MEDICAL ADVICE; Particularly to those who travel to the various regions of the Globe.
IT is of the utmost importance for every individual, to well understand the best methods of preserving health, and is the duty of every well-wisher to the cause of humanity, to contribute his services; on this principle then the following directions are written.
IN hot weather, after using any hard exercise, avoid drinking cold water, for it has proved fatal: but as drink is absolutely necessary, the water should be mixed with about one seventh or eight of good old spirits. To those who are relaxed, nothing can be better than an addition to this drink of about twelve drops of acid elixir of vitriol, three or four times a day, or a small quantity of the juice of lemons or limes: but the most wholesome beverage for them who enjoy a good state of health, is good sound porter or ale mixed with water.
[Page 10]EXCESSES of every kind should be avoided as much as possible, and drunkenness in particular. No person should sleep at night in the open air, as it is extremely hazardous, on account of the damps.
IT is strongly recommended to the commanders of ships trading to the different parts of Africa, the East, and West Indies, not to permit any of their men to remain on shore after sunset.—But if from business, of any other unavoidable circumstance, they should be sent in boats, up rivers, or on shore in the neighbourhood of marshy countries, a few large doses of bark in powder, given in wine, may enable the constitution to resist the sedative power of the chilling and noxious damps.—Or a few doses of the ague pills, which are a very powerful tonic, will answer still better in places, where from the rain and fogs, the constitution may be said to be constantly in a vapour bath.
IN order to prevent injuries from the bite of musquetoes, horse-flies, and other insects, as they sometimes produce inflammations and ulcers in the legs, and even mortifications; wear long light linen trowsers. The best remedy for the inflammation arising from these causes, is the juice of a lime, sharp vinegar, Goulard's extract of lead and water, or spirit of harts-horn and water.
[Page 11]WHEN the water is bad or putrid, it may be sweetened in the following manner: Expose it to the air as much as possible, by pumping it with a hand pump from one vessel into another, mixing a little powdered charcoal or a small portion of alum, which will throw down particles of dirt, clear the water, and its wholesomeness will not be in the slightest degree impaired. *
IN long voyages, beef, pork, &c. is frequently apt to become stale.—"In Mr. Gaine's almanac for 1797, there is a good Receipt, by which any meat, ever so stinking, may be made as sweet and wholesome in a few minutes, as any meat at all. The Receipt is as follows: Take some white ley, that is, boil some clean ashes in water; let it stand till it settles; pour this off as clear as rock water; boil your meat in this three or four minutes, or till it is sweet, then wash it and dress it in any way, and no person could discover it had ever been foetid or stinking. This will be found a useful communication to the navy, where a solution of pot-ash may be used instead of the white ley."
[Page 12]"WE find that a few pails full of this ley or solution of pot-ash, will restore to eatable condition, a barrel of stinking meat, which by the operation of the pot-ash, is restored to a sound state." *
FOR the most part small grog, that is, liquor united to a considerable quantity of water, is the drink, and through necessity salt provisions are the diet. Neither this diet, nor the liquor, produce diseases, unless the water should be very putrid, which will sometimes, in hot climates, occasion fevers of the malignant kind, and fluxes; and by the sea air, through the imprudence of the men sleeping on the deck, are pleurisies, peripneumonies, and other inflammatory diseases produced. —The Guinea-worm, I believe is peculiar to Africa, and a few parts of Asia. It has been supposed to proceed from a bad quality in the water of the country; doubtless the waters of Senegal, Gambia, Sierra Leon, Ganges, &c. are either unwholesome or muddy; supposing with Lind and others, that the Guinea-worm is generated from animalcula, or their ova, contained in the waters of the country; their production in the human body, may probably be prevented, by drinking good water.—"The Guinea-worm is a white, round, slender worm, often some yards long, lodged in the interstices of the muscles (or flesh), commonly [Page 13] in the legs, feet, or hands; when it attempts to escape through the skin, it occasions a swelling, resembling a boil, attended with great pain, until its black head appears in a small watery bladder on the head of the bile. When this bladder breaks, the head of the worm is to be secured, by tying it to a small roll of linen, spread with plaister; and part of the worm is once or twice a day to be gently drawn forth, with care not to break it, and wrapped round this roll, until it be brought away entire; then the ulcer generally heals soon; but if part of the worm breaks off, the part remaining in the flesh, can be ejected only by painful and tedious suppuration in different places. Dr. Rouppe observes, that the Guineaworm is infectious. It may at least be prudent, not to lie in the same apartment, and to avoid too free a communication with such negroes as are afflicted with them."
BEFORE we proceed to give directions how to exhibit the medicines contained in the medicine-chest, our attention shall be directed to the means pointed out by Dr. Lind, for preventing a want of provisions at sea, and close our remarks with some general observations respecting diet, more properly adapted to domestic use.
[Page 14]"THE substances I have found most fit for the purpose are powder of salep and portable soup, which convey the greatest quantity of vegetable and animal nourishment under the smallest bulk. An ounce of powdered salep, and another of portable soup, dissolved in two quarts of boiling water, become a rich thick jelly, capable of receiving any flavour from the addition of spices. This is sufficient for one man a day; two pounds of each would serve him a month: and being a mixture of both animal and vegetable food, it is more wholesome than either used alone. Hasselquist informs us, that a caravan from Ethiopia to Egypt, having expended their provisions, lived for two months on gum arabic, dissolved in water; this gum having luckily been a part of their merchandize. The gum senega or arabic, serves as a sustenance for whole negro towns, during a scarcity of other provisions, occasioned by a failure of their crops of millet and rice.
SPICES render portable soup and salep, more grateful to the palate, and also tend to improve their nutritive quality; as would appear from the following incident of famine on board a ship at sea: A Malay ship arrived from Macassar, at Manilla, which by the shifting of the monsoon, had been detained at sea much longer than was expected, the men had been reduced to such extremities for want [Page 15] of provisions, as to be obliged to subsist for two months, almost wholly upon water and spices; the latter, viz. cinnamon, mace, and pepper, being the cargo of the ship, notwithstanding which, upon their arrival at Manilla, they all, the number of thirty, were in perfect health."
GENERAL OBSERVATIONS respecting DIET, more properly adapted to domestic use—particularly in cases of indisposition or sickness.
PERSONS of imflammatory disposition, cannot use vegetables too plentifully. Oat-meal is cooling, therefore made into gruel, affords a light and proper diet for the sick, so are sago, simolina, and tapioca, used in general, in various diseases, where such diet is necessary; and in all fevers, where animal food should be generally avoided. From the finest wheat flour is made macaroni, vermicelle, &c. as they are called in Italy, which may be boiled in water, and affords excellent nourishment.
THOSE whose health is impaired, would do well to be cautious in the choice of their food; veal, poultry, mutton well boiled, and fish are extremely nutritive, oysters eaten from the shell are excellent.
MILK is friendly and nutritive, requiring little or no exertion, to prepare for chyle, so are eggs, if [Page 16] care be taken they are not boiled hard; beef-tea is good, and with prudence roast beef may be tried, and if it sits easy, may be taken in change—hard, salted, and dried meats must be avoided. Fungusses, such as truffles, mushroons, morilles, champignons, &c. &c. are apt to tumify the stomach, especially of the delicate in constitution, and debilitated; from whence anxiety, heart-burn, cholics, hiccups. Sometimes they have been retained three or four days undigested in the stomach, occasioning the most violent pains and misery. Their juices are not liable to the same objections, should be extracted, and their solid parts, which are as tough as leather, should be thrown away. Esculent vegetables which are eaten raw, with vinegar, oil, and salt, are called salads.
VIRTUES.
SALLADS are saponaceous, detergent, cooling, and antiseptic; opening and diuretic, and, from the addition of vinegar, they become a grateful stimulant for the stomach.—From hence they excite appetite; correct an atrabilious alcaline, putrid, scorbutic diathesis; they liberate the tongue, stomach, intestines and kidneys from sordes; they cool the blood in summer, and resolve obstructions of the liver, and other viscera. They agree with [Page 17] the sedentary, scorbutic, and bilious, sanguineous; the heated, especially in hot climates or in the summer heat; provided they do not disorder the stomach by their slow digestion, or flatulency. They are improper and injurious to the cold, debilitated, and nervous, and all those who have acidity in the stomach, or inert bile.
THOSE who eat large quantities of cucumbers, are in general subject to fluxes, and other stomach and intestinal disorders.
FRUITS.
THEY resist the putrid tendency of the humours and bile, by their abounding with fixed air. By their acidulous taste they quench thirst, moderate heat, and cool. They agree most with summer heat, and in hot climates they most abound.— Care should be taken not to eat them immoderately, as they will produce disagreeable consequences, pretty generally known.
OF DRINKS.
PURE, good water, ought to be clear, without smell, taste or colour; light, cold, and contain a [Page 18] little fixed air; and, if examined by a chemical analysis, exhibits no heterogenous principle; which is known, if by adding the acid of sugar, by a fixed and a nitrous solution of silver. Little or no turbidness appears; for water perfectly pure, is scarce found in any part of the world. The best water is spring and mountainous, from rocks, the next is the river, the worst is well, and all stagnant waters.
OF BEER, ALE, &c.
ALL new ales, and small beer, are flatulent and fattening. Ale, and porter, are very good strengthening malt liquors, for those who use hard exercise.
THOSE who accustom themselves to drink malt-liquor in moderation, scarcely ever have the gout; but its immoderate use produces corpulency, and sometimes dropsy.
BEER if not very strong, is less heating than wine; it is a nourishing and analeptic drink; hence proper for the feeble and emaciated, if they labour under coughs or difficulty of breathing. In many where wine sours in the stomach, beer or good ale will agree; if it be well hopped, it is said to prevent the gravel, gout, or stone.
OF WINES.
A MODERATE use of wine strengthens the languid stomach, excites the appetite, helps digestion, strengthens the nervous system, increases heat, resists putridity, promotes perspiration, &c. A spare use of wine agrees with the aged; in infancy it should be always prohibited (except it be ordered, and taken as a medicine) for those who begin to drink wine after manhood, are much more likely to escape gout, gravel, stone, and chronic diseases, and to be healthful and long-lived, than those who in infancy or in youthful age, or, whilst they be growing, are indulged with this liquor.
WINE is a preservative against putrid diseases. It exhilirates the mind, and is the greatest friend to conviviality.
OF SPIRITUOUS LIQUORS.
As a medicine, in some cases, they are cordials and antiseptics: they agree with the flatulent, hypocondriac, nervous and low spirited; but if continued always, do mischief, destroying the tone of the stomach, viscera, &c.
WE are sorry to find the cities of America, imitate the great cities in Europe, in the baneful practice [Page 20] of dram-drinking, so destructive to the health and comfort of thousands. The [...]crease of brewing malt liquor, we trust will afford more than a partial remedy to this wide-spreading evil, by giving the people a more wholesome drink. However, we shall not quit our observations on spirits, without warning seriously all its votaries, of their dreadful, slow, poisonous qualities.
SWEET DRINKS,
ARE cyder, cherry, elder-wine, &c. punch, lemonade, orangeade, orgeat, cappilaire, &c.
THEY are cooling and pleasant; but some agree better with certain stomachs than others, and when they disagree, they should not be repeated. As to cyder, it produces the rheumatism, gout, gravel and stone, therefore much less salubrious than malt liquors.
WARM DRINKS.
TEA we believe is pretty generally used in most parts of America, and with milk or cream, makes an excellent breakfast, if the quality be good, and it agrees well with the stomach; it should [Page 21] never be drank without previously eating bread and butter, rusks, biscuits, &c. The Chinese pronounce tea noxious in inflammations of the eyes, in the cholic and palsy.
CHOCOLATE is nourishing, and proper for the debilitated hypochondriacs, and those who labour under the piles, or costiveness.
COFFEE strengthens the stomach, promotes urine, and evacuates worms and wind—removes costiveness, elevates the sinking spirits. Without milk after dinner, promotes digestion, retards putrefaction, and increases the vital motions of the blood.
TREATMENT OF DISEASES.
BLEEDING.
IN the treatment of inflammatory distempers, great attention must be paid to the season of the year and climate; for, in proportion as the country or season is hot or cold, so must bleeding be regulated. In colder countries, large bleedings are not only salutary, but absolutely necessary; in hot climates bleeding must not be often repeated; it must be frequently omitted, as it exhausts the [Page 22] strength of the patient. The inflammatory symptoms in most diseases, by profuse bleeding, are immediately succeeded by a putrifactive state of the juices, which will end in the death of the patient *.
PLEURISY AND PERIPNEUMONY.
THE first is an acute pain in the side, with fever and difficulty of breathing; the second violent difficulty of breathing and inflammatory fever. Large and repeated bleedings are necessary.—Internally, the following medicines are proper to raise perspiration.
No. 3. Take of tartar emetic two grains, dissolve it in four table spoon fulls of water, which is equal to two ounces in measure. Take three or four tea-spoonfull every four or six hours.
No. 1. In order to open the bowels, take an ounce or more of glauber salts, dissolve in half a pint of water, take a little every hour until it answers. Common nitrous drink;—dissolve two drachms of powdered salt nitre in a quart of water; [Page 23] this may be sweetened with honey, molasses, or sugar, and drank freely.
IF the difficulty of breathing or pain continues, bleeding must be repeated, and a blister must be applied in the pleurisy, directly over the pain in the side, but in the inflammation of the lungs to the pit of the stomach, which must lay on sixteen or eighteen hours, and a discharge promoted by dressing it with basilicon spread on a linen rag once or twice a day.
ACUTE, INFLAMMATORY FEVER
BEGINS with cold shiverings, succeeded by great heat, thirst, nausea, quick full pulse, pain in the head, back, and loins, &c. It commonly arises from sudden cold, the drinking cold liquors when over-heated, or when in a state of perspiration. It attacks the young, strong, and vigorous; very seldom the debilitated. Repeated bleedings are necessary, if a nausea or vomiting should be distressing. Dissolve three grains of No. 3, in four table spoonfulls of water; after the bleeding, give a large spoonfull every ten minutes or quarter of an hour, which will discharge whatever is on the stomach, and perhaps operate on the intestines; which if it should not, [Page 24] give the solution of No. 1, or half a grain of tartar emetic, with a little magnesia, and about one scruple of nitre, mixed in two ounces of common water, every hour till it operates.
FOR quenching the thirst, no drink will be equal to about a tea-cup full of vinegar, lemon, or lime juice (strained from the pulp) mixed with a quart of the common nitrous drink recommended under the pleurisy, &c.
IF the heat should be intense, it must be observed, that nitre is improper in most cases in hot climates, but inflammatory disorders are not there so frequent as in the colder countries.
IN all other respects the true inflammatory diseases may be treated exactly as the pleurisy and peripneumony. If a delirium come on, blister the legs and back. Internally give the nitrous drink, and eight or ten grains of No. 10, every four or six hours.
IN the recovery of all inflammatory disorders, a gentle laxative will be necessary—as the solution of glauber salts, or twenty grains of julap, mixed with about fifteen or twenty grains of nitre, or cream of tartar, and taken in some water. When the patient begins to recover, twenty-five drops of No. 6, in a cup of water, may be taken three or [Page 25] four times a day —Diet in the beginning, and during the augmentation of the fever, should be very low; after its termination, a greater freedom is necessary.
RHEUMATISM
CONSISTS of wandering pains, affecting the larger joints, especially those of the hip, knees, shoulders and elbows, shifting in the course of the muscles, and much increased on motion. It is divided in two kinds, the acute and chronic; and this division is necessary to be observed, on account of their difference of treatment.
IT occurs most commonly of the acute kind, from the age of puberty to that of thirty-five.
ITS causes are the sudden application of cold when heated, changes of weather, and excesses inducing a plethoric state. When attended with fever, which in the acute kind it generally is, its first symptoms begin with a considerable rigor, in which the pulse is hard and full, and other febrile appearances attend. When the fever departs, a degree of pain and stiffness is frequently felt in the joints, which recurring on changes of weather, without fever, constitutes the chronic kind.
IN the treatment of the first or acute kind, large and repeated bleedings are necessary, as indicated by the strength of the pulse, especially on the first days, and where there is much topical pain.
[Page 26]THE plentiful use of diluent liquids should be likewise enjoined, especially thin gruel or barley water with nitre.—Cooling purges are proper, but only after the abatement of pain when motion is permitted. Blisters to the part, when the pain is violent, are useful; after evacuation, sweating medicines, as fifteen or twenty grains of Dover's powder every six hours may be used with advantage.
IN the chronic kind, large evacuations are here to be avoided, and warm applications of different kinds must be applied to the part, consisting of warm oils, volatiles, turpentines, &c. The use of friction will likewise be of service.
INFLAMMATION OF THE EYE.
THE cure consists in reducing the inflammatory disposition, by bleeding and purging, and in diminishing the pain and irritability by local applications. Blisters applied to the head or behind the ears often relieve. The following application for inflamed eyes, is very proper:
- Take Goulard's extract of lead, thirty drops,
- Brandy, sixty drops,
- Water, half a pint—Bath the eyes frequently.
INFLAMMATION of the Stomach, Intestines, Liver, and Kidney.
INFLAMMATION of the stomach, is known by an acute pain in the region of the stomach, a sense of [Page 27] internal heat in the part, quick, hard contracted pulse, great anxiety, watchfulness, violent vomiting, especially after taking any thing into the stomach, much thirst, with great prostration of strength.
Inflammation of the Bowels or Intestines.—There is a fixed pain in the belly, attended with fever, costiveness, and vomiting; the pain is chiefly felt in the region of the navel.
Inflammation of the Liver.—A dull sense of pain and weight in the right side below the false ribs, much heat and anxiety, the pulse at first slow, afterwards more quickened, a sense of fulness and tension in the region of the liver, a loathing of food, sickness and vomiting, thirst, dry rough tongue, becoming black, a pale sunk countenance, frequently of a yellow colour, troublesome hiccup. Sometimes the pain is more acute, attended with difficult and painful respiration; the pain extends high in the cavity of the thorax or breast, affecting the collar bone, and resembling pleurisy; there is generally s [...]me degree of cough, and the patient cannot lie on the left side.
Inflammation of the Kidney.—The symptoms are, a sense of heat, pain, and somtiemes tumour and redness in the region of the kidney, a numbness of the leg and thigh of the affected side, the urine high coloured, and in small quantity, accompanied [Page 28] with pain, difficulty in discharging it; the patient in general, can lie more easily on the diseased than the opposite side.—There is generally nausea and vomiting, with much febrile heat and anxiety.
IN all the above disorders, bleed freely, and administer emolient opening clysters, foment the parts affected—and procure a liberal passage by the bowels, as soon as the stomach will retain proper medicine.—One ounce and half of glauber salts, dissolved in twelve ounces of water, and by adding a few drops of essence of mint, makes an agreeable opening mixture—take four spoonfulls every hour until the bowels are emptied freely. Warm bath should be frequently employed in inflammation of the bowels.
THE application of blisters to the region of the part should not be neglected, except in the inflammation of the kidney; for in that case they are not admissible, barley water with a little gumarabic dissolved in it, may be drank freely; castor-oil is an excellent aperient.
PILES.
THE piles consist of small tumors situated on the verge of the anus, or of a varicose ring surrounding it. When a discharge from such tumors takes place, they are termed bleeding: when there is no discharge, they are termed blind piles.
COSTIVENESS is one of the most frequent causes of this disease, which is to be obviated by means of [Page 29] different laxatives, suited to the particular constitution; the best of which are cream of tartar, flour of sulphur, and castor-oil.—If there is much pain, apply fomentation and poultices; and the parts during the continuance of the inflammation, should be carefully anointed with soft pomatum or hog's lard before going to stool.
USE a spare diet, and guard against intemperance in drink, which is particularly hurtful.
COUGHS.
Sometimes in changing from a warm climate to another, a violent cough is occasioned, particularly to the coldest parts of N. America. Treating such a complaint, bleeding is proper, and the cooling remedies above. If the irritation and coughing is very violent, two tea-spoon fulls of No. 16, or twenty-five or thirty drops of tincture of opium in a cup of the common nitrous drink at bed-time. In all inflammatory cases keep the bowels laxative with gentle purges of salts, or clysters, made of a spoonful of common salt and coarse sugar dissolved in half a pint of warm water, with the addition of two, three, or four table spoon fulls of castor-oil, or any other sweet oil; in order to promote expectoration and prevent consumption, asthma, &c. give a table spoonfull of No. 18, as directed, night and morning.
DIARRHOEA AND DYSENTERY.
THE diarrhoea is a violent and continued purging, with gripings, &c. the dysentery is a violent purging, in which the blood and mucus are voided with griping pains, and an inclination to go to stool without evacuation, except of a little blood and mucus.
GIVE a vomiting or nauseating dose of No. 18, in the morning fasting, so as to evacuate bilious crudities, and repeat it in small doses afterwards, two or three times a day; it will require a table spoon full, or in some cases rather more to vomit, and from three tea spoonfulls to better than half of a large spoonfull to produce a slight nausea, without vomiting, which is the alterative and tonic dose.
IF dysentery is of long standing, the cure must be performed by giving a dose night and morning.—If the pain and griping is very troublesome, twenty-five or thirty drops of tincture of opium, may be very conveniently given occasionally, or every night at bed-time.—Costiveness is sometimes the consequence of its continued use; when this happens, omit it until a dose of the anti-bilious pills, castor-oil, or rhubarb is taken.
IN the early stage of this disease, care must be taken to empty the intestines of the putrid, acrid, matter contained in them. "The vegetable alkali [Page 31] or carbonate of pot-ash, * will be found a very efficatious remedy. The dose which may be given with safety is four grains of No. 20, dissolved in half an ounce of water, and repeated every two or three hours, until natural stools are evacuated.— If a little of No. 11, jalap, or No. 19, rhubarb, be combined, its operation will be greatly assisted.
WE are informed that marine salt (common salt) dissolved in any of the vegetable acids, operated as a charm in dysenteries, in the Island of Jamaica, when all other remedies which have been celebrated in curing this disease, had failed.
IF violent pain, inflammation, &c. render bleeding necessary, it may be performed once or twice according to existing circumstances.
ATTENTION must be paid to using the means recommended for purifying the air and destroying pestilential stimulus.
SCURVY.
IT is chiefly owing to salt provisions.—Vegetables and a fresh diet are the most effectual remedies.
WHEN on ship-board, give fifteen or twenty grains of No. 12, cremor tartar, and the same quantity of No. 21, flowers of sulphur, night and morning; avoid as much as possible all salt meats, [Page 32] live principally on pease, burgoo, rice, spruce beer prepared from the essence of spruce, &c. Infusion of malt is an excellent preservative against putrid diseases in hot countries, and likewise the scurvy.— The limbs may be rubbed night and morning with vinegar. If a wine glass of the juice of oranges or lemons (or for want of both of them vinegar) with two ounces of brown sugar, were daily allowed to each man to mix with his allowance of grog, it would be extremely serviceable.
INTERMITTING FEVER AND AGUE.
THE patient is first seized with a cold shivering, this is succeeded by heat, an uneasiness, languor of the whole body, and great thirst; sometimes it is attended with a violent head-ache, at others not. —In the beginning of the disorder, it will be best to give a vomiting dose of No. 18, afterwards a gentle laxative dose of No. 22.
No. 23. Ague and Fever Pills, which effect a cure in the most obstinate cases doses. From 3 years old to 12, one pill every day at six o'clock in the morning, at two in the afternoon; and at ten at night; from 12 years old and upwards, two pills at the same hours.
THEIR use requires no restraint of diet, nor any particular regimen, only to abstain from fish, milk, salt provisions, and fermented liquor, and keep dry and warm. When a dose of the anti-bilious pills are taken, this medicine must be omitted [Page 33] for that day.—When the fever is off, the cure and return of strength may be greatly promoted by taking the following
BARK MIXTURE.
TAKE of powdered bark, one ounce, put it into a quart bottle, add to it two ounces of any spirit, and fill the bottle nearly with water; then put to this two or three drachms of No. 6. Three or four table spoonfuls should be taken three or four times a day when the fever is off.
DURING the fever, and hot sit, the diluted warm vinegar drink is to be administered.
IF the viscera is obstructed, it must be removed by a dose of No. 22, once or twice a week, and No. 24, (alterative pills,) taken on the intermediate days, according to the direction.
PUTRID TENDING BILLIOUS, OR YELLOW FEVER. *
Begins with languor, debility, head-ache, affection of the stomach peculiarly disagreeable, vomiting of bile, and sometimes a diarrhoea, great thirst, heat, and uneasiness of the whole body, and the spirits are exceedingly depressed; sometimes the anxious symptoms of vomiting are such, that no remedy whatever will allay; the eyes appear sad and watery, or in some degree inflamed, having much that appearance, which is the consequence [Page 34] of exposure to the smoke of green wood. The face often flushed, the tongue in the latter stage is of a colour nearly approaching to black, sometimes moist, but generally foul.
WE shall here particularly insist upon early attention to the first symptoms of indisposition, which are a suppression of the excretion, or perspiration of the skin and disorder in the functions of the stomach. Application of warm water to the feet, * [Page 35] Opening the bowels by repeated clysters, give a decoction of tamarinds, or an ounce and half of No. 1, dissolved in half a pint or better of tamarind [Page 36] water, give a spoonful every hour, till it operates, a dose or two of the anti-bilious pills will answer, to evacuate the intestines, where any objection arises to the taste of liquid purges.—If vomiting is not troublesome, give the acid vitriolic drink, which is made by adding twenty drops of the concentrated acid of vitriol, or two tea spoonfuls of the diluted acid of vitriol to a quart of water, which is an excellent remedy, as it cools, allays the thirst; acts as an antiputrescent, and comes in immediate contact with the seat of the disease. The bark mixture may be given with advantage as prescribed under the ague and fever, when the fever is reduced, and the patient begins to recover *.
MEANS OF PREVENTION.
WE intend in this terrible and most consuming disease, to be very minute and particular in our observations on the means of prevention.
WHEN you arrive in hot climates, as the coast of Africa, East and West-Indies, &c. if full of blood, † [Page 37] and of a plethoric habit, lose about a pint, and keep the bowels open with the anti-bilious pills, which are excellent once or twice a week. If disposed to perspire freely, omit bleeding. Take care to avoid the rains and subtle night dews, which no ordinary cloathing is proof against: drink a little small punch, or wine warm every day, before the sea-breeze sets in. Ordinary drink may be imperial water, which is made thus: Boil a large table spoonful of cream of tartar, in five pints of water for ten minutes, put the peel of the lemon into it, and two ounces of sugar. This is the best drink, and if the patient is weak and relaxed, mix a small quantity of wine.
WHEN small punch is preferred to this liquor, always strain your lime or lemon juice, clear from the pulp, to prevent the dry gripes; use exercise every morning and evening, but not early or late; cold bathing with proper precaution, is a powerful tonic or strengthener. In very hot close and moist weather, it is a very general complaint, that in the morning a sense of lassitude, aching and weariness is felt, with bitter taste in the mouth, acid or bitter eructations, sickness, sense of weight at the stomach, rising of phlegm, appetite impaired, flatulence in the stomach and bowels, vertigo or giddiness in the head, lowness of spirits, &c. Some one or more of these symptoms are usually felt, especially if foul air arising from swamps, ponds, marshes, &c. has affected the lungs and stomach.— [Page 38] Immediately take a dose of No. 18, to evacuate bilious crudities, unload the stomach, and cleanse the bronchial glands; repeat it if occasion serves. Afterwards small doses, two or three times a day, as a tonic and alterative to brace the relaxed solids, strengthen the stomach, and give firmness and energy to the nervous system.
"SHIPS being amongst the chief agents in producing foul or pestilential air, which from its heaviness has always a tendency to the lower parts, through whose sides it cannot leak out by reason of their tightness; and therefore are very often the seats of its most destructive ravages." In all countries epidemic diseases, extraordinarily mortal, are frequently bred in ships, gaols, camps, &c. and are incidental to every place ill aired and kept dirty; that is, filled with animal steams from foul or diseased bodies.
THE application of nitrous vapour to the destruction of typhus contagion, is of great importance, and will probably put a stop to the spread of contagious diseases of any kind. *
[Page 39]SMALL portions of No. 13, concentrated acid of vitriol put into a china saucer on hot sand, or over a lamp, and No. 2, purified nitre gradually sprinkled in, and the vapour diffused about the bed, and through the cabbin, half deck or room; the windows and doors being closed, the bedsteads are directed to be washed with diluted marine acid, No. 14, (viz. mix a little of it with each pail of water), and the clothes, &c. to be immersed in the same as soon as taken from the sick. By these means the spread of contagion in a most crowded hospital ship, where it was making terrible havock, was entirely stopped. Private practice confirms these assertions, the spread of scarlatina has been thus checked: and two parcels of the small-pox matter being taken, and the one exposed to the nitrous vapour, lost its power of communicating the small-pox, while the other imparted the infection to persons inoculated with it. The nitrous vapour is not at all injurious, provided care be taken not to change it into nitrous air, by the use of any metallic substance in stirring the mixture.
ALSO a quantity of water may occasionally be placed in the middle of the cabbin or room: the vapour of the water being more strongly attracted by the air than the effluvium is; the latter will be precipitated, and will fall into the water.
BUT, as spontaneous evaporation is very slow, the quantity of moisture is not sufficient in all cases to [Page 40] supply as much fluid as will precipitate the whole of the effluvium [as in cases of putrid fever, large ulcers or wounds, mortifying limb, &c.] the use of steam is recommended, by which a large portion of water being converted into vapour, a more compleat exchange will take place, and all the noxious parties be decomposed.
A QUANTITY of boiling water must be poured from one vessel to another, with a view to supply the air more readily with a proper quantity of moisture, which will precipitate the noxious effluvium and depurate the air; so ready is the atmosphere to part with the mephitic matter it contains. * Use the above means in every case where the air of the room or cabbin is surcharged with human effluvia.
To prevent an accumulation of foetor, the usual method of airing the bed-clothes, &c. upon deck in warm climates, should by no means be neglected. The cabbin, half deck, and bed-places, should be washed clean often with alkaline ley, or pot-ash, mixed with water, and fumigated with the steam of vinegar, taking care to sprinkle frequently, the floor of the cabbin and half deck with vinegar or lime juice, strained and freed from the pulp.
[Page 41]WITH regard to personal preservatives for those who are subject to danger, in addition to the medicines and other means recommended above, the four-thieves vinegar has been found a very useful preventative; cotton made into small dossils, and dipped in it, may be put up the nostrils; or a vial containing this vinegar, may be carried open before the mouth or under the nose. The following is the method of preparing it:
TAKE of lavender flowers, rosemary, wormwood, sage and mint, of each a handful; of white wine vinegar a gallon; let them stand in a sand bath, or warm place for eight days to deject; when wanted, add three drachms of camphor to each pint.
IF he is a man who enjoys health, and drinks a certain quantity of wine every day, let him not venture without it; but let him abstain from more than is necessary for this purpose; or should his habit be debilitated, a dose of bark, or a glass of Huxham's tincture of bark, may be useful, observing often to carefully wash his hands, face and mouth, making free and liberal use of water.
PUTRID SORE THROAT.
GIVE the acid drink, and bark mixture, be particularly careful to keep the mouth, tongue, and fauces clean; especially before any thing is swallowed, by a decoction of bark, made rather acid with a few drops of acid of vitriol; with which gargle the [Page 42] throat and mouth frequently—give a little castor oil or some other very gentle laxative, to open the bowels—observe similar directions as given in other putrid diseases.
LOCKED JAW, AND OTHER SPASMODIC DISEASES.
THE locked jaw is not uncommon in hot countries, and is the companion of gun-shot wounds, ulcers and amputations; or it may arise from accidents or splinters, puncturing the tendinous or nervous parts; wounds of the joints, and lying in the open air at nights in the damp foggy seasons.
IN attempting the cure of those alarming affections, we must not wholly depend on large doses of opium, musk, and warm bathing. I have seen all those methods tried, but very rarely with success—the symptoms of all spasmodic complaints are in general so clearly marked that we need not here enumerate them. The medicines, we shall place our chief dependance for success in the cure is No. 30, and a strong solution of No. 10, one pill, must if possible, be taken three or four times a day, drinking a cup-full of strong solution of camphor pretty often, use warm water baths with a small portion of No. 14, in it—large blisters may be applied to the most rigid parts.
DROPSY.
SMART doses of No. 11, thirty or forty grains, with five or six grains of No. 31, and two or three [Page 43] drachms of No. 12, every third day in honey or molasses or dissolved in half a pint of boiling water, increasing the dose if necessary, so as to operate freely, if no difficulty in breathing exists, give on the intermediate days, bitters, &c. to strengthen the habit.
JAUNDICE.
TINGES the skin with a yellow or black colour, and is cured by calomel in small doses, with one or two of the anti-bilious pills every night; a vomit in the first instance is proper. Give two or three grains of No. 3, and eight or ten of No. 47, drinking freely of warm water, or a spoon-full of No. 18, which in general empties the stomach very well; if occasion requires, repeat the emetic in a day or two.
ASTHMA,
CONSISTS in an impeded and laborious respiration, threatening suffocation.
A VOMITING dose of No. 18, will with ease, facilitate the discharge of tough, viscid, phlegm, and repeated in doses so regulated, as it may gently vomit every morning, and nauseate two or three times a day. If the asthma is of long standing, and the constitution phlegmatic, a vomiting dose may be taken two or three times a week, according to the urgency of the symptoms, taking care to keep the bowels laxative with No. 22.
SURGERY.
BRUISES and SPRAINS.
FOR external use, when the skin is not much destroyed, a mixture of sharp vinegar, with twice its quantity of water, may be applied frequently by [...] of linen cloths wrung out of it; and as often as they dry, moisten them again; or lime water, with a portion of spirit, may be used with advantage. Spiritous applications should not be used, except where the sole intention is to strengthen the injured fibres; in slighter cases, a small quantity of spirit may be mixed with vinegar, and used on the first reception of the bruise.
IF on account of a tumour or wound, a poultice is applied, the common bread poultice is the best. If the bruise is considerable, and particularly, if any internal part is affected, bleed as freely as the constitution will admit; direct a cooling liquid diet, let glisters be repeatedly injected, if the lower belly be the seat of complaint; and in all cases, repeated gentle purging is of the greatest advantage.— Violent pain may be allayed by taking a dose of tincture of opium, or Dover's powder. The anodyne antimonial drops, No. 33, give ten or fifteen drops every four or six hours; in bruises of the head, this latter medicine may be depended upon.
BURNS AND SCALDS.
APPLY immediately a quantity of raw potatoes, pounded to a proper degree of fineness; this, though a vulgar remedy, is nevertheless a very useful application [Page 45] to parts that have been scalded or burnt; but chiefly in the former case, they are to be applied cold, or bathe the parts very often with the saturnine solution made by mixing three drachms of extract of lead, No. 5, in a quart of water, to which is to be added a table spoonfull of any spirits, and keep a rag constantly wet with it on the part; when that is done, apply cerate, spread upon a rag once a day. If inflammation is considerable, give a dose of salts, and lose blood.
ITCH, and Herpetic Eruptions.
ITCH is a curtaneous eruption, of particular pustules in several parts of the body, particularly in the joints, and between the fingers, on the arms, hands and thighs; the eruption causes a violent itching, and sometimes are small, and contain a fluid, and in some cases they are large and deep, and contain a white matter, other times they are covered with crust or scabs; the heat always increases with the itching. Bleed on the first appearance, and use the herpetic linament No. 36, to the parts affected every night and morning. A few doses of gentle physic will be useful; flowers of sulphur mixed with oil or hog's lard, is a proper application.
GUN-SHOT WOUNDS, &c.
THERE are different species of wounds 1. simple cuts or incised wounds. 2. Punctured wounds. 3. Lacerated or contused wounds. 4. Gun-shot wounds, and 5, Poisoned wounds. In order to the cure of a simple incised wound, remove the effused [Page 46] blood with a sponge, pressed out of moderately warm water. If a considerable arterial haemorrhage, secure the vessel by ligature; i. e. pass a thread of strong silk by a needle round the blood vessel, and secure by a knot. Remove every extraneous body; if it can be done with prudence, extract it with your fingers, if possible; when a lead ball is the substance lodged, if it cannot be easily removed it may be left; but a splinter of wood, glass, iron, or cloth, should be removed as soon as possible after the injury is inflicted. This done, the lips of the wounds must be brought together as nearly as possible, and so retained by adhesive plaisters, if the wound is not deep, the dressings may be pledgits of soft lint, covered with one of tow, spread with some digestive ointment, as basilicon No. 35, and large enough to cover the whole. These may be secured by such bandages as the situation of the wound will admit. The first dressing usually remains two or three days, or until the discharge of matter renders the separation of them easy. The dressing may be repeated every 12 or 24 hours; when the wound is filled up with flesh, dress with the cerate No. 34, to complete the cure *.
FRACTURED LIMBS.
FRACTURES are of various kinds, viz. Transverse, oblique, and longitudinal. When a bone is split into small pieces, it is said to be splintered, they are also distinguished by different names; thus, when the soft parts remain sound, the fracture is denominated simple; when attended with a wound, communicating with the fracture, it is termed compound. Fractures are discovered by the eye, the ear, and the touch. The symptoms are pain, swelling, and tension in the contiguous parts; a more or less crooked and distorted state of the limb, a crackling or grating noise on the parts being [Page 48] handled, and loss of power to a certain extent in the injured limb.
THE indications of cure, are to replace the parts of the bone that have been removed from their natural situation, to retain them in this situation as long as may be necessary. In order to replace the parts of the bones, a slight degree of extension may be employed by the upper part of the limb, being kept firm by an assistant with his hands placed between the fracture and the contiguous joint, while the under part of it is gently extended by another, observing to keep the muscles as much relaxed as possible. If there is very great tension and inflammation, they must be removed before the replacing of the bone is attempted, by the means recommended in bruises, sprains, &c.
TO retain the bones when replaced, compresses, bandages, and a relaxed state of the limb till the cure is compleated, are necessary. The bandage must not be applied with more tightness than is necessary to retain the bones in their situation, a linen or flannel roller is the best for this purpose. In a healthy middle aged person, a simple fracture of the thigh, or bones of the leg, will require about two months for the cure. The humerus and bones of the forearm about six weeks; the collar bone, ribs, and bones of the fingers and toes, hands and feet, about three weeks. In infancy, the cure is effected in less time, but in old age the process is more slow; to reduce the fracture of the collar bone, it is [Page 49] only necessary to raise the arm, and support it at a proper height; which is done by a sling round the neck, adapted to the length of the arm, and applied equally to every part of it—the bones are generally united in a fortnight; but the corresponding arm should not be used until the end of the third or fourth week.
FRACTURES of the ribs, are discovered by the seat of the pain, and by pressure of the fingers. In general the symptoms are moderate, but in some instances the pain is severe from the first, the breathing is difficult, attended with cough and sometimes spitting of blood; the pulse is quick, full, and sometimes oppressed. In every case of fractured ribs, bleed proportionably to the strength of the patient. If any inequality is discovered, let the patient make a deep inspiration, and by equal and moderate pressure, endeavour to replace it; and to prevent its rising, apply a broad roller, or a leather belt quilted inside, with cotton or flannel, moderately tight, and let it be worn for several weeks—the diet must be low.
DISLOCATIONS.
THE principal indications of cure, are to restore the luxated part; and secondly, to retain it in its proper situation. But if inflammation, or tumour, are considerable, they should be removed by bleeding, and application of Goulard's extract of lead and water.
[Page 50]IN reducing luxations, the muscles should be put into a state of the greatest relaxation by bending the limb. The extension should be gradual and continued, until the dislo-cated bone is on a level with the cavity, or socket from whence it receded; at which time, if the head does not return of itself, it must be assisted by pressing upon it, and making a lever of the dislocated bone.
Recovery of Suspended Respiration, or Persons Apparently Dead by Drowning, &c.
FIRST, in removing the body, great care should be taken that it be not bruised, shaken violently, roughly handled, nor carried over any one's shoulders with the head hanging downwards, nor rolled upon the deck, or over a barrel, nor lifted up by the heels: for experience proves that all these methods are injurious, and often destroy the small remains of life. The body should be cautiously carried in the arms of two or more persons with the head a little raised and kept in as easy a position as possible. *
SECONDLY, the body is to be placed on a bed or mattrass, with the head a little elevated; if wet [Page 51] should be gently dried with cloths, but in such a cautious manner, as to prevent the mechanical effect of friction, from propelling the blood towards the heart. Five or six ounces of brandy, spirits, or some other warm aromatic, should be thrown into [Page 52] the stomach. If the patient seems plethoric, and more particularly if the disease has been occasioned by hanging, bleeding should be employed, and that as one of the first remedies; nor should the [Page 53] application of a proper degree of warmth be neglected. Bottles with hot water, or bricks heated, wrapped in a blanket, should be laid to the bottom of the feet; the joints of the knees, and under the arm-pits. Fresh air should be carefully admitted into the place where he lays. If an electrical machine, is at hand, gentle shocks may be directed through the fourth or fifth rib of the left side. Inflate the lungs by blowing air into them by a curved pipe if one can be had, otherwise by a person blowing air into the lungs, and pressing it out again, so as to imitate natural respiration. Electricity should never be employed on any account, without a concomitant expansion of the lungs. Tobacco, in any form is highly pernicious, and ought not therefore to be applied on any account.
INFLATING the lungs, electrifying the heart, collapsing the lungs, and the application of frictions, are to be continued four hours, if our endeavours be not previously crowned with success. Frictions should never be employed before the lungs have been several times expanded and collapsed. A little common oil or lard as a medium for the friction, is preferable to either salt or spirits, or any other stimulating substance. The above methods of restoring life are applicable to various other causes of apparent death, whether from fits, suffocation by damps, or noxious vapours, from the confined air of wells, &c.
P. S. FOR making the common bread poultice, water is decidedly preferable to milk.