INDEX.

THE END.

[1]. Observations on the Duties and Offices of a Physician.

[2]. Arbuthnot.

[3]. Many advantages would arise to society, as well as to individuals, from mothers suckling their own children. It would prevent the temptation which poor women are laid under of abandoning their children to suckle those of the rich for the sake of gain: by which means society loses many of its most useful members, and mothers become in some sense the murderers of their own offspring. I am sure I speak within the truth when I say, that not one in twenty of those children live, who are thus abandoned by their mothers. For this reason no mother should be allowed to suckle another’s child, till her own is either dead, or fit to be weaned. A regulation of this kind would save many lives among the poorer sort, and could do no hurt to the rich, as most women who make good nurses are able to suckle two children in succession upon the same milk.

[4]. Tacitus, the celebrated Roman historian, complains greatly of the degeneracy of the Roman ladies in his time, with regard to the care of their offspring. He says that, in former times, the greatest women in Rome used to account it their chief glory to keep the house and attend their children; but that now the young infant was committed to the sole care of some poor Grecian wench, or other menial servant.—We are afraid, wherever luxury and effeminacy prevail, there will be too much ground for this complaint.

[5]. The common opinion, that the diseases of infants are hard to discover and difficult to cure, has deterred many physicians from paying that attention to them which they deserve. I can, however, from experience declare, that this opinion is without foundation; and that the diseases of infants are neither so difficult to discover, nor so ill to cure, as those of adults.

[6]. Rousseau.

[7]. The Lacedemonians condemned their king Archidamus for having married a weak, puny woman; because, said they, instead of propagating a race of heroes, you will fill the throne with a progeny of changelings.

[8]. The Jews, by their laws, were, in certain cases, 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 countries, diseased persons have actually been forbid to marry. This is an evil of a complicated kind, a natural deformity, and political mischief; and therefore requires a public consideration.

[9]. A friend of mine, who was several years on the coast of Africa, tells me, that the natives neither put any clothes upon their children, nor apply to their bodies bandages of any kind, but lay them on a pallet, and suffer them to tumble about at pleasure; yet they are all strait, and seldom have any disease.

[10]. This is by no means inveighing against a thing that does not happen. In many parts of Britain at this day, a roller, eight or ten feet in length, is applied tightly round the child’s body as soon as it is born.

[11]. Stays made of bend-leather are worn by all the women of lower station in many parts of England.

I am sorry to understand, that there are still mothers mad enough to lace their daughters very tight in order to improve their shape. As reasoning would be totally lost upon such people, I shall beg leave just to ask them, Why there are ten deformed women for one man? and likewise to recommend to their perusal a short moral precept, which forbids us to deform the human body.

[12]. Children are always sickly in the fruit season, which may be thus accounted for: Two-thirds of the fruit which comes to market in this country is really unripe; and children not being in a condition to judge for themselves, eat whatever they can lay their hands upon, which often proves little better than a poison to their tender bowels. Servants, and others who have the care of children, should be strictly forbid to give them any fruit without the knowledge of their parents.

[13]. The nurse ought to be careful to keep the child in a proper position; as deformity is often the consequence of inattention to this circumstance. Its situation ought also to be frequently changed. I have known a child’s legs bent all on one side, by the nurse carrying it constantly on one arm.

[14]. If it were made the interest of the poor to keep their children alive, we should lose very few of them. A small premium given annually to each poor family, for every child they have alive at the year’s end, would save more infant lives than if the whole revenue of the crown were expended on hospitals for this purpose. This would make the poor esteem fertility a blessing; whereas many of them think it the greatest curse that can befal them; and in place of wishing their children to live, so far does poverty get the better of natural affection, that they are often very happy when they die.

[15]. It is undoubtedly the duty of parents to instruct their children, at least till they are of an age proper to take some care of themselves. This would tend much to confirm the ties of parental tenderness and filial affection, of the want of which there are at present so many deplorable instances. Though few fathers have time to instruct their children, yet most mothers have; and surely they cannot be better employed.

[16]. I am happy to find that the masters of academies now begin to put in practice this advice. Each of them ought to keep a drill serjeant for teaching the boys the military exercise. This, besides contributing to their health and vigour of body, would have many other happy effects.

[17]. I have been told that in China, where the police is the best in the world, all the children are employed in the easier part of gardening and husbandry; as weeding, gathering stones off the land, and such like.

[18]. It is amazing how children escape suffocation, considering the manner in which they are often rolled up in flannels, &c. I lately attended an infant, whom I found muffled up over head and ears in many folds of flannel, though it was in the middle of June. I begged for a little free air to the poor babe; but though this indulgence was granted during my stay, I found it always on my return in the same situation. Death, as might be expected, soon freed the infant from all its miseries; but it was not in my power to free the minds of its parents from those prejudices which proved fatal to their child.

I was very lately called to see an infant which was said to be expiring in convulsion fits. I desired the mother to strip the child, and wrap it in a loose covering. It had no more convulsion fits.

[19]. I have often known people so imposed upon, as to give an infant to a nurse to be suckled who had not one drop of milk in her breast.

[20]. If a mother on visiting her child at nurse find it always asleep, I would advise her to remove it immediately; otherwise it will soon sleep its last.

[21]. Armstrong.

[22]. When persons heated with labour have drank cold liquor, they ought to continue at work for some time after.

[23]. It is indeed to be regretted, that soldiers suffer not less from indolence and intemperance in time of peace, than from hardships in time of war. If men are idle they will be vicious. It would therefore be of great importance, could a scheme be formed for rendering the military, in times of peace, both more healthy and more useful. These desirable objects might, in our opinion, be obtained, by employing them for some hours every day, and advancing their pay accordingly. By this means, idleness, the mother of vice, might be prevented, the price of labour lowered, public works, as harbours, canals, turnpike 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 easily be conducted, so as not to depress the martial spirit, provided the men were only to work four or five hours every day, and always to work without doors: no soldier should be suffered to work too long, or to follow any sedentary employment. Sedentary employments render men weak and effeminate, quite unfit for the hardships of war: whereas working for a few hours every day without doors would inure them to the weather, brace their nerves, and increase their strength and courage.

[24]. Our countryman, the celebrated Captain Cook, has shewn how far, by proper care and attention, the diseases formerly so fatal to seamen may be prevented. In a voyage of three years and eighteen days, during which he was exposed to every climate, from the 52° north to the 71° of south latitude, of one hundred and eighteen men composing the ship’s company, he lost only one, who died of a phthisis pulmonalis. The principal means he used were, to preserve a strict attention to cleanliness, to procure abundance of vegetables and fresh provisions, especially good water, and to allow his people sufficient time for rest.

[25]. The appellation of sedentary has generally been given only to the studious; we can see no reason, however, for restricting it to them alone. Many artificers may, with as much propriety, be denominated sedentary as the studious, with this particular disadvantage, that they are often obliged to sit in very awkward postures, which the studious need not do, unless they please.

[26]. A person of observation in that line of life told me, that most taylors die of consumptions; which he attributed chiefly to the unfavourable postures in which they sit, and the unwholesomeness of those places where their business is carried on. If more attention was not paid to profit than to the preservation of human lives, this evil might be easily remedied; but while masters only mind their own interest, nothing will be done for the safety of their servants.

[27]. The poor, indeed, are generally the first who suffer by unsound provisions; but the lives of the labouring poor are of great importance to the state: besides, diseases occasioned by unwholesome food often prove infectious, by which means they reach people in every station. It is therefore the interest of all to take care that no spoilt provisions of any kind be exposed to sale.

[28]. In most eastern countries it was customary to bury the dead at some distance from any town. As this practice obtained among the Jews, the Greeks, and also the Romans, it is strange that the western parts of Europe should not have followed their example in a custom so truly laudable.

[29]. One cannot pass through a large church or cathedral, even in summer, without feeling quite chilly.

[30]. We have daily accounts of persons who lose their lives by going down into deep wells and other places where the air stagnates; all these accidents might be prevented by only letting down a lighted candle before them, and stopping when they perceive it go out; yet this precaution, simple as it is, is seldom used.

[31]. A year seldom passes that we do not hear of some hospital physician or surgeon having lost his life by an hospital fever caught from his patients. For this they have themselves alone to blame. Their patients are either in an improper situation, or they are too careless with regard to their own conduct.

[32]. It is not necessity, but fashion, which makes the use of carriages so common. There are many people who have not exercise enough to keep their humours wholesome, who yet dare not venture to make a visit to their next neighbours, but in a coach or sedan, lest they should be looked down upon. Strange, that men should be such fools as to be laughed out of the use of their limbs, or to throw away their health, in order to gratify a piece of vanity, or to comply with a ridiculous fashion!

[33]. Cheyne.

[34]. Sedentary occupations ought chiefly to be followed by women. They bear confinement much better than men, and are fitter for every kind of business which does not require much strength. It is ridiculous enough to see a lusty fellow making pins, needles, or watch-wheels, while many of the laborious parts of husbandry are carried on by the other sex. The fact is, we want men for laborious employments, while one half of the other sex are rendered useless for want of occupations suited to their strength, &c. Were girls bred to mechanical employments, we should not see such numbers of them prostitute themselves for bread, nor find such a want of men for the important purposes of navigation, agriculture, &c. An eminent silk manufacturer told me, that he found women answer better for that business, than men; and that he had lately taken a great many girls apprentices as silk-weavers. I hope his example will be followed by many others.

[35]. Golff is a diversion very common in North Britain. It is well calculated for exercising the body, and may always be taken in such moderation, as neither to overheat nor fatigue. It has greatly the preference over cricket, tennis, or any of those games which cannot be played without violence.

[36]. Men of every occupation, and in every situation of life, have lived to a good old age; nay some have enjoyed this blessing whose plan of living was by no means regular: but it consists with observation, that all very old men have been early risers. This is the only circumstance attending longevity, to which I never knew an exception.

[37]. That colds kill more than plagues, is an old observation; and, with regard to this country, it holds strictly true. Every person of discernment, however, will perceive, that most of the colds which prove so destructive to the inhabitants of Britain are owing to their imprudence in changing clothes. A few warm days in March or April induce them to throw off their winter garments, without considering that our most penetrating colds generally happen in the spring.

[38]. This madness seems to have pervaded the minds of mothers in every age and country. Terence, in his Comedy of the Eunuch, ridicules the Roman matrons for attempting to mend the shape of their daughters.

[39]. We often see persons, who are rendered quite lame by the nails of their toes having grown into the flesh, and frequently hear of mortifications proceeding from this cause. All these, and many other inconveniences attending the feet, must be imputed solely to the use of short and strait shoes.

[40]. The celebrated Boerhaave used to say, that no body suffered by cold save fools and beggars; the latter not being able to procure clothes, and the former not having sense to wear them. Be this as it may, I can with the strictest truth declare, that in many cases where the powers of medicine had been tried in vain, I have cured the patient by recommending thick shoes, a flannel waistcoat and drawers, a pair of under stockings, or a flannel petticoat, to be worn during the cold season at least.

[41]. Rousseau.

[42]. Addison.

[43]. We may form some notion of the immense quantity of ardent spirits consumed in Great Britain from this circumstance, that in the city of Edinburgh and its environs, besides the great quantity of foreign spirits duly entered, and the still greater quantity which is supposed to be smuggled, it is computed that above two thousand private stills are constantly employed in preparing a poisonous liquor called Molasses. The common people have got so universally into the habit of drinking this base spirit, that when a porter or labourer is seen reeling along the streets, they say, he has got molassed.

[44]. It is amazing that our improvements in arts, learning, and politeness, have not put the barbarous custom of drinking to excess out of fashion. It is indeed less common in South Britain than it was formerly; but it still prevails very much in the North, where this relic of barbarity is mistaken for hospitality. There no man is supposed to entertain his guests well, who does not make them drunk. Forcing people to drink, is certainly the greatest piece of rudeness that any man can be guilty of. Manliness, complaisance, or mere good-nature, may induce a man to take his glass, if urged to it, at a time when he might as well take poison. The custom of drinking to excess has long been out of fashion in France; and, as it begins to lose ground among the politer part of the English, we hope it will soon be banished from every part of this island.

[45]. Mr. Pot, in his surgical observations, mentions a disease which he calls the chimney-sweeper’s cancer, as it is almost peculiar to that unhappy set of people. This he attributes to neglect of cleanliness, and with great justice. I am convinced, that if that part of the body which is the seat of this cruel disease was kept clean by frequent walking, it would never happen. The climbing boys, as they are called, are certainly the most miserable wretches on the face of the earth; yet, for cleaning chimnies, no such persons are necessary.

[46]. In ancient Rome the greatest men did not think cleanliness an object unworthy of their attention. Pliny says, the Cloacæ, or common sewers for the conveyance of filth and nastiness from the city, were the greatest of all the public works; and bestows higher encomiums upon Tarquinius, Agrippa, and others who made and improved them, than on those who achieved the greatest conquests.

How truly great does the emperor Trajan appear, when giving directions to Pliny his proconsul, concerning the making of a common sewer for the health and convenience of a conquered city?

[47]. Thou shalt have a place also without the camp, whither thou shalt go forth abroad; and thou shalt have a paddle upon thy weapon: and it shall be when thou shalt ease thyself abroad, thou shalt dig therewith, and shalt turn back, and cover that which cometh from thee, &c.

Deuter, chap. xxii. ver. 12, 13.

[48]. As it is impossible to be thoroughly clean without a sufficient quantity of water, we would earnestly recommend it to the magistrates of great towns to be particularly attentive to this article. Most great towns in Britain are so situated as to be easily supplied with water; and those persons who will not make a proper use of it, after it is brought to their hand, certainly deserve to be severely punished. The streets of great towns, where water can be had, ought to be washed every day. This is the only effectual method for keeping them thoroughly clean; and, upon trial, we are persuaded it will be found the cheapest.

Some of the most dreadful diseases incident to human nature might, in my opinion, be entirely eradicated by cleanliness.

[49]. Were the tenth part of the care taken to prevent the importation of diseases, that there is to prevent smuggling, it would be attended with many happy consequences. This might easily be done by appointing a physician at every considerable sea-port, to inspect the ship’s company, passengers, &c. before they came ashore, and, if any fever or other infectious disorder prevailed, to order the ship to perform a short quarantine, and to send the sick to some hospital or proper place to be cured. He might likewise order all the clothes, bedding, &c. which had been used by the sick during the voyage, to be either destroyed, or thoroughly cleansed by fumigation, &c. before any of it were sent ashore. A scheme of this kind, if properly conducted, would prevent many fevers, and other infectious diseases, from being brought by sailors into sea-port towns, and by this means diffused all over the country.

[50]. There is reason to believe that infection is often conveyed from one place to another by the carelessness of the faculty themselves. Many physicians affect a familiar way of sitting upon the patient’s bedside, and holding his arm for a considerable time. If the patient has the small-pox, or any other infectious disease, there is no doubt but the doctor’s hands, clothes, &c. will carry away some of the infection; and, if he goes directly to visit another patient without washing his hands, changing his clothes, or being exposed to the open air, which is not seldom the case, is it any wonder that he should carry the disease along with him? Physicians not only endanger others, but also themselves, by this practice. And indeed they sometimes suffer for their want of care.

[51]. The ancients would not suffer even the temples of their gods, where the sick resorted, to be built within the walls of a city.

[52]. The conduct of parents with regard to the disposal of their children in marriage is often very blamable. An advantageous match is the constant aim of parents; while their children often suffer a real martyrdom betwixt their inclinations and duty. The first thing which parents ought to consult in disposing their children in marriage, is certainly their inclinations. Were due regard always paid to these, there would be fewer unhappy couples, and parents would not have so often cause to repent the severity of their conduct, after a ruined constitution, a lost character, or a distracted mind, has shewn them their mistake.

[53]. It has long been an observation among physicians, that the appearances of the urine are very uncertain, and very little to be depended on. No one will be surprised at this who considers how many ways it may be affected, and consequently have its appearance altered. The passions, the state of the atmosphere, the quantity and quality of the food, the exercise, the clothing, the state of the other evacuations, and numberless other causes, are sufficient to induce a change either in the quantity or appearance of the urine. Any one who attends to this, will be astonished at the impudence of those daring quacks, who pretend to find out diseases, and prescribe to patients from the bare inspection of their urine. These impostors, however, are very common all over Britain, and by the amazing credulity of the populace, many of them amass considerable fortunes. Of all the medical prejudices which prevail in this country, that in favour of urine doctors is the strongest. The common people have still an unlimited faith in their skill, although it has been demonstrated that no one of them is able to distinguish the urine of a horse, or any other animal, from that of a man.

[54]. I never knew a more remarkable instance of the uncertainty of the weather in this country, than happened while I was writing these notes. This morning, August 14, 1783, the thermometer in the shade was down at fifty-three degrees, and a very few days ago it stood above eighty. No one who reflects on such great and sudden changes in the atmosphere, will be surprised to find colds, coughs, rheums, with other affections of the breast and bowels, so common in this country.

[55]. If a person suspects that his bed is damp, the simple precaution of taking off the sheets and lying in the blankets, with all, or most of his clothes on, will prevent all the danger. I have practised this for many years, and never have been hurt by damp beds, though no constitution, without care, is proof against their baneful influence.

[56]. People imagine if a good fire is made in a room after it has been washed, that there is no danger from sitting in it; but they must give me leave to say that this increases the danger. The evaporation excited by the fire generates cold, and renders the damp more active.

[57]. The tap-rooms in London and other great towns, where such numbers of people spend their evenings, are highly pernicious. The breath of a number of people crowded into a low apartment, with the addition of fires, candles, the smoke of tobacco, and the fumes of hot liquor, &c. must not only render it hurtful to continue in such places, but dangerous to go out of them into a cold and chilly atmosphere.

[58]. Dr. Lind says, that twenty or twenty-five drops of laudanum put into a cup of the patient’s drink, and given about half an hour after the commencement of the hot fit, promotes the sweat, shortens the fit, relieves the head, and tends greatly to remove the disease.

[59]. It has lately been observed, that the red bark is more powerful than that which has for some time been in common use. Its superior efficacy seems to arise from its being of a more perfect growth than the quill bark, and consequently more fully impregnated with the medical properties of the plant.

[60]. In intermitting fevers of an obstinate nature, I have found it necessary to throw in the bark much faster. Indeed the benefits arising from this medicine depend chiefly upon a large quantity of it being administered in a short time. Several ounces of bark given in a few days will do more than as many pounds taken in the course of some weeks. When this medicine is intended either to stop a mortification, or cure an obstinate ague, it ought to be thrown in as fast as the stomach can possibly bear it. Inattention to this circumstance has hurt the reputation of one of the best medicines of which we are in possession.

[61]. There is reason to believe, that sundry of our own plants or barks, which are very bitter and astringent, would succeed in the cure of intermittent fevers, especially when assisted by aromatics. But as the Peruvian 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 Peruvian 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.

[62]. In obstinate agues, when the patient is old, the habit phlegmatic, the season rainy, the situation damp, or the like, it will be necessary to mix with two ounces of the bark, half an ounce of Virginian snake-root, and a quarter of an ounce of ginger, or some other warm aromatic; but when the symptoms are of an inflammatory nature, half an ounce of salt of wormwood or salt of tartar may be added to the above quantity of bark.

[63]. Arsenic has of late been recommended as an infallible remedy in the ague; but I would advise that it should be used only under the eye of a physician.

[64]. See Appendix, Saline mixture.

[65]. See Appendix, Pectoral decoction.

[66]. See Appendix, Pectoral infusion.

[67]. See Appendix, Volatile liniment.

[68]. See Appendix, Arabic emulsion.

[69]. See Appendix, Oily emulsion.

[70]. See Appendix, Solution of gum ammoniac.

[71]. See Appendix, Decoction of seneka-root.

[72]. Two things chiefly operate to prevent the benefits which would arise from sailing. The one is, that physicians seldom order it till the disease is too far advanced; and the other is, that they seldom order a voyage of a sufficient length. A patient may receive no benefit by crossing the channel, who, should he cross the Atlantic, might be completely cured. Indeed we have reason to believe, that a voyage of this kind, if taken in due time, would seldom fail to cure a consumption.

[73]. Though I do not remember to have seen one instance of a genuine consumption of the lungs cured by medicine, yet I have known a West India voyage work wonders in that dreadful disorder.

[74]. Sheffield.

[75]. I have often known persons of a consumptive habit, where the symptoms were not violent, reap great benefit from the use of oysters. They generally ate them raw, and drank the juice along with them.

[76]. See Appendix, Vulnerary decoction.

[77]. See Appendix, Chalybeate wine.

[78]. See Appendix, Mustard-whey.

[79]. See Appendix, Vomiting Julep.

[80]. See Appendix, White Decoction.

[81]. When the patient is low, ten grains of Virginian snake-root, and the same quantity of contrayerva-root, with 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 with 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 one in a cup of wine-whey, three or four times a-day.

[82]. The bark may likewise be very properly administered, along with other cordials, in the following manner: Take an ounce of Peruvian bark, orange-peel half an ounce, Virginian snake-root two drachms, saffron one drachm. Let all of them be powdered, and infused in an English pint of the best brandy for three or four days. Afterwards the liquor may be strained, and two tea-spoonfuls of it given three or four times a-day in a glass of small wine or negus.

[83]. Deafness is not always a favourable symptom in this disease. Perhaps it is only so when occasioned by abscesses formed within the ears.

[84]. The late Sir John Pringle expressed a concern lest these cautions should prevent people from attending their friends or relations when afflicted with putrid fevers. I told him I meant only to discourage unnecessary attendance, and mentioned a number of instances where putrid fevers had proved fatal to persons, who were rather hurtful than beneficial to the sick. This sagacious physician agreed with me, in thinking that a good doctor and a careful nurse were the only necessary attendants; and that all others not only endangered themselves, but generally, by their solicitude and ill-directed care, hurt the sick.

[85]. 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.

[86]. In the commercium literarium for the year 1735, we have the history of an epidemical miliary fever, which raged at Strasburgh in the months of November, December, and January; from which we learn the necessity of a temperate regimen in this malady, and likewise that physicians are not always the first who discover the proper treatment of diseases. “This fever made terrible havock even 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 a 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.

[87]. The ingenious Dr. Lind, of Edinburgh, in his inaugural dissertation concerning the putrid remitting fever of Bengal, has the following observation: “Indusia, lodices, ac stragula, sæpius sunt mutanda, ac aëri exponenda; fœces sordesque quam primum removendæ; oportet etiam ut loca quibus ægri decumbunt sint salubria, et aceto conspersa; denique ut ægris cura quanta maxima prospiciatur. Compertum ego habeo, medicum hæc fedulo observantem, quique ea exequi potest, multo magis ægris profuturum, quam medicum peritiorem hisce commodis destitutum.”

“The patient’s shirt, bed-clothes, and bedding, ought frequently to be changed, and exposed to the air, and all his excrements immediately removed; the bed-chamber should be well ventilated, and frequently sprinkled with vinegar; in short, every attention should be paid to the patient. I can affirm, that a physician who puts these in practice will much oftener succeed than one who is even more skilful, but has not opportunity of using these means.”

[88]. Convulsion-fits are no doubt very alarming, but their effects are often salutary. They seem to be one of the means made use of by Nature for breaking the force of a fever. I have always observed the fever abated, and sometimes quite removed, after one or more convulsion-fits. This readily accounts for convulsions being a favourable symptom in the fever which precedes the eruption of the small-pox, as every thing that mitigates this fever lessens the eruption.

[89]. I have known a nurse, who had the small-pox before, so infected by lying constantly a-bed with a child in a bad kind of small-pox, that she had not only a great number of pustules which broke out all over her body, but afterwards a malignant fever, which terminated in a number of imposthumes or boils, and from which she narrowly escaped with her life. We mention this to put others upon their guard against the danger of this virulent infection.

[90]. 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. 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, the sick, the dying, and the dead, are often to be seen in the same apartment.

[91]. Though this operation can never do harm, yet it is only necessary when the patient has a great load of small-pox, or when the matter which they contain is of so thin and acrid a nature, that there is reason to apprehend bad consequences from its being too quickly resorbed, or taken up again into the mass of circulating humours.

[92]. I have of late been accustomed, after the small-pox, to give one, two, three, four, or five grains of calomel, according to the age of the patient, over night, and to work it off next morning with a suitable dose of jalap.

[93]. 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 the 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 apart, and give his arm a slight scratch with a pin, 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 boy was well.

[94]. Mr. Tronchin communicates this disease by a little bit of thread dipt in the matter, which he covers with a small blistering-plaster. This method may no doubt be used with advantage in those cases where the patient is very much alarmed at the sight of any cutting instrument.

[95]. “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 weaker 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 surprise us soon after excesses committed in luxury, intemperance, or lewdness. It may likewise seize on the innocent after indispensably 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 of scars, even where the number of pustules on the face has 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 harass persons who never had this disease, insomuch that when the small-pox is epidemical, entire 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 splendour due to their office and merit. Does not inoculation, in like manner, prevent our brave sailors from 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 cabins, 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, are inconceivable, without attendance, without lodgings, without any accommodation; so that one of three commonly perishes.”

[96]. By a well-laid plan for extending inoculation, more lives might be saved at a small expence, than are at present preserved by all the hospitals in England, which cost the public such an amazing sum.

[97]. I do not know any disease wherein bleeding is more necessary than in the measles, especially when the fever runs high: in this case I have always found it relieve the patient.

[98]. Attempts have been made to communicate the measles, as well as the small-pox, by inoculation, and we make no doubt but in time the practice may succeed. Dr. Home of Edinburgh says, he communicated the disease by the blood. Others have tried this method, and have not found it succeed. Some think the disease would be more certainly communicated by rubbing the skin of a patient who has the measles with cotton, and afterwards applying the cotton to a wound, as in the small-pox; while others recommend a bit of flannel which had been applied to the patient’s skin, all the time of the disease, to be afterwards laid upon the arm or leg of the person to whom the infection is to be communicated. There is no doubt but this disease, as well as the small-pox, may be communicated various ways; the most probable, however, is either from cotton rubbed upon the skin, as mentioned above, or by introducing a little of the sharp humour which distils from the eyes of the patient into the blood. It is agreed on all hands, that such patients as have been inoculated had the disease very mildly; we therefore wish the practice were more general, as the measles have of late become very fatal.

[99]. Sydenham.

[100]. In the year 1774, during winter, a very bad species of this fever prevailed in Edinburgh. It raged chiefly among young people. The eruption was generally accompanied with a quinsey, and the inflammatory symptoms were so blended with others of a putrid nature, as to render the treatment of the disease very difficult. Many of the patients, towards the decline of the fever, were afflicted with large swellings of the submaxillary glands, and not a few had a suppuration in one or both ears.

[101]. See Appendix, White Decoction.

[102]. See Appendix, Spirit of Mindererus.

[103]. The country people in many parts of Britain call this disease a blast, and imagine it proceeds from foul air, or ill wind, as they term it. The truth is, they often lie down to rest them, when warm and fatigued, upon the damp ground, where they fall asleep, and lie so long as to catch cold, which occasions the erysipelas. This disease may indeed proceed from other causes, but we may venture to say, that nine times out of ten it is occasioned by cold caught after the body has been greatly heated or fatigued.

[104]. See Appendix, Decoction of Woods.

[105]. Any foreign body lodged in the eye may be expeditiously removed by passing a small hair pencil between the eye-lid and the ball of the eye. In some places, the peasants do this very effectually, by using their tongue in the same manner.

[106]. As most people are fond of using eye-waters and ointments in this and other diseases of the eyes, we have inserted some of the most approved forms of these medicines in the Appendix. See Appendix, Eye-water and Eye-salve.

[107]. Dr. Home.

[108]. See Appendix, Spanish Infusion.

[109]. In a former edition of this book I recommended, for an obstinate tickling cough, an oily emulsion, made with the paregoric elixir of the Edinburgh Dispensatory, instead of the common alkaline spirit. I have since been told by several practitioners, that they found it to be an excellent medicine in this disorder, and every way deserving of the character which I had given it. Where this elixir is not kept, its place may be supplied by adding to the common oily emulsion, an adequate proportion of the Thebaic tincture, or liquid laudanum.

[110]. Some complain that the pitch plaster adheres too fast, while others find difficulty in keeping it on. This proceeds from the different kinds of pitch made use of, and likewise from the manner of making it. I generally find it answer best when mixed with a little beeswax, and spread as cool as possible. The clear, hard, transparent pitch answers the purpose best.

[111]. See Appendix, Hiera Picra.

[112]. Some think the air ought not to be changed till the disease is on the decline; but there seems to be no sufficient reason for this opinion, as patients have been known to reap benefit from a change of air at all periods of the disease. It is not sufficient to take the patient out daily in a carriage. This seldom answers any good purpose; but often does hurt, by giving him cold.

[113]. See Appendix, Vomiting Julep.

[114]. Dr. Duplanil says, he has seen many good effects from the kermes mineral in this complaint, the cough being frequently alleviated even by the first dose. The dose for a child of one year old, is a quarter of a grain dissolved in a cup of any liquid, repeated two or three times a-day. For a child of two years the dose is half a grain; and the quantity must be thus increased in proportion to the age of the patient.

[115]. Some recommend the extract of hemlock as an extraordinary remedy in the hooping-cough; but so far as I have been able to observe, it is no way superior to opium, which, when properly administered, will often relieve some of the most troublesome symptoms of this disorder.

[116]. When quicksilver is given in too large quantities, it defeats its own intention, as it drags down the bottom of the stomach, which prevents it getting over the Pylorus. In this case the patient should be hung up by the heels, in order that the quicksilver may be discharged by his mouth.

[117]. See Appendix, Anti-hysteric Plaster.

[118]. As the smoke of tobacco thrown into the bowels will often procure a stool when all other means have failed, an apparatus for this purpose ought to be kept by every surgeon. It may be purchased at a small expence, and will be of service in several other cases, the recovery of drowned persons, &c.

[119]. The Ureters are two long and small canals, one on each side, which carry the urine from the bason of the kidneys to the bladder. They are sometimes obstructed by small stones of gravel falling down from the kidneys, and lodging in them.

[120]. I knew a gentleman who has had several abscesses of the liver opened, and is now a strong and healthy man, though above eighty years of age.

[121]. I have been twice brought to the gates of death by this disease, and both times it was occasioned by eating rancid bacon.

[122]. See Appendix, White Decoction.

[123]. See Appendix, Tincture of Roses.

[124]. See Appendix, Lime-water.

[125]. The caustic alkali may be prepared by mixing two parts of quicklime with one of pot-ashes, and suffering them to stand till the lixivium be formed, which must be carefully filtrated before it be used. If the solution does not happen readily, a small quantity of water may be added to the mixture.

[126]. The manner of making this broth is, to take a sheep’s head and feet with the skin upon them, and to burn the wool off with a hot iron; afterwards to boil them till the broth is quite a jelly. A little cinnamon or mace may be added, to give the broth an agreeable flavour, and the patient may take a little of it warm with toasted bread three or four times a-day. A clyster of it may likewise be given twice a-day. Such as cannot use the broth made in this way, may have the head and feet skinned; but we have reason to believe that this hurts the medicine. It is not our business here to reason upon the nature and qualities of medicine, otherwise this might be shewn to possess virtues every way suited to the cure of a dysentery which does not proceed from a putrid state of the humours. One thing we know, which is preferable to all reasoning, that whole families have often been cured by it, after they had used many other medicines in vain. It will, however, be proper that the patient take a vomit, and a dose or two of rhubarb, before he begins to use the broth. It will likewise be necessary to continue the use of it for a considerable time, and to make it the principal food.

[127]. The learned and humane Dr. Rutherford, late professor of medicine in the university of Edinburgh, used to mention this food in his public lectures with great encomiums. He directed it to be made by tying a pound or two of the finest flour, as tight as possible, in a linen rag, afterwards to dip it frequently in water, and to dredge the outside with flour, till a cake or crust was formed around it, which prevents the water from soaking into it while boiling. It is then to be boiled till it becomes a hard dry mass, as directed above. This, when mixed with milk and water, will not only answer the purpose of food, but may likewise be given in clysters.

[128]. I lately saw a young man who had been seized with a dysentery in North America. Many things had been tried there for his relief, but to no purpose. At length, tired out with disappointments from medicine, and reduced to skin and bone, he came over to Britain, rather with a view to die among his relations, than with any hopes of a cure. After taking sundry medicines here with no better success than abroad, I advised him to leave off the use of drugs, and to trust entirely to a diet of milk and fruits, with gentle exercise. Strawberries was the only fruit he could procure at that season. These he ate with milk twice, and sometimes thrice a-day. The consequence was, that in a short time his stools were reduced from upwards of twenty in a-day, to three or four, and sometimes not so many. He used the other fruits as they came in, and was in a few weeks so well as to leave that part of the country where I was, with a view to return to America.

[129]. See Appendix, Decoction of Logwood.

[130]. See Appendix, Decoction of Sarsaparilla.

[131]. When the pain is very violent, and does not yield to small doses of laudanum, the quantity may be increased. I have known a patient in extreme pain take three hundred drops in twenty-four hours; but such doses ought only to be administered by a person of skill.

[132]. This may always be prevented by the operator striking upon the teeth with any piece of metal, as this never fails to excite the pain in the carious tooth.

[133]. These are prepared by steeping or soaking pease in water, and afterwards drying them in a pot or kiln till they be quite hard. They may be used at pleasure.

[134]. That worms exist in the human body there can be no doubt; and that they must sometimes be considered as a disease, is equally certain: but this is not the case so often as people imagine. The idea that worms occasion many diseases, gives an opportunity to the professed worm-doctors of imposing on the credulity of mankind, and doing much mischief. They find worms in every case, and liberally throw in their antidotes, which generally consist of strong, drastic purges. I have known these given in delicate constitutions to the destruction of the patient, where there was not the least symptom of worms.

[135]. A medical writer of the present age has enumerated upwards of fifty British plants, all celebrated for killing and expelling worms.

[136]. A powder for the tape-worm resembling this, was long kept a secret on the Continent; it was lately purchased by the French king, and will be found under the article Powder, in the Appendix.

[137]. We think it necessary here to warn people of their danger who buy cakes, powders, and other worm medicines, at random from quacks, and give them to their children without proper care. The principal ingredients in most of these medicines is mercury, which is never to be trifled with. I lately saw a shocking instance of the danger of this conduct. A girl who had taken a dose of worm powder, bought of a travelling quack, went out, and perhaps was so imprudent as to drink cold water during its operation. She immediately swelled, and died on the following day, with all the symptoms of having been poisoned.

[138]. The very name of an operation is dreadful to most people, and they wish to try every thing before they have recourse to it. This is the reason why tapping so seldom succeeds to our wish. I have had a patient who was regularly tapped once a month for several years, and who used to eat her dinner as well after the operation as if nothing had happened. She died at last rather worn out by age than by the disease.

[139]. Some make a secret of curing the gout by muscular exercise. This secret, however, is as old as Celsus, who strongly recommends that mode of cure; and whoever will submit to it, in the fullest extent, may expect to reap solid and permanent advantages.

[140]. See Appendix, Warm Plaster.

[141]. The scrophula, as well as the rickets, is found to prevail in large manufacturing towns, where people live gross, and lead sedentary lives.

[142]. Sir John Pringle observes, that though this disease may seem trifling, there is no one in the army that is more troublesome to cure, as the infection often lurks in clothes, &c. and breaks out a second, or even a third time. The same inconveniency occurs in private families, unless particular regard is paid to the changing or cleaning of their clothes, which last is by no means an easy operation.

[143]. The itch is now by cleanliness banished from every genteel family in Britain. It still however prevails among the poorer sort of peasants in Scotland, and among the manufacturers in England. These are not only sufficient to keep the seeds of the disease alive, but to spread the infection among others. It were to be wished that some effectual method could be devised for extirpating it altogether. Several country clergymen have told me, that by getting such as were infected cured, and strongly recommending an attention to cleanliness, they have banished the itch entirely out of their parishes. Why might not others do the same?

[144]. After copious evacuations, large doses of æther have been found very efficacious in removing a fit of the asthma. I have likewise known the following mixture produce very happy effects: To four or five ounces of the solution of gum-ammoniac add two ounces of simple cinnamon-water, the same quantity of balsamic syrup, and half an ounce of paregoric elixir. Of this two table-spoonfuls may be taken every three hours.

[145]. I knew a woman who in a violent fit of anger was seized with a sanguine apoplexy. She at first complained of extreme pain, as if daggers had been thrust through her head, as she expressed it. Afterwards she became comatose, her pulse sunk very low, and was exceeding slow. By bleeding, blistering, and other evacuations, she was kept alive for about a fortnight. When her head was opened, a large quantity of extravasated blood was found in the left ventricle of the brain.

[146]. The learned Dr. Arbuthnot advises those who are troubled with costiveness to use animal oils, as fresh butter, cream, marrow, fat broths, especially those made of the internal parts of animals, as the liver, heart, midriff, &c. He likewise recommends the expressed oils of mild vegetables, as olives, almonds, pastaches, and the fruits themselves; all oily and mild fruits, as figs; decoctions of mealy vegetables; these lubricate the intestines; some saponaceous substances which stimulate gently, as honey, hydromel, or boiled honey and water, unrefined sugar, &c.

The Doctor observes, that such lenitive substances are proper for persons of dry atrabilarian constitutions, who are subject to astriction of the belly, and the piles, and will operate when stronger medicinal substances are sometimes ineffectual; but that such lenitive diet hurts those whose bowels are weak and lax. He likewise observes, that all watery substances are lenitive, and that even common water, whey, sour milk, and butter-milk, have that effect;—That new milk, especially asses milk, stimulates still more when it sours on the stomach; and that whey turned sour will purge strongly;—That most garden fruits are likewise laxative; and that some of them, as grapes, will throw such as take them immoderately into a cholera morbus, or incurable diarrhœa.

[147]. Many people imagine, that tea has no tendency to hurt the nerves, and that drinking the same quantity of warm water would be equally pernicious. This however seems to be a mistake. Many persons drink three or four cups of warm milk and water daily, without feeling any bad consequences; yet the same quantity of tea will make their hands shake for twenty-four hours. That tea affects the nerves, is likewise evident from its preventing sleep, occasioning giddiness, dimness of the sight, sickness, &c.

[148]. See Appendix, Electuary for the Epilepsy.

[149]. Many nervous people find great benefit from eating a dry biscuit, especially when the stomach is empty. I look upon this as one of the best carminative medicines; and would recommend it in all complaints of the stomach, arising from flatulence, indigestion, &c.

[150]. Though the patient may begin with this quantity, it will be necessary to increase the dose gradually as the stomach can bear it. Æther is now given in considerably greater doses than it was in Dr. Whytt’s time.

[151]. When hysteric fits are occasioned by sympathy, they may be cured by exciting an opposite passion. This is said to have been the case of a whole school of young ladies in Holland, who were all cured by being told, that the first who was seized should be burnt to death. But this method of cure, to my knowledge, will not always succeed. I would therefore advise, that young ladies who are subject to hysteric fits should not be sent to boarding schools, as the disease may be caught by imitation. I have known madness itself brought on by sympathy.

[152]. Though antispasmodics and anodynes are universally recommended in this disease, yet all the extraordinary cures that I ever knew in hysteric cases, were performed by means of tonic and corroborating medicines.

[153]. Some persons afflicted with cramps pretend to reap great benefit from small bundles of rosemary tied all night about their feet, ancles, and knees.

[154]. Armstrong on Health.

[155]. It is a pity those who have the misfortune to be born blind, or who lose their sight when young, should be suffered to remain in ignorance, or to beg. This is both cruelty and want of economy. There are many employments of which blind persons are very capable, as knitting, carding, turning a wheel, teaching languages, &c. Nor are instances wanting of persons who have arrived at the highest pitch of learning, without having the least idea of light. Witness the late famous Nicholas Sanderson of Cambridge, and my worthy friend Dr. Thomas Blacklock of Edinburgh. The former was one of the first mathematicians of his age, and the latter, besides being a good poet and philosopher, is master of all the learned languages, and a very considerable adept in the liberal arts.

[156]. Though those who have the misfortune to be born deaf are generally suffered to continue dumb, and consequently are in a great measure lost to society, yet nothing is more certain than that such persons may be taught not only to read and write, but also to speak, and to understand what others say to them. Teaching the dumb to speak will appear paradoxical to those who do not consider that the formation of sounds is merely mechanical, and may be taught without the assistance of the ear. This is not only capable of demonstration, but is actually reduced to practice by the ingenious Mr. Thomas Braidwood of Edinburgh. This gentleman has, by the mere force of genius and application, brought the teaching of dumb persons to such a degree of perfection, that his scholars are generally more forward in their education than those of the same age who enjoy all their faculties. They not only read and write with the utmost readiness, but likewise speak, and are capable of holding conversation with any person in the light. What a pity any of the human species should remain in a state of idiotism, who are capable of being rendered as useful and intelligent as others! We mention this not only from humanity to those who have the misfortune to be born deaf, but also in justice to Mr. Braidwood, whose success has far exceeded all former attempts this way; and indeed it exceeds imagination itself so far, that no person who has not seen and examined his pupils, can believe what they are capable of.—As this gentleman, however willing, is only able to teach a few, and as the far greater part of those who are born deaf cannot afford to attend him, it would be an act of great humanity, as well as of public utility, to erect an academy for their benefit.

[157]. A gentleman, on whose veracity I can depend, told me, that after using many things to no purpose for an obstinate deafness, he was at last advised to put a few drops of his own urine warm into his ears every night and morning, from which he received great benefit. It is probable that a solution of sal ammoniac, in water, would produce the same effect.

[158]. London Medical Essays.

[159]. In a cancer which had set all medicines, and even surgery, at defiance, I lately saw remarkable effects from an obstinate perseverance in a course of antiseptics. I ordered the deep ulcers to be washed to the bottom by means of a syringe, twice or thrice a-day, either with an infusion of the bark, or a decoction of carrot, and that the patient should take four or five times a-day, a glass of good wine, with half a drachm of the best powdered bark in it. The sores, after being washed, were likewise sprinkled with the same powder. When the patient began this course, her death was daily expected. She continued it for above two years, with manifest advantage; but being told by an eminent surgeon, that the bark would not cure a cancer, and that the sores ought not to be washed, she discontinued the practice, and died in a few weeks. This course was not expected to cure the cancer, but to prolong the patient’s life, which it evidently did almost to a miracle.

[160]. As hemlock is the principal medicine recommended in this disease, we would have given some directions for the gathering and preparing of that plant; but as its different preparations are now kept in the shops, we think it much safer for people to get them there, with proper directions for using them.

[161]. Though we give this prescription on the credit of Dr. Mead, yet we would not advise any person, who has reason to believe that he has been bit by a dog which was really mad, to trust to it alone. Mead was an able physician, but he seems to have been no great philosopher, and was some times the dupe of his own credulity.

[162]. The Ormskirk medicine, as it is called, seems to me to consist chiefly of cinnabar. Though it is said to be infallible, as a preventive; yet I would not advise any one to trust to it alone. Indeed it is ordered to be taken in a manner which gives it more the appearance of a charm than of a medicine. Surely if a medicine is to produce any change in the body, it must be taken for some considerable time, and in sufficient quantity.

[163]. The practice of sucking out poisons is very ancient; and indeed nothing can be more rational. Where the bite cannot be cut out, this is the most likely way for extracting the poison. There can be no danger in performing this office, as the poison does no harm unless it be taken into the body by a wound. The person who sucks the wound ought however to wash his mouth frequently with salad-oil, which will secure him from even the least inconveniency. The Psylli in Africa, and the Marsi in Italy, were famed for curing the bites of poisonous animals by sucking the wound; and we are told, that the Indians in North America practise the same at this day.

[164]. Although it is now very common to cure the gonorrhœa by astringent injections, there are still many practitioners who do not approve this mode of practice. I can, however, from much experience, assert, that it is both the most easy, elegant, and efficacious method of cure; and that any bad consequences arising from it must be owing to the ignorance or misconduct of the practitioner himself, and not to the remedy. Many, for example, use strong preparations of lead, all of which are dangerous when applied to the internal surfaces of the body; others use escharotics, which inflame and injure the parts. I have known a gonorrhœa actually cured by an injection made of green tea, and would always recommend gentle methods where they will succeed.

[165]. If the patient can swallow a solution of salts and manna, he may take six drachms, or, if his constitution requires it, an ounce of the former, with half an ounce of the latter. These may be dissolved in an English pint of boiling water, whey, or thin water-gruel, and taken early in the morning.

If an infusion of senna and tamarinds be more agreeable, two drachms of the former, and an ounce of the latter, may be infused all night in an English pint of boiling water. The infusion may be strained next morning, and half an ounce of Glauber’s salts dissolved in it. A tea-cupful of this infusion may be taken every half hour till it operates.

Should the patient prefer an electuary, the following will be found to answer very well. Take of the lenitive electuary four ounces, cream of tartar two ounces, jalap in powder two drachms, rhubarb one drachm, and as much of the syrup of pale roses as will serve to make up the whole into a soft electuary. Two or three tea-spoonfuls of this may be taken over-night, and about the same quantity next morning, every day that the patient chuses to take a purge.

The doses of the above medicines may be increased or diminished according as the patient finds it necessary. We have ordered the salts to be dissolved in a large quantity of water, because it renders their operation more mild.

[166]. Take quicksilver one drachm, gum-arabic reduced to a mucilage two drachms; let the quicksilver be rubbed with the mucilage, in a marble mortar, until the globules of mercury entirely disappear; afterwards add gradually, still continuing the trituration, half an ounce of balsamic syrup, and eight ounces of simple cinnamon-water. Two table-spoonfuls of this solution may be taken night and morning. Some reckon this the best form in which quicksilver can be exhibited for the cure of a gonorrhœa.

[167]. The Peruvian bark may be combined with other astringents, and prepared in the following manner:

Take of Peruvian bark bruised six drachms, of fresh galls bruised two drachms; boil them in a pound and a half of water to a pound; to the strained liquor add three ounces of the simple tincture of the bark. A small tea-cupful of this may be taken three times a-day, adding to each cup fifteen or twenty drops of the acid elixir of vitriol.

[168]. Take Venice turpentine, boiled to a sufficient degree of hardness, half an ounce, calomel half a drachm. Let these be mixed and formed into sixty pills, of which five or six may be taken night and morning. If, during the use of these pills, the mouth should grow sore, or the breath become offensive, they must be discontinued till these symptoms disappear.

[169]. I have been accustomed for some time past to apply leeches to inflamed testicles, which practice has always been followed with the most happy effects.

[170]. The extract of hemlock may be made into pills, and taken in the manner directed under the article Cancer.

[171]. For the dispersion of a bubo, a number of leeches applied to the part affected will be found equally efficacious as in the inflamed testicle.

[172]. When venereal ulcers are seated in the lips, the infection may be communicated by kissing. I have seen very obstinate venereal ulcers in the lips, which I had all the reason in the world to believe were communicated in this manner.

Nurses ought to beware of suckling infected children, or having their breasts drawn by persons tainted with the venereal disease. This caution is peculiarly necessary for nurses who reside in the neighbourhood of great towns.

[173]. I have found it answer extremely well to sprinkle chancres twice a-day with calomel. This will often perform a cure without any other application whatever. If the chancres are upon the glans, they may be washed with milk and water, a little warm, and afterwards the calomel may be applied as above.

[174]. The sublimate may be given in distilled water, or any other liquor that the patient chuses. I commonly order ten grains to be dissolved in an ounce of the spirit of wine, for the conveniency of carriage, and let the patient take twenty or thirty drops of it night and morning in half a glass of brandy or other spirits. Mr. Debraw, an ingenious chymist of this place, informs me, that he prepares a salt of mercury much more mild and gentle in its operation than the sublimate, though equally efficacious.

[175]. See Appendix, Decoct. of Sarsaparilla.

[176]. Though we are still very much in the dark with regard to the method of curing this disease among the natives of America, yet it is generally affirmed, that they do cure it with speed, safety, and success, and that without the least knowledge of mercury. Hence it becomes an object of considerable importance to discover their method of cure. This might surely be done by making trials of the various plants which are found in those parts, and particularly of such as the natives are known to make use of. All people in a rude state take their medicines chiefly from the vegetable kingdom, and are often possessed of valuable secrets with regard to the virtues of plants, of which more enlightened nations are ignorant. Indeed we make no doubt but some plants of our own growth, were proper pains taken to discover them, would be found as efficacious in curing the venereal disease as those of America. It must however be remembered, that what will cure the venereal disease in one country, will not always be found to have equal success in another.

[177]. I have not only often seen a recent infection carried off in a few days by means of cleanliness, viz. bathing, fomentations, injections, &c. but have likewise found it of the greatest advantage in the more advanced stages of the disease. Of this I had lately a very remarkable instance, in a man whose penis was almost wholly consumed by venereal ulcers; the matter had been allowed to continue on the sores, without any care having been taken to clean them, till, notwithstanding the use of mercury and other medicines, it had produced the effects above mentioned. I ordered warm milk and water to be injected three or four times a-day into all the sinuous ulcers, in order to wash out the matter; after which they were stuffed with dry lint to absorb the fresh matter as it was generated. The patient at the same time took every day half a grain of the corrective sublimate of mercury, dissolved in an ounce of brandy, and drank an English quart of the decoction of sarsaparilla. By this treatment, in about six weeks, he was perfectly cured; and, what was very remarkable, a part of the penis was actually regenerated.

Doctor Gilchrist has given an account of a species of the lues venerea which prevails in the west of Scotland, to which the natives give the name of Sibbins or Sivvins. The Doctor observes, that the spreading of this disease is chiefly owing to a neglect of cleanliness, and seems to think, that by due attention to that virtue, it might be extirpated. The treatment of this disease is similar to that of a confirmed lues or pox. The yaws, a disease which is now very common both in America and the West India islands, may also be cured in the same manner.

[178]. It is the duty of mothers, and those who are intrusted with the education of girls, to instruct them early in the conduct and management of themselves at this critical period of their lives. False modesty, inattention, and ignorance of what is beneficial or hurtful at this time, are the sources of many diseases and misfortunes in life, which a few sensible lessons from an experienced matron might have prevented. Nor is care less necessary in the subsequent returns of this discharge. Taking improper food, violent affections of the mind, or catching cold at this period, is often sufficient to ruin the health, or to render the female ever after incapable of procreation.

[179]. Two drachms of allum and one of Japan earth may be pounded together, and divided into eight or nine doses, one of which may be taken three times a day.

Persons whose stomachs cannot bear the allum, may take two table-spoonfuls of the tincture of roses three or four times a-day, to each dose of which ten drops of laudanum may be added.

If these should fail, half a drachm of the Peruvian bark, in powder, with ten drops of the elixir of vitriol, may be taken, in a glass of red wine, four times a-day.

[180]. Every mother who procures an abortion does it at the hazard of her life; yet there are not a few who run this risk merely to prevent the trouble of bearing and bringing up children. It is surely a most unnatural crime, and cannot, even in the most abandoned, be viewed without horror; but in the decent matron, it is still more unpardonable.—Those wretches who daily advertise their assistance to women in this business, deserve, in my opinion, the most severe of all human punishments.

[181]. Though the management of women in child-bed has been practised as an employment since the earliest accounts of time; yet it is still in most countries on a very bad footing. Few women think of following this employment till they are reduced to the necessity of doing it for bread. Hence not one in a hundred of them have any education, or proper knowledge of their business. It is true, that Nature, if left to herself, will generally expel the fœtus; but it is equally true, that most women in child-bed require to be managed with skill and attention, and that they are often hurt by the superstitious prejudices of ignorant and officious midwives. The mischief done in this way is much greater than is generally imagined; most of which might be prevented by allowing no women to practise midwifery but such as are properly qualified. Were due attention paid to this, it would not only be the means of saving many lives, but would prevent the necessity of employing men in this indelicate and disagreeable branch of medicine, which is, on many accounts, more proper for the other sex.

[182]. We cannot help taking notice of that ridiculous custom which still prevails in some parts of the country, 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 patient with their noise; and often, by their untimely and impertinent advice, do much mischief.

[183]. In a violent flooding after delivery, I have seen very good effects from the following mixture: Take of penny-royal water, simple cinnamon-water, and syrup of poppies, each two ounces, elixir of vitriol a drachm. Mix, and take two table-spoonfuls every two hours, or oftner, if necessary.

[184]. Take of crabs claws prepared half an ounce, purified nitre two drachms, saffron powdered half a drachm; 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 asafœtida in a cup of penny-royal tea.

[185]. Midwives ought to be very cautious in administering vomits or purges to women in child-bed. I have known a woman, who was recovering extremely well, thrown into the most imminent danger, by a strong purge which was given her by an officious midwife.

[186]. Dr. Cheyne avers, that want of children is oftner the fault of the male than of the female, and strongly recommends a milk and vegetable diet to the former as well as the latter; adding, that his friend Dr. Taylor, whom he calls the Milk-doctor of Croydon, 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.

[187]. Of the officious and ill-judged care of midwives, we shall adduce only one instance, viz. the common practice of torturing infants by squeezing their breasts, to draw off the milk, as they call it. Though a small quantity of moisture is generally found in the breasts of infants, yet, as they are certainly not intended to give suck, this ought never to be drawn off. I have seen this cruel operation bring on hardness, inflammation, and suppuration of the breasts; but never knew any ill consequences from its being omitted. When the breasts are hard, the only application that we would recommend is a soft poultice, or a little of the diachylon plaster, spread thin upon a bit of soft leather, about the size of half a crown, and applied over each nipple. These may be suffered to continue till the hardness disappears.

[188]. See Appendix, Laxative absorbent Mixture.

[189]. Some nurses remove this complaint by sucking the child’s nose. This is by no means a cleanly operation; but when nurses have the resolution to do it, I am far from discouraging the practice.

[190]. I some time ago saw a very striking instance of the danger of substituting drying medicines in the place of cleanliness and wholesome food, in the Foundling Hospital at Ackworth, where the children were grievously afflicted with scabbed heads and other cutaneous disorders. Upon inquiry it was found, that very little attention was paid either to the propriety or soundness of their provisions, and that cleanliness was totally neglected; accordingly it was advised that they should have more wholesome food, and be kept thoroughly clean. This advice, however, was not followed. It was too troublesome to the servants, superintendants, &c. The business was to be done by medicine; which was accordingly attempted, but had nearly proved fatal to the whole house. Fevers and other internal disorders immediately appeared, and at length a putrid dysentery, which proved so infectious, that it carried off a great many of the children, and spread over a considerable part of the neighbouring country.

[191]. In this disease bleeding is not always proper; but in very full habits it must certainly be of use.

[192]. I was lately favoured with a letter from Dr. William Turnbull in London, a physician of great experience, and who, from his former situation on the north-east coast of England, had many opportunities of observing the symptoms and progress of this dangerous disease. I am sorry the letter came too late to be inserted at length; but as the Doctor’s sentiments differ very little from my own, this misfortune is the less to be regretted. The Doctor indeed observes, that he never found blistering of any service; but recommends cataplasms of garlic, camphor, and Venice treacle, to be applied both to the throat and soles of the feet. He likewise recommends boluses of camphor, castor, valerian root, salt of hartshorn, and musk, adapted to the age, strength, &c. of the patient; after which he advises two spoonfuls of the following decoction:—Take of garlic and distilled vinegar each an ounce, hysop-water eight ounces; beat up the ingredients together, gradually mixing the water, and adding three ounces of honey. Let the whole be simmered over a gentle fire, and afterwards drained for use.

[193]. One reason why this disease is seldom or never cured, may be, that it is seldom known till too far advanced to admit of remedy. Did parents watch the first symptoms, and call a physician in due time, I am inclined to think that something might be done. But these symptoms are not yet sufficiently known, and are often mistaken even by physicians themselves. Of this I lately saw a striking instance in a patient attended by an eminent practitioner of this city, who had all along mistaken the disease for teething.

[194]. Dr. Tissot, in his Advice to the People, gives the following directions for gathering, preparing, and applying the agaric.—“Gather in autumn,” says he, “while the fine weather lasts, the agaric of the oak, which is a kind of fungus or excrescence issuing from the wood of that tree. It consists at first of four parts, which present themselves successively: 1. The outward rind or skin, which may be thrown away. 2. The part immediately under this rind, which is the best of all. This is to be beat well with a hammer, till it becomes soft and very pliable. This is the only preparation it requires, and a slice of it of a proper size is to be applied directly over the bursting open blood vessels. It constringes and brings them close together, stops the bleeding, and generally falls off at the end of two days. 3. The third part adhering to the second may serve to stop the bleeding from the smaller vessels; and the fourth and last part may be reduced to powder as conducing to the same purpose.”—Where the agaric cannot be had, sponge may be used in its stead. It must be applied in the same manner, and has nearly the same effects.

[195]. See Appendix, Wax plaster.

[196]. See Appendix, Yellow basilicum.

[197]. See Appendix, Turner’s cerate.

[198]. In ulcers of the lower limbs great benefit is often received from tight rollers, or wearing a laced stocking, as this prevents the flux of humours to the sores, and disposes them to heal.

[199]. Various pieces of machinery have been contrived for counteracting the force of the muscles, and retaining the fragments of broken bones; but as descriptions of these without drawings would be of little use, I shall refer the reader to a cheap and useful performance on the nature and cure of fractures, lately published by my ingenious friend Mr. Aitken, surgeon in Edinburgh; wherein that gentleman has not only given an account of the machines recommended in fractures by former authors, but has likewise added several improvements of his own, which are peculiarly useful in compound fractures, and in cases where patients with broken bones are obliged to be transported from one place to another.

[200]. A great many external applications are recommended for strains, some of which do good, and others hurt. The following are such as may be used with the greatest safety, viz. poultices made of stale beer or vinegar and oatmeal, camphorated spirits of wine, Mindererus’s spirit, volatile liniment, volatile aromatic spirit diluted with a double quantity of water, and the common fomentation, with the addition of brandy or spirit of wine.

[201]. I would here beg leave to recommend it to every practitioner, when his patient complains of pain in the belly with obstinate costiveness, to examine the groins and every place where a rupture may happen, in order that it may be immediately reduced. By neglecting this, many perish who were not suspected to have had ruptures till after they were dead. I have known this happen where half a dozen of the faculty were in attendance.

[202]. A woman in one of the hospitals of this city lately discharged a great number of pins, which she had swallowed in the course of her business, through an ulcer in her side.

[203]. These accidents are not always the effects of carelessness. I have known an infant overlaid by its mother being seized in the night with an hysteric fit. This ought to serve as a caution against employing hysteric women as nurses; and should likewise teach such women never to lay an infant in the same bed with themselves, but in a small adjacent one.

[204]. The Author is happy to observe, that, since the first publication of this work, several societies have been instituted in Britain with the same benevolent intention as that of Amsterdam, and that their endeavours have proved no less successful. He is likewise happy to observe, that premiums have been awarded to those who have been active in their endeavours to restore to life persons who had been drowned, or suddenly deprived of life by any accident. How much is this superior to the superstitious institution, which allows any man a premium who brings a dead person out of the water, so that he may receive Christian burial; but allows nothing to the person who brings him out alive, or who recovers him after he has been to all appearance dead.

[205]. The late celebrated Dr. Smollet has indeed said, that if he were persuaded he had an ulcer in the lungs, he would jump into the cold bath: but here the Doctor evidently shews more courage than discretion; and that he was more a man of wit than a physician, every one will allow. A nervous asthma, or an atrophy, may be mistaken for a pulmonary consumption; yet, in the two former, the cold bath proves often beneficial, though I never knew it to in the latter. Indeed, all the phthisical patients I ever saw, who had tried the cold bath, were evidently hurt by it.

[206]. The celebrated Galen says, that immersion in cold water is fit only for the young of lions and bears; and recommends warm bathing, as conducive to the growth and strength of infants. How egregiously do the greatest men err whenever they lose sight of facts, and substitute reasoning in physic in place of observation and experience!

[207]. The greatest class of mineral waters in this country is the chalybeate. In many parts of Britain these are to be found in almost every field; but those chiefly in use, for medical purposes, are the purging chalybeates, as the waters of Scarborough, Cheltenham, Thorp Arch, Nevil Holt, &c. Of those which do not purge, the waters of Tunbridge stand in the highest repute. The saline purging waters, as those of Acton, Epsom, Kilburn, &c. are also in very general esteem; but the fountains most frequented by the sick in this country, are those to which the minerals impart a certain degree of heat, as Bath, Bristol, Buxton, &c.

[208]. When I speak of drinking a glass of the water over-night, I must beg leave to caution those who follow this plan against eating heavy suppers. The late Dr. Daultry of York, who was the first that brought the Harrowgate waters into repute, used to advise his patients to drink a glass before they went to bed; the consequence of which was, that having eat a flesh supper, and the water operating in the night, they were often tormented with gripes, and obliged to call for medical assistance.

[209]. See a paper on this subject in the Edinburgh Physical and Literary Essays, by the ingenious Dr. John Gardener.

[210]. A very good tincture of guaiacum, for domestic use, may be made by infusing two or three ounces of the gum in a bottle of rum or brandy.

[211]. See Collyrium of Lead.

TRANSCRIBER’S NOTES

PageChanged fromChanged to
[161]If the patient be afflicted with reaching, or an inclinationIf the patient be afflicted with retching, or an inclination
[357]sitting with the head bear near an open window, orsitting with the head bare near an open window, or
[415]as wearing flannel, lying to long a-bedas wearing flannel, lying too long a-bed
[533]but induces a plethora, or two great a fulness ofbut induces a plethora, or too great a fulness of