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MEDICAL ADVICE TO SEAMEN; WITH
DIRECTIONS FOR A
MEDICINE CHEST.
SEAFARING people are that class of mankind who are supposed to be in perfect health when they enrol themselves for any particular voyage or cruise; notwithstanding their hardiness, they are liable to many and numerous excruciating maladies, during the prosecution of their respective voyages to different parts of the world: Whatever, therefore has a tendency to meliorate, or render comfortable the situation of the sick on board of vessels, must be an acquisition truly important and useful to all navigators. I shall therefore, by way of preface to the directions for a sea medicine chest, offer some general outlines on the appearance and management of the principal diseases which occur to seamen in different voyages and places. It has been a common practice to put up medicine chests, with directions containing the doses and virtues
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[...] article only. This cannot be of much service to the people, unless the master or prescriber has a previous knowledge of diseases, or is a person of judgment sufficient to discern the character of the disease, and thereby judge what particular indication is best suited remove it.
Many sick people at sea have suffered much, and had their complaint prolonged, in consequence of a too frequent, and often opposite repetition of medicines; this is in consequence of the similarity there is in the symptoms of many diseases, which in their respective natures, are diametrically opposite, and which, without some general rule or guide, no man can make a necessary distinction. The short system which I here present, will be brief and concise; at the same time containing an illustration of circumstances, necessary to mark the general characteristic, on which most of the diseases incident to seamen, depend. Whereby the master may know on what grounds to prescribe his medicines, and how he may judge of their effects, and conduct his applications through all the variety of symptoms that occur, in general diseases.
Sailors are very apt to be careless of their health, especially while in port, and expose themselves to every intemperance that can possibly produce the occasional causes of diseases. It is therefore incumbent on the master to watch his people closely, while under his care; and when sick, to make faithful investigation respecting their conduct and habits, during a number of days before the arrival of the disease.
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ALL GENERAL DISEASES ARE DIVIDED INTO FOUR ORDERS, viz:— FEVERS, INFLAMMATIONS, FLUXES, AND DISEASES OF WEAKNESS.
ORDER I.
FEVERS.
FEVERS, comprehend all those diseases which are attended with the following symptoms: viz. the patient complains first of a dull pain in the back and limbs, weakness of the joints, especially of the knees, a heavy pain, load, and disagreeable sensations at the stomach, with a natural aversion to move about or exercise; a yawning, stretching, &c. succeeded by slight cold chills, flying through the body, head ach, sickness at the stomach, the eye looks dull and heavy, sometimes very red and prominent, as the cold chill advances the skin is pale and shrivelled; these symptoms are next succeeded by heats throughout the body, with the appearance of enlarged veins, quick, hard and laborious pulse, striking from 70 to 100 strokes in a minute,
[Page 6] sometimes the pulse feels small, quick and trembling; sickness at the stomach, sometimes occasions violent vo
[...], and sometimes purgings; the patient is uneasy and restless, but complains of no particular pain except in the head, which sometimes occasions deliriums, a wildness, and incoherent speaking, pulling and hauling the bed cloaths, &c. These symptoms continue 6 or 8 hours, when they abate a little, but return again towards night with their former violence, and continue to observe these periods until the 9th, 11th, 14th, and sometimes run on to the 20th and 24th day of the disease, before a solution terminates either in death or health. These different periods of the disease vary according to the climate, state of the patient's constitution, nature of the reigning diseases of the place, and a variety of circumstances which often shorten or lengthen a fever: It is to be observed that different people with different constitutions will be differently affected with the same fever. Some are attacked with all the above mentioned symptoms, with violent vomitings of black matter, and bleeding at the nose, eyes and gums; others with the same fever, in the same place and vessel, have all those symptoms mild, and a very clear head, with quiet stomach and bowels; others again are seized with violent heat and pains in the head and bones, and continue in the greatest tortures two or three days, and die sudden. These last circumstances depend on the manner of living; to frequent intoxication, and being late out in night air fogs, lying on deck evenings; carousing in hot, close houses, and suddenly going into the air; the nature of the prevailing sickness in port; being in
[...], still rivers, canals, marshy places, &c. &c.
These are the general marks of contagious and epid
[...]al fevers, which sweep off so many of our Amer
[...]
[...]; but seamen are liable to fevers from different
[...], as sudden colds, with obstructed perspiration;
[Page] from a foul and weakened stomach, bad provisions, &c. &c. and many get fevers from their own carelessness or negligence, as has been before mentioned; but they are all cured much in the same manner; varying the modes in proportion to the violent symptoms of the fever present.
METHOD OF CURE.
AFTER having examined the patient's constitution, his habits of living, and the state of his stomach and bowels; and whether those symptoms mentioned above, are actually present, the judgment will dictate what particular evacuation will be most proper. If the sickness at stomach, with vomiting of bile, is the most prevalent, it will be proper to give a vomit, No. 1. and after the operation is finished, if the heat, thirst, quick pulse, and symptoms of fever continue to rage, blood letting must be had recourse to, drawn freely, and repeated as the symptoms require, having regard to the robust habit of the patient, &c. It is to be remembered, that we cannot be too free with the lancet in many climates, especially in the West-Indies, and in our southern states, among the fevers incident to those climates; after bleeding, a purge, No. 3. is to be given, and should it not operate largely, it must be repeated again. These three general evacuations are only to be depended upon in the cure of fevers, and must be repeated as the symptoms of fever and violence of the complaint indicate. For drink, the fever julep, No. 18. may be taken often, by mixing it with water, barley tea cold, beverage, lemonade water, or fifteen or twenty drops of No. 10. mixed with a pint of water, may be
[Page 8] a drink constantly, and is very proper in hot climates, where putrefaction is to be dreaded; crem. Tartar water, &c. The patient must be kept cool, and suffered to breathe pure air.
If notwithstanding the exhibition of these general indications of
vomiting, bleeding, purging, and
cooling, the fever should run on till it terminates in a putrid, dissolved state of the blood, which is known by an abatement of all pains or uneasiness; a black, dry tongue, with a yellow streak across the middle of it; stinking breath, and weakening, clammy sweats, hollow eyes, blood starting from the gums, nose, bowels, and the recovery of his senses, you must lay aside all those cooling medicines, and give freely of No. 4. No. 11. brandy, wine, and wash the patient freely in good spirits and vinegar, keeping his cabin well ventilated, &c. But in this stage of the business it will be proper to have the advice of a physician.
ORDER II.
INFLAMMATIONS.
UNDER this head are
internal and
external inflammations: The internal are
plenrisy, quinsey, rheumatism, gout, inflammation of the
stomach, bowels, kidnies, &c. &c. They are attended with the above symptoms of fever, heat, quick and strong pulse; with a particular seated severe pain in those parts, where the disorder fixes; at the side in
pleurisy, throat in
quinsies, &c. &c. All internal inflammations attended with fever, proceed from great and sudden colds, exposure to damp air when
[Page 9] sweated, and also drinking largely of cold water when warm, &c. &c.
External inflammations are painful swellings, with redness of the part, tending to encrease to large tumors, and suppuration.
Internal inflammations are cured by blood-letting, purging with salts, No. 2. and powder, No. 3. drinking freely of barley and flaxseed tea, crem. Tartar water, &c.
External inflammations are cured by applying the mineral water, No. 16. and purging with salts and
[...] powder, No. 3. bleeding, and if the swelling is
[...] and increases to maturate, poultices of
[...] bread and milk, must be applied warm,
[...] repeated, till it is fit to be opened with a
[...].
ORDER III.
FLUXES, Such as
Dysentery, Cholera Morbus, Diarrhaea, or common Looseness, &c.
DYSENTERY or
bloody flux, is cured by bleeding, if feverish, purging with salts, No. 2. sometimes taking a vomit, if sick at the stomach; drinking freely of barley tea; after the bowels are emptied, take twenty-five or thirty drops of No. 5. every night, and drink barley and toasted bread made into paste, with rice plentifully salted.
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[...] morbus is cured by immediately taking large draughts of
[...] broth, and clysters of the same; sometimes it will be proper to give a vomit, No. 1. and if the vomiting and purging still continue, give thirty or forty drops of No. 5.
A common looseness is often very salutary, therefore should never be stopped too suddenly; it may be cured by taking warm burnt brandy, with eighteen or twenty drops of No. 5. at going to bed.
ORDER IV.
DISEASES OF
WEAKNESS.
THOUGH they do not frequently occur at sea, yet many times seamen are liable to lingering diseases, which require some of the master's skill; such as
scurvy, dropsical swellings, intermitting fevers, colics, rheumatisms without fever,
jaundice, &c.
Scurvy is cured by taking ten or fourteen drops of No. 10. in water, three times a day, eating fruit vegetables, drinking lemonade, and if there are any scurvy sores, and spongy, they must be cut out with a lancet, and dressed with line, and salve, No. 7.
Dropsical swellings are cured by friction, taking bark, brandy, wine, and nourishing diet; gentle exercise, &c.
Intermitting fever, commonly called fever and ague, is cured by taking a vomit, No. 1. and when the fever
[...] off, a tea spoonful of bark every two hours, in
[...], &c.
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Colics are cured by taking clyster
[...], purging
[...], No. 3. fomenting the belly with flannels wrung out of boiling water, and applied warm to the belly.
Jaundice is cured by purging with No. 3. taking a pill of Castile soap two or three times a day; exercise; good diet, bitters, No. 11. bark, No. 4. brandy, wine, &c.
Sudden maladies, as convulsion fits, suppression of the urine, &c. often occur at sea; the former requires thirty or forty drops of No. 5. every hour till relief; the latter, fomenting the belly and bladder, as in colic, drinking flaxseed tea, crem. Tartar water, &c. &c.
Wounds; such as cuts and bruises, are to be treated with some considerable care: If an important part is cut deep, and large blood vessels are separated, the bleeding must be stopped by compressing the edges of the wound together, filling it with lint, and if it bleeds much, cover it with lint and flour, and compress it close, letting the lint and flour remain on till the parts are united: It is best to sew up an incised wound, when it can be done.
VENEREAL DISEASE.
A SIMPLE gonorrhoea or running, without any taint in the blood, may be cured by taking a powder, No. 3. every other morning, till the patient has taken three; by injecting sweet oil into the yard two or three times a day; this is highly recommended.
When the virus of the disease has entered the blood,
[Page 12] and occasioned scaldings, swellings, pains, &c. &c. then the general cure is to be attempted: Let the patient first be purged two or three times with salts, and purging powders, No. 3. then begin and take a table spoonful of No. 14. morning and evening. Let his diet be rather spare, and to eat no salted or greasy provisions; drink brandy and gin only; and purge every fourth day till he is well, &c. Buboes, or swellings in the groin, must be carried away in their beginning, if possible; rub on them at going to bed, the ointment, No. 8. taking care not to get any cold, &c.
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No. I.
VOMITS.
TAKE one of these powders, and dissolve it in six table spoonfuls of cold water, then take four spoonfuls down, and wait fifteen minutes; if it does not then operate, take one spoonful every fifteen minutes, till it does; then work it off with warm water, and after the operation is over, take fifteen drops of No. 5. in some toast water.
No. II.
SALTS.
DOSE a table spoonful to three dissolved in water.
No. III.
PURGING POWDERS.
TAKE one of these mixed in molasses or syrup, drinking gruel only till it operates.
No. IV.
PERUVIAN BARK.
DOSE a tea spoonful every two hours, in warm water, wine, gin, or molasses: Care must be taken not to administer this in the paroxysms of a fever.
No. V.
LAUDANUM.
DOSE from twenty-five to sixty drops, as the emergency of the case may require; this medicine is proper to procure sleep, rest and ease from pains, to stop looseness of the bowels, and good in cases as before directed.
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No. VI.
SMELLING DROPS.
TO be used and taken five or eight drops in water, when faint, in fevers, every three or four hours.
No. VII.
HEALING SALVE.
TO heal and digest wounds or ulcers, having care to extirpate all proud fungus flesh, by the use of No. 17.
No. VIII.
MERCURIAL OINTMENT.
TO be rubbed in the groin, &c. as directed in venereal disease; good to kill lice, &c.
No. IX.
TURLINGTON BALSAM.
SEE the printed directions.
No. X.
ELIXIR VITRIOL.
DOSE from eight to fifteen drops three times a day; besides its uses mentioned before, it is good to create an impaired appetite, strengthening to the system, &c.
No. XI.
BITTERS.
TWO large table spoonfuls of this put into a quart of good spirit or brandy, make an excellent bitter; which is good to take after a fever, or to prevent the catching of fevers in sickly places; to strengthen the stomach and bowels; good in jaundice, dropsy, and all diseases of weakness, &c.
No. XII.
ENGLISH BARLEY.
SEE fevers.
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No. XIII.
SPANISH FLIES.
BLISTERS are indicated in pleurisies; deliriums in fevers, after bleeding, and many other diseases. Take a piece of leather, cloth, or brown paper, and spread a plaister with No. 7. and strew it over with these flies, and press it into the plaister till it is covered, then rub the part with vinegar and apply the plaister, and when it has raised a blister, let it out, and keep on the plaister till it has done running; afterwards dress it with a thin plaister of No. 7.
No. XIV.
VENEREAL POWDERS.
WHEN you wish to cure the disease as before mentioned, take one of these powders and put it into one quart of brandy, or wine, and when dissolved, take as before directed.
N. B. Be careful that these powders do not get misplaced, or taken instead of vomit, No. 1. Death would be a consequence.
No. XV.
CREM. TARTAR.
SEE fevers.
No. XVI.
MINERAL WATER,
IS made thus: Take a half pint of pure water and drop of this into it. Shaking the water until it becomes nearly as white as milk, then use it as before directed.
No. XVII.
PRECIPITATE.
TO eat proud flesh, &c.
No.
XVIII. FEVER JULEP.
TAKE one pint of water and put into it a
[Page 16] powder, No. 1. and take a table spoonful every two hours; this is an excellent julep in the bilious inflammatory fevers of the hot climates.
Auctori. S. H. P. LEE,
PHYSICIAN.