for pre­venting and curing the itch is CLEANLINESS. Where it prevails, the itch will seldom approach, and if it should, it will soon be banished. The quantity of ointment men­tioned above will generally be sufficient for the cure of one person; but, if any symptoms of the disease should appear again, the medicine may be repeated. It is both more safe and efficacious when persisted in for a considerable time, than when a large quantity is applied at once. It will like­wise be proper that the patient, while he is using the oint­ment, should take a purge once a week.

PEOPLE ought to be extremely cautious not to mistake o­ther eruptions for the itch; as the stoppage of these may be attended with fatal consequences. Many of the eruptive diseases to which children are liable, have a near resem­blance to the itch; and I have often known infants killed by being rubbed with greasy ointments that made these e­ruptions strike suddenly in, which nature had thrown out to preserve the patient's life, or prevent some other disease.

MUCH michief is likewise done by the use of mercu­ry in this disease. I have known some persons mad enough [Page 288] to wash the parts affected with a strong solution of the cor­rosive sublimate, which had almost proved fatal. Others use the mercurial ointment without taking the least care either to avoid cold or observe a proper regimen. The consequences of such conduct may be easily guessed. I have known even the mercurial girdles produce tragical effects, and would advise every person, as he values his health, to beware how he uses them. Mercury ought never to be used as a medicine without the greatest care. Ignorant people look upon these girdles as a kind of charm, without considering that the mercury enters the blood.

AS sulphur is both the most safe and efficacious medicine for the itch, we shall not recommend any other. Other medicines may be used by persons of skill, but are not to be ventured upon by the ignorant. Those who would avoid this detestable disease ought to beware of infected persons, to use wholesome food, and to study universal cleanliness.

OF THE ASTHMA.

THE asthma is a disease of the lungs, which seldom admits of a cure. Persons in the decline of life are most liable to this disease. It is divided into the moist and dry, or hu­moural and nervous. The former is attended with expec­toration or spitting; but in the latter the patient seldom spits, unless sometimes a little tough phlegm by the mere force of coughing.

CAUSES.—The asthma is sometimes hereditary. It may likewise proceed from a bad formation of the breast; the fumes of metals or minerals taken into the lungs ^*; vi­olent exercise, especially running; the obstructions of cu­stomary evacuations, as the menses, haemorrhoids, the sudden retrocession of the gout, or striking in of eruptions, as the small-pox, measles, violent passions of the mind, as sudden fear, or surprise. In a word, the disease may proceed from any cause that either impedes the circu­lation of the blood through the lungs, or prevents their be­ing duly expanded by the air.

[Page 289] SYMPTOMS.—An asthma is known by a quick laborious respiration, which is generally performed with a kind of wheezing noise. Sometimes the difficulty of breath­ing is so great that the patient is obliged to keep an erect posture, otherwise he is in danger of being suffocated. A fit or paroxism of the asthma is very apt to happen after a person has been exposed to cold easterly winds, or has been abroad in thick foggy weather, or has got wet, or continu­ed long in a damp place under ground, or the like.

A fit of the asthma is generally ushered in with great list­lessness, want of sleep, hoarseness, cough, belching of wind, a sense of heaviness about the breast; and difficulty of breathing. To these succeed heat, fever, pain of the head, sickness and nausea, great oppression of the breast, palpitation of the heart, a weak and sometimes intermitting pulse, an involuntary flow of tears, bilious vomitings, &c. All the symptoms grow worse towards night; the patient is easier when up than in bed, and is very desirous of cool air.

REGIMEN.—The food ought to be light, and of easy digestion. Boiled meats are generally preferred to roasted, and the flesh of young animals to that of old. All windy food, and whatever is apt to swell upon the stomach▪ is to be avoided. Light puddings, white broths, and ripe fruits baked, boiled or roasted, are proper. Strong liquor of all kinds, especially malt-liquor, is hurtful. The pati­ent should eat a very light supper, or rather none at all. His cloathing should be warm, especially in the winter-season. A flannel shirt or waistcoat, and thick shoes, are of great service; as all disorders of the breast are much re­lieved by keeping the feet warm, and promoting the perspi­ration.

BUT nothing is of so great importance in the asthma as pure and moderately warm air. Asthmatic people can sel­dom bear either the close heavy air of a large town, or the sharp, keen atmosphere of a bleak hilly country; a medium between these is therefore to be chosen. The air near a large town is often better than at a distance, provided the patient be removed so far as not to be affected by the smoke. Some asthmatic patients indeed breathe easier in town than in the country; but this is seldom the case, especially in towns where much coal is burnt. Asthmatic persons who are obliged to be in town all day, ought, at least, to sleep out of it. Even this will often prove of great service. Those [Page 290] who can afford it ought to travel into a warmer climate. Many asthmatic persons who cannot live in Britain enjoy very good health in the south of France, or in Spain or Italy.

EXERCISE is likewise of very great importance in the asthma, as it promotes the digestion, and greatly assists in the preparation of the blood. The blood of asthmatic per­sons is seldom duly prepared, owing to the proper action of the lungs being impeded. For this reason such people ought daily to take as much exercise, either on foot, horse­back, or in a machine, as they can bear.

MEDICINE.—Almost all that can be done by medicine in this disease, is to relieve the patient when seiz­ed with a violent fit. This indeed requires the greatest ex­pedition, as the disease often proves suddenly fatal. In the paroxism or fit, the body is generally bound, a clyster ought therefore to be administred, and if there be occasion, it may be repeated two or three times. The patient's feet ought to be put into warm water, and afterwards rubbed with a warm hand, or dry cloth. If there be a violent spasm about the breast or stomach, warm fomentations, or bladders filled with warm milk and water, may be applied to the part affected, and warm cataplasms to the soles of the feet. The patient must drink freely of diluting li­quors, and may take a tea-spoonful of the tincture of castor and saffron, mixed together in a cup of valerian-tea, twice or thrice a-day. Sometimes a vomit has a very good effect, and snatches the patient, as it were, from the jaws of death. This will be more safe after other evacuations have been premised.

OUT OF THE FIT. In the moist asthma, such things as promote expectoration or spitting, ought to be used; as the syrup of squills, gum-ammoniac, and such like. A common spoonful of the syrup or oxomell of squills, mixed with an equal quantity of cinnamon-water, may be taken three or four times a-day. Any quantity of gum-ammo­niac, with an equal quantity of asafoetida, may be made into pills, and four or five of them taken every night at bed-time.

IN the convulsive or nervous asthma, antispasmodics and bracers are the most proper medicines. The patient may take a tea-spoonful of the paregoric elixir twice a-day. The jesuits bark is likewise proper in this case. It may be taken in substance, or infused in wine. In short, every thing [Page 291] that braces the nerves, or takes off spasm, may be of use in a nervous asthma. It is often relieved by the use of asses milk; I have likewise known cows milk drank warm of a morning, have a very good effect in this case.

IN every species of asthma issues have a good effect; they may either be made in the back or side, and should never be allowed to dry up. We shall here, once for all, observe, that in most chronic diseases, issues are extremely proper. They are both a safe and efficacious remedy; and and tho' they do not always cure the disease, yet they will often prolong the patient's life.

OF THE APOPLEXY.

THE apoplexy is a sudden loss of sense and motion, wherein the patient is to all appearance dead, only the heart and lungs still continue to move. This disease, by a little care, might often be prevented, but can seldom be cured. It chiefly attacks sedentary persons of a gross ha­bit, who use a rich and plentiful diet, and indulge in strong liquors. People in the decline of life are most subject to the apoplexy. It prevails most in winter, especially in long rainy seasons, and very low states of the barometer.

CAUSES.—The immediate cause of an apoplexy is a compression of the brain, occasioned by an effusion of blood, or of watery humours on that part. The former is called a sanguine, and the latter a serous apoplexy. It may be produced by any cause that increases the circulation to­wards the brain, or prevents the return of the blood from the head; as intense study; violent passions ^*; viewing ob­jects for a long time obliquely; wearing any thing too tight about the neck; a rich and luxurious diet; suppressi­on of urine; suffering the body to cool suddenly after having been very hot; continuing long in a warm bath; the excessive use of spiceries, or high-seasoned food; excess [Page 292] of venery; the sudden striking in of any eruption; suf­fering issues, seatons, &c. suddenly to dry up, or the stop­page of any customary evacuation; a mercurial salivation suddenly checked by cold; wounds or bruises on the head; long exposure to excessive cold; poisonous exhalations; &c.

SYMPTOMS, and method of cure.—The usu­al forerunners of an apoplexy are giddiness, pain, [...] swimming of the head; loss of memory; drowsiness; [...] in the ears; the night mare; a spontaneous flux of tears, and laborious respiration. When persons of an apoplectic make observe these symptoms, they have reason to fear the approach of a [...]it, and should endeavour to prevent it by plentiful bleeding, low diet, and opening medicines.

IN the sanguine apoplexy, if the patient does not die suddenly, the countenance appears florid, the face is swell­ed or puffed up, and the blood-vessels, especially about the neck and temples, are turged; the pulse beats strong; the eyes are prominent and fixed, and the breathing is difficult, and performed with a s [...]orting noise. The excrements and urine are often voided spontaneously, and the patient is sometimes seized with a vomiting.

IN this case every method must be taken to lessen the force of the blood towards the head. The patient should be kept perfectly easy and cool. His head should be raised pret­ty high, and his feet suffered to hang down. His cloaths ought to be loosened, especially about the neck, and fresh air admitted into his chamber. His garters should be tied pretty tight, by which means the motion of the blood from the lower extremities will be retarded. As soon as the patient is placed in a proper posture, he should be bled pret­ty freely in the neck or arm, and, if there be occasion, the operation may be repeated in two or three hours. A laxa­tive clyster with plenty of sweet oil, or fresh butter and a large spoonful of common salt in it, may be administred eve­ry two hours; and blistering plasters applied betwixt the shoulders, and to the calves of the legs.

AS soon as the symptoms are a little abated, and the pa­tient is able to swallow, he ought to drink freely of some di­luting opening liquor, as a decoction of tamarinds and li­quorice, cream-tartar-whey, or common whey with cream of tartar dissolved in it. Or he may take any cooling purge, as Glauber's salts, or manna dissolved in an infusion of senna, or the like. All spirits and other strong liquors are to be [Page 293] avoided. Even volatile salts held to the nose do mischief. Vomits, for the same reason, ought not be given, nor any thing that may increase the motion of the blood towards the head.

IN the serous apoplexy, the symptoms are nearly similar, only the pulse is not so strong, the countenance is less flo­rid, and the breathing less difficult. Bleeding is not so ne­cessary here, as in the former case. It may however ge­nerally be performed once with safety and advantage; but should not be repeated. The patient should be placed in the same posture as directed above, and should have blister­ing plasters applied, and receive opening clysters in the same manner. Purges are here likewise necessary, and the pati­ent may drink strong balm tea. If he be inclined to sweat, it ought to be promoted by drinking small wine whey, or an infusion of carduus benedictus. A plentiful sweat kept up for a considerable time, has often carried off a serous a­poplexy.

WHEN apoplectic symptoms proceed from opium, or o­ther narcotic substances taken into the stomach, vomits are necessary. The patient is generally relieved, as soon as he has discharged the poison in this way.

PERSONS of an apoplectic make, or those who have been attacked by it, ought to use a very spare and slender diet, a­voiding all strong liquors, spiceries, and high seasoned food. They ought likewise to guard against all violent passi­ons, and to avoid the extremes of heat and cold. The head should be shaved, and daily washed with cold water. The feet ought to be kept warm, and never suffered to con­tinue long wet. The belly must, by all means, be kept open, either by food or medicine, and blood ought to be let every spring and fall. Moderate exercise should likewise be taken; but it ought never to be continued too long. No­thing has a greater effect in preventing an apoplexy than is­sues or perpetual blisters; but great care must be taken ne­ver to suffer them to dry up, without opening others in their stead. Apoplectic persons ought never to go to sleep with a full stomach, nor to lie with their heads too low, or wear any thing tight about their necks.

OF THE PALSY.

THE palsy is a loss or diminution of sense, or motion, or of both, in one or more parts of the body. It is more or less dangerous, according to the importance of the part af­fected. A palsy of the heart, lungs, or any part necessary for life, is mortal. When it affects the stomach, the intes­tines, or the bladder, it is highly dangerous. If the face be affected, the case is bad, as this shews, that the disease proceeds from the brain. If the part affected feels cold, is insensible, or wastes away, there is small hopes of a cure, especially, if the judgement and memory begin to fail.

CAUSES.—THE immediate cause of the palsy is whatever prevents the regular exertion of the nervous pow­er upon any particular muscle or part of the body. The occasional and predisposing causes are various, as drunkenness; wounds of the brain, or spinal marrow; pressure upon the brain or nerves; very cold or damp air; the suppression of customary evacuations; sudden fear; want of exercise; or or whatever greatly relaxes the system, as drinking much tea, ^* or coffee, &c. Wounds of the nerves themselves, or any thing that obstructs the regular action of that vital pow­er contained in them, will occasion a palsy. It may like­wise proceed from the poisonous fumes of metals or minerals, as mercury, lead, arsenick, &c.

IN young persons of a full habit, where there are symp­toms of inflammation, the palsy must be treated in the same manner as the sanguine apoplexy. The patient must be bled, blistered, and have his belly kept open by sharp cly­sters or pugative medicines. But, in old age, or when the disease proceeds from relaxation or debility, which is gene­rally the case, a quite contrary course must be pursued. The diet mu [...] be warm and attenuating, consisting chiefly of spicy and aromatic vegetables, as mustard, horse-radish, &c. The drink may be generous wine, mustard-whey, or brandy and water. Friction with the flesh brush, or a warm hand, is extremely proper, especially on the parts [Page 295] affected. Blistering-plasters may likewise be applied to the affected parts with advantage. When this cannot be done, they may be rubbed with the volatile liniment, or the nerve-ointment of the Edinburgh dispensatory. But the best external application is electricity. The shocks should be received on the part affected; and they ought daily to be repeated for several weeks. This is not only proper for curing, but also for preventing a palsy.

VOMITS are very beneficial in this kind of palsy, and ought to be frequently administred. Caephalic snuff, or any thing that makes the patient sneeze, is likewise useful. Some pretend to have found great benefit from rubbing the parts affected with nettles; but this does not seem to be any ways preferable to blistering. If the tongue be affected, the patient may gargle his mouth frequently with brandy and mustard; or he may hold a bit of sugar in his mouth wet with the palsy-drops or compound spirits of lavender. The wild valerian root is a very proper medicine in this case. It may either be taken in an infusion with sage­leaves, or half a dram of it in powder may be given in a glass of wine three times a day. If the patient cannot use the valerian, he may take of sal volatile oleosum, compound spirits of lavender, and tincture of castor, each half an ounce; mix these together, and take forty or fifty drops in a glass of wine, three or four times a day. A table spoon­ful of mustard-seed taken frequently is a very good medi­cine. The patient ought likewise to chew cinnamon bark, ginger, or other warm spiceries.

EXERCISE is of the utmost importance in the palsy; but the patient must beware of cold, damp, and moist air. He ought to wear flannel next his skin; and, if possible, should remove into a warmer climate.

OF THE EPILEPSY, OR FALLING SICKNESS.

THE epilepsy is a sudden deprivation of all the senses, wherein the patient falls suddenly down, and is affected with violent convulsive motions. Children, especially those that are delicately brought up, are most subject to it. It more frequently attacks men than women, and is very diffi­cult to cure. When the epilepsy attacks children, there is reason to hope it may go off about the time of puberty. [Page 296] When it attacks any person after twenty years of age, the cure is difficult; but when after forty, a cure is hardly to be ex­pected. If the fit continues only for a short space, and re­turns seldom, there is reason to hope; but if it continues long and returns frequently, the prospect is bad. It is a very unfavourable symptom, when the patient is seized with the fits in his sleep.

CAUSES.—Sometimes the epilepsy is a hereditary disease. It may likewise proceed from a sudden fright of the mother when with child of the patient; from blows, bruises, or wounds on the head; a collection of water, blood, or serous humours in the brain; a polypus; tumours or concretions within the skull; excessive drinking; intense study; excess of venery; worms; teething; suppression of customary evacuations; too great emptiness or repletion; violent passions or affections of the mind, as fear, joy, &c. hysteric affections; contagion received into the body, as the infection of the small-pox, measles, &c.

SYMPTOMS.—An epileptic fit is generally pre­ceded by an unusual weariness; pain of the head; dulness; giddiness; noise in the ears; dimness of sight; palpitation of the heart; disturbed sleep; difficult breathing; the bow­els are inflated with wind; the urine is in great quantity, but thin; the complexion is pale; the extremities are cold, and the patient feels as it were a stream of cold air ascend­ing towards his head.

IN the fit, the patient generally makes an unusual noise; his thumbs are drawn in towards the palms of the hands; his eyes are distorted; he starts, and foams at the mouth; his extremities are bent or twisted various ways; he often discharges his seed, urine, and foeces involuntarily; and is quite destitute of all sense and reason. After the fit is over, his senses gradually return, and he complains of a kind of stupor, weariness, and pain of his head; but has no remem­brance of what happened to him during the fit.

SOMETIMES the fits return at stated periods, as at the full or change of the moon: at other times they are excited by violent affections of the mind, a debauch of liquor, ex­cessive heat, cold, or the like.

THIS disease, from the difficulty of investigating its causes, and its strange symptoms, was formerly attributed to the wrath of the gods, or the agency of evil spirits. In modern times it has often, by the vulgar, been imputed to [Page 297] witchcraft or fascination. It depends however as much up­on natural causes as any other malady; and its cure can only be effected by persisting in the use of proper means.

REGIMEN.—Epileptic patients ought, if possible, to breathe a pure and free air. Their diet should be nourish­ing, but of easy digestion. They ought to drink nothing strong, to avoid swines flesh, water-fowl, and likewise all windy and oily vegetables, as cabbage, nuts, &c. They ought to keep themselves cheerful, carefully avoiding all occasions of violent passions, as anger, fear, &c ^*.

EXERCISE is likewise of great use; but the patient must be careful to avoid all extremes either of heat or cold, all dangerous situations, as standing upon precipices, riding deep waters, &c. Any thing that makes him giddy, is apt to occasion a [...]it, as turning round, looking into a deep pit, or the like; all these ought therefore to be avoided with the utmost care.

MEDICINE.—The intentions of cure must vary according to the cause of the disease. If the patient be of a sanguine temperament, and there be reason to fear an inflammation in the brain, bleeding and other evacuations will be necessary. When the disease is occasioned by the stoppage of customary evacuations, these, if possible, must be restored; if this cannot be done, others may be substi­tuted in their place. Issues or setons, in this case, have often a very good effect. When there is reason to believe that the disease proceeds from worms, proper medicines must be used to kill or carry off these vermin. When the disease proceeds from teething, the belly should be kept open by emollient clysters, the feet frequently bathed in warm wa­ter, and, if the fits prove obstinate, a blistering plaster may be put betwixt the shoulders. The same method is to be followed, when epileptic fits precede the eruption of the small-pox, or measles, &c.

WHEN the disease is hereditary, or proceeds from a wrong formation of the brain a cure is not to be expected. When it is owing to some fault in the nervous system such [Page 298] medicines as tend to brace and strengthen the nerves may be used, as the Jesuits bark, Valerian root, misletoe of the oak, snake-root, &c.

FULLER recommends the following electuary as a most excellent anti-epileptic. Take Jesuits bark in powder three ounces, Virginian snake-root powdered one ounce, as much syrup of paeony or cloves as is sufficient to form it in­to a soft electuary. The dose to an adult is a dram, or a­bout the size of a nutmeg, morning and evening. It must be continued for three or four months, and after­wards repeated, three or four days before the new and full moon, for some time.

MEAD recommends an electuary against the epilepsy much of the same nature, only he uses Valerian-root in place of the snake-root. It must be taken in the same manner as the above. The patient ought always to be bled, and to take a purge or two before he begins to use these medicines. They will likewise have a better effect if the patient drinks a tea-cupful of the decoction of guaiacum after each dose. It may be made by boiling two ounces of guaiacum shavings, and one ounce of raisins of the sun stoned, in two English quarts of water to one. Strain the liquor, and afterwards let it stand to settle, then pour off the clear from the feces.

COLEBATCH says, that the misletoe cures an epilepsy as certainly as the Jesuits bark does an intermittent fever. The dose to an adult is half a dram of the powder, four times a-day, drinking after it a draught of a strong infusion of the same plant. Though this medicine has not been found to answer the high encomiums which have been passed upon it, yet in obstinate epileptic cases it deserves a trial. It must be used for a considerable time, in order to produce any sa­lutary effects.

MUSK has sometimes been found to answer very well in the epilepsy. Ten or twelve grains of it, with the same quantity of factitious cinnabar, may be made up into a bo­lus and taken every night and morning.

SOMETIMES the epilepsy has been cured by electricity.

CONVULSION FITS proceed from the same causes, and must be treated in the same manner as the epilepsy.

THERE is one particular species of convulsions, which commonly goes by the name of St. Vitus's dance, wherein the patient is agitated with strange motions and gesticulati­ons, which by the common people are generally believed [Page 299] to be the effects of witchcraft. This disease may be cured by repeated bleedings and purges; and afterwards using the medicines prescribed above for the epilepsy, viz. the jesuits-bark, and snake-root, &c. Chalybeate waters, are found to be beneficial in this case. The cold bath is likewise of singular service, and ought never to be neglected when the patient can bear it.

OF NERVOUS, HYSTERIC, AND HYPOCHONDRIAC DISORDERS.

OF ALL diseases incident to mankind, those of the ner­vous kind are the most complicated and difficult to cure. A volume would not be sufficient to point out the various symptoms. They imitate almost every disease; and are sel­dom alike in two different persons, or even in the same person at different times. Like Proteus, they are continual­ly changing shape; and upon every fresh attack, the pati­ent thinks he feels symptoms which he never experienced before. Nor do they only effect the body, the mind like­wise suffers, and is often thereby rendered extremely weak and peevish. The low spirits, timorousness, melancho­ly, and fickleness of temper which generally attend ner­vous disorders, induce many people to believe, that they are entirely diseases of the mind; but this change of temper is rather a consequence, than the cause of nervous diseases.

CAUSES.—Every thing that tends to relax or weaken the body, predisposes it to nervous diseases, as in­dolence, excessive venery, drinking great quantities of tea, or other weak watery liquors, frequent bleeding, purging, vomiting, &c. Whatever hurts the digestion, or prevents the proper assimilation of the aliment, has likewise this ef­fect, as long fasting, excess in eating or drinking, the use of windy, crude, or unwholesome aliments, a bending posture of the body, &c.

NERVOUS disorders often proceed from affections of the mind, as grief, disappointments, anxiety, intense study, &c. Few studious persons are free from nervous diseases. Nor is this at all to be wondered at; intense thinking not only preys upon the spirits, but prevents the person from taking proper exercise, by which means the digestion i [...]-im­paired, the nourishment prevented, the solids relaxed, and the whole mass of humours vitiated. Grief and disappoint­ment [Page 300] likewise produce the same effects. I have known more hysteric and hypochondriac patients, who dated the commencement of their disorders from the loss of a husband, a favourite child, or from some disappointment in life, than from any other cause. In a word, whatever weakens [...]he body, or depresses the spirits, may occasion nervous dis­orders, as unwholesome air, want of sleep, great fatigue, &c.

SYMPTOMS.—We shall only mention some of the most general symptoms of these disorders, as it would be both an useless and impracticable task to point out the whole. They generally begin with windy inflations or di­stensions of the stomach and intestines, especially under the false ribs of the left side, where a hard tumour may some­times be perceived. The appetite and digestion are general­ly bad; yet sometimes there is an uncommon craving for food, and a quick digestion. The food often turns sour on the stomach; and the patient is troubled with vomiting of clear water, tough phlegm, or a blackish coloured liquor resembling the grounds of coffee. Excruciating pains are often felt about the navel, attended with a rumbling or murmuring noise in the bowels. The belly is sometimes loose, but more commonly bound, which occasions a reten­tion of wind and great uneasiness.

THE urine is sometimes in small quantity, at other times very copious and quite clear. There is a great straitness of the breast with difficulty of breathing; violent palpitations of the heart; sudden flushings of heat in various parts of the body; at other times a sense of cold, as if water were pour­ed on them; flying pains in the arms and limbs; pains in the back and belly, resembling those occasioned by gravel; the pulse very variable, sometimes uncommonly slow, and at other times very quick; yawning, the hiccup, frequent sighings and a sense of suffocation, as if from a ball or lump in the throat; alternate fits of crying and convulsive laugh­ing; the sleep is unsound, and seldom refreshing; and the patient is often troubled with the night-mare.

AS the disease increases, the patient is molested with headachs, cramps, and fixt pains in various parts of the body; the eyes are clouded, and often affected with pain and dryness; there is a noise in the ears, and often a dull­ness of hearing; in short, the whole animal functions are impaired. The mind is disturbed on the most trivial occa­sions, [Page 301] and is hurried into the most perverse commotions, in­quietudes, terror, sadness, anger, diffidence, &c. The pa­tient is apt to entertain wild imaginations, and extravagant fancies; the memory becomes weak, and the reason fails. Nothing is more characteristic of this disease than a constant dread of death. This renders the patients peevish, fickle, impatient, and apt to run from one physician to another; which is one reason why they seldom reap any benefit from medicine, as they have not sufficient resolution to persist in any one course till it has time to produce its proper effects. They are likewise apt to imagine that they labour under dis­eases from which they are quite free, and are very angry if any one attempts to laugh them out of their ridiculous no­tions.

REGIMEN.—Hysteric and hypochondriac per­sons ought never to fast long. Their food should be solid and nourishing, but of easy digestion. Fat meats, and heavy sauces, are hurtful. All excess should be carefully avoided. They ought never to eat more at a time than they can easily digest. Heavy suppers are to be avoided. If the patient feels himself weak and faint between meals, he ought to eat a bit of bread, and drink a glass of wine. Tho' wine in excess enfeebles the body, and impairs the faculties of the mind, yet taken in moderation, it strengthens the stomach, and promotes digestion. Wine and water is a very proper drink at meals. If wine sours on the stomach, or the patient is much troubled with wind, brandy and wa­ter will answer better. Every thing that is windy, or hard of digestion, must be avoided. All weak and warm liquors are hurtful, as tea, coffee, punch, &c. People may find a temporary relief from these, but they always increase the malady, as they weaken the stomach, and hurt digestion. Above all things, drams are to be avoided. Whatever im­mediate ease the patient may feel from the use of ardent spi­rits, they are sure to aggravate the malady, and prove cer­tain poisons at last. These cautions are the more necessa­ry here, as all hysteric and hypochondriac persons are pe­culiarly fond of tea and ardent spirits; to the use of which many of them fall a victim.

EXERCISE is of such importance in nervous disorders, that it is worth all other medicines. Riding on horseback is generally esteemed the best, as it gives motion to the whole body, without fatiguing it. I have known some patients, [Page 302] however, with whom walking agreed better, and others who were most benefited by riding in a machine. Every one ought to use that which he finds most beneficial. Long sea-voyages have an excellent effect; and to those who can afford to take them, and have sufficient resolution, we would by all means recommend this course. Even change of place, and the sight of new objects, by diverting the mind, have a great tendency to remove these complaints. For this reason a long journey, or a voyage, is of much more advantage than riding short journeys near home.

A cool and dry air is the best, as it braces and imparts vigour to the whole body. Nothing tends more to relax and enervate than hot air, especially that which is render­ed so by great fires, or stoves in small apartments. But when the stomach or bowels are weak, the body ought to be well guarded against cold, especially in winter, by wear­ing a thin flannel waistcoat next the skin. This will keep up an equal perspiration, and defend the alimentary canal from many impressions, to which it would otherwise be subject, upon every sudden change from warm to cold wea­ther. Rubbing the body frequently with a flesh-brush, or a coarse linen cloth, is likewise beneficial, as it promotes the circulation, perspiration, &c. Persons who have weak nerves ought to rise early, and take exercise before break­fast, as lying too long a-bed cannot fail to relax the solids. They ought likewise to be diverted, and to be kept as easy and cheerful as possible. Nothing hurts the nervous system, or weakens the digestive powers more than fear, grief, or anx­iety.

MEDICINES.—Tho' nervous diseases are sel­dom radically cured, yet their symptoms may sometimes be alleviated, and the patient's life rendered, at least, more comfortable, by proper medicines.

WHEN the patient is costive, he ought to take a little rhubarb, or some other mild purgative, and should never suffer his belly to be long bound. All strong and violent purga­tives are however to be avoided, as aloes, jalap, &c. I have generally seen an infusion of senna and rhubarb in brandy answer very well. This may be made of any strength, and taken in such quantity as the patient finds necessary.

WHEN the digestion is bad, and the stomach relaxed and weak, bitters will be of service. The best of these are the jesuits bark and gentian root, which may be prepared and [Page 303] used in the following manner. Take jesuits bark in pow­der, an ounce and a half, gentian-root and orange peel bruised, of each half an ounce. Infuse these ingredients in a bottle of brandy or whisky, for five or six days, then strain the liquor, and take a table spoonful in half a glass of water an hour before breakfast, dinner, and supper.

NOTHING tends more to strengthen the nervous system than cold bathing. This practice, if duly persisted in, will produce very extraordinary effects; but when the liver or other viscera are obstructed, or otherwise unsound, the cold bath is improper. The most proper seasons for it are summer and autumn. It will be sufficient, especially for persons of a spare habit, to go into the cold bath three or four times a week. If the patient be weakened by it, or feels chilly for a long time after coming out, it is improper.

IN patients afflicted with wind, I have always observed the greatest benefit from the acid elixir of vitriol. It may be taken in the quantity of fifteen, twenty, or thirty drops, twice or thrice a-day, in a glass of water. This both ex­pels wind, strengthens the stomach, and promotes digesti­on.

OPIATES are greatly extolled in these maladies; but as they only palliate the symptoms, and generally afterwards increase the disease, we would advise people to be extreme­ly cautious in the use of them, lest habit render them at last absolutely necessary.

IT would be an easy matter to enumerate many medicines which have been extolled for relieving nervous disorders; but whoever wishes for a thorough cure must expect it from regimen alone; we shall therefore omit mentioning more medicines, and again recommend the strictest attention to DIET, AIR, EXERCISE, and AMUSEMENTS.

OF MELANCHOLY AND MADNESS.

MELANCHOLY and madness are nearly allied. They both proceed from the same origin, and may be considered as only different degrees of the same disease. A delirium without a fever is the common definition of madness: Indeed it is not a very accurate one; but there is no great occasi­on to be solicitous about the definition of a disease which every body knows. It is of far greater importance to know how it is occasioned, and by what means it may be cured.

[Page 304] CAUSES.—It may proceed from a hereditary dis­position; intense thinking, especially where the mind is long occupied about one object; violent passions or affecti­ons of the mind, as love, fear, joy, grief, over-weening pride, and such like. It may also be occasioned by exces­sive venery; narcotic or stupifactive poisons; a sedentary life; solitude; the suppression of customary evacuations; accute fevers, or other diseases. Violent anger will change melancholy into madness; and excessive cold, especially of the lower extremities, will force the blood in­to the brain, and produce all the symptoms of madness. It may likewise proceed from the use of aliment that is hard of digestion, or which cannot be easily assimilated; from a callous state of the integuments of the brain, or a dryness of the brain itself. To all which we may add gloomy or mistaken notions of religion ^*.

SYMPTOMS.—When persons begin to be me­lancholy, they are dull; dejected; timorous; watchful; fond of solitude; fretful; fickle; captious and inquisitive; solicitous about trifles; sometimes niggardly, and at other times prodigal. The belly is generally bound; the urine thin, and in small quantity; the stomach and bowels in­flated with wind; the complexion pale; the pulse slow and weak. The functions of the mind are also greatly pervert­ed, in so much that the patient often imagines himself dead, or changed into some other animal. Some have ima­gined, their bodies were made of glass, or other brittle sub­stances, and were afraid to move lest they should be broken in pieces. The unhappy patient, in this case, unless care­fully watched, is apt to put an end to his own miserable life.

THE signs of approaching madness are: Redness of the eyes, with a tremulous and constant vibration of the eye­lids; a change of disposition and behaviour; supercilious looks; a haughty carriage; grinding of the teeth; unac­countable malice to particular persons; excessive watchful­ness, violent headachs; quickness of hearing; noise in the ears, &c.

[Page 305] PERSONS actually mad are in an excessive rage when pro­voked to anger. Some wander about, others make a hide­ous noise. Some shun the sight of men; others, if permit­ted, would tear themselves, or those whom they meet, to pieces. Some in the highest degree of the disorder see ima­ges before their eyes, and fancy themselves struck with lightening. To these we may add incredible strength, and great insensibility to hunger and cold.

WHEN the disease is owing to an obstruction of custom­ary evacuations, or any bodily disorder, it is easier cured than when it proceeds from the mind. Madness attended with mirth is not so dangerous as that which is accompani­ed with sadness. A discharge of blood from the nose, a vi­olent looseness, scabby eruptions, the bleeding piles, or the menses, sometimes carry off this disease.

DISEASES of the mind often intermit for several years, and return again. In some they return annually at the sol­ [...]ics; in others about the time of the equinoxes. Some­times the raving fits observe the lunar periods; in which [...]ase the disease is thought to have some affinity with the e­pilepsy.

REGIMEN.—The diet ought to consist chiefly of vegetables of a cooling and opening quality. Animal food, especially salted or smoke-dried fish or flesh, ought to be avoided. All kinds of shell-fish are bad. Aliments pre­pared with onions, garlic, or any thing that generates thick blood, are likewise improper. All kinds of fruits that are wholesome may be eat with advantage. Boerhaave gives an instance of a patient who by a long use of whey, water, and garden-fruits, evacuated a great quantity of black matter, and recovered his senses. This seems to have been the method of cure practiced at the Assyrian court; where we find the monarch himself, when seized with mad­ness, was turned out to graze.

STRONG liquors of every kind ought to be avoided as poison. The most proper drink is water, whey, or very small beer. Tea and coffee are improper. If honey agrees with the patient, it may be eat freely, or his drink sweet­ened with it. Infusions of balm-leaves, penny-royal, the roots of wild valerian, or the flowers of the lime-tree, may be drank freely, either by themselves, or sweetened with honey, as the patient shall chuse.

[Page 306] THE patient ought to take as much exercise in the open air as he can bear. This helps to dissolve the viscid humours, it removes obstructions, promotes the perspiration, and all the other secretions. Every kind of madness is attended with a diminished perspiration; all means ought therefore to be used to promote that necessary and salutary discharge. Nothing can have a more direct tendency to increase the disease than the common method of confining the patient to a close apartment. Were a proper space allotted for him to run about in, where he could neither hurt himself nor others, it would contribute much to promote a cure. It would have still a better effect, if he were obliged to labour a piece of ground. By [...], hoeing, planting, sow­ing, &c. both the body and mind would be exercised.

A PLAN of this kind, with a strict vegetable diet, would be a more rational method of cure than confining the patient in Bedlam, o [...] sending him to a private mad-house. These institutions, as they are generally managed, are far more likely to make a wise man mad than to restore a madman to his senses. Even running about at large, tho' it may be attended with some bad consequences, is more likely to re­store the patient than confining him in a mad-house. I have known several instances of persons cured by exercise, amusements, and a vegetable diet, who, in all probability, had they been confined, would have continued lunatic for life. A long journey, or a voyage, especially into a warm­er climate, with agreeable companions, has often very hap­py effects.

MEDICINE.—IN the cure of madness, great re­gard must be paid to the mind. When the patient is in a low melancholy state, his mind ought to be soothed and di­verted with variety of amusements, as entertaining stories, pastimes, music, &c. This seems to have been the method of curing melancholy among the Jews, as we learn from the story of King Saul; and indeed it is a very rational one. Nothing can remove diseases of the mind so effectually as applications to the mind itself, the most efficacious of which is music. The patient's company ought likewise to con­sist of such persons as are agreeable to him. People in this state are apt to conceive unaccountable aversions against particular persons; and the very sight of such persons is sufficient to distract their minds, and throw them into the [Page 307] utmost perturbation. In all kinds of madness, it is better to sooth and calm the mind than to ruffle it by contradicti­on.

WHEN the patient is high, evacuations are necessary. In this case he must be bled, and have his belly kept open by purging medicines, as manna, rhubarb, cream of tartar, or the solube tartar. I have seen the last have very good ef­fects. It may be taken in the dose of half an ounce, dis­solved, in water gruel every day, for sundry weeks, or even for months, if necessary. More or less may be given according as it operates. Vomits have likewise a good ef­fect; but they must be pretty strong, otherwise they will not operate.

MADNESS has sometimes been cured by camphire. Ten or twelve grains of it may be rubbed in a mortar with half a dram of nitre, and taken twice a day, or oftner if the stomach will bear it. If it will not sit upon the stomach in this form, it may be made into pills with gum asafaetida and Russian castor, and taken in the quantity above direct­ed. Musk has likewise been found efficacious in this case; b [...] to have any effect, it must be given in large doses. A scruple or twenty five grains may be made into a bolus with a little honey or syrup, and taken twice or thrice a day. The antimonial wine is by some extolled for the cure of madness. It may be taken in the dose of forty or fifty drops, twice or thrice a day, in a cup of tea. The tincture of hellebore h [...]s likewise been in great esteem; but I never saw any con­siderable effects from it. Each of the above medicines may be of service in some particular case, provided it be duly persisted in, and where one fails, it may not be amiss to try another.

AS it is very difficult to induce patients in this disease to take medicines, we shall mention some outward appli­cations which sometimes do good; the principal of these are issues, setons, and cold bathing. Issues may be [...] in any part of the body, but they generally have the [...] ef­fect near the spine of the back. The discharge from these may be greatly promoted by dressing them with the mild blistering ointment, and keeping what are commonly called the orrice peas in them. The salt water is most proper for bathing in; but when that cannot be obtained, the patient may be daily immersed in fresh water. Some [Page 308] recommend bathing the body in warm water, and at the same time pouring cold water upon the head.

THAT kind of madness or delirium which proceeds from mere weakness, requires a quite different method of treat­ment. It is often the effect of fevers injudiciously treated, wherein the patient's strength has been exhausted by frequent bleedings and purgings. This must be removed by nourish­ing diet, exercise proportioned to the patient's strength, and cordial medicines. All evacuations are here carefully to be avoided. The patient may take frequently a glass of good wine, in which a little jesuits bark has been infused.

OF POISONS.

EVERY person ought, in some measure, to be acquaint­ed with the nature and cure of poisons. They are general­ly taken unawares, and their effects are often so sudden and violent, as not to admit of delay, or allow time to procure the assistance of physicians. Indeed no great degree of me­dical knowledge is here necessary, the remedies for most poisons being generally at hand, or easily obtained, and nothing but common prudence needful in the application of them.

THE vulgar notion that every poison is cured by some counter poison, as a specific, has done much hurt. People believe they can do nothing for the patient, unless they know the particular antidote to that kind of poison which he has taken. Whereas the cure of all poisons taken into the stomach, without exception, depends on discharging them as soon as possible.

THERE is no case wherein nature points out the method of cure more clearly than in this. Poison is seldom long in the stomach before it occasions sickness with an inclination to vomit. This shews plainly what ought to be done. In­deed common sense dictates to every man, that, if any thing has been taken into the stomach which endangers life, it ought immediately to be discharged. Were this duly re­garded, most of the mischief occasioned by poison might be prevented. The method of cure is obvious, and the means of performing it are in the hands of every man.

POISONS, either belong to the animal, vegetable, or mi­neral kingdom.

[Page 309] MINERAL poisons are commonly of an acrid or corrosive quality, as arsenic, the corrosive sublimate of mercury, &c.

THOSE of the vegetable kind are generally of a narcotic or stupifactive quality, as poppy, hemlock, henbane, ber­ries of the deadly night-shade, &c.

POISONOUS animals communicate their infection, either by the bite or sting. This poison is very different from the former, both in its symptoms and cure.

MINERAL POISONS.—Arsenic is the most common of this class; and, as the whole of them are pret­ty similar both in their effects and method of cure, what is said with respect to it will be applicable to every other spe­cies of corrosive poison.

WHEN a person has taken arsenic, he soon percieves a burning heat, and violent pricking pain in his stomach and bowels, with vomiting and intolerable thirst. The tongue and throat feel rough and dry; and, if proper help be not soon administred, the patient is seized with great anxiety, hiccupping, faintings, and coldness of the extremeties. To these succeed black vomits, foetid stools, with a mortifica­tion of the stomach and intestines, which are the immedi­ate forerunners of death.

ON the first appearance of these symptoms, the patient should drink large quantities of new milk and salad oil till he vomits; or he may drink warm water mixed with oil. Fat broths are also proper, provided they can be got ready in time. Where no oil is to be had, fresh butter may be melted and mixed with the milk or water. These things are to be drank as long as the inclination to vomit conti­nues. Some have drank eight or ten English quarts before the vomiting ceased; and it is never safe to leave off drink­ing while one particle of the poison remains in the stomach.

THESE oily or fat substances not only provoke vomiting, but likewise blunt the acrimony of the poison, and prevent its wounding the bowels; but if they should not make the person vomit, half a [...] or two scruples of the powder of ipecacoanha must be given, or a few spoonfuls of the oxy­mel of squills mixed with the water which he drinks. Vo­miting may likewise be excited by tickling the inside of the throat with a feather.

IF the tormenting pains are felt in the lower belly, and there is reason to fear, that the intestines are attacked, clys­ters of milk and oil must be very frequently thrown up; [Page 310] and the patient must drink emollient decoctions of bar­ley, oatmeal, marshmallows, and such like.

AFTER the poison has been evacuated, the patient ought, for some time, to live upon such things as are of a healing and cooling quality. To abstain from flesh and all strong liquors, and to live upon milk, broth, gruel, light pud­dings, and other spoon mea [...]s of easy digestion. His drink should be barley-water, linseed-tea, or infusions of any of the mild mucilaginous vegetables.

VEGETABLE POISONS, besides heat and pain of the stomach, commonly occasion some degree of giddiness, and often a kind of stupidity or folly. Persons who have taken these must be treated in the same manner as for the mineral or corrosive.

THOUGH the vegetable poisons, when allowed to remain in the stomach, often prove fatal; yet the danger is gene­rally over as soon as they are discharged. Not being of such a caustic or corrosive nature, they are less apt to wound and inflame the bowels than mineral substances, no time however ought to be lost in having them expelled the sto­mach.

OPIUM, being frequently taken by mistake, merits par­ticular attention. It is used as a medicine both in a solid and liquid form, which latter commonly goes by the name of laudanum. It is indeed a valuable medicine when taken in proper quantity; but as an over-dose proves a strong poison, we shall point out its common effects, to­gether with the method of cure.

TOO great a quantity of opium generally occasions great drowsiness, with stupor and other apoplectic symptoms. Sometimes the person has so great an inclination to sleep, that it is almost impossible to keep him awake. Every me­thod must however be tried for this purpose. He should be tossed, shaked, and moved about. Sharp blistering plasters should be applied to his legs or arms, and stimulating me­dicines, as salts of hartshorn, &c. held under his nose. It will also be proper to let blood. At the same time every method must be taken to make him discharge the poison. This may be done in the manner directed above, viz. by the use of strong vomits, drinking plenty of warm water with oil, &c.

MEAD, besides vomits, in this case, recommends acid medicines with lixivial salts. He says, that he has often [Page 311] given salt of wormwood mixed with juice of lemon in re­peated doses with great success.

IF the body should remain weak and languid after the poison has been discharged, nourishing diet and cordials will be necessary; but when there is reason to fear that the sto­mach or bowels are inflamed, the greatest circumspection is necessary both with regard to food and medicine.

ANIMAL POISONS.—We shall begin with the bite of a mad dog, as it is both the most common and dangerous animal poison in this country.

THE creatures naturally liable to contract the hydropho­bia are, so far as we yet know, all o [...] the dog-kind, viz. dogs, foxes, and wolves. O [...] the last we have none in this island; and it so seldom happens that any person is bit by the second, that they scarce deserve to be taken notice of. If such a thing should happen, the method of treatment is precisely the same as for the bite of a mad dog.

THE symptoms of madness in a dog are as follow. At first he looks dull, shews an aversion to food and company: He does not bark as usual, but seems to murmur, is peevish, and apt to bite strangers: His [...]ars and tail droop more than usual, and he appears drowsy. Afterwards he begins to loll out his tongue, and froth at the mouth, his eyes seeming heavy and watery. He now, if not confined, takes off, runs panting along with a kind of dejected air, and endea­vours to bite every one he meets. Other dogs are said to fly from him. Some think this a certain sign of madness sup­posing that they know him by the smell; but it is not to be depended on. If he escapes being killed, he seldom runs above two or three days, till he dies exhausted with heat, hunger, and fatigue.

THIS disease is most frequent after long dry hot seasons; and such dogs as live upon putrid stinking carrion, without having enough of fresh water, are most liable to it.

WHEN any person is bit by a dog, the strictest enquiry ought to be made, whether the animal be really mad. Many disagreeable consequences arise from neglecting to as­certain this point. Some people have lived in continual anxiety for many years, because they had been bit by a dog which they believed to be mad; but, as he had been killed on the spot, it was impossible to ascertain the fact. This should induce us, instead of killing a dog the moment he [Page 312] has bit any person, to do all in our power to keep him alive, at least till we can be certain whether he be mad or not.

MANY circumstances may contribute to make people imagine a dog mad. He loses his master, runs about in quest of him, is set upon by other dogs, and perhaps by men. The creature thus frightened, beat, and abused, looks wild, and lolls out his tongue as he runs along. Immediately a crowd is after him; while he, finding himself closely pur­sued, and taking every one he meets for an enemy, natu­rally attempts to bite in self-defence. He soon gets knock­ed on the head, and passes currently for a mad dog, as it is then impossible to prove the contrary.

THIS being the true history of, by far, the greater part of those dogs which pass for mad, is it any wonder that numberless whimsical medicines have been extolled for pre­venting the effects of their bite? This readily accounts for the great variety of infallable remedies for the bite of a mad dog, which are to be met with in almost every family. Though not one in a thousand has any claim to merit, yet they are all supported by numberless vouchers. No wonder that imaginary diseases should be cured by imaginary reme­dies. In this way credulous people first impose upon them­selves, and then deceive others. The same medicine that was supposed to prevent the effects of the bite, when the dog was not mad, is recommended to a person who has had the misfortune to be bit by a dog that was really mad. He takes it, trusts to it, and is undone.

TO these mistakes we must impute the frequent ill suc­cess in preventing the effects of the bite of a mad dog. It is not owing so much to a defect in medicine, as to wrong applications. I am persuaded if proper medicines were taken immediately after the bite is received, and continued for a sufficient length of time, we should not lose one in a thousand of those who have the misfortune to be bit by a mad dog.

THIS poison is generally communicated by a wound, which, nevertheless, heals as soon as a common wound: But afterwards it begins to feel painful, and as the pain spreads towards the neighbouring parts, the person becomes heavy and listless. His sleep is unquiet with frightful dreams; he sighs, looks dull, and loves solitude. These are the forerunners, or rather the first symptoms, of that dreadful disease occasioned by the bite of a mad dog. But [Page 313] as we do not propose to treat the disease itself, but to point out the method of preventing it, we shall not take up time in shewing its progress from the first invasion to its com­monly fatal end.

THE common notion, that this poison may lie in the body for many years, and afterwards prove fatal, seems not to be well founded. It must render such persons as have had the misfortune to be bit very unhappy, and can have no good effects. If the person takes proper medicines for for­ty days after being bit, and feels no symptoms of the dis­ease, there is reason to believe him out of danger. Some indeed have gone mad twelve months after being bit; but I never knew it happen later; and of this I only remember to have seen one instance.

THE medicines recommended for preventing the effects of the bite of a mad dog, are chiefly such as promote urine and perspiration; to which may be added antispasmodics.

DR MEAD recommends a preventive medicine, which he says he never knew fail, though in the space of thirty years he had used it a thousand times.

THE medicine is as follows:

"TAKE ash-coloured ground liver-wort, cleaned, dried, and powdered, half an ounce; of black pepper powdered, a quarter of an ounce. Mix these well together, and divide the powder into four doses; one of which must be taken every morning fasting, for four mornings successively, in half an English pint of cows milk warm.

AFTER these four doses are taken, the patient must go into the cold bath, or a cold spring or river, every morning fasting, for a month; he must be dipped all over, but not stay in (with his head above water) longer than half a mi­nute, if the water be very cold. After this he must go in three times a-week for a fortnight longer.

THE person must be bled before he begins to use the me­dicine ^*."

[Page 314] WE shall next mention the famous East India specific, as it is called. This medicine is composed of cinnabar and musk. It is esteemed a great antispasmodic, and by many, thought to be an infallible remedy for preventing the effects of the bite of a mad dog.

"TAKE native and factitious cinnabar, of each twenty-four grains, musk sixteen grains. Let these be made into a fine powder, and taken in a glass of arrack or brandy."

THIS single dose is said to secure the person for thirty days, at the end of which it must be repeated; but if he has any symptoms of the disease, it must be repeated in three hours.

THE following is likewise a good antispasmodic medicine.

TAKE of Virginian snake-root in powder, half a dram, gum asafoetida twelve grains, gum Camphire seven grains; make these into a bolus with a little syrup of saffron.

CAMPHIRE may also be given in the following manner:

TAKE purified nitre half an ounce, Virginian snake-root in powder two drams, camphire one dram; rub them toge­ther in a mortar, and divide [...]he whole into ten doses.

MERCURY is another medicine of great efficacy, both in the prevention and cure of this kind of madness. When used as a preventive, it will be sufficient to rub daily a dram of the ointment into the parts about the wound.

VINEGAR is likewise of considerable service, and should be taken freely, either in the patient's food or drink.

THESE are the principal medicines recommended for preventing the effects of the bite of a mad dog. We would not however advise people to trust to any one of them; but from a proper combination of their different powers, there is the greatest reason to hope for success.

THE great error in the use of these medicines lies in not taking them for a sufficient length of time. They are used more like charms than medicines intended to produce any change in the body. To this, and not to the insufficiency [Page 315] of the medicines, must we impute their frequent want of success.

DR MEAD says, that the virtue of his medicine con­sists in promoting urine. But how a poison should be ex­pelled by urine, with only three or four doses of any medi­cine, however powerful, is not easy to conceive. More time is certainly necessary; and here the defect of the Doc­tor's prescription seems to lie.

THE East-India specific is still more exceptionable on this account.

AS these and most other medicines, taken singly, have frequently been found to fail, we shall recommend the fol­lowing course.

IF a person be bit in a fleshly part, where there is no hazard of hurting any large blood-vessel, the parts adjacent to the wound may be cut away. But if this be not done soon after receiving the bite, it will be better to omit it.

THE wound may be washed with salt and water, or a pickle made of vinegar and salt, and afterwards dressed twice a-day with yellow basilicon mixed with some red pre­cipitate.

THE patient should begin to use either Dr Mead's me­dicine, or some of the others mentioned above. If he takes Mead's medicine he may use it as the Doctor directs for four days successively. Let him then omit it for two or three days, and again repeat the same number of doses as before.

DURING this course, he must rub into the parts about the wound, daily, one dram of the mercurial or blue oint­ment, as it is called. This may be done for ten or twelve days at least.

WHEN this course is over, he may take a purge or two, and then begin to use the cold bath. This must be used every morning for five or six weeks; but if the patient should feel cold and chilly for a long time after coming out of the cold bath, it will be better to use a t [...]pid one, or to have the water [...] little warmed.

IN the mean time, we would advise him not to leave off all internal medicines, but to take either one of the boluses of snake-root, asafoetida and camphire; or one of the pow­ders of nitre, camphire, and snake-root, twice a-day. These may be continued for a fortnight or three weeks longer.

[Page 316] IF the person has gone through the above course of me­dicine, and no symptoms of madness appear, he may be reckoned out of danger. It will nevertheless be adviseable, for the greater safety, to take a dose or two of Dr Mead's medicine, at every full or change of the moon, for the three or four succeeding months.

DURING the use of the mercurial ointment, the patient must keep within doors, and take nothing cold.

A PROPER regimen must be observed during the whole course. The patient should abstain from flesh, and all salt­ed and high-seasoned provisions. He must avoid strong li­quors, and live mostly upon a light and rather spare diet. His mind should be kept as easy and cheerful as possible, and all excessive heat and violent passions avoided with the utmost care.

I HAVE never seen this course of medicine, with proper regimen, fail to prevent the hydrophobia, and cannot help again observing, that the want of success must generally be owing either to the application of improper medicines, or not using proper ones for a sufficient length of time.

MANKIND are extremely fond of every thing that promi­ses a sudden or miraculous cure. By trusting to these they often lose their lives, when a regular course of medicine would have rendered them absolutely safe. This holds re­markably in the present case: Numbers of people, for ex­ample, believe if they or their cattle be once dipped in the sea, it is sufficient: as if the salt water were a charm against the effects of the bite. This and such like whims have proved fatal to many.

SOME people believe, if a person be bit by a dog that is not m [...]d, if he should go mad afterwards, that the person will be seized with the disorder at the same time. This no­tion is too ridiculous to deserve a serious confutation ^*.

THE next poisonous animal that we shall mention is the VIPER. The grease of this animal rubbed into the wound is generally reckoned a cure for the bite. Though this is all that the viper-catchers commonly do when they are [Page 317] bit, I should hardly think it sufficient for the bite of an enraged viper. It would surely be more safe to have the wound well sucked, ^† and afterwards rubbed with warm sa­lad oil. A poultice of bread and milk, with plenty of salad oil in it, should likewise be applied to the wound, and the patient ought to drink freely of wine whey with some spirits of hartshhorn; or, if that be not at hand, of water gruel with vinegar in it, to make him sweat. If the patient be sick, he may take a vomit. This course will be sufficient for the bite of any of the poisonous animals of this country.

WITH regard to poisonous insects, as the bee, wasp, hornet, &c. their stings are seldom attended with great dan­ger, unless where a person happens to be stung by a num­ber of them at once. In this case something should be done to abate the pain and inflammation. Some, for this pur­pose, apply honey, others lay pounded parsley to the part. Some recommend a mixture of vinegar and Venice-treacle; but I have always found rubbing the part with warm salad-oil succeed very well. Indeed, if the stings be so numerous as to endanger the patient's life, which is sometimes the case, he must not only have oily poultices applied to the part, but must likewise be bled and take some cooling me­dicines, as nitre, cream of tartar, &c. with plenty of dilu­ting liquors.

IT is the happiness of this island to have very few poison­ous animals, and even these are not of the most virulent kind. Nine tenths of the effects usually attributed to poi­son or venom are really other diseases, and depend upon quite different causes.

WE cannot however make the same observation with re­gard to poisonous vegetables. These abound every where, and prove often fatal to the ignorant and unwary ^*. This [Page 318] indeed is, in a great measure, owing to carelessness. Chil­dren ought early to be cautioned against eating any sort of roots or berries which they do not know. We would like­wise advise parents to destroy all poisonous plants in their gardens, &c. or else to keep them in places where their children can have no access.

BUT it is not children alone who suffer by eating poiso­nous plants: We have every year accounts of adults poison­ed by eating hemlock-roots instead of parsnips, or some fungus which they gather for mushrooms, &c. These ex­amples ought to put people upon their guard with respect to the former, and put the latter entirely out of use.

OF THE STONE AND GRAVEL.

WHEN small stones are lodged in the kidneys, or dis­charged along with the urine, the patient is said to be afflic­ted with gravel. If one of these stones happens to make a lodgment in the bladder for some time, it accumulates fresh matter, and at length becomes too large to pass off with the urine. In this case the patient is said to have the stone.

CAUSES.—THIS disease may be occasioned by high living; the use of strong astringent wines ^*; a seden­tary life; lying too hot, soft, or too much on the back; the constant use of water which is impregnated with earthy or stony particles, aliments of an astringent or windy na­ture, &c. It may likewise proceed from an hereditary dis­position. Persons in the decline of life, and those who have been much afflicted with the gout or rheumatism are most subject to it.

SYMPTOMS.—SMALL stones or gravel in the kidneys occasion pain in the loins; sickness; vomiting; and sometimes bloody urine. When the stone descends into the ureter, and is too large to pass along with ease, all the above symptoms are increased; the pain extends to­wards the bladder; the thigh and leg of the affected side feel benumbed; the testicles are drawn upwards, and the urine is obstructed.

[Page 319] A STONE in the bladder is known from a pain at the time, as well as before and after making water; from the urine coming away by drops, or stopping suddenly when in a full stream; by a violent pain in the neck of the blad­der upon motion, especially on horseback or in a coach on rough road; from a white, thick, copious, stinking, mu­cous sediment in the urine; from an itching in the top of the penis; from an inclination to go to stool while the urine is discharged; from the patient's passing his urine more ea­sily when lying than in an erect posture; and from a kind of convulsive motion occasioned by the sharp pain in dis­charging the last drops of the urine.

REGIMEN.—Persons afflicted with the gravel or stone should, avoid aliments of a windy or heating nature, as salt-meats, sour fruits, &c. Their diet ought chiefly to consist of such things as tend to promote the secretion of u­rine, and to keep the belly open. Artichoaks, asparagus, spinnage, lettuces, succory, parsley, purslane, turnip [...], po­tatoes, carrots, and radishes may be safely eat. Onions, leeks, and cellery are, in this case, reckoned medicinal. The most proper drink is whey, butter-milk, milk and wa­ter, barley-water; decoctions of the roots of marshmallows, parsley, liquorice; or of other mild mucilaginous vegetables, as linseed, &c. If the patient has been accustomed to gene­rous liquors, he may drink small gin-punch without acid. But spirits must be used very sparingly, as every thing that heats is hurtful.

GENTLE exercise is proper; but if violent, it is apt [...] occcasion bloody urine. We would therefore advise that it should be taken in moderation. Persons afflicted with gra­vel often pass a great number of stones after riding on horse­back, or in a machine; but those who have a stone in the bladder are seldom able to bear these kinds of exercise. Where there is a hereditary tendency to this disease, a se­dentary life ought never to be indulged. Were people care­ful, upon the first symptoms of gravel, to observe a pro­per regimen of diet, and to take sufficient exercise, it might often be carried off, or, at least, prevented from in­creasing; but if the same course which occasioned the dis­ease be persisted in, it cannot fail to become worse.

MEDICINE.—In what is called a fit of the gra­vel, which is commonly occasioned by a stone sticking in the ureter or some part of the urinary passages, the patient must [Page 320] be bled, warm fomentations applied to the parts, emolient clysters administered, and diluting mucilaginous liquors drank, &c. The treatment of this case has been fully pointed out under the articles, inflammation of the kidneys and bladder, to which we refer the reader.

DR WHYTT advises patients who are subject to fre­quent fits of gravel in the kidneys, but have no stone in the bladder, to drink every morning, two or three hours before breakfast, an English pint of oyster or cockle-shell lime-water. The Doctor very justly observes, that though this quantity might be too small to have any sensible effect in dissolving a stone in the bladder; yet it may very probably prevent its growth.

WHEN a stone is formed in the bladder, the Doctor re­commends Alicant soap, and oyster or cockle-shell lime-water ^* to be taken in the following manner. The patient must swallow every day, in any form that is least disagreea­ble, an ounce of the internal part of Alicant soap, and drink three or four English pints of oyster or cockle-shell lime-water. The soap is to be divided into three doses; the largest to be taken fasting in the morning early; the se­cond at noon; and the third at seven in the evening, drinking above each dose a large draught of the lime-water; the remainder of which he may take any time betwixt din­ner and supper, instead of other liquors.

THE patient should begin with a smaller quantity of the lime-water and soap than what is mentioned above; at first an English pint of the former and three drams of the latter, taken daily, may be enough. This quantity, however, he may increase by degrees, and ought to persevere in the use of these medicines, especially if he finds any abatement of his complaints, for several months; nay, if the stone be very large, for years. It may likewise be proper for the patient, if he be severely pained, not only to begin with the soap and lime-water in small quantities, but to take the second or third lime-water instead of the first. However, after he has been for some time accustomed to these medi­cines [Page 321] he may not only take the first water, but, if he finds he can easily bear it, heighten its dissolving power still more by pouring it a second time on fresh calcined shells.

THE only other medicine which we shall mention is the uva ursi. It has been greatly extolled of late years both for the gravel and stone. It seems, however, to be, in all respects, inferior to the soap and lime-water; but as it is less disagreeable, and has frequently, to my knowledge, re­lieved gravelly complaints, it deserves a trial. It is general­ly taken in powder from half a dram to a whole dram, two or three times a-day. It may be mixed in a cup of tea or gruel, or taken in any way that is most agreeable to the pa­tient.

OF THE HICCUP.

THE hiccup is a spasmodic or convulsive affection of the stomach and midriff, arising from any cause that irritates their nervous fibres.

IT may proceed from excess in eating or drinking; from a hurt of the stomach; poisons; inflammations of the sto­mach, intestines, bladder, midriff, or the rest of the viscera. In gangrenes, acute and malignant fevers, a hiccup is often the forerunner of death. I have known an obstinate hic­cup proceed from a schirrous tumour of the pylorus, or right orifice of the stomach.

WHEN the hiccup proceeds from excess, especially from aliment that is flatulent, or hard of digestion, a draught of generous wine, or a dram of any spiritous liquor, will ge­nerally remove it. If poison be the cause, plenty of milk and oil must be drank, as has been formerly recommended. When it proceeds from an inflammation of the stomach, &c. it is very dangerous. In this case the cooling regimen must be observed. The patient must be bled, and take frequent­ly a few drops of the sweet spirits of nitre in a cup of wine-whey. His stomach must likewise be fomented with cloths dipped in warm water; or bladders filled with warm milk and water applied to it.

A HICCUP proceeding from a gangrene, or mortificati­on, is generally incurable. In this case the Peruvian bark, with other antiseptic medicines, are most likely to succeed. If the hiccup be a primary disease, and proceeds from a foul stomach, loaded either with a pituitous or a bilious hu­mour, [Page 322] a gentle vomit and purge, if the patient be able to bear them, will be of service. If it arises from flatulencies, the carminatives directed for the heart-burn, page 255. must be used.

WHEN the hiccup proves very obstinate, recourse must be had to the most powerful aromatic and antispasmodic medicines. The principal of these is musk; fifteen or twenty grains of which may be made into a bolus, and re­peated occasionally. Opiates are likewise of service; but they must be used with caution. A bit of sugar dipped in compound spirits of lavender, or the volatile aromatic tinc­ture, may be taken frequently. The Peruvian bark is like­wise of use. External applications are sometimes also be­neficial; as the stomach plaster, or a cataplasm of the Ve­nice treacle of the Edinburgh or London dispensatory, ap­plied to the stomach.

I LATELY attended a patient who had almost a constant hiccup for above nine weeks. It was frequently stopped by the use of musk, opium, wine, and other cordial and anti­spasmodic medicines, but always returned. Nothing in­deed gave the patient so much ease as brisk small beer. By drinking freely of this, the hiccup was often kept off for several days, which was more than could be done by the most powerful medicines. He was at length seized with a vomiting of blood, which soon put an end to his life. Up­on opening his body, a large schirrous tumour was found near the pylorus or right orifice of the stomach.

CRAMP OF THE STOMACH.

THO' this, for the most part, is only a symptom of ner­vous or hysteric disorders, we thought proper to treat it se­parately; as it often seizes people suddenly, is very dange­rous, and requires immediate assistance.

IF the patient has any inclination to vomit, he ought to take some draughts of warm water, or weak camomile tea, to clean his stomach. After this, if he has been costive, a laxative clyster must be given. He ought then to take some doses of laudanum. The best way of administering it is in a clyster. Sixty or seventy drops of liquid laudanum may be given in a clyster of warm water. This is much more certain than laudanum given by the mouth, which is often [Page 323] vomited, and in some cases increases the pain and spasms in the stomach.

IF the pain and cramps return with great violence, after the effects of the anodyne clyster are over, another with an equal or larger quantity of opium, may [...]e given; and e­very four or five hours a bolus with ten or twelve grains of musk, and half a dram of the Venice treacle. In the mean time, the stomach ought to be fomented with cloths dipped in warm water; or bladders filled with warm milk and wa­ter, should be constantly applied to it. I have often seen these produce the most happy effects. The anodyne balsam may also be rubbed into the stomach; and an antihysteric plaster worn upon it for some time after the cramps are re­moved, to prevent their return.

IN very violent and lasting pains of the stomach, some blood ought to be let, unless the weakness of the patient makes it improper. When the pain or cramps of the sto­mach proceed from a suppression of the menses, bleeding is of great use. If they be owing to the gout, some of the warm cordial waters, or a large dram of good brandy, or rum, will be necessary. Blistering plasters ought likewise, in this case, to be applied to the ancles.

WANT OF APPETITE.

THIS may proceed from a soul stomach; indigestable food; the want of free a [...]r and exercise; grief; fear; anx­iety; or any of the depressing passions; excessive heat; living much upon strong broths, or fat meats; the immo­derate use of strong liquors, tea, tabacco, opium, &c.

THE patient ought, if possible, to make choice of an o­pen dry air; to take exercise daily on horseback, or in a machine; to rise betimes; and to avoid all intense thought. He should use a diet of easy digestion, avoiding every thing that is fat and oily; he ought to chuse agreeable company; and should avoid intense heat and great fatigue.

IF want of appetite proceeds from errors in diet, or any other part of the patient's regiment, it ought to be changed. If nausea and reachings to vomit, shew that the stomach is loaded with crudities, a vomit will be of service. After this a gentle purge or two of rhubarb, or any of the bitter purging salts, may be taken. The patient ought next to use an infusion in wine of any of the stomachic bitters; as [Page 324] Gentian root, jesuits bark, orange peel, &c. He may also eat orange peel or ginger candied.

THOUGH gentle evacuations be necessary, all strong pur­ges and vomits are to be avoided, as they tend to weaken the stomach and hurt digestion. After proper evacuations, bitter elixirs and tinctures with aromatics may be used. The patient may take, twice a-day, a common spoonful of the stomachic tincture; or, if he be costive, the same quantity of the bitter tincture of rhubarb. Elixir of vitriol is an excellent medicine in most cases of indigestion, weak­ness of the stomach, or want of appetite. Twenty or thirty drops of it may be taken twice or thrice a-day in a glass of wine or water. It may likewise be mixed with the tincture of the bark, two drams of the former to a [...] [...] of the latter, and a tea-spoonful of it taken in win [...] o [...] [...]ater, as above.

THE chalybeate waters are of great service in this case. I [...]ver knew these fail to sharpen the appetite, if drank in [...]e [...]ation. The salt water has likewise this effect; but it [...]ust not be used too freely. The waters of Harrowgate, [...] [...]orough, Moffat, and most other spaws in Britain, [...] used with the same intention. We would advise [...] are afflicted with indigestion and want of appetite, [...] [...]air to these places of public rendezvous. The very change of air, and the cheerful company will be of service; not to mention the exercise, dissipation, amusements, &c.

OF DEAFNESS.

DEAFNESS is sometimes owing to an original fault, or wrong formation of the car itself. It may likewise be occa­sioned by wounds, ulcers, or any thing that destroys the fa­bric of the ear. It is often the effect of old age; of violent cold▪ in the head; of fevers; of excessive noise; of hard wax in the ear; of too great moisture or dryness of the ear, &c.

PERSONS who are born deaf are seldom cured. When deafness is the effect of wounds or ulcers in the ear, or of old age, it is not easily removed. If it proceeds from cold of the head, the patient must be careful to keep his head warm, especially in the night; he should likewise take a purge or two, and should keep his feet warm, and bathe them frequently in warm water. When deafness is the ef­fect [Page 325] of fevers, it generally ceases of itself, after the patient recovers strength. If it proceeds from dry wax sticking in the ears, it must be softened by dropping oil into them for a few nights, at bedtime; afterwards they must be syringed with warm milk and water, or milk and oil.

IF deafness proceeds from dryness of the ears, which may be known by looking into them, half an ounce of the oil of almonds, and the same quantity of liquid opod [...]ldoch, or tincture of asafoetida, may be mixed together, and a few drops of it put into the ear every night at bed-time, stopping them afterwards with a little wool or cotton. I have often known this have good effects. When the ears abound with moisture, it may be drained off by an issue or seton, which must be made as near the parts affected as possible.

MANY medicines are recommended for the cure of deaf­ness, some of which, in obstinate cases, at least, deserve a trial. Some recommend the gall of an eel mixed with spirit of wine, to be dropped into the ear; others equal parts of Hungary water and spirits of lavender. Etmuler recom­mends amber and musk; and Brookes says he has often known hardness of hearing cured by putting a grain or two of musk into the ear with cotton-wool. But these and o­ther application must be varied according to the cause. We cannot conclude this article without recommending the greatest attention to warmth. From whatever cause deaf­ness proceeds, the patient ought to keep his head warm. I have known more benefit from this alone, in the most obsti­nate cases of deafness, than from all the medicines I ever saw used.

OF THE NIGHT-MARE.

IN this disease the patient, in time of sleep, imagines he feels an uncommon oppression or weight about his breast or stomach, which he can by no means shake off. He groans, and sometimes cries out, tho' oftener he attempts to speak in vain. Sometimes he imagines himself engaged with an enemy, and, in danger of being killed, attempts to run a­way, but finds he cannot. Sometimes he fancies himself in a house that is on fire, or that he is in danger of being drowned in a river. He often thinks he is falling over a pre­cipice, and the dread of being dashed to pieces suddenly a­wakes him.

[Page 326] THIS disorder has been supposed to proceed from too much blood; from a stagnation of blood in the brain, lungs, &c. But its general cause is indigestion. Persons of weak nerves, who lead a sedentary life, and live full, are most commonly afflicted with the night-mare. Nothing tends more to produce it than heavy suppers, especially if eat late, or the patient goes to bed soon after. Wind is like­wise a very frequent cause of this disease; for which reason those who are afflicted with it ought to avoid all flatulent food. Deep thought, anxiety, or any thing that oppresses the mind, ought also to be avoided.

PERSONS afflicted with the night-mare ought to eat very light suppers. They should never go to bed immediately after eating, nor lie upon their back with the head low. As they generally moan, or make some noise in the fit, they should be waked, or spoken to by such as hear them, as the uneasiness generally goes off as soon as the patient is awake. Dr Whytt says he generally found a dram of brandy, taken at bed-time, prevent this disease. That, however, is a bad custom, and, in time, loses its effect. We would rather have the patient depend upon cheerfulness, and exercise through the day, a light supper taken early, and the use of food of easy digestion, &c. than to accustom himself to drams. A draught of cold water will often promote digestion as much as a glass of brandy, and is much safer. After a per­son of weak digestion however has eat flatulent food, a dram may be necessary; in this case we would recommend it as the most proper medicine.

PERSONS who are young, and full of blood, if troubled with the night-mare, ought to purge, bleed, and use a spare diet.

OF SWOONINGS.

THE principal causes of swooning are, sudden transiti­ons from cold to heat; breathing air that is deprived of its proper spring or elasticity; great fatigue; excessive weak­ness; loss of blood; long fasting; fear, grief, and other vi­olent passions or affections of the mind.

IT is well known, that persons who have been long ex­posed to cold, often faint or fall into a swoon, upon coming into the house, especially if they drink hot liquor, or sit near a large fire. This might easily be prevented by peo­ple [Page 327] taking care not to go into a warm room immediately after having been exposed to the cold air, to approach the fire gradually, and not to eat or drink any thing hot, till the body has been gradually brought into a warm tempera­ture.

WHEN any one, in consequence of neglecting these pre­cautions, falls into swoon, he ought immediately to be re­moved to a cooler apartment, to have ligatures applied above his knees and elbows, and to have his hands and face sprinkled with vinegar. He should likewise be made to smell to vinegar, and should have a spoonful or two of wa­ter, if he can swallow, with about a third part of vinegar mixed with it, poured into his mouth. If the fainting fits prove obstinate, it will be necessary to bleed the patient, and afterwards to give him a clyster,

As air that is breathed over and over loses its elasticity or spring, it is no wonder if persons who respire in it often fall into swooning or fainting fits. They are, in this case, deprived of the very principle of life. Hence it is that fainting fits are so frequent in all crowded assemblies, espe­cially in hot seasons. Such fits however must be consider­ed as a kind of temporary death; and, to the weak and de­licate, they sometimes prove fatal in reality. They ought therefore to be avoided with the utmost care. The method of doing this is obvious. Let assembly rooms, and all o­ther places of public resort, be well ventilated; and let the weak and delicate avoid such places, particularly in warm seasons.

A PERSON who faints, in such a situation, ought im­mediately to be carried into the open air; his temples should be rubbed with strong vinegar or brandy, and volatile spi­rits or salts held to his nose. He should be laid upon his back with his head low, and have a little wine, or some o­ther cordial, poured into his mouth, as soon as he is able to swallow it. If the person has been subject to hysteric fits, castor or asafoetida should be applied to the nose, or burnt feathers, horn, or leather, &c.

WHEN fainting fits proceed from mere weakness or ex­haustion, which is often the case after great fatigue, long fasting, loss of blood, or the like, the patient must be sup­ported with generous cordials, as jellies, wines, spirituous liquors, &c. These however must be given at first in very small quantities, and increased gradually as the patient is [Page 328] able to bear them. He ought to be allowed to lie quite still and easy upon his back, with his head low, and should have fresh air admitted into his chamber. His food should consist of nourishing broths, sago-gruel with wine, new milk, and other things of a light and cordial nature. These things are to be given out of the fit. All that can be done while the person continues in the fit is, to l [...]t him smell to a bottle of Hungary water, eau de luc [...], or spirits of harts­horn, and to rub his temples with warm brandy, or to lay a compress dipped in it to the pit of his stomach.

IN fainting fits that proceed from fear, grief, or other vi­olent passions to affections of the mind, the patient must be very cautiously managed. He should be suffered to remain at rest, and only made to smell to some vinegar. After he has come to himself he may drink freely of warm lemonade, or balm tea, with some orange or lemon peel in it. It will likewise be proper, if the fainting fits have been long and severe, to clean the bowels by throwing in an emolient clyster or two.

DISEASES OF WOMEN.

THE diseases peculiar to women arise chiefly from their monthly evacuations, pregnancy, and child-birth. Fe­males generally begin to menstruate about the age of fif­teen, and leave it off about fifty, which renders these two periods the most critical of their lives. About the first ap­pearance of this discharge the constitution undergoes a very considerable change, generally indeed for the better, but sometimes for the worse. The greatest care is now necessa­ry, as the future health and happiness of the female depends, in a great measure, upon her conduct at this period. If a girl about this time of life be confined to the house, kept constantly sitting, and neither allowed to romp about, nor employed in some active business, which gives exercise to the whole body, she becomes weak, relaxed and puny; her blood not being duly prepared, she looks pale and wan; her health, spirits, and vigor decline, and she sinks into a valetudinary for life. Such is the fate of numbers of those unhappy females who either from the indulgence of mo­thers, or their own narrow circumstances, are, at this cri­tical period of life, denied the benefit of exercise and free air.

[Page 329] A LAZY indolent disposition proves very hurtful to girls at this period. One seldom meets with complaints from obstructions amongst the more active and laborious part of the sex; whereas the indolent and lazy are seldom free from them. These are, in a manner, eat up by the chlorosis, or green sickness, and other diseases of this nature. We would therefore recommend it to all who wish to escape these calamities, to avoid indolence and inactivity, as their greatest enemies, and to take as much exercise, especially in the open air, as possible.

ANOTHER thing that proves very hurtful to girls about this period of life, is unwholesome food. Fond of all man­ner of trash, they often eat every out-of-the-way thing they can get, till their blood and humours are quite vitiated. Hence ensue indigestions, want of appetite, and a whole train of evils. If the fluids be not duly prepared, it is ut­terly impossible that the secretions should be properly per­formed; Accordingly we find that such girls as lead an in­dolent life, and eat great quantities of trash, are not only subject to obstructions of the menses, but likewise to glan­dular obstructions; as the scrophula or King's evil, &c.

A DULL disposition is likewise very hurtful to girls at this period. It is a rare thing to see a sprightly girl who does not enjoy good health, while the grave, moping, me­lancholy creature proves the very prey of vapours and hy­stericks. Youth is the season for mirth and cheerfulness. Let it therefore be indulged. It is an absolute duty. To lay in a stock of health in time of youth is as necessary a piece of prudence as to make provision against the decays of old age. While therefore wise Nature prompts the hap­py youth to join in sprightly amusements, let not the severe dictates of hoary age forbid the useful impulse, nor damp with serious gloom the seasons destined to mirth a [...] inno­cent festivity.

ANOTHER thing very hurtful to females about this p [...] ­od of life is strait cloaths. They are fond of a fine shape, and foolishly imagine, that this can be acquired by strait cloaths. Hence by squeezing their stomach and bowels they hurt the digestion, and occasion many incurable ma­ladies. This error is not indeed so common as it has been; but, as fashions change, it may come in again, we there­fore think it not improper to mention it. I know many fe­males who, to this day, feel the direful effects of that [Page 330] wretched custom which prevailed some time ago, of squeez­ing every girl into as small a size in the middle as possible. Human invention could not possibly have devised a practice more destructive to health.

AFTER a female has arrived at that period of life when the menses usually begin to flow, and they do not appear, but, on the contrary, her health and spirits begin to de­cline, we would advise, instead of shutting the poor girl up in the house, and dosing her with steel, asafoetida, and o­ther nauseous drugs, to place her in a situation where she can enjoy the benefit of free air and agreeable company. There let her eat wholesome food, take plenty of exercise and amusements, and we have little reason to fear but Na­ture, thus assisted, will do her proper work. She seldom fails unless where the fault is on our side.

WHEN the menses have once begun to flow, the greatest care should be taken to avoid every thing that may tend to obstruct them. Females ought to be exceeding careful of what they eat or drink at the time they are out of order. Every thing that is cold, or apt to sour on the stomach, ought to be avoided; as fruit, butter milk, and such like. Fish, and all kinds of food that are hard of digestion, are also to be avoided. As it is impossible to mention every [...] that may disagree with individuals at this time, we would recommend it to every female to be very attentive to what disagrees with her own stomach, and carefully to a­void it.

COLD is extremely hurtful to females at this particular period. More of the sex date their disorders from colds, [...] while they were out of order, than from all other causes. This ought surely to put them upon their guard, and to make them very circumspect in their conduct at such times. A degree of cold that will not in the least hurt them [...] another time, will, at this period, be sufficient to ruin their health and constitution altogether.

THE greatest attention ought at this time to be paid to the mind, which should be kept as easy and cheerful as possible. Every part of the animal oeconomy is influenced by the passions, but none more so than this. Anger, fear, grief, and other affections of the mind, often occasion ob­structions of the menstrual flux, which prove absolutely in­curable.

[Page 331] FROM whatever cause this flux is obstructed, unless the female be pregnant, proper means should be used to restore it. For this purpose we would rcommend plenty of exercise, in a dry, open, and rather cool air; wholesome diet, and, if the body be weak and languid, generous liquors; also cheerful company, and all manner of amusements. If these fail, the following medicines may be tried.

IF the obstructions proceed from a weak relaxed state of the solids, such medicines as tend to promote digestion, to brace the solids, and assist the body in preparing good blood, ought to be used. The principal of these are iron, the je­suits bark, and other bitter and a stringent medicines. Fi­lings of iron may be infused in wine or ale, two ounces to an English quart, and after it has stood in a warm place twenty four hours, it may be strained, and a small cupful drank three or four times a-day; or they may be reduced to a fine powder, and taken in the dose of half a dram, mixed with a little honey or treacle, three or four times a-day. The bark and other bitters may either be taken in substance or infusion as is most agreeable to the patient.

WHEN obstructions proceed from a viscid state of the blood, and the patient is of a gross full habit, evacuations, and such medicines as attenuate the humours, are necessa­ry. The patient, in this case ought to be bled, to bathe her feet frequently in warm water, to take now and then a dose of cooling physic, and to live upon a spare thin diet. Her drink should be whey, water, or small beer, and she ought to take plenty of exercise.

WHEN obstructions proceed from affections of the mind, every method should be taken to amuse and divert the pati­ent. And that she may the more readily forget the cause of her affliction, she ought, if possible, to be removed from the place where it happened. A change of place, by pre­senting the mind with a variety of new objects, [...] often a very happy influence in relieving it from the deepest dis­tress. A soothing, kind, and affable behaviour to persons in this situation is also of the last importance. This would often prevent, the fatal consequences which proceed from a harsh treatment of females, who are so unfortunate as to be crossed in their inclinations; or who meet with disappoint­ments in love, &c.

THO' many diseases proceed from obstruction, it is not always to be considered as the cause, but often as the ef­fect [Page 332] of other maladies. When that is the case, instead of giving medicines to force down the menses, which might be dangerous, we ought, by all means, to endeavour to restore the patient's health and strength. When that is effected the other will return of course.

BUT the menstrual flux may be too great as well as too small. When that is the case, the patient becomes weak, the colour pale, the appetite and digestion are bad, and oedematous swellings of the feet, dropsies and consumpti­ons often ensue. This frequently happens to women about the age of forty five or fifty, and is very difficult to cure. It may proceed from a sedentary life; a full diet, consist­ing chiefly of salted, high-seasoned, or acrid food; the ex­cessive use of spiritous liquors; too much exercise; violent passions of the mind, &c.

TO restrain this flux, the patient ought to be kept quiet and easy both in body and mind. If it be very violent, she ought to lie in bed with her head low; to live upon a cool and slender diet, as veal or chicken-broths with bread; and to drink decoctions of nettle-roots, or the greater con [...]rey. If these be not sufficient to stop the flux, stronger astringents may be used, as allum, dragons blood, &c. As much powdered allum as will lie upon a sixpence may b [...] taken in a glass of red wine twice or thrice a-day, or oftener if the patient's stomach [...] bear it. Such as cannot take allum in substance may use the allum-whey. Females who have frequent returns of this complaint, ought to use the jesuits bark for a considerable time. Half a dram of bark may be mixed in a glass of red wine three or four times a-day, or it may be taken in common water, and sharpened with spi­rits of vitriol.

BUT the uterine flux may offend in quality as well as in quantity. What is usually called the fluor albus or whites, is a very common disease, and proves extremely hurtful to delicate women. This discharge is not always white, but sometimes pale, yellow, green, or of a blackish colour; sometimes it is sharp and corrosive; sometimes foul and foe­tid, &c. It is attended with a pale complexion, pain in the spine of the back, loss of appetite, swelling of the feet, &c. It generally proceeds from a relaxed and debilitated state of the body, arising from indolence, the excessive use of tea, coffee, or other weak and watery diet.

[Page 333] TO remove this disease, the patient must take as much exercise as she can bear without fatigue. Her food must be solid and nourishing, but of easy digestion; and her drink pretty generous, as red port or claret wine. These may be drank pure or mixed with water, as the patient inclines. Tea and coffee are to be avoided. I have often known strong broths have an exceeding good effect in this case. The patient ought not to lie too long a bed. When medi­cine is wanted, we know none preferable to the jesuits bark, which, in this case, ought always to be taken in substance.

THAT period of life at which the menses cease to flow is likewise very critical to the sex. The stoppage of any customary evacuation, however small, is sufficient to dis­order the whole frame, and often to destroy life itself. Hence it comes to pass that so many women either fall into chronic disorders, or die about this time: Such of them however as survive it, without contracting any chronic dis­ease, often become more healthy and hardy than they were before, and enjoy strength and vigour to a very great age.

IF the menses cease all of a sudden, in women of a full ha­bit, they ought to abate somewhat of their usual quantity of food, especially of the more nourishing kind, as flesh, eggs, &c. They ought likewise to take plenty of exercise, and to keep the belly open. This may be done by taking, once or twice a-week, a little rhubarb, or an infusion of hiera picra in wine or brandy.

IT often happens that women of a gross habit, at this pe­riod of life, have ulcerous sores break out about their an­cles, or in other parts of the body. Such ulcers ought to be considered as critical, and should either be suffered to continue open, or artificial drains should be opened in their stead. Women who will needs have such sores dried up, are often soon after seized with acute or chronic diseases, of which they die.

PERSONS of either sex ought to be very cautious in drying up sores which break out towards the decline of life. We would lay it down as a rule, where ever such sores appear, that before any attempts be made to heal them, an issue or seton should be set in some part of the body. Few things bid fairer for preserving health, or prolonging life, especi­ally in persons who live full, than an issue, or some other drain constantly kept open in the decline of life. This is [Page 334] imitating Nature, who often, at this period, endeavours to relieve herself by a fistula, the haemorrhoidal flux, &c.

OF PREGNANCY.

PREGNANCY is not a disease, but as it subjects women to several ailments, it may not be improper to point out the methods of preventing or relieving them.

PREGNANT women are often afflicted with the heart­burn. The method of treating this complaint has already been pointed out in page 254. and the one following. They are likewise, in the more early periods of pregnancy, often harrassed with sickness and vomiting, especially in the morn­ing. These complaints may generally be relieved by care­fully observing the directions contained in pages 244. and 245. The head-ach and tooth-ach are also very troublesome symp­toms of pregnancy. The former may generally be removed by keeping the belly gently open, by the use of prunes, figs, roasted apples, and such like. When the pain is very vio­lent, bleeding may be necessary. For the treatment of the latter, we must refer the reader to that article page 249.

EVERY pregnant woman is more or less in danger of a­bortion. This should be guarded against with greatest care, as it not only weakens the constitution, but renders the woman liable to the same misfortune afterwards. Abor­tion may happen at any period of pregnancy, but it is most common in the second or third month. Sometimes howe­ver it happens in the fourth or fifth. If it happens within the first month, it is usually called a false conception; if after the seventh month, the child may often be kept alive by proper care.

THE common causes of abortion are, the death of the child; weakness or relaxation of the mother; great evacua­ations; violent motion; rai [...]ing great weights; reaching too high; vomiting; coughing; convulsion-fits; strokes on the belly; falls; fevers; disagreeable smells; excess of blood; indolence; high living; or the contrary; violent passions or affections of the mind, as fear, grief, &c.

THE signs of approaching abortion are, a pain in the joins, or about the bottom of the belly; a dull heavy pain in the inside of the thighs; a flight degree of coldness or shivering; sickness; palpitation of the heart; the breasts [Page 335] become flat and soft; the belly falls; and there is a dis­charge of blood or watery humours from the womb.

TO prevent abortion, we would advise women of a weak or relaxed habit to use solid food, avoiding great quantities of tea, and other weak and watery liquors; to rise early, and go soon to bed; to shun damp houses; to take frequent exercise in the open air, but to avoid fatigue; and never to go abroad in damp foggy weather, if they can shun it. Women of a full habit ought to use a spare diet, avoiding strong liquors, and every thing that may tend to heat the body, or increase the quantity of blood. Their diet should be of an opening nature, consisting principally of vegeta­ble substances. Every woman with child ought to be kept cheerful and easy in her mind. All violent passions hurt the foetus, and endanger an abortion.

WHEN any signs of abortion appear, the woman ought to be laid in bed on a mattress, with her head low. She should be kept quiet, and her mind soothed and comforted. She ought not to be kept too warm, nor to take any thing of a heating nature. Her food should consist of broths, rice and milk, jellies, or gruels with a very little wine in them.

IF she be able to bear it, she should lose, at least, half a pound of blood from the arm. Her drink ought to be bar­ley-water sharpened with cream of tartar; or she may take half a dram of powdered nitre in a cup of water-gruel, eve­ry five or six hours. If the woman be seized with a violent looseness, she ought to drink the decoction of calcined hartshorn prepared. If she be affected with vomiting, let her take frequently one of the saline draughts recommend­ed page 143.

SANGUINE robust women, who are liable to miscarry at a certain time of pregnancy, ought always to be bled a few days before that period arrives. By this means, and obser­ving the regimen above prescribed, they may often escape that misfortune.

THO' we recommend due care for preventing abortion, we would not be understood as restraining pregnant women from their usual exercises. This would operate the quite contrary way. Want of exercise not only relaxes the body, but induces a plethora, or too great a fulness of the vessels, which are the two principal causes of abortion.

OF CHILDBIRTH.

MANY diseases proceed from the want of due care in child-bed. The more hardy part of the sex are apt to despise the necessary precautions after delivery. They think, when the labour-pains are ended, the danger is over; but in truth it may only then be said to be begun. Nature if left to herself, will seldom fail to expel the foetus; but proper care and management are certainly necessary for the recove­ry of the mother. No doubt, mischief may be done by too much as well as by too little care. Hence it is that females who have the greatest number of attendants in child-bed, generally recover worst. But this is not peculiar to the state of child-bed. Excessive care always defeats its own intention, and is generally more dangerous than none at all.

DURING actual labour, nothing of a heating nature must be given. The woman may, now and then, take a little panada, and her drink ought to be toast and water, or thin groat-gruel. Spirits, wines, cordial-waters, and other things, which are given with a view to strengthen the mo­ther, and promote the birth, for the most part tend only to increase the fever, inflame the womb, and retard the la­bour. Besides, they endanger the woman afterwards, as they often occasion violent and mortal haemorrhages, or predispose her to eruptive and other fevers.

WHEN the labour proves tedious and difficult, to pre­vent inflammations, it will be proper to bleed. An emoli­ent clyster ought likewise frequently to be administered; and the patient should sit over the steams of warm water. The passage ought to be gently rubbed with a little soft pomatum or fresh butter, and cloths wrung out of warm water ap­plied over the belly. If Nature seems to sink, and the wo­man be greatly exhausted with fatigue, a draught of gene­rous wine, or some other cordial, may be given, but not otherwise. These directions are sufficient in natural la­bours, and in all preternatural cases, a skillful surgeon, or man-midwife, ought to be called as soon as possible.

WE cannot help taking notice of that ridiculous custom which still prevails in some country-places, of collecting a number of women together upon such occasions. These, instead of being useful, serve only to crowd the house, and obstruct the necessary attendants. Besides, they hurt the [Page 337] patient with their noise; and often by their untimely and [...]pertinent advice, do much mischief.

AFTER delivery, the woman ought to be kept as quiet and easy as possible. Her food should be light and thin; as gruel, panada, &c. and her drink weak and diluting. To this rule however there are some exceptions. I have known several hysteric women, whose spirits could not be supported in child-bed without solid food and generous li­quors; to such a glass of wine and a bit of chicken must be allowed.

SOMETIMES an excessive haemorrhage or flooding hap­pens after delivery. In this case, the patient should be laid with her head low, have ligatures applied above her knees and elbows, and be in all respects treated as for an excessive flux of the menses. If the flooding proves violent, linen cloths, which have been wrung out of a mixture of equal parts of vinegar and water, should be applied to the belly, the loins, and the thighs: These must be changed as they grow dry; and may be discontinued as soon as the flooding abates.

IF there be violent pains after delivery, the patient ought to drink plentifully of warm diluting liquors, as tea with a little saffron; or an infusion of camomile flowers; and to take small broths, with carroway seeds or a bit of orange-peel in them; an ounce of the oil of sweet almonds may likewise be frequently taken in a cup of any of the above li­quors; and if the patient be restless, a spoonful of the sy­rup of poppies may now and then be mixed with a cup of her drink. If she be hot or feverish, one of the following powders may be taken in a cup of her usual drink, every five or six hours. Take of crabs claws prepared half an ounce, purified nitre two drams, saffron powdered half a dram; rub them together in a mortar, and divide the whole into eight or nine doses. When the patient is low spirit­ed, or troubled with hysterical complaints, she ought to take frequently twelve or fifteen drops of the tincture of asafoetida in a cup of penny-royal tea.

AN inflammation of the womb is a dangerous and not un­frequent disease after delivery. It is known by pains in the lower part of the belly, which are greatly increased upon touching; by the tension or tightness of the parts; great weakness; change of countenance; a constant fever, with a weak and hard pulse; a slight delirium or raving; some­times [Page 338] incessant vomiting; a hiccup; a discharge of redish stinking sharp water from the womb; an inclination to go to stool; a heat, and sometimes total suppression of urine.

THIS must be treated like other inflammatory disorders, by bleeding and plentiful dilution. The drink may be thin gruel or barley water; in a cup of which half a dram of nitre may be dissolved, and taken three or four times a day. Clysters of warm water must be frequently administred; and the belly should be fomented by cloths wrung out of warm water, or by applying bladders filled with warm milk and water to it.

A SUPPRESSION of the lochia, or usual discharges after de­livery, and the milk-fever, must be treated nearly in the same manner as an inflammation of the womb. In all these cases the [...]afest course is plentiful dilution, gentle evacuati­ons, and fomentations of the parts affected. In the milk-fever, the breasts may be embrocated with a little warm lin­seed oil, or the leaves of red cabbage may be applied to them. The child should be often put to the breast, or it should be drawn by some other person.

NOTHING would tend more to prevent the milk-fever than putting the child early to the breast. The custom of not allowing children to suck for the first two or three days, is contrary to Nature and common sense, and is very hurtful both to the mother and child. Every mother who has milk in her breasts, ought either to suckle her own child, or to have her breasts frequently drawn, at least for the first month. This would prevent many of the diseases which prove fatal to women in child-bed.

WHEN an inflammation happens in the breast, attended with redness, hardness, and other symptoms of suppuration, the [...]afest application is a poultice of bread and milk, softened with oil or fresh butter. This may be renewed twice a day till the tumour be either discussed or brought to suppuration. Afterwards it may be dressed with yellow basilicon, or any other digestive ointment. The use of repellants, in this case, is very dangerous; they often occasion fevers, and sometimes cancers: Whereas a suppuration is seldom attend­ed with any danger, and has often the most salutary effects.

WHEN the nipples are fretted or chapt, they may be a­nointed with a mixture of oil and bees-wax, or a little gum arabic may be sprinkled on them. I have seen Hungary-water applied to the nipples have a very good effect. Should [Page 339] the complaint prove obstinate, the nurse ought to be purg­ed, which generally removes it.

THE miliary fever is a disease very incident to women in child-bed. But as it has been treated of already, we shall take no farther notice of it here than only, with the celebrat­ed Hoffman, to observe, that this fever of child-bed women might generally be prevented, if they, during their preg­nancy, were regular in their diet, used moderate exercise, took now and then a gentle laxative of manna, rhubarb, or cream of tartar; not forgetting to bleed in the first months, and avoid all sharp air. When the labour is coming on, it is not to be hastened with forcing medicines, which inflame the blood and humours, or put them into unnatural com­motions. Care should be taken, after the birth, that the natural excretions proceed regularly; and if the pulse be quick, a little nitrous powder should be given, &c.

WE shall conclude our observations on child-bed women by recommending it to them, above all things, to beware of cold. Poor women, whose circumstances oblige them to quit their bed too soon, often contract diseases from cold, of which they never recover. It is pity the poor are not better taken care of in this situation. But the better sort of women run the greatest hazard from being kept too hot. They are generally kept in a sort of bagnio for the first eight or ten days, and then dressed out to see company. The danger of this conduct must be obvious to every one. The superstitious custom of obliging women to keep the house till they go to church, is likewise a very common cause of catching cold. All churches are damp, and most of them cold; consequently they are the very worst places to which a woman can go to make her first visit, after being confined in a warm room for a month. We make this observation from experience, having often had occasion to attend wo­men whose disorders were the effect of cold caught in this way.

OF BARRENNESS.

BARRENNESS may be very properly reckoned among the diseases of females, as few married women who have not children enjoy a good state of health. It may proceed from various causes; but we shall only take notice of two, viz. high living and relaxation. It is very certain that high [Page 340] living vitiates the humours, and prevents fecundity. We seldom find a barren woman among the labouring poor, while nothing is more common amongst the rich and afflu­ent. The inhabitants of every country are prolific in pro­portion to their poverty, and it would be an easy matter to adduce many instances of women who, by being reduced to live entirely upon a milk and vegetable diet, have con­ceived and brought forth children, though they never had any before. Would the rich use the same sort of food and exercise as the better sort of peasants, they would seldom have cause to envy their poor vassals and dependents the blessing of a numerous and healthy offspring, while they pine in sorrow for the want of even a single heir to their ex­tensive dominions.

AFFLUENCE begets indolence, which not only vitiates the humours, but induces a general relaxation of the solids; a state highly unfavourable to procreation. As we have the greatest reason to believe, that relaxation is one of the most common causes of barrenness, we would recommend the following course for removing it. First, plenty of exer­cise in the open air; secondly, the use of the cold bath; and lastly, astringent medicines. It is well known, that many women who had been long barren, have, by the use of the cold bath not only become mothers, but have after­wards enjoyed a much better state of health. This should induce all barren women not only to try the cold bath, but to persist in the use of it for a long time, otherwise it cannot be expected to produce any considerable effects.

THO' a vegetable diet, plenty of exercise, and the cold bath, are the medicines most to be relied upon, we shall mention [...], which has sometimes proved effectual, viz. common allum. About the third or fourth day of the menstrual flux the woman must take as much powdered al­lum at bed-time, in a cup of wine or negas, as will lie up­on sixpence. This must be repeated for three or four nights running. If it has not the desired effect, it may be taken in the same manner next time the menses return. I have known several women who always conceived after taking this medicine, and never without it.

THE above observations on diet, air, and exercise, are applicable to men as well as to women. Dr Chyne avers, that want of children is oftener the fault of the male than of the female, and strongly recommends a milk and veget­able [Page 341] diet to the former as well as the latter; adding, that his friend Dr Taylor, whom he calls the milk Doctor of Croyden, had brought sundry opulent families in his neigh­bourhood, who had continued some years after marriage without progeny, to have several fine children, by keeping both parents, for a considerable time, to a milk and veget­able diet.

DISEASES OF CHILDREN.

THE nursing and management of children having been pretty fully treated of in the first part of this book, we shall only here take notice of such of their diseases as have not been already mentioned.

RETENTION OF THE MECONIUM.

THE stomach and bowels of a new-born infant are filled with a blackish coloured matter of the consistence of syrup, commonly called the meconium. This is generally passed soon after the birth by the mere effort of nature, in which case it is not necessary to give the infant any kind of medi­cine. But if it should be retained, or not sufficiently carri­ed off, it may occasion wind, gripes, jaundice, restlessness, convulsions, &c.

THE most proper medicine for expelling the meconium is the mother's milk, which is always, at first, of a purga­tive quality. But, if the the mother does not gives suck, or, if her milk happens not to be sufficiently purgative, a little of the syrup of pale roses may be given, or a small quantity of the syrup of rhubarb diluted with water, and sweetened with honey or coarse sugar. If these are not at hand, a common spoonful of whey sweetened with a teaspoonful of honey may be given.

ALL kind of oils are to be avoided; they are quite indi­gestible by infants, and tend only to load their stomachs and makes them sick.

THE APHTHAE OR THRUSH.

THE aphthae are little whitish ulcers affecting the whole inside of the mouth, tongue, throat, and stomach of in­fants. Sometimes they reach through the whole intestinal [Page 342] canal; in which case they are very dangerous, and often put▪ an end to the infant's life.

IF the aphthae are of a pale colour, pellucid, few in number, soft, superficial, and fall easily off, they are not dangerous; but if opake, yellow, brown, black, thick, or running together, they are bad.

IT is generally thought that the aphthae owe their origin to acid humours; but we have reason to believe that these, and several other eruptive diseases of infants, are, in a great measure, owing to too hot a regimen both of the mother and child. It is a rare thing to find a child who is not dosed with wine, punch, cinnamon waters, or some other hot and inflaming liquors, almost as soon as it is born. It is well known that these will occasion inflammatory disorders even in adults; is it any wonder then that they should heat and inflame the tender bodies of infants, and set, as it were, the whole constitution on a blaze?

THE most proper medicines for the aphthae are those of a cooling and gentle opening nature. Five grains of rhu­barb and a dram of magnesia alba may be rubbed together, and divided into six doses, one of which may be given to the child every five or six hours. These powders may ei­ther be given in the child's food or a little of the syrup of pale roses, and may be repeated as often as is found necessa­ry to keep the belly open.

MANY things have been recommended for gargling the mouth and throat in this disease; but it is not easy to apply these in very young infants; we would therefore recommend it to the nurse to rub the child's mouth frequently with a little borax and honey; or with the following mixture. Take fine honey an ounce, borax a dram, burnt allum half a dram, rose-water two drams; mix them together. These may be applied with the finger, or by means of a bit of soft rag tied to the end of a probe.

OF ACIDITIES.

THE food of children being, for the most part, of an acescent nature, it readily turns four upon the stomach, e­specially if the body be any how disordered. Hence it comes to pass, that most diseases of children are accompa­nied with evident signs of acidity, as green stools, gripes, &c. These appearances have induced many to believe, [Page 343] that all the diseases of children were owing to an acid a­bounding in the stomach and bowels; but whoever considers the matter attentively, will find, that these symptoms of a­cidity are oftener the effect than the cause of diseases.

NATURE evidently intended, that the food of children should be acescent; and until the body be disordered, or the digestion hurt, from some other cause, we will venture to say, that the acescent quality of their food is seldom in­jurious to them. Acidity however is often a symptom of infantile disorders, and, as it is a very troublesome one, we shall point out the method of relieving it.

WHEN green stools, gripes, purgings, &c. shew, that the bowels abound with an acid, the child should have a little small broth instead of milk, with light white bread in it; and should have plenty of exercise in order to promote the digestion. It has been customary in this case to give the pearl-julep, chalk, crabs eyes, and other testaceous pow­ders. These indeed, by their absorbent quality, may cor­rect the acidity; but they are attended with this inconve­niency, that they are apt to lodge in the bowels, and occa­sion a costiveness, which may prove very hurtful to the in­fant. For this reason they should never be given unless mixed with purgative medicines; as rhubarb, manna, or such like.

THE best medicine which we know, in all cases of aci­dity, is that fine insipid powder called magnesia alba. It purges, and, at the same time, corrects the acidity; by which means it not only removes the disease, but carries off its cause. It may be given in any kind of food, from ten grains to a teaspoonful, according to the age of the pa­tient. I have often known it have good effects when given in the following manner. Take of magnesia alba two drams, fine rhubarb in powder half a dram, pepper-mint water and common water, of each two ounces, as much syrup of sugar as will make it agreeable. Shake the bottle, and give the child a table-spoonful three or four times a-day.

WHEN an infant is troubled with gripes, it ought not to be dosed with brandy, spiceries, and other hot things, but should have its belly opened with an emolient clyster, or the medicine mentioned above; and at the same time a little brandy may be rubbed on its belly with a warm hand before the fire. I have seldom seen this fail to ease the [Page 344] gripes of infants. It is often more effectual, and always more safe than brandy taken inwardly.

GALLING AND EXCORIATION.

THESE are very troublesome to children. They happen chiefly about the groin and wrinkles of the neck, under the arms, behind the ears, and in other parts that are moisten­ed by the sweat or urine.

AS these complaints are, in a great measure, owing to want of cleanliness, the most effectual means of prevent­ing them are, to wash the parts frequently with water, to change the linen often, and in a word, to keep the child, in all respects, thoroughly clean. When this is not suffi­cient, the excoriated parts may be sprinkled with absorbent or drying powders; such as burnt hartshorn, tutty, chalk, crabs claws prepared, &c. Any of these may be tied in a rag, and the powder shook out on the disordered places.

WHEN the parts affected are very sore, and tend to a real ulceration, it will be proper to add a little sugar of lead to the powders; or to anoint the place with a little cam­phorated ointment. If the parts be washed with spring wa­ter, in which a little white vitriol has been dissolved, it will dry and heal them very powerfully.

STOPPAGE OF THE NOSE.

THE nostrils of infants are often plugged up with a gross mucus, which prevents their breathing freely, and likewise renders it difficult for them to suck or swallow.

SOME, in this case, order, after a suitable purge, two or three grains of white vitriol dissolved in half an ounce of marjoram water and [...], to be applied now and then to the nostrils with a linen rag. Wed [...]lius says, If two grains of white vitriol, and the same quantity of elaterium, be dis­solved in half an ounce of marjoram water, and applied to the nose, as above directed, that it brings away the mucus without sneezing.

IN obstinate cases these things may be tried; but we have never found any thing else necessary, than to rub the nose at bed-time with a little oil of sweet almonds, or a bit of fresh butter. This resolves the filth, and renders the breathing more free.

OF ERUPTIONS.

CHILDREN, while on the breast, are seldom free from e­ruptions of one kind or other. These however are not often dangerous, and ought never to be stopped but with the greatest caution. They tend to free the bodies of infants from hot and acrid humours, which, if retained, might produce fatal disorders.

THE eruptions of children are chiefly owing to the fol­lowing causes, viz. improper food, and neglect of cleanli­ness. If a child be stuffed at all hours with food that his stomach is not able to digest, such food, not being proper­ly assimilated, instead of nourishing the body, fills it with gross humours. These must either break out in form of e­ruptions upon the skin, or remain in the body, and occasi­on fevers and other internal disorders. That neglect of cleanliness is a very general cause of eruptive disorders, must be obvious to every one. The children of the poor, and of all who despise cleanliness, are almost constantly found to swarm with vermin, and are generally covered over with the scab, itch, and other eruptions.

WHEN eruptions are the effect of improper food, or want of cleanliness, a proper attention to these alone will generally be sufficient to remove them. If this should not be the case, some drying medicines will be necessary; but they should never be applied without the greatest caution. If drying medicines are applied, the belly ought at the same time to be kept open, and cold is carefully to be avoided. We know no medicine that is more safe for dry­ing up cutaneous eruptions than sulphur, provided it be sparingly used. A little of the flowers of sulphur may be mixed with the white ointment or hog's lard, and the parts affected frequently touched with it.

THE most obstinate of all the eruptions incident to chil­dren are, the tinea capitis, or scabbed head, and chilblains. The scabbed head is often exceeding difficult to cure, and sometimes indeed the cure proves worse than the disease. I have frequently known children seized with internal disor­ders, of which they died soon after their scabbed heads had been healed by the application of drying medicines ^*. The [Page 346] cure ought always first to be attempted by keeping the head very clean, cutting off the hair, combing and brushing a­way the scabs, &c. If this be not sufficient, let the head be shaved once a-week, and washed daily with soap and warm water, or with lime-water. Should these fail, a plaster of black pitch may be applied, in order to pull out the hair by the roots. And if there be proud flesh, it should be touched with a bit of blue vitriol, or sprinkled with a lit­tle burnt allum. While these things are doing, the pati­ent must be kept to a regular light diet, his belly should be kept gently open; and cold, as far as possible, ought to be avoided. To prevent any bad consequences from stopping this discharge, it will be proper, especially in children of a delicate habit, to make an issue in the neck or arm, which may be kept open till the patient becomes more strong, and the constitution be somewhat confirmed.

CHILBLAINS commonly attack children in cold weather. They are generally occasioned by the feet or hands being kept long wet or cold, and afterwards suddenly heated. When children are cold, instead of taking exercise to warm themselves gradually, they run to the fire. This occasions a sudden rarefaction of the humours, and an infarction of the vessels; which being often repeated, the vessels are, at last, over-distended, and forced to give way.

To prevent it, violent cold and sudden heat must be e­qually avoided. When the parts begin to look red and swell, the patient ought to be purged, and to have the affected parts frequently rubbed with mustard and brandy, or something of a warm nature. They ought likewise to be covered with flannel, and kept warm and dry. Some apply warm ashes betwixt cloths to the swelled parts, which frequently help to reduce them. When there is a sore, it [Page 347] must be dressed with Turner's cerate, or some other drying ointment; as the ointment of tutty, the plaster of ceruss, &c. These sores are indeed troublesome, but seldom dan­gerous. They generally heal as soon as the warm weather sets in.

OF DIFFICULT BREATHING.

CHILDREN are often seized very suddenly with a great difficulty of breathing, which, if not quickly relieved, proves mortal. This disease is known by various names in different parts of the country. In the East coast of Scot­land it is called the croup. On the West they call it the chock or stuffing. In some parts of England, where I have met with it, the good women call it the rising of the lights. It seems to be a species of asthma, attended with very acute and violent symptoms.

THIS disease generally prevails in cold and wet seasons. It is most common upon the sea-coast, and in low marshy countries. Children of a gross and lax habit are most lia­ble to it. I have sometimes known it hereditary. It gene­rally attacks children in the night, after having been much exposed to damp cold easterly winds through the day. Damp houses, wet feet, thin shoes, wet cloaths, or any thing that obstructs the perspiration, may occasion this disease.

IT is attended with a frequent pulse, quick and labori­ous breathing, which is performed with a peculiar kind of croaking noise that may be heard at a considerable distance. The voice is sharp and shrill, and the face is generally much flushed, tho' sometimes it is of a livid colour.

WHEN a child is seized with the above symptoms, his feet should be put into warm water. He ought likewise to be bled, and to have a laxative clyster administered as soon as possible. He should be made to breathe over the steams of warm water, or an emolient decoction, and emolient ca­taplasms or fomentations may be applied round his neck. If the symptoms do not abate, a blistering plaster must be applied round the neck, or betwixt the shoulders, and the child may take frequently a table-spoonful of the following julep. Take penny-royal water three ounces, syrup of al­thea and balsamic syrup, each one ounce, mix them toge­ther.

[Page 348] SOME, in this case, recommend asafoetida. It may both be given in form of clyster, and taken by the mouth. Two drams of asafoetida may be dissolved in one ounce of Minde­rerus's spirit, and three ounces of penny-royal water. A table-spoonful of this mixture may be given every hour, or oftener if the patient's stomach be able to bear it. If the patient cannot be brought to take this medicine, two drams of the asafoetida may be dissolved in a common clyster, and administered every six or eight hours, till the violence of the disease abates.

To prevent a return of this disease, all those things which occasion it must be carefully avoided; as wet feet, cold, damp easterly winds, &c. Children who have had frequent returns of this disease, or whose constitution seems to predispose them to it, ought to have their diet properly regulated; all food that is viscid or hard of digestion, and all crude, raw, trashy fruits, are to be avoided. They ought likewise to have a drain constantly kept open in some part of their body, by means of a seton or issue. I have sometimes known a Burgundy pitch plaster, worn continually betwixt the shoulders for several years, have a very happy effect in preventing the return of this dreadful disorder.

OF TEETHING.

DR Arbuthnot observes, that above a tenth part of in­fants die in teething, by symptoms proceeding from the ir­ritation of the tender nervous parts of the jaws, occasioning inflammations, fevers, convulsions, gangrenes, &c. These symptoms are, in a great measure, owing to the great deli­cacy and exquisite sensibility of the nervous system at this time of life. But this natural sensibility of the nerves in infancy is too often increased by an effeminate education. Hence it comes to pass, that children who are delicately brought up always suffer most in teething, and often [...]all by convulsive disorders.

ABOUT the sixth or seventh month the teeth generally begin to make their appearance; first the incisores, or fore­teeth; next the canini, or dog-teeth; and lastly, the mola­res, or grinders. About the seventh year there comes a new set; and about the twentieth the two inner grinders, called dentes sapientiae, the teeth of wisdom.

[Page 349] CHILDREN, about the time of cutting their teeth, slaver much, and have generally a looseness, which is no bad sign; but when the teething is difficult, especially when the dog-teeth begin to make their way through the gums, the child has startings in his sleep, tumours of the gums, in­quietude, watchings, gripes, green stools, the thrush, fe­ver, difficult breathing, convulsions, and epilepsies, which often end in death.

DIFFICULT teething is; in all respects, to be treated as an inflammatory disease. If the belly be bound, it must be opened either by emollient clysters or gentle purgatives; as manna, magnesia alba, rhubarb, [...]enna, &c. The food should be light, and in small quantity; the drink plentiful, but weak and diluting, as infusions of balm, or of the lime-tree flowers; to which about a third or fourth part of milk may be added.

IF the fever be very high, bleeding will be necessary; but this, in very young children, ought always to be sparingly performed. It is an evacuation which they bear the worst of any. Purging, vomiting, or sweating, agree much better with them, and are generally more beneficial. Harris however observes, that, when an inflammation appears, the physician will labour in vain, if the cure be not begun with applying a leech under each ear. If the child be seized with convulsion fits, a blistering plaster may be applied betwixt the shoulders, or one behind each ear.

DR Sydenham says, that in fevers occasioned by teeth­ing, he never could find any remedy so effectual as two, three, or four drops of spirits of hartshorn in a spoonful of simple water, or other convenient vehicle, given every four hours. The number of doses may be four, five, or six. I have often prescribed this medicine with success, but al­ways [...]ound a larger dose necessary. It may be given from five drops to fifteen or twenty, according to the age of the child.

IN Scotland, it is very common, when children are cut­ting their teeth, to put a small Burgundy pitch plaster be­tween their shoulders. This generally eases the tickling cough which attends teething, and is by no means an use­less application. When the teeth are bred with difficulty, it ought to be kept on during the whole time of teething. [Page 350] It may be enlarged as occasion requires, and ought to be renewed, at least, once a month.

SEVERAL things have been recommended for rubbing the gums, as oils, mucilages, &c.; but from these much is not to be expected. What we would recommend for this pur­pose is virgin-honey. A little of this may be rubbed on with the finger three or four times a-day. Children are generally at this time disposed to chew whatever they get into their hands. For this reason they ought never to be without somewhat that will yield a little to the pressure of their gums, as a crust of bread, a wax-candle, a bit of li­quorice-root, or such like. These are far more proper than corral, ivory, silver, or any other impenetrable substance.

WITH regard to cutting the gums, we have seldom known it of any real advantage. In obstinate cases it ought however to be tried; but as it is generally performed by a surgeon, we shall not spend time in describing the operation.

IN order to render the teething less difficult, parents ought to take care that their childrens food be light and wholesome, and that their nerves be braced by plenty of exercise without doors, and the use of the cold bath, &c. Were these things duly regarded, few children would die of teething.

AS the limits of this performance will not permit us to treat the diseases of infants at more length, we shall only observe, that, if properly nursed, their diseases would be very few, and would seldom prove fatal. The nurse may, for the most part, do the business of the physician; but the physician can never do that of the nurse.

THE diseases of children are far less complicated than those of adults, and consequently much easier under­stood; the method of curing them is likewise very simple, and cannot readily be mistaken. In all the acute diseases of children, cool air, diluting liquors, and gentle evacuati­ons, are almost the only things needful; and in their chro­nic diseases, restorative diet, free air, and proper exercise, are what the cure must chiefly depend upon.

OF WOUNDS.

NO part of medicine has been more mistaken than the treatment and cure of wounds. Mankind in general believe, that certain herbs, ointments, and salves are possessed of [Page 351] wonderful healing virtues, and imagine that no wound can be cured without the application of them. It is however a fact, that no external application whatever contributes to­wards the cure of a wound, any other way than by keep­ing the parts soft, and defending them from the external air, which may be as effectually done by soft lint as by the most pompous applications, while it is exempt from many of the bad consequences attending them.

THE same observation holds with respect to internal ap­plications. These only promote the cure of wounds in so far as they tend to prevent a fever, or to remove any cause that might obstruct or impede the operations of Nature. It is Nature alone that cures wounds; all that art can do is to remove obstacles, and to put the parts in such a condition as is the most favourable to Nature's efforts.

WITH this simple view, we shall consider the treatment of wounds, and endeavour to point out such steps as ought to be taken to facilitate their cure.

THE first thing to be done when any person has received a wound is to examine whether any foreign body be lodged in it, as wood, stone, iron, lead, glass, dirt, bits of cloth, &c. These, if it can be easily done, ought to be extract­ed, and the wound cleaned, before any dressings be appli­ed. When that cannot be effected with safety, on account of the patient's weakness, or loss of blood, &c. they must be suffered to remain in the wound, and be afterwards ex­tracted when the patient is more able to bear it.

WHEN a wound penetrates into any of the cavities of the body, as the breast, the bowels, &c. or where any con­siderable blood-vessel is cut, a skillful surgeon ought imme­diately to be called, otherwise the patient may lose his life. But sometimes the discharge of blood is so great, that if it be not stopt, the patient may die even before a surgeon, tho' at no great distance, can arrive. In this case, some­thing must be done by those who are present. If the wound be in any of the limbs, the bleeding may generally be stopt by applying a tight ligature or bandage round the member a little above the wound. The best method of doing this is to put a strong broad garter round the part, but so [...]lack as easily to admit a small piece of stick to be put under it, which must be twisted, in the same manner as a country­man does a cart-rope to secure his loading, till the bleeding stops. Whenever this is the case, he must take care to [Page 352] twist it no longer, as straining too tight might occasion an inflammation of the parts and endanger a gangrene.

IN parts where this bandage cannot be applied, various other methods may be tried to stop the bleeding, as the ap­plication of styptics, astringents, &c. Cloths dipped in a solution of blue vitriol in water, or the styptic water of the Dispensatories, may be applied to the wound. When these cannot be obtained, strong spirits of wine may be used. Some recommend the Agaric ^* of the oak as preferable to a­ny of the other styptics; and indeed it deserves considerable encomiums. It is easily obtained, and ought to be kept in every family, in case of accidents. A piece of it must be laid upon the wound and covered with a good deal of lint, above which a bandage must be applied so [...]ight as to keep it firmly on.

THO' spirits, tincture, and hot balsams may be used, in order to stop the bleeding when it is excessive, they are im­proper at other times. They do not promote but retard the cure, and often change a simple wound into an ulcer. People imagine, because hot balsams congeal the blood, and seem, as it were, to [...]older up the wound, that they therefore heal it; but this is only a deception. They may indeed stop the flowing blood, by searing the mouths of the vessels; but, by rendering the parts callous, they obstruct the cure.

IN slight wounds which do not penetrate much deeper than the skin, the best application is a bit of the common black sticking plaster. This keeps the sides of the wound [Page 353] together, and prevents the air from getting into it, which is all that is necessary. When a wound penetrates deep, it is not safe to keep its lips quite close; this keeps in the matter, and is apt to make the wound fester. In this case the best way is to fill the wound with soft lint commonly called caddis. This however must not be stuffed in too hard otherwise it will do hurt. It may be covered over with a cloth dipped in oil, or spread with the common wax ^* plas­ster; and the whole must be kept on by a proper bandage.

WE shall not spend time in describing the different ban­dages that may be proper for wounds in different parts of the body; common sense will generally suggest the most commodious method of applying a bandage; besides descrip­tions of this kind are not easily remembered.

THE first dressing ought to continue on for at least two days; after which it may be removed, and fresh lint appli­ed as before. If any part of the first dressing sticks so close that it cannot be removed with ease or safety to the patient, it may be allowed to continue, and fresh lint dipped in sweet oil laid above it. This will soften it so as to make it come off easily at next dressing. Afterwards the wound may be dressed every day in the same manner till it be quite heal. Those who are fond of salves or ointments, may, after the wound is become very superficial, dress it, twice a-day, with the yellow basilicon ointment ^†; and if fungous, or what is called proud flesh, should rise in the wound, it may be checked, by mixing with the ointment, a little burnt allum or red precipitate.

WHEN a wound is greatly inflamed, the most proper ap­plication is a poultice of bread and milk, softened with a little sweet oil or fresh butter. This must be applied in­stead of the plaster, and should be changed two or three times a-day.

[Page 354] IF the wound be large, and there is reason to fear an in­flammation, the patient must be kept on a very low diet. He must abstain from flesh, strong liquors, and every thing that is of a heating nature. If he be of a full habit, and has lost but little blood from the wound, he must be bled; and, if the symptoms be urgent, the operation may be re­peated. But when the patient has been greatly weakened by loss of blood from the wound, it will be dangerous to bleed him, even tho' a fever should ensue. Nature should never be too far exhausted. It is always more safe to al­low her to struggle with the disease in her own way, than to sink the patients strength by excessive evacuations.

WOUNDED persons ought to be kept very quiet and easy. Every thing that ruffles the mind, or moves the passions, as love, anger, fear, excessive joy, &c. are very hurtful. They ought, above all things, to abstain from venery. The belly should be kept gently open either by laxative clysters, or by cool vegetable diet, as roasted apples, stewed prunes, boiled spinnage, &c.

OF BURNS.

IN slight burns which do not break the skin, it is custom­ary to hold the part near the fire for a competent time, to [...]ub it with salt, or to lay a compress upon it dipped in spi­rits of wine or brandy. But when the burn has penetrated [...] deep as to blister or break the skin, it must be dressed with some emollient and gently drying ointment, as the ointment of calamine, commonly called Turner's cerate ^*. This may be [...]ixed with an equal quantity of fresh olive-oil, and spread [...]pon a soft rag, and applied to the part affected. When this ointment cannot be had, an egg may be beat up with about an equal quantity of the sweetest salad oil. This [...] serve very well till a proper ointment can be prepared. When the burning is very deep, after the first two or three days, it should be dressed with equal parts of yellow basili­con ointment and Turner's cerate mixed together.

[Page 355] WHEN the burn is violent, or has occasioned a high de­gree of inflammation, and there is reason to fear a gangrene or mortification will ensue, the same means must be used to prevent it as are recommended in other violent inflamma­tions. The patient, in this case, must live low, and drin [...] freely of weak diluting liquors. He must likewise be bl [...] once and, if occasion requires, a second time. His belly should be kept open; and, if the burnt parts become livid or black, with other symptoms of mortification, it will be necessary to bathe them frequently with warm camphorat­ed spirits of wine, tincture of myrrh, or other antiseptics mixed with a decoction of the bark. In this case the ba [...]k must likewise be taken internally.

OF BRUISES.

BRUISES are generally productive of worse consequence [...] than wounds. The danger from them does not appear immediately, by which means it often happens that they are neglected till past cure. It is needless to give any defi­nition of a disease so universally known; we shall therefore proceed to point out the method of treating it.

IN [...]light bruises it will be sufficient to bathe the par [...] with a mixture of equal quantities of vinegar and wate [...], and to keep cloths wet with this mixture constantly applie [...] to it. This is far more proper than rubbing it with brandy, spirits of wine, or other ardent spirits, which are commonly used in such cases.

IN some parts of the country the peasants apply to a re­cent bruise a poultice of fresh cow's dung, with very happy effects.

WHEN a bruise is very violent, the patient ought imme­diately to be bled, and put upon a proper regimen. His food should be light and cool, and his drink weak, and of an opening nature; as whey sweetened with honey, decoc­tions of tamarinds, barley, cream-tartar-whey, and [...] like. The bruised part must be bathed with vinegar and water, as directed above; and a poultice made by boiling crumbs of bread, elder flowers, and camomile flowers, in equal quantities of vinegar and water, applied to it. This poultice is peculiarly proper when a wound is joined to the bruise. It may be renewed two or three times a-day.

[Page 356] As the structure of the vessels is totally destroyed by a violent bruise, there often ensues a great loss of substance, which produces an ulcerous sore very difficult to cure. If the bone be affected, the sore will not heal before an exfo­liation takes place, that is, before the diseased part of the bone separates, and comes out through the wound. This is often a very slow operation, and may even require several years to be compleated. Hence it happens, that these sores are frequently mistaken for the King's evil, and treated as such, though, in fact, they proceed solely from the injury which the solid parts received from the blow.

PATIENTS in this situation are pestered with different ad­vices. Every person who sees them proposes a new remedy, till the sore is in a manner, poisoned with various and oppo­site applications, and, is often at length rendered abso­lutely incurable. The best method of managing such sores is, to take care that the patient's constitution does not suffer by confinement, or improper medicine, and to apply nothing to them but some simple ointment spread upon soft lint, over which a poultice of bread and milk, with boiled camomile flowers, or the like, may be put to nourish the part, and keep it soft and warm. Nature, thus assisted, will generally in time operate a cure, by throwing off the diseased parts of the bone, after which the sore soon heals.

OF DISLOCATIONS.

DISLOCATIONS are generally occasioned by falls, blows, or the like. They are always dangerous, and sometimes, unless immediately reduced, they prove fatal. A person who has the misfortune, by a fall from his horse, or the like, to dislocate his neck, is often left to perish, while it is in the power of every person present to do all that is neces­sary for his recovery. But people are seized with a kind of panic upon these occasions, and are often so much afraid of doing wrong, that they do nothing at all. This is, in fact, allowing a person to die for fear of hurting him.

WHEN the neck is dislocated, or put out of joint, the patient is immediately deprived of all sense and motion; his countenance soon turns bloated and blackish; his neck swells; and his face is generally turned toward [...] one shoul­der. He should immediately be laid upon his back on the ground, and the operator must place himself behind him in [Page 357] such a manner, as to be able to lay hold of his head with both his hands, while he makes a resistance by placing his knees against the patient's shoulders. In this position, with one hand under the chin, and the other under the hinder part of the head, he must pull with considerable force, gently twist­ing it at the same time, if the face be turned to one side, till he perceives that the joint is replaced. This is easily known from the noise which bones generally makes upon one ano­ther in the very act of reduction, from the patient's beginning soon after to breathe, and from the head continuing in its proper position, &c. This operation, like many others, is easier performed than described, and requires only common prudence and sufficient resolution in the operator. I have known instances of its being happily performed even by women, and frequently by men of no medical education.

THO' dislocations of the limbs are less dangerous, they ought nevertheless to be reduced as soon as possible. When the operation is long delayed it becomes very difficult, and sometimes even impractible. Besides, when a bone has been dislocated for a considerable time, it can seldom be kept in its place after it has been reduced. A mechanical genius, with a very slight notion of the structure of the human body, will enable any person to reduce a dislocated bone. All that is necessary is to make a proper exstension and at the same time, to push the head of the bone towards the socket ^*.

AFTER the bone has been reduced, a roller wet with equal parts of vinegar and water may be applied round the joint. The member ought to be placed in the most natu­ral and easy posture, and kept so for some time, till the parts recover their wonted strength and tone.

OF BROKEN BONES.

THERE are in most country villages some person who pretends to the art of reducing fractures. Tho' in general such persons are very ignorant, yet some of them are very successful; which evidently proves, that a small degree of learning, with a sufficient share of common sense, will en­able [Page 358] a man to be useful in this way. We would however advise people never to trust such operators when an expert and skilful surgeon can be had; but when that is imprac­ticable, they must be employed; we shall therefore recom­mend the following hints to their consideration.

WHEN a large bone is broken, the patient's diet ought, in all respects to be the same as that of a person in a fever. He should likewise be kept quiet and cool, and his belly should be kept gently open either by emollient clysters, or, if these cannot be conveniently administered, by food that is of an opening quality; as stewed prunes, apples boiled in milk, boiled spinnage, &c. It ought however to be here remarked, that persons who have been accustomed to live high, are not all of a sudden to be reduced to a very low diet. This might have fatal consequences. There is often a necessity of indulging bad habits, in some measure, even where the nature of the disease might require a different treatment.

IT will generally be necessary to bleed the patient after a fracture, especially if he be young, of a full habit, or has, at the same time, received any bruise or contusion. This operation should be performed as soon after the accident happens as possible, and if the patient be very feverish, it may be repeated next day. When several of the ribs are broken, bleeding is peculiarly necessary.

IF any of the large bones which support the weight of the body be broken, the patient must keep his bed for several weeks. It is by no means however necessary that he should lie all this while, as is customary, upon his back. This situation sinks the spirits, galls and frets the patients skin, and renders him very uneasy. After the second week he may be gently raised up, and may sit several hours, support­ed by a bed chair, or the like, which will greatly relieve him. Great care however must be taken in raising him up, and laying him down, that he exert no strength of his own, otherwise the action of the muscles may pull the bone out of its place.

IT is of great importance to keep the patient dry and clean while in this situation. By neglecting this he is of­ten so galled and excoriated, that he is forced to keep shift­ing places for ease. I have sometimes known a fractured thigh bone, after it had lain strait for above a fortnight, misplaced by this means, and continue bent for life, in spite of all that could be done.

[Page 359] BONE-SETTERS ought carefully to examine whether the bone be not shattered, or broken into a great many pieces. In this case it will generally be necessary to have the limb taken off, otherwise a gangrene or mortification may ensue. The horror which attends the very idea of an amputation often occasions its being delayed in such cases till too late. I, some time ago, saw a shocking instance of this in a mason, who had the misfortune to fall from the third story of a house. In one of his legs, which had struck a beam, the bones were so shattered and split near the [...]ncle, that they felt almost like a bag of small stones. Some of their sharp points had likewise penetrated the skin. It was advised that the leg should immediately be taken off; but to this the patient's friends would not consent. After tak­ing three or four days to consider of it, the operation was at last determined upon, and was accordingly performed; but alas, it was in vain! The mortification had already proceeded too far to be stopped, and the miserable patient died in two days.

WHEN a fracture is accompanied with a wound, it must be dressed in all respects as a common wound.

All that art can do towards the cure of a broken bone, is to lay it perfectly straight, and to keep it quite easy. All tight bandages do hurt. They had much better be wanting altogether. A great many of the bad consequences which proceed from fractured bones are owing to tight bandages. This is one of the ways in which the excess of art, or rather the abuse of art, does more mischief than would be occasi­oned by the want of it. Some of the most sudden cure [...] of broken bones which w [...]re ever known, happened when no bandages were applied at all. Some method however must be taken to keep the member steady; but this may be done many ways without bracing it with a tight bandage. We are not however against the use of bandages altogether. It is only the wrong application of them which we find fault with.

IN fractures of the ribs, where a bandage cannot be pro­perly used, an adhesive plaster may be applied over the part. The patient in this case ought to keep himself quite easy, avoiding every thing that may occasion sneezing, laughing, coughing or the [...]. He ought to keep his body in a straight posture, and should take care that his stomach be [Page 360] constantly distended, by taking frequently some light food, and drinking freely of weak watery liquors.

THE most proper external application for a fracture is oxycrate, or a mixture of vinegar and water. The banda­ges should be wet with this at every dressing before they be applied, and the part may be frequently sprinkled with it.

OF STRAINS.

STRAINS are often attended with worse consequences than broken bones. The reason is obvious; they are generally neglected. When a bone is broken, the patient is under a necessity of keeping it easy, because he cannot make use of it; but when a joint is only strained, the person finding he can still make a shift to move it, is sorry to lose his time for so trifling an ailment. In this way he deceives himself, and converts into an incurable malady what might have been removed by only keeping the part easy for a few days.

COUNTRY people generally immerse a strained limb in cold water. This is very proper, provided it be done im­mediately, and not kept in too long. But the custom of keeping the part immersed in cold water for many hours together, is certainly dangerous. This relaxes instead of bracing the part, and is more likely to produce a disease than remove one.

WRAPPING a garter, or some other bandage, pretty tight about the strained part, is likewise of use. It helps to restore the proper tone of the vessels, and prevents the ac­tion of the parts from encreasing the disease. It should not however be applied too tight. I have frequently known bleeding near the affected part, in violent strains, have a ve­ry good effect.

BUT what we would recommend above all things for a strain is ease. It is more to be depended upon than any medicine, and seldom fails to remove the complaint.

OF ULCERS.

ULCERS may be the consequence of wounds, bruises, or tumours, improperly treated; but they generally proceed from an ill state of the humours, or what may be called a bad habit of body.

[Page 361] WHEN this is the case they ought not to be hastily dried up, otherwise it may prove fatal to the patient. Ulcers happen most commonly in the decline of life; and persons who neglect exercise and live full, are most liable to them. They might often be prevented by retrenching some part of the solid food, or by opening artificial drains, as issues, setons, or the like.

AN ulcer may be known from a wound by its discharg­ing a thin watery humour, which is often so acrid as to in­flame and corrode the skin; by the hardness and perpen­dicular situation of its sides or edges, and by the time of its duration, &c.

IT requires considerable skill to be able to judge when an ulcer ought to be healed, and when not. In general, all ulcers which proceed from a bad habit of body should be suffered to continue open at least till the constitution be so far changed by proper regimen, or the use of medicine; that they seem disposed to heal of their own accord. Ul­cers which are the effect of malignant fevers, or acute dis­eases, may generally be healed with safety after the health has been restored for some time. The cure ought not however to be attempted too soon, nor at any time without the use of purging medicines and a proper regimen. When wounds or bruises have by wrong treatment, degenerated into ulcers, if the constitution be good, they may generally be healed with safety. Whenulcers either accompany chro­nical diseases, or come in their stead, they must be cautiously healed. If an ulcer conduces to the patient's health, it ought never to be healed; but if, on the contrary, it wastes the strength, and consumes the patient by a slow [...]ever, it should be healed as soon as possible.

WE would earnestly recommend a strict attention to these particulars, to all who have the misfortune to labour under this disorder, as we have frequently known people throw away their lives by the want of it, while they were extolling and generously rewarding those whom they ought to have looked upon as their murderers.

THE most proper regimen for promoting the cure of ulcers, is to avoid all spices, all salted and high seasoned food, all strong liquors, and to lessen the usual quantity [...] flesh meat. The belly ought to be kept gently open by a diet consisting chiefly of cooling laxative vegetables and by drinking butter-milk, or whey sweetned with honey or the like. The patient ought to be constantly cheerful, and [Page 362] should take as much exercise as he can easily bear.

WHEN the bottom and sides of an ulcer seem hard and callous, they may be sprinkled twice a day with a little red precipitate of mercury, and afterwards dressed with the yellow basilicon ointment. Some chuse to have the edges of the ulcer scarified with a lancet; but this operation ought to be performed by a surgeon.

LIME-WATER has frequently been known to have very happy effects in the cure of obstinate ulcers. It may be used in the same manner as directed for the stone and gravel.

MY late learned and ingenious friend, Dr Whytt, strongly recommends the use of a solution of the corrosive sublimate of mercury in brandy, for the cure of obstinate ill conditioned ulcers. I have frequently found this medi­cine, when given according to the Doctor's directions, prove very successful; but it should never be administred without the greatest care. It is made by dissolving four grains of the corrosive sublimate of mercury in eight ounces of the best French brandy. The dose is a table-spoonful night and morning; at the same time washing the sore twice or thrice a-day with it. In a letter which I had from the Doctor a little before his death, he informs me, "That he observed washing the sore thrice a-day with a solution of trible strength was very useful." This me­dicine ought always to be prepared with the greatest care, and ought never to be administred but under the eye of some person of [...] in physic.

OF IMPOSTHUMES, OR BOILS.

BOILS are generally the efforts of Nature to expel noxi­ous humours out of the body. Their suppuration ought therefore by all means to be promoted. I do not remember ever to have seen one instance of the constitution being hurt by them, but have often known it greatly mended, especially when care was taken to promote a full and free suppuration.

IMPOSTHUMES may proceed from the use of trashy fruits, or any other unwholesome food, from hunger, excessive labour, or the like. They are attended with acute pain, hardness, redness of the part, and all the symptoms of in­flammation.

BLEEDING and purging will sometimes discuss these tu­mours at the beginning; but as soon as it is evident that [Page 363] matter is collecting, it will be proper to apply a poultice of bread and milk, with a little oil or fresh butter. This may be renewed twice a-day; and if the suppuration goes slow­ly on, a raw onion may be cut into small pieces, or bruised in a mortar, and spread upon the top of the poultice. This will promote the suppuration more in one day than a simple poultice will do in three or four.

WHEN the boil turns soft, appears of a white or yel­lowish colour, and is quite full of matter, if it does not break of itself, it should be opened with a lancet. This operation is no ways dangerous, and is very little painful, as the skin is very thin and greatly distended. If no other instrument be at hand, it may be opened with a large needle; but it is always better to make use of a lancet or some instrument that will make a pretty large wound, in order that the matter may be discharged freely.

AFTER the imposthume has broke, or been opened, it may be dressed twice a-day with yellow basilicon ointment, spread upon lint, or a bit of soft rag. It will still however be proper to keep the poultice applied to it, till such time as the matter be entirely discharged. After the matter has been discharged, the patient ought to be purged.

WHEN boils return frequently, it shews a bad state of the humours, and merits particular attention. The patient ought to be peculiarly attentive to his diet, and, if the dis­ease proceeds from any error in it, it should be changed as soon as possible. Repeated purges are generally necessary in the case; and infusions of the bitter plants, as water-trefoil, camomile-flowers, &c. ought to be drank freely. Those who are able to afford it, should take a course of the purging mineral waters.

OF WHITLOWS.

A whitlow is a painful tumour appearing near the end of a finger, the humour of which is often so sharp as to corrode the tendons and nerves, and sometimes even the bone itself.

THESE tumours sometimes proceed from the puncture of a sharp body, as a thorn, a pin, a splinter, or the like. But their most general causes, as was formerly observed, are sudden changes from cold to heat, or the contrary. Hence the disease is very common among milk-maids, especially at that season of the year when they go a milking in a cold [Page 364] nipping frosty morning, and, as soon as they get home, plunge their hands into warm water, or hold them near the fire.

THE pain of a whitlow is commonly so great, as to render the patient exceeding restless. It is attended with an inflammation and often with an evident pulsation. When the humour lies deep, the inflammation spreads over the whole hand, and sometimes it extends up the arm even to the shoulder. The pain, inflammation, and fever have sometimes been so violent, in this case, as to prove mortal.

MANY things are recommended for discussing the in­flammation; as bleeding, blistering, the patient, the hold­ing the part in [...] vinegar, dipping it frequently in scalding-hot water, and such like. These may sometimes succeed at the beginning, but they do no good afterwards. The safest course is to promote the suppuration, by apply­ing cataplasms, or poultices of bread and milk, with boiled camomile flowers. Or, if a more active and ripening poul­tice be necessary, the white lilly-root, or a little honey may be added; but these should not be applied till there be evi­dent signs of a suppuration.

WHEN the inflamation and fever run very high, it will be necessary to bleed the patient, and to keep him upon a low diet, allowing him to drink freely of diluting liquors.

WHEN the matter is lodged deep, it is not safe to wait till the tumour breaks and discharges itself. In this case the matter must be let out by making a deep incision, otherwise it will corrode and destroy the bone. This o­peration should always be performed by a surgeon if one can be had. I have frequently seen one bone of the finger lost by the matter remaining too long in contact with it. Indeed whenever the inflammation beings very deep, it is hardly possible to save the bone.

AFTER the tumor has burst, or been laid open, it may be dressed with the yellow basilicon ointment, or some other digestive, and a poultice applied over it. If proud flesh ap­pears, it may be kept down by sprinkling a little burnt al­lum over it.

IF any symptoms of a gangrene or mortification appear, as a black, pale or lived colour of the parts, &c. the patient must have immediate recourse to the bark, a dram of which must be taken every two or three hours. The part must also be scarified, and fomented with a strong decoction of the bark, or camomile flowers; to which some spirit of sea-salt or strong vinegar, may be added.

[Page 365] As whitlows and mortifications of the extremities are often the effects of violent cold, we would advise people who have been exposed to an excessive degree of it, if their hands or feet are greatly benumbed, to wash them in cold water, or rub them, for some time with snow, and to keep at a distance from the fire. This would not only prevent whitlows, but is the only method of restoring frozen limbs, and of pre­venting a mortification from extreme cold.

OF RUPTURES.

THIS disease happens most frequently to children and old people. Men are greatly more liable to it than wo­men, especially those who are naturally of a weak and relaxed habit. In infants it is generally occasioned by ex­cessive crying, violent coughing, repeated efforts to vomit, &c. In adults it is commonly the effect of blows, violent exertions of the strength, as leaping, carrying great weights, &c. An oily or very moist diet, by inducing a general re­laxation of the solids, is commonly thought to predispose the body to ruptures.

ON the first appearance of a rupture in an infant it ought to be laid upon its back, with its head very low. While in this posture, if the gut does not return of itself, it may ea­sily be put up by gentle pressure. After it is returned, a piece of sticking plaster may be applied over the part, and a proper truss or bandage must be constantly worn for a con­siderable time. The method of making and applying these rupture-bandages for children is pretty well known. The child must, as far as possible, be kept from crying, and from all violent motion, till the rupture is quite healed.

IN adults, when the gut has been forced down with great violence, or happens, from any cause, to be inflamed, it is often very difficult to return it, and sometimes quite impracticable without an operation which it is not our bu­siness to describe. As I have been fortunate enough how­ever always to succeed in my attempts to return the gut, without having recourse to any other means than what are in the power of every man, I shall very briefly mention the method which I generally pursue. After the patient has been bled, he must be laid upon his back, with his head very low, and his breech raised high with pillows. In this situation flannel-cloths wrung out of a decoction of mallows and camomile-flowers, or, if these are not at hand, [Page 366] of warm water, must be applied for a considerable time. A clyster made of this decoction, with a large spoonful of but­ter and a little salt, may be afterwards thrown up. If these should not prove successful, recourse must be had to pres­sure. If the tumour be very hard, considerable force will be necessary; but it is not force alone which succeeds here. The operator, at the same time that he makes a pressure with the palms of his hand, must with his fingers conduct the gut in by the same aperture thro' which it came out. The manner of doing this can be much easier conceived than described. Should all these endeavours prove ineffec­tual, clysters of the smoke of tobacco must be tried. These have been often known to succeed where every other me­thod [...]ailed.

AN adult, after the gut has been returned, must wear a steel-bandage. It is needless to describe these, as they are only to be had from the artists who make them. They are generally uneasy to the wearer for some time, but by custom they become quite easy. No person who has had a rupture after he arrived at man's estate, should ever be without one of these bandages.

PERSONS who have a rupture ought carefully to avoid all violent exercise, carrying great weights, leaping, running, and the like. They should likewise avoid windy aliment and strong liquors; and should carefully guard against catching cold.

OF CASUALTIES.

AS it is often impracticable to obtain even the smallest degree of medical assistance in many of those accidents which endanger life, we shall conclude with a few obser­vations upon some of the most common and hazardous of them.

THE first we shall name is the stoppage of substances be­tween the mouth and the stomach. Though accidents of this kind are unavoidable, yet, generally speaking, they are the effect of carelessness. Children have a strong inclination to put every thing in their mouths which they get hold of. This ought to make nurses careful in keeping every thing from them that they can swallow, which would be hurtful. Even adults are far less careful in this respect than they ought to be. Nothing should ever be held in the mouth which it would be dangerous to swallow, as a fit of cough­ing, [Page 367] or some other accident, may force it over. Notwith­standing the numberless accidents which are daily occasion­ed by holding pins in the mouth, many women have their mouths, for the most part, full of them through the day; and some of them even sleep with them there all night.

WHEN a pin, or any other sharp body is swallowed, it will generally descend into the stomach, if its head, or blunt end goes foremost; but if the point goes foremost, it is apt to stop, and when that happens, every effort to force it down will only serve to fix it faster in. In this case the best way is to make the patient vomit, either by tickling his throat with a feather, or giving him a vomit. I have fre­quently known pins which had s [...]uck in the gullet for seve­ral days, brought up by swallowing a bit of tough meat ti­ed to a strong thread, and drawing it quickly up again.

ALL hard or sharp substances, which might hurt or wound the bowels, ought, if possible, to be discharged upwards. Substances that will dissolve in the stomach, if they cannot be brought up, may be pushed down. When a mouthful of solid food stops in the gullet, it may often be forced up by giving the person a blow on the back betwixt the shoul­ders. If this should not succeed, the throat may be tickled with the finger or a feather. I lately saw a halfpenny, which had stuck fast in the gullet of a boy about eight years old, thrown up by only thrusting a finger down his throat.

PERSONS who have the misfortune to fall into the water are often given up for dead, when it is certain they might, by proper care, be recovered. The great intention which should be kept in view is to restore the natural warmth and renew the circulation and breathing. Tho' cold is by no means the cause of the person's death, yet it will prove an effectual obstacle to his recovery. For this reason, after stripping him of his wet cloaths, if he had any on when the accident happened, his body must be strongly rubbed for a considerable time with coarse linen cloths as warm as they can be made. As soon as a bed can be got ready, and well heated, he may be laid in it, and the [...]ubbing still conti­nued. Warm cloth [...] should be laid to his stomach and bowels, and hot bricks, or bottles filled with warm water, to the soles of his feet. He should likewise be bled. The most proper part for this operation is in the jugular vein, both because it is most likely to bleed, and affords the most sudden relief to the head.

[Page 368] IN order to renew the breathing, a strong person may blow his own breath into the patient's mouth with all the force he can; or, what will succeed better, the smoke of tobacco may be blown into the lungs, by means of a pipe or funnel. I have known a pig drowned and restored to life, two or three different times successively, by blowing air into its mouth with a pair of bellows. It will likewise be proper to throw up the smoke of tobacco into the intes­tines, in form of a clyster, by means of a proper pipe. Strong volatile salts ought also to be applied to the nose, or spirits of hartshorn, burnt feathers, &c. The nose ought likewise to be tickled with a feather dipped in volatile spi­rits, and warm spirits of wine should be rubbed upon the temples, pit of the stomach, &c.

IF these do not succeed, the person may be put into a warm bath, or laid among warm ashes. Dr T [...]ssot menti­ons an instance of a girl who was restored to li [...]e, after be­ing taken out of the water to all appearance dead, by lay­ing her naked body upon hot or warm ashes; by covering her with others equally hot; by putting a bonnet round her head, with a stocking round her neck stuffed with the same, and heaping coverings over all.

THE same method must be pursued for the recovery of persons strangled as for those who are drowned.—Such as have the misfortune to be stunned by a [...]all, a blow, or the like, must also be treated nearly upon the same princi­ples. Every method must be taken to keep up the genial warmth, and to restore the vital functions. Nor ought we to despair too soon of success. I have been happy enough to recover a person who was taken up for dead by a fall from a horse, after six hours endeavours, during the great­er part of which time he hardly shewed any signs of life.

NOTHING is more certain than that life, when seeming­ly lost, might often be restored by persisting for a sufficient time in the use of proper means; and that many of those unhappy persons who perish by accidents, are really lost for want of due care. Surely all the laws of religion and hu­manity call upon us to do every thing in our power to save the lives of our fellow-men. Who would not chuse to be the happy instrument of preserving an useful member of society, and perhaps of preventing the ruin of an innocent family?