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+The Project Gutenberg EBook of Advice to the people in general, with
+regard to their health, by Samuel Auguste David Tissot
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: Advice to the people in general, with regard to their health
+
+Author: Samuel Auguste David Tissot
+
+Translator: J. Kirkpatrick
+
+Release Date: March 9, 2012 [EBook #39044]
+
+Language: English
+
+Character set encoding: ASCII
+
+*** START OF THIS PROJECT GUTENBERG EBOOK ADVICE TO THE PEOPLE ***
+
+
+
+
+Produced by Bryan Ness, Enrico Segre and the Online
+Distributed Proofreading Team at http://www.pgdp.net (This
+file was produced from images generously made available
+by The Internet Archive/Canadian Libraries)
+
+
+
+
+
+                          Advice to the people
+
+
+                                _ADVICE_
+                               __to the__
+                        _PEOPLE_ in __General__,
+                                __with__
+
+                      Regard to their __Health__:
+
+
+
+
+But more particularly calculated for those, who, by their Distance from
+regular Physicians, or other very experienced Practitioners, are the
+most unlikely to be seasonably provided with the best Advice and
+Assistance, in acute Diseases, or upon any sudden inward or outward
+Accident.
+
+                                 _WITH_
+
+A Table of the most cheap, yet effectual Remedies, and the plainest
+Directions for preparing them readily.
+
+                Translated from the _French_ Edition of
+
+                 Dr. __Tissot's__ _Avis au Peuple_, &c.
+
+Printed at _Lyons_; with all his own Notes; a few of his medical
+Editor's at _Lyons_; and several occasional Notes, adapted to this
+_English_ Translation,
+
+                       By J. _Kirkpatrick_, M. D.
+
+
+
+
+    _In the Multitude of the People is the Honour of a King; and for
+       the Want of People cometh the Destruction of the Prince._
+
+                                                   Proverbs xiv, 28.
+    -----------------------------------------------------------------
+
+
+
+
+                              __LONDON:__
+
+ Printed for T. _Becket_ and P. A. _De Hondt_, at _Tully's_ Head, near
+                    _Surry-Street_, in the _Strand_.
+
+                               M DCC LXV.
+
+
+
+
+                       _the Translator's_ PREFACE.
+
+
+Though the great Utility of those medical Directions, with which the
+following Treatise is thoroughly replenished, will be sufficiently
+evident to every plain and sensible Peruser of it; and the extraordinary
+Reception of it on the Continent is recited in the very worthy Author's
+Preface; yet something, it should seem, may be pertinently added, with
+Regard to this Translation of it, by a Person who has been strictly
+attentive to the Original: a Work, whose Purpose was truly necessary and
+benevolent; as the Execution of it, altogether, is very happily
+accomplished.
+
+It will be self evident, I apprehend, to every excellent Physician, that
+a radical Knowledge of the Principles, and much Experience in the
+Exercise, of their Profession, were necessary to accommodate such a Work
+to the Comprehension of those, for whom it was more particularly
+calculated. Such Gentlemen must observe, that the certain Axiom of
+_Nature's curing Diseases_, which is equally true in our Day, as it was
+in that of _Hippocrates_, so habitually animates this Treatise, as not
+to require the least particular Reference. This _Hippocratic_ Truth as
+certain (though much less subject to general Observation) as that
+Disease, or Age, is finally prevalent over all sublunary Life, the most
+attentive Physicians discern the soonest, the most ingenuous readily
+confess: and hence springs that wholesome Zeal and Severity, with which
+Dr. _Tissot_ encounters such Prejudices of poor illiterate Persons, as
+either oppose, or very ignorantly precipitate, her Operations, in her
+Attainment of Health. These Prejudices indeed may seem, from this Work,
+to be still greater, and perhaps grosser too, in _Swisserland_ than
+among ourselves; though it is certain there is but too much Room for the
+Application of his salutary Cautions and Directions, even in this
+Capital; and doubtless abundantly more at great Distances from it. It
+may be very justly supposed, for _one_ Instance, that in most of those
+Cases in the Small Pocks, in which the Mother undertakes the Cure of her
+Child, or confides it to a Nurse, that Saffron, in a greater or less
+Quantity, and Sack or Mountain Whey, are generally still used in the
+Sickening before Eruption; to accelerate that very Eruption, whose
+gradual Appearance, about the fourth Day, from that of Seizure
+inclusive, is so favourable and promising to the Patient; and the
+Precipitation of which is often so highly pernicious to them. Most of,
+or rather all, his other Cautions and Corrections seem equally necessary
+here, as often as the Sick are similarly circumstanced, under the
+different acute Diseases in which he enjoins them.
+
+Without the least Detraction however from this excellent Physician, it
+may be admitted that a few others, in many other Countries, might have
+sufficient Abilities and Experience for the Production of a like Work,
+on the same good Plan. This, we find, Dr. _Hirzel_, principal Physician
+of _Zurich_, had in Meditation, when the present Treatise appeared,
+which he thought had so thoroughly fulfilled his own Intention, that it
+prevented his attempting to execute it. But the great Difficulty
+consisted in discovering a Physician, who, with equal Abilities,
+Reputation and Practice, should be qualified with that _much rarer_
+Qualification of caring so much more for the Health of those, who could
+never pay him for it, than for his own Profit or Ease, as to determine
+him to project and to accomplish so necessary, and yet so self-denying,
+a Work. For as the Simplicity he proposed in the Style and Manner of it,
+by condescending, in the plainest Terms, to the humblest Capacities,
+obliged him to depress himself, by writing rather beneath the former
+Treatises, which had acquired him the Reputation of medical Erudition,
+Reasoning and Elegance; we find that the Love of Fame itself, so
+stimulating even to many ingenuous Minds, was as impotent as that of
+Wealth, to seduce him from so benign, so generous a Purpose. Though,
+upon Reflection, it is by no Means strange to see wise Men found their
+Happiness, which all [however variously and even oppositely] pursue,
+rather in Conscience, than on Applause; and this naturally reminds us of
+that celebrated Expression of _Cato_, or some other excellent Ancient,
+"that he had rather _be_ good, than _be reputed_ so."
+
+However singular such a Determination may now appear, the Number of
+reputable medical Translators into different Languages, which this
+original Work has employed on the Continent, makes it evident, that real
+Merit will, sooner or later, have a pretty general Influence; and induce
+many to imitate that Example, which they either could not, or did not,
+propose. As the truly modest Author has professedly disclaimed all
+Applause on the Performance, and contented himself with hoping an
+Exemption from Censure, through his Readers' Reflection on the peculiar
+Circumstances and Address of it; well may his best, his faithfullest
+Translators, whose Merit and Pains must be of a very secondary Degree to
+his own, be satisfied with a similar Exemption: especially when joined
+to the Pleasure, that must result from a Consciousness of having
+endeavoured to extend the Benefits of their Author's Treatise, to
+Multitudes of their own Country and Language.
+
+For my own Particular, when after reading the Introduction to the Work,
+and much of the Sequel, I had determined to translate it; to be as just
+as possible to the Author, and to his _English_ Readers, I determined
+not to interpolate any Sentiment of my own into the Text, nor to omit
+one Sentence of the Original, which, besides its being _Detraction_ in
+its literal Sense, I thought might imply it in its worst, its figurative
+one; for which there was no Room. To conform as fully as possible to the
+Plainness and Perspicuity he proposed, I have been pretty often obliged
+in the anatomical Names of some Parts, and sometimes of the Symptoms, as
+well as in some pretty familiar, though not entirely popular Words, to
+explain all such by the most common Words I have heard used for them; as
+after mentioning the _Diaphragm_, to add, or _Midriff_--the
+_Trachaea_--or _Windpipe_--_acrimonious_, or _very sharp_, and so of many
+others. This may a little, though but a little, have extended the
+Translation beyond the Original; as the great Affinity between the
+_French_ and _Latin_, and between the former and many _Latin_ Words
+borrowed from the _Greek_, generally makes the same anatomical or
+medical Term, that is technical with us, vernacular or common with them.
+But this unavoidable Tautology, which may be irksome to many Ears, those
+medical Readers, for whom it was not intended, will readily forgive,
+from a Consideration of the general Address of the Work: while they
+reflect that meer Style, if thoroughly intelligible, is least essential
+to those Books, which wholly consist of very useful, and generally
+interesting, Matter.
+
+As many of the Notes of the Editor of _Lyons_, as I have retained in
+this Version (having translated from the Edition of _Lyons_) are
+subscribed _E. L._ I have dispensed with several, some, as evidently
+less within Dr. _Tissot's_ Plan, from tending to theorize, however
+justly or practically, where he must have had his own Reasons for
+omitting to theorize: a few others, as manifestly needless, from what
+the Author had either premised, or speedily subjoined, on the very same
+Circumstance: besides a very few, from their local Confinement to the
+Practice at _Lyons_, which lies in a Climate somewhat more different
+from our own than that of _Lausanne_. It is probable nevertheless, I
+have retained a few more than were necessary in a professed Translation
+of the original Work: but wherever I have done this, I have generally
+subjoined my Motive for it; of whatever Consequence that may appear to
+the Reader. I have retained all the Author's own Notes, with his Name
+annexed to them; or if ever the Annotator was uncertain to me, I have
+declared whose Note I supposed it to be.
+
+Such as I have added from my own Experience or Observation are
+subscribed _K_, to distinguish them from the others; and that the
+Demerit of any of them may neither be imputed to the learned Author, nor
+to his Editor. Their principal Recommendation, or Apology is, that
+whatever Facts I have mentioned are certainly true. I have endeavoured
+to be temperate in their Number and Length, and to imitate that strict
+Pertinence, which prevails throughout the Author's Work. If any may have
+ever condescended to consider my Way of writing, they will conceive this
+Restraint has cost me at least as much Pains, as a further Indulgence of
+my own Conceptions could have done. The few Prescriptions I have
+included in some of them, have been so conducted, as not to give the
+Reader the least Confusion with Respect to those, which the Author has
+given in his Table of Remedies, and which are referred to by numerical
+Figures, throughout the Course of his Book.
+
+The moderate Number of Dr. _Tissot's_ Prescriptions, in his Table of
+Remedies, amounting but to seventy-one, and the apparent Simplicity of
+many of them, may possibly disgust some Admirers of pompous and compound
+Prescription. But his Reserve, in this important Respect, has been
+thoroughly consistent with his Notion of Nature's curing Diseases; which
+suggested to him the first, the essential Necessity of cautioning his
+Readers against doing, giving, or applying any thing, that might oppose
+her healing Operations (a most capital Purpose of his Work) which
+important Point being gained, the mildest, simplest and least hazardous
+Remedies would often prove sufficient Assistants to her. Nevertheless,
+under more severe and tedious Conflicts, he is not wanting to direct the
+most potent and efficacious ones. The Circumstances of the poor Subjects
+of his medical Consideration, became also a very natural Object to him,
+and was in no wise unworthy the Regard of the humane Translator of
+_Bilguer on Amputations_, or rather _against_ the crying Abuse of them;
+an excellent Work, that does real Honour to them both; and which can be
+disapproved by none, who do not prefer the frequently unnecessary
+Mutilation of the afflicted, to the Consumption of their own Time, or
+the Contraction of their Employment.
+
+Some Persons may imagine that a Treatise of this Kind, composed for the
+Benefit of labouring People in _Swisserland_, may be little applicable
+to those of the _British_ Islands: and this, in a very few Particulars,
+and in a small Degree, may reasonably be admitted. But as we find their
+common Prejudices are often the very same; as the _Swiss_ are the
+Inhabitants of a colder Climate than _France_, and generally, as Dr.
+_Tissot_ often observes, accustomed to drink (like ourselves) more
+strong Drink than the _French_ Peasantry; and to indulge more in eating
+Flesh too, which the Religion of _Berne_, like our own, does not
+restrain; the Application of his Advice to them will pretty generally
+hold good here. Where he forbids them Wine and Flesh, all Butchers Meat,
+and in most Cases all Flesh, and all strong Drink should be prohibited
+here: especially when we consider, that all his Directions are confined
+to the Treatment of acute Diseases, of which the very young, the
+youthful, and frequently even the robust are more generally the
+Subjects. Besides, in some few of the _English_ Translator's Notes, he
+has taken the Liberty of moderating the Coolers, or the Quantities of
+them (which may be well adapted to the great Heats and violent _Swiss_
+Summers he talks of) according to the Temperature of our own Climate,
+and the general Habitudes of our own People. It may be observed too,
+that from the same Motive, I have sometimes assumed the Liberty of
+dissenting from the Text in a very few Notes, as for Instance, on the
+Article of Pastry, which perhaps is generally better here than in
+_Swisserland_ (where it may be no better than the coarse vile Trash that
+is hawked about and sold to meer Children) as I have frequently, in
+preparing for Inoculation, admitted the best Pastry (but not of Meat)
+into the limited Diet of the Subjects of Inoculation, and constantly
+without the least ill Consequence. Thus also in Note [70] Page 287, 288,
+I have presumed to affirm the Fact, that a strong spirituous Infusion of
+the Bark has succeeded more speedily in some Intermittents, in
+particular Habits, than the Bark in Substance. This I humbly conceive
+may be owing to such a _Menstruum's_ extracting the Resin of the Bark
+more effectually (and so conveying it into the Blood) than the Juices of
+the Stomach and of the alimentary Canal did, or could. For it is very
+conceivable that the _Crasis_, the Consistence, of the fibrous Blood may
+sometimes be affected with a morbid Laxity or Weakness, as well as the
+general System of the muscular Fibres.
+
+These and any other like Freedoms, I am certain the Author's Candour
+will abundantly pardon; since I have never dissented for Dissention's
+Sake, to the best of my Recollection; and have the Honour of harmonizing
+very generally in Judgment with him. If _one_ useful Hint or Observation
+occurs throughout my Notes, his Benevolence will exult in that essential
+Adherence to his Plan, which suggested it to me: While an invariable
+ecchoing Assentation throughout such Notes, when there really was any
+salutary Room for doubting, or for adding (with Respect to ourselves)
+would discover a Servility, that must have disgusted a liberal manly
+Writer. One common good Purpose certainly springs from the generous
+Source, and replenishes the many Canals into which it is derived; all
+the Variety and little Deviations of which may be considered as more
+expansive Distributions of its Benefits.
+
+Since the natural Feelings of Humanity generally dispose us, but
+especially the more tender and compassionate Sex, to advise Remedies to
+the poor Sick; such a Knowledge of their real Disease, as would prevent
+their Patrons, Neighbours and Assistants from advising a wrong Regimen,
+or an improper or ill-timed Medicine, is truly essential to relieving
+them: and such we seriously think the present Work is capable of
+imparting, to all commonly sensible and considerate Perusers of it. A
+Vein of unaffected Probity, of manly Sense, and of great Philanthropy,
+concur to sustain the Work: And whenever the Prejudices of the Ignorant
+require a forcible Eradication; or the crude Temerity and Impudence of
+Knaves and Impostors cry out for their own Extermination, a happy
+Mixture of strong Argument, just Ridicule, and honest Severity, give a
+poignant and pleasant Seasoning to the Work, which renders it
+occasionally entertaining, as it is continually instructive.
+
+A general Reader may be sometimes diverted with such Customs and Notions
+of the _Swiss_ Peasants, as are occasionally mentioned here: and
+possibly our meerest Rustics may laugh at the brave simple _Swiss_, on
+his introducing a Sheep into the Chamber of a very sick Person, to save
+the Life of the Patient, by catching its own Death. But the humblest
+Peasantry of both Nations are agreed in such a Number of their absurd
+unhealthy Prejudices, in the Treatment of Diseases, that it really
+seemed necessary to offer our own the Cautions and Counsels of this
+principal Physician, in a very respectable Protestant Republick, in
+Order to prevent their Continuance. Nor is it unreasonable to presume,
+that under such a Form of Government, if honestly administered upon its
+justest Principles, the People may be rather more tenderly regarded,
+than under the Pomp and Rage of Despotism, or the Oppression of some
+Aristocracies.
+
+Besides the different Conditions of [1] Persons, to whom our Author
+recommends the Patronage and Execution of his Scheme, in his
+Introduction, it is conceived this Book must be serviceable to many
+young Country Practitioners, and to great Numbers of Apothecaries, by
+furnishing them with such exact and striking Descriptions of each acute
+Disease and its Symptoms, as may prevent their mistaking it for any
+other; a Deception which has certainly often been injurious, and
+sometimes even fatal: for it is dreadful but to contemplate the
+Destruction or Misery, with which Temerity and Ignorance, so frequently
+combined, overwhelm the Sick. Thus more Success and Reputation, with the
+Enjoyment of a better Conscience, would crown their Endeavours, by a
+more general Recovery of, or Relief to, their Patients. To effect this,
+to improve every Opportunity of eschewing medical Evil, and of doing
+medical Good, was the Author's avowed Intention; which he informs us in
+his Preface, he has heard, from some intelligent and charitable Persons,
+his Treatise had effected, even in some violent Diseases. That the same
+good Consequences may every where attend the numerous Translations of
+it, must be the fervent Wish of all, except the Quacks and Impostors he
+so justly characterizes in his thirty-third Chapter! and particularly of
+all, who may be distinguishably qualified, like himself, to,
+
+--_Look through Nature up to Nature's GOD!_
+
+ [1] Of all these the Schoolmasters, _with us_, may seem the most
+     reasonably exempted from this Duty.
+
+
+
+
+                       The AUTHOR's _DEDICATION._
+
+
+_To the most Illustrious, the most Noble and Magnificent Lords, the
+Lords President and Counsellors of the Chamber of Health, of the City
+and Republick of_ Berne.
+
+_Most honourable Lords_,
+
+When I first published the following Work, my utmost Partiality to it
+was not sufficient to allow me the Confidence of addressing it to Your
+Lordships. But Your continual Attention to all the Objects, which have
+any Relation to that important Part of the Administration of the State,
+which has been so wisely committed to Your Care, has induced You to take
+Notice of it. You have been pleased to judge it might prove useful, and
+that an Attempt must be laudable, which tends to the Extermination of
+erroneous and inveterate Prejudices, those cruel Tyrants, that are
+continually opposing the Happiness of the People, even under that Form
+and Constitution of Government, which is the best adapted to establish
+and to increase it.
+
+Your Lordships Approbation, and the splendid Marks of [2] Benevolence,
+with which You have honoured me, have afforded me a juster Discernment
+of the Importance of this Treatise, and have inclined me to hope, _most
+Illustrious, most Noble, and Magnificent Lords_, that You will permit
+this new Edition of it to appear under the Sanction of your Auspices;
+that while the Publick is assured of Your general Goodness and
+Beneficence, it may also be informed of my profoundly grateful Sense of
+them, on the same Occasion.
+
+ [2] See the Author's Preface, immediately following this Dedication.
+
+May the present Endeavour then, in fully corresponding to my Wishes,
+effectually realize Your Lordships utmost Expectations from it; while
+You condescend to accept this small Oblation, as a very unequal
+Expression of that profound Respect, with which I have the Honour to be,
+
+_Most Illustrious, Most Noble, and Magnificent Lords,_
+
+                           _Your most humble_
+                               _And most_
+                          _Obedient Servant_,
+
+                                                           _TISSOT._
+
+    _Lausanne_,
+    _Dec. 3, 1762._
+
+
+
+
+                         THE AUTHOR's _PREFACE._
+
+
+_If Vanity too often disposes many to speak of themselves, there are
+some Occasions, on which a total Silence might be supposed to result
+from a still higher Degree of it: And the very general Reception of the
+*Advice to the People* has been such, that there would be Room to
+suspect me of that most shocking Kind of Pride, which receives Applause
+with Indifference (as deeming its own Merit Superior to the greatest) if
+I did not appear to be strongly impressed with a just Sense of that
+great Favour of the Publick, which has been so very obliging, and is so
+highly agreable, to me._
+
+_Unfeignedly affected with the unhappy Situation of the poor Sick in
+Country Places in *Swisserland*, where they are lost from a Scarcity of
+the best Assistance, and from a fatal Superfluity of the worst, my sole
+Purpose in writing this Treatise has been to serve, and to comfort them.
+I had intended it only for a small Extent of Country, with a moderate
+Number of Inhabitants; and was greatly surprized to find, that within
+five or six Months after its Publication, it was become one of the most
+extensively published Books in *Europe*; and one of those Treatises, on
+a scientific Subject, which has been perused by the greatest Number of
+Readers of all Ranks and Conditions. To consider such Success with
+Indifference, were to have been unworthy of it, which Demerit, at least
+on this Account, I cannot justly be charged with; since Indifference has
+not been my Case, who have felt, as I ought, this Gratification of
+Self-love; and which, under just and prudent Restrictions, may perhaps
+be even politically cherished; as the Delight naturally arising from
+having been approved, is a Source of that laudable Emulation, which has
+sometimes produced the most essential good Consequences to Society
+itself. For my own particular, I can truly aver, that my Satisfaction
+has been exquisitely heightened on this Occasion, as a Lover of my
+Species: since judging from the Success of this Work (a Success which
+has exceeded my utmost Expectations) of the Effects that may reasonably
+be expected from it, I am happily conscious of that Satisfaction, or
+even Joy, which every truly honest Man must receive, from rendering
+essential good Offices to others. Besides which, I have enjoyed, in its
+utmost Extent, that Satisfaction which every grateful Man must receive
+from the Approbation and Beneficence of his Sovereign, when I was
+distinguished with the precious Medal, which the illustrious Chamber of
+Health of the Republick of Berne honoured me with, a few Months after
+the Publication of this Treatise; together with a Letter still more
+estimable, as it assured me of the extraordinary Satisfaction the
+Republick had testified on the Impression of it; a Circumstance, which I
+could not avoid this publick Acknowledgement of, without the greatest
+Vanity and Ingratitude. This has also been a very influencing Motive
+with me, to exert my utmost Abilities in perfecting this new Edition, in
+which I have made many Alterations, that render it greatly preferable to
+the first; and of which Amendments I shall give a brief Account, after
+saying somewhat of the Editions, which have appeared elsewhere._
+
+_The first is that, which Messrs. *Heidegger*, the Booksellers published
+in the *German* Language at *Zurich*, about a Year since. I should have
+been highly delighted with the meer Approbation of *__M. Hirzel__*,
+first Physician of the Canton of *Zurich, &c.* whose superior and
+universal Talents; whose profound Knowledge in the Theory of Physick;
+and the Extent and Success of whose Practice have justly elevated him
+among the small Number of extraordinary Men of our own Times; he having
+lately obtained the Esteem and the Thanks of all *Europe,* for the
+History of one of her [3] Sages. But I little expected the Honour this
+Gentleman has done me, in translating the *Advice to the People* into
+his own Language. Highly sensible nevertheless as I am of this Honour, I
+must always reflect with Regret, that he has consumed that important
+Time, in rendering my Directions intelligible to his Countrymen, which
+he might have employed much more usefully, in obliging the World with
+his own._
+
+_He has enriched his Translation with an excellent Preface, which is
+chiefly employed in a just and beautiful Portrait and Contrast of the
+true, and of the false Physician; with which I should have done myself
+the Pleasure to have adorned the present [4] Edition; if the Size of
+this Volume, already too large, had not proved an Obstacle to so
+considerable an Addition; and if the Manner, in which *Mr.* *__Hirzel__*
+speaks of its Author, had permitted me with Decency to publish his
+Preface. I have been informed by some Letters, that there have been two
+other *German* Translation of it; but I am not informed by whom.
+However, *__M. Hirzel's__* Preface, his own Notes, and some Additions
+with which I have furnished him, renders his Edition preferable to the
+first in *French*, and to the other *German* Translations already made._
+
+ [3] _Le Socrate rustique_, a Work, which every Person should read.
+
+ [4] This Preface is indeed premised to this _French_ Edition, but a
+     Translation of it was omitted, to avoid extending the Bulk and
+     Price of the Work. Dr. _Tissot_ must then have been ignorant of
+     this Addition, when first published at _Lyons_.
+
+_The Second Edition is that, which the younger *__Didot__*, the
+Bookseller, published towards the End of the Winter at *Paris*. He had
+requested me to furnish him with some Additions to it, which I could not
+readily comply with._
+
+_The Third Edition is a *Dutch* Translation of it, which will be very
+speedily published by *__M. Renier Aremberg__*, Bookseller at
+*Rotterdam*. He had begun the Translation from my first Edition; but
+having wrote to know whether I had not some Additions to make, I desired
+him to wait for the Publication of this. I have the good Fortune to be
+very happy in my Translators; it being *__M. Bikker__*, a celebrated
+Physician at *Rotterdam* (so very advantagiously known in other
+Countries, by his beautiful *Dissertation on Human Nature*, throughout
+which Genius and Knowledge proceed Hand in Hand) who will present his
+Countrymen with the *Advice to the People*, in their own Language: and
+who will improve it with such Notes, as are necessary for a safe and
+proper Application of its Contents, in a Climate, different from that in
+which it was wrote. I have also heard, there has been an *Italian*
+Translation of it._
+
+_After this Account of the foreign Editions, I return to the present
+one, which is the second of the original *French* Treatise. I shall not
+affirm it is greatly corrected, with Respect to fundamental Points: for
+as I had advanced nothing in the first, that was not established on
+Truth and Demonstration, there was no Room for Correction, with Regard
+to any essential Matters. Nevertheless, in this I have made, 1, a great
+Number of small Alterations in the Diction, and added several Words, to
+render the Work still more simple and perspicuous. 2, The typographical
+Execution of this is considerably improved in the Type, the Paper and
+Ink, the Spelling, Pointing, and Arrangement of the Work. 3, I have made
+some considerable Additions, which are of three Kinds. Not a few of them
+are new Articles on some of the Subjects formerly treated of; such as
+the Articles concerning Tarts and other Pastry Ware; the Addition
+concerning the Regimen for Persons, in a State of Recovery from
+Diseases; the Preparation for the Small Pocks; a long Note on the
+Jesuits Bark; another on acid Spirits; one on the Extract of Hemlock:
+besides some new Matter which I have inserted; such as an Article with
+Regard to proper Drinks; one on the Convulsions of Infants; one on
+Chilblains; another on Punctures from Thorns; one upon the Reason of the
+Confidence reposed in Quacks, and the thirty-first Chapter entirely: in
+which I have extended the Consideration of some former Articles, that
+seemed to me a little too succinct and short. There are some Alterations
+of this last, this additional, Kind, interspersed almost throughout the
+whole Substance of this Edition; but especially in the two Chapters
+relating to Women and Children._
+
+_The Objects of the XXXI Chapter are such as require immediate
+Assistance, viz. Swoonings, Haemorrhages, that is, large spontaneous
+Bleedings; the Attacks of Convulsions, and of Suffocations; the
+Consequences of Fright and Terror; Disorders occasioned by unwholesome
+or deadly Vapours; the Effects of Poison, and the sudden Invasions of
+excessive Pain._
+
+_The Omission of this Chapter was a very material Defect in the original
+Plan of this Work. The Editor of it at Paris was very sensible of this
+Chasm, or Blank, as it may be called, and has filled it up very
+properly: and if I have not made Use of his Supplement, instead of
+enlarging myself upon the Articles of which he has treated, it has only
+been from a Purpose of rendering the whole Work more uniform; and to
+avoid that odd Diversity, which seems scarcely to be avoided in a
+Treatise composed by two Persons. Besides which, that Gentleman has said
+nothing of the Articles, which employ the greatest Part of that Chapter,
+*viz.* the Swoonings, the Consequences of great Fear, and the noxious
+Vapours._
+
+_Before I conclude, I ought to justify myself, as well as possible, to a
+great Number of very respectable Persons both here and abroad, (to whom
+I can refuse nothing without great Chagrine and Reluctance) for my not
+having made such Additions as they desired of me. This however was
+impossible, as the Objects, in which they concurred, were some chronical
+Distempers, that are entirely out of the Plan, to which I was strictly
+attached, for many Reasons. The first is, that it was my original
+Purpose to oppose the Errors incurred in Country Places, in the
+Treatment of acute Diseases; and to display the best Method of
+conducting such, as do not admit of waiting for the Arrival of distant
+Succour; or of removing the Patients to Cities, or large Towns. It is
+but too true indeed, that chronical Diseases are also liable to improper
+Treatment in small Country Places: but then there are both Time and
+Convenience to convey the Patients within the Reach of better Advice; or
+for procuring them the Attendance of the best Advisers, at their own
+Places of Residence. Besides which, such Distempers are considerably
+less common than those to which I had restrained my Views: and they will
+become still less frequent, whenever acute Diseases, of which they are
+frequently the Consequences, shall be more rationally and safely
+conducted._
+
+_The second Reason, which, if alone, would have been a sufficient one,
+is, that it is impossible to subject the Treatment of chronical
+Distempers to the Capacity and Conduct of Persons, who are not
+Physicians. Each acute Distemper generally arises from one Cause; and
+the Treatment of it is simple and uniform; since those Symptoms, which
+manifest the Malady, point out its Cause and Treatment. But the Case is
+very differently circumstanced in tedious and languid Diseases; each of
+which may depend on so many and various Causes (and it is only the real,
+the true Cause, which ought to determine us in selecting its proper
+Remedies) that though the Distemper and its Appellation are evidently
+known, a meer By-stander may be very remote from penetrating into its
+true Cause; and consequently be incapable of chusing the best Medicines
+for it. It is this precise and distinguishing Discernment of the real
+particular Cause *[or of the contingent Concurrence of more than one]*
+that necessarily requires the Presence of Persons conversant in the
+Study and the Practice of all the Parts of Physick; and which Knowledge
+it is impossible for People, who are Strangers to such Studies, to
+arrive at. Moreover, their frequent Complexness; the Variety of their
+Symptoms; the different Stages of these tedious Diseases [not exactly
+attended to even by many competent Physicians] the Difficulty of
+ascertaining the different Doses of Medicines, whose Activity may make
+the smallest Error highly dangerous, &c. &c. are really such trying
+Circumstances, as render the fittest Treatment of these Diseases
+sufficiently difficult and embarrassing to the most experienced
+Physicians, and unattainable by those who are not Physicians._
+
+_A third Reason is, that, even supposing all these Circumstances might
+be made so plain and easy, as to be comprehended by every Reader, they
+would require a Work of an excessive Length; and thence be
+disproportioned to the Faculties of those, for whom it was intended. One
+single chronical Disease might require as large a Volume as the present
+one._
+
+_But finally, were I to acknowledge, that this Compliance was both
+necessary and practicable, I declare I find it exceeds my Abilities; and
+that I am also far from having sufficient Leisure for the Execution of
+it. It is my Wish that others would attempt it, and may succeed in
+accomplishing it; but I hope these truly worthy Persons, who have
+honoured me by proposing the Achievement of it to myself, will perceive
+the Reasons for my not complying with it, in all their Force; and not
+ascribe a Refusal, which arises from the very Nature of the thing,
+either to Obstinacy, or to any Want of an Inclination to oblige them._
+
+_I have been informed my Citations, or rather References, have puzzled
+some Readers. It was difficult to foresee this, but is easy to prevent
+it for the future. The Work contains Citations only of two Sorts; one,
+that points to the Remedies prescribed; and the other, which refers to
+some Passage in the Book itself, that serves to illustrate those
+Passages in which I cite. Neither of these References could have been
+omitted. The first is marked thus, *No.* with the proper Figure to it,
+as 1, 2, &c. This signifies, that the Medicine I direct is described in
+the Table of Remedies, according to the Number annexed to that
+Character. Thus when we find directed, in any Page of the Book, the warm
+Infusion *No. 1*; in some other, the Ptisan *No. 2*; or in a third, the
+Almond Milk, or Emulsion *No. 4*, it signifies, that such Prescriptions
+will be found at the Numbers 1, 2, and 4; and this Table is printed at
+the End of the Book._
+
+_If, instead of forming this Table, and thus referring to the
+Prescriptions by their Numbers, I had repeated each Prescription as
+often as I directed it, this Treatise must have been doubled in Bulk,
+and insufferably tiresome to peruse. I must repeat here, what I have
+already said in the former Edition, that the [5] Prices of the
+Medicines, or of a great Number of them, are those at which the
+Apothecaries may afford them, without any Loss, to a Peasant in humble
+Circumstances. But it should be remembered, they are not set down at the
+full Prices which they may handily demand; since that would be unjust
+for some to insist on them at. Besides, there is no Kind of Tax in
+*Swisserland*, and I have no Right to impose one._
+
+ [5] The Reasons for omitting the Prices _here_, may be seen Page 23 of
+     this Translation.
+
+_The Citations of the second Kind are very plain and simple. The whole
+Work is divided into numbered Paragraphs distinguished by the Mark Sec..
+And not to swell it with needless Repetitions, when in one Place I might
+have even pertinently repeated something already observed, instead of
+such Repetition at Length, I have only referred to the Paragraph, where
+it had been observed. Thus, for Example when we read Page 81, Sec. 50
+--*When the Disease is so circumstanced as we have described*, Sec. 46,--
+this imports that, not to repeat the Description already given, I refer
+the Reader to that last Sec. for it._
+
+_The Use of these Citations is not the least Innovation, and extremely
+commodious and easy: but were there only a single Reader likely to be
+puzzled by them, I ought not to omit this Explanation of them, as I can
+expect to be generally useful, only in Proportion as I am clear: and it
+must be obvious, that a Desire of being extensively useful is the sole
+Motive of this Work. I have long since had the Happiness of knowing,
+that some charitable and intelligent Persons have applied the Directions
+it contains, with extraordinary Success, even in violent Diseases: And I
+shall arrive at the Height of my Wishes, if I continue to be informed,
+that it contributes to alleviate the Sufferings, and to prolong the
+Days, of my rational Fellow Creatures._
+
+_N. B._ A Small Blank occurring conveniently here in the Impression, the
+Translator of this Work has employed it to insert the following proper
+Remark, _viz._
+
+Whenever the Tea or Infusion of the Lime-tree is directed in the Body of
+the Book, which it often is, the _Flowers_ are always meant, and not the
+_Leaves_; though by an Error of the Press, or perhaps rather by an
+Oversight of the Transcribers of this Version, it is printed _Leaves_
+instead of _Flowers_ P. 392, as noted and corrected in the _Errata_.
+These Flowers are easily procurable here, meerly for gathering, in most
+Country Places in _July_, as few Walks, Vistas, &c. are without these
+Trees, planted for the pleasant Shade they afford, and to keep off the
+Dust in Summer, though the Leaf drops rather too early for this Purpose.
+Their Flowers have an agreeable Flavour, which is communicated to Water
+by Infusion, and rises with it in Distillation. They were, to the best
+of my Recollection, an Ingredient in the antiepileptic Water of
+_Langius_, omitted in our late Dispensatories of the College. They are
+an Ingredient in the antiepileptic Powder, in the List of Medicines in
+the present Practice of the _Hotel Dieu_ at _Paris_: and we think were
+in a former Prescription of our _Pulvis de Gutteta_, or Powder against
+Convulsions. Indeed they are considered, by many medical Writers, as a
+Specific in all Kinds of Spasms and Pains; and __Hoffman__ affirms, he
+knew a very tedious Epilepsy cured by the Use of an Infusion of these
+Flowers.
+
+I also take this Opportunity of adding, that as this Translation is
+intended for the Attention and the Benefit of the Bulk of the
+Inhabitants of the _British_ Empire, I have been careful not to admit
+any Gallicisms into it; as such might render it either less
+intelligible, or less agreeable to its Readers. If but a single one
+occurs, I either have printed it, or did intend it should be printed,
+distinguishably in Italics. _K._
+
+
+
+
+                            __Introduction.__
+
+
+The Decrease of the Number of Inhabitants, in most of the States of
+Europe, is a Fact, which impresses every reflecting Person, and is
+become such a general Complaint, as is but too well established on plain
+Calculations. This Decrease is most remarkable in Country Places. It is
+owing to many Causes; and I shall think myself happy, if I can
+contribute to remove one of the greatest of them, which is the
+pernicious Manner of treating sick People in Country Places. This is my
+sole Object, tho' I may be excused perhaps for pointing out the other
+concurring Causes, which may be all included within these two general
+Affirmations; That greater Numbers than usual emigrate from the Country;
+and that the People increase less every where.
+
+There are many Sorts of Emigration. Some leave their Country to enlist
+in the Service of different States by Sea and Land; or to be differently
+employ'd abroad, some as Traders, others as Domestics, _&c._
+
+Military Service, by Land or Sea, prevents Population in various
+Respects. In the first Place, the Numbers going abroad are always less,
+often _much_ less, than those who return. General Battles, with all the
+Hazards and Fatigues of War; detached Encounters, bad Provisions, Excess
+in drinking and eating, Diseases that are the Consequences of Debauches,
+the Disorders that are peculiar to the Country; epidemical, pestilential
+or contagious Distempers, caused by the unwholsome Air of Flanders,
+Holland, Italy and Hungary; long Cruises, Voyages to the East or West
+Indies, to Guinea, &c. destroy a great Number of Men. The Article of
+Desertion also, the Consequences of which they dread on returning home,
+disposes many to abandon their Country for ever. Others, on quitting the
+Service, take up with such Establishments, as it has occasionally thrown
+in their Way; and which necessarily prevent their Return. But in the
+second Place, supposing they were all to come back, their Country
+suffers equally from their Absence; as this very generally happens
+during that Period of Life, when they are best adapted for Propagation;
+since that Qualification on their Return is impaired by Age, by
+Infirmities and Debauches: and even when they do marry, the Children
+often perish as Victims to the Excesses and Irregularities of their
+Fathers: they are weak, languishing, distempered, and either die young,
+or live incapable of being useful to Society. Besides, that the
+prevailing Habit of Libertinage, which many have contracted, prevents
+several of them from marrying at all. But notwithstanding all these
+inconvenient Consequences are real and notorious; yet as the Number of
+those, who leave their Country on these Accounts, is limited, and indeed
+rather inconsiderable, if compared with the Number of Inhabitants which
+must remain at home: as it may be affirmed too, that this relinquishing
+of their Country, may have been even necessary at some Times, and may
+become so again, if the Causes of Depopulation should cease, this kind
+of Emigration is doubtless the least grievous of any, and the last which
+may require a strict Consideration.
+
+But that abandoning of their Country, or _Expatriation_, as it may be
+termed, the Object of which is a Change of the Emigrants Condition, is
+more to be considered, being more numerous. It is attended with many and
+peculiar Inconveniencies, and is unhappily become an epidemical Evil,
+the Ravages of which are still increasing; and that from one simple
+ridiculous Source, which is this; that the Success of one Individual
+determines a hundred to run the same Risque, ninety and nine of whom may
+probably be disappointed. They are struck with the apparent Success of
+one, and are ignorant of the Miscarriage of others. Suppose a hundred
+Persons might have set out ten Years ago, to _seek their Fortune_, as
+the saying is, at the End of six Months they are all forgotten, except
+by their Relations; but if one should return the same Year, with more
+Money than his own Fortune, more than he set out with; or if one of them
+has got a moderate Place with little Work, the whole Country rings with
+it, as a Subject of general Entertainment. A Croud of young People are
+seduced by this and sally forth, because not one reflects, that of the
+ninety nine, who set out with the hundredth Person, one half has
+perished, many are miserable, and the Remainder come back, without
+having gained any thing, but an Incapacity to employ themselves usefully
+at home, and in their former Occupations: and having deprived their
+Country of a great many Cultivaters, who, from the Produce of the Lands,
+would have attracted considerable Sums of Money, and many comfortable
+Advantages to it. In short, the very small Proportion who succeed, are
+continually talked of; the Croud that sink are perpetually forgot. This
+is a very great and real Evil, and how shall it be prevented? It would
+be sufficient perhaps to publish the extraordinary Risque, which may be
+easily demonstrated: It would require nothing more than to keep an exact
+yearly Register of all these Adventurers, and, at the Expiration of six,
+eight, or ten Years, to publish the List, with the Fate, of every
+Emigrant. I am greatly deceived, or at the End of a certain Number of
+Years, we should not see such Multitudes forsake their native Soil, in
+which they might live comfortably by working, to go in Search of
+Establishments in others; the Uncertainty of which, such Lists would
+demonstrate to them; and also prove, how preferable their Condition in
+their own Country would have been, to that they have been reduced to.
+People would no longer set out, but on almost certain Advantages: fewer
+would undoubtedly emigrate, more of whom, from that very Circumstance,
+must succeed. Meeting with fewer of their Country-men abroad, these
+fortunate few would oftner return. By this Means more Inhabitants would
+remain in the Country, more would return again, and bring with them more
+Money to it. The State would be more populous, more rich and happy; as
+the Happiness of a People, who live on a fruitful Soil, depends
+essentially on a great Number of Inhabitants, with a moderate Quantity
+of pecuniary Riches.
+
+But the Population of the Country is not only necessarily lessened, in
+Consequence of the Numbers that leave it; but even those who remain
+increase less, than an equal Number formerly did. Or, which amounts to
+the same Thing, among the same Number of Persons, there are fewer
+Marriages than formerly; and the same Number of Marriages produce fewer
+Christenings. I do not enter upon a Detail of the Proofs, since merely
+looking about us must furnish a sufficient Conviction of the Truth of
+them. What then are the Causes of this? There are two capital ones,
+Luxury and Debauchery, which are Enemies to Population on many Accounts.
+
+Luxury compells the wealthy Man, who would make a Figure; and the Man of
+a moderate Income, but who is his equal in every other Respect, and who
+_will_ imitate him, to be afraid of a numerous Family; the Education of
+which must greatly contract that Expence he had devoted to Parade and
+Ostentation: And besides, if he must divide his Estate among a great
+many Children, each of them would have but a little, and be unable to
+keep up the State and the Train of the Father's. Since Merit is unjustly
+estimated by exterior Shew and Expence, one must of Course endeavour to
+attain for himself, and to leave his Children in, a Situation capable of
+supporting that Expence. Hence the fewer Marriages of People who are not
+opulent, and the fewer Children among People who marry.
+
+Luxury is further prejudicial to the Increase of the People, in another
+Respect. The irregular Manner of Life which it introduces, depresses
+Health; it ruins the Constitutions, and thus sensibly affects
+Procreation. The preceding Generation counted some Families with more
+than twenty Children: the living one less than twenty Cousins. Very
+unfortunately this Way of thinking and acting, so preventive of
+Increase, has extended itself even into Villages: and they are no longer
+convinced there, that the Number of Children makes the Riches of the
+Countryman. Perhaps the next Generation will scarcely be acquainted with
+the Relation of Brotherhood.
+
+A third Inconvenience of Luxury is, that the Rich retreat from the
+Country to live in Cities; and by multiplying their Domestics there,
+they drain the former. This augmented Train is prejudicial to the
+Country, by depriving it of Cultivaters, and by diminishing Population.
+These Domestics, being seldom sufficiently employed, contract the Habit
+of Laziness; and they prove incapable of returning to that Country
+Labour, for which Nature intended them. Being deprived of this Resource
+they scarcely ever marry, either from apprehending the Charge of
+Children, or from their becoming Libertines; and sometimes, because many
+Masters will not employ married Servants. Or should any of them marry,
+it is often in the Decline of Life, whence the State must have the fewer
+Citizens.
+
+Idleness of itself weakens them, and disposes them to those Debauches,
+which enfeeble them still more. They never have more than a few
+Children, and these sickly; such as have not Strength to cultivate the
+Ground; or who, being brought up in Cities, have an Aversion to the
+Country.
+
+Even those among them who are more prudent, who preserve their Morals,
+and make some Savings, being accustomed to a City Life, and dreading the
+Labour of a Country one (of the Regulation of which they are also
+ignorant) chuse to become little Merchants, or Tradesmen; and this must
+be a Drawback from Population, as any Number of Labourers beget more
+Children than an equal Number of Citizens; and also by Reason, that out
+of any given Number, more Children die in Cities, than in the Country.
+
+The same Evils also prevail, with Regard to female Servants. After ten
+or twelve Years Servitude, the Maid-Servants in Cities cannot acquit
+themselves as good Country Servants: and such of them as chuse this
+Condition, quickly fail under that Kind or Quantity of Work, for which
+they are no longer constituted. Should we see a Woman married in the
+Country, a Year after leaving Town, it is easy to observe, how much that
+Way of living in the Country has broke her. Frequently their first
+Child-bed, in which Term they have not all the Attendance their Delicacy
+demands, proves the Loss of their Health; they remain in a State of
+Languor, of Feebleness, and of Decay: they have no more Children; and
+this renders their Husbands unuseful towards the Population of the
+State.
+
+Abortions, Infants carried out of their Country after a concealed
+Pregnancy, and the Impossibility of their getting Husbands afterwards,
+are frequently the Effects of their Libertinage.
+
+It is to be apprehended too these bad Effects are rather increasing with
+us; since, either for want of sufficient Numbers, or from oeconomical
+Views, it has become a Custom, instead of Women Servants, to employ
+Children, whose Manners and whole Constitutions are not yet formed; and
+who are ruined in the same Manner, by their Residence in Town, by their
+Laziness, by bad Examples, and bad Company.
+
+Doubtless much remains still unsaid on these important Heads; but
+besides my Intention not to swell this Treatise immoderately, and the
+many Avocations, which prevent me from launching too far into what may
+be less within the Bounds of Medicine, I should be fearful of digressing
+too far from my Subject. What I have hitherto said however, I think
+cannot be impertinent to it; since in giving Advice to the People, with
+Regard to their Health, it was necessary to display to them the Causes
+that impaired it: though what I might be able to add further on this
+Head, would probably be thought more remote from the Subject.
+
+I shall add then but a single Hint on the Occasion. Is it not
+practicable, in Order to remedy those Evils which we cannot prevent, to
+select some particular Part or Canton of the Country, wherein we should
+endeavour by Rewards, _1st._ Irremoveably to fix all the Inhabitants.
+_2dly._ To encourage them by other Rewards to a plentiful and legitimate
+Increase. They should not be permitted to go out of it, which must
+prevent them from being exposed to the Evils I have mentioned. They
+should by no means intermarry with any Strangers, who might introduce
+such Disorders among them. Thus very probably this Canton, after a
+certain Time, would become even over-peopled, and might send out
+Colonies to the others.
+
+One Cause, still more considerable than those we have already mention'd,
+has, to this very Moment, prevented the Increase of the People in
+France. This is the Decay of Agriculture. The Inhabitants of the
+Country, to avoid serving in the Militia; to elude the Days-Service
+impos'd by their Lords, and the Taxes; and being attracted to the City
+by the Hopes of Interest, by Laziness and Libertinage, have left the
+Country nearly deserted. Those who remain behind, either not being
+encouraged to work, or not being sufficient for what there is to do,
+content themselves with cultivating just as much as is absolutely
+necessary for their Subsistence. They have either lived single, or
+married but late; or perhaps, after the Example of the Inhabitants of
+the Cities, they have refused to fulfil their Duty to Nature, to the
+State, and to a Wife. The Country deprived of Tillers, by this
+Expatriation and Inactivity, has yielded nothing; and the Depopulation
+of the State has daily increased, from the reciprocal and necessary
+Proportion between Subsistence and Population, and because Agriculture
+alone can increase Subsistence. A single Comparison will sufficiently
+evince the Truth and the Importance of these Principles, to those who
+have not seen them already divulged and demonstrated in the Works of
+the [6] Friend of Man.
+
+ [6] The Marquis of Mirabeau.
+
+"An old Roman, who was always ready to return to the Cultivation of his
+Field, subsisted himself and his Family from one Acre of Land. A Savage,
+who neither sows nor cultivates, consumes, in his single Person, as much
+Game as requires fifty Acres to feed them. Consequently _Tullus
+Hostilius_, on a thousand Acres, might have five thousand Subjects:
+while a Savage Chief, limited to the same Extent of Territory, could
+scarcely have twenty: such an immense Disproportion does Agriculture
+furnish, in Favour of Population. Observe these two great Extremes. A
+State becomes dispeopled or peopled in that Proportion, by which it
+recedes from one of these Methods, and approaches to the other." Indeed
+it is evident, that wherever there is an Augmentation of Subsistence, an
+Increase of Population will soon follow; which again will still further
+facilitate the Increase of Provisions. In a State thus circumstanced Men
+will abound, who, after they have furnished sufficient Numbers for the
+Service of War, of Commerce, of Religion, and for Arts and Professions
+of every kind, will further also furnish a Source for Colonies, who will
+extend the Name and the Prosperity of their Nation to distant Regions.
+There will ensue a Plenty of Commodities, the Superfluity of which will
+be exported to other Countries, to exchange for other Commodities, that
+are not produced at home; and the Balance, being received in Money, will
+make the Nation rich, respectable by its Neighbours, and happy.
+Agriculture, vigorously pursued, is equal to the Production of all these
+Benefits; and the present Age will enjoy the Glory of restoring it, by
+favouring and encouraging Cultivaters, and by forming Societies for the
+Promotion of Agriculture.
+
+I proceed at length to the fourth Cause of Depopulation, which is the
+Manner of treating sick People in the Country. This has often affected
+me with the deepest Concern. I have been a Witness, that Maladies,
+which, in themselves, would have been gentle, have proved mortal from a
+pernicious Treatment: I am convinced that this Cause alone makes as
+great a Havock as the former; and certainly it requires the utmost
+Attention of Physicians, whose Duty it is to labour for the Preservation
+of Mankind. While we are employing our assiduous Cares on the more
+polished and fashionable Part of them in Cities, the larger and more
+useful Moiety perish in the Country; either by particular, or by highly
+epidemical, Diseases, which, within a few Years past, have appeared in
+different Villages, and made no small Ravages. This afflicting
+Consideration has determined me to publish this little Work, which is
+solely intended for those Patients, who, by their Distance from
+Physicians, are deprived of their Assistance. I shall not give a Detail
+of my Plan, which is very simple, in this Part; but content myself with
+affirming, I have used my utmost Care to render it the most useful I
+possibly could: and I dare hope, that if I have not fully displayed its
+utmost Advantages, I have at least sufficiently shewn those pernicious
+Methods of treating Diseases, that should incontestably be avoided. I am
+thoroughly convinced, the Design might be accomplished more compleatly
+than I have done it; but those who are so capable of, do not attempt,
+it: I happen to be less timid; and I hope that thinking Persons will
+rather take it in good part of me, to have published a Book, the
+composing of which is rather disagreeable from its very Facility; from
+the minute Details, which however are indispensable; and from the
+Impossibility of discussing any Part of it (consistently with the Plan)
+to the Bottom of the Subject; or of displaying any new and useful
+Prospect. It may be compared, in some Respects, to the Works of a
+spiritual Guide, who was to write a Catechism for little Children.
+
+At the same time I am not ignorant there have already been a few Books
+calculated for Country Patients, who are remote from Succour: but some
+of these, tho' published with a very good Purpose, produce a bad Effect.
+Of this kind are all Collections of Receipts or Remedies, without the
+least Description of the Disease; and of Course without just Directions
+for the Exhibition, or Application, of them. Such, for Example, is the
+famous Collection of Madam _Fouquet_, and some more in the same manner.
+Some others approach towards my Plan; but many of them have taken in too
+many Distempers, whence they are become too voluminous. Besides, they
+have not dwelt sufficiently upon the Signs of the Diseases; upon their
+Causes; the general Regimen in them, and the Mismanagement of them.
+Their Receipts are not generally as simple, and as easy to prepare, as
+they ought to be. In short, the greater Part of their Writers seem, as
+they advanced, to have grown tired of their melancholy Task, and to have
+hurried them out too expeditiously. There are but two of them, which I
+must name with Respect, and which being proposed on a Plan very like my
+own, are executed in a superior Manner, that merits the highest
+Acknowlegements of the Publick. One of these Writers is M. _Rosen_,
+first Physician of the Kingdom of _Sweden_; who, some Years since,
+employed his just Reputation to render the best Services to his Country
+Men. He has made them retrench from the Almanacs those ridiculous Tales;
+those extraordinary Adventures; those pernicious astrological
+Injunctions, which there, as well as here, answer no End, but that of
+keeping up Ignorance, Credulity, Superstition, and the falsest
+Prejudices on the interesting Articles of Health, of Diseases, and of
+Remedies. He has also taken Care to publish simple plain Treatises on
+the most popular Distempers; which he has substituted in the Place of
+the former Heap of Absurdities. These concise Works however, which
+appear annually in their Almanacs, are not yet translated from the
+_Swedish_, so that I was unqualified to make any Extracts from them. The
+other is the Baron _Van Swieten_, first Physician to their Imperial
+Majesties, who, about two Years since, has effected for the Use of the
+Army, what I now attempt for sick People in the Country. Though my Work
+was greatly advanced, when I first saw his, I have taken some Passages
+from it: and had our Plans been exactly alike, I should imagine I had
+done the Publick more Service by endeavouring to extend the Reading of
+his Book, than by publishing a new one. Nevertheless, as he is silent on
+many Articles, of which I have treated diffusively; as he has treated of
+many Distempers, which did not come within my Plan; and has said nothing
+of some others which I could not omit; our two Works, without entering
+into the Particulars of the superior Merit of the Baron's, are very
+different, with Regard to the Subject of the Diseases; tho' in such as
+we have both considered, I account it an Honour to me to find, we have
+almost constantly proceeded upon the same Principles.
+
+The present Work is by no means addressed to such Physicians, as are
+thoroughly accomplished in their Profession; yet possibly, besides my
+particular medical Friends, some others may read it. I beg the Favour of
+all such fully to consider the Intention, the Spirit, of the Author, and
+not to censure him, as a Physician, from the Composition of this Book. I
+even advise them here rather to forbear perusing it; as a Production,
+that can teach them nothing. Such as read, in order to criticize, will
+find a much greater Scope for exercising that Talent on the other
+Pamphlets I have published. It were certainly unjust that a Performance,
+whose sole abstracted Object is the Health and Service of my Countrymen,
+should subject me to any disagreeable Consequences: and a Writer may
+fairly plead an Exemption from any Severity of Censure, who has had the
+Courage to execute a Work, which cannot pretend to a Panegyric.
+
+Having premised thus much in general, I must enter into some Detail of
+those Means, that seem the most likely to me, to facilitate the
+beneficial Consequences, which, I hope, may result to others, from my
+present Endeavours. I shall afterwards give an Explanation of some Terms
+which I could not avoid using, and which, perhaps, are not generally
+understood.
+
+The Title of _Advice to the People_, was not suggested to me by an
+Illusion, which might persuade me, this Book would become a Piece of
+Furniture, as it were, in the House of every Peasant. Nineteen out of
+twenty will probably never know of its Existence. Many may be unable to
+read, and still more unable to understand, it, plain and simple as it
+is. I have principally calculated it for the Perusal of intelligent and
+charitable Persons, who live in the Country; and who seem to have, as it
+were, a Call from Providence, to assist their less intelligent poor
+Neighbours with their Advice.
+
+It is obvious, that the first Gentlemen I have my Eye upon, are the
+Clergy. There is not a single Village, a Hamlet, nor even the House of
+an Alien in the Country, that has not a Right to the good Offices of
+some one of this Order; And I assure myself there are a great Number of
+them, who, heartily affected with the Distress of their ailing Flocks,
+have wished many hundred Times, that it were in their Power to give
+their Parishioners some bodily Help, at the very Time they were
+disposing them to prepare for Death; or so far to delay the Fatality of
+the Distemper, that the Sick might have an Opportunity of living more
+religiously afterwards. I shall think myself happy, if such truly
+respectable Ecclesiastics shall find any Resources in this Performance,
+that may conduce to the Accomplishment of their beneficent Intentions.
+Their Regard, their Love for their People; their frequent Invitations to
+visit their principal Neighbours; their Duty to root out all
+unreasonable Prejudices, and Superstition; their Charity, their
+Learning; the Facility, with which their general Knowlege in Physics,
+qualifies them to comprehend thoroughly all the medical Truths, and
+Contents of this Piece, are so many Arguments to convince me, that they
+will have the greatest Influence to procure that Reformation, in the
+Administration of Physick to poor Country People, which is so necessary,
+so desirable, an Object.
+
+In the next Place, I dare assure myself of the Concurrence of Gentlemen
+of Quality and Opulence, in their different Parishes and Estates, whose
+Advice is highly regarded by their Inferiors; who are so powerfully
+adapted to discourage a wrong, and to promote a right Practice, of which
+they will easily discern all the Advantages. The many Instances I have
+seen of their entering, with great Facility, into all the Plan and
+Conduct of a Cure; their Readiness and even Earnestness to comfort the
+Sick in their Villages; and the Generosity with which they prevent their
+Necessities, induce me to hope, from judging of these I have not the
+Pleasure to know, by those whom I have, that they will eagerly embrace
+an Opportunity of promoting a new Method of doing good in their
+Neighbourhood. Real Charity will apprehend the great Probability there
+is of doing Mischief, tho' with the best Intention, for want of a proper
+Knowledge of material Circumstances; and the very Fear of that Mischief
+may sometimes suspend the Exercise of such Charity; notwithstanding it
+must seize, with the most humane Avidity, every Light that can
+contribute to its own beneficent Exertion.
+
+Thirdly, Persons who are rich, or at least in easy Circumstances, whom
+their Disposition, their Employments, or the Nature of their Property,
+fixes in the Country, where they are happy in doing good, must be
+delighted to have some proper Directions for the Conduct and
+Effectuation of their charitable Intentions.
+
+In every Village, where there are any Persons, of these three
+Conditions, they are always readily apprized of the Distempers in it, by
+their poor Neighbours coming to intreat a little Soup, Venice Treacle,
+Wines, Biscuits, or any thing they imagine necessary for their sick
+Folks. In Consequence of some Questions to the Bystanders, or of a Visit
+to the sick Person, they will judge at least of _what kind_ the Disease
+is; and by their prudent Advice they may be able to prevent a Multitude
+of Evils. They will give them some Nitre instead of Venice Treacle;
+Barley, or sweet Whey, in lieu of Soup. They will advise them to have
+Recourse to Glysters, or Bathings of their Feet, rather than to Wine;
+and order them Gruel rather than Biscuits. A man would scarcely believe,
+'till after the Expiration of a few Years, how much Good might be
+effected by such proper Regards, so easily comprehended, and often
+repeated. At first indeed there may be some Difficulty in eradicating
+old Prejudices, and inveterately bad Customs; but whenever these were
+removed, good Habits would strike forth full as strong Roots, and I hope
+that no Person would be inclined to destroy them.
+
+It may be unnecessary to declare, that I have more Expectation from the
+Care and Goodness of the Ladies, than from those of their Spouses, their
+Fathers, or Brothers. A more active Charity, a more durable Patience, a
+more domestic Life; a Sagacity, which I have greatly admired in many
+Ladies both in Town and Country, that disposes them to observe, with
+great Exactness; and to unravel, as it were, the secret Causes of the
+Symptoms, with a Facility that would do Honour to very good Practioners,
+and with a Talent adapted to engage the Confidence of the Patient:--All
+these, I say, are so many characteristical Marks of their Vocation in
+this important and amicable Duty; nor are there a few, who fulfil it
+with a Zeal, that merits the highest Commendation, and renders them
+excellent Models for the Imitation of others.
+
+Those who are intrusted with the Education of Youth, may also be
+supposed sufficiently intelligent to take some Part in this Work; and I
+am satisfied that much Good might result from their undertaking it. I
+heartily wish, they would not only study to _distinguish the Distemper_
+(in which the principal, but by no means an insuperable Difficulty
+consists; and to which I hope I have considerably put them in the Way)
+but I would have them learn also the Manner of applying Remedies. Many
+of them have; I have known some who bleed, and who have given Glysters
+very expertly. This however all may easily learn; and perhaps it would
+not be imprudent, if the Art of bleeding well and safely were reckoned a
+necessary Qualification, when they are examined for their Employment.
+These Faculties, that of estimating the Degree of a Fever, and how to
+apply and to dress Blisters, may be of great Use within the
+Neighbourhood of their Residence. Their Schools, which are not
+frequently over-crouded, employ but a few of their daily Hours; the
+greater part of them have no Land to cultivate; and to what better Use
+can they apply their Leisure, than to the Assistance and Comfort of the
+Sick? The moderate Price of their Service may be so ascertained, as to
+incommode no Person; and this little Emolument might render their own
+Situation the more agreeable: besides which, these little Avocations
+might prevent their being drawn aside sometimes, by Reason of their
+Facility and frequent Leisure, so as to contract a Habit of drinking too
+often. Another Benefit would also accrue from accustoming them to this
+kind of Practice, which is, that being habituated to the Care of sick
+People, and having frequent Occasions to write, they would be the better
+qualify'd, in difficult Cases, to advise with those, who were thought
+further necessary to be consulted.
+
+Doubtless, even among Labourers, there may be many, for some such I have
+known, who being endued with good natural Sense and Judgment, and
+abounding with Benevolence, will read this Book with Attention, and
+eagerly extend the Maxims and the Methods it recommends.
+
+And finally I hope that many Surgeons, who are spread about the Country,
+and who practice Physic in their Neighbourhood, will peruse it; will
+carefully enter into the Principles established in it, and will conform
+to its Directions; tho' a little different perhaps from such as they may
+have hitherto practiced. They will perceive a Man may learn at any Age,
+and of any Person; and it may be hoped they will not think it too much
+Trouble to reform some of their Notions in a Science, which is not
+properly within their Profession (and to the Study of which they were
+never instituted) by those of a Person, who is solely employed in it,
+and who has had many Assistances of which they are deprived.
+
+Midwives may also find their Attendance more efficacious, as soon as
+they are thoroughly disposed to be better informed.
+
+It were heartily to be wished, that the greater Part of them had been
+better instructed in the Art they profess. The Instances of Mischief
+that might have been avoided, by their being better qualify'd, are
+frequent enough to make us wish there may be no Repetition of them,
+which it may be possible to prevent. Nothing seems impossible, when
+Persons in Authority are zealously inclined to prevent every such Evil;
+and it is time they should be properly informed of one so essentially
+hurtful to Society.
+
+The Prescriptions I have given consist of the most simple Remedies, and
+I have adjoined the Manner of preparing them so fully, that I hope no
+Person can be at any Loss in that Respect. At the same time, that no one
+may imagine they are the less useful and efficacious for their
+Simplicity, I declare, they are the same I order in the City for the
+most opulent Patients. This Simplicity is founded in Nature: the
+Mixture, or rather the Confusion, of a Multitude of Drugs is ridiculous.
+If they have the very same Virtues, for what Purpose are they blended?
+It were more judicious to confine ourselves to that, which is the most
+effectual. If their Virtues are different, the Effect of one destroys,
+or lessens, the Effect of the other; and the Medicine ceases to prove a
+Remedy.
+
+I have given no Direction, which is not very practicable and easy to
+execute; nevertheless it will be discernible, that some few are not
+calculated for the Multitude, which I readily grant. However I have
+given them, because I did not lose Sight of some Persons; who, tho' not
+strictly of the Multitude, or Peasantry, do live in the Country, and
+cannot always procure a Physician as soon, or for as long a Time, as
+they gladly would.
+
+A great Number of the Remedies are entirely of the Country Growth, and
+may be prepared there; but there are others, which must be had from the
+Apothecaries. I have set down the Price [7] at which I am persuaded all
+the Country Apothecaries will retail them to a Peasant, who is not
+esteemed a rich one. I have marked the Price, not from any Apprehension
+of their being imposed on in the Purchase, for this I do not apprehend;
+but, that seeing the Cheapness of the Prescription, they may not be
+afraid to buy it. The necessary Dose of the Medicine, for each Disease,
+may generally be purchased for less Money than would be expended on
+Meat, Wine, Biscuits, and other improper things. But should the Price of
+the Medicine, however moderate, exceed the Circumstances of the Sick,
+doubtless the Common Purse, or the Poors-Box will defray it: moreover
+there are in many Country Places Noblemens Houses, some of whom
+charitably contribute an annual Sum towards buying of Medicines for poor
+Patients. Without adding to which Sum, I would only intreat the Favour
+of each of them to alter the Objects of it, and to allow their sick
+Neighbours the Remedies and the Regimen directed here, instead of such
+as they formerly distributed among them.
+
+ [7] This oeconomical Information was doubtless very proper, where our
+     judicious and humane Author published it; but notwithstanding his
+     excellent Motives for giving it, we think it less necessary here,
+     where many Country Gentlemen furnish themselves with larger or
+     smaller Medicine Chests, for the Benefit of their poor sick
+     Neighbours; and in a Country, where the settled parochial Poor are
+     provided with Medicines, as well as other Necessaries, at a
+     parochial Expence. Besides, tho' we would not suppose our Country
+     Apothecaries less considerate or kind than others, we acknowledge
+     our Apprehension, that in such Valuation of their Drugs (some of
+     which often vary in their Price) might dispose a few of them,
+     rather to discountenance the Extension of a Work, so well intended
+     and executed as Dr. _Tissot's_; a Work, which may not be wholly
+     unuseful to some of the most judicious among them, and will be
+     really necessary for the rest. _K._
+
+It may still be objected, that many Country Places are very distant from
+large Towns; from which Circumstance a poor Peasant is incapable of
+procuring himself a seasonable and necessary Supply in his Illness. I
+readily admit, that, in Fact, there are many Villages very remote from
+such Places as Apothecaries reside in. Yet, if we except a few among the
+Mountains, there are but very few of them above three or four Leagues
+from some little Town, where there always lives some Surgeon, or some
+Vender of Drugs. Perhaps however, even at this Time, indeed, there may
+not be many thus provided; but they will take care to furnish themselves
+with such Materials, as soon as they have a good Prospect of selling
+them, which may constitute a small, but new, Branch of Commerce for
+them. I have carefully set down the Time, for which each Medicine will
+keep, without spoiling. There is a very frequent Occasion for some
+particular ones, and of such the School-masters may lay in a Stock. I
+also imagine, if they heartily enter into my Views, they will furnish
+themselves with such Implements, as may be necessary in the Course of
+their Attendance. If any of them were unable to provide themselves with
+a sufficient Number of good Lancets, an _Apparatus_ for Cupping, and a
+Glyster Syringe (for want of which last a Pipe and Bladder may be
+occasionally substituted) the Parish might purchase them, and the same
+Instruments might do for the succeeding School-master. It is hardly to
+be expected, that all Persons in that Employment would be able, or even
+inclined, to learn the Way of using them with Address; but one Person
+who did, might be sufficient for whatever Occasions should occur in this
+Way in some contiguous Villages; with very little Neglect of their
+Functions among their Scholars.
+
+Daily Instances of Persons, who come from different Parts to consult me,
+without being capable of answering the Questions I ask them, and the
+like Complaints of many other Physicians on the same Account, engaged me
+to write the last Chapter of this Work. I shall conclude this
+Introduction with some Remarks, necessary to facilitate the Knowledge of
+a few Terms, which were unavoidable in the Course of it.
+
+The Pulse commonly beats in a Person in good Health, from the Age of
+eighteen or twenty to about sixty six Years, between sixty and seventy
+Times in a Minute. It sometimes comes short of this in old Persons, and
+in very young Children it beats quicker: until the Age of three or four
+Years the Difference amounts at least to a third; after which it
+diminishes by Degrees.
+
+An intelligent Person, who shall often touch and attend to his own
+Pulse, and frequently to other Peoples, will be able to judge, with
+sufficient Exactness, of the Degree of a Fever in a sick Person. If the
+Strokes are but one third above their Number in a healthy State, the
+Fever is not very violent: which it is, as often as it amounts to half
+as many more as in Health. It is very highly dangerous, and may be
+generally pronounced mortal, when there are two Strokes in the Time of
+one. We must not however judge of the Pulse, solely by its Quickness,
+but by its Strength or Weakness; its Hardness or Softness; and the
+Regularity or Irregularity of it.
+
+There is no Occasion to define the strong and the feeble Pulse. The
+Strength of it generally affords a good Prognostic, and, supposing it
+too strong, it may easily be lowered. The weak Pulse is often very
+menacing.
+
+If the Pulse, in meeting the Touch, excites the Notion of a dry Stroke,
+as though the Artery consisted of Wood, or of some Metal, we term it
+_hard_; the opposite to which is called _soft_, and generally promises
+better. If it be strong and yet soft, even though it be quick, it may be
+considered as a very hopeful Circumstance. But if it is strong and hard,
+that commonly is a Token of an Inflammation, and indicates Bleeding and
+the cooling Regimen. Should it be, at the same time, small, quick and
+hard, the Danger is indeed very pressing.
+
+We call that Pulse regular, a continued Succession of whole Strokes are
+made in equal Intervals of Time; and in which Intervals, not a single
+Stroke is wanting (since if that is its State, it is called an
+intermitting Pulse.) The Beats or Pulsations are also supposed to
+resemble each other so exactly in Quality too, that one is not strong,
+and the next alternately feeble.
+
+As long as the State of the Pulse is promising; Respiration or Breathing
+is free; the Brain does not seem to be greatly affected; while the
+Patient takes his Medicines, and they are attended with the Consequence
+that was expected; and he both preserves his Strength pretty well, and
+continues sensible of his Situation, we may reasonably hope for his
+Cure. As often as all, or the greater Number of these characterizing
+Circumstances are wanting, he is in very considerable Danger.
+
+The Stoppage of Perspiration is often mentioned in the Course of this
+Work. We call the Discharge of that Fluid which continually passes off
+through the Pores of the Skin, _Transpiration_; and which, though
+invisible, is very considerable. For if a Person in Health eats and
+drinks to the Weight of eight Pounds daily, he does not discharge four
+of them by Stool and Urine together, the Remainder passing off by
+insensible Transpiration. It may easily be conceived, that if so
+considerable a Discharge is stopt, or considerably lessened; and if this
+Fluid, which ought to transpire through the Skin, should be transfered
+to any inward Part, it must occasion some dangerous Complaint. In fact
+this is one of the most frequent Causes of Diseases.
+
+To conclude very briefly--All the Directions in the following Treatise
+are solely designed for such Patients, as cannot have the Attendance of
+a Physician. I am far from supporting, they ought to do instead of one,
+even in those Diseases, of which I have treated in the fullest Manner;
+and the Moment a Physician arrives, they ought to be laid aside. The
+Confidence reposed in him should be entire, or there should be none. The
+Success of the Event is founded in that. It is his Province to judge of
+the Disease, to select Medicines against it; and it is easy to foresee
+the Inconveniences that may follow, from proposing to him to consult
+with any others, preferably to those he may chuse to consult with; only
+because they have succeeded in the Treatment of another Patient, whose
+Case they suppose to have been nearly the same with the present Case.
+This were much the same, as to order a Shoemaker to make a Shoe for one
+Foot by the Pattern of another Shoe, rather than by the Measure he has
+just taken.
+
+_N. B._ Though a great Part of this judicious Introduction is less
+applicable to the political Circumstances of the British Empire, than to
+those of the Government for which it was calculated; we think the good
+Sense and the unaffected Patriotism which animate it, will supersede any
+Apology for our translating it. The serious Truth is this, that a
+thorough Attention to Population seems never to have been more expedient
+for ourselves, than after so bloody and expensive, though such a
+glorious and successful War: while our enterprizing Neighbours, who will
+never be our Friends, are so earnest to recruit their Numbers; to
+increase their Agriculture; and to force a Vent for their Manufactures,
+which cannot be considerably effected, without a sensible Detriment to
+our own. Besides which, the unavoidable Drain from the People here,
+towards an effectual Cultivation, Improvement, and Security of our
+Conquests, demands a further Consideration. _K._
+
+
+
+
+                       _ADVICE_ _TO THE_ _PEOPLE_,
+
+
+                    With Respect to their _HEALTH._
+
+                            *__Chapter I.__*
+
+
+
+            _Of the most usual Causes of popular Maladies._
+
+
+                              __Sect.__ 1.
+
+The most frequent Causes of Diseases commonly incident to Country People
+are, 1. Excessive Labour, continued for a very considerable Time.
+Sometimes they sink down at once in a State of Exhaustion and Faintness,
+from which they seldom recover: but they are oftener attacked with some
+inflammatory Disease; as a Quinsey, a Pleurisy, or an Inflammation of
+the Breast.
+
+There are two Methods of preventing these Evils: one is, to avoid the
+Cause which produces them; but this is frequently impossible. Another
+is, when such excessive Labour has been unavoidable, to allay their
+Fatigue, by a free Use of some temperate refreshing Drink; especially by
+sweet Whey, by Butter-milk, or by [8] Water, to a Quart of which a
+Wine-glass of Vinegar may be added; or, instead of that, the expressed
+Juice of Grapes not fully ripe, or even of Goosberries or Cherries:
+which wholesome and agreeable Liquors are refreshing and cordial. I
+shall treat, a little lower, of inflammatory Disorders. The Inanition or
+Emptiness, though accompanied with Symptoms different from the former,
+have yet some Affinity to them with Respect to their Cause, which is a
+kind of general Exsiccation or Dryness. I have known some cured from
+this Cause by Whey, succeeded by tepid Baths, and afterwards by Cow's
+Milk: for in such Cases hot Medicines and high Nourishment are fatal.
+
+ [8] This supposes they are not greatly heated, as well as fatigued, by
+     their Labour or Exercise, in which Circumstance free and sudden
+     Draughts of cooling Liquors might be very pernicious: and it
+     evidently also supposes these Drinks to be thus given, rather in
+     Summer, than in very cold Weather, as the Juice of the unripe
+     Grapes, and the other fresh Fruits sufficiently ascertain the
+     Season of the Year. We think the Addition of Vinegar to their Water
+     will scarcely ever be necessary in this or the adjoining Island, on
+     such Occasions. The Caution recommended in this Note is abundantly
+     enforced by Dr. _Tissot_, Sec. 4: but considering the Persons, to whom
+     this Work is more particularly addressed, we were willing to
+     prevent every Possibility of a Mistake, in so necessary, and
+     sometimes so vital a Point. _K._
+
+Sec. 2. There is another Kind of Exhaustion or Emptiness, which may be
+termed real Emptiness, and is the Consequence of great Poverty, the Want
+of sufficient Nourishment, bad Food, unwholesome Drink, and excessive
+Labour. In Cases thus circumstanced, good Soups and a little Wine are
+very proper. Such happen however very seldom in this Country: I believe
+they are frequent in some others, especially in many Provinces of
+_France_.
+
+Sec. 3. A second and very common Source of Disorders arises, from Peoples'
+lying down and reposing, when very hot, in a cold Place. This at once
+stops Perspiration, the Matter of which being thrown upon some internal
+Part, proves the Cause of many violent Diseases, particularly of
+Quinseys, Inflammations of the Breast, Pleurisies, and inflammatory
+Cholics. These Evils, from this Cause, may always be avoided by avoiding
+the Cause, which is one of those that destroy a great Number of People.
+However, when it has occurred, as soon as the first Symptoms of the
+Malady are perceiveable, which sometimes does not happen till several
+Days after, the Patient should immediately be bled; his Legs should be
+put into Water moderately hot, and he should drink plentifully of the
+tepid Infusion marked No. 1. Such Assistances frequently prevent the
+Increase of these Disorders; which, on the contrary, are greatly
+aggravated, if hot Medicines are given to sweat the Patient.
+
+Sec. 4. A third Cause is drinking cold Water, when a Person is extremely
+hot. This acts in the same Manner with the second; but its Consequences
+are commonly more sudden and violent. I have seen most terrible Examples
+of it, in Quinseys, Inflammations of the Breast, Cholics, Inflammations
+of the Liver, and all the Parts of the Belly, with prodigious Swellings,
+Vomitings, Suppressions of Urine, and inexpressible Anguish. The most
+available Remedies in such Cases, from this Cause, are, a plentiful
+Bleeding at the Onset, a very copious Drinking of warm Water, to which
+one fifth Part of Whey should be added; or of the Ptisan No. 2, or of an
+Emulsion of Almonds, all taken warm. Fomentations of warm Water should
+also be applied to the Throat, the Breast and Belly, with Glysters of
+the same, and a little Milk. In this Case, as well as in the preceding
+one, (Sec. 3.) a _Semicupium_, or Half-bath of warm Water has sometimes
+been attended with immediate Relief. It seems really astonishing, that
+labouring People should so often habituate themselves to this pernicious
+Custom, which they know to be so very dangerous to their very Beasts.
+There are none of them, who will not prevent their Horses from drinking
+while they are hot, especially if they are just going to put them up.
+Each of them knows, that if he lets them drink in that State, they might
+possibly burst with it; nevertheless he is not afraid of incurring the
+like Danger himself. However, this is not the only Case, in which the
+Peasant seems to have more Attention to the Health of his Cattle, than
+to his own.
+
+Sec. 5. The fourth Cause, which indeed affects every Body, but more
+particularly the Labourer, is, the Inconstancy of the Weather. We shift
+all at once, many times a Day, from Hot to Cold, and from Cold to Hot,
+in a more remarkable Manner, and more suddenly, than in most other
+Countries. This makes Distempers from Defluxion and Cold so common with
+us: and it should make us careful to go rather a little more warmly
+cloathed, than the Season may seem to require; to have Recourse to our
+Winter-cloathing early in Autumn, and not to part with it too early in
+the Spring. Prudent Labourers, who strip while they are at Work, take
+care to put on their Cloaths in the Evening when they return home. [9]
+Those, who from Negligence, are satisfied with hanging them upon their
+Country Tools, frequently experience, on their Return, the very unhappy
+Effects of it. There are some, tho' not many Places, where the Air
+itself is unwholsome, more from its particular Quality, than from its
+Changes of Temperature, as at _Villeneuve_, and still more at _Noville_,
+and in some other Villages situated among the Marshes which border on
+the _Rhone_. These Countries are particularly subject to intermitting
+Fevers; of which I shall treat briefly hereafter.
+
+ [9] This good Advice is enforced in a Note, by the Editor of _Lyons_,
+     who observes, it should be still more closely attended to, in
+     Places, where Rivers, Woods or Mountains retain, as it were, a
+     considerable Humidity; and where the Evenings are, in every Season,
+     cold and moist.--It is a very proper Caution too in our own
+     variable Climate, and in many of our Colonies in North _America_.
+     _K._
+
+Sec. 6. Such sudden Changes are often attended with great Showers of Rain,
+and even cold Rain, in the Middle of a very hot Day; when the Labourer
+who was bathed, as it were, in a hot Sweat, is at once moistened in cold
+Water; which occasions the same Distempers, as the sudden Transition
+from Heat to Cold, and requires the same Remedies. If the Sun or a hot
+Air succeed immediately to such a Shower, the Evil is considerably
+lighter: but if the Cold continues, many are often greatly incommoded by
+it.
+
+A Traveller is sometimes thoroughly and unavoidably wet with Mud; the
+ill Consequence of which is often inconsiderable, provided he changes
+his Cloaths immediately, when he sets up. I have known fatal Pleurisies
+ensue from omitting this Caution. Whenever the Body or the Limbs are
+wet, nothing can be more useful than bathing them in warm Water. If the
+Legs only have been wet, it may be sufficient to bath them. I have
+radically, thoroughly, cured Persons subject to violent Cholics, as
+often as their Feet were wet, by persuading them to pursue this Advice.
+The Bath proves still more effectual, if a little Soap be dissolved in
+it.
+
+Sec. 7. A fifth Cause, which is seldom attended to, probably indeed because
+it produces less violent Consequences, and yet is certainly hurtful, is
+the common Custom in all Villages, of having their Ditches or Dunghills
+directly under their Windows. Corrupted Vapours are continually exhaling
+from them, which in Time cannot fail of being prejudicial, and must
+contribute to produce putrid diseases. Those who are accustomed to the
+Smell, become insensible of it: but the Cause, nevertheless, does not
+cease to be unwholesomly active; and such as are unused to it perceive
+the Impression in all its Force.
+
+Sec. 8. There are some Villages, in which, after the Curtain Lines are
+erased, watery marshy Places remain in the Room of them. The Effect of
+this is still more dangerous, because that putrify'd Water, which
+stagnates during the hot Season, suffers its Vapours to exhale more
+easily, and more abundantly, than that in the Curtain Lines did. Having
+set out for _Pully le Grand_, in 1759, on Account of an epidemical
+putrid Fever which raged there, I was sensible, on traversing the
+Village, of the Infection from those Marshes; nor could I doubt of their
+being the Cause of this Disease, as well as of another like it, which
+had prevailed there five Years before. In other Respects the Village is
+wholesomly situated. It were to be wished such Accidents were obviated
+by avoiding these stagnated Places; or, at least, by removing them and
+the Dunghils, as far as possible from the Spot, where we live and lodge.
+
+Sec. 9. To this Cause may also be added the Neglect of the Peasants to air
+their Lodgings. It is well known that too close an Air occasions the
+most perplexing malignant Fevers; and the poor Country People respire no
+other in their own Houses. Their Lodgings, which are very small, and
+which notwithstanding inclose, (both Day and Night) the Father, Mother,
+and seven or eight Children, besides some Animals, are never kept open
+during six Months in the Year, and very seldom during the other six. I
+have found the Air so bad in many of these Houses, that I am persuaded,
+if their Inhabitants did not often go out into the free open Air, they
+must all perish in a little Time. It is easy, however, to prevent all
+the Evils arising from this Source, by opening the Windows daily: so
+very practicable a Precaution must be followed with the happiest
+Consequences.
+
+Sec. 10. I consider Drunkenness as a sixth Cause, not indeed as producing
+epidemical Diseases, but which destroys, as it were, by Retail, at all
+times, and every where. The poor Wretches, who abandon themselves to it,
+are subject to frequent Inflammations of the Breast, and to Pleurisies,
+which often carry them off in the Flower of their Age. If they sometimes
+escape through these violent Maladies, they sink, a long Time before the
+ordinary Approach of old Age, into all its Infirmities, and especially
+into an Asthma, which terminates in a Dropsy of the Breast. Their
+Bodies, worn out by Excess, do not comply and concur, as they ought,
+with the Force or Operation of Remedies; and Diseases of Weakness,
+resulting from this Cause, are almost always incurable. It seems happy
+enough, that Society loses nothing in parting with these Subjects, who
+are a Dishonour to it; and whose brutal Souls are, in some Measure,
+dead, long before their Carcases.
+
+Sec. 11. The Provisions of the common People are also frequently one Cause
+of popular Maladies. This happens 1st, whenever the Corn, not well
+ripened, or not well got in, in bad [10] _Harvests_, has contracted an
+unwholesome Quality. Fortunately however this is seldom the Case; and
+the Danger attending the Use of it, may be lessened by some Precautions,
+such as those of washing and drying the Grain completely; of mixing a
+little Wine with the Dough, in kneading it; by allowing it a little more
+Time to swell or rise, and by baking it a little more. 2dly, The fairer
+and better saved Part of the Wheat is sometimes damaged in the Farmers
+House; either because he does not take due Care of it, or because he has
+no convenient Place to preserve it, only from one Summer to the next. It
+has often happened to me, on entering one of these bad Houses, to be
+struck with the Smell of Wheat that has been spoiled. Nevertheless,
+there are known and easy Methods to provide against this by a little
+Care; though I shall not enter into a Detail of them. It is sufficient
+to make the People sensible, that since their chief Sustenance consists
+of Corn, their Health must necessarily be impaired by what is bad. 3dly,
+That Wheat, which is good, is often made into bad Bread, by not letting
+it rise sufficiently; by baking it too little, and by keeping it too
+long. All these Errors have their troublesome Consequences on those who
+eat it; but in a greater Degree on Children and Valetudinarians, or
+weakly People.
+
+[10] Thus I have ventured to translate _Etes_ (_Summers_) to apply it to
+     this and the neighbouring Islands. Their Harvests in _Swisserland_
+     perhaps are earlier, and may occur in _August_, and that of some
+     particular Grain, probably still earlier. _K._
+
+Tarts or Cakes may be considered as an Abuse of Bread, and this in some
+Villages is increased to a very pernicious Height. The Dough is almost
+constantly bad, and often unleavened, ill baked, greasy, and stuffed
+with either fat or sour Ingredients, which compound one of the most
+indigestible Aliments imaginable. Women and Children consume the most of
+this Food, and are the very Subjects for whom it is the most improper:
+little Children especially, who live sometimes for many successive Days
+on these Tarts, are, for the greater Part, unable to digest them
+perfectly. Hence they receive a [11] Source of Obstructions in the
+Bowels of the Belly, and of a slimy Viscidity or Thickishness,
+throughout the Mass of Humours, which throws them into various Diseases
+from Weakness; slow Fevers, a Hectic, the Rickets, the King's Evil, and
+Feebleness; for the miserable Remainder of their Days. Probably indeed
+there is nothing more unwholesome than Dough not sufficiently leavened,
+ill-baked, greasy, and soured by the Addition of Fruits. Besides, if we
+consider these Tarts in an oeconomical View, they must be found
+inconvenient also for the Peasant on that Account.
+
+[11] The Abuse just mentioned can scarcely be intended to forbid the
+     moderate Use of good Pastry, the Dough of which is well raised and
+     well baked, the Flower and other Ingredients sound, and the Paste
+     not overcharged with Butter, even though it were sweet and fresh.
+     But the Abuse of Alum and other pernicious Materials introduced by
+     our Bakers, may too justly be considered as one horrible Source of
+     those Diseases of Children, &c. which our humane and judicious
+     Author mentions here. What he adds, concerning the Pastries being
+     rendered still more unwholesome by the sour Fruits sometimes baked
+     in it, is true with Respect to those Children and others, who are
+     liable to Complaints from Acidities abounding in the Bowels; and
+     for all those who are ricketty or scrophulous, from a cold and
+     viscid State of their Humours. But as to healthy sanguine Children,
+     who are advanced and lively, and others of a sanguine or bilious
+     Temperament, we are not to suppose a moderate Variety of this Food
+     injurious to them; when we consider, that the Sharpness and Crudity
+     of the Fruit is considerably corrected by the long Application of
+     Fire; and that they are the Produce of Summer, when bilious
+     Diseases are most frequent. This suggests however no bad Hint
+     against making them immoderately sweet. _K._
+
+Some other Causes of Maladies may also be referred to the Article of
+Food, tho' less grievous and less frequent, into a full Detail of which
+it is very difficult to enter: I shall therefore conclude that Article
+with this general Remark; that it is the Care which Peasants usually
+take in eating slowly, and in chewing very well, that very greatly
+lessens the Dangers from a bad Regimen: and I am convinced they
+constitute one of the greatest Causes of that Health they enjoy. We may
+further add indeed the Exercise which the Peasant uses, his long abiding
+in the open Air, where he passes three fourths of his Life; besides
+(which are also considerable Advantages) his happy Custom of going soon
+to Bed, and of rising very early. It were to be wished, that in these
+Respects, and perhaps on many other Accounts, the Inhabitants of the
+Country were effectually proposed as Models for reforming the Citizens.
+
+Sec. 12. We should not omit, in enumerating the Causes of Maladies among
+Country People, the Construction of their Houses, a great many of which
+either lean, as it were, close to a higher Ground, or are sunk a little
+in the Earth. Each of these Situations subjects them to considerable
+Humidity; which is certain greatly to incommode the Inhabitants, and to
+spoil their Provisions, if they have any Quantity in Store; which, as we
+have observed, is another, and not the least important, Source of their
+Diseases. A hardy Labourer is not immediately sensible of the bad
+Influence of this moist and marshy Habitation; but they operate at the
+long Run, and I have abundantly observed their most evident bad Effects,
+especially on Women in Child-bed, on Children, and in Persons recovering
+of a preceding Disease. It would be easy to prevent this Inconvenience,
+by raising the Ground on which the House stood, some, or several, Inches
+above the Level of the adjacent Soil, by a Bed of Gravel, of small
+Flints, pounded Bricks, Coals, or such other Materials; and by avoiding
+to build immediately close to, or, as it were, under a much higher Soil.
+This Object, perhaps, may well deserve the Attention of the Publick; and
+I earnestly advise as many as do build, to observe the necessary
+Precautions on this Head. Another, which would cost still less Trouble,
+is to give the Front of their Houses an Exposure to the South-East. This
+Exposure, supposing all other Circumstances of the Building and its
+Situation to be alike, is both the most wholesome and advantageous. I
+have seen it, notwithstanding, very often neglected, without the least
+Reason being assigned for not preferring it.
+
+These Admonitions may possibly be thought of little Consequence by three
+fourths of the People. I take the Liberty of reminding them, however,
+that they are more important than they may be supposed; and so many
+Causes concur to the Destruction of Men, that none of the Means should
+be neglected, which may contribute to their Preservation.
+
+Sec. 13. The Country People in _Swisserland_ drink, either 1, pure Water,
+2, some Wine, 3, Perry, made from wild Pears, or sometimes Cyder from
+Apples, and, 4, a small Liquor which they call _Piquette_, that is
+Water, which has fermented with the Cake or Husks of the Grapes, after
+their Juice has been expressed. Water however is their most general
+Drink; Wine rarely falling in their Way, but when they are employed by
+rich Folks; or when they can spare Money enough for a Debauch. Fruit
+Wines and the [12] _Piquettes_ are not used in all Parts of the Country;
+they are not made in all Years; and keep but for some Months.
+
+[12] This Word's occurring in the plural Number will probably imply, the
+     _Swiss_ make more than one Species of this small Drink, by pouring
+     Water on the Cake or Remainder of their other Fruits, after they
+     have been expressed; as our People in the Cyder, and perhaps in the
+     Perry, Counties, make what they call _Cyderkin_, _Perkin_, _&c._ It
+     should seem too from this Section, that the laborious Countrymen in
+     _Swisserland_ drink no Malt Liquor, though the Ingredients may be
+     supposed to grow in their Climate. Now Beer, of different Strength,
+     making the greater Part of our most common Drink, it may be proper
+     to observe here, that when it is not strong and heady, but a
+     middling well-brewed Small-beer, neither too new, nor hard or sour,
+     it is full as wholesome a Drink for laborious People in Health as
+     any other, and perhaps generally preferable to Water for such;
+     which may be too thin and light for those who are unaccustomed to
+     it; and more dangerous too, when the labouring Man is very hot, as
+     well as thirsty. The holding a Mouthful of any weak cold Liquor in
+     the Mouth without swallowing 'till it becomes warm, there, and
+     spurting it out before a Draught is taken down would be prudent;
+     and in Case of great Heat, to take the requisite Quantity rather at
+     two Draughts, with a little Interval between them, than to swallow
+     the Whole precipitately at one, would be more safe, and equally
+     refreshing, though perhaps less grateful. _K._
+
+Our Waters in general, are pretty good; so that we have little Occasion
+to trouble ourselves about purifying them; and they are well known in
+those Provinces where they are chiefly and necessarily used. [13] The
+pernicious Methods taken to improve or meliorate, as it is falsely
+called, bad Wines, are not as yet sufficiently practiced among us, for
+me to treat of them here: and as our Wines are not hurtful, of
+themselves, they become hurtful only from their Quantity. The
+Consumption of made Wines and _Piquettes_ is but inconsiderable, and I
+have not hitherto known of any ill Effects from them, so that our
+Liquors cannot be considered as Causes of Distempers in our Country; but
+in Proportion to our Abuse of them by Excess. The Case is differently
+circumstanced in some [14] other Countries; and it is the Province of
+Physicians who reside in them, to point out to their Country-Men the
+Methods of preserving their Health; as well as the proper and necessary
+Remedies in their Sickness.
+
+[13] The bad Quality of Water is another common Cause of Country
+     Diseases; either where the Waters are unwholesome, from the Soils
+     in which they are found, as when they flow through, or settle, on
+     Banks of Shells; or where they become such, from the Neighbourhood
+     of, or Drainings from Dunghills and Marshes.
+
+     When Water is unclear and turbid, it is generally sufficient to let
+     it settle in order to clear itself, by dropping its Sediment. But
+     if that is not effected, or if it be slimy or muddy, it need only
+     be poured into a large Vessel, half filled with fine Sand, or, for
+     want of that, with Chalk; and then to shake and stir it about
+     heartily for some Minutes. When this Agitation is over, the Sand,
+     in falling to the Bottom of the Vessel, will attract some of the
+     Foulness suspended in the Water. Or, which is still better, and
+     very easy to do, two large Vessels may be set near together, one of
+     which should be placed considerably higher than the other. The
+     highest should be half filled with Sand. Into this the turbid, or
+     slimy muddy Water is to be poured; whence it will filter itself
+     through the Body of Sand, and pass off clear by an Opening or
+     Orifice made at the Bottom of the Vessel; and fall from thence into
+     the lower one, which serves as a Reservoir. When the Water is
+     impregnated with Particles from the Beds of Selenites, or of any
+     Spar (which Water we call hard, because Soap will not easily
+     dissolve in it, and Puls and other farinaceous Substances grow hard
+     instead of soft, after boiling in it) such Water should be exposed
+     to the Sun, or boiled with the Addition of some Puls, or leguminous
+     Vegetables, or Bread toasted, or untoasted. When Water is in its
+     putrid State, it may be kept till it recovers its natural sweet
+     one: but if this cannot be waited for, a little Sea Salt should be
+     dissolved in it, or some Vinegar may be added, in which some
+     grateful aromatic Plant has been infused. It frequently happens,
+     that the publick Wells are corrupted by foul Mud at the Bottom, and
+     by different Animals which tumble in and putrify there. Drinking
+     Snow-water should be avoided, when the Snow is but lately fallen,
+     as it seems to be the Cause of those swelling wenny Throats in the
+     Inhabitants of some Mountains; and of endemic Cholics in many
+     Persons. As Water is so continually used, great Care should be
+     taken to have what is good. Bad Water, like bad Air, is one of the
+     most general Causes of Diseases; that which produces the greater
+     Number of them, the most grieveous ones; and often introduces such
+     as are epidemical. _E. L. i.e._ the Editor of Lyons.
+
+[14] Many Persons, With a Design to preserve their Wines, add Shot to
+     them, or Preparations of Lead, Alum, &c. The Government should
+     forbid, under the most severe Penalties, all such Adulterations, as
+     tend to introduce the most painful Cholics, Obstruction, and a long
+     Train of Evils, which it sometimes proves difficult to trace to
+     this peculiar Cause; while they shorten the lives of, or cruelly
+     torment, such over credulous Purchasers, as lay in a Stock of bad
+     Wines, or drink of them, without distinction, from every Wine
+     Merchant or Tavern. _E. L._
+
+     _This Note, from the Editor at_ Lyons, _we have sufficient Reason
+     for retaining here. K._
+
+
+
+
+                             __Chapter II.__
+
+
+   _Of the Causes which aggravate the Diseases of the People. General
+                            Considerations._
+
+
+                             __Sect.__ 14.
+
+The Causes already enumerated in the first Chapter occasion Diseases;
+and the bad Regimen, or Conduct of the People, on the Invasion of them,
+render them still more perplexing, and very often mortal.
+
+There is a prevailing Prejudice among them, which is every Year attended
+with the Death of some Hundreds in this Country, and it is this--That
+all Distempers are cured by Sweat; and that to procure Sweat, they must
+take Abundance of hot and heating things, and keep themselves very hot.
+This is a Mistake in both Respects, very fatal to the Population of the
+State; and it cannot be too much inculcated into Country People; that by
+thus endeavouring to force Sweating, at the very Beginning of a Disease,
+they are with great Probability, taking Pains to kill themselves. I have
+seen some Cases, in which the continual Care to provoke this Sweating,
+has as manifestly killed the Patient, as if a Ball had been shot through
+his Brains; as such a precipitate and untimely Discharge carries off the
+thinner Part of the Blood, leaving the Mass more dry, more viscid and
+inflamed. Now as in all acute Diseases (if we except a very few, and
+those too much less frequent) the Blood is already too thick; such a
+Discharge must evidently increase the Disorder, by co-operating with its
+Cause. Instead of forcing out the watery, the thinner Part of the Blood,
+we should rather endeavour to increase it. There is not a single Peasant
+perhaps, who does not say, when he has a Pleurisy, or an Inflammation of
+his Breast, that his Blood is too thick, and that it cannot circulate.
+On seeing it in the Bason after Bleeding, he finds it _black, dry,
+burnt_; these are his very Words. How strange is it then, that common
+Sense should not assure him, that, far from forcing out the _Serum_, the
+watery Part, of such a Blood by sweating, there is a Necessity to
+increase it?
+
+Sec. 15. But supposing it were as certain, as it is erroneous, that
+Sweating was beneficial at the Beginning of Diseases, the Means which
+they use to excite it would not prove the less fatal. The first
+Endeavour is, to stifle the Patient with the Heat of a close Apartment,
+and a Load of Covering. Extraordinary Care is taken to prevent a Breath
+of fresh Air's squeezing into the Room; from which Circumstance, the Air
+already in it is speedily and extremely corrupted: and such a Degree of
+Heat is procured by the Weight of the Patient's Bed-cloaths, that these
+two Causes alone are sufficient to excite a most ardent Fever, and an
+Inflammation of the Breast, even in a healthy Man. More than once have I
+found myself seized with a Difficulty of breathing, on entering such
+Chambers, from which I have been immediately relieved, on obliging them
+to open all the Windows. Persons of Education must find a Pleasure, I
+conceive, in making People understand, on these Occasions, which are so
+frequent, that the Air being more indispensably necessary to us, if
+possible, than Water is to a Fish, our Health must immediately suffer,
+whenever that ceases to be pure; in assuring them also, that nothing
+corrupts it sooner than those Vapours, which continually steam from the
+Bodies of many Persons inclosed within a little Chamber, from which the
+Air is excluded. The Absurdity of such Conduct is a self-evident
+Certainty. Let in a little fresh Air on these miserable Patients, and
+lessen the oppressing Burthen of their Coverings, and you generally see
+upon the Spot, their Fever and Oppression, their Anguish and Raving, to
+abate.
+
+Sec. 16. The second Method taken to raise a Sweat in these Patients is, to
+give them nothing but hot things, especially Venice Treacle, Wine, or
+some [15] _Faltranc_, the greater Part of the Ingredients of which are
+dangerous, whenever there is an evident Fever; besides Saffron, which is
+still more pernicious. In all feverish Disorders we should gently cool,
+and keep the Belly moderately open; while the Medicines just mentioned
+both heat and bind; and hence we may easily judge of their inevitable
+ill Consequences. A healthy Person would certainly be seized with an
+inflammatory Fever, on taking the same Quantity of Wine, of Venice
+Treacle, or of _Faltranc_, which the Peasant takes now and then, when he
+is attacked by one of these Disorders. How then should a sick Person
+escape dying by them? Die indeed he _generally_ does, and sometimes with
+astonishing Speed. I have published some dreadful Instances of such
+Fatality some Years since, in another Treatise. In fact they still daily
+occur, and unhappily every Person may observe some of them in his own
+Neighbourhood.
+
+[15] This Word, which must be of German, not of French Extraction,
+     strictly signifies, _Drink for a Fall_, as we say _Pulvis ad
+     Casum_, &c. Powder for a Fall, or a supposed inward Bruise. Dr.
+     _Tissot_ informs me, it is otherwise called the vulnerary Herbs, or
+     the Swiss Tea; and that it is an injudicious _Farrago_ or Medley of
+     Herbs and Flowers, blended with Bitters, with stimulating, harsh
+     and astringent Ingredients, being employed indiscriminately in all
+     their Distempers by the Country People in _Swisserland_. _K._
+
+Sec. 17. But I shall be told perhaps, that Diseases are often carried off
+by Sweat, and that we ought to be guided by Experience. To this I
+answer, it is very true, that Sweating cures some particular Disorders,
+as it were, at their very Onset, for Instance, those Stitches that are
+called spurious or false Pleurisies, some rheumatic Pains, and some
+Colds or Defluxions. But this only happens when the Disorders depend
+solely and simply on stopt or abated Perspiration, to which such Pain
+instantly succeeds; where immediately, before the Fever has thickened
+the Blood, and inflamed the Humours; and where before any internal
+Infarction, any Load, is formed, some warm Drinks are given, such as
+_Faltranc_ and Honey; which, by restoring Transpiration, remove the very
+Cause of the Disorder. Nevertheless, even in such a Case, great Care
+should be had not to raise too violent a Commotion in the Blood, which
+would rather restrain, than promote, Sweat, to effect which
+Elder-flowers are in my Opinion preferable to _Faltranc_. Sweating is
+also of Service in Diseases, when their Causes are extinguished, as it
+were, by plentiful Dilution: then indeed it relieves, by drawing off,
+with itself, some Part of the distempered Humours; after which their
+grosser Parts have passed off by Stool and by Urine: besides which, the
+Sweat has also served to carry off that extraordinary Quantity of Water,
+we were obliged to convey into the Blood, and which was become
+superfluous there. Under such Circumstances, and at such a Juncture, it
+is of the utmost Importance indeed, not to check the Sweat, whether by
+Choice, or for Want of Care. There might often be as much Danger in
+doing this, as there would have been in endeavouring to force a Sweat,
+immediately upon the Invasion of the Disorder; since the arresting of
+this Discharge, under the preceding Circumstances, might frequently
+occasion a more dangerous Distemper, by repelling the Humour on some
+inward vital Part. As much Care therefore should be taken not to check,
+imprudently, that Evacuation by the Skin, which naturally occurs towards
+the Conclusion of Diseases, as not to force it at their Beginning; the
+former being almost constantly beneficial, the latter as constantly
+pernicious. Besides, were it even necessary, it might be very dangerous
+to force it violently; since by heating the Patients greatly, a vehement
+Fever is excited; they become scorched up in a Manner, and the Skin
+proves extremely dry. Warm Water, in short, is the best of Sudorifics.
+
+If the Sick are sweated very plentifully for a Day or two, which may
+make them easier for some Hours; these Sweats soon terminate, and cannot
+be excited again by the same Medicines. The Dose thence is doubled, the
+Inflammation is increased, and the Patient expires in terrible Anguish,
+with all the Marks of a general Inflammation. His Death is ascribed to
+his Want of Sweating; when it really was the Consequence of his Sweating
+too much at first; and of his taking Wine and hot Sudorifics. An able
+Swiss Physician had long since assured his Countrymen, that Wine was
+fatal to them in Fevers; I take leave to repeat it again and again, and
+wish it may not be with as little Success.
+
+Our Country Folks, who in Health, naturally dislike red Wine, prefer it
+when Sick; which is wrong, as it binds them up more than white Wine. It
+does not promote Urine as well; but increases the Force of the
+circulating Arteries, and the Thickness of the Blood, which were already
+too considerable.
+
+Sec. 18. Their Diseases are also further aggravated by the Food that is
+generally given them. They must undoubtedly prove weak, in Consequence
+of their being sick; and the ridiculous Fear of the Patients' dying of
+Weakness, disposes their Friends to force them to eat; which, increasing
+their Disorder, renders the Fever mortal. This Fear is absolutely
+chimerical; never yet did a Person in a Fever die merely from Weakness.
+They may be supported, even for some Weeks, by Water only; and are
+stronger at the End of that Time, than if they had taken more solid
+Nourishment; since, far from strengthening them, their Food increases
+their Disease, and thence increases their Weakness.
+
+Sec. 19. From the first Invasion of a Fever, Digestion ceases. Whatever
+solid Food is taken corrupts, and proves a Source of Putridity, which
+adds nothing to the Strength of the Sick, but greatly to that of the
+Distemper. There are in fact a thousand Examples to prove, that it
+becomes a real Poison: and we may sensibly perceive these poor
+Creatures, who are thus compelled to eat, lose their Strength, and fall
+into Anxiety and Ravings, in Proportion as they swallow.
+
+Sec. 20. They are also further injured by the Quality, as well as the
+Quantity, of their Food. They are forced to sup strong Gravey Soups,
+Eggs, Biscuits, and even Flesh, if they have but just Strength and
+Resolution to chew it. It seems absolutely impossible for them to
+survive all this Trash. Should a Man in perfect Health be compelled to
+eat stinking Meat, rotten Eggs, stale sour Broth, he is attacked with as
+violent Symptoms, as if he had taken real Poison, which, in Effect, he
+has. He is seized with Vomiting, Anguish, a violent Purging, and a
+Fever, with Raving, and eruptive Spots, which we call the Purple Fever.
+Now when the very same Articles of Food, in their soundest State, are
+given to a Person in a Fever, the Heat, and the morbid Matter already in
+his Stomach, quickly putrify them; and after a few Hours produce all the
+abovementioned Effects. Let any Man judge then, if the least Service can
+be expected from them.
+
+Sec. 21. It is a Truth established by the first of Physicians, above two
+thousand Years past, and still further ratified by his Successors, that
+as long as a sick Person has a bad Humour or Ferment in his Stomach, his
+Weakness increases, in Proportion to the Food he receives. For this
+being corrupted by the infected Matter it meets there, proves incapable
+of nourishing, and becomes a conjunct or additional Cause of the
+Distemper.
+
+The most observing Persons constantly remark, that whenever a feverish
+Patient sups, what is commonly called some good Broth, the Fever gathers
+Strength and the Patient Weakness. The giving such a Soup or Broth,
+though of the freshest soundest Meat, to a Man who has a high Fever, or
+putrid Humours in his Stomach, is to do him exactly the same service, as
+if you had given him, two or three Hours later, stale putrid Soup.
+
+Sec. 22. I must also affirm, that this fatal Prejudice, of keeping up the
+Patients' Strength by Food, is still too much propagated, even among
+those very Persons, whose Talents and whose Education might be expected
+to exempt them from any such gross Error. It were happy for Mankind, and
+the Duration of their Lives would generally be more extended, if they
+could be thoroughly persuaded of this medical, and so very demonstrable,
+Truth;--That the only things which can strengthen sick Persons are
+those, which are able to weaken their Disease; but their Obstinacy in
+this Respect is inconceivable: it is another Evil superadded to that of
+the Disease, and sometimes the more grievous one. Out of twenty sick
+Persons, who are lost in the Country, more than two Thirds might often
+have been cured, if being only lodged in a Place defended from the
+Injuries of the Air, they were supplied with Abundance of good Water.
+But that most mistaken Care and Regimen I have been treating of,
+scarcely suffers one of the twenty to survive them.
+
+Sec. 23. What further increases our Horror at this enormous Propensity to
+heat, dry up, and cram the sick is, that it is totally opposite to what
+Nature herself indicates in such Circumstances. The burning Heat of
+which they complain; the Dryness of the Lips, Tongue and Throat; the
+flaming high Colour of their Urine; the great Longing they have for
+cooling things; the Pleasure and sensible Benefit they enjoy from fresh
+Air, are so many Signs, or rather Proofs, which cry out with a loud
+Voice, that we ought to attemperate and cool them moderately, by all
+means. Their foul Tongues, which shew the Stomach to be in the like
+Condition; their Loathing, their Propensity to vomit, their utter
+Aversion to all solid Food, and especially to Flesh; the disagreeable
+Stench of their Breath; their Discharge of fetid Wind upwards and
+downwards, and frequently the extraordinary Offensiveness of their
+Excrements, demonstrate, that their Bowels are full of putrid Contents,
+which must corrupt all the Aliments superadded to them; and that the
+only thing, which can prudently be done, is to dilute and attemper them
+by plentiful Draughts of refreshing cooling Drinks, which may promote an
+easy Discharge of them. I affirm it again, and I heartily wish it may be
+thoroughly attended to, that as long as there is any Taste of
+Bitterness, or of Putrescence; as long as there is a _Nausea_ or
+Loathing, a bad Breath, Heat and Feverishness with fetid Stools, and
+little and high-coloured Urine; so long all flesh, and Flesh-Soup, Eggs,
+and all kind of Food composed of them, or of any of them, and all Venice
+Treacle, Wine, and all heating things are so many absolute Poisons.
+
+Sec. 24. I may possibly be censured as extravagant and excessive on these
+Heads by the Publick, and even by some Physicians: but the true and
+enlightened Physicians, those who attend to the Effects of every
+Particular, will find on the contrary, that far from exceeding in this
+Respect, I have rather feebly expressed their own Judgment, in which
+they agree with that of all the good ones, who have existed within more
+than two thousand Years; that very Judgment which Reason approves, and
+continual Experience confirms. The Prejudices I have been contending
+against have cost _Europe_ some Millions of Lives.
+
+Sec. 25. Neither should it be omitted, that even when a Patient has very
+fortunately escaped Death, notwithstanding all this Care to obtain it,
+the Mischief is not ended; the Consequences of the high Aliments and
+heating Medicines being, to leave behind the Seed, the Principle, of
+some low and chronical Disease; which increasing insensibly, bursts out
+at length, and finally procures him the Death he has even wished for, to
+put an End to his tedious Sufferings.
+
+Sec. 26. I must also take Notice of another dangerous common Practice;
+which is that of purging, or vomiting a Patient, at the very Beginning
+of a Distemper. Infinite Mischiefs are occasioned by it. There are some
+Cases indeed, in which evacuating Medicines, at the Beginning of a
+Disease, are convenient and even necessary. Such Cases shall be
+particularly mentioned in some other Chapters: but as long as we are
+unacquainted with them, it should be considered as a general Rule, that
+they are hurtful at the Beginning; this being true very often; and
+always, when the Diseases are strictly inflammatory.
+
+Sec. 27. It is hoped by their Assistance, at that Time, to remove the Load
+and Oppression of the Stomach, the Cause of a Disposition to vomit, of a
+dry Mouth, of Thirst, and of much Uneasiness; and to lessen the Leaven
+or Ferment of the Fever. But in this Hope they are very often deceived;
+since the Causes of these Symptoms are seldom of a Nature to yield to
+these Evacuations. By the extraordinary Viscidity or Thickness of the
+Humours, that foul the Tongue, we should form our Notions of those,
+which line the Stomach and the Bowels. It may be washed, gargled and
+even scraped to very little good Purpose. It does not happen, until the
+Patient has drank for many Days, and the Heat, the Fever and the great
+Siziness of the Humours are abated, that this Filth can he thoroughly
+removed, which by Degrees separates of itself. The State of the Stomach
+being conformable to that of the Tongue, no Method can effectually scour
+and clean it at the Beginning: but by giving refreshing and diluting
+Remedies plentifully, it gradually frees itself; and the Propensity to
+vomit, with its other Effects and Uneasinesses, go off naturally, and
+without Purges.
+
+Sec. 28. Neither are these Evacuations only negatively wrong, merely from
+doing no Good; for considerable Evil positively ensues from the
+Application of those acrid irritating Medicines, which increase the Pain
+and Inflammation; drawing the Humours upon those Parts that were already
+overloaded with them; which by no means expel the Cause of the Disease,
+that not being at this time fitted for Expulsion, as not sufficiently
+concocted or ripe: and yet which, at the same Time, discharge the
+thinnest Part of the Blood, whence the Remainder becomes more thick; in
+short which carry off the useful, and leave the hurtful Humours behind.
+
+Sec. 29. The Vomit especially, being given in an inflammatory Disease, and
+even without any Distinction in all acute ones, before the Humours have
+been diminished by Bleeding, and diluted by plentiful small Drinks, is
+productive of the greatest Evils; of Inflammations of the Stomach, of
+the Lungs and Liver, of Suffocations and Frenzies. Purges sometimes
+occasion a general Inflammation of the Guts, which [16] terminates in
+Death. Some Instances of each of these terrible Consequences have I
+seen, from blundering Temerity, Imprudence and Ignorance. The Effect of
+such Medicines, in these Circumstances, are much the same with those we
+might reasonably expect, from the Application of Salt and Pepper to a
+dry, inflamed and foul Tongue, in Order to moisten and clean it.
+
+[16] It is pretty common to _hear_ of Persons recovering from
+     Inflammations of the Bowels, or Guts, which our Author more justly
+     and ingenuously considers as general Passports to Death: for it is
+     difficult to conceive, that a real and _considerable_ Inflammation
+     of such thin, membranous, irritable Parts, lined with such
+     putrescent Humours and Contents, and in so hot and close a
+     Situation, could be restored to a sound and healthy State _so
+     often_ as Rumour affirms it. This makes it so important a Point, to
+     avert every Tendency to an Inflammation of these feculent Parts, as
+     to justify a Bleeding directed, solely, from this Precaution, and
+     which might have been no otherwise indicated by a Disease, attended
+     with any Symptom, that threatened such an Inflammation. But when a
+     Person recovers, there can be no anatomical Search for such
+     Inflammations, or its Effects, the real or imaginary Cure of which
+     may well amaze the Patient, and must greatly redound to the Honour
+     of his Prescriber; so that there may be Policy sometimes in giving
+     a moderate Disease a very bad Name. _K._
+
+Sec. 30. Every Person of sound plain Sense is capable of perceiving the
+Truth of whatever I have advanced in this Chapter: and there would be
+some Degree of Prudence, even in those who do not perceive the real good
+Tendency of my Advice, not to defy nor oppose it too hardily. The
+Question relates to a very important Object; and in a Matter quite
+foreign to themselves, they undoubtedly owe some Deference to the
+Judgment of Persons, who have made it the Study and Business of their
+whole Lives. It is not to myself that I hope for their Attention, but to
+the greatest Physicians, whose feeble Instrument and Eccho I am. What
+Interest have any of us in forbidding sick People to eat, to be stifled,
+or to drink such heating things as heighten their Fever? What Advantage
+can accrue to us from opposing the fatal Torrent, which sweeps them off?
+What Arguments can persuade People, that some thousand Men of Genius, of
+Knowledge, and of Experience, who pass their Lives among a Croud and
+Succession of Patients; who are entirely employed to take Care of them,
+and to observe all that passes, have been only amusing and deceiving
+themselves, on the Effects of Food, of Regimen and of Remedies? Can it
+enter into any sensible Head, that a Nurse, who advises Soup, an Egg, or
+a Biscuit, deserves a Patient's Confidence, better than a Physician who
+forbids them? Nothing can be more disagreeable to the latter, than his
+being obliged to dispute continually in Behalf of the poor Patients; and
+to be in constant Terror, lest this mortally officious Attendance, by
+giving such Food as augments all the Causes of the Disease, should
+defeat the Efficacy of all the Remedies he administers to remove it; and
+should fester and aggravate the Wound, in Proportion to the Pains he
+takes to dress it. The more such absurd People love a Patient, the more
+they urge him to eat, which, in Effect, verifies the Proverb of _killing
+one with Kindness_.
+
+
+
+
+                            __Chapter III.__
+
+
+ _Of the Means that ought to be used, at the Beginning of Diseases; and
+                    of the Diet in acute Diseases._
+
+
+                             __Sect.__ 31.
+
+I have clearly shewn the great Dangers of the Regimen, or Diet, and of
+the principal Medicines too generally made Use of by the Bulk of the
+People, on these Occasions. I must now point out the actual Method they
+may pursue, without any Risque, on the Invasion of some acute Diseases,
+and the general Diet which agrees with them all. As many as are desirous
+of reaping any Benefit from this Treatise, should attend particularly to
+this Chapter; since, throughout the other Parts of it, in Order to avoid
+Repetitions, I shall say nothing of the Diet, except the particular
+Distemper shall require a different one, from that of which I am now to
+give an exact Detail. And whenever I shall say in general, that a
+Patient is to be put upon a Regimen, it will signify, that he is to be
+treated according to the Method prescribed in this Chapter; and all such
+Directions are to be observed, with Regard to Air, Food, Drink and
+Glysters; except when I expressly order something else, as different
+Ptisans, Glysters, &c.
+
+Sec. 32. The greater Part of Diseases (by which I always understand acute
+and feverish ones) often give some Notice of their Approach a few Weeks,
+and, very commonly, some Days before their actual Invasion; such as a
+light Lassitude, or Weariness, Stiffness or Numbness; less Activity than
+usual, less Appetite, a small Load or Heaviness at Stomach; some
+Complaint in the Head; a profounder Degree of Sleep, yet less composed,
+and less refreshing than usual; less Gayety and Liveliness; sometimes a
+light Oppression of the Breast, a less regular Pulse; a Propensity to be
+Cold; an Aptness to sweat; and sometimes a Suppression of a former
+Disposition to sweat. At such a Term it may be practicable to prevent,
+or at least considerably to mitigate, the most perplexing Disorders, by
+carefully observing the four following Points.
+
+1. To omit all violent Work or Labour, but yet not so, as to discontinue
+a gentle easy Degree of Exercise.
+
+2. To bring the Complainant to content himself without any, or with very
+little, solid Food; and especially to renounce all Flesh, Flesh-broth,
+Eggs and Wine.
+
+3. To drink plentifully, that is to say, at least three Pints, or even
+four Pints daily, by small Glasses at a Time, from half hour to half
+hour, of the Ptisans No. 1 and 2, or even of warm Water, to each Quart
+of which may be added half a Glass of Vinegar. No Person can be
+destitute of this very attainable Assistance. But should there be a Want
+even of Vinegar, a few Grains of common [17] Salt may be added to a
+Quart of warm Water for Drink. Those who have Honey will do well to add
+two or three Spoonfuls of it to the Water. A light Infusion of Elder
+Flowers, or of those of the Linden, the Lime-tree, may also be
+advantageously used, and even well settled and clear sweet Whey.
+
+[17] This Direction of our Author's, which may surprize some, probably
+     arises from his preferring a small Quantity of the marine Acid to
+     no Acid at all: For though a great Proportion of Salt, in saving
+     and seasoning Flesh and other Food, generally excites Thirst, yet a
+     little of it seems to have rather a different Effect, by gently
+     stimulating the salivary Glands: And we find that Nature very
+     seldom leaves the great diluting Element wholly void of this
+     quickening, antiputrescent Principle. _K._
+
+4. Let the Person, affected with such previous Complaints, receive
+Glysters of warm Water, or the Glyster No. 5. By pursuing these
+Precautions some grievous Disorders have often been happily rooted out:
+and although they should not prove so thoroughly efficacious, as to
+prevent their Appearance, they may at least be rendered more gentle, and
+much less dangerous.
+
+Sec. 33. Very unhappily People have taken the directly contrary Method.
+From the Moment these previous, these forerunning Complaints are
+perceived, they allow themselves to eat nothing but gross Meat, Eggs, or
+strong Meat-Soups. They leave off Garden-Stuff and Fruits, which would
+be so proper for them; and they drink heartily (under a Notion of
+strengthening the Stomach and expelling Wind) of Wine and other Liquors,
+which strengthen nothing but the Fever, and expel what Degree of Health
+might still remain. Hence all the Evacuations are restrained; the
+Humours causing and nourishing the Diseases are not at all attempered,
+diluted, nor rendered proper for Evacuation. Nay, on the very contrary,
+they become more sharp, and more difficult to be discharged: while a
+sufficient Quantity of diluting refreshing Liquor, asswages and
+separates all Matters foreign to the Blood, which it purifies; and, at
+the Expiration of some Days, all that was noxious in it is carried off
+by Stool, by Urine, or by Sweat.
+
+Sec. 34. When the Distemper is further advanced, and the Patient is already
+seized with that Coldness or Shuddering, in a greater or less Degree,
+which ushers in all Disease; and which is commonly attended with an
+universal Oppression, and Pains over all the Surface of the Body; the
+Patient, thus circumstanced, should be put to Bed, if he cannot keep up;
+or should sit down as quietly as possible, with a little more Covering
+than usual: he should drink every Quarter of an Hour a small Glass of
+the Ptisan, No. 1 or 2, warm; or, if that is not at Hand, of some one of
+those Liquids I have recommended Sec. 32.
+
+Sec. 35. These Patients earnestly covet a great Load of covering, during
+the Cold or Shivering; but we should be very careful to lighten them as
+soon as it abates; so that when the succeeding Heat begins, they may
+have no more than their usual Weight of Covering. It were to be wished
+_perhaps_, they had rather less. The Country People lie upon a
+Feather-bed, and under a downy Coverlet, or Quilt, that is commonly
+extremely heavy; and the Heat which is heightened and retained by
+Feathers, is particularly troublesome to Persons in a Fever.
+Nevertheless, as it is what they are accustomed to, this Custom may be
+complied with for one Season of the Year: but during our Heats, or
+whenever the Fever is very violent, they should lie on a Pallet (which
+will be infinitely better for them) and should throw away their
+Coverings of Down, so as to remain covered only with Sheets, or
+something else, less injurious than Feather-Coverings. A Person could
+scarcely believe, who had not been, as I have, a Witness of it, how much
+Comfort a Patient is sensible of, in being eased of his former
+Coverings. The Distemper immediately puts on a different Appearance.
+
+Sec. 36. As soon as the Heat after the _Rigor_, or Coldness and Shuddering,
+approaches, and the Fever is manifestly advanced, we should provide for
+the Patient's _Regimen_. And
+
+1, Care should be taken that the Air, in the Room where he lies, should
+not be too hot, the mildest Degree of Warmth being very sufficient; that
+there be as little Noise as possible, and that no Person speak to the
+Sick, without a Necessity for it. No external Circumstance heightens the
+Fever more, nor inclines the Patient more to a _Delirium_ or Raving,
+than the Persons in the Chamber, and especially about the Bed. They
+lessen the Spring, the elastic and refreshing Power, of the Air; they
+prevent a Succession of fresh Air; and the Variety of Objects occupies
+the Brain too much. Whenever the Patient has been at Stool, or has made
+Urine, these Excrements should be removed immediately. The Windows
+should certainly be opened Night and Morning, at least for a Quarter of
+an Hour each Time; when also a Door should be opened, to promote an
+entire Renovation or Change of the Air in the Room. Nevertheless, as the
+Patient should not be exposed at any Time to a Stream or Current of Air,
+the Curtains of his Bed should be drawn on such Occasions; and, if he
+lay without any, Chairs, with Blankets or Cloaths hung upon them, should
+be substituted in the Place of Curtains, and surround the Bed; while the
+Windows continued open, in Order to defend the Patient from the Force of
+the rushing Air. If the Season, however, be rigidly cold, it will be
+sufficient to keep the Windows open, but for a few Minutes, each Time.
+In Summer, at least one Window should be set open Day and Night. The
+pouring a little Vinegar upon a red-hot Shovel also greatly conduces to
+restore the Spring, and correct the Putridity, of the Air. In our
+greatest Heats, when that in the Room seems nearly scorching, and the
+sick Person is sensibly and greatly incommoded by it, the Floor may be
+sprinkled now and then; and Branches of Willow or Ash-trees dipt a
+little in Pails of Water may be placed within the Room.
+
+Sec. 37. 2. With Respect to the Patient's Nourishment, he must entirely
+abstain from all Food; but he may always be allowed, and have daily
+prepared, the following Sustenance, which is one of the wholesomest, and
+indisputably the simplest one. Take half a Pound of Bread, a Morsel of
+the freshest Butter about the Size only of a Hazel Nut (which may even
+be omitted too) three Pints and one quarter of a Pint of Water. Boil
+them 'till the Bread be entirely reduced to a thin Consistence. Then
+strain it, and give the Patient one eighth Part of it every three, or
+every four, Hours; but still more rarely, if the Fever be vehemently
+high. Those who have Groats, Barley, Oatmeal, or Rice, may boil and
+prepare them in the same Manner, with some Grains of Salt.
+
+Sec. 38. The Sick may also be sometimes indulged, in lieu of these
+different Spoon-Meats, with raw Fruits in Summer, or in Winter with
+Apples baked or boiled, or Plumbs and Cherries dried and boiled. Persons
+of Knowledge and Experience will be very little, or rather not at all,
+surprized to see various Kinds of Fruit directed in acute Diseases; the
+Benefit of which they may here have frequently seen. Such Advice can
+only disgust those, who remain still obstinately attached to old
+Prejudices. But could they prevail on themselves to reflect a little,
+they must perceive, that these Fruits which allay Thirst; which cool and
+abate the Fever; which correct and attemper the putrid and heated Bile;
+which gently dispose the Belly to be rather open, and promote the
+Secretion and Discharge of the Urine, must prove the properest
+Nourishment for Persons in acute Fevers. Hence we see, as it were by a
+strong Admonition from Nature herself, they express an ardent Longing
+for them; and I have known several, who would not have recovered, but
+for their eating secretly large Quantities of those Fruits they so
+passionately desired, and were refused. As many however, as are not
+convinced by my Reasoning in this Respect, may at least make a Tryal of
+my Advice, on my Affirmation and Experience; when I have no doubt but
+their own will speedily convince them of the real Benefit received from
+this Sort of Nourishment. It will then be evident, that we may safely
+and boldly allow, in all continual Fevers, Cherries red and black,
+Strawberries, the best cured Raisins, Raspberries, and Mulberries;
+provided that all of them be perfectly ripe. Apples, Pears and Plumbs
+are less melting and diluting, less succulent, and rather less proper.
+Some kinds of Pears however are extremely juicy, and even watery almost,
+such as the Dean or Valentia Pear, different Kinds of the Buree Pear;
+the St. Germain, the Virgoleuse; the green sugary Pear, and the Summer
+Royal, which may all be allowed; as well as a little Juice of very ripe
+Plumbs, with the Addition of Water to it. This last I have known to
+asswage Thirst in a Fever, beyond any other Liquor. Care should be
+taken, at the same Time, that the Sick should never be indulged in a
+great Quantity of any of them at once, which would overload the Stomach,
+and be injurious to them; but if they are given a little at a Time and
+often, nothing can be more salutary. Those whose Circumstances will
+afford them China Oranges, or Lemons, may be regaled with the Pulp and
+Juice as successfully; but without eating any of their Peel, which is
+hot and inflaming.
+
+Sec. 39. 3. Their Drink should be such as allays Thirst, and abates the
+Fever; such as dilutes, relaxes, and promotes the Evacuations by Stool,
+Urine and Perspiration. All these which I have recommended in the
+preceding Chapters, jointly and severally possess these Qualities. A
+Glass or a Glass and a half of the Juice of such Fruits as I have just
+mentioned, may also be added to three full Pints of Water.
+
+Sec. 40. The Sick should drink at least twice or thrice that Quantity
+daily, often, and a little at once, between three or four Ounces, every
+Quarter of an Hour. The Coldness of the Drink should just be taken off.
+
+Sec. 41. 4. If the Patient has not two Motions in the 24 Hours; if the
+Urine be in small Quantity and high coloured; if he rave, the Fever
+rage, the Pain of the Head and of the Loins be considerable, with a Pain
+in the Belly, and a Propensity to vomit, the Glyster No. 5 should be
+given at least once a Day. The People have generally an Aversion to this
+kind of Remedy; notwithstanding there is not any more useful in feverish
+Disorders, especially in those I have just recounted; and one Glyster
+commonly gives more Relief, than if the Patient had drank four or five
+Times the Quantity of his Drinks. The Use of Glysters, in different
+Diseases, will be properly ascertained in the different Chapters, which
+treat of them. But it may be observed in this Place, that they are never
+to be given at the very Time the Patient is in a Sweat, which seems to
+relieve him.
+
+Sec. 42. 5. As long as the Patient has sufficient Strength for it, he
+should sit up out of Bed one Hour daily, and longer if he can bear it;
+but at least half an Hour. It has a Tendency to lessen the Fever, the
+Head-ach, and a Light-headiness, or Raving. But he should not be raised,
+while he has a hopeful Sweating; though such Sweats hardly ever occur,
+but at the Conclusion of Diseases, and after the Sick has had several
+other Evacuations.
+
+Sec. 43. 6. His Bed should be made daily while he sits up; and the Sheets
+of the Bed, as well as the Patient's Linen, should be changed every two
+Days, if it can be done with Safety. An unhappy Prejudice has
+established a contrary, and a really dangerous, Practice. The People
+about the Patient dread the very Thought of his rising out of Bed; they
+let him continue there in nasty Linen loaden with putrid Steams and
+Humours; which contribute, not only to keep up the Distemper, but even
+to heighten it into some Degree of Malignity. I do again repeat it here,
+that nothing conduces more to continue the Fever and Raving, than
+confining the Sick constantly to Bed, and witholding him from changing
+his foul Linen: by relieving him from both of which Circumstances I
+have, without the Assistance of any other Remedy, put a Stop to a
+continual Delirium of twelve Days uninterrupted Duration. It is usually
+said, the Patient is too weak, but this is a very weak Reason. He must
+be in very nearly a dying Condition, not to be able to bear these small
+Commotions, which, in the very Moment when he permits them, increase his
+Strength, and immediately after abate his Complaints. One Advantage the
+Sick gain by sitting up a little out of Bed, is the increased Quantity
+of their Urine, with greater Facility in passing it. Some have been
+observed to make none at all, if they did not rise out of Bed.
+
+A very considerable Number of acute Diseases have been radically,
+effectually, cured by this Method, which mitigates them all. Where it is
+not used, as an Assistance at least, Medicines are very often of no
+Advantage. It were to be wished the Patient and his Friends were made to
+understand, that Distempers were not to be expelled at once with rough
+and precipitate Usage; that they must have their certain Career or
+Course; and that the Use of the violent Methods and Medicines they chuse
+to employ, might indeed abridge the Course of them, by killing the
+Patient; yet never otherwise shortened the Disease; but, on the
+contrary, rendered it more perplexing, tedious and obstinate; and often
+entailed such unhappy Consequences on the Sufferer, as left him feeble
+and languid for the rest of his Life.
+
+Sec. 44. But it is not sufficient to treat, and, as it were, to conduct the
+Distemper properly. The Term of Recovery from a Disease requires
+considerable Vigilance and Attention, as it is always a State of
+Feebleness, and, thence, of Depression and Faintness. The same Kind of
+Prejudice which destroys the Sick, by compelling them to eat, during the
+Violence of the Disease, is extended also into the Stage of
+Convalescence, or Recovery; and either renders it troublesome and
+tedious; or produces fatal Relapses, and often chronical Distempers. In
+Proportion to the Abatement, and in the Decline, of the Fever, the
+Quantity of Nourishment may be gradually increased: but as long as there
+are any Remains of it, their Qualities should be those I have already
+recommended. Whenever the Fever is compleatly terminated, some different
+Foods may be entered upon; so that the Patient may venture upon a little
+white Meat, provided it be tender; some [18] Fish; a little Flesh-Soup,
+a few Eggs at times, with Wine property diluted. It must be observed at
+the same Time, that those very proper Aliments which restore the
+Strength, when taken moderately, delay the perfect Cure, if they exceed
+in Quantity, tho' but a little; because the Action of the Stomach being
+extremely weakened by the Disease and the Remedies, is capable only, as
+yet, of a small Degree of Digestion; and if the Quantity of its Extents
+exceed its Powers, they do not digest, but become putrid. Frequent
+Returns of the Fever supervene; a continual Faintishness; Head-achs; a
+heavy Drowsiness without a Power of Sleeping comfortably; flying Pains
+and Heats in the Arms and Legs; Inquietude; Peevishness; Propensity to
+Vomit; Looseness; Obstructions, and sometimes a slow Fever, with a
+Collection of Humours, that comes to Suppuration.
+
+All these bad Consequences are prevented, by the recovering Sick
+contenting themselves, for some Time, with a very moderate Share of
+proper Food. We are not nourished in Proportion to the Quantity we
+swallow, but to that we digest. A Person on the mending Hand, who eats
+moderately, digests it and grows strong from it. He who swallows
+abundantly does not digest it, and instead of being nourished and
+strengthened, he withers insensibly away.
+
+[18] The most allowable of these are Whitings, Flounders, Plaice, Dabbs,
+     or Gudgeons; especially such of the last as are taken out of clear
+     current Streams with gravelly Bottoms. Salmon, Eels, Carp, all the
+     Skate kind, Haddock, and the like, should not be permitted, before
+     the Sick return to their usual Diet when in Health. _K._
+
+Sec. 45. We may reduce, within the few following Rules, all that is most
+especially to be observed, in Order to procure a compleat, a perfect
+Termination of acute Diseases; and to prevent their leaving behind them
+any Impediments to Health.
+
+1. Let these who are recovering, as well as those who are actually sick,
+take very little Nourishment at a time, and take it often.
+
+2. Let them take but one sort of Food at each Meal, and not change their
+Food too often.
+
+3. Let them chew whatever solid Victuals they eat, very carefully.
+
+4. Let them diminish their Quantity of Drink. The best for them in
+general is Water, [19] with a fourth or third Part of white Wine. Too
+great a Quantity of Liquids at this time prevents the Stomach from
+recovering its Tone and Strength; impairs Digestion; keeps up Weakness;
+increases the Tendency to a Swelling of the Legs; sometimes even
+occasions a slow Fever; and throws back the Person recovering into a
+languid State.
+
+[19] We have known many who had an Aversion to Water, and with whom, on
+     that very Account, it might probably agree less, find Water very
+     grateful, in which a thoroughly baked and hot, not burnt, Slice of
+     Bread had been infused, untill it attained the Colour of fine clear
+     Small-beer, or light Amber coloured Beer, and we never saw any
+     Inconvenience result from it. Doubtless pure, untoasted elemental
+     Water may be preferable for those who like, and have been
+     accustomed to it. _K._
+
+5. Let them go abroad as often as they are able, whether on Foot, in a
+Carriage, or on Horseback. This last Exercise is the healthiest of all,
+and three fourths of the labouring People in this Country, who have it
+in their Power to procure it without Expense, are in the wrong to
+neglect it. They, who would practice it, should mount before their
+principal Meal, which should be about Noon, and never ride after it.
+Exercise taken before a Meal strengthens the Organs of Digestion, which
+is promoted by it. If the Exercise is taken soon after the Meal, it
+impairs it.
+
+6. As People in this State are seldom quite as well towards Night, in
+the Evening they should take very little Food. Their Sleep will be the
+less disturbed for this, and repair them the more, and sooner.
+
+7. They should not remain in Bed above seven, or eight Hours.
+
+8. The Swelling of the Legs and Ancles, which happens to most Persons at
+this time, is not dangerous, and generally disappears of itself; if they
+live soberly and regularly, and take moderate Exercise.
+
+9. It is not necessary, in this State, that they should go constantly
+every Day to Stool; though they should not be without one above two or
+three. If their Costiveness exceeds this Term, they should receive a
+Glyster the third Day, and even sooner, if they are heated by it, if
+they feel puffed up, are restless, and have any Pains in the Head.
+
+10. Should they, after some time, still continue very weak; if their
+Stomach is disordered; if they have, from time to time, a little
+irregular Fever, they should take three Doses daily of the Prescription
+No. 14. which fortifies the Digestions, recovers the strength, and
+drives away the Fever.
+
+11. They must by no means return to their Labour too soon. This
+erroneous Habit daily prevents many Peasants from ever getting perfectly
+well, and recovering their former Strength. From not having been able to
+confine themselves to Repose and Indolence for some Days, they never
+become as hearty hardy Workmen as they had been: and this premature
+hasty Labour makes them lose in the Consequence, every following Week of
+their Lives, more time than they ever gained, by their over-early
+resuming of their Labour. I see every Day weakly Labourers, Vineroons,
+and other Workmen, who date the Commencement of their Weakness from that
+of some acute Disease, which, for want of proper Management through the
+Term of their Recovery, was never perfectly cured. A Repose of seven or
+eight Days, more than they allowed themselves, would have prevented all
+these Infirmities; notwithstanding it is very difficult to make them
+sensible of this. The Bulk, the Body of the People, in this and in many
+other Cases, look no further than the present Day; and never extend
+their Views to the following one. They are for making no Sacrifice to
+Futurity; which nevertheless must be done, to render it favourable to
+us.
+
+
+
+
+                             __Chapter IV.__
+
+
+                  _Of an Inflammation of the Breast._
+
+
+                             __Sect.__ 46.
+
+The Inflammation of the Breast, or Peripneumony, or a Fluxion upon the
+Breast, is an Inflammation of the Lungs, and most commonly of one only,
+and consequently on one Side. The Signs by which it is evident, are a
+Shivering, of more or less Duration, during which the Person affected is
+sometimes very restless and in great Anguish, an essential and
+inseparable symptom; and which has helped me more than once to
+distinguish this Disease certainly, at the very Instant of its Invasion.
+Besides this, a considerable Degree of Heat succeeds the Shivering,
+which Heat, for a few ensuing Hours, is often blended as it were, with
+some Returns of Chilliness. The Pulse is quick, pretty strong,
+moderately full, hard and regular, when the Distemper is not very
+violent; but small, soft and irregular, when it is very dangerous. There
+is also a Sensation of Pain, but rather light and tolerable, in one Side
+of the Breast; sometimes a kind of straitning or Pressure on the Heart;
+at other times Pains through the whole Body, especially along the Reins;
+and some Degree of Oppression, at least very often; for sometimes it is
+but very inconsiderable. The Patient finds a Necessity of lying almost
+continually upon his Back, being able to lie but very rarely upon either
+of his Sides. Sometimes his Cough is dry, and then attended with the
+most Pain; at other times it is accompanied with a Spitting or Hawking
+up, blended with more or less Blood, and sometimes with pure sheer
+Blood. There is also some Pain, or at least a Sensation of Weight and
+Heaviness in the Head: and frequently a Propensity to rave. The Face is
+almost continually flushed and red: though sometimes there is a Degree
+of Paleness and an Air of Astonishment, at the Beginning of the Disease,
+which portend no little Danger. The Lips, the Tongue, the Palate, the
+Skin are all dry; the Breath hot; the Urine little and high coloured in
+the first Stage: but more plentiful, less flaming, and letting fall much
+Sediment afterwards. There is a frequent Thirst, and sometimes an
+Inclination to vomit; which imposing on the ignorant Assistants, have
+often inclined them to give the Patient a Vomit, which is mortal,
+especially at this Juncture. The Heat becomes universal. The Symptoms
+are heightened almost every Night, during which the Cough is more
+exasperated, and the Spitting or Expectoration in less Quantity. The
+best Expectoration is of a middling Consistence, neither too thin, nor
+too hard and tough, like those which are brought up at the Termination
+of a Cold; but rather more yellow, and mixed with a little Blood, which
+gradually becomes still less, and commonly disappears entirely, before
+the seventh Day. Sometimes the Inflammation ascends along the Wind-pipe,
+and in some Measure suffocates the Patient, paining him considerably in
+Swallowing, which makes him think he has a sore Throat.
+
+Sec. 47. Whenever the Disease is very violent at first, or increases to be
+such, the Patient cannot draw his Breath, but when he sits up. The Pulse
+becomes very small and very quick; the Countenance livid, the Tongue
+black; the Eyes stare wildly; and he suffers inexpressible Anguish,
+attended with incessant Restlessness and Agitation in his Bed. One of
+his Arms is sometimes affected with a sort of Palsy; he raves without
+Intermission; can neither thoroughly wake nor sleep. The Skin of his
+Breast and of his Neck is covered (especially in close sultry Weather,
+and when the Distemper is extremely violent) with livid Spots, more or
+less remarkable, which should be called _petechial_ ones, but are
+improperly termed the _pourpre_, or purple. The natural Strength becomes
+exhausted; the Difficulty of breathing increases every Moment; he sinks
+into a Lethargy, and soon dies a terrible Death in Country Places, by
+the very Effects of the inflaming Medicines they employ on such
+Occasions. It has been known in Fact, that the Use of them has raised
+the Distemper to such a Height, that the very Heart has been rent open,
+which the Dissection of the Body has demonstrated.
+
+Sec. 48. If the Disease rushes on at once, with a sudden and violent
+Attack; if the Horror, the Cold and Shivering last many Hours, and are
+followed with a nearly scorching Degree of Heat; if the Brain is
+affected from the very Onset; if the Patient has a small Purging,
+attended with a _Tenesinus_, or straining to Stool, often termed a
+_Needy_; if he abhors the Bed; if he either sweat excessively, or if his
+Skin be extremely dry; if his natural Manner and Look are considerably
+changed; and if he spits up with much Difficulty, the Disease is
+extremely dangerous.
+
+Sec. 49. He must directly, from the first Seizure in this State, be put
+upon a Regimen, and his Drink must never be given cold. It should either
+be the Barley Water No. 2, the Almond Emulsion No. 4, or that of No. 7.
+The Juices of the Plants, which enter into the last of these Drinks, are
+excellent Remedies in this Case; as they powerfully attenuate, or melt
+down, the viscid thick Blood, which causes the Inflammation.
+
+The Advantage of Bleeding:
+
+As long as the Fever keeps up extremely violent; while the Patient does
+not expectorate sufficiently; continues raving; has a violent Head-ach,
+or raises up pure Blood, the Glyster No. 5 must be given thrice, or at
+least twice, in twenty four Hours. However the principal Remedy is
+Bleeding. As soon as ever the preceding cold Assault is over, twelve
+Ounces of Blood must be taken away at once; and, if the Patient be young
+and strong, fourteen or even sixteen. This plentiful Bleeding gives him
+more Ease, than if twenty four Ounces had been drawn, at three different
+Times.
+
+Sec. 50. When the Disease is circumstanced as described (Sec. 46) that first
+Bleeding makes the Patient easy for some Hours; but the Complaint
+returns; and to obviate its Violence, as much as possible, we must,
+except things promise extremely well, repeat the Bleeding four Hours
+after the first, taking again twelve Ounces of Blood, which pretty often
+proves sufficient. But if, about the Expiration of eight or ten Hours,
+it appears to kindle up again, it must be repeated a third, or even a
+fourth Time. Yet, with the Assistance of other proper Remedies, I have
+seldom been obliged to bleed a fourth Time, and have sometimes found the
+two first Bleedings sufficient.
+
+If the Disease has been of several Days Duration, when I have first been
+called; if the Fever is still very high; if there be a Difficulty of
+Breathing; if the Patient does not expectorate at all, or brings up too
+much Blood; without being too solicitous about the Day of the Disease,
+the Patient should be bled, though it were on the tenth. [20]
+
+Sec. 51. In this, and in all other inflammatory Diseases, the Blood is in a
+very thick viscid State: and almost immediately on its being drawn, a
+white tough Skin, somewhat like Leather, is formed on its Top, which
+most People have seen, and which is called the _pleuritic Crust_. It is
+thought a promising Appearance, when at each Bleeding it seems less
+hard, and less thick, than it was at the preceding ones: and this is
+very generally true, if the Sick feels himself, at the same Time,
+sensibly better: but whoever shall attend _solely_ to the Appearance of
+the Blood, will find himself often deceived. It will happen, even in the
+most violent Inflammation of the Breast, that this Crust is not formed,
+which is supposed to be a very unpromising Sign. There are also, in this
+Respect, many odd Appearances, which arise from the smallest
+Circumstances; so that we must not regulate the Repetitions of our
+bleeding, solely by this Crust: and in general we must not be over
+credulous in supposing, that the Appearances in the Blood, received into
+the Bason, can enable us to determine, with Certainty, of its real State
+in the Body.
+
+[20] We should however, with the greater Circumspection (of how much the
+     longer standing the Disease has been, and by how much the more
+     difficult the viscous Humours are to be melted down and dislodged)
+     attend to the Coction of the Matter of Expectoration; which Nature
+     does not often easily effect, and which she effects the more
+     imperfectly and slowly, the weaker he is. Her last Efforts have
+     often been attended with such high Paroxysms, as have imposed even
+     upon very competent Physicians, and have made them open a Vein a
+     few Hours before the Patients' Death, from their Pulses being
+     strong, hard and frequent. Excessive Weakness is the Sign, by which
+     we may discover such unavailing Efforts to be the last. _E. L._
+
+Sec. 52. When the sick Person is in the Condition described (Sec. 47) the
+Bleeding is not only unattended with Ease; but sometimes it is also
+pernicious, by the sudden Weakness to which it reduces him. Generally in
+such a Case all Medicines and Means are insignificant: and it is a very
+bad Sign in this Disease, when this Discharge is not attended with Ease
+and Benefit to the Sick; or when there are some Circumstances, which
+oblige us to be sparing of it.
+
+Sec. 53. The Patient's Legs should every Day, for one half Hour, be put
+into a Bath of warm Water, wrapping him up closely; that the Cold may
+not check that Perspiration, which the Bath promotes.
+
+Sec. 54. Every two Hours he should take two Spoonfuls of the Mixture No. 8,
+which promotes all the Discharges, and chiefly that of Expectoration.
+
+Sec. 55. When the Oppression and Straitness are considerable, and the Cough
+dry, the Patient may receive the Vapour of boiling Water, to which a
+little Vinegar has been added. There are two ways of effecting this;
+either by placing below his Face, after setting him up, a Vessel filled
+with such boiling hot Water, and covering the Patient's Head and the
+Vessel with a Linen Cloth, that may inclose the Steam; or else by
+holding before his Mouth a Spunge dipped in the same boiling Liquor.
+This last Method is the least effectual, but it fatigues the Patient
+considerably less. When this bad Symptom is extremely pressing, Vinegar
+alone should be used without Water; and the Vapour of it has often saved
+Patients, who seemed to have one Foot in the Grave: but it should be
+continued for several Hours.
+
+Sec. 56. The outward Remedies directed in No. 9. are also applied with
+Success to the Breast, and to the Throat.
+
+Sec. 57. When the Fever is extremely high, the Sick should take every Hour,
+a Spoonful of the Mixture No. 10. in a Cup of the Ptisan [21] but
+without diminishing on this Account the usual Quantity of his other
+Drinks, which may be taken immediately after it.
+
+[21] The Use of Acids, in Inflammations of the Breast, requires no
+     little Consideration. Whenever the sick Person has an Aversion to
+     them; when the Tongue is moist, the Stomach is heavy and
+     disordered, and the Habit and Temperament of the Patient is mild
+     and soft; when the Cough is very sharp without great Thirst, we
+     ought to abstain from them. But when the Inflammation is joined to
+     a dry Tongue, to great Thirst, Heat and Fever, they are of great
+     Service. Slices of China Oranges sprinkled with Sugar may be given
+     first; a light Limonade may be allowed afterwards; and at last
+     small Doses of the Mixture, No. 10. if it becomes necessary. _E.
+     L._--I have chosen to retain this Note of the Editor of _Lyons_,
+     from having frequently seen the Inefficacy, and sometimes, I have
+     even thought, the ill Effects of Acids in Peripneumonies and
+     Pleurisies, in a Country far South of _Swisserland_; and where
+     these Diseases are very frequent, acute and fatal. On the other
+     hand I shall add the Substance of what Dr. _Tissot_ says on this
+     Head in a Note to his Table of Remedies, wherein he affirms, that
+     he has given in this Disease very large Doses of them, rising
+     gradually from small ones, and always with great Success;
+     intreating other Physicians to order this Acid (the Spirit of
+     Sulphur) in the same large Doses which he directs in this Chapter,
+     and assuring himself of their thanks, for its good
+     Consequences--Now the only ill Effect I can surmize here, from
+     shewing this Diversity of Opinion in these two learned Physicians,
+     and my own Doubts, is, that the Subjects of this Disease in Country
+     Places may prove somewhat confused and irresolute by it, in their
+     Conduct in such Cases. But as all of us certainly concur in the
+     great Intention of doing all possible Good, by the extensive
+     Publication of this Treatise, I shall take leave to observe that in
+     this Disease, and in Pleurisies, more solid Benefit has been
+     received in _Carolina_, _Virginia_, &c. from the Use of the
+     _Seneka_ Rattle-snake Root, than from any other Medicine whatever.
+     Bleeding indeed is necessarily premised to it; but it has often
+     saved the Necessity of many repeated Bleedings. This Medicine,
+     which is termed in Latin, the _Polygala Virginiana_, is certainly
+     rather of a saponaceous attenuating Quality, and betrays not any
+     Marks of Acidity, being rather moderately acrid. There will be
+     Occasion to mention it more particularly in the subsequent Chapter,
+     as such a Liberty can need no Apology to any philosophical
+     Physician. _K._
+
+Sec. 58. As long as the Patient shall grow worse, or only continue equally
+bad, the same Medicines are to be repeated. But if on the third Day
+(tho' it rarely happens so soon) or fourth, or fifth, the Disease takes
+a more favourable Turn; if the Exasperation returns with less Violence;
+the Cough be less severe; the Matter coughed up less bloody: if
+Respiration becomes easier; the Head be less affected; the Tongue not
+quite so dry; if the high Colour of the Urine abates, and its Quantity
+be increased, it may be sufficient then to keep the Patient carefully to
+his Regimen, and to give him a Glyster every Evening. The Exasperation
+that occurs the fourth Day is often the highest.
+
+Sec. 59. This Distemper is most commonly terminated and carried off by
+Expectoration, and often by Urine, which on the seventh, the ninth, or
+the eleventh Day, and sometimes on the Days between them, begins to let
+fall a plentiful Sediment, or Settling, of a pale red Colour, and
+sometimes real _Pus_ or ripe Matter. These Discharges are succeeded by
+Sweats, which are as serviceable then, as they were injurious at the
+Beginning of the Disease.
+
+Sec. 60. Some Hours before these Evacuations appear, there come on, and not
+seldom, some very alarming Symptoms, such as great Anguish;
+Palpitations, some Irregularity in the Pulse; an increased Oppression;
+convulsive Motions (this being what is called the _Crisis_, the Height,
+or Turn of the Distemper) but they are no ways dangerous, provided they
+do not occasion any improper Treatment. These Symptoms depend on the
+morbid and purulent Matter, which, being dislodged, circulates with the
+Humours, and irritates different Parts, until the Discharge of it has
+fairly begun; after which all such Symptoms disappear, and Sleep
+generally ensues. However I cannot too strongly insist on the Necessity
+of great Prudence in such Circumstances. Sometimes it is the Weakness of
+the Patient, and at other times Convulsions, or some other Symptoms,
+that terrify the By-standers. If, which is most generally the Case, the
+absurd Practice of directing particular Remedies for such Accidents
+takes place, such as spirituous Cordials, Venice Treacle, Confections,
+Castor and Rue; the Consequence is, that Nature being disturbed in her
+Operations, the _Crisis_ or Turn is not effected; the Matter which
+should be discharged by Stool, by Urine, or by Sweat, is not discharged
+out of the Body; but is thrown upon some internal or external part of
+it. Should it be on some inward part, the Patient either dies at once;
+or another Distemper succeeds, more troublesome and incurable than the
+first. Should it be expelled to some outward part, the Danger indeed is
+less; and as soon as ever such a Tumour appears, ripening Pultices
+should be apply'd to bring it to a Head, after which it should
+immediately be opened.
+
+Sec. 61. In order to prevent such unhappy Consequences, great Care must be
+taken, whenever such terrifying Symptoms come on, [about the Time of the
+_Crisis_] to make no Change in the Diet, nor in the Treatment of the
+Patient; except in giving him the loosening Glyster No. 5; and applying
+every two Hours a Flannel, squeezed out of warm Water, which may cover
+all the Belly, and in a Manner go round the Body behind the Reins. The
+Quantity of his Drink may also be increased a little; and that of his
+Nourishment lessened, as long as this high and violent State continues.
+
+Sec. 62. I have not spoken of Vomits or Purges, as being directly contrary
+to the Nature of this Disease. Anodynes, or Opiates, to procure Sleep
+are also, in general, very improper. In a few Cases, however, they may
+possibly be useful; but these Cases are so very difficult to be
+sufficiently distinguished, that Opiates should never be admitted in
+this Disease, without the Presence and Advice of a Physician. I have
+seen many Patients, who have been thrown into an incurable Hectic, by
+taking them improperly. When the Disease is not received in a mortal
+Degree, nor has been injudiciously treated, and proceeds in a benign
+regular Manner, the Patient may be called very well and safe by the
+fourteenth Day; when he may, if he has an Appetite, be put upon the Diet
+of People who are recovering. But if he still retains an Aversion to
+Food; if his Mouth is foul and furred, and he is sensible of some
+Heaviness in his Head, he should take the purging Potion No. 11.
+
+Sec. 63. Bleedings from the Nose occur sometimes naturally in this Disease,
+even after repeated Bleedings by Art; these are very benign and
+favourable, and are commonly attended with more Ease and Relief than
+artificial Bleedings. Such voluntary Discharges may sometimes be
+expected, when the Patient is sensibly mended in many Respects after the
+Use of the Lancet; and yet complains of a great Pain in his Head,
+accompanied with quick sparkling Eyes, and a Redness of the Nose.
+Nothing should be done to stop these voluntary Bleedings, since it would
+be very dangerous: For when Nature has fulfilled her Intention by them,
+they cease of themselves. At other times, but more rarely, the Distemper
+is carried off by a natural Purging, attended with moderate Pain, and
+the Discharge of bilious Matter.
+
+Sec. 64. If the Expectoration, or hawking up of Matter, stops very
+suddenly, and is not speedily attended with some other Evacuation; the
+Oppression and Anguish of the Patient immediately return, and the Danger
+is great and pressing. If the Distemper, at this Juncture, is not of
+many Days standing; if the Patient is a strong Person; if he has not as
+yet been plentifully bled; if there be still some Blood mixed with the
+Humour he expectorates; or if the Pulse be strong and hard, he should be
+bled immediately in the Arm; and constantly receive the Steam of hot
+Water and Vinegar by the Mouth, and drink plentifully of the Ptisan No.
+2, something hotter than ordinary. But if his Circumstances, after this
+Suppression, are different from these just mentioned; instead of
+bleeding him, two Blisters should be applied to the Legs; and he should
+drink plentifully of the Ptisan No. 12.
+
+The Causes which oftenest produce this Suppression of his Expectoration
+are, 1, a sharp and sudden cold Air. 2, too hot a one. 3, over hot
+Medicines. 4, excessive Sweating. 5, a Purge prematurely and
+injudiciously timed. and 6, some immoderate Passion of the Mind.
+
+Sec. 65. When the Sick has not been sufficiently bled, or not soon enough;
+and even sometimes, which I have seen, when he has been greatly weakened
+by excessive Bleeding; so that the Discharges by Stool, Urine,
+Expectoration and Perspiration, have not been sufficiently made; when
+these Discharges have been confused by some other Cause; or the Disease
+has been injudiciously treated; then the Vessels that have been
+inflamed, do not unload themselves of the Humours, which stuff up and
+oppress them: but there happens in the Substance of the affected Lung,
+the same Circumstance we see daily occur on the Surface of the Body. If
+an inflammatory Tumour or Swelling does not disperse itself, and
+disappears insensibly, it forms an Imposthume or Abscess. Thus exactly
+also in the inflamed Lung, if the Inflammation is not dissipated, it
+forms an Abscess, which, in that part, is called a _Vomica:_ and the
+Matter of that Abscess, like the external ones, remains often long
+inclosed in its Sac or Bag, without bursting open its Membrane or Case,
+and discharging the Matter it contains.
+
+Sec. 66. If the Inflammation was not very deeply seated in the inward
+Substance of the diseased Lung; but was extended to its Surface, that
+is, very near the Ribs, the Sac will burst on the Surface of the Lung;
+and the Matter contained in it must be discharged into the Cavity, or
+Hollowness of the Breast, between the Lung, the Ribs, and the Diaphragm
+or Midriff, which is the Membrane that divides the Breast and the Belly.
+But when the Inflammation is considerably deeper, the Imposthume bursts
+withinside of the Lung itself. If its Orifice, or Opening is so small,
+that but little can get out at once; if the Quantity of all the Matter
+be inconsiderable, and the Patient is at the same Time pretty strong, he
+coughs up the Matter, and is very sensibly relieved. But if this
+_Vomica_ be large, or if its Orifice is wide, and it throws out a great
+Quantity of Matter at once; or if the Patient is very weak, he dies the
+Moment it bursts, and that sometimes when it is least expected. I have
+seen one Patient so circumstanced expire, as he was conveying a Spoonful
+of Soup to his Mouth; and another, while he was wiping his Nose. There
+was no present Symptom in either of these Cases, whence a Physician
+might suppose them likelier to die at that Instant, than for some Hours
+before. The _Pus_, or Matter, is commonly discharged through the Mouth
+after Death, and the Bodies very soon become putrified.
+
+Sec. 67. We call that _Vomica_ which is not burst, an _occult_ or hidden,
+and that which is, an evident or open one. It is of considerable
+Importance to treat exactly and clearly of this Topic; as a great Number
+of Country People die of these Imposthumes, even without a Suspicion of
+the Cause of their Death. I had an Instance of it some Days since, in
+the School-master of a Village. He had an occult and very considerable
+_Vomica_ in the left Lung, which was the Consequence of an Inflammation
+of the Breast, that had been treated improperly at the Beginning. He
+seemed to me not likely to live twenty four Hours; and really died in
+the Night, after inexpressible Anguish.
+
+Sec. 68. Whatever Distemper is included within the Breast of a living
+Patient, is neither an Object of the Sight or Touch whence these
+_Vomicas_, these inward Tumours, are so often unknown, and indeed
+unsuspected. The Evacuations that were necessary for the Cure, or
+sometimes for the Prevention, of them, have not taken place, during the
+first fourteen Days. At the End of this Term, the Patient, far from
+being cured, is not very considerably relieved; but, on the contrary,
+the Fever continues to be pretty high, with a Pulse continually quick;
+in general soft and weak; though sometimes pretty hard, and often
+fluctuating, or, as it were, waving. His Breathing is still difficult
+and oppressed; with small cold Shudderings from Time to Time; an
+Exasperation of the Fever; flushed Cheeks, dry Lips, and Thirst.
+
+The Increase of these Symptoms declare, that _Pus_ or Matter is
+thoroughly formed: the Cough then becomes more continual; being
+exasperated with the least Motion; or as soon as ever the Patient has
+taken any Nourishment. He can repose only on the Side affected. It often
+happens indeed, that he cannot lie down at all; but is obliged to be set
+up all Day; sometimes even without daring to lean a little upon his
+Loins, for fear of increasing the Cough and Oppression. He is unable to
+sleep; has a continual Fever, and his Pulse frequently intermits.
+
+The Fever is not only heightened every Evening; but the smallest
+Quantity of Food, the gentlest Motion, a little Coughing, the lightest
+Agitation of the Mind, a little more than usual Heat in the Chamber,
+Soup either a little too strong, or a little too salt, increase the
+Quickness of his Pulse the Moment they occur, or are given. He is quite
+restless, has some short Attacks of the most terrible Anguish,
+accompanied and succeeded by Sweatings on his Breast, and from his whole
+Countenance. He sweats sometimes the whole Night; his Urine is reddish,
+now frothy, and at other times oily, as it were. Sudden Flushings, hot
+as Flames, rise into his whole Visage. The greater Number of the Sick
+are commonly sensible of a most disagreeable Taste in their Mouth; some
+of old strong Cheese; others of rotten Eggs; and others again of
+stinking Meat, and fall greatly away. The Thirst of some is
+unquenchable; their Mouths and Lips are parched; their Voice weak and
+hoarse; their Eyes hollow, with a kind of Wildness in their Looks. They
+have a general Disgust to all Food; and if they should ask for some
+particular Nourishment without seeing it, they reject it the Moment it
+is brought them; and their Strength at length seems wholly exhausted.
+
+Besides these Symptoms, a little Inflation, or _Bloatedness_, as it
+were, is sometimes observed on the Breast, towards the Side affected;
+with an almost insensible Change of Colour. If the _Vomica_ be situated
+at the Bottom of the affected Lobe of the Lungs, and in its internal
+Part, that is, nearly in the Middle of the Breast, some _Puffiness_ or
+light Swelling may be perceived in some Bodies, by gently pressing the
+Pit of the Stomach; especially when the Patient coughs. In short,
+according to the Observations of a German Physician, if one strike the
+open Hand on the Breast, covered only with a Shirt, it retains in the
+Spot, which is directly opposite to the _Vomica_, a flat heavy Sound, as
+if one struck a Piece of Flesh; while in striking on the other Side it
+gives a clear loud Sound, as from a Drum. I still doubt however, whether
+this Observation will generally hold true; and it would be hazardous to
+affirm there is no Abscess in a Breast, which does not return this heavy
+Sound.
+
+Sec. 69. When a _Vomica_ is formed, as long as it is not emptied, all the
+Symptoms I have already enumerated increase, and the _Vomica_ grows in
+Size: the whole Side of the Lung affected sometimes becomes a Bag or Sac
+of Matter. The sound Side is compressed; and the Patient dies after
+dreadful Anguish, with the Lung full of _Pus_, and without having ever
+brought up any.
+
+To avoid such fatal Consequences, it is necessary to procure the Rupture
+and Discharge of this inward Abscess, as soon as we are certain of its
+Existence: And as it is safer it should break within the Lobe affected,
+from whence it may be discharged by hawking up; than that it should
+burst and void itself into the Cavity of the Breast, for Reasons I shall
+give hereafter, we must endeavour, that this Rupture may be effected
+within the internal Substance of the Lungs.
+
+Sec. 70. The most effectual Methods to procure this are, 1. To make the
+Patient continually receive, by his Mouth, the Vapour of warm Water. 2.
+When by this Means that part of the Sac or Abscess is softened, where we
+could wish the Rupture of it to happen, the Patient is to swallow a
+large Quantity of the most emollient Liquid; such as Barley Water,
+Almond Milk, light Veal Broth, or Milk and Water. By this Means the
+Stomach is kept always full: so that the Resistance to the Lungs being
+considerable on that Side, the Abscess and its Contents will naturally
+be pressed towards the Side of the Wind-pipe, as it will meet with less
+Resistance there. This fulness of the Stomach will also incline the
+Patient to cough, which may concur to produce a good Event. Hence, 3, we
+should endeavour to make the Patient cough, by making him smell to some
+Vinegar, or even snuff up a little; or by injecting into his Throat, by
+the Means of a small Syringe or Pipe, such as Children make out of short
+Pieces of Elder-Boughs, a little Water or Vinegar. 4. He should be
+advised to bawl out aloud, to read loud, or to laugh heartily; all which
+Means contribute to burst open the Abscess, as well as those two
+following ones. 5. Let him take every two Hours a Soup-Ladle of the
+Potion No. 8. 6. He should be put into a Cart, or some other Carriage;
+but not before he has drank plentifully of such Liquors as I have just
+mentioned: after which the Shaking and Jolting in the Carriage have
+sometimes immediately procured that Rupture, or breaking of the Bag or
+Abscess, we wished for.
+
+Sec. 71. Some Years since I saw a Country Maid Servant, who was left in a
+languishing Condition after an Inflammation of the Breast; without any
+Person's suspecting her Ailment. This Woman being put into a Cart, that
+was sent for a Load of Hay; one of the Wheels run violently against a
+Tree: she swooned away, and at the same Time brought up a great Quantity
+of digested Matter. She continued to bring up more; during which I was
+informed of her Case, and of the Accident, which effectually cured her.
+
+A _Swiss_ Officer, who served in _Piedmont_, had been in a languid State
+of Health for some Months; and returned home to set himself down as
+easily as he could, without conceiving any considerable Hopes of
+Recovery. Upon entering into his own Country, by the Way of _Mount
+Bernard_; and being obliged to go some Paces on Foot, he fell down; and
+remained in a Swoon above a Quarter of an Hour: during which Time he
+threw up a large Quantity of Matter, and found himself that very Moment
+very greatly relieved. I ordered him a proper Diet, and suitable
+Medicines: his Health became perfectly established; and the Preservation
+of his Life was principally owing to this lucky Fall.
+
+Many Persons afflicted with a _Vomica_, faint away the very Instant it
+breaks. Some sharp Vinegar should be directly held to their Nose. This
+small Assistance is generally sufficient, where the bursting of it is
+not attended with such Appearances as shew it to be mortal, in which
+Case every Application is insignificant.
+
+Sec. 72. If the sick Person was not extremely weak before the Bursting of
+the Abscess; if the Matter was white, and well conditioned; if the Fever
+abates after it; if the Anguish, Oppression and Sweats terminate; if the
+Cough is less violent; if the Patient is sensibly easier in his
+Situation or Posture; if he recovers his Sleep and Appetite; if his
+usual Strength returns; if the Quantity he expectorates, or brings up,
+becomes daily and gradually less; and if his Urine is apparently better,
+we may have Room to hope, that by the Assistance of these Remedies I
+shall immediately direct, he may be radically, compleatly cured.
+
+Sec. 73. But if on the contrary; when his Strength is exhausted before the
+bursting of the Abscess; when the Matter is too thin and transparent,
+brown, green, yellow, bloody and of an Offensive Smell; if the Pulse
+continues quick and weak; if the Patient's Appetite, Strength and Sleep
+do not improve, there remains no hope of a Cure, and the best Medicines
+are ineffectual: Nevertheless we ought to make some Tryal of them.
+
+Sec. 74. They consist of the following Medicines and Regulations. 1. Give
+every four Hours a little Barley or Rice Cream. 2. If the Matter brought
+up is thick and glewy, so that it is very difficult to be loosened and
+discharged, give every two Hours a Soup-ladle of the Potion No. 8; and
+between the giving these two, let the Patient take every half Hour a Cup
+of the Drink No. 13. 3. When the Consistence of the Matter is such, that
+there is no Occasion for these Medicines to promote the Discharge of it,
+they must be omitted; tho' the same Sort and Quantity of Food are to be
+continued; but with the Addition of an equal Quantity of Milk; or, which
+would be still more beneficial, instead of this Mixture, we should give
+an equal Quantity of sweet Milk, taken from a good Cow, which, in such a
+Case, may compose the whole Nourishment of the Patient. 4. He should
+take four Times a Day, beginning early in the Morning, and at the
+Distance of two Hours, a Dose of the Powder No. 14, diluted in a little
+Water, or made into a _Bolus_, or Morsel, with a little Syrup or Honey.
+His common Drink should be Almond Emulsion, commonly called Almond Milk,
+or Barley Water, or fresh Water with a fourth part Milk. 5. He should
+air and exercise every Day on Horseback, or in a Carriage, according as
+his Strength and his Circumstances will allow him. But of all Sorts of
+Exercise, that upon a trotting Horse is, beyond all Comparison, the very
+best, and the easiest to be procured by every Body; provided the Disease
+be not too far advanced; since in such a Situation, any Exercise, that
+was only a little violent, might prove pernicious.
+
+Sec. 75. The Multitude, who are generally illiterate, seldom consider any
+thing as a Remedy, except they swallow it. They have but little
+Confidence in _Regimen_, or any Assistance in the Way of Diet, and
+consider Riding on Horseback as wholly useless to them. This is a
+dangerous Mistake, of which I should be glad to undeceive them: since
+this Assistance, which appears so insignificant to them, is probably the
+most effectual of any: it is that in Fact, without which they can
+scarcely expect a Cure, in the highest Degrees of this Disease: it is
+that, which perhaps alone may recover them, provided they take no
+improper Food. In brief it is considered, and with Reason, as the real
+Specific for this Disease.
+
+Sec. 76. The Influence of the Air is of more Importance in this Disorder,
+than in any others; for which Reason great Care should be taken to
+procure the best, in the Patient's Chamber. For this Purpose it should
+often be ventilated, or have an Admission of fresh Air, and be sweetened
+from Time to Time, tho' very lightly, with a little good Vinegar; and in
+the Season it should be plentifully supplied with agreeable Herbs,
+Flowers and Fruits. Should the Sick be unfortunately situated, and
+confined in an unwholsome Air, there can be but little Prospect of
+curing him, without altering it.
+
+Sec. 77. Out of many Persons affected with these Disorders, some have been
+cured by taking nothing whatsoever but Butter-milk; others by Melons and
+Cucumbers only; and others again by Summer Fruits of every Sort.
+Nevertheless, as such Cases are singular, and have been but few, I
+advise the Patient to observe the Method I have directed here, as the
+surest.
+
+Sec. 78. It is sufficient if he have a Stool once in two, or even in three,
+Days. Hence, there is no Reason for him, in this Case, to accustom
+himself to Glysters: they might excite a Looseness, which may be very
+dangerous.
+
+Sec. 79. When the Discharge of the Matter from the Breast diminishes, and
+the Patient is perceivably mended in every Respect, it is a Proof that
+the Wound in the Abscess is deterged, or clean, and that it is disposed
+to heal up gradually. If the Suppuration, or Discharge, continues in
+great Quantity; if it seems but of an indifferent Consistence; if the
+Fever returns every Evening, it may be apprehended, that the Wound,
+instead of healing, may degenerate into an Ulcer, which must prove a
+most embarrassing Consequence. Under such a Circumstance, the Patient
+would fall into a confirmed Hectic, and die after some Months Sickness.
+
+Sec. 80. I am not acquainted with any better Remedy, in such a dangerous
+Case, than a Perseverance in these already directed, and especially in
+moderate Exercise on Horseback. In some of them indeed Recourse may be
+had to the sweet Vapours of some vulnerary Herbs in hot Water, with a
+little Oil of Turpentine, as directed No. 15. I have seen them succeed;
+but the safest Way is to consult a Physician, who may examine and
+consider, if there is not some particular Circumstance combined with the
+Disease, that proves an Obstacle to the Cure of it. If the Cough
+prevents the Patient from Sleeping, he may take in the Evening two or
+three Table Spoonfuls of the Prescription No. 16, in a Glass of Almond
+Milk or Barley Water.
+
+Sec. 81. The very same Causes which suddenly suppress the Expectoration, in
+an Inflammation of the Breast, may also check the Expectoration from a
+_Vomica_ already begun: in which Circumstance the Patient is speedily
+afflicted with an Oppression and Anguish, a Fever and evident
+Feebleness. We should immediately endeavour to remove this Stoppage, by
+the Vapour of hot Water; by giving a Spoonful of the Mixture No. 3 every
+Hour; by a large Quantity of the Ptisan No. 12, and by a proper Degree
+of Motion or Exercise. As soon as ever the Expectoration returns, the
+Fever and the other Symptoms disappear. I have seen this Suppression in
+strong Habits quickly followed with an Inflammation about the Seat of
+the _Vomica_, which has obliged me to bleed, after which the
+Expectoration immediately returned.
+
+Sec. 82. It happens sometimes, that the _Vomica_ is entirely cleansed; the
+Expectoration is entirely finished, or drained off, the Patient seems
+well, and thinks himself compleatly cured: but soon after, the
+Uneasiness, Oppression, Cough and Fever are renewed, because the
+Membrane or Bag of the _Vomica_ fills again: again it empties itself,
+the Patient expectorates for some Days, and seems to recover. After some
+Time however, the same Scene is repeated; and this Vicissitude, or
+Succession, of moderate and of bad Health, often continues for some
+Months and even some Years. This happens when the _Vomica_ is emptied,
+and is gradually deterged; so that its Membranes, or Sides touch or
+approach each other; but without cicatrizing or healing firmly; and then
+there drops or leaks in very gradually fresh Matter. For a few Days this
+seems no ways to incommode the Patient; but as soon as a certain
+Quantity is accumulated, he is visited again with some of the former
+Symptoms, 'till another Evacuation ensues. People thus circumstanced, in
+this Disease, sometimes appear to enjoy a tolerable Share of Health. It
+may be considered as a kind of internal Issue, which empties and
+cleanses itself from Time to Time; pretty frequently in some
+Constitutions, more slowly in others; and under which some may attain a
+good middling Age. When it arrives however at a very considerable
+Duration, it proves incurable. In its earliest State, it gives way
+sometimes to a Milk-diet, to riding on Horseback; and to the Medicine
+No. 14.
+
+Sec. 83. Some may be surprized, that in treating of an Abscess of the
+Lungs, and of the Hectic, which is a Consequence of it, I say nothing of
+those Remedies, commonly termed _Balsamics_, and so frequently employed
+in them, for Instance, Turpentines, Balsam of Peru, of Mecca,
+Frankincense, Mastich, Myrrh, Storax and Balsam of Sulphur. I shall
+however say briefly here (because it is equally my Design to destroy the
+Prejudice of the People, in favour of improper Medicines, and to
+establish the Reputation of good ones) that I never in such Cases made
+use of these Medicines; because I am convinced, that their Operation is
+generally hurtful in such Cases; because I see them daily productive of
+real Mischief; that they protract the Cure, and often change a slight
+Disorder into an incurable Disease. They are incapable of perfect
+Digestion, they obstruct the finest Vessels of the Lungs, whose
+Obstructions we should endeavour to remove; and evidently occasion,
+except their Dose be extremely small, Heat and Oppression. I have very
+often seen to a Demonstration, that Pills compounded of Myrrh,
+Turpentine and Balsam of Peru, have, an Hour after they were swallowed,
+occasioned a Tumult and Agitation in the Pulse, high Flushings, Thirst
+and Oppression. In short it is demonstrable to every unprejudiced
+Person, that these Remedies, as they have been called, are truly
+prejudicial in this Case; and I heartily wish People may be disabused
+with Respect to them, and that they may lose that Reputation so
+unhappily ascribed to them.
+
+I know that many Persons, very capable in other Respects, daily make use
+of them in these Distempers: such however cannot fail of disusing them,
+as soon as they shall have observed their Effects, abstracted from the
+Virtues of the other Medicines to which they add them, and which
+mitigate the Danger of them. I saw a Patient, whom a foreign Surgeon,
+who lived at _Orbe_, attempted to cure of a Hectic with melted Bacon,
+which aggravated the Disease. This Advice seemed, and certainly was,
+absurd; nevertheless the Balsamics ordered in such Cases are probably
+not more digestible than fat Bacon. The Powder No. 14 possesses whatever
+these Balsamics pretend to: it is attended with none of the
+Inconveniencies they produce; and has all the good Qualities ascribed to
+them. Notwithstanding which, it must not be given while the Inflammation
+exists; nor when it may revive again; and no other Aliment should be
+mixed with the Milk.
+
+The famous Medicine called the _Antihectic_, (_Antihecticum Poterii_)
+has not, any more than these Balsamics, the Virtues ascribed to it in
+such Cases. I very often give it in some obstinate Coughs to Infants
+with their Milk, and then it is very useful: but I have seldom seen it
+attended with considerable Effects in grown Persons; and in the present
+Cases I should be fearful of its doing Mischief.
+
+Sec. 84. If the _Vomica_, instead of breaking within the Substance of the
+Lungs affected, should break without it, the Pus must be received into
+the Cavity of the Breast. We know when that has happened, by the
+Sensation or Feeling of the Patient; who perceives an uncommon, a
+singular kind of Movement, pretty generally accompanied with a Fainting.
+The Oppression and Anguish cease at once; the Fever abates; the Cough
+however commonly continues, tho' with less Violence, and without any
+Expectoration. But this seeming Amendment is of a short Duration, since
+from the daily Augmentation of the Matter, and its becoming more acrid
+or sharp, the Lungs become oppressed, irritated and eroded. The
+Difficulty of Breathing, Heat, Thirst, Wakefulness, Distaste, and
+Deafness, return, with many other Symptoms unnecessary to be enumerated,
+and especially with frequent Sinkings and Weakness. The Patient should
+be confined to his _Regimen_, to retard the Increase of the Disease as
+much as possible; notwithstanding no other effectual Remedy remains,
+except that of opening the Breast between two of the Ribs, to discharge
+the Matter, and to stop the Disorder it occasions. This is called the
+Operation for the _Empyema_. I shall not describe it here, as it should
+not be undertaken but by Persons of Capacity and Experience, for whom
+this Treatise was not intended. I would only observe, it is less painful
+than terrifying; and that if it is delayed too long, it proves useless,
+and the Patient dies miserably.
+
+Sec. 85. We may daily see external Inflammations turn gangrenous, or
+mortify. The same Thing occurs in the Lungs, when the Fever is
+excessive, the Inflammation either in its own Nature, extremely violent,
+or raised to such a Height by hot Medicines. Intolerable Anguish,
+extreme Weakness, frequent Faintings, Coldness of the Extremities, a
+livid and foetid thin Humour brought up instead of concocted Spitting,
+and sometimes blackish Stripes on the Breast, sufficiently distinguish
+this miserable State. I have smelt in one Case of this Kind, where the
+Patient had been attacked with this Disease (after a forced March on
+Foot, having taken some Wine with Spices to force a Sweat) his Breath so
+horribly stinking, that his Wife had many Sinkings from attending him.
+When I saw him, I could discern neither Pulse nor Intellect, and ordered
+him nothing. He died an Hour afterwards, about the Beginning of the
+third Hour.
+
+Sec. 86. An Inflammation may also become hard, when it forms what we call a
+_Scirrhus_, which is a very hard Tumour, indolent, or unpainful. This is
+known to occur, when the disease has not terminated in any of those
+Manners I have represented; and where, tho' the Fever and the other
+Symptoms disappear, the Respiration, or Breathing, remains always a
+little oppressed; the Patient still retains a troublesome Sensation in
+one Side of his Breast; and has from Time to Time a dry Cough, which
+increases after Exercise, and after eating. This Malady is but seldom
+cured; though some Persons attacked with it last many Years, without any
+other considerable Complaint. They should avoid all Occasions of
+over-heating themselves; which might readily produce a new Inflammation
+about this Tumour, the Consequences of which would be highly dangerous.
+
+Sec. 87. The best Remedies against this Disorder, and from which I have
+seen some good Effects, are the medicated Whey No. 17, and the Pills No.
+18. The Patient may take twenty Pills, and a Pint and a half of the Whey
+every Morning for a long Continuance; and receive inwardly, now and
+then, the Vapour of hot Water.
+
+Sec. 88. Each Lung, in a perfect State of Health, touches the _Pleura_, the
+Membrane, that lines the Inside of the Breast; though it is not
+connected to it. But it often happens, after an Inflammation of the
+Breast, after the Pleurisy, and in some other Cases, that these two
+Parts adhere closely to each other, and are never afterwards separated.
+However this is scarcely to be considered as a Disease; and remains
+commonly unknown, as the Health is not impaired by it, and nothing is
+ever prescribed to remove it. Nevertheless I have seen a few Cases, in
+which this Adhesion was manifestly prejudicial.
+
+
+
+
+                             __Chapter V.__
+
+
+                           _Of the Pleurisy._
+
+
+                             __Sect.__ 89.
+
+The Pleurisy, which is chiefly known by these four Symptoms, a strong
+Fever, a Difficulty of Breathing, a Cough, and an acute Pain about the
+Breast; the Pleurisy, I say, is not a different Malady from the
+Peripneumony, or Inflammation of the Breast, the Subject of the
+preceding Chapter; so that I have very little to say of it,
+particularly, or apart.
+
+Sec. 90. The Cause of this Disease then is exactly the same with that of
+the former, that is, an Inflammation of the Lungs; but an Inflammation,
+that seems rather a little more external. The only considerable
+Difference in the Symptoms is, that the Pleurisy is accompanied with a
+most acute Pain under the Ribs, and which is commonly termed a _Stitch_.
+This Pain is felt indifferently over every Part of the Breast; though
+more commonly about the Sides, under the more fleshy Parts of the
+Breast, and oftenest on the right Side. The Pain is greatly increased
+whenever the Patient coughs or draws in the Air in breathing; and hence
+a Fear of increasing it, by making some Patients forbear to cough or
+respire, as much as they possibly can; and that aggravates the Disease,
+by stopping the Course of the Blood in the Lungs, which are soon
+overcharged with it. Hence the Inflammation of this Bowel becomes
+general; the Blood mounts up to the Head; the Countenance looks deeply
+red, or as it were livid; the Patient becomes nearly suffocated, and
+falls into the State described Sec. 47.
+
+Sometimes the Pain is so extremely violent, that if the Cough is very
+urgent at the same Time, and the Sick cannot suppress or restrain it,
+they are seized with Convulsions, of which I have seen many Instances,
+but these occur almost always to Women; though they are much less
+subject than Men to this Disease, and indeed to all inflammatory ones.
+It may be proper however to observe here, that if Women should be
+attacked with it, during their monthly Discharges, that Circumstance
+should not prevent the repeated and necessary Bleedings, nor occasion
+any Alteration in the Treatment of the Disease. And hence it appears,
+that the Pleurisy is really an Inflammation of the Lungs, accompanied
+with acute Pain.
+
+Sec. 91. I am sensible that sometimes an Inflammation of the Lungs is
+communicated also to that Membrane, which lines the Inside of the
+Breast; and which is called the _Pleura_; and from thence to the
+Muscles, the fleshy Parts, over and between the Ribs. This however is
+not very frequently the Case.
+
+Sec. 92. Spring is commonly the Season most productive of Pleurisies: in
+general there are few in Summer: notwithstanding that in the Year 1762,
+there were a great many during the hottest Season, which then was
+excessively so. The Disease usually begins with a violent Shivering,
+succeeded by considerable Heat, with a Cough, an Oppression, and
+sometimes with a sensible Straitning, or Contraction, as it were, all
+over the Breast; and also with a Head-ach, a Redness of the Cheeks, and
+with Reachings to vomit. The Stitch does not always happen at the very
+first Onset; often not 'till after several Hours from the first
+Complaint; sometimes not before the second, or even the third Day.
+Sometimes the Patient feels two Stitches, in different Parts of the
+Side; though it seldom happens that they are equally sharp, and the
+lightest soon ceases. Sometimes also the Stitch shifts its Place, which
+promises well, if the Part first attacked by it continues perfectly free
+from Pain: but it has a bad Appearance, if, while the first is present,
+another also supervenes, and both continue. The Pulse is usually very
+hard in this Distemper; but in the dreadful Cases described Sec. 47 and 90,
+it becomes soft and small. There often occur at, or very quickly after,
+the Invasion, such an Expectoration, or hawking up, as happens in an
+Inflammation of the Breast; at other Times there is not the least
+Appearance of it, whence such are named dry Pleurisies, which happen
+pretty often. Sometimes the Sick cough but little, or not at all. They
+often lie more at Ease upon the Side affected, than on the sound one.
+The Progress of this Disease advances exactly like that described in the
+preceding Chapter: for how can they differ considerably? and the
+Treatment of both is the same. Large Haemorrhages, or Bleedings from the
+Nose, frequently happen, to the great Relief of the Patient; but
+sometimes such Discharges consist of a kind of corrupted Blood, when the
+Patient is very ill, and these portend Death.
+
+Sec. 93. This Distemper is often produced by drinking cold Water, while a
+Person is hot; from which Cause it is sometimes so violent, as to kill
+the Patient in three Hours. A young Man was found dead at the Side of
+the Spring, from which he had quenched his Thirst: neither indeed is it
+uncommon for Pleurisies to prove mortal within three Days.
+
+Sometimes the Stitch disappears, whence the Patient complains less; but
+at the same Time his Countenance changes; he grows pale and sad; his
+Eyes look dull and heavy, and his Pulse grows feeble. This signifies a
+Translation of the Disease to the Brain, a Case which is almost
+constantly fatal.
+
+There is no Disease in which the critical Symptoms are more violent, and
+more strongly marked, than in this. It is proper this should be known,
+as it may prevent or lessen our excessive Terror. A perfect Cure
+supervenes sometimes, at the very Moment when Death was expected.
+
+Sec. 94. This Malady is one of the most common and the most destroying
+kind, as well from its own violent Nature, as through the pernicious
+Treatment of it in Country Places. That Prejudice, which insists on
+curing all Diseases by Sweating, entirely regulates their Conduct in
+treating a Pleurisy; and as soon as a Person is afflicted with a Stitch,
+all the hot Medicines are immediately set to Work. This mortal Error
+destroys more People than Gunpowder; and it is by so much the more
+hurtful, as the Distemper is of the most violent kind; and because, as
+there is commonly not a Moment to be lost, the whole depends on the
+Method immediately recurred to.
+
+Sec. 95. The proper Manner of treating this Disease, is exactly the same in
+all Respects, with that of the Peripneumony; because, I again affirm, it
+is the very same Disease. Hence the Bleedings, the softening and
+diluting Drinks, the Steams, the Glysters, the Potion No. 8, and the
+emollient Poultices are the real Remedies. These last perhaps are still
+more effectual in the Pleurisy; and therefore they should be continually
+applied over the very Stitch.
+
+The first Bleeding, especially if there has been a considerable
+Discharge, almost constantly abates the Stitch, and often entirely
+removes it: though it more commonly returns, after an Intermission of
+some Hours, either in the same Spot, or sometimes in another. This
+shifting of it is rather favourable, especially if the Pain, that was
+first felt under the Breast, shifts into the Shoulders, to the Back, the
+Shoulder-blade, or the Nape of the Neck.
+
+When the Stitch is not at all abated, or only a little; or if, after
+having abated, it returns as violently as at first, and especially if it
+returns in the same Spot, and the Height of the other Symptoms continue,
+Bleeding must be repeated. But if a sensible Abatement of the Stitch
+continues; and if, though it returns, it should be in a smaller Degree,
+and by Intervals, or in these Places I have mentioned above; if the
+Quickness, or the Hardness of the Pulse, and all the other Symptoms are
+sensibly diminished, this repeated Bleeding may sometimes be omitted.
+Nevertheless, in a very strong Subject, it seems rather prudent not to
+omit it, since in such Circumstances it can do no Mischief; and a
+considerable Hazard may sometimes be incurred by the Omission. In very
+high and dangerous Pleurisies a frequent Repetition of bleeding is
+necessary; except some Impediment to it should arise from the particular
+Constitution of the Patient, or from his Age, or some other
+Circumstances.
+
+If, from the Beginning of the Disease, the Pulse is but a little quicker
+and harder than in a healthy State; if it is not manifestly strong; if
+the Head-ach and the Stitch are so moderate as to prove supportable; if
+the Cough is not too violent; if there is no sensible Oppression or
+Straitness, and the Patient expectorate, or cough up, Bleeding may be
+omitted.
+
+With Respect to the administering of other Remedies, the same Directions
+are to be exactly followed, which have been already given in the
+preceding Chapter, to which the Reader is referred from Sec. 53 to 66.
+
+Sec. 96. When the Disease is not very acute and pressing, I have often
+cured it in a very few Days by a single Bleeding, and a large Quantity
+of a Tea or Infusion of Elder-flowers, sweetened with Honey. It is in
+some Cases of this kind, that we often find the Water _Faltranc_
+succeed, with the Addition of some Honey, and even of Oil: though the
+Drink I have just directed is considerably preferable. That Drink which
+is compounded of equal Quantities of Wine and Water, with the Addition
+of much Venice Treacle, annually destroys a great Number of People in
+the Country.
+
+Sec. 97. In those dry Pleurisies, in which the Stitch, the Fever, and the
+Head-ach are strong and violent; and where the Pulse is very hard and
+very full, with an excessive Dryness of the Skin and of the Tongue,
+Bleeding should be frequently repeated, and at small Intervals from each
+other. This Method frequently cures the Disease effectually, without
+using any other Evacuation.
+
+Sec. 98. The Pleurisy terminates, like any other inward Inflammation,
+either by some Evacuation; by an Abscess; in a Mortification; or in a
+Scirrhosity or hard Tumour; and it often leaves Adhesions in the Breast.
+
+The Gangrene or Mortification sometimes appears on the third Day,
+without having been preceded by very vehement Pains. In such Cases the
+dead Body often looks very black, especially in the Parts near the Seat
+of the Disease: and in such the more superstitious ascribe it to some
+supernatural Cause; or draw some unhappy Presage from it, with Respect
+to those who are yet unattacked by it. This Appearance however is purely
+a natural Consequence, quite simple, and cannot be otherwise; and the
+hot Regimen and Medicines are the most prevailing Causes of it. I have
+seen it thus circumstanced in a Man in the Flower of his Age, who had
+taken Venice Treacle in Cherry Water, and the Ingredients of _Faltranc_
+infused in Wine.
+
+Sec. 99. _Vomicas_ are sometimes the Consequences of Pleurisies; but their
+particular Situation disposes them more to break [22] outwardly; which
+is the most frequent Cause of an _Empyema_ Sec. 84. "To prevent this, it is
+highly proper to apply, at the first Invasion of the Disease, to the
+Spot where the Pain chiefly rages, a small Plaister, which may exactly
+fit it; since if the Pleurisy should terminate in an Abscess or
+Imposthume, the purulent Matter will be determined to that Side.
+
+[22] That is, into the Cavity of the Breast, rather than within the
+     Substance of the Lungs.
+
+"As soon then as it is foreseen that an Abscess is forming (see Sec. 68) we
+should erode, by a light Caustic, the Place where it is expected; and as
+soon as it is removed, Care should be taken to promote Suppuration
+there. By this Means we may entertain a reasonable Hope, that the Mass
+of Matter will incline its Course to that Spot, where it will meet with
+the least Resistance, and be discharged from thence. For this Heap of
+Matter is often accumulated between the _Pleura_, and the Parts which
+adhere to it."
+
+This is the Advice of a very [23] great Physician; but I must inform the
+Reader, there are many Cases, in which it can be of no Service; neither
+ought it to be attempted, but by Persons of undoubted Abilities.
+
+[23] This is, undoubtedly, Baron _Van Swieten_, with whom he had
+     premised, he agreed considerably, in all the Diseases they had both
+     treated of. _K._
+
+With Regard to the Scirrhosity, or Hardness, and to the Circumstances of
+Adhesions, I can add nothing to what I have said in Sec. 86 and 87.
+
+Sec. 100. It has been observed that some Persons, who have been once
+attacked by this Disease, are often liable to Relapses of it, especially
+such as drink hard. I knew one Man, who reckoned up his Pleurisies by
+Dozens. A few Bleedings, at certain proper Intervals, might prevent
+these frequent Returns of it; which, joined to their excessive Drinking,
+make them languid and stupid, in the very Flower of their Age. They
+generally fall into some Species of an Asthma, and from that into a
+Dropsy, which proves the melancholy, though not an improper, Conclusion
+of their Lives. Such as can confine themselves to some proper
+Precautions, may also prevent these frequent Returns of this Disease,
+even without bleeding; by a temperate Regimen; by abstaining from Time
+to Time, from eating Flesh and drinking Wine; at which Times they should
+drink Whey, or some of those Diet-Drinks No. 1, 2, 4; and by bathing
+their Legs sometimes in warm Water; especially in those Seasons, when
+this Disease is the most likely to return.
+
+Sec. 101. Two Medicines greatly esteemed in this Disease among the
+Peasantry, and even extolled by some Physicians, are the Blood of a wild
+He Goat, and the [24] Soot in an Egg. I do not contest the Cure or
+Recovery of many Persons, who have taken these Remedies; notwithstanding
+it is not less true, that both of them, as well as the Egg in which the
+Soot is taken, are dangerous: For which Reason it is prudent, at least,
+never to make use of them; as there is great Probability, they may do a
+little Mischief; and a Certainty that they can do no Good. The _Genipi_,
+or [25] Wormwood of the Alps, has also acquired great Reputation in this
+Disease, and occasioned many Disputes between some very zealous
+Ecclesiastics, and a justly celebrated Physician. It seems not difficult
+however to ascertain the proper Use of it. This Plant is a powerful
+Bitter; it heats and excites Sweat: it seems clear, that, from such
+Consequences, it should never be employed in a Pleurisy, while the
+Vessels are full, the Pulse hard, the Fever high, and the Blood
+inflamed. In all such Circumstances it must aggravate the Disease; but
+towards the Conclusion of it, when the Vessels are considerably emptied,
+the Blood is diluted, and the Fever abated, it may then be recurred to;
+but with a constant Recollection that it is hot, and not to be employed
+without Reflection and Prudence. [26]
+
+[24] This, with great Probability, means that small black Substance
+     often visible in a rotten Egg, which is undoubtedly of a violent,
+     or even poisonous Quality. Dr. _Tissot_ terms it expressly--_la
+     suie dans un Oeuf_. K.
+
+[25] Dr. _Lewis_, who has not taken Notice of this Species of Wormwood
+     in his Improvement of _Quincy's_ Dispensatory, has mentioned it in
+     his late _Materia Medica_. K.
+
+[26] This being a proper Place for directing the Seneka Rattle Snake
+     Root, I shall observe, that the best Way of exhibiting it is in
+     Decoction, by gradually simmering and boiling two Ounces of it in
+     gross Powder, in two Pints and a half of Water, to a Pint and a
+     quarter; and then giving three Spoonfuls of it to a grown Person,
+     every six Hours. If the Stitch should continue, or return, after
+     taking it, Bleeding, which should be premised to it, must be
+     occasionally repeated; though it seldom proves necessary, after a
+     few Doses of it. It greatly promotes Expectoration, keeps the Body
+     gently open, and sometimes operates by Urine and by Sweat; very
+     seldom proving at all emetic in Decoction. The Regimen of Drinks
+     directed here in Pleurisies are to be given as usual. Dr.
+     _Tennant_, the Introducer of this valuable Medicine, confided
+     solely in it, in Bastard Peripneumonies, without Bleeding,
+     Blistering, or any other Medicines. _K._
+
+
+
+
+                             __Chapter VI.__
+
+
+                    _Of the Diseases of the Throat._
+
+
+                             __Sect.__ 102.
+
+The Throat is subject to many Diseases: One of the most frequent and the
+most dangerous, is that Inflammation of it, commonly termed a Quinsey.
+This in Effect is a Distemper of the same Nature with an Inflammation of
+the Breast; but as it occurs in a different Part, the Symptoms, of
+Course, are very different. They also vary, not a very little, according
+to the different Parts of the Throat which are inflamed.
+
+Sec. 103. The general Symptoms of an Inflammation of the Throat are, the
+Shivering, the subsequent Heat, the Fever, the Head-ach, red
+high-coloured Urine, a considerable Difficulty, and sometimes even an
+Impossibility, of swallowing any thing whatever. But if the nearer Parts
+to the _Glottis_, that is, of the Entrance into the Windpipe, or Conduit
+through which we breathe, are attacked, Breathing becomes excessively
+difficult; the Patient is sensible of extreme Anguish, and great
+Approaches to Suffocation; the Disease is then extended to the
+_Glottis_, to the Body of the Wind-pipe, and even to the Substance of
+the Lungs, whence it becomes speedily fatal.
+
+The Inflammation of the other Parts is attended with less Danger; and
+this Danger becomes still less, as the Disease is more extended to the
+outward and superficial Parts. When the Inflammation is general, and
+seizes all the internal Parts of the Throat, and particularly the
+Tonsils or Almonds, as they are called, the _Uvula_, or Process of the
+Palate, and the _Basis_, or remotest deepest Part of the Tongue, it is
+one of the most dangerous and dreadful Maladies. The Face is then
+swelled up and inflamed; the whole Inside of the Throat is in the same
+Condition; the Patient can get nothing down; he breathes with a Pain and
+Anguish, which concur, with a Stuffing or Obstruction in his Brains, to
+throw him into a kind of furious _Delirium_, or Raving. His Tongue is
+bloated up, and is extended out of his Mouth; his Nostrils are dilated,
+as tho' it were to assist him in his Breathing; the whole Neck, even to
+the Beginning of the Breast, is excessively tumified or swelled up; the
+Pulse is very quick, very weak, and often intermits; the miserable
+Patient is deprived of all his Strength, and commonly dies the second or
+third Day. Very fortunately this Kind, or Degree of it, which I have
+often seen in _Languedoc_, happens very rarely in _Swisserland_, where
+the Disease is less violent; and where I have only seen People die of
+it, in Consequence of its being perniciously treated; or by Reason of
+some accidental Circumstances, which were foreign to the Disease itself.
+Of the Multitude of Patients I have attended in this Disorder, I have
+known but one to fail under it, whose Case I shall mention towards the
+Close of this Chapter.
+
+Sec. 104. Sometimes the Disease shifts from the internal to the external
+Parts: the Skin of the Neck and Breast grows very red, and becomes
+painful, but the Patient finds himself better.
+
+At other Times the Disorder quits the Throat; but is transferred to the
+Brain, or upon the Lungs. Both these Translations of it are mortal, when
+the best Advice and Assistance cannot be immediately procured; and it
+must be acknowledged, that even the best are often ineffectual.
+
+Sec. 105. The most usual kind of this Disease is that which affects only
+the Tonsils (the Almonds) and the Palate; or rather its Process,
+_commonly called_ the Palate. It generally first invades one of the
+Tonsils, which becomes enlarged, red and painful, and does not allow the
+afflicted to swallow, but with great Pain. Sometimes the Disorder is
+confined to one Side; but most commonly it is extended to the _Uvula_,
+(the Palate) from whence it is extended to the other Tonsil. If it be of
+a mild kind, the Tonsil first affected is generally better, when the
+second is attacked. Whenever they are both affected at once, the Pain
+and the Anguish of the Patient are very considerable; he cannot swallow,
+but with great Difficulty and Complaint; and the Torment of this is so
+vehement, that I have seen Women affected with Convulsions, as often as
+they endeavoured to swallow their Spittle, or any other Liquid. They
+continue, even for several Hours sometimes, unable to take any thing
+whatever; all the upper inward Part of the Mouth, the Bottom of the
+Palate, and the descending Part of the Tongue become lightly red, or
+inflamed.
+
+A considerable Proportion of Persons under this Disease swallow Liquids
+more difficultly than Solids; by Reason that Liquids require a greater
+Action of some Part of the Muscles, in order to their being properly
+directed into their Conduit or Chanel. The Deglutition (the Swallowing)
+of the Spittle is attended with still more Uneasiness than that of other
+Liquids, because it is a little more thick and viscid, and flows down
+with less Ease. This Difficulty of swallowing, joined to the Quantity
+thence accumulated, produces that almost continual hawking up, which
+oppresses some Patients so much the more, as the Inside of their Cheeks,
+their whole Tongue, and their Lips are often galled, and even flead as
+it were. This also prevents their Sleeping, which however seems no
+considerable Evil; Sleep being _sometimes_ but of little Service in
+Diseases attended with a Fever; and I have often seen those, who thought
+their Throats almost entirely well in the Evening, and yet found them
+very bad after some Hours Sleep.
+
+The Fever, in this Species of the Disease, is sometimes, very high; and
+the Shivering often endures for many Hours. It is succeeded by
+considerable Heat, and a violent Head-ach, which yet is sometimes
+attended with a Drowsiness. The Fever is commonly pretty high in the
+Evening, though sometimes but inconsiderable, and by the Morning perhaps
+there is none at all.
+
+A light Invasion of this Disease of the Throat often precedes the
+Shivering; though most commonly it does not become manifest 'till after
+it, and at the same Time when the Heat comes on.
+
+The Neck is sometimes a little inflated, or puffed up; and many of the
+Sick complain of a pretty smart Pain in the Ear of that Side, which is
+most affected. I have but very seldom observed that they had it in both.
+
+Sec. 106. The Inflammation either disappears by Degrees, or an Abscess is
+formed in the Part which was chiefly affected. It has never happened, at
+least within my Knowledge, that this Sort of the Disease, prudently
+treated, has ever terminated either in a Mortification, or a Scirrhus:
+but I have been a Witness to either of these supervening, when Sweating
+was extorted in the Beginning of it, by hot Medicines.
+
+It is also very rare to meet with those highly dangerous Translations of
+this Disease upon the Lungs, such as are described in that Species of it
+from Sec. 103, 104. It is true indeed it does not occur more frequently,
+even in that Species, whenever the Disease is thrown out upon the more
+external Parts.
+
+Sec. 107. The Treatment of the Quinsey, as well as of all other
+inflammatory Diseases, is the same with that of an Inflammation of the
+Breast.
+
+The Sick is immediately to be put upon a Regimen; and in that Sort
+described Sec. 103, Bleeding must be repeated four or five Times within a
+few Hours; and sometimes there is a Necessity to recur still oftner to
+it. When it assaults the Patient in the most vehement Degree, all
+Medicines, all Means, are very generally ineffectual; they should be
+tried however. We should give as much as can be taken of the Drinks No.
+2 and 4. But as the Quantity they are able to swallow is often very
+inconsiderable; the Glyster No. 5 should be repeated every three Hours;
+and their Legs should be put into a Bath of warm Water, thrice a Day.
+
+Sec. 108. Cupping Glasses, with Scarification, applied about the Neck,
+after bleeding twice or thrice, have often been experienced to be highly
+useful. In the most desperate Cases, when the Neck is excessively
+swelled, one or two deep Incisions made with a Razor, on this external
+Tumour, have sometimes saved a Patient's Life.
+
+Sec. 109. In that kind, and those Circumstances, of this Disease described
+Sec. 105 we must have very frequent Recourse to Bleeding; and it should
+never be omitted, when the Pulse is very perceivably hard and full. It
+is of the utmost Consequence to do it instantaneously; since it is the
+only Means to prevent the Abscess, which forms very readily, if Bleeding
+has been neglected, only for a few Hours. Sometimes it is necessary to
+repeat it a second Time, but very rarely a third.
+
+This Disease is frequently so gentle and mild, as to be cured without
+Bleeding, by the Means of much good Management. But as many as are not
+Masters of their own Time, nor in such an easy Situation, as to be
+properly attended, ought, without the least Hesitation, to be bled
+directly, which is sometimes sufficient to remove the Complaint;
+especially if, after Bleeding, the Patient drinks plentifully of the
+Ptisan No. 2.
+
+In this light Degree of the Disease, it may suffice to bathe the Legs,
+and to receive a Glyster, once a Day each; the first to be used in the
+Morning, and the last in the Evening. Besides the general Remedies
+against Inflammations, a few particular ones, calculated precisely for
+this Disease, may be applied in each kind or Degree of it. The best are,
+first the emollient Poultices, No. 9, laid over the whole Neck. [27]
+Some have highly extolled the Application of Swallows Nests in this
+Disease; and though I make no Objection to it, I think it certainly less
+efficacious than any of those which I direct.
+
+[27] The _English_ avail themselves considerably, in this Disease, of a
+     Mixture of equal Parts of Sallad Oil, and Spirit of Sal Ammoniac;
+     or of Oil and Spirit of Hartshorn, as a Liniment and Application
+     round the Neck. This Remedy corresponds with many Indications; and
+     deserves, perhaps, the first Place amongst local Applications
+     against the inflammatory Quinsey. _E. L._
+
+2. Of the Gargarisms (No. 19) a great Variety may be prepared, of pretty
+much the same Properties, and of equal Efficacy. Those I direct here are
+what have succeeded best with me and they are very simple. [28]
+
+[28] Dr. _Pringle_ is apprehensive of some ill Effects from Acids in
+     Gargarisms [_which is probably from their supposed repelling
+     Property_] and prefers a Decoction of Figs in Milk and Water, to
+     which he adds a small Quantity of Spirit of Sal Ammoniac. _E. L._
+
+3. The Steam of hot Water, as directed Sec. 55, should be repeated five or
+six Times a Day; a Poultice should be constantly kept on, and often
+renewed; and the Patient should often gargle.
+
+There are some Persons, besides Children, who cannot gargle themselves:
+and in fact the Pain occasioned by it makes it the more difficult. In
+such a Case, instead of gargling, the same Gargarism (No. 19) may be
+injected with a small Syringe. The Injection reaches further than
+Gargling, and often causes the Patient to hawk up a considerable
+Quantity of glarey Matter (which has grown still thicker towards the
+Bottom of the Throat) to his sensible Relief. This Injection should be
+often repeated. The little hollowed Pipes of Elder Wood, which all the
+Children in the Country can make, may be conveniently employed for this
+Purpose. The Patient should breathe out, rather than inspire, during the
+Injection.
+
+Sec. 110. Whenever the Disease terminates without Suppuration, the Fever,
+the Head-ach, the Heat in the Throat, and the Pain in swallowing, begin
+to abate from the fourth Day, some times from the third, often only from
+the fifth; and from such Period that Abatement increases at a great
+Rate; so that at the End of two, three, or four Days, on the sixth,
+seventh, or eighth, the Patient is entirely well. Some few however
+continue to feel a light Degree of Pain, and that only on one Side, four
+or five Days longer, but without a Fever, or any considerable
+Uneasiness.
+
+Sec. 111. Sometimes the Fever and the other Symptoms abate, after the
+Bleeding and other Remedies; without any subsequent Amendment in the
+Throat, or any Signs of Suppuration. In such Cases we must chiefly
+persist in the Gargarisms and the Steams; and where an experienced and
+dexterous Surgeon can be procured, it were proper he should scarify the
+inflamed Tonsils. These discharge, in such Cases, a moderate Quantity of
+Blood; and this Evacuation relieves, very readily, as many as make use
+of it.
+
+Sec. 112. If the Inflammation is no ways disposed to disperse, so that an
+Abscess is forming, which almost ever happens, if it has not been
+obviated at the Invasion of the Disease; then the Symptoms attending the
+Fever continue, though raging a little less after the fourth Day: the
+Throat continues red, but of a less florid and lively Redness: a Pain
+also continues, though less acute, accompanied sometimes with
+Pulsations, and at other Times intirely without any; of which it is
+proper to take Notice: the Pulse commonly grows a little softer; and on
+the fifth or sixth Day, and sometimes sooner, the Abscess is ready to
+break. This may be discovered by the Appearance of a small white and
+soft Tumour, when the Mouth is open, which commonly appears about the
+Centre or Middle of the Inflammation. It bursts of itself; or, should it
+not, it must be opened. This is effected by strongly securing a Lancet
+to one End of a small Stick or Handle, and enveloping, or wrapping up
+the whole Blade of it, except the Point and the Length of one fourth or
+a third of an Inch, in some Folds of soft Linnen; after which the
+Abscess is pierced with the Point of this Lancet. The Instant it is
+opened, the Mouth is filled with the Discharge of a Quantity of _Pus_,
+of the most intolerable Savour and Smell. The Patient should gargle
+himself after the Discharge of it with the detersive, or cleansing
+Gargarism No. 19. It is surprising sometimes to see the Quantity of
+Matter discharged from this Imposthumation. In general there is but one;
+though sometimes I have seen two of them.
+
+Sec. 113. It happens, and not seldom, that the Matter is not collected
+exactly in the Place, where the Inflammation appeared, but in some less
+exposed and less visible Place: whence a Facility of swallowing is
+almost entirely restored; the Fever abates; the Patient sleeps; he
+imagines he is cured, and that no Inconvenience remains, but such as
+ordinarily occurs in the earliest Stage of Recovery. A Person who is
+neither a Physician, nor a Surgeon, may easily deceive himself, when in
+this State. But the following Signs may enable him to discover that
+there is an Abscess, viz. A certain Inquietude and general Uneasiness; a
+Pain throughout the Mouth; some Shiverings from Time to Time; frequently
+sharp, but short and transient, Heat: a Pulse moderately soft, but not
+in a natural State; a Sensation of Thickness and Heaviness in the
+Tongue; small white Eruptions on the Gums, on the Inside of the Cheek,
+on the Inside and Outside of the Lips, and a disagreeable Taste and
+Odour.
+
+Sec. 114. In such Cases Milk or warm Water should frequently be retained in
+the Mouth; the Vapour of hot Water should be conveyed into it; and
+emollient Cataplasms may be applied about the Neck. All these Means
+concur to the softening and breaking of the Abscess. The Finger may also
+be introduced to feel for its Situation; and when discovered, the
+Surgeon may easily open it. I happened once to break one under my
+Finger, without having made the least Effort to do it. Warm Water may be
+injected pretty forcibly, either by the Mouth or the Nostrils: this
+sometimes occasions a kind of Cough, or certain Efforts which tend to
+break it. I have seen this happen even from laughing. As to the rest,
+the Patient should not be too anxious or uneasy about the Event. I never
+saw a single Instance of a Person's dying of a Quinsey of this kind,
+after the Suppuration is truly effected; neither has it happened perhaps
+after the Time it is forming for Suppuration.
+
+Sec. 115. The glairy Matter with which the Throat is over-charged, and the
+very Inflammation of that Part, which, from its Irritation, produces the
+same Effect, as the Introduction of a Finger into it, occasions some
+Patients to complain of incessant Propensities to vomit. We must be upon
+our Guard here, and not suppose that this Heart-Sickness, as some have
+called it, results from a Disorder of, or a Load within, the Stomach,
+and that it requires a Vomit for its Removal. The giving one here would
+often prove a very unfortunate Mistake. It might, in a high
+Inflammation, further aggravate it; or we might be obliged (even during
+the Operation of the Vomit) to bleed, in order to lessen the Violence of
+the Inflammation. Such Imprudence with its bad Consequences, often
+leaves the Patient, even after the Disease is cured, in a State of
+Languor and Weakness for a considerable Time. Nevertheless, there are
+some particular Disorders of the Throat, attended with a Fever, in which
+a Vomit may be prudently given. But this can only be, when there is no
+Inflammation, or after it is dispersed; and there still remains some
+putrid Matter in the first Passages. Of such Cases I shall speak
+hereafter. [29]
+
+[29] In Diseases of the Throat, which have been preceded by such
+     Excesses in Food or strong Drink, as occur too often in many
+     Countries, when the Patient has very strong Reachings to vomit, and
+     the Tongue is moist at the same Time; we should not hesitate, after
+     appeasing the first Symptoms of the Inflammation [by sufficient
+     Bleedings, &c.] to assist the Efforts of Nature, and to give a
+     small Dose of Tartar emetic, dissolved in some Spoonfuls of Water.
+     This Remedy in this Case, promotes the Dispersion of the
+     Inflammation, beyond any other. _E. L._
+
+Sec. 116. We often see in _Swisserland_ a Disorder different from these of
+the Throat, of which we have just treated; though, like these, attended
+with a Difficulty of swallowing. It is termed in French the _Oreillons_,
+and often the _Ourles_, or swelled Ears. It is an Overfulness and
+Obstruction of those Glands and their Tubes, which are to furnish the
+_Saliva_ or Spittle; and particularly of the two large Glands which lie
+between the Ear and the Jaw; which are called the _Parotides_; and of
+two under the Jaw, called the _Maxillares_. All these being considerably
+swelled in this Disease, do not only produce a great Difficulty of
+swallowing; but also prevent the Mouth from opening; as an Attempt to do
+it is attended with violent Pain. Young Children are much more liable to
+this Disease than grown Persons. Being seldom attended with a Fever,
+there is no Occasion for Medicines: It is sufficient to defend the Parts
+affected from the external Air; to apply some proper Poultice over them;
+to lessen the Quantity of their Food considerably, denying them Flesh
+and Wine; but indulging them plentifully in some light warm Liquid, to
+dilute their Humours and restore Perspiration. I cured myself of this
+Disorder in 1754, by drinking nothing, for four Days, but Balm Tea, to
+which I added one fourth part Milk, and a little Bread. The same
+_Regimen_ has often cured me of other light Complaints of the Throat.
+
+Sec. 117. In the Spring of 1761, there were an astonishing Number of
+Persons attacked with Disorders of the Throat, of two different Kinds.
+Some of them were seized with that common Sort which I have already
+described. Without adding any thing more particularly, in Respect to
+this Species, it happened frequently to grown Persons, who were
+perfectly cured by the Method already recited. The other Species, on
+which I shall be more particular in this Place (because I know they have
+abounded in some Villages, and were very fatal) invaded Adults, or grown
+Persons also, but especially Children, from the Age of one Year, and
+even under that, to the Age of twelve or thirteen.
+
+The first Symptoms were the same with those of the common Quinsey, such
+as the Shivering, the ensuing Heat or Fever, Dejection, and a Complaint
+of the Throat: but the following Symptoms distinguished these from the
+common inflammatory Quinseys.
+
+1. The Sick had often something of a Cough, and a little Oppression.
+
+2. The Pulse was quicker, but less hard, and less strong, than generally
+happens in Diseases of the Throat.
+
+3. The Patients were afflicted with a sharp, stinging and dry Heat, and
+with great Restlessness.
+
+4. They spat less than is usual in a common Quinsey; and their Tongues
+were extremely dry.
+
+5. Though they had some Pain in swallowing, this was not their principal
+Complaint, and they could drink sufficiently.
+
+6. The Swelling and Redness of the Tonsils, of the Palate, and of its
+Process were not considerable; but the parotid and maxillary Glands, and
+especially the former, being extremely swelled and inflamed, the Pain
+they chiefly complained of, was this outward one.
+
+7. When the Disease proved considerably dangerous, the whole Neck
+swelled; and sometimes even the Veins, which return the Blood from the
+Brain, being overladen, as it were, the Sick had some Degree of
+Drowsiness, and of a _Delirium_, or Raving.
+
+8. The Paroxysms, or Returns, of the Fever were considerably irregular.
+
+9. The Urine appeared to be less inflamed, than in other Diseases of the
+Throat.
+
+10. Bleeding and other Medicines did not relieve them, as soon as in the
+other kind; and the Disease itself continued a longer Time.
+
+11. It did not terminate in a Suppuration like other Quinsies, but
+sometimes the Tonsils were ulcerated.
+
+12. [30] Almost every Child, and indeed a great many of the grown
+Persons assaulted with this Disease, threw out, either on the first Day,
+or on some succeeding one, within the first six Days, a certain
+Efflorescence, or Eruptions, resembling the Measles considerably in
+some, but of a less lively Colour, and without any Elevation, or rising
+above the Skin. It appeared first in the Face, next in the Arms, and
+descended to the Legs, Thighs and Trunk; disappearing gradually at the
+End of two or three Days, in the same Order it had observed in breaking
+out. A few others (I have seen but five Instances of it) suffered the
+most grievous Symptoms before the Eruption; and threw out the genuine
+_purpura_, or white miliary Eruption.
+
+[30] This seems to have been the same kind of Quinsey, of which Drs.
+     _Huxham_, _Fothergil_, _Cotton_ and others wrote, though under
+     different Appellations. _K._
+
+13. As soon as these Efflorescences or Eruptions appeared, the Sick
+generally found themselves better. That, last mentioned, continued four,
+five, or six Days, and frequently went off by Sweats. Such as had not
+these Ebullitions, which was the Case of many Adults, were not cured
+without very plentiful Sweats towards the Termination of the Disease:
+those which occurred at the Invasion of it being certainly unprofitable,
+and always hurtful.
+
+14. I have seen some Patients, in whom the Complaint of the Throat
+disappeared entirely, without either Eruptions or Sweats: but such still
+remained in very great Inquietude and Anguish, with a quick and small
+Pulse. I ordered them a sudorific Drink, which being succeeded by the
+Eruption, or by Sweating, they found themselves sensibly relieved.
+
+15. But whether the Sick had, or had not, these external Rednesses or
+Eruptions, every one of them parted with their Cuticle or Scarf Skin,
+which fell off, in large Scales, from the whole Surface of the Body: so
+great was the Acrimony or Sharpness of that Matter, which was to be
+discharged through the Skin.
+
+16. A great Number suffered a singular Alteration in their Voice,
+different from that which occurs in common Quinsies, the Inside of their
+Nostrils being extremely dry.
+
+17. The Sick recovered with more Difficulty after this, than after the
+common Quinsies: and if they were negligent or irregular, during their
+Recovery; particularly, if they exposed themselves too soon to the Cold,
+a Relapse ensued, or some different Symptoms; such as a Stuffing with
+Oppression, a Swelling of the Belly, windy Swellings in different Parts;
+Weakness, Loathings, Ulcerations behind the Ears, and something of a
+Cough and Hoarseness.
+
+18. I have been sent for to Children, and also to some young Folks, who,
+at the End of several Weeks, had been taken with a general Inflammation
+of the whole Body, attended with great Oppression, and a considerable
+Abatement of their Urine, which was also high-coloured and turbid, or
+without Separation. They seemed also in a very singular State of
+Indifference, or Disregard, with Respect to any Object, or Circumstance.
+I recovered every one of them entirely by Blisters, and the Powder No.
+25. The first Operation of this Medicine was to vomit them: to this
+succeeded a Discharge by Urine, and at last very plentiful Sweating,
+which compleated the Cure. Two Patients only, of a bad Constitution, who
+were a little ricketty, and disposed to glandular Scirrhosity or
+Knottiness, relapsed and died, after being recovered of the Disease
+itself for some Days.
+
+Sec. 118. I have bled some adult Persons, and made Use of the cooling
+Regimen, as long as there was an evident Inflammation: it was necessary
+after this to unload the first Passages; and at last to excite moderate
+Sweats. The same Powders No. 25 have often effected both these
+Discharges, and with entire Success. In other Cases I have made Use of
+Ipecacuanha, as directed No. 35.
+
+In some Subjects there did not appear any inflammatory Symptom; and the
+Distemper resulted solely from a Load of putrid Matter in the first
+Passages. Some Patients also discharged Worms. In such Cases I never
+bled; but the Vomit had an excellent Effect, at the very Onset of the
+Disease; it produced a perceivable Abatement of all the Symptoms;
+Sweating ensued very kindly and naturally, and the Patient recovered
+entirely a few Hours after.
+
+Sec. 119. There were some Places, in which no Symptom or Character of
+Inflammation appeared; and in which it was necessary to omit Bleeding,
+which was attended with bad Consequences.
+
+I never directed Infants to be bled. After opening the first Passages,
+Blisters and diluting Drinks proved their only Remedies. A simple
+Infusion of Elder Flowers, and those of the Lime Tree, has done great
+Service to those who drank plentifully of it.
+
+Sec. 120. I am sensible that in many Villages a great Number of Persons
+have died, with a prodigious Inflation or Swelling of the Neck. Some
+have also died in the City, and among others a young Woman of twenty
+Years of Age, who had taken nothing but hot sweating Medicines and red
+Wine, and died the fourth Day, with violent Suffocations, and a large
+Discharge of Blood from the Nose. Of the great Number I have seen in
+Person, only two died. One was a little Girl of ten Months old. She had
+an Efflorescence which very suddenly disappeared: at this Time I was
+called in; but the Humour had retreated to the Breast, and rendered her
+Death inevitable. The other was a strong Youth from sixteen to seventeen
+Years old, whose sudden Attack from the Disease manifested, from the
+very Beginning, a violent Degree of it. Nevertheless, the Symptoms
+subsiding, and the Fever nearly terminating, the Sweats which approached
+would probably have saved him. But he would not suffer them to have
+their Course, continually stripping himself quite naked. The
+Inflammation was immediately repelled upon the Lungs, and destroyed him
+within the Space of thirty Hours. I never saw a Person die with so very
+dry a Skin. The Vomit affected him very little upwards, and brought on a
+purging. His own bad Conduct seems to have been the Occasion of his
+Death; and may this serve as one Example of it.
+
+Sec. 121. I chose to expatiate on this Disease, as it may happen to reach
+other Places, where it may be useful to have been apprized of its Marks,
+and of its Treatment, which agrees as much with that of putrid Fevers,
+of which I shall speak hereafter, as with that of the inflammatory
+Diseases I have already considered: since in some Subjects the Complaint
+of the Throat has evidently been a Symptom of a putrid Fever, rather
+than of the chiefly apparent Disease, a Quinsey. [31]
+
+Sec. 122. Disorders of the Throat are, with Respect to particular Persons,
+an habitual Disease returning every Year, and sometimes oftner than once
+a Year. They may be prevented by the same Means, which I have directed
+for the Preservation from habitual Pleurisies Sec. 100; and by defending
+the Head and the Neck from the Cold; especially after being heated by
+Hunting, or any violent Exercise, or even by singing long and loud,
+which may be considered as an extraordinary Exercise of some of the
+Parts affected in this Disease.
+
+[31] I reserve some other interesting Reflections on this Disease, for
+     the second Edition of my Treatise on Fevers; and the Editor at
+     _Paris_ has very well observed, that it has some Relation to the
+     gangrenous sore Throat, which has been epidemical these twenty
+     Years past, in many Parts of _Europe_.----This Note is from Dr.
+     _Tissot_ himself.
+
+
+
+
+                            __Chapter VII.__
+
+
+                              _Of Colds._
+
+
+                             __Sect.__ 123.
+
+There are many erroneous Prejudices, with Regard to Colds, all of which
+may be attended with pernicious Consequences. The first is, that a Cold
+is never dangerous; an Error which daily destroys the Lives of many. I
+have already complained of it for many Years past; and I have since
+beheld a Multitude of such Examples of it, as have but too sufficiently
+warranted my Complaints.
+
+No Person however, it is certain, dies merely of a Cold, as long as it
+is nothing but a Cold simply; but when, from Inattention and Neglect, it
+is thrown upon, and occasions Distempers of the Breast, it may, and
+often does, prove mortal. _Colds destroy more than Plagues_, was the
+Answer of a very sagacious and experienced Physician to one of his
+Friends, who, being asked, how he was in Health, replied, Very well, I
+have nothing but a Cold.
+
+A second erroneous Prejudice is, that Colds require no Means, no
+Medicines, and that they last the longer for being nursed, or tampered
+with. The last Article may be true indeed, with Respect to the Method,
+in which the Person affected with them treats them; but the Principle
+itself is false. Colds, like other Disorders, have their proper
+Remedies; and are removed with more or less Facility, as they are
+conducted better or worse.
+
+Sec. 124. A third Mistake is, that they are not only considered as not
+dangerous, but are even supposed wholesome too. Doubtless a Man had
+better have a Cold than a more grievous Disease; though it must be still
+better to have neither of them. The most that can reasonably be said and
+admitted on this Point, is, that when a checked, or an obstructed
+Perspiration becomes the Cause of a Distemper, it is fortunate that it
+produces rather a Cold, than any very dreadful Disease, which it
+frequently does: though it were to be wished, that neither the Cause,
+nor its Effect existed. A Cold constantly produces some Disorder or
+Defect in the Functions of some Part or Parts of the Body, and thus
+becomes the Cause of a Disease. It is indeed a real Disorder itself, and
+which, when in a violent Degree, makes a very perceivable Assault upon
+our whole Machine. Colds, with their Defluxions, considerably weaken the
+Breast, and sooner or later considerably impair the Health. Persons
+subject to frequent Colds are never robust or strong; they often sink
+into languid Disorders; and a frequent Aptitude to take Cold is a Proof,
+that their Perspiration may be easily checked and restrained; whence the
+Lungs become oppressed and obstructed, which must always be attended
+with considerable Danger.
+
+Sec. 125. We may be convinced of the Weakness and Fallacy of these
+Prejudices, by considering attentively the Nature of Colds; which are
+nothing else than the very Diseases already described in the three
+preceding Chapters, though in their greatest Degree only.
+
+A Cold in Truth is almost constantly an inflammatory Disease; a light
+Inflammation of the Lungs, or of the Throat; of the Membrane or very
+thin Skin, which lines the Nostrills, and the Inside of certain Cavities
+in the Bones of the Cheeks and Forehead. These Cavities communicate with
+the Nose, in such a Manner, that when one Part of this Membrane is
+affected with an Inflammation, it is easily communicated to the other
+Parts.
+
+Sec. 126. It is scarcely necessary to describe the Symptoms of a Cold, and
+it may be sufficient to remark, 1. That their chief Cause is the same
+with that, which most commonly produces the Diseases already treated of,
+that is, an obstructed Perspiration, and a Blood somewhat inflamed. 2.
+That whenever these Diseases affect great Numbers, many Colds prevail at
+the same Time. 3. That the Symptoms which manifest a violent Cold,
+greatly resemble those which precede or usher in these Diseases. People
+are rarely attacked by great Colds, without a shivering and Fever; which
+last sometimes continues for many Days. There is a Cough, a dry Cough,
+for some Time; after which some Expectoration ensues; which allays the
+Cough, and lightens the Oppression; at which Time the Cold may be said
+to be maturated, or ripe. There are pretty often slight Stitches, but
+unfixed or flying about, with a little Complaint of the Throat. When the
+Nostrills happen to be the Seat of the Disorder, which is then very
+improperly termed a Cold of the Brain, it is often attended with a
+vehement Head-ach; which sometimes depends on an Irritation of the
+Membrane, that lines the Cavities in the Bone of the Forehead, or the
+maxillary Sinusses, that is, the Cavities in the Jaws: At first the
+Running from the Nose is very clear; thin and sharp; afterwards, in
+Proportion to the Abatement of the Inflammation, it becomes thicker; and
+the Consistence and Colour of it resemble those of what others cough up.
+The Smell, the Taste and the Appetite are commonly impaired by it.
+
+Sec. 127. Colds seem to be of no certain Duration or Continuance. Those of
+the Head or Brain generally last but a few Days; of the Breast longer.
+Some Colds nevertheless terminate in four or five Days. If they extend
+beyond this Term they prove really hurtful. 1. Because the Violence of
+the Cough disorders the whole Machine; and particularly, by forcing up
+the Blood to the Head. 2. By depriving the Person afflicted of his usual
+Sleep, which is almost constantly diminished by it. 3. By impairing the
+Appetite, and confusing the Digestion, which is unavoidably lessened by
+it. 4. By weakening the very Lungs, by the continual Agitations from
+Coughing; whence all the Humours being gradually determined towards
+them, as the weakest Part, a continual Cough subsists. Hence also they
+become overcharged with Humours, which grow viscid there; the
+Respiration is overloaded and oppressed; a slow Fever appears; Nutrition
+almost ceases; the Patient becomes very weak; sinks into a Wasting; an
+obstinate Wakefulness and Anguish, and often dies in a short Time. 5. By
+Reason that the Fever, which almost constantly accompanies great Cold,
+concurs to wear the body down.
+
+Sec. 128. Wherefore, since a Cold is a Disease of the same kind with
+Quinsies, Peripneumonies and Inflammations of the Breast, it ought to be
+treated in the same Manner. If it is a violent one, Blood should be
+taken from the Arm, which may considerably shorten its Duration: and
+this becomes most essentially necessary, whenever the Patient is of a
+sanguineous ruddy Complexion, abounds with Blood, and has a strong
+Cough, and great Head-ach. The Drinks No. 1, 2, 3, 4, should be very
+plentifully used. It is advantagious to bathe the Feet in warm Water
+every Night at going to Bed. [32] In a Word, if the Patient is put into
+a Regimen, the Cure is very speedily effected.
+
+[32] It frequently happens, that the Bathings alone remove the Head-ach,
+     and the Cough too, by relaxing the lower Parts, and the entire
+     Surface of the Body. If the Patient is costive, he should receive
+     Glysters of warm Water, in which some Bran has been boiled, with
+     the Addition of a little common Soap or Butter. _E. L._
+
+Sec. 129. The Disorder indeed, however, is often so very slight, that it
+may be thought to require very little, if any, medical Treatment, and
+may be easily cured without Physick, by abstaining from Flesh, Eggs,
+Broth, and Wine; from all Food that is sharp, fat and heavy; and by
+dieting upon Bread, Pulse, Fruit, and Water; particularly by eating
+little or no Supper; and drinking, if thirsty, a simple Ptisan of
+Barley, or an Infusion of Elder Flowers, with the Addition of a third or
+fourth Part of Milk. Bathing the Feet, and the Powder No. 20 contribute
+to dispose the Patient to sleep. Five Tea-Cups of an Infusion of the
+Red, or wild Poppy Leaves may also be ventured on safely.
+
+Sec. 130. When the Fever, Heat and Inflammation wholly disappear; when the
+Patient has kept to his Regimen for some Days, and his Blood is well
+diluted, if the Cough and Want of Sleep still continues, he may take in
+the Evening a Dose of Storax [33] Pill, or of Venice Treacle with Elder
+Flower Tea, after bathing his Feet. These Remedies by stilling the
+Cough, and restoring Perspiration, frequently cure the Cold in the Space
+of one Night. I confess at the same Time, I have seen bad Consequences
+from such Opiates, when given too early in the Complaint. It is also
+necessary, when they are given, that the Patient should have supt but
+very moderately, and that his Supper should be digested.
+
+[33] Under these Circumstances of a tickling Cough from a Cold, without
+     a Fever, and with very little Inflammation, I have known great and
+     very frequent Success, from a Dose of _Elixir paregoricum_, taken
+     at Bed-time, after a very light thin Supper. If the Patient be
+     sanguine, strong and costive, Bleeding in a suitable Quantity, and
+     a gently opening Potion, or purging Glyster, may be prudently
+     premised to it. Grown Persons may take from 30 to 80, or even 100
+     Drops of it, in Barley Water, or any other pectoral Drink; and
+     Children in the Chincough from five to twenty Drops; half an Ounce
+     of it by Measure containing about one Grain of Opium, which is the
+     Quantity contained in less than quite six Grains of the Storax
+     Pill; this last being a very available pectoral Opiate too in
+     Coughs from a Distillation, in more adult Bodies, who may also
+     prefer a Medicine in that small Size, and Form. _K._
+
+Sec. 131. An immense Number of Remedies are cried up for the Cure of Colds;
+such as Ptisans of Apples or Pippins, of Liquorice, of dry Raisins, of
+Figs, of Borage, of Ground-Ivy, of _Veronica_ or Speedwell, of Hysop, of
+Nettles, _&c. &c._ I have no Design to depreciate them; as all of them
+may possibly be useful: But unfortunately, those who have seen any
+particular one of them succeed in one Case, readily conclude it to be
+the most excellent of them all; which is a dangerous Error, because no
+one Case is a sufficient Foundation to decide upon: which besides none
+are qualified to do, who have not often seen a great Number of such
+Cases; and who do not so attentively observe the Effects of different
+Medicines, as to determine on those which most frequently agree with the
+Disorder; and which, in my Judgment, are those I have just enumerated. I
+have known a Tea or Infusion of Cherry Stalks, which is not a
+disagreeable Drink, to cure a very inveterate Cold.
+
+Sec. 132. In Colds of the Head or Brain, the Steam of warm Water alone, or
+that in which Elder Flowers, or some other mild aromatic Herbs, have
+been boiled, commonly afford a pretty speedy Relief. These are also
+serviceable in Colds fallen on the Breast. See Sec. 55.
+
+It has been a Practice, though of no very long standing, to give the Fat
+of a Whale in these Cases; but this is a very crude indigestible kind of
+Fat, and greasy oily Medicines seldom agree with Colds. Besides, this
+Whales' Fat is very disagreeable and rancid, that is rank; so that it
+were better to forbear using it: I have sometimes seen ill Effects from
+it, and rarely any good ones. [34]
+
+[34] This seems but too applicable to the very popular Use of
+     _Spermaceti_, &c. in such Cases, which can only grease the Passage
+     to the Stomach; must impair its digestive Faculty, and cannot
+     operate against the Cause of a Cold; though that Cure of it, which
+     is effected by the Oeconomy of Nature in due Time, is often
+     ascribed to such Medicines, as may rather have retarded it. _K._
+
+Sec. 133. Such Persons as abate nothing of the usual Quantity of their
+Food, when seized with a Cold, and who swallow down large Quantities of
+hot Water, ruin their Health. Their Digestion ceases; the Cough begins
+to affect the Stomach, without ceasing to afflict the Breast; and they
+incur a Chance of sinking into the Condition described Sec. 127, No. 4.
+
+Burnt Brandy and spiced Wine are very pernicious in the Beginning of
+Colds, and the Omission of them must be a very prudent Omission. If any
+good Effects have ever been known to attend the Use of them, it has been
+towards the going off of the Cold; when the Disorder maintained its
+Ground, solely from the Weakness of the Patient. Whenever this is the
+Case, there is not the least Room for farther Relaxation; but the
+Powders No. 14, should be taken every Day in a little Wine; and should
+the Humours seem likely to be thrown upon the Lungs, Blisters ought to
+be applied to the fleshy Part of the Legs.
+
+Sec. 134. Drams, or _Liqueurs_, as they are called in _French_, agree so
+very little in this last State, that frequently a very small Quantity of
+them revives a Cold that was just expiring. There really are some
+Persons who never drink them without taking Cold, which is not to be
+wondered at, as they occasion a light Inflammation in the Breast, which
+is equivalent to a Cold or Distillation.
+
+Nevertheless, People in this Disorder should not expose themselves to
+violent cold Weather, if there is a Possibility of avoiding it: though
+they should equally guard too against excessive Heat. Those, who inclose
+themselves in very hot Rooms, never get quite cured; and how is it
+possible they should be cured in such a Situation? Such Rooms,
+abstracted from the Danger of coming out of them, produce Colds in the
+same Manner that Drams do, by producing a light inflammation in the
+Breast.
+
+Sec. 135. Persons subject to frequent Colds, which Habits are sometimes
+termed _fluxionary_, or liable to Distillations, imagine, they ought to
+keep themselves very hot. This is an Error which thoroughly destroys
+their Health. Such a Disposition to take Cold arises from two Causes;
+either because their Perspiration is easily impaired; or sometimes from
+the Weakness of the Stomach or the Lungs, which require particular
+Remedies. When the Complaint arises from the Perspiration's being easily
+disturbed and lessened, the hotter they keep themselves, the more they
+sweat, and increase their Complaint the more. This incessantly warm Air
+lets down and weakens the whole Machine, and more particularly the
+Lungs; where the Humours finding less Resistance, are continually
+derived, and are accumulated there. The Skin, being constantly bathed in
+a small Sweat, becomes relaxed, soft, and incapable of compleating its
+Functions: from which Failure the slightest Cause produces a total
+Obstruction of Perspiration; and a Multitude of languid Disorders ensue.
+
+These Patients thus circumstanced, redouble their Precautions against
+the Cold, or even the Coolness of the Air, while their utmost Cautions
+are but so many effectual Means to lower their Health; and this the more
+certainly, as their Dread of the free Air necessarily subjects them to a
+sedentary Life, which increases all their Symptoms; while the hot Drinks
+they indulge in, compleat their Severity. There is but one Method to
+cure People thus situated; that is, by accustoming them gradually to the
+Air; to keep them out of hot Chambers; to lessen their Cloathing by
+Degrees; to make them sleep cool; and to let them eat or drink nothing
+but what is cold, Ice itself being wholesome in their Drink: to make
+them use much Exercise; and finally, if the Disorder be inveterate, to
+give them for a considerable Time the Powder No. 14, and make them use
+the cold Bath. This Method succeeds equally too with those, in whom the
+Disease originally depended on a Weakness of the Stomach, or of the
+Lungs: and in fact, at the End of a certain Period, these three Causes
+are always combined. Some Persons who have been subject, for many Years,
+to catch Colds throughout the Winter; and who, during that Season, never
+went out, and drank every thing warm, have been evidently the better,
+during the Winter of 1761, and 1762, for the Direction I have given
+here. They now walk out every Day; drink their Liquids cold; and by this
+Means entirely escape Colds, and enjoy perfect Health.
+
+Sec. 136. It is more customary indeed in Town, than in the Country, to have
+different Troches, and Compositions in the Mouth. I am not for excluding
+this Habit; though I think nothing is so efficacious as Juice of
+Liquorice; and provided a sufficient Dose be taken, it affords certain
+Relief. I have taken an Ounce and a half in one Day, and have felt the
+good Consequences of it very remarkably.
+
+
+
+
+                            __Chapter VIII.__
+
+
+                      _Of Diseases of the Teeth._
+
+
+                             __Sect.__ 137.
+
+The Diseases of the Teeth, which are sometimes so tedious and so
+violent, as to cause obstinate Wakefulness, a considerable Degree of
+Fever, Raving, Inflammations, Abscesses, Rottenness of the Bones,
+Convulsions and Faintings, depend on three principal Causes. 1. On a
+_Caries_ or Rottenness of the Teeth. 2. On an Inflammation of the Nerves
+of the Teeth, or of the Membrane which invests and covers them; and
+which affects the Membrane of the Gums. 3. A cold Humour or Defluxion
+that is determined to the Teeth, and to their Nerves and Membrane.
+
+Sec. 138. In the first of these Cases, the _Caries_ having eat down to, and
+exposed the naked Nerve, the Air, Food and Drink irritate, or, as it
+were sting it; and this irritation is attended with Pain more or less
+violent. Every thing that increases the Motion or Action of the affected
+Part, as Exercise, Heat or Food, will be attended with the same
+Consequence.
+
+When the Tooth is greatly decayed, there is no other Cure besides that
+by extracting it, without which the Pain continues; the Breath becomes
+very offensive; the Gum is eat down; the other Teeth, and sometimes even
+the Jaw-bone, are infected with the Rottenness: besides, that it
+prevents the Use of the other Teeth, which are infected with a kind of
+tartarous Matter, and decay.
+
+But when the Disorder is less considerable, the Progress of it may
+sometimes be restrained, by burning the Tooth with a hot Iron, or by
+filling it with Lead, if it is fitted to receive and to retain it.
+Different corroding Liquids are sometimes used on these Occasions, _Aqua
+fortis_ itself, and Spirit of Vitriol: but such Applications are highly
+dangerous, and ought to be excluded. When the Patients, from Dread,
+reject the Operations just mentioned, a little Oyl of Cloves may be
+applied, by introducing a small Pellet of Cotton, dipt in it, to the
+rotten hollow Tooth; which often affords considerable Ease, and Respite.
+Some make use of a Tincture of Opium, or Laudanum, after the same
+Manner; and indeed these two Medicines may be used together in equal
+Quantities. I have often succeeded with _Hoffman's_ mineral anodyne
+Liquor; which seemed indeed, for a few Moments, to increase the Pain;
+but Ease generally ensues after spitting a little Time. A Gargarism made
+of the Herb _Argentina_; that is Silver-weed or wild Tansey, in Water,
+frequently appeases the Pain that results from a _Caries_ of the Teeth:
+and in such Cases many People have found themselves at Ease, under a
+constant Use of it. It certainly is an Application that cannot hurt, and
+is even beneficial to the Gums. Others have been relieved by rubbing
+their Faces over with Honey.
+
+Sec. 139. The second Cause is the Inflammation of the Nerve within the
+Substance, or of the Membrane on the Outside, of the Tooth. This is
+discovered by the Patient's Temperament, Age and Manner of living. They
+who are young, sanguine, who heat themselves much, whether by Labour, by
+their Food, their Drink, by sitting up late, or by any other Excess:
+they who have been accustomed to any Discharges or Eruptions of Blood,
+whether natural or artificial, and who cease to have them as usual, are
+much exposed to the Tooth-ach, from this Cause.
+
+This Pain, or rather Torment, if in an acute Degree, commonly happens
+very suddenly, and often after some heating Cause. The Pulse is strong
+and full; the Countenance considerably red; the Mouth extremely hot:
+there is often a pretty high Fever, and a violent Head-ach. The Gums, or
+some Part of them, become inflamed, swelled, and sometimes an Abscess
+appears. At other times the Humours throw themselves upon the more
+external Parts; the Cheek swells, and the Pain abates. When the Cheek
+swells, but without any Diminution of the Pain, it then becomes an
+Augmentation, but no essential Change, of the Disorder.
+
+Sec. 140. In this Species of the Disease, we must have Recourse to the
+general Method of treating inflammatory Disorders, and direct Bleeding,
+which often produces immediate Ease, if performed early. After Bleeding,
+the Patient should gargle with Barley Water, or Milk and Water; and
+apply an emollient Cataplasm to the Cheek. If an Abscess or little
+Imposthume appears, the Suppuration or ripening of it is to be promoted,
+by holding continually in the Mouth some hot Milk, or Figs boiled in
+some Milk: and as soon as ever it seems ripe, it should be opened, which
+may be done easily, and without any Pain. The Disorder, when depending
+on this Cause, is sometimes not so violent, but of a longer Duration,
+and returns whenever the Patient heats himself; when he goes to Bed;
+when he eats any heating Food, or Drink, Wine or Coffee. In this Case he
+should be bled, without which his other Medicines will have little
+Effect; and he should bathe his Feet in warm Water for some Evenings
+successively, taking one Dose of the Powder No. 20. Entire Abstinence
+from Wine and Meat, especially at Night, has cured several Persons of
+inveterate and obstinate Maladies of the Teeth.
+
+In this Species of Tooth-ach, all hot Remedies are pernicious; and it
+often happens that Opium, Venice Treacle, and Storax Pills, are so far
+from producing the Relief expected from them, that they have aggravated
+the Pain.
+
+Sec. 141. When the Disease arises from a cold Distillation, or Humour,
+tending to these Parts, it is commonly (though equally painful) attended
+with less violent Symptoms. The Pulse is neither strong, full nor quick;
+the Mouth is less heated, and less swelled. In such Cases, the afflicted
+should be purged with the Powder No. 21, which has sometimes perfectly
+cured very obstinate Complaints of this Sort. After purging they should
+make Use of the Diet Drink of the Woods No. 22. This has cured
+Tooth-achs, which have baffled other Attempts for many Years; but it
+must be added, this Drink would be hurtful in the Disease from a
+different Cause. Blisters to the Nape of the Neck, or [35] elsewhere, it
+matters not greatly where, have often extraordinary good Effects, by
+diverting the Humour, and restoring a compleat Perspiration. In short in
+this Species, we may employ, not only with Safety, but with Success
+(especially after due purging) Pills of Storax, Opium and Venice
+Treacle. Acrid sharp Remedies, such as hard spun [35] Tobacco, Root of
+Pellitory of _Spain_, &c. by exciting much Spitting, discharge part of
+the Humour which causes the Disease, and hence diminish the Pain. The
+Smoke of Tobacco also succeeds now and then in this Disorder, whether
+this happens from the Discharge of the Rheum or Spittle it occasions; or
+whether it is owing to any anodyne Efficacy of this Plant, in which it
+resembles Opium.
+
+[35] A small Blister behind the Ear of the affected Side, or both Ears,
+     has very often removed the Pain, when from a Defluxion. It is
+     pretty common for the Subjects of this Disease to be very costive,
+     during the Exacerbations of it, which I have sometimes experienced
+     to be pretty regularly and severely quotidian, for a Week or two.
+     The Custom of smoking Tobacco very often, which the Violence of
+     this Pain has sometimes introduced, often disposes to a Blackened
+     and premature Decay of the Teeth, to which the Chewers of it are
+     less obnoxious: and this Difference may result from some particles
+     of its chemical Oil rising by Fumigation, and being retained in the
+     Teeth, which Particles are not extracted by Mastication. But with
+     Regard to the habitual Use of this very acrid and internally
+     violent Herb, for, but chiefly after, this Disease, it should be
+     considered well, whether in some Constitutions it may not pave the
+     Way to a more dangerous one, than it was introduced to remove. _K._
+
+Sec. 142. As this last Cause is often the Consequence of a Weakness in the
+Stomach, it daily happens that we see some People, whose Disorder from
+this Cause is augmented, in Proportion as they indulge in a cooling,
+refreshing Way of living. The Increase of the Disorder disposes them to
+increase the Dose of what they mistake for its Remedy, in Proportion to
+which their Pain only increases. There is a Necessity that such Persons
+should alter this Method; and make use of such Medicines as are proper
+to strengthen the Stomach, and to restore Perspiration. The Powder No.
+14. has often produced the best Consequences, when I have ordered it in
+these Cases; and it never fails to dissipate the Tooth-ach very
+speedily, which returns periodically at stated Days and Hours. I have
+also cured some Persons who never drank Wine, by advising them to the
+Use of it.
+
+Sec. 143. But besides the Diseases of the Teeth, that are owing to these
+three principal Causes, which are the most common ones; there are some
+very tedious and most tormenting Disorders of them, that are occasioned
+by a general Acrimony, or great Sharpness, of the Mass of Blood, and
+which are never cured by any other Medicines but such, as are proper to
+correct that Acrimony. When it is of a scorbutic Nature, the wild
+Horse-radish (Pepperwort) Water Cresses, Brooklime, Sorrel, and
+Wood-sorrell correct and cure it. If it is of a different Nature, it
+requires different Remedies. But very particular Details do not come
+within the Plan of this Work. As the Malady is of the chronical or
+tedious kind, it allows Time to consider and consult more particularly
+about it.
+
+The Gout and the Rheumatism are sometimes transferred to the Teeth, and
+give Rise to the most excruciating Pains; which must be treated like the
+Diseases from which they arise.
+
+Sec. 144. From what has been said on this Disorder, the Reader will
+discern, in what that imaginary Oddness may consist, which has been
+ascribed to it, from the same Application's relieving one Person in it,
+and not affording the least Relief to another. Now the plain Reason of
+this is, that these Applications are always directed, without an exact
+Knowledge of the particular Cause of the Disease, in different Subjects
+and Circumstances; whence the Pain from a rotten Tooth, is treated like
+that from an Inflammation; that from an Inflammation, like the Pain from
+a cold Humour or Fluxion; and this last like a Pain caused by a
+scorbutic Acrimony: so that the Disappointment is not in the least
+surprizing. Perhaps Physicians themselves do not always attend
+distinctly enough to the Nature of each particular Disorder: and even
+when they do, they content themselves with directing some of the less
+potent Medicines, which may be inadequate to accomplish the necessary
+Effect. If the Distemper truly be of an inflammatory Disposition,
+Bleeding is indispensible to the Cure.
+
+It happens in Fact, with Regard to the Diseases of the Teeth, as well as
+to all other Diseases, that they arise from different Causes; and if
+these Causes are not opposed by Medicines suited to them, the Disease,
+far from being cured, is aggravated.
+
+I have cured violent Tooth-achs, of the lower Jaw, by applying a
+Plaister of Meal, the White of an Egg, Brandy and Mastich, at the Corner
+of that Jaw, over the Spot where the Pulsation of the Artery may be
+perceived: and I have also mitigated the most excruciating Pains of the
+Head, by applying the same Plaister upon the temporal Artery.
+
+
+
+
+                             __Chapter IX.__
+
+
+                           _Of the Apoplexy._
+
+
+                             __Sect.__ 145.
+
+Every Person has some Idea of the Disease termed an Apoplexy, which is a
+sudden Privation or Loss of all Sense, and of all voluntary Motion; the
+Pulse at the same Time being kept up, but Respiration or Breathing,
+being oppressed. I shall treat of this Disease only in a brief Manner,
+as it is not common in our Country Villages; and as I have expatiated on
+it in a different Manner in a Letter to Dr. _Haller_, published in 1761.
+
+Sec. 146. This Disease is generally distinguished into two Kinds, the
+sanguineous and serous Apoplexy. Each of them results from an
+Overfulness of the Blood Vessels of the Brain, which presses upon, and
+prevents or impairs the Functions of the Nerves. The whole Difference
+between these two Species consists in this, that the sanguineous
+Apoplexy prevails among strong robust Persons, who have a rich, heavy,
+thick and inflammable Blood, and that in a large Quantity; in which
+Circumstance it becomes a genuine inflammatory Distemper. The serous, or
+humoral Apoplexy invades Persons of a less robust Constitution; whose
+Blood is more dilute or watery; and rather viscid, or lightly
+gelatinous, than heavy or rich; whole Vessels are in a more relaxed
+State; and who abound more in other Humours than in red Blood.
+
+Sec. 147. When the first kind of this Disease exists in its most violent
+Degree, it is then sometimes termed, an apoplectic Stroke, or thundering
+Apoplexy, which kills in a Moment or instantaneously, and admits of no
+Remedies. When the Assault is less violent, and we find the Patient with
+a strong, full and raised Pulse, his Visage red and bloated, and his
+Neck swelled up; with an oppressed and loud hoarse Respiration; being
+sensible of nothing, and capable of no other Motions, except some
+Efforts to vomit, the Case is not always equally desperate. We must
+therefore immediately,
+
+1. Entirely uncover the Patient's Head, covering the rest of his Body
+but very lightly; procure him instantly very fresh free Air, and leave
+his Neck quite unbound and open.
+
+2. His Head should be placed as high as may be, with his Feet hanging
+down.
+
+3. He must lose from twelve to fifteen Ounces of Blood, from a free open
+Orifice in the Arm: the Strength or Violence with which the Blood
+sallies out, should determine the Surgeon to take a few Ounces more or
+less. It should be repeated to the third or fourth Time, within the
+Space of three or four Hours; if the Symptoms seem to require it, either
+in the Arm, or in the Foot.
+
+4. A Glyster should be given of a Decoction of the first emollient
+opening Herbs that can be got, with four Spoonfuls of Oil, one Spoonful
+of Salt: and this should be repeated every three Hours.
+
+5. If it is possible, he should be made to swallow Water plentifully, in
+each Pot of which three Drams of Nitre are to be dissolved.
+
+6. As soon as the Height and Violence of the Pulse abates; when his
+Breathing becomes less oppressed and difficult, and his Countenance less
+inflamed, he should take the Decoction No. 23; or, if it cannot be got
+ready in Time, he should take three Quarters of an Ounce of Cream of
+Tartar, and drink Whey plentifully after it. This Medicine succeeded
+extremely well with me in a Case, where I could not readily procure any
+other.
+
+7. He should avoid all strong Liquor, Wine, distilled Spirit, whether
+inwardly or by outward Application, and should even be prevented
+from [36] smelling them.
+
+[36] I have been very authentically assured of the Death of a hale Man,
+     which happened in the very Act of pouring out a large Quantity of
+     distilled Spirits, by Gallons or Bucketfulls, from one Vessel into
+     another. _K._
+
+8. The Patient should be stirred, moved, or even touched, as little as
+it is possible: in a Word every Thing must be avoided that can give him
+the least Agitation. This Advice, I am sensible, is directly contrary to
+the common Practice; notwithstanding which it is founded in Reason,
+approved by Experience, and absolutely necessary. In Fact, the whole
+Evil results from the Blood being forced up with too much Force, and in
+too great a Quantity, to the Brain; which being thence in a State of
+Compression, prevents every Movement and every Influence of the Nerves.
+In Order, therefore, to re-establish these Movements, the Brain must be
+unloaded, by diminishing the Force of the Blood. But strong Liquors,
+Wines, Spirits, volatile Salts, all Agitation and Frictions augment it,
+and by that very Means increase the Load, the Embarrassment of the
+Brain, and thus heighten the Disease itself. On the contrary, every
+Thing that calms the Circulation, contributes to recall Sensation and
+voluntary Motion the sooner.
+
+9. Strong Ligatures should be made about the Thighs under the Ham: By
+this Means the Blood is prevented in its Ascent from the Legs, and less
+is carried up to the Head.
+
+If the Patient seems gradually, and in Proportion as he takes proper
+Medicines, to advance into a less violent State, there may be some
+Hopes. But if he rather grows worse after his earliest Evacuations, the
+Case is desperate.
+
+Sec. 148. When Nature and Art effect his Recovery, his Senses return:
+though there frequently remains a little _Delirium_ or Wandering for
+some Time; and almost always a paralytic Defect, more or less, of the
+Tongue, the Arm, the Leg, and the Muscles of the same Side of the Face.
+This Palsy sometimes goes off gradually, by the Help of cooling Purges
+from Time to Time, and a Diet that is but very moderately and lightly
+nourishing. All hot Medicines are extremely hurtful in this Case, and
+may pave the Way to a repeated Attack. A Vomit might be even fatal, and
+has been more than once so. It should be absolutely forbidden; nor
+should we even promote, by Draughts of warm Water, the Efforts of the
+Patient to vomit. They do not any ways depend on any Humour or Mass in
+the Stomach; but on the Oppression and Embarrassment of the Brain: and
+the more considerable such Efforts are, the more such Oppression is
+increased: by Reason that as long as they continue, the Blood cannot
+return from the Head, by which Means the Brain remains overcharged.
+
+Sec. 149. The other Species of Apoplexy is attended with the like Symptoms,
+excepting the Pulse not being so high nor strong; the Countenance being
+also less red, sometimes even pale; the Breathing seems less oppressed;
+and sometimes the Sick have a greater Facility to vomit, and discharge
+more upwards.
+
+As this Kind of the Disease attacks Persons who abound less in Blood;
+who are less strong, and less heated or inflamed, Bleeding is not often
+at all necessary: at least the Repetition of it is scarcely ever so: and
+should the Pulse have but a small Fulness, and not the least unnatural
+Hardness, Bleeding might even be pernicious.
+
+1. The Patient however should be placed as was directed in the former
+Mode of this Disease; though it seems not equally necessary here.
+
+2. He should receive a Glyster, but without Oil, with double the
+Quantity of Salt, and a Bit of Soap of the Size of a small Egg; or with
+four or five Sprigs of Hedge Hyssop. It may be repeated twice a Day.
+
+3. He should be purged with the Powder No. 4. [37]
+
+[37] Vomits which are so pernicious in the sanguineous Apoplexy, where
+     the Patient's Countenance and Eyes are inflamed; and which are also
+     dangerous or useless, when a Person has been very moderate in his
+     Meals, or is weakened by Age or other Circumstances, and whole
+     Stomach is far from being overloaded with Aliment, are nevertheless
+     very proper for gross Feeders, who are accustomed to exceed at
+     Table, who have Indigestions, and have a Mass of viscid glairy
+     Humours in their Stomachs; more especially, if such a one has a
+     little while before indulged himself excessively, whence he has
+     vomited without any other evident Cause, or at least had very
+     Strong _Nauseas_, or Loathings. In brief, Vomits are the true
+     Specific for Apoplexies, occasioned by any narcotic or stupifying
+     Poisons, the pernicious Effects of which cease, the Moment the
+     Persons so poisoned vomit them up. An attentive Consideration of
+     what has occurred to the Patient before his Seizure; his small
+     natural Propensity to this Disease, and great and incessant
+     Loathings, render it manifest, whether it has been caused by such
+     Poisons, or such poisonous Excesses. In these two Last Cases a
+     double Dose of Tartar emetic should be dissolved in a Goblet or Cup
+     of Water, of which the Patient should immediately take a large
+     Spoonful; which should be repeated every Quarter of an Hour, till
+     it operates. _E. L._
+
+4. His common Drink may be a Strong Infusion of Leaves of Balm.
+
+5. The Purge should be repeated the third Day.
+
+6. Blisters should immediately be applied to the fleshy Part of the
+Legs, or between the Shoulder Blades. [38]
+
+[38] These Blisters may be preceded by Cupping with Scarification on the
+     Nape of the Neck. This Remedy, often used by the ancient
+     Physicians, but too little practiced in France, is one of the most
+     speedy, and not the least efficacious, Applications in both
+     sanguine and serous Apoplexies. _E. L._
+
+7. Should Nature seem disposed to relieve herself by Sweatings, it
+should be encouraged; and I have often known an Infusion of the _Carduus
+benedictus_, or blessed Thistle, produce this Effect very successfully.
+If this Method be entered upon, the Sweat ought to be kept up (without
+stirring if possible) for many Days. It has then sometimes happened,
+that at the End of nine Days, the Patient has been totally freed from
+the Palsy, which commonly succeeds this Species of the Apoplexy, just as
+it does the other.
+
+Sec. 150. Persons who have been attacked with either kinds of this Disease
+are liable to subsequent ones; each of which is more dangerous than that
+preceding: whence an Endeavour to obviate or prevent such Relapses
+becomes of the utmost Importance. This is to be effected in each Sort by
+a very exact, and rather severe Diet, even to diminishing the usual
+Quantity of the Patient's Food; the most essential Precaution, to be
+observed by any who have been once assaulted with it, being entirely to
+leave off Suppers. Indeed those, who have been once attacked with the
+_first_, the _sanguineous Apoplexies_, should be still more exact, more
+upon their Guard, than the others. They should deny themselves whatever
+is rich and juicy, hot or aromatic, sharp, Wine, distilled Liquors and
+Coffee. They should chiefly confine themselves to Garden-Stuff, Fruits
+and Acids; such should eat but little Flesh, and only those called
+white; taking every Week two or three Doses of the Powder No. 24, in a
+Morning fasting, in a Glass of Water. They should be purged twice or
+thrice a Year with the Draught No. 23; use daily Exercise; avoid very
+hot Rooms, and the violent Heat of the Sun. They should go to Bed
+betimes, rise early, never lie in Bed above eight Hours: and if it is
+observed that their Blood increases considerably, and has a Tendency
+towards the Head, they should be bled without Hesitation: and for some
+Days restrain themselves entirely to a thin and low Regimen, without
+taking any solid Food. In these Circumstances warm Bathings are hurtful.
+In the other, the serous, Apoplexy, instead of purging with No. 23, the
+Patient should take the Purge No. 21.
+
+Sec. 151. The same Means, that are proper to prevent a Relapse, might also
+obviate or keep off a primary or first Assault, if employed in Time: for
+notwithstanding it may happen very suddenly, yet this Disease foreshews
+itself many Weeks, sometimes many Months, nay even Years beforehand, by
+Vertigos, Heaviness of the Head; small Defects of the Tongue or Speech;
+short and momentary Palsies, sometimes of one, sometimes of another,
+Part: sometimes by Loathings and Reachings to vomit; without supposing
+any Obstruction or Load in the first Passages, or any other Cause in the
+Stomach, or the adjoining Parts. There happens also some particular
+Change in the Looks and Visage not easy to be described: sharp and short
+Pains about the Region of the Heart; an Abatement of the Strength,
+without any discernible Cause of it. Besides there are still some other
+Signs, which signify the Ascent of the Humours too much to the Head, and
+shew, that the Functions of the Brain are embarrassed.
+
+Some Persons are liable to certain Symptoms and Appearances, which arise
+from the same Cause as an Apoplexy; and which indeed may be considered
+as very light benign Apoplexies, of which they sustain many Attacks, and
+yet without any considerable Annoyance of their Health. The Blood, all
+at once as it were, flushes up to their Heads: they appear heedless or
+blundering; and have sometimes Disgusts and _Nauseas_, and yet without
+any Abatement of their Understanding, their Senses, or Motion of any
+Sort. Tranquillity of Mind and Body, once Bleeding, and a few Glysters
+usually carry it off soon after its Invasion. The Returns of it may be
+prevented by the Regimen directed Sec. 150; and especially by a frequent
+Use of the Powder No. 24. At the long Run however, one of these Attacks
+commonly degenerates into a mortal Apoplexy: though this may be retarded
+for a very long Time by an exact Regimen, and by avoiding all strong
+Commotions of the Mind, but especially that of Anger or violent Rage.
+
+
+
+
+                             __Chapter X.__
+
+
+          _Of the violent Influence, or Strokes, of the Sun._
+
+
+                             __Sect.__ 152.
+
+This Appellation is applied to those Disorders, which arise from too
+violent an Influence of the Heat of the Sun, immediately upon the Head;
+and which in one Word may be termed _Insolation_.
+
+If we consider that Wood, Stone and Metals, when long exposed to the
+Sun, become very hot, and that even in temperate Climates, to such a
+Degree, that they can scarcely be touched without some Sensation of
+burning, we may easily conceive the Risk a Person undergoes, in having
+his Head exposed to the same Degree of Heat. The Blood-Vessels grow dry,
+the Blood itself becomes condensed or thickened, and a real Inflammation
+is formed, which has proved mortal in a very little Time. It was this
+Distemper, a Stroke of the Sun, which killed _Manasses_ the Husband of
+_Judith_. 'For as he was among the Labourers who bound up the Sheafs in
+the Fields, the Heat struck upon his Head, and he was taken ill; he went
+to Bed and he died.' The Signs which precede and attend this Disease
+are, being exposed in a Place where the Sun shines forth with great
+Force and Ardour; a violent Head-ach, attended with a very hot and
+extremely dry Skin: the Eyes are also dry and red, being neither able to
+remain open, nor yet to bear the Light; and sometimes there is a kind of
+continual and involuntary Motion in the Eyelid; while some Degree of
+Relief is perceivable from the Application of any cooling Liquor. It
+often happens that some cannot possibly sleep; and at other times they
+have a great Drowsiness, but attended with outrageous Wakenings: there
+is a very strong Fever; a great Faintness, and a total Disrelish and
+Loathing. Sometimes the Patient is very thirsty, and at other times not
+at all: and the Skin of his Face often looks as though it were burnt.
+
+Sec. 153. People may be affected with the Disease from this Cause, at two
+different Seasons of the Year; that is, either in the Spring, or during
+the very raging Heats; but their Events are very different. Country
+People and Labourers are but little liable to the former. They chiefly
+affect the Inhabitants of Cities, and delicate Persons, who have used
+very little Exercise in the Winter, and abound with superfluous Humours.
+If thus circumstanced they expose themselves to the Sun, as even in the
+Spring he attains a considerable Force; and, by the Course of Life they
+have led, their Humours are already much disposed to mount to the Head;
+while the Coolness of the Soil, especially when it has rained, prevents
+their Feet from being so easily warmed; the Power of the Sun acts upon
+their Head like a Blister, attracting a great Quantity of Humours to it.
+This produces excruciating Pains of the Head, frequently accompanied
+with quick and violent Shootings, and with Pain in the Eyes;
+notwithstanding this Degree of the Malady is seldom dangerous. Country
+People, and even such Inhabitants of Cities and Towns, as have not
+forbore to exercise themselves in Winter, have no Sort of Dread of these
+Strokes of the Sun, in the Spring of the Year. Its Summer Strokes are
+much more vehement and troublesome, and assault Labourers and
+Travellers, who are for a long Time exposed to the Fervour of it. Then
+it is that the Disease is aggravated to its highest Pitch, those who are
+thus struck often dying upon the Spot. In the hot Climates this Cause
+destroys many in the very Streets, and makes dreadful Havock among
+Armies on the March, and at Sieges. Some tragical Effects of it, on such
+Occasions, are seen even in the temperate Countries. After having
+marched a whole Day in the Sun, a Man shall fall into a Lethargy, and
+die within some Hours, with the Symptoms of raving Madness. I have seen
+a Tyler in a very hot Day, complaining to his Comrade of a violent Pain
+in his Head, which increased every Moment almost; and at the very
+Instant when he purposed to retire out of the Sun, he sunk down dead,
+and fell down from the House he was slating. This same Cause produces
+very often in the Country some most dangerous Phrenzies, which are
+called there hot or burning Fevers. Every Year furnishes but too many of
+them.
+
+Sec. 154. The Vehemence of the Sun is still more dangerous to those, who
+venture to sleep exposed to it. Two Mowers who fell asleep on a Haycock,
+being wakened by some others, immediately on waking, staggered, and
+pronouncing a few incoherent unmeaning Words, died. When the Violence of
+Wine and that of the Sun are combined, they kill very suddenly: nor is
+there a single Year in which Peasants are not found dead on the
+Highroads; who being drunk endeavoured to lie down in some Corner, where
+they perished by an Apoplexy, from the Heat of the Sun and of strong
+Drink. Those of them who escape so speedy and premature a Death, are
+subject for the Remainder of their Lives, to chronical, or tedious
+Head-achs; and to suffer some little Disorder and Confusion in their
+Ideas. I have seen some Cases, when after violent Head-achs of some Days
+Continuance, the Disease has been transferred to the Eyelids, which
+continued a long Time red and distended, so that they could not be kept
+asunder or open. It has also been known, that some Persons have been
+struck by the Sun into a _Delirium_ or Raving, without a Fever, and
+without complaining of a Head-ach. Sometimes a _Gutta Serena_ has been
+its Consequence; and it is very common to see People, whose long
+Continuance under the strong Light and Influence of the Sun, has made
+such an Impression upon the Eyes, as presents them with different Bodies
+flying about in the Air, which distract and confuse their Sight.
+
+A Man of forty two Years of Age, having been exposed for several Hours
+to the violent Heat of the Sun, with a very small Cap or Bonnet; and
+having past the following Night in the open Air, was attacked the next
+Day with a most severe Head-ach, a burning Fever, Reachings to vomit,
+great Anguish, and red and sparkling Eyes. Notwithstanding the best
+Assistance of several Physicians, he became phrenitic on the fifth Day,
+and died on the ninth. Suppurated Matter was discharged from his Mouth,
+one of his Nostrils, and his right Ear, a few Hours before his Death;
+upon Dissection a small Abscess was found within the Skull; and the
+whole Brain, as well as all the Membranes inclosing it, were entirely
+corrupted.
+
+Sec. 155. In very young Children, who are not, or never should be, exposed
+for any long Time to such excessive Heat (and whom a slight Cause will
+often affect) this Malady discovers itself by a heavy deep Drowsiness,
+which lasts for several Days; also by incessant Ravings mingled with
+Rage and Terror, much the same as when they are affected with violent
+Fear: and sometimes by convulsive Twitchings; by Head-achs which
+returned at certain Periods, and continual Vomitings. I have seen
+Children, who, after a Stroke of the Sun, have been harrassed a long
+Time with a little Cough.
+
+Sec. 156. Old Men who often expose themselves imprudently to the Sun, are
+little apprized of all the Danger they incur by it. A certain Person,
+who purposely sunned himself for a considerable Time, in the clear Day
+of an intermitting tertian Fever, underwent the Assault of an Apoplexy,
+which carried him off the following Day. And even when the Disease may
+not be so speedy and violent, yet this Custom (of sunning in hot
+Weather) certainly disposes to an Apoplexy, and to Disorders of the
+Head. One of the slightest Effects of much solar Heat upon the Head is,
+to cause a Defluxion from the Brain, a Swelling of the Glands of the
+Neck, and a Dryness of the Eyes, which sometimes continues for a
+considerable Term after it.
+
+Sec. 157. The effect of too much culinary, or common Fire, is of the same
+Quality with that of the Sun. A Man who fell asleep with his Head
+directly opposite, and probably, very near to the Fire, went off in an
+Apoplexy, during his Nap.
+
+Sec. 158. The Action of too violent a Sun is not only pernicious, when it
+falls upon the Head; but it is also hurtful to other Parts; and those
+who continue long exposed to it, though their Heads should not be
+affected, experience violent Pains, a disagreeable Sensation of Heat,
+and a considerable Stiffness in the Parts that have been, in some
+Manner, parched by it; as in the Legs, the Knees, the Thighs, Reins and
+Arms; and sometimes they prove feverish.
+
+Sec. 159. In contemplating the Case of a Patient, _Sun-struck_, as we may
+term it, we must endeavour to distinguish, whether there may not be also
+some other joint Causes concurring to the Effect. A Traveller, a
+labouring Man, is often as much affected by the Fatigue of his Journey,
+or of his Labour, as he is by the Influence of solar Heat.
+
+Sec. 160. It is necessary to set about the Cure of this Disease, as soon as
+ever we are satisfied of its Existence: for such as might have been
+easily preserved by an early Application, are considerably endangered by
+a Neglect of it. The Method of treating this is very much the same, with
+that of the inflammatory Diseases already mentioned; that is, by
+Bleeding, and cooling Medicines of various Kinds in their Drinks, by
+Bathings, and by Glysters. And 1. If the Disease be very high and
+urgent, a large Quantity of Blood should be taken away, and occasionally
+repeated. _Lewis_ the XIV. was bled nine Times to prevent the Fatality
+of a Stroke of the Sun, which he received in Hunting in 1658.
+
+2. After Bleeding, the Patient's Legs should be plunged into warm Water.
+This is one of the Applications that affords the most speedy Relief; and
+I have seen the Head-ach go off and return again, in Proportion to the
+Repetition, and the Duration, of these Bathings of the Legs. When the
+Disorder is highly dangerous, it will be necessary to treat the Patient
+with _Semicupia_, or warm Baths, in which he may sit up to his Hips; and
+in the most dangerous Degrees of it, even to bathe the whole Body: but
+the Water in this Case, as well as in Bathings of the Feet, should be
+only sensibly warm: the Use of hot would be highly pernicious.
+
+3. Glysters made from a Decoction of any of the emollient Herbs are also
+very effectual.
+
+4. The Patient should drink plentifully of Almond Emulsion No. 4; of
+Limonade, which is a Mixture of the Juice of Lemons and Water, (and is
+the best Drink in this Disease) of Water and Vinegar, which is a very
+good Substitute for Limonade; and of, what is still more efficacious,
+very clear Whey, with the Addition of a little Vinegar. These various
+Drinks may all be taken cold; Linen Cloths dipt in cold Water and
+Vinegar of Roses may be applied to the Forehead, the Temples, or all
+over the Head, which is equivalent to every other Application used upon
+such Occasions. Those which are the most cried up, are the Juice of
+Purslain, of Lettuce, of Houseleek, and of Vervain. The Drink No. 32 is
+also serviceable, taken every Morning fasting.
+
+Sec. 161. Cold Baths have sometimes recovered Persons out of such violent
+Symptoms, from this Cause, as have been almost quite despaired of.
+
+A Man twenty Years of Age, having been a very long Time exposed to the
+scorching Sun, became violently delirious, without a Fever, and proved
+really mad. After repeated Bleedings, he was thrown into a cold Bath,
+which was also frequently repeated; pouring cold Water, at the same
+Time, upon his Head. With such Assistance he recovered, though very
+gradually.
+
+An Officer who had rode Post for several Days successively, in very hot
+Weather, swooned away, immediately on dismounting; from which he could
+not be recovered by the ordinary Assistance in such Cases. He was saved
+however, in Consequence of being plunged into a Bath of freezing Water.
+It should be observed however, that in these Cases the cold Bath should
+never be recurred to, without previous Bleeding.
+
+Sec. 162. It is past Doubt, that if a Person stands still in the violent
+Heat of the Sun, he is more liable to be struck with it, than if he
+walks about; and the Use of white Hats, or of some Folds of clean white
+Paper under a black one, may sensibly contribute to prevent any Injury
+from the considerable Heat of the Sun; though it is a very incompetent
+Defence against a violent Degree of it.
+
+The natural Constitution, or even that Constitution, which has been
+formed from long Custom and Habit, make a very great Difference between
+the Effects of solar Heat on different Persons. People insensibly
+accustom themselves to the Impressions of it, as they do to those of all
+the other Bodies and Elements, which are continually acting upon us; and
+by Degrees we arrive at a Power of sustaining his violent Heat with
+Impunity: just as others arrive at the Hardiness of bearing the most
+rigid Colds, with very little Complaint or Inconvenience. The human Body
+is capable of supporting many more Violences and Extremes, than it
+commonly does. Its natural Force is scarcely ever ascertained among
+civilized Nations; because their Education generally tends to impair and
+lessen it, and always succeeds in this Respect. If we were inclined to
+consider a purely natural, a simply physical Man, we must look for him
+among savage Nations; where only we can discover what we are able to be,
+and to bear. We certainly could not fail of being Gainers, by adopting
+their corporal Education; neither does it seem as yet to have been
+infallibly demonstrated, that we should be great Losers in commuting our
+moral Education for theirs. [39]
+
+[39] As some may think an Apology necessary for a Translation of this
+     Chapter on a Disease, which never, or very seldom, exists in this
+     or the adjacent Island, I shall observe here, that, abstracted from
+     the Immorality of a narrow and local Solicitude only for ourselves,
+     we are politically interested as a Nation always in Trade, and
+     often at War (and whose Subjects are extended into very distant and
+     different Climates) to provide against a sudden and acute
+     Distemper, to which our Armies, our Sailors and Colonies are
+     certainly often exposed. A Fatality from this Cause is not
+     restrained to our Islands within the Tropic, where several
+     Instances of it have occurred during the late War: but it has also
+     been known to prevail as far Northward as _Pensylvania_, in their
+     Summers, and even in their Harvests. I once received a sensible
+     Scald on the Back of my Thumb, from the Sun suddenly darting out
+     through a clear Hole, as it were, in a Cloud, after a short and
+     impetuous Shower in Summer; which Scald manifestly blistered within
+     some Minutes after. Had this concentrated Ray been darted on my
+     bare Head, the Consequence might have been more dangerous; or
+     perhaps as fatal as some of the Cases recorded by Dr. _Tissot_, in
+     this Chapter. _K._
+
+
+
+
+                             __Chapter XI.__
+
+
+                          _Of the Rheumatism._
+
+
+                             __Sect.__ 163.
+
+The Rheumatism may exist either with or without a Fever. The first of
+these may be classed among the Diseases, of which I have already
+treated; being an Inflammation which is manifested by a violent Fever,
+preceded by Shivering, a subsequent Heat, hard Pulse, and a Head-ach.
+Sometimes indeed an extraordinary Coldness, with general Uneasiness and
+Inquietude, exists several Days before the Fever is perceived. On the
+second or third Day, and sometimes even on the first, the Patient is
+seized with a violent Pain in some Part of his Body, but especially
+about the Joints, which entirely prevents their Motion, and which is
+often accompanied with Heat, Redness and a Swelling of the Part. The
+Knee is often the first Part attacked, and sometimes both the Knees at
+once. When the Pain is fixed, an Abatement of the Fever frequently
+happens; though in some other Persons it continues for several Days, and
+increases every Evening. The Pain diminishes in one Part after a
+Duration of some Days, and then invades some other. From the Knee it
+descends to the Foot, or mounts to the Hip, to the Loins, the
+Shoulder-blades, Elbow, Wrist, the Nape of the Neck, and frequently is
+felt in the intermediate Parts. Sometimes one Part is quite free from
+Pain, when another is attacked; at other Times many Parts are seized
+nearly at the same Instant; and I have sometimes seen every Joint
+afflicted at once. In this Case the Patient is in a very terrible
+Situation, being incapable of any Motion, and even dreading the
+Assistance of his Attendants, as he can scarcely admit of touching,
+without a sensible Aggravation of his Pains. He is unable to bear even
+the Weight of the Bed-clothes, which must be, as it were, arched over
+his Limbs by a proper Contrivance, to prevent their Pressure: and the
+very walking across the Chamber increases his Torments. The Parts in
+which they are the most excruciating, and obstinate, are the Region of
+the Loins, the Hips, and the Nape or hinder Part of the Neck.
+
+Sec. 164. This Disease is also often extended over the Scalp and the
+Surface of the Head; and there the Pains are excessive. I have seen them
+affect the Eyelids and the Teeth with inexpressible Torment. As long as
+the Distemper is situated in the more external Parts, the Patient,
+however painful his Situation may prove, is in no great Danger, if he be
+properly treated: but if by some Accident, some Error, or by any latent
+Cause, the Disease be repelled upon an internal Part or Organ, his Case
+is extremely dangerous. If the Brain is attacked, a frantic raging
+_Delirium_ is the Consequence; if it falls upon the Lungs, the Patient
+is suffocated: and if it attacks the Stomach or the Bowels, it is
+attended with the most astonishing Pains, which are caused by the
+Inflammation of those Parts, and which Inflammation, if violent, is [40]
+speedily fatal. About two Years since I was called to a robust Man,
+whose Guts were already in a gangrenous State, which was the Consequence
+of a Rheumatism, that first attacked one Arm and one Knee; the Cure of
+which had been attempted by sweating the Patient with some hot Remedies.
+These indeed brought on a plentiful Sweat; but the inflammatory Humour
+seized the Intestines, whose Inflammation degenerated into a Gangrene,
+after a Duration of the most acute Pain for thirty-six Hours; his
+Torments terminating in Death two Hours after I saw him.
+
+[40] See Note [16] to Page 59.
+
+Sec. 165. This Malady however is often in a less violent Degree; the Fever
+is but moderate, and ceases entirely when the Pain begins; which is also
+confined to one, or not more than two Parts.
+
+Sec. 166. If the Disease continues fixed, for a considerable Time, in one
+Joint, the Motion of it is impaired for Life. I have seen a Person, who
+has now a wry Neck, of twenty Years standing, in Consequence of a
+Rheumatism in the Nape of the Neck; and I also saw a poor young Man from
+_Jurat_, who was Bed-ridden, and who had lost the Motion of one Hip and
+both Knees. He could neither stand nor sit, and there were but a few
+Postures in which he could even lie in Bed.
+
+Sec. 167. An obstructed Perspiration, an inflammatory Thickness of the
+Blood, constitute the most general Cause of the Rheumatism. This last
+concurring Cause is that we must immediately encounter; since, as long
+as that subsists, Perspiration cannot be perfectly re-established, which
+follows of Course, when the Inflammation is cured. For which Reason this
+Distemper must be conducted like the other inflammatory ones, of which I
+have already treated.
+
+Sec. 168. As soon as it is sufficiently manifest, the Glyster No. 5, should
+be injected; and twelve Ounces of Blood be taken from the Arm an Hour
+after. The Patient is to enter upon a Regimen, and drink plentifully of
+the Ptisan No. 2, and of Almond Milk or Emulsion No. 4. As this last
+Medicine may be too costly in Country Places for the poor Peasantry;
+they may drink, in Lieu of it, very clear Whey, sweetened with a little
+Honey. I have known a very severe Rheumatism cured, after twice
+bleeding, without any other Food or Medicine, for the Space of thirteen
+Days. The Whey also may be happily used by Way of Glyster.
+
+Sec. 169. If the Distemper is not considerably asswaged by the first
+Bleeding, it should be repeated some Hours after. I have ordered it four
+Times within the first two Days; and some Days after I have even
+directed a fifth Bleeding. But in general the Hardness of the Pulse
+becomes less after the second: and notwithstanding the Pains may
+continue as severe as before, yet the Patient is sensible of less
+Inquietude. The Glyster must be repeated every Day, and even twice a
+Day, if each of them is attended only with a small Discharge; and
+particularly if there be a violent Head-ach. In such Cases as are
+excessively painful, the Patient can scarcely dispose himself into a
+proper Attitude or Posture to receive Glysters: and in such
+Circumstances his Drinks should be made as opening as possible; and a
+Dose of the Cream of Tartar No. 24 should be given Night and Morning.
+This very Medicine, with the Assistance of Whey, cured two Persons I
+advised it to, of rheumatic Pains, of which they had been infested with
+frequent Returns for many Years, and which were attended with a small
+Fever.
+
+Apples coddled, Prunes stewed, and well ripened Summer Fruits are the
+properest Nourishment in this Disease.
+
+We may save the Sick a good deal of Pain, by putting one strong Towel
+always under their Back, and another under their Thighs, in order to
+move them the more easily. When their Hands are without Pain, a third
+Towel hung upon a Cord, which is fastened across the Bed, must
+considerably assist them in moving themselves.
+
+Sec. 170. When the Fever entirely disappears, and the Hardness of the Pulse
+is removed, I have ordered the Purge No. 23 with a very good Effect; and
+if it is attended with five or six Motions, the Patient is very sensibly
+relieved. The Day but one after it may be repeated successfully, and a
+third Time, after an Interval of a greater Number of Days.
+
+Sec. 171. When the Pains are extremely violent, they admit of no
+Application: Vapour-Baths however may be employed, and provided they are
+often used, and for a considerable Time, they prove very efficacious.
+The Purpose of these Baths is only to convey the Steam of boiling Water
+to the Parts affected; which may always easily be effected, by a Variety
+of simple and easy Contrivances; the Choice of which must depend on the
+different Circumstances and Situation of the Sick.
+
+Whenever it is possible, some of the emollient Applications No. 9,
+should be continually employed. A half Bath, or an entire Bath of warm
+Water, in which the Patient should remain an Hour, after sufficient
+Bleedings and many Glysters, affords the greatest Relief. I have seen a
+Patient, under the most acute Pains of the Loins, of the Hips, and of
+one Knee, put into one. He continued still under extreme Torment in the
+Bath, and on being taken out of it: but an Hour after he had been put to
+Bed, he sweated, to an incredible Quantity, for thirty six Hours, and
+was cured. The Bath should never be made use of, until after repeated
+Bleedings, or at least other equivalent Evacuations: for otherwise
+timed, it would aggravate the Disease.
+
+Sec. 172. The Pains are generally most severe in the Night; whence it has
+been usual to give composing soporific Medicines. This however has been
+very erroneous, as Opiates really augment the Cause of the Disease, and
+destroy the Efficacy of the proper Remedies: and, even not seldom, far
+from asswaging the Pains, they increase them. Indeed they agree so
+little in this Disease, that even the Patient's natural Sleep at the
+Invasion of this Complaint, is rather to his Detriment. They feel, the
+very Moment they are dropping asleep, such violent Jirks as awaken them
+with great Pain: or if they do sleep a few Minutes, the Pains are
+stronger when they awake.
+
+Sec. 173. The Rheumatism goes off either by Stool, by turbid thick Urine
+which drops a great Proportion of a yellowish Sediment, or by Sweats:
+and it generally happens that this last Discharge prevails towards the
+Conclusion of the Disease. It may be kept up by drinking an Infusion of
+Elder Flowers. At the Beginning however Sweating is pernicious.
+
+Sec. 174. It happens also, though but very seldom, that Rheumatisms
+determine by depositing a sharp Humour upon the Legs; where it forms
+Vesications, or a kind of Blisterings; which burst open and form Ulcers,
+that ought not to be healed and dried up too hastily; as this would
+occasion a speedy Return of the rheumatic Pains. They are disposed to
+heal naturally of themselves, by the Assistance of a temperate regular
+Diet, and a few gentle Purges.
+
+Sec. 175. Sometimes again, an Abscess is formed either in the affected
+Part, or in some neighbouring one. I have seen a Vineyard Dresser, who
+after violent Pains of the Loins, had an Abscess in the upper Part of
+the Thigh, which he neglected for a long Time. When I saw him, it was of
+a monstrous Size. I ordered it to be opened, when at once above three
+Pots of [41] Matter rushed out of it: but the Patient, being exhausted,
+died some Time after it.
+
+[41] This, according to our Author's Estimation of the Pot-Measure at
+     _Berne_, which is that he always means, and which he says contains
+     exactly (of Water we suppose) fifty one Ounces and a Quarter
+     (though without a material Error it may be computed at three Pounds
+     and a Quarter) will amount at least to nine Pounds and three
+     Quarters of Matter, supposing this no heavier than Water. By
+     Measure it will want but little of five of our Quarts: a very
+     extraordinary Discharge indeed of _Pus_ at once, and not unlikely
+     to be attended by the Event which soon followed. _K._
+
+Another Crisis of the Rheumatism has happened by a kind of Itch, which
+breaks out upon all the Parts adjacent to the Seat of this Disease.
+Immediately after this Eruption the Pains vanish; but the Pustules
+sometimes continue for several Weeks.
+
+Sec. 176. I have never observed the Pains to last, with considerable
+Violence, above fourteen Days, in this Species of the Rheumatism; though
+there remains a Weakness, Numbness, and some Inflation, or Puffing, of
+the adjoining Parts: and it will also be many Weeks, and sometimes even
+Months; especially if the Distemper attacked them in the Fall, before
+the Sick recover their usual Strength. I have known some Persons, who,
+after a very painful Rheumatism, have been troubled with a very
+disagreeable Sensation of Lassitude; which did not go off till after a
+great Eruption, all over the Body, of little Vesications or Blisterings,
+full of a watery Humour; many of them burst open, and others withered
+and dried up without bursting.
+
+Sec. 177. The Return of Strength into the Parts affected may be promoted by
+Frictions Night and Morning, with Flannel or any other woollen Stuff; by
+using Exercise; and by conforming exactly to the Directions given in the
+Chapter on Convalescence, or Recovery from acute Diseases. The
+Rheumatism may also be prevented by the Means I have pointed out, in
+treating of Pleurisies and Quinsies.
+
+Sec. 178. Sometimes the Rheumatism, with a Fever, invades Persons who are
+not so sanguine, or abounding in Blood; or whose Blood is not so much
+disposed to Inflammation; those whose Flesh and Fibres are softer; and
+in whose Humours there is more Thinness and Sharpness, than Viscidity
+and Thickness. Bleeding proves less necessary for Persons so
+constituted, notwithstanding the Fever should be very strong. Some
+Constitutions require more Discharges by Stool; and after they are
+properly evacuated, some Blisters should be applied, which often afford
+them a sensible Relief as soon as ever they begin to operate.
+Nevertheless they should never be used where the Pulse is hard. The
+Powder No. 25 answers very well in these Cases.
+
+Sec. 179. There is another Kind of Rheumatism, called chronical, or
+lasting. It is known by the following Characters or Marks. 1. It is
+commonly unattended with a Fever. 2. It continues a very long Time. 3.
+It seldom attacks so many Parts at once as the former. 4. Frequently no
+visible Alteration appears in the affected Part, which is neither more
+hot, red, or swelled than in its healthy State; though sometimes one or
+other of these Symptoms is evident. 5. The former, the inflammatory,
+Rheumatism assaults strong, vigorous, robust Persons: but this rather
+invades People arrived at a certain Period of Life, or such as are weak
+and languishing.
+
+Sec. 180. The Pain of the chronical Rheumatism, when left to itself, or
+injudiciously treated, lasts sometimes many Months, and even Years. It
+is particularly and extremely obstinate, when it is exerted on the Head,
+the Loins, or on the Hip, and along the Thighs, when it is called the
+_Sciatica_. There is no Part indeed which this Pain may not invade;
+sometimes it fixes itself in a small Spot, as in one Corner of the Head;
+the Angle of the Jaw; the Extremity of a Finger; in one Knee; on one
+Rib, or on the Breast, where it often excites Pains, which make the
+Patient apprehensive of a Cancer. It penetrates also to the internal
+Parts. When it affects the Lungs, a most obstinate Cough is the
+Consequence; which degenerates at length into very dangerous Disorders
+of the Breast. In the Stomach and Bowels it excites most violent Pains
+like a Cholic; and in the Bladder, Symptoms so greatly resembling those
+of the Stone, that Persons, who are neither deficient in Knowlege nor
+Experience, have been more than once deceived by them.
+
+Sec. 181. The Treatment of this chronical Rheumatism does not vary
+considerably from that of the former. Nevertheless, in the first Place,
+if the Pain is very acute, and the Patient robust, a single Bleeding at
+the Onset is very proper and efficacious. 2. The Humours ought to be
+diluted, and their Acrimony or Sharpness should be diminished, by a very
+plentiful Use of a Ptisan of [42] Burdock Roots No. 26. 3. Four or five
+Days after drinking abundantly of this, the purging [43] Powder No. 21
+may be taken with Success. In this Species of the Rheumatism, a certain
+Medicine is sometimes found serviceable. This has acquired some
+Reputation, particularly in the Country, where they bring it from,
+_Geneva_; under the Title of the Opiate for the Rheumatism, tho' I
+cannot say for what Reason; as it is indeed neither more nor less than
+the Electuary _Caryocostinum_, which may be procured at our
+Apothecaries. I shall observe however, that this Medicine has done
+Mischief in the inflammatory Rheumatism, and even in this, as often as
+the Persons afflicted with it are feeble, thin and of a hot Temperament;
+and either when they have not previously taken diluting Drinks, or when
+it has been used too long. For, in such a Circumstance, it is apt to
+throw the Patient into an irrecoverable Weakness. The Composition
+consists of the hottest Spices, and of very sharp Purgatives.
+
+[42] Half a Pint of a pretty strong Infusion of the Leaves of Buckbean,
+     which grows wild here, taken once a Day rather before Noon, has
+     also been found very serviceable in that Species of a chronical
+     Rheumatism, which considerably results from a scorbutic State of
+     the Constitution. _K._
+
+[43] Another very good Purge, in this Kind of Rheumatism, may also be
+     compounded of the best Gum Guiacum in Powder from 30 to 40 Grains;
+     dissolved in a little Yolk of a fresh Egg; adding from 6 to 10
+     Grains of Jallap powdered, and from 3 to 5 Grains of powdered
+     Ginger, with as much plain or sorrel Water, as will make a purging
+     Draught for a stronger or weaker grown Patient. Should the Pains
+     frequently infest the Stomach, while the Patient continues costive,
+     and there is no other Fever than such a small symptomatic one, as
+     may arise solely from Pain, he may safely take, if grown up, from
+     30 to 45 Drops of the volatile Tincture of Gum Guiacum, in any
+     diluting Infusion, that may not coagulate or separate the Gum. It
+     generally disposes at first to a gentle _Diaphoresis_ or Sweat, and
+     several Hours after to one, and sometimes to a second Stool, with
+     little or no Griping. _K._
+
+Sec. 182. When general Remedies have been used, and the Disorder still
+continues, Recourse should be had to such Medicines, as are available to
+restore Perspiration; and these should be persisted in for a
+considerable Time. The Pills No. 18, with a strong Infusion of Elder
+Flowers, have often succeeded in this Respect: and then after a long
+Continuance of diluting Drinks, if the Fever is entirely subdued; if the
+Stomach exerts its Functions well; the Patient is no ways costive; if he
+is not of a dry Habit of Body; and the Part affected remains without
+Inflammation, the Patient may safely take the Powder No. 29, at Night
+going to Bed, with a Cup or two of an Infusion of _Carduus benedictus_,
+or the blessed Thistle, and a Morsel of Venice Treacle of the Size of a
+Hazel Nut, or a Filberd. This Remedy brings on a very copious Sweating,
+which often expells the [44] Disease. These Sweats may be rendered full
+more effectual, by wrapping up the affected Part in a Flanel dipt in the
+Decoction No. 27.
+
+[44] Gum Guaiacum, given from six to ten Grains Morning and Night, is
+     often very successful in these Cases. It may be made into Pills or
+     Bolusses with the Rob of Elder, or with the Extract of Juniper. _E.
+     L._
+
+Sec. 183. But of all these Pains, the Sciatica is one of the most tedious
+and obstinate. Nevertheless I have seen the greatest Success, from the
+Application of seven or eight Cupping-Glasses on the tormented Part; by
+which, without the Assistance of any other Remedy, I have cured, in a
+few Hours, Sciaticas of many Years standing, which had baffled other
+Remedies. Blisters, or any such stimulating Plaisters, as bring on a
+Suppuration and Discharge from the afflicted Part, contribute also
+frequently to the Cure; tho' less effectually than Cupping, which should
+be repeated several Times. Green Cere-cloth, commonly called Oil-cloth,
+(whether the Ingredients be spread on Taffety or on Linen) being applied
+to the diseased Part, disposes it to sweat abundantly, and thus to
+discharge the sharp Humour which occasions the Pain. Sometimes both
+these Applications, but especially that spread on Silk (which may be
+applied more exactly and closely to the Part, and which is also spread
+with a different Composition) raise a little Vesication on the Part as
+Blisters do. A Plaister of Quicklime and Honey blended together has
+cured inveterate Sciaticas. Oil of Eggs has sometimes succeeded in such
+Cases. A Seton has also been successfully made in the lower Part of the
+Thigh. Finally some Pains, which have not yielded to any of these
+Applications, have been cured by actual burning, inflicted on the very
+Spot, where the most violent Pain has been felt; except some particular
+Reason, drawn from an anatomical Knowlege of the Part, should determine
+the Surgeon not to apply it there. The Scull or Head should never be
+cauterized with a burning Iron.
+
+Sec. 184. The hot Baths of _Bourbon_, _Plombiers_, _Aix-la-Chapelle_ and
+many others are often very efficacious in these chronical Pains:
+notwithstanding I really think, there is no rheumatic Pain that may not
+be cured without them. The common People substitute to these a Bath made
+of the Husk of Grapes, after their Juice is expressed, which cures some
+by making them sweat abundantly. Cold Baths however are the best to keep
+off this Disease; but then they cannot always be safely ventured on.
+Many Circumstances render the Use of them impracticable to particular
+Persons. Such as are subject to this chronical Rheumatism, would do very
+well to rub their whole Bodies every Morning, if they could, but
+especially the afflicted Parts, with Flanel. This Habit keeps up
+Perspiration beyond any other Assistance; and indeed sometimes even
+increases it too much. It would be serviceable too, if such Subjects of
+this cruel Disease wore Flanel all over their Skin, during the Winter.
+
+After a violent Rheumatism, People should long be careful to avoid that
+cold and moist Air, which disposes them to relapse.
+
+Sec. 185. Rheumatic People have too frequent a Recourse to very improper
+and hurtful Medicines, in this Distemper, which daily produce very bad
+Consequences. Such are spirituous Medicines, Brandy, and Arquebusade
+Water. They either render the Pain more obstinate and fixed, by
+hardening the Skin; or they repell the Humour to some inward Part. And
+Instances are not wanting of Persons who have died suddenly, from the
+Application of Spirit of Wine upon the Parts, that were violently
+afflicted with the Rheumatism. It also happens sometimes that the
+Humour, having no Outlet through the Skin, is thrown internally on the
+Bone and affects it. A very singular Fact occurred in this Respect, an
+Account of which may be serviceable to some Persons afflicted with the
+Disease. A Woman at Night was chaffing the Arm of her Husband, who had
+the Rheumatism there, with Spirit of Wine; when a very lucky Accident
+prevented the Mischief she might have occasioned by it. The Spirit of
+Wine took Fire from the Flame of the Candle she made use of, and burned
+the diseased Part. It was drest of Course, and the Suppuration that
+attended it, entirely cured the Rheumatism.
+
+Sharp and greasy Unctions or Ointments produce very bad Effects, and are
+equally dangerous. A _Caries_, a Rottenness of the Bones, has ensued
+upon the Use of a Medicine called, The Balsam of Sulphur with
+Turpentine. I was consulted in 1750, three Days before her Decease,
+about a Woman, who had long endured acute rheumatic Pains. She had taken
+various Medicines, and, among the rest, a considerable Quantity of a
+Ptisan, in which Antimony was blended with some purging Medicines, and a
+greasy spirituous Balsam had been rubbed into the Part. The Fever, the
+Pains, and the Dryness of the Skin soon increased; the Bones of the
+Thighs and Arms became carious: and in moving the Patient no more than
+was necessary for her Relief and Convenience, without taking her out of
+her Bed, both Thighs and one Arm broke. So dreadful an Example should
+make People cautious of giving or applying Medicines inconsiderately,
+even in such Diseases, as appear but trifling in themselves. I must also
+inform the Readers, there are some rheumatic Pains, which admit of no
+Application; and that almost every Medicine aggravates them. In such
+Cases the afflicted must content themselves with keeping the Parts
+affected from the Impressions of the Air, by a Flanel, or the Skin of
+some Animal with the Fur on.
+
+It is also more advisable sometimes to leave a sufferable and inveterate
+Pain to itself, especially in old or weakly People, than to employ too
+many Medicines, or such violent ones, as should affect them more
+importantly than the Pains did.
+
+Sec. 186. If the Duration of the Pains fixed in the same Place, should
+cause some Degree of Stiffness in the Joint affected, it should be
+exposed twice a Day to the Vapour of warm Water, and dried well
+afterwards with hot Linen: then it should be well chaffed, and lastly
+touched over with Ointment of Marsh-mallows. Pumping, if superadded to
+this Vapour, considerably increases its Efficacy. I directed, for a Case
+of this Sort, a very simple Machine of white Tin, or Lattin, which
+combined the Application of the Steam and the Pump.
+
+Sec. 187. Very young Children are sometimes subject to such violent and
+extended Pains, that they cannot bear touching in any Part, without
+excessive Crying. We must be careful to avoid mistaking these Cases, and
+not to treat them like Rheumatisms. They sometimes are owing to Worms,
+and go off when these have been discharged.
+
+
+
+
+                            __Chapter XII.__
+
+
+                      _Of the Bite of a mad Dog._
+
+
+                             __Sect.__ 188.
+
+Men may contract the particular and raging Symptom, which is very
+generally peculiar to this Disease from this Cause, and even without any
+Bite; but this happens very rarely indeed. It is properly a Distemper
+belonging to the canine _Genus_, consisting of the three Species of
+Dogs, Wolves, and Foxes, to whom only it seems inherent and natural;
+scarcely ever arising in other Animals, without its being inflicted by
+them. Whenever there occurs one of them who breeds it, he bites others,
+and thus the Poison, the Cause of this terrible Disease, is diffused.
+Other Animals besides the canine Species, and Men themselves being
+exposed to this Accident, do sometimes contract the Disease in all its
+Rage and Horror: though it is not to be supposed, that this is always an
+unfailing Consequence.
+
+Sec. 189. If a Dog who used to be lively and active, becomes all at once
+moapish and morose; if he has an Aversion to eat; a particular and
+unusual Look about his Eyes; a Restlessness, which appears from his
+continually running to and fro, we may be apprehensive he is likely to
+prove mad; at which very Instant he ought to be tied up securely, that
+it may be in our Power to destroy him as soon as the Distemper is
+evident. Perhaps it might be even still safer to kill him at once.
+
+Whenever the Malady is certain, the Symptoms heighten pretty soon. His
+Aversion to Food, but especially to Drink, grows stronger. He no longer
+seems to know his Master, the Sound of his Voice changes; he suffers no
+Person to handle or approach him; and bites those who attempt it. He
+quits his ordinary Habitation, marching on with his Head and his Tail
+hanging downwards; his Tongue lolling half out, and covered with Foam or
+Slaver, which indeed not seldom happens indifferently to all Dogs. Other
+Dogs scent him, not seldom at a considerable Distance, and fly him with
+an Air of Horror, which is a certain Indication of his Disease.
+Sometimes he contents himself with biting only those who happen to be
+near him: while at other Times becoming more enraged, he springs to the
+right and left on all Men and Animals about him. He hurries away with
+manifest Dread from whatever Waters occur to him: at length he falls
+down as spent and exhausted; sometimes he rises up again, and drags
+himself on for a little Time, commonly dying the third, or, at the
+latest, on the fourth Day after the manifest Appearance of the Disease,
+and sometimes even sooner.
+
+Sec. 190. When a Person is bit by such a Dog, the Wound commonly heals up
+as readily, as if it was not in the least poisonous: but after the
+Expiration of a longer or shorter Term, from three Weeks to three
+Months; but most commonly in about six Weeks, the Person bitten begins
+to perceive, in the Spot that was bit, a certain dull obtuse Pain. The
+Scar of it swells, inflames, bursts open, and weeps out a sharp, foetid,
+and sanious, or somewhat bloody Humour. At the same Time the Patient
+becomes sad and melancholy: he feels a kind of Indifference,
+Insensibility, and general Numbness; an almost incessant Coldness; a
+Difficulty of breathing; a continual Anguish, and Pains in his Bowels.
+His Pulse is weak and irregular, his sleep restless, turbid, and
+confused with Ravings; with starting up in Surprize, and with terrible
+Frights. His Discharges by Stool are often much altered and irregular,
+and small cold Sweats appear at very short Intervals. Sometimes there is
+also a slight Pain or Uneasiness in the Throat. Such is the first Degree
+of this Disease, and it is called by some Physicians the dumb Rage, or
+Madness.
+
+Sec. 191. Its second Degree, the confirmed or downright Madness, is
+attended with the following Symptoms. The Patient is afflicted with a
+violent Thirst, and a Pain in drinking. Soon after this he avoids all
+Drink, but particularly Water, and within some Hours after, he even
+abhors it. This Horror becomes so violent, that the bringing Water near
+his Lips, or into his Sight, the very Name of it, or of any other Drink;
+the Sight of Objects, which, from their Transparence, have any
+Resemblance of Water, as a Looking Glass, _&c._ afflicts him with
+extreme Anguish, and sometimes even with Convulsions. They continue
+however still to swallow (though not without violent Difficulty) a
+little Meat or Bread, and sometimes a little Soup. Some even get down
+the liquid Medicines that are prescribed them, provided there be no
+Appearance of Water in them; or that Water is not mentioned to them, at
+the same Time. Their Urine becomes thick and high-coloured, and
+sometimes there is a Suppression or Stoppage of it. The Voice either
+grows hoarse, or is almost entirely abolished: but the Reports of the
+bitten barking like Dogs are ridiculous and superstitious Fictions, void
+of any Foundation; as well as many other Fable, that have been blended
+with the History of this Distemper. The Barking of Dogs however is very
+disagreeable to them. They are troubled with short _Deliriums_ or
+Ravings, which are sometimes mixed with Fury. It is at such times that
+they spit all around them; that they attempt also to bite, and sometimes
+unhappily effect it. Their Looks are fixed, as it were, and somewhat
+furious, and their Visage frequently red. It is pretty common for these
+miserable Patients to be sensible of the Approach of their raging Fit,
+and to conjure the Bystanders to be upon their Guard. Many of them never
+have an Inclination to bite. The increasing Anguish and Pain they feel
+become inexpressible: they earnestly wish for Death; and some of them
+have even destroyed themselves, when they had the Means of effecting it.
+
+Sec. 192. It is with the Spittle, and the Spittle only, that this dreadful
+Poison unites itself. And here it may be observed, 1, That if the Wounds
+have been made through any of the Patient's Cloaths, they are less
+dangerous than those inflicted immediately on the naked Skin. 2, That
+Animals who abound in Wool, or have very thick Hair, are often preserved
+from the mortal Impression of the Poison; because in these various
+Circumstances, the Cloaths, the Hair, or the Wool have wiped, or even
+dried up, the Slaver of their Teeth. 3, The Bites inflicted by an
+infected Animal, very soon after he has bitten many others, are less
+dangerous than the former Bites, because their Slaver is lessened or
+exhausted. 4, If the Bite happens in the Face, or in the Neck, the
+Danger is greater, and the Operation of the Venom is quicker too; by
+Reason the Spittle of the Person so bit is sooner infected. 5, The
+higher the Degree of the Disease is advanced, the Bites become
+proportionably more dangerous. From what I have just mentioned here it
+may be discerned, why, of many who have been bitten by the same
+Sufferer, some have been infected with this dreadful Disease, and others
+not.
+
+Sec. 193. A great Number of Remedies have been highly cried up, as famous
+in the Cure of this Disease; and, in _Swisserland_ particularly, the
+Root of the Eglantine or wild Rose, gathered at some particular times,
+under the favorable Aspects of the Moon, and dried with some
+extraordinary Precautions. There is also the Powder of _Palmarius_ of
+calcined Egg Shells, that of the _Lichen terrestris_, or Ground
+Liverwort, with one third Part of Pepper, a Remedy long celebrated in
+_England_; Powder of Oyster-Shells; of Vervain; bathing in Salt Water;
+St. Hubert's Key, _&c. &c._ But the Death of a Multitude of those who
+have been bitten, notwithstanding their taking the greatest Part of all
+these boasted Antidotes; and the Certainty of no one's escaping, who had
+been attacked with the high raging Symptom, the _Hydrophobia_, have
+demonstrated the Inefficacy of them all, to all _Europe_. It is
+incontestable that to the Year 1730, not a single Patient escaped, in
+whom the Disease was indisputably manifest; and that every Medicine then
+employed against it was useless. When Medicines had been given before
+the great Symptom appeared, in some of those who took them, it
+afterwards appeared, in others not. The same different Events occurred
+also to others who were bitten, and who took not the least Medicine; so
+that upon the whole, before that Date, no Medicine seemed to be of any
+Consequence. Since that Time, we have had the Happiness to be informed
+of a certain Remedy, which is Mercury, joined to a few others.
+
+Sec. 194. In short there is a Necessity for destroying or expelling the
+Poison itself, which Mercury effects, and is consequently the
+Counter-poison of it. That poison produces a general Irritation of the
+Nerves; this is to be removed or asswaged by Antispasmodics: so that in
+Mercury, or Quicksilver, joined to Antispasmodics, consists the whole
+that is indicated in the Cure of this Disease. There really have been
+many Instances of Persons cured by these Medicines, in whom the
+Distemper had been manifest in its Rage and Violence; and as many as
+have unfortunately received the Cause of it in a Bite, should be firmly
+persuaded, that in taking these Medicines, and using all other proper
+Precautions, they shall be entirely secured from all its ill
+Consequences. Those also in whom the Rage and Fury of this Distemper is
+manifest, ought to use the same Medicines, with entire [45] Hope and
+Confidence, which may justly be founded on the many Cures effected by
+them. It is acknowledged however, that they have proved ineffectual in a
+few Cases; but what Disease is there, which does not sometimes prove
+incurable?
+
+[45] This Advice is truly prudent and judicious; Hope, as I have
+     observed on a different Occasion, being a powerful, though
+     impalpable, Cordial: and in such perilous Situations, we should
+     excite the most agreeable Expectations we possibly can in the
+     Patient; that Nature, being undepressed by any desponding
+     melancholy ones, may exert her Functions the more firmly, and
+     co-operate effectually with the Medicines, against her internal
+     Enemy. _K._
+
+Sec. 195. The very Moment after receiving the Bite, is it happens to be in
+the Flesh, and if it can safely be effected, all the Part affected
+should be cut [46] away. The Ancients directed it to be cauterized, or
+burnt with a red hot Iron (meer Scarification being of very little
+Effect) and this Method would very probably prove effectual. It requires
+more Resolution, however, than every Patient is endued with. The Wound
+should be washed and cleansed a considerable Time with warm Water, with
+a little Sea-Salt dissolved in it. After this into the Lips and Edges of
+the Wound, and into the Surface of the Part all about it, should be
+rubbed a Quarter of an Ounce of the Ointment No. 28; and the Wound
+should be dressed twice daily, with the soft lenient Ointment No. 29, to
+promote Suppuration; but that of No. 28 is to be used only once a Day.
+
+[46] I knew a brave worthy Gentleman abroad, who above forty Years past
+     thus preserved his Life, after receiving the Bite of a large
+     Rattle-Snake, by resolutely cutting it and the Flesh surrounding it
+     out, with a sharp pointed Penknife.--Perhaps those who would not
+     suffer the Application of the actual Cautery, that is, of a red hot
+     Iron (which certainly promises well for a Cure) might be persuaded
+     to admit of a potential Cautery, where the Bite was inflicted on a
+     fleshy Part. Though even this is far from being unpainful, yet the
+     Pain coming on more gradually, is less terrifying and horrid. And
+     when it had been applied quickly after, and upon the Bite, and kept
+     on for 3 or 4 Hours, the Discharge, after cutting the _Eschar_,
+     would sooner ensue, and in more Abundance, than that from the
+     actual Cautery; the only Preference of which seems to consist in
+     its being capable perhaps of absorbing, or otherwise consuming, all
+     the poisonous _Saliva_ at once. This Issue should be dressed
+     afterwards according to our Author's Direction; and in the gradual
+     healing of the Ulcer, it may be properly deterged by adding a
+     little Praecipitate to the Digestive. Neither would this interfere
+     with the Exhibition of the _Tonquin_ Powder No. 30, nor the
+     antispasmodic _Bolus_ No. 31, if they should be judged necessary.
+     And these perhaps might prove the most certain Means of preventing
+     the mortal Effects of this singular animal Poison, which it is so
+     impossible to analyze, and so extremely difficult to form any
+     material Idea of; but which is not the Case of some other Poisons.
+     _K._
+
+In point of Regimen, the Quantity of Nourishment should be less than
+usual, particularly in the Article of [47] Flesh: he should abstain from
+Wine, spirituous Liquors, all Sorts of Spices and hot inflaming Food. He
+should drink only Barley-Water, or an Infusion of the Flowers of the
+Lime-tree. He should be guarded against Costiveness by a soft relaxing
+Diet, or by Glysters, and bathe his Legs once a Day in warm Water. Every
+third Day one Dose of the Medicine No. 30 should be taken; which is
+compounded of Mercury, that counterworks the Poison, and of Musk which
+prevents the Spasms, or convulsive Motions. I confess at the same Time
+that I have less Dependance on the Mercury given in this Form, and think
+the rubbing in of its Ointment considerably more efficacious, which I
+should hope may always prevent the Fatality of this dreadful, surprizing
+Disease. [48]
+
+[47] It seems not amiss to try the Effects of a solely vegetable Diet
+     (and that perhaps consisting more of the acescent than alcalescent
+     Herbs and Roots) in this Disease, commencing immediately from the
+     Bite of a known mad Dog. These carnivorous Animals, who naturally
+     reject all vegetable Food, are the only primary Harbingers or
+     Breeders of it; though they are capable of transmitting it by a
+     Bite to graminivorous and granivorous ones. The Virtue of Vinegar
+     in this Disease, said to have been accidentally discovered on the
+     Continent, seems not to have been hitherto experienced amongst us;
+     yet in Case of such a morbid Accident it may require a Tryal; tho'
+     not so far, as to occasion the Omission of more certainly
+     experienced Remedies, with some of which it might be improper. _K._
+
+[48] The great Usefulness of mercurial Frictions, we may even say, the
+     certain Security which they procure for the Patients, in these
+     Cases, provided they are applied very soon after the Bite, have
+     been demonstrated by their Success in _Provence_, at _Lyons_, at
+     _Montpellier_, at _Pondacherry_, and in many other Places.  Neither
+     have these happy Events been invalidated by any Observations or
+     Instances to the contrary. It cannot therefore be too strongly
+     inculcated to those who have been bitten by venomous Animals, to
+     comply with the Use of them. They ought to be used in such a
+     Quantity, and after such a Manner, as to excite a moderate
+     Salivation, for fifteen, twenty, or even thirty Days. _E. L._
+     Though this Practice may justly be pursued from great Caution, when
+     no Cautery had been speedily applied to, and no such Discharge had
+     been obtained from, the bitten Part; yet wherever it had, this long
+     and depressing Salivation, I conceive, would be very seldom
+     necessary; and might be hurtful to weak Constitutions. _K._
+
+Sec. 196. If the raging Symptom, the Dread of Water, has already appeared,
+and the Patient is strong, and abounds with Blood, he should, 1, be bled
+to a considerable Quantity, and this may be repeated twice, thrice, or
+even a fourth Time, if Circumstances require it.
+
+2, The Patient should be put, if possible, into a warm Bath; and this
+should be used twice daily.
+
+3, He should every Day receive two, or even three of the emollient
+Glysters No. 5.
+
+4, The Wound and the Parts adjoining to it should be rubbed with the
+Ointment No. 28, twice a Day.
+
+5, The whole Limb which contains the Wound should be rubbed with Oil,
+and be wrapped up in an oily Flanel.
+
+6, Every three Hours a Dose of the Powder No. 30, should be taken in a
+Cup of the Infusion of Lime-tree and Elder Flowers.
+
+7, The Prescription No. 31, is to be given every Night, and to be
+repeated in the Morning, if the Patient is not easy, washing it down
+with the same Infusion.
+
+8, If there be a great Nauseousness at Stomach, with a Bitterness in the
+Mouth, give the Powder No. 35, which brings up a copious Discharge of
+glewy and bilious Humours.
+
+9, There is very little Occasion to say any thing relating to the
+Patient's Food, in such a Situation. Should he ask for any, he may be
+allowed Panada, light Soup, Bread, Soups made of farinaceous or mealy
+Vegetables, or a little Milk.
+
+Sec. 197. By the Use of these Remedies the Symptoms will be observed to
+lessen, and to disappear by Degrees; and finally Health will be
+re-established. But if the Patient should long continue weak, and
+subject to Terrors, he may take a Dose of the Powder No. 14, thrice a
+Day.
+
+Sec. 198. It is certain that a Boy, in whom the raging Symptom of This
+Disease had just appeared, was perfectly cured, by bathing all about the
+wounded Part with Sallad-Oil, in which some Camphire and Opium were
+dissolved; with the Addition of repeated Frictions of the Ointment No.
+28, and making him take some _Eau de luce_ with a little Wine. This
+Medicine, a Coffee-Cup of which may be given every four Hours, allayed
+the great Inquietude and Agitation of the Patient; and brought on a very
+plentiful Sweat, on which all the Symptoms vanished.
+
+Sec. 199. Dogs may be cured by rubbing in a triple Quantity of the same
+Ointment directed for Men, and by giving them the Bolus No. 33. But both
+these Means should be used as soon as ever they are bit. When the great
+Symptom is manifest, there would be too much Danger in attempting to
+apply one, or to give the other; and they should be immediately killed.
+It might be well however to try if they would swallow down the Bolus, on
+its being thrown to them.
+
+As soon as ever Dogs are bit, they should be safely tied up, and not let
+loose again, before the Expiration of three or four Months.
+
+Sec. 200. A false and dangerous Prejudice has prevailed with Regard to the
+Bites from Dogs, and it is this--That if a Dog who had bit any Person,
+without being mad at the Time of his biting, should become mad
+afterwards, the Person so formerly bitten, would prove mad too at the
+same Time. Such a Notion is full as absurd, as it would be to affirm,
+that if two Persons had slept in the same Bed, and that one of them
+should take the Itch, the Small-Pocks, or any other contagious Disease,
+ten or twelve Years afterwards, that the other should also be infected
+with that he took, and at the same Time too.
+
+Of two Circumstances, whenever a Person is bit, one must certainly be.
+Either the Dog which gives the Bite, is about to be mad himself, in
+which Case this would be evident in a few Days; and then it must be said
+the Person was bitten by a mad Dog: Or else, that the Dog was absolutely
+sound, having neither conceived, or bred in himself, nor received from
+without the Cause, the Principle, of Madness: in which last Case I ask
+any Man in his Senses, if he could communicate it. No Person, no Thing
+imparts what it has not. This false and crude Notion excites those who
+are possessed with it to a dangerous Action: they exercise that Liberty
+the Laws unhappily allow them of killing the Dog; by which Means they
+are left uncertain of his State, and of their own Chance. This is a
+dreadful Uncertainty, and may be attended with embarrassing and
+troublesome Consequences, independant of the Poison itself. The
+reasonable Conduct would be to secure and observe the Dog very closely,
+in Order to know certainly whether he is, or is not, mad.
+
+Sec. 201. It is no longer necessary to represent the Horror, the Barbarity
+and Guilt of that cruel Practice, which prevailed, not very long since,
+of suffocating Persons in the Height of this Disease, with the
+Bed-cloaths, or between Matrasses. It is now prohibited in most
+Countries; and doubtless will be punished, or, at least ought to be,
+even in those where as yet it is not.
+
+Another Cruelty, of which we hope to see no repeated Instance, is that
+of abandoning those miserable Patients to themselves, without the least
+Resource or Assistance: a most detestable Custom even in those Times,
+when there was not the least Hope of saving them; and still more
+criminal in our Days, when they may be recovered effectually. I do again
+affirm, that it is not very often these afflicted Patients are disposed
+to bite; and that even when they are, they are afraid of doing it; and
+request the Bystanders to keep out of their Reach: So that no Danger is
+incurred; or where there is any, it may easily be avoided by a few
+Precautions.
+
+
+
+
+                            __Chapter XIII.__
+
+
+                         _Of the Small-Pocks._
+
+
+                             __Sect.__ 202.
+
+The Small-Pocks is the most frequent, the most extensive of all
+Diseases; since out of a hundred Persons there are not more than [49]
+four or five exempted from it. It is equally true however, that if it
+attacks almost every Person, it attacks them but once, so that having
+escaped through it, they are always secure from [50] it. It must be
+acknowleged, at the same Time, to be one of the most destructive
+Diseases; for if in some Years or Seasons, it proves to be of a very
+mild and gentle Sort, in others it is almost as fatal as the Plague: it
+being demonstrated, by calculating the Consequences of its most raging,
+and its gentlest Prevalence, that it kills one seventh of the Number it
+attacks.
+
+[49] As far as the Number of inoculated Persons, who remained entirely
+     uninfected (some very few after a second Inoculation) has enabled
+     me, I have calculated the Proportion naturally exempted from this
+     Disease, though residing within the Influence of it, to be full 25
+     in 1000. See Analysis of Inoculation, Ed. 2d. P. 157. Note *. _K._
+
+[50] It has sometimes been observed (and the Observation has been such,
+     as not to be doubted) that a very mild distinct Small-Pocks has
+     sometimes invaded the same Person twice: But such Instances are so
+     very rare, that we may very generally affirm, those who have once
+     had it, will never have it again. _E. L._----In Deference to a few
+     particular Authorities, I have also supposed such a repeated
+     Infection. (Analysis of Inoculation, Ed. 2d. P. 43.) though I have
+     really never seen any such myself; nor ever heard more than two
+     Physicians affirm it, one at _Versailles_, and another in _London_;
+     the last of whom declared, he took it upon the Credit of a Country
+     Physician, thoroughly acquainted with this Disease, and a Witness
+     to the Repetition of it. Hence we imagine the Editor of this Work
+     at _Lyons_ might have justly termed this Re-infection _extremely_
+     rare, which would have a Tendency to reconcile the Subjects of the
+     Small-Pocks, more generally, to the most salutary Practice of
+     Inoculation. Doubtless some other eruptive Fevers, particularly,
+     the Chicken Pocks, Crystals, _&c._ have been often mistaken for the
+     real Small-Pocks by incompetent Judges, and sometimes even by
+     Persons better qualified, yet who were less attentive to the
+     Symptoms and Progress of the former. But whoever will be at the
+     Pains to read Dr. _Paux' Parallele de la petite verole naturalle
+     avec l'artificielle_, or a practical Abstract of Part of it in the
+     Monthly Review. Vol. XXV. P. 307 to 311, will find such a just,
+     clear and useful Distinction of them, as may prevent many future
+     Deceptions on this frequently interesting Subject. _K._
+
+Sec. 203. People generally take the Small-Pocks in their Infancy, or in
+their Childhood. It is very seldom known to attack only one Person in
+one Place: its Invasions being very generally epidemical, and seizing a
+large Proportion of those who have not suffered it. It commonly ceases
+at the End of some Weeks, or of some Months, and rarely ever appears
+again in the same Place, until four, five or six Years after.
+
+Sec. 204. This Malady often gives some Intimation of its Approach, three or
+four Days before the Appearance of the Fever, by a little Dejection;
+less Vivacity and Gaiety than usual; a great Propensity to sweat; less
+Appetite; a slight Alteration of the Countenance, and a kind of pale
+livid Colour about the Eyes: Notwithstanding which, in Children of a lax
+and phlegmatic Constitution, I have known a moderate Agitation of their
+Blood, (before their Shivering approached) give them a [51] Vivacity,
+Gaiety, and a rosy Improvement of their Complexion, beyond what Nature
+had given them.
+
+[51] The same Appearances very often occur in such Subjects by
+     Inoculation, before actual Sickening, as I have observed and
+     instanced, Ed. 1st. P. 62, Ed. 2. P. 75, 76. _K._
+
+Certain short Vicissitudes of Heat or Coldness succeed the former
+introductory Appearances, and at length a considerable Shivering, of the
+Duration of one, two, three or four Hours: This is succeeded by violent
+Heat, accompanied with Pains of the Head, Loins, Vomiting, or at least
+with a frequent Propensity to vomit.
+
+This State continues for some Hours, at the Expiration of which the
+Fever abates a little in a Sweat, which is sometimes a very large one:
+the Patient then finds himself better, but is notwithstanding cast down,
+torpid or heavy, very squeamish, with a Head-ach and Pain in the Back,
+and a Disposition to be drowsy. The last Symptom indeed is not very
+common, except in Children, less than seven or eight Years of Age.
+
+The Abatement of the Fever is of small Duration; and some Hours after,
+commonly towards the Evening, it returns with all its Attendants, and
+terminates again by Sweats, as before.
+
+This State of the Disease lasts three or four Days; at the End of which
+Term, and seldom later, the first Eruptions appear among the Sweat,
+which terminates the Paroxysm or Return of the Fever. I have generally
+observed the earliest Eruption to appear in the Face, next to that on
+the Hands, on the fore Part of the Arms; on the Neck, and on the upper
+Part of the Breast. As soon as this Eruption appears, if the Distemper
+is of a gentle Kind and Disposition, the Fever almost entirely vanishes:
+the Patient continues to sweat a little, or transpire; the Number of
+Eruptions increases, others coming out on the Back, the Sides, the
+Belly, the Thighs, the Legs, and the Feet. Sometimes they are pushed out
+very numerously even to the Soles of the Feet; where, as they increase
+in Size, they often excite very sharp Pain, by Reason of the great
+Thickness and Hardness of the Skin in these Parts.
+
+Frequently on the first and second Day of Eruption (speaking hitherto
+always of the mild Kind and Degree of the Disease) there returns again a
+very gentle Revival of the Fever about the Evening, which, about the
+Termination of it, is attended with a considerable and final Eruption:
+though as often as the Fever terminates perfectly after the earliest
+Eruption, a very distinct and very small one is a pretty certain
+Consequence. For though the Eruption is already, or should prove only
+moderate, the Fever, as I have before said, does not totally disappear;
+a small Degree of it still remaining, and heightening a little every
+Evening.
+
+These Pustules, or Efflorescences, on their first Appearance, are only
+so many very little red Spots, considerably resembling a Flea-bite; but
+distinguishable by a small white Point in the Middle, a little raised
+above the rest, which gradually increases in Size, with the Redness
+extended about it. They become whiter, in Proportion as they grow
+larger; and generally upon the sixth Day, including that of their first
+Eruption, they attain their utmost Magnitude, and are full of _Pus_ or
+Matter. Some of them grow to the Size of a Pea, and some still a little
+larger; but this never happens to the greatest Number of them. From this
+Time they begin to look yellowish, they gradually become dry, and fall
+off in brown Scales, in ten or eleven Days from their first Appearance.
+As their Eruption occurred on different Days, they also wither and fall
+off successively. The Face is sometimes clear of them, while Pustules
+still are seen upon the Legs, not fully ripe, or suppurated: and those
+in the Soles of the Feet often remain much longer.
+
+Sec. 205. The Skin is of Course extended or stretched out by the Pustules;
+and after the Appearance of a certain Quantity, all the Interstices, or
+Parts between the Pustules, are red and bright, as it were, with a
+proportionable Inflation or Swelling of the Skin. The Face is the first
+Part that appears bloated, from the Pustules there first attaining their
+utmost Size: and this inflation is sometimes so considerable, as to look
+monstrous; the like happens also to the Neck, and the Eyes are entirely
+closed up by it. The Swelling of the Face abates in Proportion to the
+scabbing and drying up of the Pustules; and then the Hands are puffed up
+prodigiously. This happens successively to the Legs, the Tumour or
+Swelling, being the Consequence of the Pustules attaining their utmost
+Size, which happens by Succession, in these different Parts.
+
+Sec. 206. Whenever there is a very considerable Eruption, the Fever is
+heightened at the Time of Suppuration, which is not to be wondered at;
+one single Boil excites a Fever: How is it possible then that some
+hundred, nay some thousand of these little Abscesses should not excite
+one? This Fever is the most dangerous Period, or Time of the Disease,
+and occurs between the ninth and the thirteenth Days; as many
+Circumstances vary the Term of Suppuration, two or three Days. At this
+painful and perilous Season then, the Patient becomes very hot, and
+thirsty: he is harrassed with Pain; and finds it very difficult to
+discover a favourable easy Posture. If the Malady runs very high, he has
+no Sleep; he raves, becomes greatly oppressed, is seized with a heavy
+Drowsiness; and when he dies, he dies either suffocated or lethargic,
+and sometimes in a State compounded of both these Symptoms.
+
+The Pulse, during this Fever of Suppuration, is sometimes of an
+astonishing Quickness, while the Swelling of the Wrists makes it seem,
+in some Subjects, to be very small. The most critical and dangerous Time
+is, when the Swellings of the Face, Head and Neck are in their highest
+Degree. Whenever the Swelling begins to fall, the Scabs on the Face to
+dry [_supposing neither of these to be too sudden and premature, for the
+visible Quantity of the Pustules_] and the Skin to shrivel, as it were,
+the Quickness of the Pulse abates a little, and the Danger diminishes.
+When the Pustules are very few, this second Fever is so moderate, that
+it requires some Attention to discern it, so that the Danger is next to
+none.
+
+Sec. 207. Besides those Symptoms, there are some others, which require
+considerable Attention and Vigilance. One of these is the Soreness of
+the Throat, with which many Persons in the Small-Pocks are afflicted, as
+soon as the Fever grows pretty strong. It continues for two or three
+Days; feels very strait and troublesome in the Action of Swallowing; and
+whenever the Disease is extremely acute, it entirely prevents
+Swallowing. It is commonly ascribed to the Eruption of Pustules in the
+Throat; but this is a Mistake, such Pustules being almost
+constantly [52] imaginary. It begins, most frequently, before the
+Eruption appears; if this Complaint is in a light Degree, it terminates
+upon the Eruption; and whenever it revives again in the Course of the
+Disease, it is always in Proportion to the Degree of the Fever. Hence we
+may infer it does not arise from the Pustules, but is owing to the
+Inflammation; and as often as it is of any considerable Duration, it is
+almost ever attended with another Symptom, the Salivation, or a
+Discharge of a great Quantity of Spittle. This Salivation rarely exists,
+where the Disease is very gentle, or the Patient very young; and is full
+as rarely absent, where it is severe, and the Patient is past seven or
+eight Years old: but when the Eruption is very confluent, and the
+Patient adult, or grown up, the Discharge is surprizing. Under these
+Circumstances it flows out incessantly, allowing the afflicted Patient
+no Rest or Respite; and often incommodes him more than any other Symptom
+of the Distemper; and so much the more, as after its Continuance for
+some Days, the Lips, the Inside of the Cheeks, the Tongue, and the Roof
+of the Mouth are entirely peeled or flead, as it were. Nevertheless,
+however painful and embarrassing this Discharge may prove, it is very
+important and salutary. Meer Infants are less subject to it, some of
+them having a Looseness, in Lieu of it: and yet I have observed even
+this last Discharge to be considerably less frequent in them, than a
+Salivation is in grown People.
+
+[52] As Pustules are, and not very seldom, visible on the Tongue, and
+     sometimes on the Roof, even to its Process called the Palate, which
+     I have plainly seen; it seems not very easy to assign any
+     insuperable Obstacle to the Existence of a few within the Throat;
+     though this scarcely ever occurs, in the distinct Small-Pocks.
+     Doubtless however, a considerable Inflammation of that Part will be
+     as likely to produce the great Difficulty of Swallowing, as the
+     Existence of Pustules there; which our learned Author does not
+     absolutely reject, and consequently will forgive this Supposition
+     of them; especially if he credits the ocular Testimony of Dr.
+     _Violante_, cited in the Analysis, Ed. 2d. p 71. _K._
+
+Sec. 208. Children, to the Age of five or six Years, are liable to
+Convulsions, before Eruption: these however are not dangerous, if they
+are not accompanied with other grievous and violent Symptoms. But such
+Convulsions as supervene, either when Eruption having already occurred,
+suddenly retreats, or _strikes in_, according to the common Phrase; or
+during the Course of the Fever of Suppuration, are greatly more
+terrifying.
+
+Involuntary Discharges of Blood from the Nose often occur, in the first
+Stage of this Distemper, which are extremely serviceable, and commonly
+lessen, or carry off, the Head-ach. Meer Infants are less subject to
+this Discharge; though they have sometimes a little of it: and I have
+known a considerable _Stupor_ or Drowsiness, vanish immediately after
+this Bleeding.
+
+Sec. 209. The Small-Pocks is commonly distinguished into two Kinds, the
+confluent and the distinct, such a Distinction really existing in
+Nature: but as the Treatment of each of them is the same; and as the
+Quantity or Dose of the Medicines is only to be varied, in Proportion to
+the Danger of the Patient (not to enter here into very tedious Details,
+and such as might exceed the Comprehension of many of our Readers; as
+well as whatever might relate particularly to the malignant Small-Pocks)
+I shall limit myself within the Description I have premised, which
+includes all the Symptoms common to both these Kinds of the Small-Pocks.
+I content myself with adding here, that we may expect a very confluent
+and dangerous Pock, is, at the very Time of seizure, the Patient is
+immediately attacked with many violent Symptoms; more especially if his
+Eyes are extremely quick, lively, and even glistening, as it were; if he
+vomits almost continually; if the Pain of his Loins be violent; and if
+he suffers at the same Time great Anguish and Inquietude: If in Infants
+there is great _Stupor_ or Heaviness; if Eruption appears on the third
+Day, and sometimes even on the second: as the hastier Eruptions in this
+Disease signify the most dangerous Kind and Degree of it; and on the
+contrary, the slower Eruption is, it is the safer too; supposing this
+Slowness of the Eruption not to have been the Consequence of great
+Weakness, or of some violent inward Pain.
+
+Sec. 210. The Disorder is sometimes so very mild and slight, that Eruption
+appears with scarcely any Suspicion of the Child's having the least
+Ailment, and the Event is as favourable as the Invasion. The Pustules
+appear, grow large, suppurate and attain their Maturity, without
+confining the Patient to his Bed, or lessening either his Sleep, or
+Appetite.
+
+It is very common to see Children in the Country (and they are seldom
+more than Children who have it so very gently) run about in the open
+Air, through the whole Course of this Disease, and feeding just as they
+do in Health. Even those who take it in a somewhat higher Degree,
+commonly go out when Eruption is finished, and give themselves up,
+without Reserve, to the Voracity of their Hunger. Notwithstanding all
+this Neglect, many get perfectly cured; though such a Conduct should
+never be proposed for Imitation, since Numbers have experienced its
+pernicious Consequences, and several of these Children have been brought
+to me, especially from _Jurat_, who after such Neglect, in the Course of
+the mild and kindly Sort of this Distemper, have contracted Complaints
+and Infirmities of different Kinds, which have been found very difficult
+to subdue.
+
+Sec. 211. This still continues to be one of these Distempers, whose Danger
+has long been increased by its improper Treatment, and especially by
+forcing the Patients into Sweats; and it still continues to be
+increased, particularly among Country People. They have seen Eruption
+appear, where the Patient sweats, and observed he found himself better
+after its Appearance: and hence they conclude that, by quickening and
+forcing out this Eruption, they contribute to his Relief; and suppose,
+that by increasing the Quantity of his Sweats, and the Number of his
+Eruptions, the Blood is the better cleared and purified from the Poison.
+These are mortal Errors, which daily Experience has demonstrated, by
+their tragical Consequences.
+
+When the Contagion or Poison, which generates this Disease, has been
+admitted into the Blood, it requires a certain Term to produce its usual
+Effects: at which Time the Blood being tainted by the Venom it has
+received, and by that which such Venom has formed or assimilated from
+it, Nature makes an Effort to free herself of it, and to expell it by
+the Skin, precisely at the Time when every Thing is predisposed for that
+Purpose. This Effort pretty generally succeeds, being very often rather
+too rapid and violent, and very seldom too weak. Hence it is evident,
+that whenever this Effort is deficient, it ought not to be heightened by
+hot Medicines or Means, which make it too violent and dangerous: for
+when it already exceeds in this Respect, a further Increase of such
+Violence must render it mortal. There are but few Cases in which the
+Efforts of Nature, on this Occasion, are too languid and feeble,
+especially in the Country; and whenever such rare Cases do occur, it is
+very difficult to form a just and proper Estimation of them: for which
+Reason we should be very reserved and cautious in the Use of heating
+Medicines, which are so mortally pernicious in this Disease.
+
+Wine, Venice Treacle, cordial Confections, hot Air, and Loads of
+Bed-cloths, annually sweep off Thousands of Children, who might have
+recovered, if they had taken nothing but warm Water: and every Person
+who is interested in the Recovery of Patients in this Distemper, ought
+carefully to prevent the smallest Use of such Drugs; which, if they
+should not immediately aggravate it to a fatal Degree, yet will
+certainly increase the Severity and Torment of it, and annex the most
+unhappy and tragical Consequences to it.
+
+The Prejudice in this Point is so strongly rooted, that a total
+Eradication of it must be very difficult: but I only desire People would
+be convinced by their own Eyes, of the different Success of the hot
+Regimen, and of that I shall propose. And here indeed I must confess, I
+found more Attention and Docility, on this Point, among the Inhabitants
+of the City, and especially in the last epidemical spreading of the
+Small-Pocks, than I presumed to hope for. Not only as many as consulted
+me on the Invasion of it, complied exactly with the cooling Regimen I
+advised them; but their Neighbours also had Recourse to it, when their
+Children sickened: and being often called in when it had been many Days
+advanced, I observed with great Pleasure, that in many Houses, not one
+heating Medicine had been given; and great Care had been taken to keep
+the Air of the Patient's Chamber refreshingly cool and temperate. This
+encourages me to expect, that this Method hereafter will become general
+here. What certainly ought most essentially to conduce to this is, that
+notwithstanding the Diffusion or spreading of this Disease was as
+numerous and extensive as any of the former, the Mortality, in
+Consequence of it, was evidently less.
+
+Sec. 212. At the very Beginning of the Small-Pocks (which may be reasonably
+suspected, from the Presence of the Symptoms I have already described;
+supposing the Person complaining never to have had it, and the Disease
+to prevail near his Residence) the Patient is immediately to be put on a
+strict Regimen, and to have his Legs bathed Night and Morning in warm
+Water. This is the most proper and promising Method to lessen the
+Quantity of Eruption in the Face and Head, and to facilitate it every
+where else on the Surface. Glysters also greatly contribute to abate the
+Head-ach, and to diminish the Reachings to vomit, and the actual
+Vomitings, which greatly distress the Patient; but which however it is
+highly absurd and pernicious to stop by any stomachic cordial
+Confection, or by Venice Treacle; and still more dangerous to attempt
+removing the Cause of them, by a Vomit or Purge, which are hurtful in
+the beginning of the Small-Pocks.
+
+If the Fever be moderate, the Bathings of the Legs on the first Day of
+sickening, and one Glyster may suffice then. The Patient must be
+restrained to his Regimen; and instead of the Ptisan No. 1, 2, 4, a very
+young Child should drink nothing but Milk diluted with two thirds of
+Elder Flower or Lime-tree Tea, or with Balm Tea, if there be no
+perceivable Fever; and in short, if they have an Aversion to the Taste
+of them all, with only the same Quantity of good clear [53] Water. An
+Apple coddled or baked may be added to it; and if they complain of
+Hunger, a little Bread may be allowed; but they must be denied any Meat,
+or Meat Broth, Eggs and strong Drink; since it has appeared from
+Observations frequently repeated, that Children who had been indulged
+with such Diet proved the worse for it, and recovered more slowly than
+others. In this early Stage too, clear Whey alone may serve them instead
+of every other Drink, the good Effects of which I have frequently been a
+Witness to; or some Buttermilk may be allowed. When the Distemper is of
+a mild Species, a perfect Cure ensues, without any other Assistance or
+Medicine: but we should not neglect to purge the Patient as soon as the
+Pustules are perfectly scabbed on the greater Part of his Face, with the
+Prescription No. 11, which must be repeated six Days after. He should
+not be allowed Flesh 'till after this second Purge; though after the
+first he may he allowed some well-boiled Pulse, or Garden-stuff and
+Bread, and in such a Quantity, as not to be pinched with Hunger, while
+he recovers from the Disease.
+
+[53] A Negro Girl, about five or six Years old, under a coherent Pock,
+     stole by Night out of the Garret where she lay, into a Kitchen out
+     of Doors, where she drank plentifully of cold Water. How often she
+     repeated these nightly cooling Potions I never could certainly
+     learn, though they occurred in my own House in _South-Carolina_ in
+     Summer. But it is certain the Child recovered as speedily as
+     others, whose Eruption was more distinct, and who drank
+     Barley-Water, very thin Rice or Indian Corn Gruel, Balm Tea, or the
+     like. In fact, throughout the Course of this Visitation from the
+     Small Pocks in _Carolina_ in 1738, we had but too many
+     Demonstrations of the fatal Co-operation of violent Heat with their
+     Contagion; and not a very few surprizing Instances of the salutary
+     Effects of being necessarily and involuntarily exposed to same very
+     cooling Accidents after Infection, and in some Cases after Eruption
+     too: which I then more particularly mentioned is a small
+     controversial Tract printed there. _K._
+
+Sec. 213. But if the Fever should be strong, the Pulse hard, and the Pain
+of the Head and Loins should be violent, he must, 1. immediately lose
+Blood from the Arm; receive a Glyster two Hours after; and, if the Fever
+continues, the Bleeding must be repeated. I have directed a Repetition
+of it even to the fourth Time, within the two first Days, to young
+People under the Age of eighteen; and it is more especially necessary in
+such Persons as, with a hard and full Pulse, are also affected with a
+heavy Drowsiness and a _Delirium_, or Raving.
+
+2. As long as the Fever continues violently, two, three, and even four
+Glysters should be given in the 24 Hours; and the Legs should be bathed
+twice.
+
+3. The Patient is to be taken out of Bed, and supported in a Chair as
+long as he can tolerably bear it.
+
+4. The Air of his Chamber should frequently be renewed, and if it be too
+hot, which it often is in Summer, in Order to refresh it, and the
+Patient, the Means must be employed which are directed Sec. 36.
+
+5. He is to be restrained to the Ptisans No. 2 or 4; and if that does
+not sufficiently moderate the Fever, he should take every Hour, or every
+two Hours, according to the Urgency of the Case, a Spoonful of the
+Mixture No. 10; mixed with a Cup of Ptisan. After the Eruption, the
+Fever being then abated, there is less Occasion for Medicine; and should
+it even entirely disappear, the Patient may be regulated, as directed, Sec.
+212.
+
+Sec. 214. When, after a Calm, a Remission or Intermission of some Days, the
+Process of Suppuration revives the Fever, we ought first, and
+especially, to keep the [54] Body very open. For this Purpose, _a_ an
+Ounce of _Catholicon_ should be added to the Glysters; or they might be
+simply made of Whey, with Honey, Oil and Salt. _b_ Give the Patient
+three times every Morning, at the Interval of two Hours between each,
+three Glasses of the Ptisan No. 32. _c_ Purge him _after_ two Days, with
+the Potion No. 23, but on that Day he must not take the Ptisan No. 32.
+
+[54] We must remember that Dr. _Tissot_ is treating _here_ of the higher
+     or confluent Degrees of this Disease; for in the distinct
+     Small-Pocks, it is common to find Persons for several Days without
+     a Stool, and without the least perceiveable Disorder for Want of
+     one (their whole Nourishment being very light and liquid) in which
+     Cases, while Matters proceeded well in all other Respects, there
+     seems little Occasion for a great Solicitude about Stools: But if
+     one should be judged necessary after four or five Days Costiveness,
+     accompanied with a Tightness or Hardness of the Belly, doubtless
+     the Glyster should be of the lenient Kind (as those directed by our
+     Author are) and not calculated to produce more than a second Stool
+     at the very most. Indeed, where there is Reason to apprehend a
+     strong secondary Fever, from the Quantity of Eruption, and a
+     previously high Inflammation, it is more prudent to provide for a
+     Mitigation of it, by a moderately open Belly, than to suffer a long
+     Costiveness; yet so as to incur very little Hazard of abating the
+     Salivation, or retarding the Growth or Suppuration of the Pustules,
+     by a Superpurgation, which it may be too easy to excite in some
+     Habits. If the Discharge by spitting, and the Brightness and
+     Quantity of Suppuration, have been in Proportion to the Number of
+     Eruptions; though the Conflict from the secondary Fever, where
+     these have been numerous, is often acute and high; and the Patient,
+     who is in great Anguish, is far from being out of Danger, yet
+     Nature pretty generally proves stronger than the Disease, in such
+     Circumstances. As the _Elect. Catholicon_, is little used, or made
+     here, the lenitive Electuary of our Dispensatory may be substituted
+     for it, or that of the _Edinburgh_ Dispensatory, which was
+     calculated particularly for Glysters. _K._
+
+2. He must, if the Distemper be very violent, take a double Dose of the
+Mixture No. 10.
+
+3. The Patient should be taken out of Bed, and kept up in a Room well
+aired Day and Night, until the Fever has abated. Many Persons will
+probably be surprized at this Advice; nevertheless it is that which I
+have often experienced to be the most efficacious, and without which the
+others are ineffectual. They will say, how shall the Patient sleep at
+this Rate? To which it may be answered, Sleep is not necessary, nay, it
+is hurtful in this State and Stage of the Disease. Besides, he is really
+unable to sleep: the continual Salivation prevents it, and it is very
+necessary to keep up the Salivation; which is facilitated by often
+injecting warm Water and Honey into his Throat. It is also of
+considerable Service to throw some up his Nostrils, and often thus to
+cleanse the Scabs which form within them. A due Regard to these
+Circumstances not only contributes to lessen the Patient's Uneasiness,
+but very effectually also to his Cure.
+
+4. If the Face and Neck are greatly swelled, emollient Cataplasms are to
+be applied to the Soles of the Feet; and if these should have very
+little Effect, Sinapisms should be applied. These are a kind of Plaister
+or Application composed of Yeast, Mustard-flower, and some Vinegar. They
+sometimes occasion sharp and almost burning Pain, but in Proportion to
+the Sharpness and Increase of these Pains, the Head and Neck are
+remarkably relieved.
+
+Sec. 215. The Eyelids are puffed up and swelled when the Disease runs high,
+so as to conceal the Eyes, which are closed up fast for several Days.
+Nothing further should be attempted, with Respect to this Circumstance,
+but the frequent moistening of them with a little warm Milk and Water.
+The Precautions which some take to stroke them with Saffron, a gold
+Ducat, or Rose-water are equally childish and insignificant. What
+chiefly conduces to prevent the Redness or Inflammation of the Eyes
+after the Disease, and in general all its other bad Consequences, is to
+be content for a considerable Time, with a very moderate Quantity of
+Food, and particularly to abstain from Flesh and Wine. In the very bad
+Small Pocks, and in little Children, the Eyes are closed up from the
+Beginning of the Eruption.
+
+Sec. 216. One extremely serviceable Assistance, and which has not been made
+use of for a long Time past, except as a Means to preserve the
+Smoothness and Beauty of the Face; but yet which has the greatest
+Tendency to preserve Life itself, is the Opening of the Pustules, not
+only upon the Face, but all over the Body. In the first Place, by
+opening them, the Lodgment or Retention of _Pus_ is prevented, which may
+be supposed to prevent any Erosion, or eating down, from it; whence
+Scars, deep Pitts and other Deformities are obviated. Secondly, in
+giving a Vent to the Poison, the Retreat of it into the Blood is cut
+off, which removes a principal Cause of the Danger of the Small-Pocks.
+Thirdly, the Skin is relaxed; the Tumour of the Face and Neck diminish
+in Proportion to that Relaxation; and thence the Return of the Blood
+from the Brain is facilitated, which must prove a great Advantage. The
+Pustules should be opened every where, successively as they ripen. The
+precise Time of doing it is when they are entirely white; when they just
+begin to turn but a very little yellowish; and when the red Circle
+surrounding them is quite pale. They should be opened with very fine
+sharp-pointed Scissars; this does not give the Patient the least Pain;
+and when a certain Number of them are opened, a Spunge dipt in a little
+warm Water is to be repeatedly applied to suck up and remove that _Pus_,
+which would soon be dried up into Scabs. But as the Pustules, when
+emptied thus, soon fill again, a Discharge of this fresh Matter must be
+obtained in the same Manner some Hours after; and this must sometimes be
+repeated five or even six Times successively. Such extraordinary
+Attention in this Point may probably be considered as minute, and even
+trivial, by some; and is very unlikely to become a [55] general
+Practice: but I do again affirm it to be of much more Importance than
+many may imagine; and that as often as the Fever attending Suppuration
+is violent and menacing, a very general, exact and repeated opening,
+emptying, and absorbing of the ripened Pustules, is a Remedy of the
+utmost Importance and Efficacy; as it removes two very considerable
+Causes of the Danger of this Disease, which are the Matter itself, and
+the great Tension and Stiffness of the Skin.
+
+[55] This Practice which I had heard of, and even suggested to myself,
+     but never seen actually enterprized, seems so very rational as
+     highly to deserve a fair Trial in the confluent Degrees of the
+     Small-Pocks [for in the distinct it can scarcely be necessary]
+     wherein every probable Assistance should be employed, and in which
+     the most potent Medicines are very often unsuccessful. We have but
+     too many Opportunities of trying it sufficiently; and it certainly
+     has a more promising Aspect than a Practice so highly recommended
+     many Years ago, of covering all the Pustules (which is sometimes
+     the whole Surface of the Patient) in Melilot, or suppose any other
+     suppurating, Plaister; which will effectually prevent all
+     Perspiration, and greatly increase the Soreness, Pain and
+     Embarrassment of the Patient, at the Height of the Disease. I can
+     conceive but one bad Consequence that might possibly sometimes
+     result from the former; but this (besides the Means that may be
+     used to avert it) is rather remote, and so uncertain, until the
+     Trial is repeatedly made, that I think it ought not to be named, in
+     Competition with the Benefits that may arise from it in such Cases,
+     as seem, otherwise, too generally irrecoverable. _K._
+
+Sec. 217. In the Treatment of this Disease, I have said nothing with
+Respect to Anodynes, or such Medicines as procure Sleep, which I am
+sensible are pretty generally employed in it, but which I scarcely ever
+direct in this violent Degree of the Disease, and the Dangers of which
+Medicine in it I have demonstrated in the Letter to Baron _Haller_,
+which I have already mentioned. For which Reason, wherever the Patient
+is not under the Care and Direction of a Physician, they should very
+carefully abstain from the Use of Venice Treacle, Laudanum, _Diacodium_,
+that is the Syrup of white Poppies, or even of the wild red Poppy; Syrup
+of Amber, Pills of Storax, of _Cynoglossum_ or Hounds-tongue, and, in
+one Word, of every Medicine which produces Sleep. But still more
+especially should their Use be entirely banished, throughout the
+Duration of the secondary Fever, when even natural Sleep itself is
+dangerous. One Circumstance in which their Use may sometimes be
+permitted, is in the Case of weakly Children, or such as are liable to
+Convulsions, where Eruption is effected not without Difficulty. But I
+must again inculcate the greatest Circumspection, in the Use of such
+Medicines, whose Effects are fatal, [56] when the Blood-vessels are
+turgid or full; whenever there is Inflammation, Fever, a great
+Distension of the Skin; whenever the Patient raves, or complains of
+Heaviness and Oppression; and when it is necessary that the Belly should
+be open; the Urine plentifully discharged; and the Salivation be freely
+promoted.
+
+[56] The Use of Opiates in this Disease undoubtedly requires no Small
+     Consideration, the great _Sydenham_ himself not seeming always
+     sufficiently guarded in the Exhibition of them; as far as
+     Experience since his Day has enabled Physicians to judge of this
+     Matter. In general our Author's Limitations of them seem very just;
+     though we have seen a few clear Instances, in which a light Raving,
+     which evidently arose from Want of Sleep (joined to some Dread of
+     the Event of the Disease by Inoculation) was happily removed, with
+     every other considerable Complaint, by a moderate Opiate. In sore
+     and fretful Children too, under a large or middling Eruption, as
+     the Time gained to Rest is taken from Pain, and from wasting their
+     Spirits in Crying and Clamour, I have seen Suppuration very
+     benignly promoted by _Diacodium_. But in the _Crisis_ of the
+     secondary Fever in the confluent or coherent Pock, when there is a
+     morbid Fulness, and Nature is struggling to unload herself by some
+     other Outlets than those of the Skin, which now are totally
+     obstructed (and which seems the only Evacuation, that is not
+     restrained by Opiates) the giving and repeating them then, as has
+     too often been practised, seems importantly erroneous; for I think
+     Dr. _Swan_ has taken a judicious Liberty of dissenting from the
+     great Author he translates, in forbidding an Opiate, if the
+     Spitting abates, or grows so tough and ropy, as to endanger
+     Suffocation. As the Difference of our Oeconomy in the
+     Administration of Physic from that in _Swisserland_, and Dr.
+     _Tissot's_ just Reputation may dispose many Country Practitioners
+     to peruse this Treatise, I take the Liberty of referring such
+     Readers, for a Recollection of some of my Sentiments of Opiates,
+     long before the Appearance of this Work in French, to the second
+     Edition of the Analysis from P. 94 to 97, _&c._ _K._
+
+Sec. 218. If Eruption should suddenly retreat, or strike in, heating,
+soporific, spirituous and volatile Remedies should carefully be avoided:
+but the Patient may drink plentifully of the Infusion No. 12 pretty hot,
+and should be blistered on the fleshy Part of the Legs. This is a very
+embarrassing and difficult Case, and the different Circumstances
+attending it may require different Means and Applications, the Detail
+and Discussion of which are beyond my Plan here. Sometimes a single
+Bleeding has effectually recalled Eruption at once.
+
+Sec. 219. The only certain Method of surmounting all the Danger of this
+Malady, is to inoculate. But this most salutary Method, which ought to
+be regarded as a particular and gracious Dispensation of Providence, can
+scarcely be attainable by, or serviceable to, the Bulk of the People,
+except in those Countries, where Hospitals [57] are destined
+particularly for Inoculation. In these where as yet there are none, the
+only Resource that is left for Children who cannot be inoculated at
+home, is to dispose them happily for the Distemper, by a simple easy
+Preparation.
+
+[57] That I have long since had the Honour of agreeing with our learned
+     Author, in this Consideration for the Benefit of the Body of the
+     People, which is the Benefit of the State, will appear from p. 288
+     of Analys. Ed. 1st. and from p. 371, 372 of the Second. _K._
+
+Sec. 220. This Preparation consists, upon the whole, in removing all Want
+of, and all Obstructions to, the Health of the Person subject to this
+Disease, if he have any such; and in bringing him into a mild and
+healthy, but not into a very robust and vigorous, State; as this
+Distemper is often exceedingly violent in this last.
+
+It is evident, that since the Defects of Health are very different in
+different Bodies, the Preparations of them must as often vary; and that
+a Child subject to some habitual Disorder, cannot be prepared in the
+same Method with another who has a very opposite one. The Detail and
+Distinctions which are necessary on this important Head, would be
+improper here, whether it might be owing to their unavoidable Length; or
+to the Impossibility of giving Persons, who are not Physicians,
+sufficient Knowlege and Information to qualify them for determining on,
+and preferring, the most proper Preparation in various Cases.
+Nevertheless I will point out some such as may be very likely to agree,
+pretty generally, with Respect to strong and healthy Children. [58]
+
+[58] The Substance of this Section flows from the Combination of an
+     excellent Understanding with great Experience, mature Reflection,
+     and real Probity; and fundamentally exposes both the Absurdity of
+     such as universally decry any Preparation of any Subject previous
+     to Inoculation, (which is said to be the Practice of a present very
+     popular Inoculator in _Paris_) and the opposite Absurdity of giving
+     one and the very same Preparation to all Subjects, without
+     Distinction; though this was avowed to have been successfully fully
+     practised in _Pensylvania_, some Years since; which the Reader may
+     see Analys. Ed. 2d, from p. 329 to 331 and the Note there. _K._
+
+The first Step then is an Abatement of their usual Quantity of Food.
+Children commonly eat too much. Their Limitation should be in Proportion
+to their Size and Growth, where we could exactly ascertain them: but
+with Regard to all, or to much the greater Number of them, we may be
+allowed to make their Supper very light, and very small.
+
+Their second Advantage will consist in the Choice of their Food. This
+Circumstance is less within the Attainment of, and indeed less necessary
+for, the common People, who are of Course limited to a very few, than to
+the Rich, who have Room to make great Retrenchments on this Account. The
+Diet of Country People being of the simplest Kind, and almost solely
+consisting of Vegetables and of Milk-meats, is the most proper Diet
+towards preparing for this Disease. For this Reason, such Persons have
+little more to attend to in this Respect, but that such Aliments be
+sound and good in their Kind; that their Bread be well baked; their
+Pulse dressed without Bacon, or rancid strong Fat of any sort; that
+their Fruits should be well ripened; that their Children should have no
+Cakes or Tarts, [But see Note [11], P. 40, 41.] and but little Cheese.
+These simple Regulations may be sufficient, with Regard to this Article
+of their Preparation.
+
+Some Judgment may be formed of the good Consequences of their Care on
+these two Points, concerning the Quantity and Quality of the Childrens
+Diet, by the moderate Shrinking of their Bellies; as they will be
+rendered more lively and active by this Alteration in their living; and
+yet, notwithstanding a little less Ruddiness in their Complexion, and
+some Abatement of their common Plight of Body, their Countenances, upon
+the whole, will seem improved.
+
+The third Article I would recommend, is to bathe their Legs now and then
+in warm Water, before they go to Bed. This promotes Perspiration, cools,
+dilutes the Blood, and allays the Sharpness of it, as often as it is
+properly timed.
+
+The fourth Precaution, is the frequent Use of very clear Whey. This
+agreeable Remedy, which consists of the Juices of Herbs filtred through,
+and concocted, or as it were, sweetened by the Organs of a healthy
+Animal, answers every visible Indication (I am still speaking here of
+sound and hearty Children). It imparts a Flexibility, or Soupleness to
+the Vessels; it abates the Density, the heavy Consistence and Thickness
+of the Blood; which being augmented by the Action of the poisonous Cause
+of the Small-Pocks, would degenerate into a most dangerous
+inflammatory [59] Viscidity or Thickness. It removes all Obstructions in
+the _Viscera_, or Bowels of the lower Cavity, the Belly. It opens the
+Passages which strain off the Bile; sheaths, or blunts, its Sharpness,
+gives it a proper Fluidity, prevents its Putridity, and sweetens
+whatever excessive Acrimony may reside throughout the Mass of Humours.
+It likewise promotes Stools, Urine and Perspiration; and, in a Word, it
+communicates the most favourable Disposition to the Body, not to be too
+violently impressed and agitated by the Operation of an inflammatory
+Poison: And with Regard to such Children as I have mentioned, for those
+who are either sanguine or bilious, it is beyond all Contradiction, the
+most effectual preparatory Drink, and the most proper to make them
+amends for the Want of Inoculation.
+
+[59] There may certainly be an inflammatory Acrimony or Thinness, as
+     well as Thickness of the Blood; and many medical Readers may think
+     a morbid Fusion of the red Globules to be a more frequent Effect of
+     this Contagion, than an increased Viscidity of them. See Analys.
+     Ed. 2d. p. 75 to 83. But this Translation, conforming to the Spirit
+     of its Original, admits very little Theory, and still less
+     Controversy, into its Plan. _K._
+
+I have already observed, that it may also be used to great Advantage,
+during the Course of the Disease: but I must also observe, that however
+salutary it is, in the Cases for which I have directed it, there are
+many others in which it would be hurtful. It would be extremely
+pernicious to order it to weak, languishing, scirrhous, pale Children,
+subject to Vomitings, Purgings, Acidities, and to all Diseases which
+prove their Bowels to be weak, their Humours to be sharp: so that People
+must be very cautious not to regard it as an universal and infallible
+Remedy, towards preparing for the Small-Pocks. Those to whom it is
+advised, may take a few Glasses every Morning, and even drink it daily,
+for their common Drink; they may also sup it with Bread for Breakfast,
+for Supper, and indeed at any Time.
+
+If Country People will pursue these Directions, which are very easy to
+observe and to comprehend, whenever the Small-Pocks rages, I am
+persuaded it must lessen the Mortality attending it. Some will certainly
+experience the Benefit of them; such I mean as are very sensible and
+discreet, and strongly influenced by the truest Love of their Children.
+Others there are Alas! who are too stupid to discern the Advantage of
+them, and too unnatural to take any just Care of their Families.
+
+
+
+
+                            __Chapter XIV.__
+
+
+                           _Of the Measles._
+
+
+                             __Sect.__ 221.
+
+The Measles, to which the human Species are as generally liable, as to
+the Small-Pocks, is a Distemper considerably related to it; though,
+generally speaking, it is less fatal; notwithstanding which, it is not a
+little destructive in some Countries. In _Swisserland_ we lose much
+fewer, immediately in the Disease, than from the Consequences of it.
+
+It happens now and then that the Small-Pocks and the Measles rage at the
+same Time, and in the same Place; though I have more frequently
+observed, that each of them was epidemical in different Years. Sometimes
+it also happens that both these Diseases are combined at once in the
+same Person; and that one supervenes before the other has finished its
+Course, which makes the Case very perilous.
+
+Sec. 222. In some Constitutions the Measles gives Notice of its Approach
+many Days before its evident Invasion, by a small, frequent and dry
+Cough, without any other sensible Complaint: though more frequently by a
+general Uneasiness; by Successions of Shivering and of Heat; by a severe
+Head-ach in grown Persons; a Heaviness in Children; a considerable
+Complaint of the Throat; and, by what particularly characterizes this
+Distemper, an Inflammation and a considerable Heat in the Eyes, attended
+with a Swelling of the Eye-lids, with a Defluxion of sharp Tears, and so
+acute a Sensation, or Feeling of the Eyes, that they cannot bear the
+Light; by very frequent Sneezings, and a Dripping from the Nose of the
+same Humour with that, which trickles from the Eyes.
+
+The Heat and the Fever increases with Rapidity; the Patient is afflicted
+with a Cough, a Stuffing, with Anguish, and continual Reachings to
+vomit; with violent Pains in the Loins; and sometimes with a Looseness,
+under which Circumstance he is less persecuted with Vomiting. At other
+times, and in other Subjects, Sweating chiefly prevails, though in less
+Abundance than in the Small-Pocks. The Tongue is foul and white; the
+Thirst is often very high; and the Symptoms are generally more violent
+than in the mild Small-Pocks.
+
+At length, on the fourth or fifth Day, and sometimes about the End of
+the third, a sudden Eruption appears and in a very great Quantity,
+especially about the Face; which in a few Hours is covered with Spots,
+each of which resembles a Flea-bite; many of them soon joining form red
+Streaks or Suffusions larger or smaller, which inflame the Skin, and
+produce a very perceivable Swelling of the Face; whence the very Eyes
+are sometimes closed. Each small Spot or Suffusion is raised a little
+above the Surface, especially in the Face, where they are manifest both
+to the Sight and the Touch. In the other Parts of the Body, this
+Elevation or Rising is scarcely perceivable by any Circumstance, but the
+Roughness of the Skin.
+
+The Eruption, having first appeared in the Face, is afterwards extended
+to the Breast, the Back, the Arms, the Thighs and Legs. It generally
+spreads very plentifully over the Breast and the Back, and sometimes red
+Suffusions are found upon the Breast, before any Eruption has appeared
+in the Face.
+
+The Patient is often relieved, as in the Small-Pocks, by plentiful
+Discharges of Blood from the Nose, which carry off the Complaints of the
+Head, of the Eyes, and of the Throat.
+
+Whenever this Distemper appears in its mildest Character, almost every
+Symptom abates after Eruption, as it happens in the Small-Pocks; though,
+in general, the Change for the better is not as thoroughly perceivable,
+as it is in the Small-Pocks. It is certain the Reachings and Vomitings
+cease almost entirely; but the Fever, the Cough, the Head-ach continue;
+and I have sometimes observed that a bilious Vomiting, a Day or two
+after the Eruption, proved a more considerable Relief to the Patient
+than the Eruption had. On the third or fourth Day of the Eruption, the
+Redness diminishes; the Spots, or very small Pustules, dry up and fall
+off in very little branny Scales; the Cuticle, or superficial Skin also
+shrivels off; and is replaced by one succeeding beneath it. On the ninth
+Day, when the Progress of the Malady has been speedy, and on the
+eleventh, when it has been very slow, no Trace of the Redness is to be
+found; and the Surface immediately resumes its usual Appearance.
+
+Sec. 223. Notwithstanding all which the Patient is not safe, except, during
+the Course of the Distemper, or immediately after it, he has had some
+considerable Evacuation; such as the Vomiting I have just mentioned; or
+a bilious Looseness; or considerable Discharges by Urine; or very
+plentiful Sweating. For when any of these Evacuations supervene, the
+Fever vanishes; the Patient resumes his Strength, and perfectly
+recovers. It happens sometimes too, and even without any of these
+perceivable Discharges, that insensible Perspiration expels the Relics
+of the poisonous Cause of this Disease, and the Patient recovers his
+Health. Yet it occurs too often, that this Venom not having been
+entirely expelled (or its internal Effects not having been thoroughly
+effaced) it is repelled upon the Lungs, where it produces a slight
+Inflammation. In Consequence of this the Oppression, the Cough, the
+Anguish, and Fever return, and the Patient's Situation becomes very
+dangerous. This Outrage is frequently less vehement, but it proves
+tedious and chronical, leaving a very obstinate Cough behind it, with
+many Resemblances of the Whooping-Cough. In 1758 there was an epidemic
+State of the Measles here extremely numerous, which affected great
+Numbers: Almost all who had it, and who were not very carefully and
+judiciously attended, were seized in Consequence of it with that Cough,
+which proved very violent and obstinate.
+
+Sec. 224. However, notwithstanding this be the frequent Progress and
+Consequence of this Disease, when left entirely to itself, or
+erroneously treated, and more particularly when treated with a hot
+Regimen; yet when proper Care was taken to moderate the Fever at the
+Beginning, to dilute, and to keep up the Evacuations, such unhappy
+Consequences have been very rare.
+
+Sec. 225. The proper Method of conducting this Distemper is much the same
+with that of the Small-Pocks.
+
+1, If the Fever be high, the Pulse hard, the Load and Oppression heavy,
+and all the Symptoms violent, the Patient must be bled once or twice.
+
+2, His Legs must be bathed, and he must take some Glysters: the
+Vehemence of the Symptoms must regulate the Number of each.
+
+3, The Ptisans No. 3 or 4 must be taken, or a Tea of Elder and Lime-tree
+Flowers, to which a fifth Part Milk may be added.
+
+4, The Vapour, the Steam of warm Water should also be employed, as very
+conducive to asswage the Cough; the Soreness of the Throat, and the
+Oppression the Patient labours under.
+
+5, As soon as the Efflorescence, the Redness becomes pale, the Patient
+is to be purged with the Draught No. 23.
+
+6, He is still to be kept strictly to his Regimen, for two Days after
+this Purge; after which he is to be put upon the Diet of those who are
+in a State of Recovery.
+
+7, If during the Eruption such Symptoms supervene as occur [at the same
+Term] in the Small-Pocks, they are to be treated in the Manner already
+directed there.
+
+Sec. 226. Whenever this Method has not been observed, and the Accidents
+described Sec. 223 supervene, the Distemper must be treated like an
+Inflammation in its first State, and all must be done as directed Sec. 225.
+If the Disease is not vehement, [60] Bleeding may be omitted. If it is
+of some standing in gross Children, loaded with Humours, inactive, and
+pale, we must add to the Medicines already prescribed the Potion No. 8,
+and Blisters to the Legs.
+
+[60] Our Author very prudently limits this Discharge, and the Repetition
+     of it, in this Disease (Sec. 225) as an erroneous Excess of it has
+     sometimes prevailed. I have seen a very epidemical Season of the
+     Measles, where Bleeding was not indicated in one third of the
+     infected. And yet I have known such an Abuse of Bleeding in it,
+     that being repeated more than once in a Case before Eruption (the
+     Measles probably not being suspected) the Eruption was retarded
+     several Days; and the Patient, a young Lady of Condition, remained
+     exceeding low, faint and sickish; 'till after recruiting a very
+     little, the Measles appeared, and she recovered. In a Youth of a
+     lax Fibre, where the Measles had appeared, a seventh or eighth
+     Bleeding was ordered on a Stitch in the Side, supervening from
+     their too early Disappearance, and the Case seemed very doubtful.
+     But Nature continued very obstinately favourable in this Youth, who
+     at length, but very slowly, recovered. His Circulation remained so
+     languid, his Strength, with his Juices, so exhausted, that he was
+     many Weeks before he could sit upright in a Chair, being obliged to
+     make Use of a Cord depending from the Ceiling, to raise himself
+     erectly in his Seat. _K._
+
+Sec. 227. It often happens from the Distance of proper Advice, that the
+Relics, the Dregs as it were, of the Disease have been too little
+regarded, especially the Cough; in which Circumstance it forms a real
+Suppuration in the Lungs, attended with a slow Fever. I have seen many
+Children in Country Villages destroyed by this Neglect. Their Case is
+then of the same Nature with that described Sec. 68 and 82, and terminates
+in the same Manner in a Looseness, (attended with very little Pain) and
+sometimes a very foetid one, which carries off the Patient. In such
+Cases we must recur to the Remedies prescribed Sec. 74, Article 3, 4, 5; to
+the Powder No. 14; and to Milk and Exercise. But it is so very difficult
+to make Children take the Powder, that it may be sometimes necessary to
+trust to the Milk without it, which I have often seen in such Situations
+accomplish a very difficult Cure. I must advise the Reader at the same
+Time, that it has not so compleat an Effect, as when it is taken solely
+unjoined by any other Aliment; and that it is of the last Importance not
+to join it with any, which has the least Acidity or Sharpness. Persons
+in easy Circumstances may successfully take, at the same Time,
+_Pfeffer_, [61] _Seltzer_, _Peterstal_, or some other light Waters,
+which are but moderately loaded with mineral Ingredients. These are also
+successfully employed in all the Cases, in which the Cure I have
+mentioned is necessary.
+
+[61] Bristol Water will be no bad Substitute for any of these, in such
+     Cases. _K._
+
+Sec. 228. Sometimes there remains, after the Course of the Measles, a
+strong dry Cough, with great Heat in the Breast, and throughout the
+whole Body, with Thirst, an excessive Dryness of the Tongue, and of the
+whole Surface of the Body. I have cured Persons thus indisposed after
+this Distemper, by making them breathe in the Vapour of warm Water; by
+the repeated Use of warm Baths; and by allowing them to take nothing for
+several Days but Water and Milk.
+
+Before I take leave of this Subject, I assure the Reader again, that the
+contagious Cause of the Measles is of an extremely sharp and acrid
+Nature. It appears to have some Resemblance to the bilious Humour, which
+produces the _Erisipelas_, or St. Anthony's Fire; and thence it demands
+our particular Attention and Vigilance; without which very troublesome
+and dangerous Consequences may be apprehended. I have seen, not very
+long since, a young Girl, who was in a very languid State after the
+Measles, which she had Undergone three Years before: It was at length
+attended with an Ulceration in her Neck, which was cured, and her Health
+finally restored by _Sarsaparilla_ with Milk and Water.
+
+Sec. 229. The Measles have been communicated by [62] Inoculation in some
+Countries, where it is of a very malignant Disposition; and that Method
+might also be very advantageous in this. But what we have already
+observed, with Respect to the Inoculation of the Small-Pocks, _viz._
+That it cannot be extended to the general Benefit of the People, without
+the Foundation of Hospitals for that very Purpose, is equally applicable
+to the Inoculation of the Measles.
+
+[62] The only Account I have read of this Practice, is in the learned
+     Dr. _Home's_ _Medical Facts and Experiments_, published in 1759,
+     which admits, that but nine out of fifteen of the Subjects of this
+     Practice took. Cotton dipt in the Blood of a Patient in the Measles
+     was inserted into the Arms of twelve; and three received the Cotton
+     into their Nostrils, after the Chinese Manner of infusing the
+     Small-Pocks; but of these last not one took, and one of those who
+     had taken, had the Measles again two Months after. We think the
+     sharp hot Lymph distilling from the inflamed Eyes of Persons in
+     this Disease, a likelier Vehicle to communicate it than the Blood,
+     especially the dry Blood, which was sometimes tried; since the
+     human _Serum_ seems the Fluid more particularly affected by it; and
+     this must have been evaporated when the Blood grew dry. A few
+     practical Strictures on this Work, and particularly on this
+     Practice described in it, appeared in the Monthly Review Vol. XXI.
+     P. 68 to 75. _K._
+
+
+
+
+                             __Chapter XV.__
+
+
+                   _Of the ardent or burning Fever._
+
+
+                             __Sect.__ 230.
+
+The much greater Number of the Diseases I have hitherto considered,
+result from an Inflammation of the Blood, combined with the particular
+Inflammation of some Part, or occasioned by some Contagion or Poison,
+which must be evacuated. But when the Blood is solely and strongly
+inflamed, without an Attack on any particular Part, this Fever, which we
+term hot or burning, is the Consequence.
+
+Sec. 231. The Signs which make it evident are, a Hardness and Fulness of
+the Pulse in a higher Degree than happens in any other Malady; an
+excessive Heat; great Thirst; with an extraordinary Dryness of the Eyes,
+Nostrils, Lips, of the Tongue, and of the Throat; a violent Head-ach;
+and sometimes a Raving at the Height of the Paroxysm, or Increase of the
+Fever, which rises considerably every Evening. The Respiration is also
+somewhat oppressed, but especially at the Return of this Paroxysm, with
+a Cough now and then; though without any Pain in the Breast, and without
+any Expectoration, or coughing up. The Body is costive; the Urine very
+high coloured, hot, and in a small Quantity. The Sick are also liable to
+start sometimes, but especially when they seem to sleep; for they have
+little sound refreshing Sleep, but rather a kind of Drowsiness, that
+makes them very little attentive to, or sensible of, whatever happens
+about them, or even of their own Condition. They have sometimes a little
+Sweat or Moisture; though commonly a very dry Skin; they are manifestly
+weak, and have either little or no Smell or Taste.
+
+Sec. 232. This Disease, like all other inflammatory ones, is produced by
+the Causes which thicken the Blood, and increase its Motion; such as
+excessive Labour, violent Heat, Want of Sleep, the Abuse of Wine or
+other strong Liquors; the long Continuance of a dry Constitution of the
+Air, Excess of every kind, and heating inflaming Food.
+
+Sec. 233. The Patient, under these Circumstances, ought, 1, immediately to
+be put upon a Regimen; to have the Food allowed him given only every
+eight Hours, and, in some Cases, only twice a Day: and indeed, when the
+Attack is extremely violent, Nourishment may be wholly omitted.
+
+2, Bleeding should be performed and repeated, 'till the Hardness of the
+Pulse is sensibly abated. The first Discharge should be considerable,
+the second should be made four Hours after. If the Pulse is softened by
+the first, the second may be suspended, and not repeated before it
+becomes sufficiently hard again, to make us apprehensive of Danger: but
+should it continue strong and hard, the Bleeding may be repeated on the
+same Day to a third Time, which often happens to be all the Repetitions
+that are necessary.
+
+3, The Glyster No. 5 should be given twice, or even thrice, daily.
+
+4, His Legs are to be bathed twice a Day in warm Water: his Hands may be
+bathed in the same Water. Linen or Flanel Cloths dipt in warm Water may
+be applied over the Breast, and upon the Belly; and he should regularly
+drink the Almond Milk No. 4 and the Ptisan No. 7. The poorest Patients
+may content themselves with the last, but should drink very plentifully
+of it; and after the Bleeding properly repeated, fresh Air and the
+plentiful Continuance of small diluting Liquors generally establish the
+Health of the Patient.
+
+5, If notwithstanding the repeated Bleedings, the Fever still rages
+highly, it may be lessened by giving a Spoonful of the Potion No. 10
+every Hour, till it abates; and afterwards every three Hours, until it
+becomes very moderate.
+
+Sec. 234. Haemorrhages, or Bleedings, from the Nose frequently occur in this
+Fever, greatly to the Relief and Security of the Patient.
+
+The first Appearances of Amendment are a softening of the Pulse, (which
+however does not wholly lose all its Hardness, before the Disease
+entirely terminates) a sensible Abatement of the Head-ach; a greater
+Quantity of Urine, and that less high coloured; and a manifestly
+approaching Moisture of the Tongue. These favourable Signs keep
+increasing in their Degree, and there frequently ensue between the ninth
+and the fourteenth Day, and often after a Flurry of some Hours
+Continuance, very large Evacuations by Stool; a great Quantity of Urine,
+which lets fall a palely reddish Sediment; the Urine above it being very
+clear, and of a natural Colour; and these accompanied with Sweats in a
+less or greater Quantity. At the same Time the Nostrils and the Mouth
+grow moist: the brown and dry Crust which covered the Tongue, and which
+was hitherto inseparable from it, peels off of itself; the Thirst is
+diminished; the Clearness of the Faculties rises; the Drowsiness goes
+off, it is succeeded by comfortable Sleep, and the natural Strength is
+restored. When Things are evidently in this Way, the Patient should take
+the Potion No. 23, and be put upon the Regimen of those who are in a
+State of Recovery. It should be repeated at the End of eight or ten
+Days. Some Patients have perfectly recovered from this Fever, without
+the least Sediment in their Urine.
+
+Sec. 235. The augmenting Danger of this Fever may be discerned, from the
+continued Hardness of the Pulse, though with an Abatement of its
+Strength; if the Brain becomes more confused; the Breathing more
+difficult; if the Eyes, Nose, Lips and Tongue become still more dry, and
+the Voice more altered. If to these Symptoms there be also added a
+Swelling of the Belly; a Diminution of the Quantity of Urine; a constant
+Raving; great Anxiety, and a certain Wildness of the Eyes, the Case is
+in a manner desperate; and the Patient cannot survive many Hours. The
+Hands and Fingers at this Period are incessantly in Motion, as if
+feeling for something upon the Bed-Cloths, which is commonly termed,
+their hunting for Flies.
+
+
+
+
+                            __Chapter XVI.__
+
+
+                          _Of putrid Fevers._
+
+
+                             __Sect.__ 236.
+
+Having treated of such feverish Distempers, as arise from an
+Inflammation of the Blood, I shall here treat of those produced by
+corrupt Humours, which stagnate in the Stomach, the Guts, or other
+Bowels of the lower Cavity, the Belly; or which have already passed from
+them into the Blood. These are called putrid Fevers, or sometimes
+bilious Fevers, when a certain Degeneracy or Corruption of the Bile
+seems chiefly to prevail in the Disease.
+
+Sec. 237. This Distemper frequently gives Notice of its Approach, several
+Days before its manifest Attack; by a great Dejection, a Heaviness of
+the Head; Pains of the Loins and Knees; a Foulness of the Mouth in the
+Morning; little Appetite; broken Slumber; and sometimes by an excessive
+Head-ach for many Days, without any other Symptom. After this, or these
+Disorders, a Shivering comes on, followed by a sharp and dry Heat: the
+Pulse, which was small and quick during the Shivering, is raised during
+the Heat, and is often very strong, though it is not attended with the
+same Hardness, as in the preceding Fever; except the putrid Fever be
+combined with an inflammatory one, which it sometimes is. During this
+Time, that is the Duration of the Heat, the Head-ach is commonly
+extremely violent; the Patient is almost constantly affected with
+Loathings, and sometimes even with Vomiting; with Thirst, disagreeable
+Risings, a Bitterness in the Mouth; and very little Urine. This Heat
+continues for many Hours, frequently the whole Night; it abates a little
+in the Morning, and the Pulse, though always feverish, is then something
+less so, while the Patient suffers less, though still greatly dejected.
+
+The Tongue is white and furred, the Teeth are foul, and the Breath
+smells very disagreeably. The Colour, Quantity and Consistence of the
+Urine, are very various and changeable. Some Patients are costive,
+others frequently have small Stools, without the least Relief accruing
+from them. The Skin is sometimes dry, and at other Times there is some
+sensible Perspiration, but without any Benefit attending it. The Fever
+augments every Day, and frequently at unexpected irregular Periods.
+Besides that _great_ Paroxysm or Increase, which is perceivable in all
+the Subjects of this Fever, some have also other _less_ intervening
+ones.
+
+Sec. 238. When the Disease is left to itself, or injudiciously treated; or
+when it proves more powerful than the Remedies against it, which is by
+no Means seldom the Case, the Aggravations of it become longer, more
+frequent and irregular. There is scarcely an Interval of Ease. The
+Patient's Belly is swell'd out like a Foot-ball; a _Delirium_ or Raving
+comes on; he proves insensible of his own Evacuations, which come away
+involuntarily; he rejects Assistance, and keeps muttering continually,
+with a quick, small, irregular Pulse. Sometimes little Spots of a brown,
+or of a livid Colour appear on the Surface, but particularly about the
+Neck, Back and Breast. All the Discharges from his Body have a most
+foetid Smell: convulsive Motions also supervene, especially in the Face;
+he lies down only on his Back, sinks down insensibly towards the Foot of
+the Bed, and picks about, as if catching Flies; his Pulse becomes so
+quick and so small, that it cannot be perceived without Difficulty, and
+cannot be counted. His Anguish seems inexpressible: his Sweats stream
+down from Agony: his Breast swells out as if distended by Fullness, and
+he dies miserably.
+
+Sec. 239. When this Distemper is less violent, or more judiciously treated,
+and the Medicines succeed well, it continues for some Days in the State
+described Sec. 237, without growing worse, though without abating. None of
+these Symptoms however appear, described Sec. 238; but, on the contrary,
+all the Symptoms become milder, the Paroxysms, or Aggravations, are
+shorter and less violent, the Head-ach more supportable; the Discharges
+by Stool are less frequent, but more at once, and attended with Relief
+to the Patient. The Quantity of Urine is very considerable, though it
+varies at different Times in Colour and Consistence, as before. The
+Patient soon begins to get a little Sleep, and grows more composed and
+easy. The Tongue disengages itself from its Filth and Furriness, and
+Health gradually, yet daily, advances.
+
+Sec. 240. This Fever seems to have no critical Time, either for its
+Termination in Recovery, or in Death. When it is very violent, or very
+badly conducted, it proves sometimes fatal on the ninth Day. Persons
+often die of it from the eighteenth to the twentieth; sometimes only
+about the fortieth; after having been alternately better and worse.
+
+When it happens but in a light Degree, it is sometimes cured within a
+few Days, after the earliest Evacuations. When it is of a very different
+Character, some Patients are not out of Danger before the End of six
+Weeks, and even still later. Nevertheless it is certain, that these
+Fevers, extended to this Length of Duration, often depend in a great
+Measure on the Manner of treating them; and that in general their Course
+must be determined, some time from the fourteenth to the thirtieth Day.
+
+Sec. 241. The Treatment of this Species of Fevers is comprized in the
+following Method and Medicines.
+
+1, The Patient must be put into a _Regimen_; and notwithstanding he is
+far from costive, and sometimes has even a small Purging, he should
+receive one Glyster daily. His common Drink should be Lemonade, (which
+is made of the Juice of Lemons, Sugar and Water) or the Ptisan No. 3.
+Instead of Juice of Lemons, Vinegar may be occasionally substituted,
+which, with Sugar and Water, makes an agreeable and very wholesome Drink
+in these Fevers.
+
+2, If there be an Inflammation also, which may be discovered by the
+Strength and the Hardness of the Pulse, and by the Temperament and
+Complexion of the Patient; if he is naturally robust, and has heated
+himself by any of the Causes described, Sec. 232, he should be bled once,
+and even a second Time, if necessary, some Hours after. I must observe
+however, that very frequently there is no such Inflammation, and that in
+such a Case, Bleeding would be hurtful.
+
+3, When the Patient has drank very plentifully for two Days of these
+Liquids, if his Mouth still continues in a very foul State, and he has
+violent Reachings to vomit, he must take the Powder No. 34, dissolved in
+half a [63] Pot of warm Water, a [64] Glass of it being to be drank
+every half Quarter of an Hour. But as this Medicine vomits, it must not
+be taken, except we are certain the Patient is not under any
+Circumstance, which forbids the Use of a Vomit: all which Circumstances
+shall be particularly mentioned in the Chapter, respecting the Use of
+such Medicines, as are taken by way of Precaution, or Prevention. If the
+first Glasses excite a plentiful Vomiting, we must forbear giving
+another, and be content with obliging the Patient to drink a
+considerable Quantity of warm Water. But if the former Glasses do not
+occasion Vomiting, they must be repeated, as already directed until they
+do. Those who are afraid of taking this Medicine, which is usually
+called, the Emetic, may take that of No. 35, also drinking warm Water
+plentifully during its Operation; but the former is preferable, as more
+prevalent, in dangerous Cases. We must caution our Readers at the same
+Time, that wherever there is an Inflammation of any Part, neither of
+these Medicines must be given, which might prove a real Poison in such a
+Circumstance; and even if the Fever is extremely violent, though there
+should be no particular Inflammation, they should not be given.
+
+[63] That is about two Ounces more than a Pint and a half of our
+     Measure.
+
+[64] About three Ounces.
+
+The Time of giving them is soon after the End of the Paroxysm, when the
+Fever is at the lowest. The Medicine No. 34 generally purges, after it
+ceases to make the Patient vomit: But No. 35 is seldom attended with the
+same Effect.
+
+When the Operation of the Vomit is entirely over, the Sick should return
+to the Use of the Ptisan; and great Care must be taken to prohibit them
+from the Use of Flesh Broth, under the Pretext of working off a Purging
+with it. The same Method is to be continued on the following Days as on
+the first; but as it is of Importance to keep the Body open, he should
+take every Morning some of the Ptisan No. 32. Such, as this would be too
+expensive for, may substitute, in the room of it, a fourth Part of the
+Powder No. 34 in five or six Glasses of Water, of which they are to take
+a Cup every two Hours, beginning early in the Morning. Nevertheless, if
+the Fever be very high, No. 32 should be preferred to it.
+
+4, After the Operation of the Vomit, if the Fever still continue, if the
+Stools are remarkably foetid, and if the Belly is tense and distended as
+it were, and the Quantity of Urine is small, a Spoonful of the Potion
+No. 10 should be given every two Hours, which checks the Putridity and
+abates the Fever. Should the Distemper become violent, and very
+pressing, it ought to be taken every Hour.
+
+5, Whenever, notwithstanding the giving all these Medicines as directed,
+the Fever continues obstinate; the Brain is manifestly disordered; there
+is a violent Head-ach, or very great Restlessness, two blistering
+Plaisters No. 36 must be applied to the inside and fleshy Part of the
+Legs, and their Suppuration and Discharge should be continued as long as
+possible.
+
+6, If the Fever is extremely violent indeed, there is a Necessity
+absolutely to prohibit the Patient from receiving the least Nourishment.
+
+7, When it is thought improper, or unsafe, to give the Vomit, the
+Patient should take in the Morning, for two successive Days, three Doses
+of the Powder No. 24, at the Interval of one Hour between each: This
+Medicine produces some bilious Stools, which greatly abate the Fever,
+and considerably lessen the Violence of all the other Symptoms of the
+Disease. This may be done with Success, when the excessive Height of the
+Fever prevents us from giving the Vomit: and we should limit ourselves
+to this Medicine, as often as we are uncertain, what ever the
+Circumstances of the Disease and the Patient will admit of the Vomiting;
+which may thus be dispensed with, in many Cases.
+
+8, When the Distemper has manifestly and considerably declined; the
+Paroxysms are more slight; and the Patient continues without any Fever
+for several Hours, the daily use of the purging opening Drinks should be
+discontinued. The common Ptisans however should be still made use of;
+and it will be proper to give every other Day two Doses of the Powder
+No. 24, which sufficiently obviates every ill Consequence from this
+Disease.
+
+9, If the Fever has been clearly off for a long Part of the Day; if the
+Tongue appears in a good healthy State; if the Patient has been well
+purged; and yet one moderate Paroxysm of the Fever returns every Day, he
+should take four Doses of the Powder No. 14 between the End of one
+Return and the Beginning of the next, and continue this Repetition some
+Days. People who cannot easily procure this Medicine, may substitute,
+instead of it, the bitter Decoction No. 37. four Glasses of which may be
+taken at equal Intervals, between the two Paroxysms or Returns of the
+Fever.
+
+10, As the Organs of Digestion have been considerably weakened through
+the Course of this Fever, there is a Necessity for the Patient's
+conducting himself very prudently and regularly long after it, with
+Regard both to the Quantity and Quality of his Food. He should also use
+due Exercise as soon as his Strength will permit, without which he may
+be liable to fall into some chronical and languishing Disorder,
+productive of considerable Languor and Weakness. *
+
+ [*] As our Jail, Hospital, and Camp Fevers may often be ranged in this
+     Class, as of the most putrid Kind, and not seldom occasioned by bad
+     Food, bad Air, unclean, unwholesome Lodging, _&c._ a judicious Use
+     may certainly be made of a small Quantity of genuine, and not
+     ungenerous, Wine in such of them, as are not blended with an
+     inflammatory Cause, or inflammable Constitution, or which do not
+     greatly result from a bilious Cause; though in these last, where
+     there is manifest Lowness and Dejection, perhaps a little Rhenish
+     might be properly interposed between the Lemonade and other Drinks
+     directed Sec. 241. Doubtless Dr. _Tissot_ was perfectly apprized of
+     this salutary Use of it in some low Fevers; but the Necessity of
+     its being regulated by the Presence of a Physician has probably
+     disposed him rather to omit mentioning it, than to leave the
+     Allowance of it to the Discretion of a simple Country Patient, or
+     his ignorant Assistants. _K._
+
+
+
+
+                            __Chapter XVII.__
+
+
+                         _Of malignant Fevers._
+
+
+                             __Sect.__ 242.
+
+Those Fevers are termed malignant, in which the Danger is more than the
+Symptoms would make us apprehensive of: they have frequently a fatal
+Event without appearing so very perilous; on which Account it has been
+well said of this Fever, that it is a Dog which bites without barking.
+
+Sec. 243. The distinguishing _Criterion_ or Mark of malignant Fevers is a
+total Loss of the Patient's Strength, immediately on their first Attack.
+They arise from a Corruption of the Humours, which is noxious to the
+very Source and Principle of Strength, the Impairing or Destruction of
+which is the Cause of the Feebleness of the Symptoms; by Reason none of
+the Organs are strong enough to exert an Opposition sufficiently
+vigorous, to subdue the Cause of the Distemper.
+
+If, for Instance or Illustration, we were to suppose, that when two
+Armies were on the Point of engaging, one of them should be nearly
+deprived of all their Weapons, the Contest would not appear very
+violent, nor attended with great Noise or Tumult, though with a horrible
+Massacre. The Spectator, who, from being ignorant of one of the Armies
+being disarmed, would not be able to calculate the Carnage of the
+Battle, but in Proportion to its Noise and Tumult, must be extremely
+deceived in his Conception of it. The Number of the Slain would be
+astonishing, which might have been much less (though the Noise and
+Clangor of it had been greater) if each Army had been equally provided
+for the Combat.
+
+Sec. 244. The Causes of this Disease are a long Use of animal Food or Flesh
+alone, without Pulse, Fruits or Acids; the continued Use of other bad
+Provisions, such as Bread made of damaged Corn or Grain, or very stale
+Meat. Eight Persons, who dined together on corrupt Fish, were all seized
+with a malignant Fever, which killed five of them, notwithstanding the
+Endeavours of the most able Physicians. These Fevers are also frequently
+the Consequence of a great Dearth or Famine; of too hot and moist an
+Air, or an Air, which highly partakes of these two Qualities; so that
+they happen to spread most in hot Years, in Places abounding with
+Marshes and standing Waters. They are also the Effect of a very close
+and stagnant Air, especially if many Persons are crouded together in it,
+this being a Cause that particularly tends to corrupt the Air. Tedious
+Grief and Vexation also contribute to generate these Fevers.
+
+Sec. 245. The Symptoms of malignant Fevers are, as I have already observed,
+a total and sudden Loss of Strength, without any evident preceding
+Cause, sufficient to produce such a Privation of Strength: at the same
+Time there is also an utter Dejection of the Mind, which becomes almost
+insensible and inattentive to every Thing, and even to the Disease
+itself; a sudden Alteration in the Countenance, especially in the Eyes:
+some small Shiverings, which are varied throughout the Space of
+twenty-four Hours, with little Paroxysms or Vicissitudes of Heat;
+sometimes there is a great Head-ach and a Pain in the Loins; at other
+Times there is no perceivable Pain in any Part; a kind of Sinkings or
+Faintings, immediately from the Invasion of the Disease, which is always
+very unpromising; not the least refreshing Sleep; frequently a kind of
+half Sleep, or Drowsiness; a light and silent or inward Raving, which
+discovers itself in the unusual and astonished Look of the Patient, who
+seems profoundly employed in meditating on something, but really thinks
+of nothing, or not at all: Some Patients have, however, violent Ravings;
+most have a Sensation of Weight or Oppression, and at other Times of a
+Binding or Tightness about, or around, the Pit of the Stomach.
+
+The sick Person seems to labour under great Anguish: he has sometimes
+slight convulsive Motions and Twitchings in his Face and his Hands, as
+well as in his Arms and Legs. His Senses seem torpid, or as it were
+benumbed. I have seen many who had lost, to all Appearance, the whole
+five, and yet some of them recover. It is not uncommon to meet with
+some, who neither see, understand, nor speak. Their Voices change,
+become weak, and are sometimes quite lost. Some of them have a fixed
+Pain in some Part of the Belly: this arises from a Stuffing or
+Obstruction, and often ends in a Gangrene, whence this Symptom is highly
+dangerous and perplexing.
+
+The Tongue is sometimes very little altered from its Appearance in
+Health; at other Times covered over with a yellowish brown Humour; but
+it is more rarely dry in this Fever than in the others; and yet it
+sometimes does resemble a Tongue that has been long smoaked.
+
+The Belly is sometimes very soft, and at other Times tense and hard. The
+Pulse is weak, sometimes pretty regular, but always more quick than in a
+natural State, and at some Times even very quick; and such I have always
+found it, when the Belly has been distended.
+
+The Skin is often neither hot, dry, nor moist: it is frequently
+overspread with petechial or eruptive Spots (which are little Spots of a
+reddish livid Colour) especially on the Neck, about the Shoulders, and
+upon the Back. At other Times the Spots are larger and brown, like the
+Colour of Wheals from the Strokes of a Stick.
+
+The Urine of the Sick is almost constantly crude, that is of a lighter
+Colour than ordinary. I have seen some, which could not be
+distinguished, merely by the Eye, from Milk. A black and stinking
+Purging sometimes attends this Fever, which is mortal, except the Sick
+be evidently relieved by the Discharge.
+
+Some of the Patients are infested with livid Ulcers on the Inside of the
+Mouth, and on the Palate. At other Times Abscesses are formed in the
+Glands of the Groin, of the Arm-pit, in those between the Ears and the
+Jaw; or a Gangrene may appear in some Part, as on the Feet, the Hands,
+or the Back. The Strength proves entirely spent, the Brain is wholly
+confused: the miserable Patient stretched out on his Back, frequently
+expires under Convulsions, an enormous Sweat, and an oppressed Breast
+and Respiration. Haemorrhages also happen sometimes and are mortal, being
+almost unexceptionably such in this Fever. There is also in this, as in
+all other Fevers, an Aggravation of the Fever in the Evening.
+
+Sec. 246. The Duration and _Crisis_ of these malignant, as well as those of
+putrid Fevers, are very irregular. Sometimes the Sick die on the seventh
+or eighth Day, more commonly between the twelfth and the fifteenth, and
+not infrequently at the End of five or six Weeks. These different
+Durations result from the different Degree and Strength of the Disease.
+Some of these Fevers at their first Invasion are very slow; and during a
+few of the first Days, the Patient, though very weak, and with a very
+different Look and Manner, scarcely thinks himself sick.
+
+The Term or Period of the Cure or the Recovery, is as uncertain as that
+of Death in this Distemper. Some are out of Danger at the End of fifteen
+Days, and even sooner; others not before the Expiration of several
+Weeks.
+
+The Signs which portend a Recovery are, a little more Strength in the
+Pulse; a more concocted Urine; less Dejection and Discouragement; a less
+confused Brain; an equal kindly Heat; a pretty warm or hot Sweat in a
+moderate Quantity, without Inquietude or Anguish; the Revival of the
+different Senses that were extinguished, or greatly suspended in the
+Progress of the Disease; though the Deafness is not a very threatening
+Symptom, if the others amend while it endures.
+
+This Malady commonly leaves the Patient in a very weak Condition; and a
+long Interval will ensue between the End of it, and their recovering
+their full Strength.
+
+Sec. 247. It is, in the first place, of greater Importance in this
+Distemper than in any other, both for the Benefit of the Patients, and
+those who attend them, that the Air should be renewed and purified.
+Vinegar should often be evaporated from a hot Tile or Iron in the
+Chamber, and one Window kept almost constantly open.
+
+2, The Diet should be light; and the Juice of Sorrel may be mixed with
+their Water; the Juice of Lemons may be added to Soups prepared from
+different Grains and Pulse; the Patient may eat sharp acid Fruits, such
+as tart juicy [65] Cherries, Gooseberries, small black Cherries; and
+those who can afford them, may be allowed Lemons, Oranges and
+Pomgranates.
+
+[65] The French Word is _Griettes_, which _Beyer_ englishes, _the
+     Agriot, the red or sour Cherry_; and _Chambaud, the sweeter large
+     black Cherry or Mazzard_--But as Dr. _Tissot_ was recommending the
+     Use of Acids, it is more probably the first of these: so that our
+     Morellas, which make a pleasant Preserve, may be a good Substitute
+     to them, supposing them not to be the same. Our Berbery Jam, and
+     Jelly of Red Currants, may be also employed to answer the same
+     Indication. _K._
+
+3, The Patient's Linen should be changed every two Days.
+
+4, Bleeding is very rarely necessary, or even proper, in this Fever; the
+Exceptions to which are very few, and cannot be thoroughly ascertained,
+as fit and proper Exceptions to the Omission of Bleeding, without a
+Physician, or some other very skilful Person's seeing the Patient.
+
+5, There is often very little Occasion for Glysters, which are sometimes
+dangerous in this Fever.
+
+6, The Patient's common Drink should be Barley Water made acid with the
+Spirit No. 10, at the Rate of one Quarter of an Ounce to at least full
+three Pints of the Water, or acidulated agreeably to his Taste. He may
+also drink Lemonade.
+
+7, It is necessary to open and evacuate the Bowels, where a great
+Quantity of corrupt Humours is generally lodged. The Powder No. 35 may
+be given for this Purpose, after the Operation of which the Patient
+generally finds himself better, at least for some Hours. It is of
+Importance not to omit this at the Beginning of the Disease; though if
+it has been omitted at first, it were best to give it even later,
+provided no particular Inflammation has supervened, and the Patient has
+still some Strength. I have given it, and with remarkable Success, on
+the twentieth Day.
+
+8, Having by this Medicine expelled a considerable Portion of the bad
+Humours, which contribute to feed and keep up the Fever, the Patient
+should take every other Day, during the Continuance of the Disease, and
+sometimes even every Day, one Dose of the Cream of Tartar and Rhubarb
+No. 38. This Remedy evacuates the corrupt Humours, prevents the
+Corruption of the others; expells the Worms that are very common in
+these Fevers, which the Patient sometimes discharges upwards and
+downwards; and which frequently conduce to many of the odd and
+extraordinary Symptoms, that are observed in malignant Fevers. In short
+it strengthens the Bowels, and, without checking the necessary
+Evacuations, it moderates the Looseness, when it is hurtful.
+
+9, If the Skin be dry, with a Looseness, and that by checking it, we
+design to increase Perspiration, instead of the Rhubarb, the Cream of
+Tartar may be blended with the Ipecacuana, No. 39, which, being given in
+small and frequent Doses, restrains the Purging, and promotes
+Perspiration. This Medicine, as the former, is to be taken in the
+Morning; two Hours after, the Sick must begin with the Potion No. 40,
+and repeat it regularly every three Hours; until it be interrupted by
+giving one of the Medicines No. 38 or 39: After which the Potion is to
+be repeated again, as already directed, till the Patient grows
+considerably better.
+
+10, If the Strength of the Sick be very considerably depressed, and he
+is in great Dejection and Anguish, he should take, with every Draught of
+the Potion, the Bolus, or Morsel No. 41. If the _Diarrhoea_, the Purging
+is violent, there should be added, once or twice a Day to the Bolus, the
+Weight of twenty Grains, or the Size of a very small Bean, of
+_Diascordium_; or if that is not readily to be got, as much Venice
+Treacle.
+
+11, Whenever, notwithstanding all this Assistance, the Patient continues
+in a State of Weakness and Insensibility, two large Blisters should be
+applied to the fleshy Insides of the Legs, or a large one to the Nape of
+the Neck: and sometimes, if there be a great Drowsiness, with a manifest
+Embarrassment of the Brain, they may be applied with great Success over
+the whole Head. Their Suppuration and Discharge is to be promoted
+abundantly; and, if they dry up within a few Days, others are to be
+applied, and their Evacuation is to be kept up for a considerable Time.
+
+12, As soon as the Distemper is sufficiently abated, for the Patient to
+remain some Hours with very little or no Fever, we must avail ourselves
+of this Interval, to give him six, or at least five Doses of the
+Medicine No. 14, and repeat the same the next Day, which may prevent the
+Return of the Fever: [66] after which it may be sufficient to give daily
+only two Doses for a few Days.
+
+[66] Observation and Experience have demonstrated the Advantage of the
+     Bark, to obviate a Gangrene, and prevent the Putrefaction of animal
+     Substances. We therefore conclude it may be usefully employed in
+     malignant Fevers, as soon as the previous and necessary Evacuations
+     shall have taken Place. _E. L._--Provided there be very clear and
+     regular Remissions at least. _K._
+
+13, When the Sick continue entirely clear of a Fever, or any Return,
+they are to be put into the _Regimen_ of Persons in a State of Recovery.
+But if his Strength returns very slowly, or not at all; in Order to the
+speedier Establishment and Confirmation of it, he may take three Doses a
+Day of the _Theriaca Pauperum_, or poor Man's Treacle No. 42, the first
+of them fasting, and the other twelve Hours after. It were to be wished
+indeed, this Medicine was introduced into all the Apothecaries Shops, as
+an excellent Stomachic, in which Respect it is much preferable to Venice
+Treacle, which is an absurd Composition, dear and often dangerous. It is
+true it does not dispose the Patients to Sleep; but when we would
+procure them Sleep, there are better Medicines than the Treacle to
+answer that Purpose. Such as may not think the Expence of the Medicine
+No. 14, too much, may take three Doses of it daily for some Weeks,
+instead of the Medicine No. 42, already directed.
+
+Sec. 248. It is necessary to eradicate a Prejudice that prevails among
+Country People, with Regard to the Treatment of these Fevers; not only
+because it is false and ridiculous, but even dangerous too. They imagine
+that the Application of Animals can draw out the Poison of the Disease;
+in Consequence of which they apply Poultry, or Pigeons, Cats or sucking
+Pigs to the Feet, or upon the Head of the Patient, having first split
+the living Animals open. Some Hours after they remove their strange
+Applications, corrupted, and stinking very offensively; and then ascribe
+such Corruption and horrid Stink to the Poison they suppose their
+Application to be charged with; and which they suppose to be the Cause
+of this Fever. But in this supposed Extraction of Poison, they are
+grosly mistaken, since the Flesh does not stink in Consequence of any
+such Extraction, but from its being corrupted through Moisture and Heat:
+and they contract no other Smell but what they would have got, if they
+had been put in any other Place, as well as on the Patient's Body, that
+was equally hot and moist. Very far from drawing out the Poison, they
+augment the Corruption of the Disease; and it would be sufficient to
+communicate it to a sound Person, if he was to suffer many of these
+animal Bodies, thus absurdly and uselessly butchered, to be applied to
+various Parts of his Body in Bed; and to lie still a long Time with
+their putrified Carcases fastened about him, and corrupting whatever Air
+he breathed there.
+
+With the same Intention they fasten a living Sheep to the Bed's-foot for
+several Hours; which, though not equally dangerous, is in some Measure
+hurtful, since the more Animals there are in a Chamber, the Air of it is
+proportionably corrupted, or altered at least from its natural
+Simplicity, by their Respiration and Exhalations: but admitting this to
+be less pernicious, it is equally absurd. It is certain indeed, the
+Animals who are kept very near the sick Person breathe in the poisonous,
+or noxious Vapours which exhale from his Body, and may be incommoded
+with them, as well as his Attendants: But it is ridiculous to suppose
+their being kept near the Sick causes such Poison to come out of their
+Bodies. On the very contrary, in contributing still further to the
+Corruption of the Air, they increase the Disease. They draw a false
+Consequence, and no Wonder, from a false Principle; saying, if the Sheep
+dies, the Sick will recover. Now, most frequently the Sheep does not
+die; notwithstanding which the Sick sometimes recover; and sometimes
+they both die.
+
+Sec. 249. The Cause of Malignant Fevers is, not infrequently, combined with
+other Diseases, whose Danger it extremely increases. It is blended for
+Instance, with the Poison of the Small-Pocks, or of the Measles. This
+may be known by the Union of those Symptoms, which carry the Marks of
+Malignity, with the Symptoms of the other Diseases. Such combined Cases
+are extremely dangerous; they demand the utmost Attention of the
+Physician; nor is it possible to prescribe their exact Treatment here;
+since it consists in general of a Mixture of the Treatment of each
+Disease; though the Malignity commonly demands the greatest Attention.
+
+
+
+
+                           __Chapter XVIII.__
+
+
+                       _Of intermitting Fevers._
+
+
+                             __Sect.__ 250.
+
+Intermitting Fevers, commonly called here, Fevers and Agues, are those,
+which after an Invasion and Continuance for some Hours, abate very
+perceivably, as well as all the Symptoms attending them, and then
+entirely cease; nevertheless, not without some periodical or stated
+Return of them.
+
+They were very frequent with us some Years since; and indeed might even
+be called epidemical: but for the five or six last Years, they have been
+much less frequent throughout the greater Part of _Swisserland_:
+notwithstanding they still continue in no small Number in all Places,
+where the Inhabitants breathe the Air that prevails in all the marshy
+Borders of the _Rhone_, and in some other Situations that are exposed to
+much the same humid Air and Exhalations.
+
+Sec. 251. There are several Kinds of intermitting Fevers, which take their
+different Names from the Interval or different Space of Time, in which
+the Fits return.
+
+If the Paroxysm or Fit returns every Day, it is either a true Quotidian,
+or a double Tertian Fever: The first of these may be distinguished from
+the last by this Circumstance, that in the Quotidian, or one Day Fever,
+the Fits are long; and correspond pretty regularly to each other in
+Degree and Duration. This however is less frequent in _Swisserland_. In
+the double Tertian, the Fits are shorter, and one is alternately light,
+and the other more severe.
+
+In the simple Tertian, or third Day's Fever, the Fits return every other
+Day; so that three Days include one Paroxysm, and the Return of another.
+
+In a Quartan, the Fit returns every fourth Day, including the Day of the
+first and that of the second Attack: so that the Patient enjoys two
+clear Days between the two sick ones.
+
+The other kinds of Intermittents are much rarer. I have seen however one
+true Quintan, or fifth Day Ague, the Patient having three clear Days
+between two Fits; and one regularly weekly Ague, as it may be called,
+the Visitation of every Return happening every Sunday.
+
+Sec. 252. The first Attack of an intermittent Fever often happens, when the
+Patient thought himself in perfect Health. Sometimes however it is
+preceded by a Sensation of Cold and a kind of Numbness, which continue
+some Days before the manifest Invasion of the Fit. It begins with
+frequent Yawnings, a Lassitude, or Sensation of Weariness, with a
+general Weakness, with Coldness, Shivering and Shaking: There is also a
+Paleness of the extreme Parts of the Body, attended with Loathings, and
+sometimes an actual Vomiting. The Pulse is quick, weak, and small, and
+there is a considerable Degree of Thirst.
+
+At the End of an Hour or two, and but seldom so long as three or four
+Hours, a Heat succeeds, which increases insensibly, and becomes violent
+at its Height. At this Period the whole Body grows red, the Anxiety of
+the Patient abates; the Pulse is very strong and large, and his Thirst
+proves excessive. He complains of a violent Head-ach, and of a Pain in
+all his Limbs, but of a different sort of Pain from that he was sensible
+of, while his Coldness continued. Finally, having endured this hot
+State, four, five or six Hours, he falls into a general Sweat for a few
+more: upon which all the Symptoms already mentioned abate, and sometimes
+Sleep supervenes.
+
+At the Conclusion of this Nap the Patient often wakes without any
+sensible Fever; complaining only of Lassitude and Weakness. Sometimes
+his Pulse returns entirely to its natural State between the two Fits;
+though it often continues a little quicker than in perfect Health; and
+does not recover its first Distinctness and Slowness, till some Days
+after the last Fit.
+
+One Symptom, which most particularly characterises these several Species
+of intermitting Fevers, is the Quality of the Urines which the Sick pass
+after the Fit. They are of a reddish Colour, and let fall a Sediment, or
+Settling, which exactly resembles Brick-dust. They are sometimes frothy
+too, and a Pellicle, or thin filmy Skin, appears on the Top, and adheres
+to the Sides of the Glass that contains them.
+
+Sec. 253. The Duration of each Fit is of no fixed Time or Extent, being
+various according to the particular sort of Intermittents, and through
+many other Circumstances. Sometimes they return precisely at the very
+same Hour; at other Times they come one, two, or three Hours sooner, and
+in other Instances as much later than the former. It has been imagined
+that those Fevers, whose Paroxysms returned sooner than usual, were
+sooner finally terminated: but there seems to be no general Rule in this
+Case.
+
+Sec. 254. Intermitting Fevers are distinguished into those of Spring and
+Autumn. The former generally prevail from February to June: the latter
+are those which reign from July to January. Their essential Nature and
+Characters are the very same, as they are not different Distempers;
+though the various Circumstances attending them deserve our
+Consideration. These Circumstances depend on the Season itself, and the
+Constitution of the Patients, during such Seasons. The Spring
+Intermittents are sometimes blended with an inflammatory Disposition, as
+that is the Disposition of Bodies in that Season; but as the Weather
+then advances daily into an improving State, the Spring Fevers are
+commonly of a shorter Duration. The autumnal Fevers are frequently
+combined and aggravated with a Principle of Putrefaction; and as the Air
+of that Season rather degenerates, they are more tedious and obstinate.
+
+Sec. 255. The autumnal Fevers seldom begin quite so early as July, but much
+oftner in August: and the Duration to which they are often extended, has
+increased the Terror which the People entertain of Fevers that begin in
+that Month. But that Prejudice which ascribes their Danger to the
+Influence of August, is a very absurd Error; since it is better they
+should set in then than in the following Months; because they are
+obstinate in Proportion to the Tardiness, the Slowness of their
+Approach. They sometimes appear at first considerably in the Form of
+putrid Fevers, not assuming that of Intermittents till some Days after
+their Appearance: but very happily there is little or no Danger in
+mistaking them for putrid Fevers, or in treating them like such. The
+Brick-coloured Sediment, and particularly the Pellicle or Film on the
+Surface of the Urine, are very common in autumnal Intermittents, and are
+often wanting in the Urine of putrid Fevers. In these latter, it is
+generally less high coloured, and leaning rather to a yellow, a kind of
+Cloudiness is suspended in the Middle of it. These also deposite a white
+Sediment, which affords no bad Prognostic.
+
+Sec. 256. Generally speaking, intermitting Fevers are not mortal; often
+terminating in Health of their own Accord (without the Use of any
+Medicine) after some Fits. In this last Respect Intermittents in the
+Spring differ considerably from those in the Fall, which continue a long
+Time, and sometimes even until Spring, if they are not removed by Art,
+or if they have been improperly treated.
+
+Quartan Fevers are always more obstinate and inveterate than Tertians;
+the former sometimes persevering in certain Constitutions for whole
+Years. When these Sorts of Fevers occur in boggy marshy Countries, they
+are not only very chronical or tedious, but Persons infested with them
+are liable to frequent Relapses.
+
+Sec. 257. A few Fits of an Intermittent are not very injurious, and it
+happens sometimes, that they are attended with a favourable Alteration
+of the Habit in Point of Health; by their exterminating the Cause or
+Principle of some languid and tedious Disorder; though it is erroneous
+to consider them as salutary. If they prove tedious and obstinate, and
+the Fits are long and violent, they weaken the whole Body, impairing all
+its Functions, and particularly the Digestions: They make the Humours
+sharp and unbalmy, and introduce several other Maladies, such as the
+Jaundice, Dropsy, Asthma and slow wasting Fevers. Nay sometimes old
+Persons, and those who are very weak, expire in the Fit; though such an
+Event never happens but in the cold Fit.
+
+Sec. 258. Very happily Nature has afforded us a Medicine, that infallibly
+cures these Fevers: this is the _Kinkina_, or Jesuits Bark; and as we
+are possessed of this certain Remedy, the only remaining Difficulty is
+to discover, if there be not some other Disease combined with these
+Fevers, which Disease might be aggravated by the Bark. Should any such
+exist, it must be removed by Medicines adapted to it, before the Bark is
+given. [67]
+
+[67] This admirable Medicine was unknown in Europe, till about one
+     hundred and twenty Years past; we are obliged to the Spaniards for
+     it, who found it in the Province of Quito in Peru; the Countess of
+     Chinchon being the first European who used it in America, whence it
+     was brought to Spain, under the Name of the Countesses Powder. The
+     Jesuits having soon dispensed and distributed it abroad, it became
+     still more publick by the Name of the Jesuits Powder: and since it
+     has been known by that of _Kinkina_ or the Peruvian Bark. It met
+     with great Opposition at first; some deeming it a Poison, while
+     others considered it as a divine Remedy: so that the Prejudices of
+     many being heightened by their Animosity, it was nearly a full
+     Century, before its true Virtue and its Use were agreed to: and
+     about twenty Years since the most unfavourable Prejudices against
+     it pretty generally subsided. The Insufficience of other Medicines
+     in several Cases; its great Efficaciousness; and the many and
+     surprizing Cures which it did, and daily does effect; the Number of
+     Distempers; the different kinds of Fevers, in which it proves the
+     sovereign Remedy; its Effects in the most difficult chirurgical
+     Cases; the Comfort, the Strength and Sprits it gives those who need
+     and take it, have at length opened every Persons Eyes; so that it
+     has almost unanimously obtained the first Reputation, among the
+     most efficacious Medicines. The World is no longer amused with
+     Apprehensions of its injuring the Stomach; of its fixing, or
+     _shutting up_ the Fever (as the Phrase has been) without curing it;
+     that it shuts up the Wolf in the Sheepfold; that it throws those
+     who take it into the Scurvy, the Asthma, the Dropsy, the Jaundice.
+     On the contrary they are persuaded it prevents there very Diseases;
+     and, that if it is ever hurtful, it is only when it is either
+     adulterated, as most great Remedies have been; or has been wrongly
+     prescribed, or improperly taken: or lastly when it meets with some
+     latent, some unknown Particularities in a Constitution, which
+     Physicians term an _Idiosyncrasy_, and which prevent or pervert its
+     very general Effects. _Tissot._
+
+Sec. 259. In the vernal, or Spring-Fevers, if the Fits are not very severe;
+if the Patient is evidently well in their Intervals; if his Appetite,
+his Strength, and his Sleep continue as in Health, no Medicine should be
+given, nor any other Method be taken, but that of putting the Person,
+under such a gentle Intermittent, upon the Regimen directed for Persons
+in a State of Recovery. This is such a Regimen as pretty generally
+agrees with all the Subjects of these Fevers: for if they should be
+reduced to the Regimen proper in acute Diseases, they would be weakened
+to no Purpose, and perhaps be the worse for it. But at the same Time if
+we were not to retrench from the Quantity, nor somewhat to vary the
+Quality of their usual Food in a State of Health; as there is not the
+least Digestion made in the Stomach, during the whole Term of the Fit;
+and as the Stomach is always weakened a little by the Disease, crude and
+indigested Humours would be produced, which might afford a Fuel to the
+Disease. Not the least solid Food should be allowed, for at least two
+Hours before the usual Approach of the Fit.
+
+Sec. 260. If the Fever extends beyond the sixth, or the seventh Fit; and
+the Patient seems to have no Occasion for a Purge; which may be learned
+by attending to the Chapter, which treats of Remedies to be taken by Way
+of Precaution; [68] he may take the Bark, that is the Powder No. 14. If
+it is a Quotidian, a daily Fever, or a double Tertian, six Doses,
+containing three Quarters of an Ounce, should be taken between the two
+Fits; and as these Intermissions commonly consist of but ten or twelve,
+or at the most of fourteen or fifteen Hours, there should be an Interval
+of only one Hour and a half between each Dose. During this Interval the
+Sick may take two of his usual Refreshments or Suppings.
+
+[68] It happens very seldom that intermitting Fevers require [69] no
+     Purge towards their Cure, especially in Places, which are disposed
+     to generate Putridity. There is always some material Cause
+     essential to these Fevers, of which Nature disembarrasses herself
+     more easily by Stools, than by any other Discharge: And as there is
+     not the least Danger to be apprehended from a gentle Purge, such at
+     those of No. 11 or 23, we think it would be prudent always to
+     premise a Dose or two of either to the Bark. _E. L._
+
+[69] Yet I have known many in whom no Purge was necessary, and have seen
+     some rendered more obstinate and chronical by erroneous Purging.
+     But a Vomit is very generally necessary before the Bark is given.
+     _K._
+
+When the Fever is a Tertian, an Ounce should be given between the two
+Fits: which makes eight Doses, one of which is to be taken every three
+Hours.
+
+In a Quartan I direct one Ounce and a half, to be taken in the same
+Manner. It is meer trifling to attempt preventing the Returns with
+smaller Doses. The frequent Failures of the Bark are owing to over small
+Doses. On such Occasions the Medicine is cried down, and censured as
+useless, when the Disappointment is solely the Fault of those who do not
+employ it properly. The last Dose is to be given two Hours before the
+usual Return of the Fit.
+
+The Doses, just mentioned, frequently prevent the Return of the Fit; but
+whether it returns or not, after the Time of its usual Duration is past,
+repeat the same Quantity, in the same Number of Doses, and Intervals,
+which certainly keeps off another. For six Days following, half the same
+Quantity must be continued, in the Intervals that would have occurred
+between the Fits, if they had returned: and during all this Time the
+Patient should inure himself to as much Exercise, as he can well bear.
+
+Sec. 261. Should the Fits be very strong, the Pain of the Head violent, the
+Visage red, the Pulse full and hard; if there is any Cough; if, even
+after the Fit is over, the Pulse still is perceivably hard; if the Urine
+is inflamed, hot and high-coloured, and the Tongue very dry, the Patient
+must be bled, and drink plentifully of Barley Water No. 3. These two
+Remedies generally bring the Patient into the State described Sec. 259: in
+which State he may take on a Day, when the Fever is entirely off, three
+or four Doses of the Powder No. 24, and then leave the Fever to pursue
+its own Course for the Space of a few Fits. But should it not then
+terminate of itself, the Bark must be recurred to.
+
+If the Patient, even in the Interval of the Returns, has a foetid,
+furred Mouth, a Loathing, Pains in the Loins, or in the Knees, much
+Anxiety, and bad Nights, he should be purged with the Powder No. 21 or
+the Potion No. 23, before he takes the Bark.
+
+Sec. 262. If Fevers in Autumn appear to be of the continual kind, and very
+like putrid Fevers, the Patients should drink abundantly of Barley
+Water; and if at the Expiration of two or three Days, there still
+appears to be a Load or Oppression at the Stomach, the Powder No. 34 or
+that of 35 is to be given (but see Sec. 241): and if, after the Operation
+of this, the Signs of Putridity continue, the Body is to be opened with
+repeated Doses of the Powder No. 24; or, where the Patients are very
+robust, with No. 21; and when the Fever becomes quite regular, with
+distinct _Remissions_ at least, the Bark is to be given as directed Sec.
+260.
+
+But as autumnal Fevers are more obstinate; after having discontinued the
+Bark for eight Days; and notwithstanding there has been no Return of the
+Fever, it is proper to resume the Bark, and to give three Doses of it
+daily for the succeeding eight Days, more especially if it was a
+Quartan; in which Species I have ordered it to be repeated, every other
+eight Days, for six Times.
+
+Many People may find it difficult to comply with this Method of Cure,
+which is unavoidably expensive, through the Price of the Bark. I thought
+however this ought not to prevent me from averring it to be the only
+certain one; since nothing can be an equivalent _Succedaneum_ or
+Substitute to this Remedy, which is the only sure and safe one in all
+these Cases. The World had long been prepossessed with Prejudices to the
+contrary: it was supposed to be hurtful to the Stomach; to prevent which
+it has been usual to make the Sick eat something an Hour after it.
+Nevertheless, very far from injuring the Stomach, it is the best
+Medicine in the Universe to strengthen it; and it is a pernicious
+Custom, when a Patient is obliged to take it often, to eat an Hour after
+it. It had also been imagined to cause Obstructions, and that it
+subjected Patients to a Dropsy: but at present we are convinced, it is
+the obstinate and inveterate Duration of the Intermittent, that causes
+Obstructions, and paves the Way to a Dropsy. The Bark, in Consequence of
+its speedily curing the Fever, does not only prevent the former Disease;
+but when it continues, through an injudicious Omission of the Bark, a
+proper Use of it is serviceable in the Dropsy. In a Word, if there is
+any other Malady combined with the Fever, sometimes that indeed prevents
+the Success of the Bark, yet without rendering it hurtful. But whenever
+the intermitting Fever is simple and uncombined, it ever has, and ever
+will render the Patient all possible Service. In another Place I shall
+mention such Means and Methods as may in some Degree, though but
+imperfectly, be substituted instead of it.
+
+After the Patient has begun with the Bark, he must take no purging
+Medicine, as that Evacuation would, with the greatest Probability,
+occasion a Return of the Fever.
+
+Sec. 263. Bleeding is never, or extremely seldom indeed necessary in a
+Quartan Ague, which occurs in the Fall oftner than in the Spring; and
+with the Symptoms of Putridity rather than of Inflammation.
+
+Sec. 264. The Patient ought, two Hours before the Invasion of the Fit, to
+drink a small Glass of warm Elder Flower Tea, sweetened with Honey,
+every Quarter of an Hour, and to walk about moderately; this disposes
+him to a very gentle Sweat, and thence renders the ensuing Coldness and
+the whole Fit milder. He is to continue the same Drink throughout the
+Duration of the cold Fit; and when the hot one approaches, he may either
+continue the same, or substitute that of No. 2, which is more cooling.
+It is not necessary however, in this State, to drink it warm, it is
+sufficient that it be not over cold. When the Sweat, at the Termination
+of the hot Fit, is concluded, the Patient should be well wiped and
+dried, and may get up. If the Fit was very long, he may be allowed a
+little Gruel, or some other such Nourishment during the Sweat.
+
+Sec. 265. Sometimes the first, and a few successive Doses of the Bark purge
+the Patient. This is no otherwise an ill Consequence, than by its
+retarding the Cure; since, when it purges, it does not commonly prevent
+the Return of the Fever; so that these Doses may be considered as to no
+Purpose, and others should be repeated, which, ceasing to purge, do
+prevent it. Should the Looseness notwithstanding continue, the Bark must
+be discontinued for one entire Day, in order to give the Patient half a
+Quarter of an Ounce of Rhubarb: after which the Bark is to be resumed
+again, and if the Looseness still perseveres, fifteen Grains of Venice
+Treacle should be added to each Dose, but not otherwise. All other
+Medicines which are superadded, very generally serve only to increase
+the Bulk of the Dose, while they lessen its Virtue.
+
+Sec. 266. Before our thorough Experience of the Bark, other bitter
+Medicines were used for the same Purpose: these indeed were not
+destitute of Virtue in such Cases, though they were considerably less
+available than the Bark. Under No. 43, some valuable Prescriptions of
+that kind may be seen, whose Efficacy I have often experienced: though
+at other Times I have been obliged to leave them off, and recur to the
+Bark more successfully. Filings of Iron, which enter into the third
+Prescription, are an excellent Febrifuge in particular Cases and
+Circumstances. In the Middle of the Winter 1753, I cured a Patient of a
+Quartan Ague with it, who would not be prevailed on to take the Bark. It
+must be confessed he was perfectly regular in observing the _Regimen_
+directed for him; and that, during the most rigid Severity of the
+Winter, he got every Day on Horseback, and took such a Degree of other
+Exercise in the open Air, as disposed him to perspire abundantly.
+
+Sec. 267. Another very practicable easy Method, of which I have often
+availed my Patients, under tertian Fevers (but which succeeded with me
+only twice in Quartans) was to procure the Sufferer a very plentiful
+Sweat, at the very Time when the Fit was to return, in its usual Course.
+To effect this he is to drink, three or four Hours before it is
+expected, an Infusion of Elder Flowers sweetened with Honey, which I
+have already recommended Sec. 264; and one Hour before the usual Invasion
+of the Shivering, he is to go into Bed, and take, as hot as he can drink
+it, the Prescription No. 44.
+
+I have also cured some Tertians and even Quartans, in 1751 and 1752, by
+giving them, every four Hours between the Fits, the Powder No. 45. But I
+must acknowledge that, besides its having often failed me, and its never
+succeeding so speedily as the Bark, I have found it weaken some
+Patients; it disorders, or disagrees with, their Stomachs: and in two
+Cases, where it had removed the Fever, I was obliged to call in the Bark
+for a thorough Establishment of the Patient's Health. Nevertheless, as
+these Medicines are very cheap and attainable, and often do succeed, I
+thought I could not properly omit them.
+
+Sec. 268. A Multitude of other Remedies are cried up for the Cure of
+Fevers: though none of them are equally efficacious with those I have
+directed: and as many of them are even dangerous, it is prudent to
+abstain from them. Some Years since certain Powders were sold here,
+under the Name of the _Berlin_ Powders; these are nothing but the Bark
+masqued or disguised (which has sometimes been publickly discovered) and
+have always been sold very dear: though the Bark well chosen, and
+freshly powdered when wanted, is greatly preferable.
+
+Sec. 269. I have often known Peasants, who had laboured for several Months
+under intermitting Fevers; having made Use of many bad Medicines and
+Mixtures for them, and observed no Manner of Regimen. Such I have
+happily treated by giving them the Remedies No. 34, or 35; and
+afterwards, for some Days, that of No. 38; at the End of which Time, I
+have ordered them the Bark (See Sec. 260) or other Febrifuges, as at Sec. 266,
+267; and then finally ordered them for some Days, to take Morsels of the
+poor Man's Treacle (See Sec. 247, _Art._ 13) to strengthen and confirm
+their Digestions, which I have found very weak and irregular.
+
+Sec. 270. Some Intermittents are distinguished as pernicious or malignant,
+from every Fit's being attended with the most violent Symptoms. The
+Pulse is small and irregular, the Patient exceedingly dejected, and
+frequently swooning; afflicted with inexpressible Anguish, Convulsions,
+a deep Drowsiness, and continual Efforts to go to Stool, or make Urine,
+but ineffectually. This Disease is highly pressing and dangerous; the
+Patient may die in the third Fit, and rarely survives the sixth, if he
+is not very judiciously treated. Not a Moment should be lost, and there
+is no other Step to be taken, but that of giving the Bark continually,
+as directed Sec. 260, to prevent the succeeding Fits. These worst Kinds of
+Intermittents are often combined with a great Load of putrid Humours in
+the first Passages: and as often as such an aggravating Combination is
+very evident, we should immediately after the End of one Fit, give a
+Dose of Ipecacuana No. 35, and, when its Operation is finished, give the
+Bark. But I chuse to enter into very few Details on this Species of
+Intermittents, both as they occur but seldom, and as the Treatment of
+them is too difficult and important, to be submitted to the Conduct of
+any one but a Physician. My Intention has only been to represent them
+sufficiently, that they may be so distinguished when they do occur, as
+to apprize the People of their great Danger.
+
+Sec. 271. The same Cause which produces these intermitting Fevers,
+frequently also occasions Disorders, which return periodically at the
+same Hour, without Shivering, without Heat, and often without any
+Quickness of the Pulse. Such Disorders generally preserve the
+Intermissons of quotidian or tertian Fevers, but much seldomer those of
+Quartans. I have seen violent Vomittings, and Reachings to vomit, with
+inexpressible Anxiety; the severest Oppressions, the most racking
+Cholics; dreadful Palpitations and excessive Tooth-achs: Pains in the
+Head, and very often an unaccountable Pain over one Eye, the Eyelid,
+Eyebrow and Temple, on the same Side of the Face; with a Redness of that
+Eye, and a continual, involuntary trickling of Tears. I have also seen
+such a prodigious Swelling of the affected Part, that the Eye projected,
+or stood out, above an Inch from the Head, covered by the Eyelid, which
+was also extremely inflated or puffed up. All these Maladies begin
+precisely at a certain Hour; last about the usual Time of a Fit; and
+terminating without any sensible Evacuation, return exactly at the same
+Hour, the next Day, or the next but one.
+
+There is but one known Medicine that can effectually oppose this Sort,
+which is the Bark, given as directed Sec. 260. Nothing affords Relief in
+the Fit, and no other Medicine ever suspends or puts it off. But I have
+cured some of these Disorders with the Bark, and especially those
+affecting the Eyes, which happen oftner than the other Symptoms, after
+their Duration for many Weeks, and after the ineffectual Use of
+Bleeding, Purging, Baths, Waters, Blisters, and a great Number of other
+Medicines. If a sufficient Dose of it be given, the next Fit is very
+mild; the second is prevented; and I never saw a Relapse in these Cases,
+which sometimes happens after the Fits of common Intermittents seemed
+cured.
+
+Sec. 272. In Situations where the Constitution of the Air renders these
+Fevers very common, the Inhabitants should frequently burn in their
+Rooms, at least in their lodging Rooms, some aromatic Wood or Herbs.
+They should daily chew some Juniper Berries, and drink a fermented
+Infusion of them. These two Remedies are very effectual to fortify the
+weakest Stomachs, to prevent Obstructions, and to promote Perspiration.
+And as these are the Causes which prolong these Fevers the most
+obstinately; nothing is a more certain Preservation from them than these
+cheap and obvious Assistances. [70]
+
+[70] I have seen several Cases in very marshy maritime Countries, with
+     little good drinking Water, and far South of _Swisserland_, where
+     intermitting Fevers, with Agues at different Intervals, are
+     annually endemic, very popular, and often so obstinate as to return
+     repeatedly, whenever the weekly precautionary Doses of the Bark
+     have been omitted (through the Patient's nauseating the frequent
+     Swallowing of it) so that the Disease has sometimes been extended
+     beyond the Term of a full Year, and even far into a second,
+     including the temporary Removals of it by the Bark. Nevertheless,
+     in some such obstinate Intermittents, and particularly Quartans
+     there, wherein the Bark alone has had but a short and imperfect
+     Effect, I have known the following Composition, after a good Vomit,
+     attended with speedy and final Success, _viz._ Take of fresh
+     Sassafras Bark, of Virginia Snake-root, of Roch-Allom, of Nutmeg,
+     of diaphoretic Antimony, and of Salt of Wormwood of each one
+     Drachm. To these well rubbed together into fine Powder, add the
+     Weight of the whole, of the best and freshest Bark; then drop in
+     three Drops of the chemical Oil of Mint, and with Syrup of Cloves
+     make it into the Consistence of an Electuary or Bolus, for 12 Doses
+     for a grown Person, to be taken at the Distance of three or four
+     Hours from each other, while the Patient is awake, according to the
+     longer or shorter Intermission of the Fever.
+
+     I have also known, particularly in obstinate autumnal Agues there,
+     an Infusion of two Ounces of the best Bark in fine Powder, or two
+     Ounces and a half in gross Powder, in a Quart of the best Brandy,
+     for three or four Days (a small Wine Glass to be taken by grown
+     Persons at the Distance of from four to six Hours) effectually and
+     speedily terminate such intermittent Agues, as had given but little
+     Way to the Bark in Substance. This was certainly more suitable for
+     those who were not of a light delicate Habit and Temperament, and
+     who had not been remarkable for their Abstinence from strong
+     Liquors: the inebriating Force of the Brandy being remarkably
+     lessened, by the Addition and long Infusion of the Bark. These
+     Facts which I saw, are the less to be wondered at, as in such
+     inveterate, but perfectly clear and distinct Intermittents, both
+     the State of the Fluids and Solids seem very opposite to their
+     State in an acutely inflammatory Disease. _K._
+
+
+
+
+                            __Chapter XIX.__
+
+
+
+             _Of the Erisipelas, and the Bites of Animals._
+
+
+                             __Sect.__ 273.
+
+The Erisipelas, commonly called in English, St. Anthony's Fire, and in
+Swisserland _the Violet_, is sometimes but a very slight Indisposition
+which appears on the Skin, without the Person's being sensible of any
+other Disorder; and it most commonly breaks out either in the Face, or
+on the Legs. The Skin becomes tense, or stiff, rough and red; but this
+Redness disappears on pressing the Spot with a Finger, and returns on
+removing it. The Patient feels in the Part affected a burning Heat,
+which makes him uneasy, and sometimes hinders him from sleeping. The
+Disorder increases for the Space of two or three Days; continues at its
+Height one or two, and then abates. Soon after this, that Part of the
+Skin that was affected, falls off in pretty large Scales, and the
+Disorder entirely terminates.
+
+Sec. 274. But sometimes this Malady is considerably more severe, beginning
+with a violent Shivering, which is succeeded by a burning Heat, a
+vehement Head-ach, a Sickness at Heart, as it is commonly termed, or
+Reachings to vomit, which continue till the _Erisipelas_ appears, which
+sometimes does not happen before the second, or even the third Day. The
+Fever then abates, and the Sickness goes off, though frequently a less
+Degree of Fever, and of Sickness or Loathing remain, during the whole
+Time, in which the Disease is in its increasing State. When the Eruption
+and Inflammation happen in the Face, the Head-ach continues, until the
+Decline, or going off, of the Disease. The Eyelid swells, the Eye is
+closed, and the Patient has not the least Ease or Tranquillity. It often
+passes from one Cheek to the other, and extends successively over the
+Forehead, the Neck, and the Nape of the Neck; under which Circumstance
+the Disease is of a more than ordinary Duration. Sometimes also when it
+exists in a very high Degree, the Fever continues, the Brain is
+obstructed and oppressed; the Patient raves; his Case becomes extremely
+dangerous; whence sometimes, if he is not very judiciously assisted, he
+dies, especially if of an advanced Age. A violent _Erisipelas_ on the
+Neck brings on a Quinsey, which may prove very grievous, or even fatal.
+
+When it attacks the Leg, the whole Leg swells up; and the Heat and
+Irritation from it is extended up to the Thigh.
+
+Whenever this Tumour is considerable, the Part it seizes is covered with
+small Pustules filled with a clear watery Humour, resembling those which
+appear after a Burn, and drying afterwards and scaling off. I have
+sometimes observed, especially when this Distemper affected the Face,
+that the Humour, which issued from these little Pustules, was extremely
+thick or glewy, and formed a thick Scurf, or Scabs nearly resembling
+those of sucking Children: they have continued fast on the Face many
+Days before they fell off.
+
+When the Disease may be termed violent, it sometimes continues eight,
+ten, twelve Days at the same Height; and is at last terminated by a very
+plentiful Sweat, that may sometimes be predicted by a Restlessness
+attended with Shiverings, and a little Anxiety of some Hours Duration.
+Throughout the Progress of the Disease, the whole Skin is very dry, and
+even the Inside of the Mouth.
+
+Sec. 275. An _Erisipelas_ rarely comes to Suppuration, and when it does,
+the Suppuration is always unkindly, and much disposed to degenerate into
+an Ulcer. Sometimes a malignant kind of _Erisipelas_ is epidemical,
+seizing a great Number of Persons, and frequently terminating in
+Gangrenes.
+
+Sec. 276. This Distemper often shifts its Situation; it sometimes retires
+suddenly; but the Patient is uneasy and disordered; he has a Propensity
+to vomit, with a sensible Anxiety and Heat: the _Erisipelas_ appears
+again in a different Part, and he feels himself quite relieved from the
+preceding Symptoms. But if instead of re-appearing on some other Part of
+the Surface, the Humour is thrown upon the Brain, or the Breast, he dies
+within a few Hours; and these fatal Changes and Translations sometimes
+occur, without the least Reason or Colour for ascribing them either to
+any Error of the Patient, or of his Physician.
+
+If the Humour has been transferred to the Brain, the Patient immediately
+becomes delirious, with a highly flushed Visage, and very quick
+sparkling Eyes: very soon after he proves downright frantic, and goes
+off in a Lethargy.
+
+If the Lungs are attacked, the Oppression, Anxiety, and Heat are
+inexpressible.
+
+Sec. 277. There are some Constitutions subject to a very frequent, and, as
+it were, to an habitual _Erisipelas_. If it often affects the Face, it
+is generally repeated on the same Side of it, and that Eye is, at
+length, considerably weakened by it.
+
+Sec. 278. This Distemper results from two Causes; the one, an acrid sharp
+Humour, which is commonly bilious, diffused through the Mass of Blood;
+the other consists in that Humour's not being sufficiently discharged by
+Perspiration.
+
+Sec. 279. When this Disease is of a gentle Nature, such as it is described
+Sec. 273, it will be sufficient to keep up a very free Perspiration, but
+without heating the Patient; and the best Method to answer this Purpose
+is putting him upon the Regimen so often already referred to, with a
+plentiful Use of Nitre in Elder Tea. Flesh, Eggs and Wine are prohibited
+of Course, allowing the Patient a little Pulse and ripe Fruits. He
+should drink Elder Flower Tea abundantly, and take half a Drachm of
+Nitre every three Hours; or, which amounts to the same Thing, let three
+Drachms of Nitre be dissolved in as much Infusion of Elder Flowers, as
+he can drink in twenty-four Hours. Nitre may be given too in a Bolus
+with Conserve of Elder-berries. These Medicines keep the Body open, and
+increase Urine and Perspiration.
+
+Sec. 280. When the Distemper prevails in a severer Degree, if the Fever is
+very high, and the Pulse, at the same Time, strong or hard, it may be
+necessary to bleed once: but this should never be permitted in a large
+Quantity at a Time in this Disease; it being more adviseable, if a
+sufficient Quantity has not been taken at once, to bleed a second Time,
+and even a third, if the Fever should prove very high, as it often does,
+and that sometimes in so violent a Degree, as to render it extremely
+dangerous: and in some such Cases Nature has sometimes saved the
+Patients by effecting a large Hemorrhage, or Bleeding, to the Quantity
+of four or five Pounds. This Conduct a very intelligent and prudent
+Physician may presume to imitate; but I dare not advise the same Conduct
+to that Class of Physicians, for which only I write: it being safer for
+them to use repeated Bleedings in such Cases, than one in an excessive
+Quantity. These erisipelatous Fevers are often excited by a Person's
+being too long over-heated.
+
+After Bleeding the Patient is to be restrained to his Regimen; Glysters
+are to be given until there is a sensible Abatement of the Fever; and he
+should drink the Barley Water freely, No. 3.
+
+When the Fever is somewhat diminished, either the Purge No. 23 should be
+given, or a few Doses every Morning of Cream of Tartar No. 24. Purging
+is absolutely necessary to carry off the stagnant Bile, which is
+generally the first Cause of the violent Degrees of this Distemper. It
+may sometimes be really necessary too, if the Disease is very tedious;
+if the Loathing and Sickness at Stomach is obstinate; the Mouth
+ill-favoured, and the Tongue foul, (provided there be only a slight
+Fever, and no Fear of an Inflammation) to give the Medicines No. 34 or
+35, which, in Consequence of the Agitation, the Shaking they occasion,
+remove these Impediments still better than Purges.
+
+It commonly happens that this Disease is more favourable after these
+Evacuations; nevertheless it is sometimes necessary to repeat them the
+next Day, or the next but one; especially if the Malady affects the
+Head. Purging is the true Evacuation for curing it, whenever it attacks
+this Part. By carrying off the Cause of the Disease, they diminish it,
+and prevent its worst Effects.
+
+Whenever, even after these Evacuations, the Fever still continues to be
+very severe, the Patient should take every two Hours, or occasionally,
+oftner, two Spoonfuls of the Prescription No. 10, added to a Glass of
+Ptisan.
+
+It will be very useful, when this Disease is seated in the Head or Face,
+to bathe the Legs frequently in warm Water; and where it is violent
+there, also to apply Sinapisms to the Soles of the Feet. I have seen
+this Application, in about four Hours attract, or draw down an
+_Erisipelas_ to the Legs, which had spread over the Nose, and both the
+Eyes. When the Distemper once begins to go off by Sweating, this should
+be promoted by Elder-flower Tea and Nitre (See Sec. 279) and the Sweating
+may be encouraged to Advantage for some Hours.
+
+Sec. 281. The best Applications that can be made to the affected Part are
+1st, The Herb Robert, a Kind of _Geranium_, or Crane's-Bill; or Chervil,
+or Parsley, or Elder Flowers: and if the Complaint be of a very mild
+Disposition, it may be sufficient to apply a very soft smooth Linen over
+it, which some People dust over with a little dry Meal.
+
+2, If there is a very considerable Inflammation, and the Patient is so
+circumstanced as to be very tractable and regularly attended, Flanels
+wrung out of a strong Decoction of Elder-flowers and applied warm,
+afford him the speediest Ease and Relief. By this simple Application I
+have appeased the most violent Pains of a St. Anthony's Fire, which is
+the most cruel Species of an Erisipelas, and has some peculiar Marks or
+Symptoms extraordinary.
+
+3, The Plaister of Smalt, and Smalt itself No. 46, are also very
+successfully employed in this Disease. This Powder, the farinaceous, or
+mealy ones, or others cried up for it, agree best when a thin watery
+Humour distills or weeps from the little Vesications attending it, which
+it is convenient to absorb by such Applications; without which
+Precaution it might gall, or even ulcerate the Part.
+
+All other Plaisters, which are partly compounded of greasy, or of
+resinous Substances, are very dangerous: they often repel, or strike in
+the _Erisipelas_, occasioning it to ulcerate, or even to gangrene. If
+People who are naturally subject to this Disease should apply any such
+Plaister to their Skin, even in its soundest State, an _Erisipelas_ is
+the speedy Consequence.
+
+Sec. 282. Whenever the Humour occasioning the Distemper is repelled, and
+thrown upon the Brain, the Throat, the Lungs, or any internal Part, the
+Patient should be bled; Blisters must be applied to the Legs; and Elder
+Tea, with Nitre dissolved in it, should be plentifully drank.
+
+Sec. 283. People who are liable to frequent Returns of an Erisipelas,
+should very carefully avoid using Milk, Cream, and all fat and viscid,
+or clammy Food, Pies, brown Meat, Spices, thick and heady Liquors, a
+sedentary Life, the more active Passions, especially Rage, and, if
+possible, all Chagrin too. Their Food should chiefly consist of Herbage,
+Fruits, of Substances inclining to Acidity, and which tend to keep the
+Body open; they should drink Water, and some of the light white Wines;
+by no Means omitting the frequent Use of Cream of Tartar. A careful
+Conformity to these Regulations is of real Importance, as, besides the
+Danger of the frequent Visitations of this Disease, they denote some
+slight Indispositions of the Liver and the Gall-bladder; which, if too
+little attended to, might in Time prove very troublesome and pernicious.
+
+Such mineral Waters as are gently opening are very proper for these
+Constitutions, as well as the Juice of Succory, and clarified Whey, of
+which they should take about three Pints every Morning, during the five
+or six Summer Months. This becomes still more efficacious, if a little
+Cream of Tartar and Honey be added to it.
+
+
+
+             _Of the Stings, or little Wounds, by Animals._
+
+
+Sec. 284. The Stings or little Bites of Animals, frequently producing a
+kind of _Erisipelas_, I shall add a very few Words concerning them in
+this Place.
+
+Of the Serpents in this Country none but the Vipers are poisonous; and
+none of these are found except at _Baume_, where there is a _Viperary_,
+if we may be allowed that Word. We have no Scorpions, which are somewhat
+poisonous; our Toads are not in the least so: whence the only Stings we
+are exposed to, are those of Bees, Wasps, Hornets, Muskitos or Gnats,
+and Dragon [71] Flies: all of which are sometimes attended with severe
+Pain, a Swelling, and a very considerable erisipelatous Redness; which,
+if it happens in the Face, sometimes entirely closes the Eyes up;
+occasioning also a Fever, Pains of the Head, Restlessness, and Sickness
+at Heart; and, when the Pains are in a violent Degree, Faintings and
+Convulsions, though always without any mortal Consequence. These
+Symptoms go off naturally within a few Days, without any Assistance:
+Nevertheless they may either be prevented, diminished in Degree, or
+shortned in Duration.
+
+[71] These, in some Parts of America, are called Muskito Hawks; but we
+     do not recollect their biting there. _K._
+
+1, By extracting the Sting of the Animal, if it is left behind.
+
+2, By a continual Application of one of the Remedies directed Sec. 281,
+Article 1 and 2, particularly the Infusion of Elder-flowers, to which a
+little Venice Treacle is added; or by covering the Part affected with a
+Pultice, made of Crum of Bread, Milk, Honey, and a little Venice
+Treacle. [72]
+
+[72] Pounded Parsley is one of the most availing Applications in such
+     Accidents. _E.L._
+
+3, By bathing the Legs of the Person stung repeatedly in warm Water.
+
+4, By retrenching a little of their customary Food, especially at Night,
+and by making them drink an Infusion of Elder-flowers, with the Addition
+of a little Nitre. Oil, if applied very quickly after the Sting,
+sometimes prevents the Appearance of any Swelling, and from thence the
+Pains that attend it.
+
+
+
+
+                             __Chapter XX.__
+
+
+  _Of spurious, or false Inflammations of the Breast, and of spurious,
+                         bilious, Pleurisies._
+
+
+                             __Sect.__ 285.
+
+The Inflammation of the Breast and that Pleurisy, which is called
+_bilious_, are the same Disease. It is properly a putrid Fever, attended
+with an Infarction or Stuffing of the Lungs, though without Pain; in
+which Circumstance it is called a putrid or bilious Peripneumony: but
+when attended with a Pain of the Side, a Stitch, it is called a spurious
+or bastard Pleurisy.
+
+Sec. 286. The Signs which distinguish these Diseases from the inflammatory
+ones of the same Name, described Chap. IV and V, are a less hard and
+less strong, but a quicker Pulse, though unaccompanied with the same
+Symptoms which constitute the inflammatory ones (See Sec. 47 and 90). The
+Mouth is foul, and has a Sensation of Bitterness; the Patient is
+infested with a sharp and dry Heat; he has a Feeling of Heaviness and
+Anxiety all about his Stomach, with Loathings: he is less flushed and
+red in these, than in the inflammatory Diseases, but rather a little
+yellow. He has a dejected wan Look; his Urine resembles that in putrid
+Fevers, and not that of inflammatory ones; and he has very often a small
+bilious Looseness, which is extremely offensive. The Skin is commonly
+very dry in this Disease; the Humour spit up is less thick, less
+reddish, and rather more yellow than in the inflammatory Diseases of the
+same Names.
+
+Sec. 287. They must be treated after the manner of putrid Fevers, as in Sec.
+241. Supposing some little Degree of Inflammation to be combined with
+the Disease, it may be removed by a single Bleeding. After this the
+Patient is to drink Barley Water No. 3, to make Use of Glysters; and as
+soon as all Symptoms of any Inflammation wholly disappear, he is to take
+the vomiting and purging Draught No. 34. But the utmost Caution must be
+taken not to give it, before every Appearance of any Inflammation is
+totally removed; as giving it sooner would be certain Death to the Sick:
+and it is dreadful but to think of agitating, by a Vomit, Lungs that are
+inflamed, and overloaded with Blood, whose Vessels burst and discharge
+themselves, only from the Force of Expectoration. After an Interval of
+some Days, he may be purged again with the Medicine No. 23. The
+Prescription No. 25 succeeds also very well as a Vomit. If the Fever is
+violent, he must drink plentifully of the Potion No. 10.
+
+Blisters to the Legs are very serviceable, when the Load and Oppression
+are not considerably abated after general Evacuations.
+
+Sec. 288. The false Inflammation of the Breast is an Overfulness or
+Obstruction in the Lungs, accompanied with a Fever; and it is caused by
+extremely thick and tenacious Humours; and not by a really inflammatory
+Blood, or by any putrid or bilious Humour.
+
+Sec. 289. This Distemper happens more frequently in the Spring, than in any
+other Season. Old Men, puny, ill-constitutioned Children, languid Women,
+feeble young Men, and particularly such as have worn their Constitutions
+out by drinking, are the Subjects most frequently attacked by it;
+especially if they have used but little Exercise throughout the Winter:
+if they have fed on viscid, mealy and fat Aliments, as Pastry, Chesnuts,
+thick Milk or Pap, and Cheese. All their Humours have contracted a thick
+glutinous Quality; they are circulated with Difficulty, and when Heat or
+Exercise in the Spring increases their Motion at once, the Humours,
+already stuffing up the Lungs, still more augment that Plenitude, whence
+these vital Organs are fatally extended, and the Patient dies.
+
+Sec. 290. This Distemper is known to exist,
+
+1, By the previous Existence of the Causes already mentioned.
+
+2, By the Symptoms which precede and usher it in. For Example, the
+Patient many Days before-hand has a slight Cough; a small Oppression
+when he moves about; a little Restlessness, and is sometimes a little
+choleric or fretful. His Countenance is higher coloured than in Health;
+he has a Propensity to sleep, but attended with Confusion and without
+Refreshment, and has sometimes an extraordinary Appetite.
+
+3, When this State has continued for some Days, there comes on a cold
+Shivering, though more considerable for its Duration than its Violence;
+it is succeeded by a moderate Degree of Heat, but that attended with
+much Inquietude and Oppression. The sick Person cannot confine himself
+to the Bed; but walks to and fro in his Chamber, and is greatly
+dejected. The Pulse is weak and pretty quick; the Urine is sometimes but
+little changed from that in Health; at other Times it is discharged but
+in a small Quantity, and is higher coloured: he coughs but moderately,
+and does not expectorate, or cough up, but with Difficulty. The Visage
+becomes very red, and even almost livid; he can neither keep awake, nor
+sleep well; he raves for some Moments, and then his Head grows clear
+again. Sometimes it happens, especially to Persons of advanced Age, that
+this State suddenly terminates in a mortal Swoon or Fainting: at other
+Times and in other Cases, the Oppression and Anguish increase; the
+Patient cannot breathe but when sitting up, and that with great
+Difficulty and Agony: the Brain is utterly disturbed and embarrassed;
+this State lasts for some Hours, and then terminates of a sudden.
+
+Sec. 291. This is a very dangerous Distemper; because, in the first Place,
+it chiefly attacks those Persons whose Temperament and Constitution are
+deprived of the ordinary Resources for Health and Recovery: in the
+second Place, because it is of a precipitate Nature, the Patient
+sometimes dying on the third Day, and but seldom surviving the seventh;
+while the Cause of it requires a more considerable Term for its Removal
+or Mitigation. Besides which, if some Indications present for the
+Employment of a Remedy, there are frequently others which forbid it; and
+all that seems to be done is, as follows;
+
+1, If the Patient has still a pretty good Share of Health; if he is not
+of too advanced an Age; if the Pulse has a perceivable Hardness, and yet
+at the same Time some Strength; if the Weather is dry, and the Wind
+blows from the North, he should be bled once, to a moderate Quantity.
+But if the greater Part of these Circumstances are wanting, Bleeding
+would be very prejudicial. Were we obliged to establish some general and
+positive Rule in this Case, it were better to exclude Bleeding, than to
+admit it.
+
+2, The Stomach and the Bowels should be unloaded from their viscid
+glutinous Contents; and the Medicines which succeed the best in this
+Respect are No. 35, when the Symptoms shew there is a great Necessity
+for vomiting, and there is no Inflammation; or the Prescription No. 25,
+which after vomiting, purges by Stool, promotes Urine, breaks down and
+divides the viscid Humours that occasion the Disease, and increase
+Perspiration. When we are afraid of hazarding the Agitation of a Vomit
+and its Consequences, the Potion, No. 11 may be given; but we must be
+very cautious, in Regard to old Men, even with this; as such may expire
+during the Operation of it.
+
+3, They should, from the Beginning of the Disease, drink plentifully of
+the Ptisan No. 26, which is the best Drink in this Disease; or that of
+No. 12, adding half a Dram of Nitre to every Pint of it.
+
+4, A Cup of the Mixture No. 8 must be taken every two Hours.
+
+5. Blisters are to be applied to the Insides of the Legs.
+
+When the Case is very doubtful and perplexing, it were best to confine
+ourselves to the three last-mentioned Remedies, which have often been
+successful in severe Degrees of this Disease; and which can occasion no
+ill Consequence.
+
+Sec. 292. When this Malady invades old People, though they partly recover,
+they never recover perfectly, entirely, from it: and if due Precaution
+is not taken, they are very liable to fall into a Dropsy of the Breast
+after it.
+
+Sec. 293. The spurious or false Pleurisy is a Distemper that does not
+affect the Lungs, but only the Teguments, the Skin, and the Muscles
+which cover the Ribs. It is the Effect of a rheumatic Humour thrown upon
+these Parts, in which, as it produces very sharp Pains resembling that
+which is called a _Stitch_, it has from this Circumstance, been termed a
+Pleurisy.
+
+It is generally supposed by the meer Multitude, and even by some of a
+different Rank, that a false Pleurisy is more dangerous than a genuine,
+a true one; but this is a Mistake. It is often ushered in by a
+Shivering, and almost ever attended with a little Fever, a small Cough,
+and a slight Difficulty of breathing; which, as well as the Cough, is
+occasioned from the Circumstance of a Patient's (who feels Pain in
+Respiration, or Breathing) checking Breathing as much as he can; this
+accumulates a little too much Blood in the Lungs; but yet he has no
+Anguish, nor the other Symptoms of acute true Pleurisies. In some
+Patients this Pain is extended, almost over the whole Breast, and to the
+Nape of the Neck. The sick Person cannot repose himself on the Side
+affected.
+
+This Disorder is not more dangerous than a Rheumatism, except in two
+Cases; 1, When the Pain is so very severe, that the Patient strongly
+endeavours not to breathe at all, which brings on a great Infarction or
+Stoppage in the Lungs. 2, When this Humour, like any other rheumatic
+one, is transferred to some internal Part.
+
+Sec. 294. It must be treated exactly like a Rheumatism. See Sec. 168 and 169.
+
+After bleeding once or more, a Blister applied to the affected Part is
+often attended with a very good Effect: This being indeed the Kind
+of [73] Pleurisy, in which it particularly agrees.
+
+[73] The Seneka Rattle-Snake root, already recommended in true
+     Pleurisies, will, with the greatest Probability, be found not less
+     effectual in these false ones, in which the Inflammation of the
+     Blood is less. The Method of giving it may be seen P. 118,
+     N. ([26].) By Dr. _Tissot's_ having never mentioned this valuable
+     Simple throughout his Work, it may be presumed, that when he wrote
+     it, this Remedy had not been admitted into the Apothecaries Shops
+     in _Swisserland_. _K._
+
+Sec. 295. This Malady sometimes gives Way to the first Bleeding; often
+terminating on the third, fourth or fifth Day, by a very plentiful
+Sweat, and rarely lasting beyond the seventh. Sometimes it attacks a
+Person very suddenly, after a Stoppage of Perspiration; and then, if at
+once before the Fever commences, and has had Time to inflame the Blood,
+the Patient takes some _Faltrank_, it effects a speedy Cure by restoring
+Perspiration. They are such Cases as these, or that mentioned Sec. 96,
+which have given this Composition the Reputation it has obtained in this
+Disease: a Reputation nevertheless, which has every Year proved tragical
+in its Consequences to many Peasants, who being deceived by some
+misleading Resemblances in this Distemper, have rashly and ignorantly
+made Use of it in true inflammatory Pleurisies.
+
+
+
+
+                            __Chapter XXI.__
+
+
+
+                _Of the Cholic and its different Kinds._
+
+
+                             __Sect.__ 296.
+
+The Appellation of a Cholic is commonly given to all Pains of the Belly
+indiscriminately; but I apply it in this Place only to such as attack
+the Stomach, or the Intestines, the Guts.
+
+Cholics may and do result from very many Causes; and the greater Number
+of Cholics are chronical or tedious Complaints, being more common among
+the inactive Inhabitants of Cities, and Workmen in sedentary Trades,
+than among Country People. Hence I shall treat here only of the small
+Variety of Cholics, which happen the most usually in Villages. I have
+already proved that the fatal Events of some Distempers were occasioned
+by endeavouring to force the Patients into Sweats; and the same unhappy
+Consequences have attended Cholics, from accustoming the Subjects of
+this Disease to Drams, and hot inflaming spirituous Liquors, with an
+Intention to expel the Wind.
+
+
+
+                     _Of the inflammatory Cholic._
+
+
+Sec. 297. The most violent and dangerous kind of Cholic is that, which
+arises from an Inflammation of the Stomach, or of the Intestines. It
+begins most commonly without any Shivering, by a vehement Pain in the
+Belly, which gradually becomes still more so. The Pulse grows quick and
+hard; a burning Pain is felt through the whole Region of the Belly;
+sometimes there is a watery _Diarrhoea_, or Purging; at other Times the
+Belly is rather costive, which is attended with Vomiting, a very
+embarrassing and dangerous Symptom: the Countenance becomes highly
+flushed; the Belly tense and hard; neither can it be touched scarcely
+without a cruel Augmentation of the Patient's Pain, who is also
+afflicted with extreme Restlessness; his Thirst is very great, being
+unquenchable by Drink; the Pain often extends to the Loins, where it
+proves very sharp, and severe; little Urine is made, and that very red,
+and with a kind of burning Heat. The tormented Patient has not a
+Moment's Rest, and now and then raves a little. If the Disease is not
+removed or moderated, before the Pains rise to their utmost Height and
+Violence, the Patient begins at length to complain less; the Pulse
+becomes less strong and less hard than before, but quicker: his Face
+first abates of its Flush and Redness, and soon after looks pale; the
+Parts under the Eyes become livid; the Patient sinks into a low stupid
+Kind of _Delirium_, or Raving; his Strength entirely deserts him; the
+Face, Hands, Feet, and the whole Body, the Belly only excepted, become
+cold: the Surface of the Belly appears bluish; extreme Weakness follows,
+and the Patient dies. There frequently occurs, just a Moment before he
+expires, an abundant Discharge of excessively foetid Matter by Stool;
+and during this Evacuation he dies with his Intestines quite gangrened,
+or mortified.
+
+When the Distemper assaults the Stomach, the Symptoms are the very same,
+but the Pain is felt higher up, at the Pit of the Stomach. Almost every
+thing that is swallowed is cast up again; the Anguish of the tortured
+Patient is terrible, and the Raving comes on very speedily. This Disease
+proves mortal in a few Hours.
+
+Sec. 298. The only Method of succeeding in the Cure of it is as follows:
+
+1, Take a very large Quantity of Blood from the Arm; this almost
+immediately diminishes the Violence of the Pains, and allays the
+Vomiting: besides its contributing to the greater Success of the other
+Remedies. It is often necessary to repeat this Bleeding within the Space
+of two Hours.
+
+2, Whether the Patient has a Looseness, or has not, a Glyster of a
+Decoction of Mallows, or of Barley Water and Oil, should be given every
+two Hours.
+
+3, The Patient should drink very plentifully of Almond Milk No. 4; or a
+Ptisan of Mallow Flowers, or of Barley, all which should be warm.
+
+4, Flanels dipt in hot, or very warm Water should be continually applied
+over the Belly, shifting them every Hour, or rather oftner; for in this
+Case they very quickly grow dry.
+
+5, If the Disease, notwithstanding all this, continues very obstinate
+and violent, the Patient should be put into a warm Water Bath, the
+extraordinary Success of which I have observed.
+
+When the Distemper is over, that is to say, when the Pains have
+terminated, and the Fever has ceased, so that the Patient recovers a
+little Strength, and gets a little Sleep, it will be proper to give him
+a Purge, but a very gentle one. Two Ounces of Manna, and a Quarter of an
+Ounce of Sedlitz [74] Salt dissolved in a Glass of clear Whey is
+generally sufficient, at this Period, to purge the most robust and hardy
+Bodies. Manna alone may suffice for more delicate Constitutions: as all
+acrid sharp Purges would be highly dangerous, with Regard to the great
+Sensibility and tender Condition of the Stomach, and of the Intestines
+after this Disease.
+
+[74] Glauber or Epsom Salt may be substituted, where the other is not to
+     be readily procured. _K._
+
+Sec. 299. It is sometimes the Effect of a general Inflammation of the
+Blood; and is produced, like other inflammatory Diseases, by
+extraordinary Labour, very great Heat, heating Meats or Drinks, _&c._ It
+is often the Consequence of other Cholics which have been injudiciously
+treated, and which otherwise would not have degenerated into
+inflammatory ones; as I have many Times seen these Cholics introduced
+after the Use of heating Medicines; one Instance of which may be seen Sec.
+164.
+
+Sec. 300. Ten Days after I had recovered a Woman out of a severe Cholic,
+the Pains returned violently in the Night. She, supposing them to arise
+only from Wind, hoped to appease them by drinking a deal of distilled
+Walnut Water; which, far from producing any such Effect, rendered them
+more outrageous. They soon were heightened to a surprising Degree, which
+might reasonably be expected. Being sent for very early in the Morning,
+I found her Pulse hard, quick, short; her Belly was tense and hard; she
+complained greatly of her Loins: her Urine was almost entirely stopt.
+She past but a few Drops, which felt as it were scalding hot, and these
+with excessive Pain. She went very frequently to the Close-stool, with
+scarcely any Effect; her Anguish, Heat, Thirst, and the Dryness of her
+Tongue were even terrifying: and her wretched State, the Effect of the
+strong hot Liquor she had taken, made me very apprehensive for her. One
+Bleeding, to the Quantity of fourteen Ounces, somewhat abated all the
+Pains; she took several Glysters, and drank off a few Pots of _Orgeat_
+in a few Hours. By these Means the Disease was a little mitigated; by
+continuing the same Drink and the Glysters the Looseness abated; the
+Pain of the Loins went off, and she passed a considerable Quantity of
+Urine, which proved turbid, and then let fall a Sediment, and the
+Patient recovered. Nevertheless I verily believe, if the Bleeding had
+been delayed two Hours longer, this spirituous Walnut Water would have
+been the Death of her. During the Progress of this violent Disease, no
+Food is to be allowed; and we should never be too inattentive to such
+Degrees of Pain, as sometimes remain after their Severity is over; lest
+a _Scirrhus_, an inward hard Tumour, should be generated, which may
+occasion the most inveterate and tedious Maladies.
+
+Sec. 301. An Inflammation of the Intestines, and one of the Stomach, may
+also terminate in an Abscess, like an Inflammation of any other Part;
+and it may be apprehended that one is forming, when, though the Violence
+of the Pains abates, there still remains a slow, obtuse, heavy Pain,
+with general Inquietude, little Appetite, frequent Shiverings; the
+Patient at the same Time not recovering any Strength. In such Cases the
+Patient should be allowed no other Drinks, but what are already directed
+in this Chapter, and some Soops made of Pulse, or other farinaceous
+Food.
+
+The Breaking of the Abscess may sometimes be discovered by a slight
+Swoon or fainting Fit; attended with a perceivable Cessation of a Weight
+or Heaviness in the Part, where it was lately felt: and when the _Pus_,
+or ripe Matter, is effused into the Gut, the Patient sometimes has
+Reachings to vomit, a _Vertigo_, or Swimming in the Head, and the Matter
+appears in the next Stools. In this Case there remains an Ulcer within
+the Gut, which, if either neglected, or improperly treated, may pave the
+Way to a slow wasting Fever, and even to Death. Yet this I have cured by
+making the Patient live solely upon skimmed Milk, diluted with one third
+Part Water, and by giving every other Day a Glyster, consisting of equal
+Parts of Milk and Water, with the Addition of a little Honey.
+
+When the Abscess breaks on the Outside of the Gut, and discharges its
+Contents into the Cavity of the Belly, it becomes a very miserable Case,
+and demands such further Assistance as cannot be particularized here.
+
+
+
+                        _Of the bilious Cholic._
+
+
+Sec. 302. The bilious Cholic discovers itself by very acute Pains, but is
+seldom accompanied with a Fever; at least not until it has lasted a Day
+or two. And even if there should be some Degree of a Fever, yet the
+Pulse, though quick, is neither strong nor hard: the Belly is neither
+tense or stretched as it were, nor burning hot, as in the former Cholic:
+the Urine comes away with more Ease, and is less high-coloured:
+Nevertheless the inward Heat and Thirst are considerable; the Mouth is
+bitter; the Vomiting or Purging, when either of them attend it,
+discharge a yellowish Humour or Excrement; and the Patient's Head is
+often vertiginous or dizzy.
+
+Sec. 303. The Method of curing this is,
+
+1, By injecting Glysters of Whey and Honey; or, if Whey is not readily
+procurable, by repeating the Glyster, No. 5.
+
+2, By making the Sick drink considerably of the same Whey, or of a
+Ptisan made of the Root of Dog's-Grass (the common Grass) and a little
+Juice of Lemon, for want of which, a little Vinegar and Honey may be
+substituted instead of it. [75]
+
+[75] Pullet, or rather Chicken Water, but very weak, may often do
+     instead of Ptisan, or serve for a little Variety of Drink to some
+     Patients. _E. L._--K.
+
+3, By giving every Hour one Cup of the Medicine No. 32; or where this is
+not to be had, half a Drachm of Cream of Tartar at the same short
+Intervals.
+
+4, Fomentations of warm Water and Half-baths are also very proper.
+
+5, If the Pains are sharp and violent, in a robust strong Person, and
+the Pulse is strong and tense, Bleeding should be used to prevent an
+Inflammation.
+
+6, No other Nourishment should be given, except some maigre Soops, made
+from Vegetables, and particularly of Sorrel.
+
+7, After plentiful Dilution with the proper Drink, if no Fever
+supervenes; if the Pains still continue, and the Patient discharges but
+little by Stool, he should take a moderate Purge. That directed No. 47
+is a very proper one.
+
+Sec. 304. This bilious Cholic is habitual to many Persons; and may be
+prevented or greatly mitigated by an habitual Use of the Powder No. 24;
+by submitting to a moderate Retrenchment in the Article of Flesh-meat;
+and by avoiding heating and greasy Food, and the Use of Milk.
+
+
+
+          _Of Cholics from Indigestions, and of Indigestion._
+
+
+Sec. 305. Under this Appellation I comprehend all those Cholics, which are
+either owing to any overloading Quantity of Food taken at once; or to a
+Mass or Accumulation of Aliments formed by Degrees in such Stomachs, as
+digest but very imperfectly; or which result from noxious Mixtures of
+Aliment in the Stomach, such as that of Milk and Acids; or from Food
+either not wholesome in its self, or degenerated into an unwholesome
+Condition.
+
+This kind of Cholic may be known from any of these Causes having
+preceded it; by its Pains, which are accompanied with great
+Restlessness, and come on by Degrees, being less fixed than in the
+Cholics before treated of. These Cholics are also without any Fever,
+Heat or Thirst, but accompanied with a Giddiness of the Head, and
+Efforts to vomit, and rather with a pale, than a high-coloured Visage.
+
+Sec. 306. These Disorders, from these last Causes, are scarcely ever
+dangerous in themselves; but may be made such by injudicious Management,
+and doing more than is necessary or proper: as the only Thing to be done
+is to promote the Discharges by warm Drinks. There are a considerable
+Variety of them, which seem equally good, such as warm Water, or even
+cold Water with a Toast, with the Addition either of a little Sugar, or
+a little Salt: a light Infusion of Chamomile, or of Elder-flowers,
+common Tea, or Baum, it imports little which, provided the Patient drink
+plentifully of them: in Consequence of which the offending Matter is
+discharged, either by vomiting, or a considerable purging; and the
+speedier and more in Quantity these Discharges are, the sooner the
+Patient is relieved.
+
+If the Belly is remarkably full and costive, Glysters of warm Water and
+Salt should be injected.
+
+The Expulsion of the obstructing Matter is also facilitated, by rubbing
+the Belly heartily with hot Cloths.
+
+Sometimes the Humours, or other retained Contents of the Belly, are more
+pernicious from their Quality, than their Quantity; and then the Malady
+may be dissipated without the former Discharges, by the irritating sharp
+Humour being diluted, or even drowned, as it were, in the Abundance of
+small watery Drinks. When the Pains invade first in the Stomach, they
+become less sharp, and the Patient feels less Inquietude, as soon as the
+Cause of the Pain has descended out of the Stomach into the Intestines,
+whose Sensations are something less acute than, or somewhat different
+from, those of the Stomach.
+
+It is often found that after these plentiful Discharges, and when the
+Pains are over, there remains a very disagreeable Taste in the Mouth,
+resembling the Savour of rotten Eggs. This may be removed by giving some
+Doses of the Powder No. 24, and drinking largely of good Water:
+
+It is an essential Point in these Cases, to take no Food before a
+perfect Recovery.
+
+Sec. 307. Some have been absurd enough in them, to fly at once to some
+heating Cordial Confection, to Venice Treacle, Aniseed Water, Geneva, or
+red Wine to stop these Evacuations; but there cannot be a more fatal
+Practice: since these Evacuations are the only Thing which can cure the
+Complaint, and to stop them is to deprive the Person, who was in Danger
+of drowning, of the Plank which might save him. Nay should this
+Endeavour of stopping them unhappily succeed, the Patient is either
+thrown into a putrid Fever, or some chronical tedious Malady; unless
+Nature, much wiser than such a miserable Assistant, should prevail over
+the Obstacles opposed to her Recovery, and restore the obstructed
+Evacuations by her own Oeconomy, in the Space of a few Days.
+
+Sec. 308. Sometimes an Indigestion happens, with very little Pain or
+Cholic, but with violent Reachings to vomit, inexpressible Anguish,
+Faintings, and cold Sweats: and not seldom also the Malady begins, only
+with a very sudden and unexpected Fainting: the Patient immediately
+loses all his Senses, his Face is pale and wan: he has some Hickups
+rather than Reachings to vomit, which joined to the Smallness of his
+Pulse, to the Easiness of his respiring, or breathing, and to the
+Circumstance of his being attacked immediately, or very soon, after a
+Meal, makes this Disorder distinguishable from a real Apoplexy.
+Nevertheless, when it rises to this Height, with these terrible
+Symptoms, it sometimes kills in a few Hours. The first thing to be done
+is to throw up a sharp Glyster, in which Salt and Soap are to be
+dissolved; next to get down as much Salt and Water as he can swallow;
+and if that is ineffectual, the Powder No. 34 is to be dissolved in
+three Cups of Water; one half of which is to be given directly; and, if
+it does not operate in a Quarter of an Hour, the other half. Generally
+speaking the Patient's Sense begins to return, as soon as he begins to
+vomit.
+
+
+
+                  _Of the flatulent or windy Cholic._
+
+
+Sec. 309. Every Particular which constitutes our Food, whether solid or
+liquid, contains much Air, but some of them more than others. If they do
+not digest soon enough, or but badly, which occasions a sensible Escape
+of such Air; if they are such as contain an extraordinary Quantity of
+Air; or if the Guts being straitened or compressed any where in the
+Course of their Extent, prevent that Air from being equally diffused
+(which must occasion a greater Proportion of it in some Places) then the
+Stomach and the Guts are distended by this Wind; and this Distention
+occasions these Pains, which are called flatulent, or windy.
+
+This Sort of Cholic rarely appears alone and simple; but is often
+complicated with, or added, as it were, to the other Sorts, of which it
+is a Consequence; and is more especially joined with the Cholic from
+Indigestions, whose Symptoms it multiplies and heightens. It may be
+known, like that, by the Causes which have preceded it, by its not being
+accompanied either with Fever, Heat, or Thirst; the Belly's being large
+and full, though without Hardness, being unequal in its Largeness, which
+prevails more in one Part of it than in another, forming something like
+Pockets of Wind, sometimes in one Part, sometimes in another; and by the
+Patient's feeling some Ease merely from the rubbing of his Belly, as it
+moves the Wind about; which escaping either upwards or downwards affords
+him still a greater Relief.
+
+Sec. 310. When it is combined with any different Species of the Cholic, it
+requires no distinct Treatment from that Species; and it is removed or
+dissipated by the Medicines which cure the principal Disease.
+
+Sometimes however it does happen to exist alone, and then it depends on
+the Windiness of the solid and liquid Food of the Person affected with
+it, such as the _Must_ or new Wine, Beer, especially very new Beer,
+certain Fruits and Garden-stuff. It may be cured by a Glyster; by
+chaffing the Belly with hot Cloths; by the Use of Drink moderately
+spiced; and especially by Camomile Tea, to which a little cordial
+Confection, or even Venice Treacle, may be added. When the Pains are
+almost entirely vanished, and there is no Fever, nor any unhealthy
+Degree of Heat; and if the Patient is sensible of a Weakness at Stomach,
+he may take a little aromatic, or spiced Wine, or even a small cordial
+stomachic Dram. It should be observed, that these are not to be allowed
+in any other Kind of Cholic.
+
+Sec. 311. When any Person is frequently subject to cholic-like Pains, it is
+a Proof that the digestive Faculty is impaired; the restoring of which
+should be carefully attended to; without which the Health of the Patient
+must suffer considerably, and he must be very likely to contract many
+tedious and troublesome Disorders.
+
+
+
+                        _Of Cholics from Cold._
+
+
+Sec. 312. When any Person has been very cold, and especially in his Feet,
+it is not uncommon for him to be attacked, within a few Hours after it,
+with violent Cholic Pains, in which heating and spirituous Medicines are
+very pernicious: but which are easily cured by rubbing the Legs well
+with hot Cloths; and keeping them afterwards for a considerable Time in
+warm Water; advising them at the same Time to drink freely of a light
+Infusion of Chamomile or Elder-flowers.
+
+The Cure will be effected the sooner, if the Patient is put to Bed and
+sweats a little, especially in the Legs and Feet.
+
+A Woman who had put her Legs into a pretty cool Spring, after travelling
+in the Height of Summer, was very quickly after attacked with a most
+violent Cholic. She took different hot Medicines; she became still
+worse; she was purged, but the Distemper was still further aggravated. I
+was called in on the third Day, a few Hours before her Decease.
+
+In such Cases, if the Pain be excessive, it may be necessary to
+bleed; [76] to give a Glyster of warm Water; to keep the Legs several
+Hours over the Steam of hot Water, and afterwards in the Water; to drink
+plentifully of an Infusion of the Flowers of the Lime-tree, with a
+little Milk; and if the Distemper is not subdued by these Means,
+Blisters should be applied to the Legs, which I have known to be highly
+efficacious.
+
+[76] Bleeding should not be determined on too hastily in this Sort of
+     Cholic, but rather be omitted, or deferred at least, till there be
+     an evident Tendency to an Inflammation. _E. L._
+
+     The Propriety or Impropriety of Bleeding in a Cholic from this
+     Cause should be determined, I think, from the State of the Person
+     it happens to: So that Bleeding a strong Person with a firm Fibre,
+     and a hard Pulse, may be very prudent and precautionary: But if it
+     be a weakly lax Subject with a soft and low Pulse, there may be
+     Room either for omitting, or for suspending it. _K._
+
+Sec. 313. It appears, through the Course of this Chapter, that it is
+necessary to be extremely on our Guard, against permitting the Use of
+heating and spirituous Medicines in Cholics, as they may not only
+aggravate, but even render them mortal. In short they should never be
+given, and when it is difficult to discover the real Cause of the
+Cholic, I advise Country People to confine themselves to the three
+following Remedies, which cannot be hurtful in any Sort of Cholic, and
+may remove as many as are not of a violent Nature. First then, let
+Glysters be frequently repeated. 2, Let the Patient drink warm Water
+plentifully, or Elder Tea. 3, Let the Belly be often fomented in pretty
+warm Water, which is the most preferable Fomentation of any.
+
+Sec. 314 I have said nothing here of the Use of any Oils in this Disease,
+as they agree but in very few Species of Cholics, and not at all in
+those of which I have been treating. For this Reason I advise a total
+Disuse of them, since they may be of bad Consequence in many Respects.
+
+Sec. 315. Chronical Diseases not coming within the Plan of this Work, I
+purposely forbear treating of any Kind of those tedious Cholics, which
+afflict some People for many Years: but I think it my Duty to admonish
+such, that their Torments being very generally occasioned by
+Obstructions in the _Viscera_, or different Bowels of the Belly, or by
+some other Fault, and more particularly in those Organs, which are
+intended to prepare the Bile, they should, 1, avoid with the greatest
+Care, the Use of sharp, hot, violent Medicines, Vomits, strong Purges,
+Elixirs, _&c._ 2, They should be thoroughly on their Guard against all
+those, who promise them a very speedy Cure, by the Assistance of some
+specific Remedy; and ought to look upon them as Mountebanks, into whose
+Hands it is highly dangerous to trust themselves. 3, They should be
+persuaded, or rather convinced, that they can entertain no reasonable
+Hope of being cured, without an exact Conformity to a proper and
+judicious Regimen, and a long Perseverance in a Course of mild and safe
+Remedies. 4, They should continually reflect with themselves, that there
+is little Difficulty in doing them great Mischief; and that their
+Complaints are of that Sort, which require the greatest Knowledge and
+Prudence in those Persons, to whom the Treatment and Cure of them are
+confided.
+
+
+
+
+                            __Chapter XXII.__
+
+
+
+           _Of the Iliac Passion, and of the Cholera-morbus._
+
+
+                             __Sect.__ 316.
+
+These violent Diseases are fatal to many Country People, while their
+Neighbours are frequently so ignorant of the Cause of their Death, that
+Superstition has ascribed it to Poison, or to Witchcraft.
+
+Sec. 317. The first of these, the _Miserere_, or Iliac Passion, is one of
+the most excruciating Distempers. If any Part of the Intestines, the
+Cavity of the Guts is closed up, whatever may have occasioned it, the
+Course or Descent of the Food they contain is necessarily stopped; in
+which Case it frequently happens, that that continual Motion observed in
+the Guts of a living Animal dissected, and which was intended to
+detrude, or force their Contents downwards, is propagated in a directly
+contrary Manner, from the Guts towards the Mouth.
+
+This Disease sometimes begins after a Constipation, or Costiveness, of
+some Days; at other Times without that Costiveness having been preceded
+by Pains in any Part of the Belly, especially around the Navel; but
+which Pains, gradually increasing after their Commencement, at length
+become extremely violent, and throw the Patient into excessive Anguish.
+In some of these Cases a hard Tumour may be felt, which surrounds the
+Belly like a Cord. The Flatulences within become very audible, some of
+them are discharged upwards; in a little Time after, Vomitings come on,
+which increase till the Patient has thrown up all he had taken in, with
+a still further Augmentation of the excessive Pain. With the first of
+his Vomitings he only brings up the last Food he had taken, with his
+Drink and some yellowish Humour: but what comes up afterwards proves
+stinking; and when the Disease is greatly heightened, they have what is
+called the Smell of Excrement or Dung; but which rather resembles that
+of a putrid dead Body. It happens too sometimes, that if the Sick have
+taken Glysters composed of Materials of a strong Smell, the same Smell
+is discernible in the Matter they vomit up. I confess however I never
+saw either real Excrements, or the Substance of their Glysters, brought
+up, much less the Suppositories that were introduced into the Fundament:
+and were it credible that Instances of this Kind had occurred, they must
+be allowed very difficult to account for. Throughout this whole Term of
+the Disease, the Patient has not a single Discharge by Stool; the Belly
+is greatly distended; the Urine not seldom suppressed, and at other
+Times thick and foetid. The Pulse, which at first was pretty hard,
+becomes quick and small; the Strength entirely vanishes; a Raving comes
+on; a Hiccup almost constantly supervenes, and sometimes general
+Convulsions; the Extremities grow cold, the Pulse scarcely perceivable;
+the Pain and the Vomiting cease, and the Patient dies very quickly
+after.
+
+Sec. 318. As this Disease is highly dangerous, the Moment it is strongly
+apprehended, it is necessary to oppose it by proper Means and Remedies:
+the smallest Error may be of fatal Consequence, and hot inflaming
+Liquids have been known to kill the Patient in a few Hours. I was called
+in the second Day of the Disease to a young Person, who had taken a good
+deal of Venice Treacle: Nothing could afford her any Relief, and she
+died early on the third Day.
+
+This Disease should be treated precisely in the same Manner as an
+inflammatory Cholic; the principal Difference being, that in the former
+there are no Stools, but continual Vomitings.
+
+1, First of all then the Patient should be plentifully bled, if the
+Physician has been called in early enough, and before the Sick has lost
+his Strength.
+
+2, He should receive opening Glysters made of a Decoction of Barley
+Water, with five or six Ounces of Oil in each.
+
+3, We should endeavour to allay the violent Efforts to vomit, by giving
+every two Hours a Spoonful of the Mixture No. 48.
+
+4, The Sick should drink plentifully, in very small Quantities, very
+often repeated, of an appeasing, diluting, refreshing Drink, which tends
+at the same Time to promote both Stools and Urine. Nothing is preferable
+to the Whey No. 49, if it can be had immediately: if not, give simple
+clear Whey sweetened with Honey, and the Drinks prescribed Sec. 298, Art.
+3.
+
+5, The Patient is to be put into a warm Bath, and kept as long as he can
+bear it, repeating it as often daily too, as his Strength will permit.
+
+6, After Bleeding, warm Bathing, repeated Glysters and Fomentations, if
+each and all of these have availed nothing; the Fume or Smoak of Tobacco
+may be introduced in the Manner of a Glyster, of which I shall speak
+further, in the Chapter on Persons drowned.
+
+I cured a Person of this Disease, by conveying him into a Bath,
+immediately after bleeding him, and giving him a Purge on his going into
+the Bath.
+
+Sec. 319. If the Pain abates before the Patient has quite lost his
+Strength; if the Pulse improves at the same Time; if the Vomitings are
+less in Number, and in the Quantity of the Matter brought up; if that
+Matter seems in a less putrid offensive State; if he feels some
+Commotion and Rumbling in his Bowels; if he has some little Discharge by
+Stool; and if at the same Time he feels himself a little stronger than
+before, his Cure may reasonably be expected; but if he is otherwise
+circumstanced he will soon depart. It frequently happens, a single Hour
+before Death, that the Pain seems to vanish, and a surprising Quantity
+of extremely foetid Matter is discharged by Stool: the Patient is
+suddenly seized with a great Weakness and Sinking, falls into a cold
+Sweat, and immediately expires.
+
+Sec. 320. This is the Disease which the common People attribute to, and
+term, the _Twisting of the Guts_; and in which they make the Patients
+swallow Bullets, or large Quantities of Quick-silver. This twisting,
+tangling, or Knoting of the Guts is an utter, an impossible Chimera; for
+how can they admit of such a Circumstance, as one of their Extremities,
+their Ends, is connected to the Stomach, and the other irremoveably
+fastened to the Skin of the Fork or Cleft of the Buttocks? In Fact this
+Disease results from a Variety of Causes, which have been discovered on
+a Dissection of those who have died of it. It were to be wished indeed
+this prudent Custom, so extremely conducive to enrich, and to perfect,
+the Art of Physick, were to prevail more generally; and which we ought
+rather to consider as a Duty to comply with, than a Difficulty to submit
+to; as it is our Duty to contribute to the Perfection of a Science, on
+which the Happiness of Mankind so considerably depends. I shall not
+enter into a Detail of these Causes; but whatever they are, the Practice
+of swallowing Bullets in the Disease is always pernicious, and the like
+Use of Mercury must be often so. Each of these pretended Remedies may
+aggravate the Disease, and contribute an insurmountable Obstacle to the
+Cure--Of that Iliac Passion, which is sometimes a Consequence of
+Ruptures, I shall treat in another Place.
+
+
+
+                        _Of the Cholera-morbus._
+
+
+Sec. 321. This Disease is a sudden, abundant, and painful Evacuation by
+vomiting and by Stool.
+
+It begins with much Flatulence, or Wind, with Swelling and slight Pains
+in the Belly, accompanied with great Dejection; and followed with large
+Evacuations either by Stool or by Vomit at first, but whenever either of
+them has begun, the other quickly follows. The Matter evacuated is
+either yellowish, green, brown, whitish, or black; the Pains in the
+Belly violent; the Pulse, almost constantly feverish, is sometimes
+strong at first, but soon sinks into Weakness, in Consequence of the
+prodigious Discharge. Some Patients purge a hundred Times in the Compass
+of a few Hours: they may even be seen to fall away; and if the Disease
+exists in a violent Degree, they are scarcely to be known within three
+or four Hours from the Commencement of these Discharges. After a great
+Number of them they are afflicted with Spasms, or Cramps, in their Legs,
+Thighs, and Arms, which torment them as much as the Pains in the Belly.
+When the Disease rages too highly to be asswaged, Hiccups, Convulsions
+and a Coldness of the Extremities approach; there is a scarcely
+intermitting Succession of fainting, or swooning Fits, the Patient dying
+either in one of them, or in Convulsions.
+
+Sec. 322. This Disease, which constantly depends on a Bile raised to the
+highest Acrimony, commonly prevails towards the End of July and in
+August: especially if the Heats have been very violent, and there have
+been little or no Summer Fruits, which greatly conduce to attempt: and
+allay the putrescent Acrimony of the Bile.
+
+Sec. 323. Nevertheless, however violent this Distemper may be, it is less
+dangerous, and also less tormenting than the former, many Persons
+recovering from it.
+
+1, Our first Endeavour should be to dilute, or even to drown this acrid
+Bile, by Draughts, by Deluges, of the most mitigating Drinks; the
+irritation being so very great, that every Thing having the least
+Sharpness is injurious. Wherefore the patient should continually take
+in, by Drink, and by Way of Glyster, either Barley-Water, Almond-Milk,
+or pure Water, with one eighth Part Milk, which has succeeded very well
+in my Practice. Or he may use a very light Decoction, or Ptisan, as it
+were, of Bread, which is made by gently boiling a Pound of toasted
+Bread, in three or four Pots of Water for half an Hour. In _Swisserland_
+we prefer Oat bread. We also successfully use pounded Rye, making a
+light Ptisan of it.
+
+A very light thin Soup made of a Pullet, a Chicken, or of one Pound of
+lean Veal, in three Pots of Water, is very proper too in this Disease.
+Whey is also employed to good Purpose; and in those Places, where it can
+easily be had, Butter-milk is the best Drink of any. But, whichever of
+these Drinks shall be thought preferable, it is a necessary Point to
+drink very plentifully of it; and the Glysters should be given every two
+Hours.
+
+2, If the Patient is of a robust Constitution, and sanguine Complexion,
+with a strong Pulse at the Time of the Attack, and the Pains are very
+severe, a first, and in some Cases, a second Bleeding, very early in the
+Invasion, asswages the Violence of the Malady, and allows more Leisure
+for the Assistance of other Remedies. I have seen the Vomiting cease
+almost entirely, after the first Bleeding.
+
+The Rage of this Disease abates a little after a Duration of five or six
+Hours: we must not however, during this Remission or Abatement, forbear
+to throw in proper Remedies; since it returns soon after with great
+Force, which Return however indicates no Alteration of the Method
+already entered upon.
+
+3, In general the warm Bath refreshes the Patient while he continues in
+it; but the Pains frequently return soon after he is taken out, which,
+however, is no Reason for omitting it, since it has frequently been
+found to give a more durable Relief. The Patient should continue in it a
+considerable Time, and, during that Time, he should take six or seven
+Glasses of the Potion No. 32, which has been very efficacious in this
+Disease. By these Means the Vomiting has been stopt; and the Patient,
+upon going out of the Bath, has had several large Stools, which very
+considerably diminished the Violence of the Disease.
+
+4, If the Patient's Attendants are terrified by these great Evacuations,
+and determine to check them (however prematurely) by Venice Treacle,
+Mint Water, Syrup of white Poppies, called Diacodium, by Opium or
+Mithridate, it either happens, that the Disease and all its Symptoms are
+heightened, to which I have been a Witness; or, if the Evacuations
+should actually be stopt, the Patient, in Consequence of it, is thrown
+into a more dangerous Condition. I have been obliged to give a Purge, in
+order to renew the Discharges, to a Man, who had been thrown into a
+violent Fever, attended with a raging _Delirium_, by a Medicine composed
+of Venice Treacle, Mithridate and Oil. Such Medicines ought not to be
+employed, until the Smallness of the Pulse, great Weakness, violent and
+almost continual Cramps, and even the Insufficience of the Patient's
+Efforts to vomit, make us apprehensive of his sinking irrecoverably. In
+such Circumstances indeed he should take, every Quarter or half Quarter
+of an Hour, a Spoonful of the Mixture No. 50, still continuing the
+diluting Drinks. After the first Hour, they should only be given every
+Hour, and that only to the Extent of eight Doses. But I desire to insist
+upon it here, that this Medicine should not be given too early in this
+Distemper.
+
+Sec. 324. If the Patient is likely to recover, the Pains and the
+Evacuations gradually abate; the Thirst is less; the Pulse continues
+very quick, but it becomes regular. There have been Instances of their
+Propensity to a heavy kind of Drowsiness at this Time; for perfect
+refreshing Sleep advances but slowly after this Disease. It will still
+be proper to persevere in the Medicines already directed, though
+somewhat less frequently. And now we may begin to allow the Patient a
+few Soups from farinaceous mealy Substances; and as soon as the
+Evacuations accompanying this Disease are evidently ceased, and the
+Pains are vanished; though an acute Sensibility and great Weakness
+continues, beside such Soups, he may be allowed some new-laid Eggs, very
+lightly boiled, or even raw, for some Days. After this he must be
+referred to the Regimen so frequently recommended to Persons in a State
+of Recovery: when the concurring Use of the Powder No. 24, taken twice a
+Day, will greatly assist to hasten and to establish his Health.
+
+
+
+
+                           __Chapter XXIII.__
+
+
+                    _Of a Diarrhoea, or Looseness._
+
+
+                             __Sect.__ 325.
+
+Every one knows what is meant by a Looseness or Purging, which the
+Populace frequently call a Flux, and sometimes a Cholic.
+
+There are certain very chronical, or tedious and obstinate ones, which
+arise from some essential Fault in the Constitution. Of such, as foreign
+to my Plan, I shall say nothing.
+
+Those which come on suddenly, without any preceding Disorder, except
+sometimes a slight Qualm or short Loathing, and a Pain in the Loins and
+Knees; which are not attended with smart Pains nor a Fever (and
+frequently without any Pain, or any other Complaint) are oftener of
+Service than prejudicial. They carry off a Heap of Matter that may have
+been long amassed and corrupted in the Body; which, if not discharged,
+might have produced some Distemper; and, far from weakening the Body,
+such Purgings as these render it more strong, light and active.
+
+Sec. 326. Such therefore ought by no Means to be stopped, nor even speedily
+checked: they generally cease of themselves, as soon as all the noxious
+Matter is discharged; and as they require no Medicine, it is only
+necessary to retrench considerably from the ordinary Quantity of
+Nourishment; to abstain from Flesh, Eggs and Wine or other strong Drink;
+to live only on some Soups, on Pulse, or on a little Fruit, whether raw
+or baked, and to drink rather less than usual. A simple Ptisan with a
+little Syrup of _Capillaire_, or Maiden-hair, is sufficient in these
+Purgings, which require no Venice Treacle, Confection, nor any Drug
+whatever.
+
+Sec. 327. But should it continue more than five or six Days, and manifestly
+weaken the Patient; if the Pain attending it grows a little severe; and
+especially if the Irritation, the urging to Stool, proves more frequent,
+it becomes seasonable to check, or to stop, it. For this Purpose the
+Patient is to be put into a Regimen; and if the Looseness has been
+accompanied with a great Loathing, with Risings or Wamblings at Stomach,
+with a foul furred Tongue, and a bad Taste in the Mouth, he must take
+the Powder No. 35. But if these Symptoms do not appear, give him that of
+No. 51: and during the three following Hours, let him take, every half
+Hour, a Cup of weak light Broth, without any Fat on it.
+
+If the Purging, after being restrained by this Medicine, should return
+within a few Days, it would strongly infer, there was still some tough
+viscid Matter within, that required Evacuation. To effect this he should
+take the Medicines No. 21, 25 or 27; and afterwards take fasting, for
+two successive Mornings, half the Powder, No. 51.
+
+On the Evening of that Day when the Patient took No. 35, or No. 51, or
+any other Purge, he may take a small Dose of Venice Treacle.
+
+Sec. 328. A Purging is often neglected for a long Time, without observing
+the least Regimen, from which Neglect they degenerate into tedious and
+as it were habitual, perpetual ones, and entirely weaken the Patient. In
+such Cases, the Medicine No. 35 should be given first; then, every other
+Day for four Times successively, he should take No. 51: during all which
+Time he should live on nothing but Panada (See Sec. 57) or on Rice boiled
+in weak Chicken-broth. A strengthing stomachic Plaister has sometimes
+been successfully applied, which may be often moistened in a Decoction
+of Herbs boiled in Wine. Cold and Moisture should be carefully avoided
+in these Cases, which frequently occasion immediate Relapses, even after
+the Looseness had ceased for many Days.
+
+
+
+
+                            __Chapter XXIV.__
+
+
+                  _Of the Dysentery, or Bloody-flux._
+
+
+                             __Sect.__ 329.
+
+The Dysentery is a Flux or Looseness of the Belly, attended with great
+Restlessness and Anguish, with severe Gripings, and frequent
+Propensities to go to Stool. There is generally a little Blood in the
+Stools, though this is not a constant Symptom, and is not essential to
+the Existence of a Dysentery; notwithstanding it may not be much less
+dangerous, for the Absence of this Symptom.
+
+Sec. 330. The Dysentery is often epidemical; beginning sometimes at the End
+of July, though oftner in August, and going off when the Frosts set in.
+The great preceding Heats render the Blood and the Bile acrid or sharp;
+and though, during the Continuance of the Heat, Perspiration is kept up
+(See Introduct. P. 28) yet as soon as the Heat abates, especially in the
+Mornings and Evenings, that Discharge is diminished; and by how much the
+more Viscidity or Thickness the Humours have acquired, in Consequence of
+the violent Heats, the Discharge of the sharp Humour by Perspiration
+being now checked, it is thrown upon the Bowels which it irritates,
+producing Pains in, and Evacuations from them.
+
+This Kind of Dysentery may happen at all Times, and in all Countries;
+but if other Causes, capable of producing a Putridity of the Humours, be
+complicated with it; such as the crouding up a great Number of People
+into very little Room, and very close Quarters, as in Hospitals, Camps,
+or Prisons, this introduces a malignant Principle into the Humours,
+which, co-operating with the simpler Cause of the Dysentery, renders it
+the more difficult and dangerous.
+
+Sec. 331. This Disease begins with a general Coldness rather than a
+Shivering, which lasts some Hours; the Patient's Strength soon abates,
+and he feels sharp Pains in his Belly, which sometimes continue for
+several Hours, before the Flux begins. He is affected with _Vertigos_,
+or Swimmings in the Head, with Reachings to vomit, and grows pale; his
+Pulse at the same Time being very little, if at all, feverish, but
+commonly small, and at length the Purging begins. The first Stools are
+often thin, and yellowish; but in a little Time they are mixt with a
+viscid ropy Matter, which is often tinged with Blood. Their Colour and
+Consistence are various too, being either brown, greenish or black,
+thinner or thicker, and foetid: The Pains increase before each of the
+Discharges, which grow very frequent, to the Number of eight, ten,
+twelve or fifteen in an Hour: then the Fundament becomes considerably
+irritated, and the _Tenesmus_ (which is a great Urgency to go to Stool,
+though without any Effect) is joined to the Dysentery or Flux, and often
+brings on a Protrusion or falling down of the Fundament, the Patient
+being now most severely afflicted. Worms are sometimes voided, and
+glairy hairy Humours, resembling Pieces or Peelings of Guts, and
+sometimes Clots of Blood.
+
+If the Distemper rises to a violent Height, the Guts become inflamed,
+which terminates either in Suppuration or in Mortification; the
+miserable Patient discharges _Pus_, or black and foetid watery Stools:
+the Hiccup supervenes; he grows delirious; his Pulse sinks; and he falls
+into cold Sweats and Faintings which terminate in Death.
+
+A kind of Phrenzy, or raging _Delirium_, sometimes comes on before the
+Minute of Expiration. I have seen a very unusual Symptom accompany this
+Disease in two Persons, which was an Impossibility of swallowing, for
+three Days before Death.
+
+But in general this Distemper is not so extremely violent; the
+Discharges are less frequent, being from twenty-five to forty within a
+Day and Night. Their Contents are less various and uncommon, and mixed
+with very little Blood; the Patient retains more Strength; the Number of
+Stools gradually decrease; the Blood disappears; the Consistence of the
+Discharges improves; Sleep and Appetite return, and the Sick recovers.
+
+Many of the Sick have not the least Degree of Fever, nor of Thirst,
+which perhaps is less common in this Disease, than in a simple Purging
+or Looseness.
+
+Their Urine sometimes is but in a small Quantity; and many Patients have
+ineffectual Endeavours to pass it, to their no small Affliction and
+Restlessness.
+
+Sec. 332. The most efficacious Remedy for this Disease is a Vomit. That of
+No. 34, (when there is no present Circumstance that forbids the giving a
+Vomit) if taken immediately on the first Invasion of it, often removes
+it at once; and always shortens its Duration. That of No. 35 is not less
+effectual; it has been considered for a long Time, even as a certain
+Specific, which it is not, though a very useful Medicine. If the Stools
+prove less frequent after the Operation of either of them, it is a good
+Sign; if they are no Ways diminished, we may apprehend the Disease is
+like to be tedious and obstinate.
+
+The Patient is to be ordered to a Regimen, abstaining from all
+Flesh-meat with the strictest Attention, until the perfect Cure of the
+Disease. The Ptisan No. 3 is the best Drink for him.
+
+The Day after the Vomit, he must take the Powder No. 51 divided into two
+Doses: the next Day he should take no other Medicine but his Ptisan; on
+the fourth the Rhubarb must be repeated; after which the Violence of the
+Disease commonly abates: His Diet during the Disease is nevertheless to
+be continued exactly for some Days; after which he may be allowed to
+enter upon that of Persons in a State of Recovery.
+
+Sec. 333. The Dysentery sometimes commences with an inflammatory Fever; a
+feverish, hard, full Pulse, with a violent Pain in the Head and Loins,
+and a stiff distended Belly. In such a Case the Patient must be bled
+once; and daily receive three or even four of the Glysters No. 6,
+drinking plentifully of the Drink No. 3.
+
+When all Dread of an Inflammation is entirely over, the Patient is to be
+treated in the Manner just related; though often there is no Necessity
+for the Vomit: and if the inflammatory Symptoms have run high, his first
+Purge should be that of No. 11, and the Use of the Rhubarb may be
+postponed, till about the manifest Conclusion of the Disease.
+
+I have cured many Dysenteries, by ordering the Sick no other Remedy, but
+a Cup of warm Water every Quarter of an Hour; and it were better to rely
+only on this simple Remedy, which must be of some Utility, than to
+employ those, of whose Effects Country People are ignorant, and which
+are often productive of very dangerous ones.
+
+Sec. 334. It sometimes happens that the Dysentery is combined with a putrid
+Fever, which makes it necessary, after the Vomit, to give the Purges No.
+23 or 47, and several Doses of No. 24, before the Rhubarb is given. No.
+32 is excellent in this combined Case.
+
+There was in _Swisserland_ in the Autumn of 1755, after a very numerous
+Prevalence of epidemical putrid Fevers had ceased, a Multitude of
+Dysenteries, which had no small Affinity with, or Relation to, such
+Fevers. I treated them first, with the Prescription No. 34, giving
+afterwards No. 32; and I directed the Rhubarb only to very few, and that
+towards the Conclusion of the Disease. By much the greater Number of
+them were cured at the End of four or five Days. A small Proportion of
+them, to whom I could not give the Vomit, or whose Cases were more
+complicated, remained languid a considerable Time, though without
+Fatality or Danger.
+
+Sec. 335. When the Dysentery is blended with Symptoms of Malignity (See Sec.
+245) after premising the Prescription No. 35, those of No. 38 and 39 may
+be called in successfully.
+
+Sec. 336. When the Disease has already been of many Days standing, without
+the Patient's having taken any Medicines, or only such as were injurious
+to him, he must be treated as if the Distemper had but just commenced;
+unless some Symptoms, foreign to the Nature of the Dysentery, had
+supervened upon it.
+
+Sec. 337. Relapses sometimes occur in Dysenteries, some few Days after the
+Patients appeared well; much the greater Number of which are occasioned
+either by some Error in Diet, by cold Air, or by being considerably
+over-heated. They are to be prevented by avoiding these Causes of them;
+and may be removed by putting the Patient on his Regimen, and giving him
+one Dose of the Prescription No. 51. Should it return even without any
+such discoverable Causes, and if it manifests itself to be the same
+Distemper renewed, it must be treated as such.
+
+Sec. 338. This Disease is sometimes combined too with an intermitting
+Fever; in which Case the Dysentery must be removed first, and the
+intermittent afterwards. Nevertheless if the Access, the Fits of the
+Fever have been very strong, the Bark must be given as directed Sec. 259.
+
+Sec. 339. One pernicious Prejudice, which still generally prevails is, that
+Fruits are noxious in a Dysentery, that they even give it, and aggravate
+it; and this perhaps is an extremely ill-grounded one. In truth bad
+Fruits, and such as have not ripened well, in unseasonable Years, may
+really occasion Cholics, a Looseness (though oftner a Costiveness) and
+Disorders of the Nerves, and of the Skin; but never can occasion an
+epidemical Dysentery or Flux. Ripe Fruits, of whatever Species, and
+especially Summer Fruits, are the real Preservatives from this Disease.
+The greatest Mischief they can effect, must result from their thinning
+and washing down the Humours, especially the thick glutinous Bile, if
+they are in such a State; good ripe Fruits being the true Dissolvents of
+such; by which indeed they may bring on a Purging, but such a one, as is
+rather a Guard against a Dysentery.
+
+We had a great, an extraordinary Abundance of Fruit in 1759 and 1760,
+but scarcely any Dysenteries. It has been even observed to be more rare,
+and less dangerous than formerly; and if the Fact is certain, it cannot
+be attributed to any thing more probably, than to the very numerous
+Plantations of Trees, which have rendered Fruit very plenty, cheap and
+common. Whenever I have observed Dysenteries to prevail, I made it a
+Rule to eat less Flesh, and Plenty of Fruit; I have never had the
+slightest Attack of one; and several Physicians use the same Caution
+with the same Success.
+
+I have seen eleven Patients in a Dysentery in one House, of whom nine
+were very tractable; they eat Fruit and recovered. The Grandmother and
+one Child, whom she loved more than the rest, were carried off. She
+managed the Child after her own Fashion, with burnt Wine, Oil, and some
+Spices, but no Fruit. She conducted herself in the very same Manner, and
+both died.
+
+In a Country Seat near _Berne_, in the Year 1751, when these Fluxes made
+great Havock, and People were severely warned against the Use of Fruits,
+out of eleven Persons in the Family, ten eat plentifully of Prunes, and
+not one of them was seized with it: The poor Coachman alone rigidly
+observed that Abstinence from Fruit injoined by this Prejudice, and took
+a terrible Dysentery.
+
+This same Distemper had nearly destroyed a Swiss Regiment in Garrison in
+the South of _France_; the Captains purchased the whole Crop of several
+Acres of Vineyard; there they carried the sick Soldiers, and gathered
+the Grapes for such as could not bear being carried into the Vineyard;
+those who were well eating nothing else: after this not one more died,
+nor were any more even attacked with the Dysentery.
+
+A Clergyman was seized with a Dysentery, which was not in the least
+mitigated by any Medicines he had taken. By meer Chance he saw some red
+Currans; he longed for them, and eat three Pounds of them between seven
+and nine o'Clock in the Morning; that very Day he became better, and was
+entirely well on the next.
+
+I could greatly enlarge the Number of such Instances; but these may
+suffice to convince the most incredulous, whom I thought it might be of
+some Importance to convince. Far from forbidding good Fruit, when
+Dysenteries rage, the Patients should be encouraged to eat them freely;
+and the Directors of the Police, instead of prohibiting them, ought to
+see the Markets well provided with them. It is a Fact of which Persons,
+who have carefully informed themselves, do not in the least doubt.
+Experience demonstrates it, and it is founded in Reason, as good Fruit
+counter-operates all the Causes of Dysenteries. [77]
+
+[77] The Experience of all Countries and Times so strongly confirms
+     these important Truths, that they cannot be too often repeated, too
+     generally published, whenever and wherever this Disease rages. The
+     Succession of cold Showers to violent Heats; too moist a
+     Constitution of the Air; an Excess of animal Food; Uncleanliness
+     and Contagion, are the frequent Causes of epidemical Fluxes. _E.
+     L._
+
+     I have retained the preceding Note, abridged from this Gentleman,
+     as it contains the Suffrage of another experienced Physician,
+     against that Prejudice of ripe Fruits occasioning Fluxes, which is
+     too popular among ourselves, and probably more so in the Country
+     than in _London_. I have been also very credibly assured, that the
+     Son of a learned Physician was perfectly cured of a very obstinate
+     Purging, of a Year's Continuance (in Spite of all the usual
+     officinal Remedies) by his devouring large Quantities of ripe
+     Mulberries, for which he ardently longed, and drinking very freely
+     of their expressed Juice. The Fact occurred after his Father's
+     Decease, and was affirmed to me by a Gentleman intimately
+     acquainted with them both. _K._
+
+Sec. 340. It is important and even necessary, that each Subject of this
+Disease should have a Close-stool or Convenience apart to himself, as
+the Matter discharged is extremely infectious: and if they make Use of
+Bed-pans, they should be carried immediately out of the Chamber, the Air
+of which should be continually renewed, burning Vinegar frequently in
+it.
+
+It is also very necessary to change the Patient's Linen frequently;
+without all which Precautions the Distemper becomes more violent, and
+attacks others who live in the same House. Hence it is greatly to be
+wished the People in general were convinced of these Truths.
+
+It was _Boerhaave's_ Opinion, that all the Water which was drank, while
+Dysenteries were epidemical, should be _stummed_, as we term it, or
+sulphurized. [78]
+
+[78] Our learned Author, or his medical Editor at _Lyons_, observes
+     here, 'that in the Edition of this Treatise at _Paris_, there was
+     an essential Mistake, by making _Boerhaave_ recommend the Addition
+     of Brandy, _Eau de vie_, instead of stumming or sulphurizing it,'
+     for which this Note, and the Text too use the Verb _branter_, which
+     Word we do not find in any Dictionary. We are told however, it
+     means to impregnate the Casks in which the Water is reserved, with
+     the Vapour of Sulphur, and then stopping them; in the same Manner
+     that Vessels are in some Countries, for the keeping of Wine. He
+     observes the Purpose of this is to oppose Corruption by the acid
+     Steams of the Sulphur. _K._
+
+Sec. 341. It has happened, by some unaccountable Fatality, that there is no
+Disease, for which a greater Number of Remedies are advised, than for
+the Dysentery. There is scarcely any Person but what boasts of his own
+Prescription, in Preference to all the rest, and who does not boldly
+engage to cure, and that within a few Hours, a tedious severe Disease,
+of which he has formed no just Notion, with some Medicine or
+Composition, of whose Operation he is totally ignorant: while the poor
+Sufferer, restless and impatient, swallows every Body's Recommendation,
+and gets poisoned either through Fear, downright Disgust or Weariness,
+or through entire Complaisance. Of these many boasted Compositions, some
+are only indifferent, but others pernicious. I shall not pretend to
+detail all I know myself, but after repeatedly affirming, that the only
+true Method of Cure is that I have advised here, the Purpose of which is
+evacuating the offending Matter; I also affirm that all those Methods,
+which have a different Scope or Drift, are pernicious; but shall
+particularly observe, that the Method most generally followed, which is
+that of stopping the Stools by Astringents, or by Opiates, is the worst
+of all, and even so mortal a one, as to destroy a Multitude of People
+annually, and which throws others into incurable Diseases. By preventing
+the Discharge of these Stools, and inclosing the Wolf in the Fold, it
+either follows, 1, that this [79] retained Matter irritates and inflames
+the Bowels from which Inflammation excruciating Pains arise, an acute
+inflammatory Cholic, and finally a Mortification and Death; or a
+_Schirrhus_, which degenerates into a _Cancer_, (of which I have seen a
+dreadful Instance) or else an Abscess, Suppuration and Ulcer. Or 2, this
+arrested Humour is repelled elsewhere, producing a _Scirrhus_ in the
+Liver, or Asthmas, Apoplexy, Epilepsy, or Falling Sickness; horrible
+rheumatic Pains, or incurable Disorders of the Eyes, or of the
+Teguments, the Skin and Surface.
+
+[79] A first or second Dose of Glauber Salt has been known to succeed in
+     the epidemical Summer Fluxes of the hotter Climates, when repeated
+     Doses of Rhubarb and Opiates had failed. Such Instances seems a
+     collateral Confirmation of Dr. _Tissot's_ rational and successful
+     Use of cooling opening Fruits in them. _K._
+
+Such are the Consequences of all the astringent Medicines, and of those
+which are given to procure Sleep in this Disease, as Venice Treacle,
+Mithridate and Diascordium, when given too early in Dysenteries.
+
+I have been consulted on Account of a terrible Rheumatism, which ensued
+immediately after taking a Mixture of Venice Treacle and Plantain, on
+the second Day of a Dysentery.
+
+As those who advise such Medicines, are certainly unaware of their
+Consequences, I hope this Account of them will be sufficient, to prevent
+their Repetition.
+
+Sec. 342. Neither are Purges without their Abuse and Danger; they determine
+the Course of all the Humours more violently to the tender afflicted
+Parts; the Body becomes exhausted; the Digestions fail; the Bowels are
+weakened, and sometimes even lightly ulcerated, whence incurable
+_Diarrhoeas_ or Purgings ensue, and prove fatal after many Years
+Affliction.
+
+Sec. 343. If the Evacuations prove excessive, and the Distemper tedious,
+the Patient is likely to fall into a Dropsy; but if this is immediately
+opposed, it may be removed by a regular and drying Diet, by
+Strengthners, by Friction and proper Exercise.
+
+
+
+
+                            __Chapter XXV.__
+
+
+                             _Of the Itch._
+
+
+                             __Sect.__ 344.
+
+The Itch is an infectious Disorder contracted by touching infected
+Persons or Cloaths, but not imbibed from the Air: So that by carefully
+avoiding the _Medium_, or Means of Contagion, the Disorder may be
+certainly escaped.
+
+Though any Part of the Body may be infested with the Itch, it commonly
+shews itself on the Hands, and chiefly between the Fingers. At first one
+or two little Pimples or Pustules appear, filled with a kind of clear
+Water, and excite a very disagreeable Itching. If these Pustules are
+broke by scratching them, the Water oozing from them infects the
+neighbouring Parts. At the Beginning of this Infection it can scarcely
+be distinguished, if a Person is not well apprized of its Nature; but in
+the Progress of it, the little Pustules increase both in Number and
+Size; and when they are opened by scratching, a loathsome kind of Scab
+is formed, and the Malady extends over the whole Surface. Where they
+continue long, they produce small Ulcers, and are at that Time highly
+contagious.
+
+Sec. 345. Bad Diet, particularly the Use of Salt Meat, bad unripe Fruit,
+and Uncleanliness occasion this Disease; though it is oftnest taken by
+Contagion. Some very good Physicians suppose it is never contracted
+otherwise; but I must take Leave to dissent, as I have certainly seen it
+exist without Contagion.
+
+When it happens to a Person, who cannot suspect he has received it by
+Contact, his Cure should commence with a total Abstinence from all Salt,
+sour, fat and spicy Food. He should drink a Ptisan of wild and bitter
+Succory, or that of No. 26, five or six Glasses of which may be daily
+taken; at the End of four or five Days, he may be purged with No. 21, or
+with an Ounce of _Sedlitz_ [or _Epsom_] Salt. His Abstinence, his
+Regimen is to be continued; the Purge to be repeated after six or seven
+Days; and then all the Parts affected, and those very near them, are to
+be rubbed in the Morning fasting, with a fourth Part of the Ointment No.
+52. The three following Days the same Friction is to be repeated, after
+which the same Quantity of Ointment is to be procured, and used in the
+same Proportion; but only every other Day. It happens but seldom that
+this Method fails to remove this disagreeable Malady; sometimes however
+it will return, in which Case, the Patient must be purged again, and
+then recur to the Ointment, whose good Effects I have experienced, and
+continually do.
+
+If the Disease has been very lately contracted, and most certainly by
+Contact, the Ointment may be fearlessly employed, as soon as it is
+discovered, without taking any Purge before it. But if, on the contrary,
+the Disease has been long neglected, and has rose to a high Degree, it
+will be necessary to restrain the Patient a long Time to the Regimen I
+have directed; he must be repeatedly purged, and then drink plentifully
+of the Ptisan No. 26, before the Ointment is rubbed in. When the Malady
+is thus circumstanced, I have always begun with the Ointment No. 28,
+half a Quarter of which is to be used every Morning. I have also
+frequently omitted the Use of that No. 52, having always found the
+former as certain, but a little slower in its Effects.
+
+Sec. 346. While these Medicines are employed, the Patient must avoid all
+Cold and Wet, especially if he makes Use of No. 28, [80] in which there
+is Quick-silver; which, if such Precautions were neglected, might bring
+on a Swelling of the Throat and Gums, and even rise to a Salivation. Yet
+this Ointment has one Advantage in its having no Smell, and being
+susceptible of an agreeable one; while it is very difficult to disguise
+the disagreeable Odour of the other.
+
+The Linen of a Person in this Disease ought to be often changed; but his
+upper Cloaths must not be changed: because these having been infected,
+might, when worn again, communicate the Itch to the Wearer again, after
+he had been cured.
+
+Shirts, Breeches and Stockings may be fumigated with Sulphur, before
+they are put on; and this Fumigation should be made in the open Air.
+
+[80] I have seen a pretty singular Consequence from the Abuse of
+     mercurial Unction for the Itch; whether it happened from the
+     Strength or Quantity of the Ointment, or from taking Cold after
+     applying it, as this Subject, a healthy Youth of about sixteen,
+     probably did, by riding three or four Miles through the Rain. But
+     without any other previous Complaint, he awoke quite blind one
+     Morning, wondering, as he said, when it would be Day. His Eyes were
+     very clear, and free from Inflammation, but the Pupil was wholly
+     immoveable, as in a _Gutta serena_. I effected the Cure by some
+     moderate Purges repeated a few Times; by disposing him to sweat by
+     lying pretty much in Bed (it being towards Winter) and by promoting
+     his Perspiration, chiefly with Sulphur: after which the shaved
+     Scalp was embrocated with a warm nervous Mixture, in which Balsam
+     of _Peru_ was a considerable Ingredient. In something less than
+     three Weeks he could discern a glowing Fire, or the bright Flame of
+     a Candle. As his Sight increased, he discerned other Objects, which
+     appeared for some Days inverted to him, with their Colours
+     confused; but Red was most distinguishable. He discovered the Aces
+     sooner than other Cards; and in about six or seven Weeks recovered
+     his full Sight in all its natural Strength, which he now enjoys.
+     _K._
+
+Sec. 347. If this Disorder becomes very inveterate and tedious, it exhausts
+the Patient, in Consequence of its not suffering him to sleep at Nights,
+as well as by his restless Irritation; and sometimes even brings on a
+Fever, so that he falls away in Flesh, and his Strength abates.
+
+In such a Case he must take, 1, a gentle Purge.
+
+2, Make Use frequently of warm Baths.
+
+3, He must be put on the Regimen of Persons in a State of Recovery.
+
+4, He must take Morning and Evening, fifteen Days successively, the
+Powder No. 53, with the Ptisan No. 26.
+
+This Malady is often very obstinate, and then the Medicines must be
+varied according to the Circumstances, the Detail of which I avoid here.
+
+Sec. 348. After giving repeated Purges in such obstinate Cases, mineral
+Waters abounding with Sulphur, such as [81] those of _Yverdun_, &c.
+often effect a Cure; and simple cold Bathings in Rivers or Lakes have
+sometimes succeeded in very inveterate Cases of this Disorder.
+
+[81] Sea water, and those of _Dulwich_, _Harrigate_, _Shadwell_, &c.
+     will be full as effectual. _K._
+
+Nothing conduces more to the long Continuance of this Malady, than the
+Abuse of hot Waters, such as infusions of Tea, &c.
+
+Sec. 349. I shall conclude this Chapter, with a repeated Injunction not to
+be too free or rash in the Use of the Ointment No. 52, and other outward
+Remedies for extinguishing the Itch. There is hardly any Complaint, but
+what has been found to be the Consequence of too sudden a Removal of
+this Disorder by outward Applications, before due Evacuations have been
+made, and a moderate Abatement of the Sharpness of the Humours has been
+effected.
+
+
+
+
+                            __Chapter XXVI.__
+
+
+
+             _The Treatment of Diseases peculiar to Women._
+
+
+                             __Sect.__ 350.
+
+Besides all the preceding Diseases, to which Women are liable in common
+with Men, their Sex also exposes them to others peculiar to it, and
+which depend upon four principal Sources; which are their monthly
+Discharges, their Pregnancy, their Labours in Child-birth, and the
+Consequences of their Labours. It is not my present Design to treat
+professedly on each of the Diseases arising from these Causes, which
+would require a larger Volume than I have proposed; but I shall confine
+myself to certain general Directions on these four Heads.
+
+Sec. 351. Nature, who intended Women for the Increase, and the Nourishment
+of the human Race at the Breast, has subjected them to a periodical
+Efflux, or Discharge, of Blood: which Circumstance constitutes the
+Source, from whence the Infant is afterwards to receive his Nutrition
+and Growth.
+
+This Discharge generally commences, with us, between the Age of sixteen
+and eighteen. Young Maidens, before the Appearance of this Discharge,
+are frequently, and many for a long Time, in a State of Weakness,
+attended with various Complaints, which is termed the _Chlorosis_, or
+Green Sickness, and Obstructions: and when their Appearance is extremely
+slow and backward, it occasions very grievous, and sometimes even mortal
+Diseases. Nevertheless it is too usual, though very improper, to ascribe
+all the Evils, to which they are subject at this Term of Life, solely to
+this Cause; while they really often result from a different Cause, of
+which the Obstructions themselves are sometimes only the Effect; and
+this is the natural, and, in some Degree, even necessary Feebleness of
+the Sex. The Fibres of Women which are intended to be relaxed, and to
+give Way, when they are unavoidably extended by the Growth of the Child,
+and its inclosing Membranes (which frequently arise to a very
+considerable Size) should necessarily be less stiff and rigid, less
+strong, and more lax and yielding than the Fibres of Men. Hence the
+Circulation of their Blood is more slow and languid than in Males; their
+Blood is less compact and dense, and more watery; their Fluids are more
+liable to stagnate in their different Bowels, and to form Infarctions
+and Obstructions.
+
+Sec. 352. The Disorders to which such a Constitution subjects them might,
+in some Measure, be prevented, by assisting that Languor or Feebleness
+of their natural Movements, by such an Increase of their Force, as
+Exercise might contribute to: But this Assistance, which in some Manner
+is more necessary for Females than Males, they are partly deprived of,
+by the general Education and Habitude of the Sex; as they are usually
+employed in managing Household Business, and such light sedentary Work,
+as afford them less Exercise and Motion, than the more active
+Occupations of Men. They stir about but little, whence their natural
+Tendency to Weakness increases from Habit, and thence becomes morbid and
+sickly. Their Blood circulates imperfectly; its Qualities become
+impaired; the Humours tend to a pretty general Stagnation; and none of
+the vital Functions are completely discharged.
+
+From such Causes and Circumstances they begin to sink into a State of
+Weakness, sometimes while they are very young, and many Years before
+this periodical Discharge could be expected. This State of Languor
+disposes them to be inactive; a little Exercise soon fatigues them,
+whence they take none at all. It might prove a Remedy, and even effect a
+Cure, at the Beginning of their Complaint; but as it is a Remedy, that
+is painful and disagreeable to them, they reject it, and thus increase
+their Disorders.
+
+Their Appetite declines with the other vital Functions, and gradually
+becomes still less; the usual salutary Kinds of Food never exciting it;
+instead of which they indulge themselves in whimsical Cravings, and
+often of the oddest and most improper Substances for Nutrition, which
+entirely impair the Stomach with its digestive Functions, and
+consequently Health itself.
+
+But sometimes after the Duration of this State for a few Years, the
+ordinary Time of their monthly Evacuations approaches, which however
+make not the least Appearance, for two Reasons. The first is, that their
+Health is too much impaired to accomplish this new Function, at a Time
+when all the others are so languid: and the second is, that under such
+Circumstances, the Evacuations themselves are unnecessary; since their
+final Purpose is to discharge (when the Sex are not pregnant) that
+superfluous Blood, which they were intended to produce, and whose
+Retention would be unhealthy, when not applied to the Growth of the
+Foetus, or Nourishment of the Child: and this Superfluity of Blood does
+not exist in Women, who have been long in a very low and languishing
+State.
+
+Sec. 353. Their Disorder however continues to increase, as every one daily
+must, which does not terminate. This Increase of it is attributed to the
+Suppression or Non-appearance of their monthly Efflux, which is often
+erroneous; since the Disorder is not always owing to that Suppression,
+which is often the Effect of their Distemperature. This is so true, that
+even when the Efflux happens, if their Weakness still continues, the
+Patients are far from being the better for it, but the reverse. Neither
+is it unusual to see young Lads, who have received from Nature, and from
+their Parents, a sort of feminine Constitution, Education and Habitude,
+infested with much the same Symptoms, as obstructed young Women.
+
+Country Girls, who are generally more accustomed to such hardy Work and
+Exercise as Country Men, are less subject to these Complaints, than
+Women who live in Cities.
+
+Sec. 354. Let People then be careful not to deceive themselves on this
+important Account; since all the Complaints of young Maidens are not
+owing to the Want of their Customs. Nevertheless it is certain there are
+some of them, who are really afflicted from this Cause. For Instance,
+when a strong young Virgin in full Health, who is nearly arrived to her
+full Growth, and who manifestly abounds with Blood, does not obtain this
+Discharge at the usual Time of Life, then indeed this superfluous Blood
+is the Fountain of very many Disorders, and greatly more violent ones
+than those, which result from the contrary Causes already mentioned.
+
+If the lazy inactive City Girls are more subject to the Obstructions,
+which either arise from the Weakness and Languor I have formerly taken
+Notice of, or which accompany it; Country Girls are more subject to
+Complaints from this latter Cause (too great a Retention of superfluous
+Blood) than Women who live in Cities: and it is this last Cause that
+excites those singular Disorders, which appear so supernatural to the
+common People, that they ascribe them to Sorcery.
+
+Sec. 355. And even after these periodical Discharges have appeared, it is
+known that they have often been suppressed, without the least unhealthy
+Consequence resulting from that Suppression. They are often suppressed,
+in the Circumstances mentioned Sec. 351, by a Continuance of the Disease,
+which was first an Obstacle or Retardment to their Appearance; and in
+other Cases, they have been suppressed by other Causes, such as Cold,
+Moisture, violent Fear, any very strong Passion; by too chilly a Course
+of Diet, with Indigestion; or too hot and irritating Diet; by Drinks
+cooled with Ice, by Exercise too long continued, and by unusual
+Watching. The Symptoms, occasioned by such Suppressions, are sometimes
+more violent than those, which preceded the first Appearance of the
+Discharge.
+
+Sec. 356. The great Facility with which this Evacuation may be suppressed,
+diminished, or disordered, by the Causes already assigned; the terrible
+Evils which are the Consequences of such Interruptions and
+Irregularities of them, seem to me very cogent Reasons to engage the Sex
+to use all possible Care, in every Respect, to preserve the Regularity
+of them; by avoiding, during their Approach and Continuance, every Cause
+that may prevent or lessen them. Would they be thoroughly persuaded, not
+solely by my Advice, but by that of their Mothers, their Relations,
+their Friends, and by their own Experience, of what great Importance it
+is to be very attentive to themselves, at those critical Times, I think
+there is not one Woman, who from the first, to the very last Appearance
+of them, would not conduct herself with the most scrupulous Regularity.
+
+Their Demeanour, in these Circumstances, very fundamentally interests
+their own Health, as well as that of their Children; and consequently
+their own Happiness, as well as that of their Husbands and Families.
+
+The younger and more delicate they are, Caution becomes the more
+necessary for them. I am very sensible a strong Country Girl is too
+negligent in regulating herself at those critical Seasons, and sometimes
+without any ill Consequence; but at another Time she may suffer severely
+for it: and I could produce a long List of many, who, by their
+Imprudence on such Occasions, have thrown themselves into the most
+terrible Condition.
+
+Besides the Caution with which Females should avoid these general
+Causes, just mentioned in the preceding Section, every Person ought to
+remember what has most particularly disagreed with her during that Term,
+and for ever constantly to reject it.
+
+Sec. 357. There are many Women whose Customs visit them without the
+slightest Impeachment of their Health: others are sensibly disordered on
+every Return of them; and to others again they are very tormenting, by
+the violent Cholics, of a longer or a shorter Duration, which precede or
+accompany them. I have known some of these violent Attacks last but some
+Minutes, and others which continued a few Hours. Nay some indeed have
+persisted for many Days, attended with Vomiting, Fainting, with
+Convulsions from excessive Pain, with Vomiting of Blood, Bleedings from
+the Nose, _&c._ which, in short, have brought them to the very Jaws of
+Death. So very dangerous a Situation requires the closest Attention;
+though, as it results from several and frequently very opposite Causes,
+it is impossible within the present Plan, to direct the Treatment that
+may be proper for each Individual. Some Women have the Unhappiness to be
+subject to these Symptoms every Month, from the first Appearance, to the
+final Termination, of these Discharges; except proper Remedies and
+Regimen, and sometimes a happy Child-birth, remove them. Others complain
+but now and then, every second, third, or fourth Month; and there are
+some again, who having suffered very severely during the first Months,
+or Years, after their first Eruptions, suffer no more afterwards. A
+fourth Number, after having had their Customs for a long Time, without
+the least Complaint, find themselves afflicted with cruel Pains, at
+every Return of them; if by Imprudence, or some inevitable Fatality,
+they have incurred any Cause, that has suppressed, diminished, or
+delayed them. This Consideration ought to suggest a proper Caution even
+to such, as generally undergo these Discharges, without Pain or
+Complaint: since all may be assured, that though they suffer no sensible
+Disorder at that Time, they are nevertheless more delicate, more
+impressible by extraneous Substances, more easily affected by the
+Passions of the Mind, and have also weaker Stomachs at these particular
+Periods.
+
+Sec. 358. These Discharges may also be sometimes too profuse in Quantity,
+in which Case the Patients become obnoxious to very grievous Maladies;
+into the Discussion of which however I shall not enter here, as they are
+much less frequent than those, arising from a Suppression of them.
+Besides which, in such Cases, Recourse may be had to the Directions I
+shall give hereafter, when I treat of that Loss of Blood, which may be
+expedient, during the Course of Gravidation or Pregnancy. See Sec. 365.
+
+Sec. 359. Finally, even when they are the most regular, after their
+Continuance for a pretty certain Number of Years (rarely exceeding
+thirty-five) they go off of their own Accord, and necessarily, between
+the Age of forty-five and fifty; sometimes even sooner, but seldom
+continuing longer: and this _Crisis_ of their ceasing is generally a
+very troublesome, and often a very dangerous, one for the Sex.
+
+Sec. 360. The Evils mentioned Sec. 352 may be prevented, by avoiding the
+Causes producing them; and, 1, by obliging young Maidens to use
+considerable Exercise; especially as soon as there is the least Reason
+to suspect the Approach of this Disorder, the _Chlorosis_, or Green
+Sickness.
+
+2, By watching them carefully, that they eat nothing unwholesome or
+improper; as there are scarcely any natural Substances, even among such
+as are most improper for them, and the most distasteful, which have not
+sometimes been the Objects of their sickly, their unaccountable
+Cravings. Fat Aliments, Pastry, farinaceous or mealy, and sour and
+watery Foods are pernicious to them. Herb-Teas, which are frequently
+directed as a Medicine for them, are sufficient to throw them into the
+Disorder, by increasing that Relaxation of their Fibres, which is a
+principal Cause of it. If they must drink any such Infusions, as
+medicated Drinks, let them be taken cold: but the best Drink for them is
+Water, in which red hot Iron has been extinguished.
+
+3, They must avoid hot sharp Medicines, and such as are solely intended
+to force down their Terms, which are frequently attended with very
+pernicious Consequences, and never do any good: and they are still the
+more hurtful, as the Patient is the younger.
+
+4, If the Malady increases, it will be necessary to give them some
+Remedies; but these should not be Purges, nor consist of Diluters, and
+Decoctions of Herbs, of Salts, and a Heap of other useless and noxious
+Ingredients; but they should take Filings of Iron, which is the most
+certain Remedy in such Cases. These Filings Should be of true simple
+Iron, and not from Steel; and Care should be taken that it be not rusty,
+in which State it has very little Effect.
+
+At the Beginning of this Distemper, and to young Girls, it is sufficient
+to give twenty Grains daily, enjoining due Exercise and a suitable Diet.
+When it prevails in a severer Degree, and the Patient is not so young, a
+Quarter of an Ounce may be safely ventured on: Certain Bitters or
+Aromatics may be advantageously joined to the Filings, which are
+numbered in the Appendix, 54, 55, 56, and constitute the most effectual
+Remedies in this Distemper, to be taken in the Form of Powder, of vinous
+Infusion, or of Electary. [82] When there is a just Indication to bring
+down the Discharge, the vinous Infusion No. 55 must be given, and
+generally succeeds: but I must again repeat it (as it should carefully
+be considered) that the Stoppage or Obstruction of this Discharge is
+frequently the Effect, not the Cause, of this Disease; and that there
+should be no Attempt to force it down, which in such a Case, may
+sometimes prove more hurtful than beneficial; since it would naturally
+return of its own Accord, on the Recovery, and with the Strength, of the
+Patient: as their Return should follow that of perfect Health, and
+neither can precede Health, nor introduce it. There are some Cases
+particularly, in which it would be highly dangerous to use hot and
+active Medicines, such Cases for Instance, as are attended with some
+Degree of Fever, a frequent Coughing, a Haemorrhage, or Bleeding, with
+great Leanness and considerable Thirst: all which Complaints should be
+removed, before any hot Medicines are given to force this Evacuation,
+which many very ignorantly imagine cures all other female Disorders; an
+Error, that has prematurely occasioned the Loss of many Womens' Lives.
+
+[82] The _French_ Word here, _Opiat_, is sometimes used by them for a
+     compound Medicine of the Consistence of an Electary; and cannot be
+     supposed, in this Place, to mean any Preparation, into which
+     _Opium_ enters. _K._
+
+Sec. 361. While the Patient is under a Course of these Medicines, she
+should not take any of those I have forbidden in the preceding Sections;
+and the Efficacy of these should also be furthered with proper Exercise.
+That in a Carriage is very healthy; Dancing is so too, provided it be
+not extended to an Excess. In Case of a Relapse in these Disorders, the
+Patient is to be treated, as if it were an original Attack.
+
+Sec. 362. The other Sort of Obstructions described Sec. 354 requires a very
+different Treatment. Bleeding, which is hurtful in the former Sort, and
+the Use, or rather Abuse, of which has thrown several young Women into
+irrecoverable Weaknesses, has often removed this latter Species, as it
+were, in a Moment. Bathing of the Feet, the Powders No. 20, and Whey
+have frequently succeeded: but at other Times it is necessary to
+accommodate the Remedies and the Method to each particular Case, and to
+judge of it from its own peculiar Circumstances and Appearances.
+
+Sec. 363. When these Evacuations naturally cease through Age (See Sec. 359) if
+they stop suddenly and all at once, and had formerly flowed very
+largely, Bleeding must, 1, necessarily be directed, and repeated every
+six, every four, or even every three Months.
+
+2, The usual Quantity of Food should be somewhat diminished, especially
+of Flesh, of Eggs and of strong Drink.
+
+3, Exercise should be increased.
+
+4, The Patient should frequently take, in a Morning fasting, the Powder
+No. 24, which is very beneficial in such Cases; as it moderately
+increases the natural Excretions by Stool, Urine and Perspiration; and
+thence lessens that Quantity of Blood, which would otherwise
+superabound.
+
+Nevertheless, should this total Cessation of the monthly Discharge be
+preceded by, or attended with, any extraordinary Loss of Blood, which is
+frequently the Case, Bleeding is not so necessary; but the Regimen and
+Powder just directed are very much so; to which the Purge No. 23 should
+now and then be joined, at moderate Intervals. The Use of astringent
+Medicines at this critical Time might dispose the Patient to a Cancer of
+the Womb.
+
+Many Women die about this Age, as it is but too easy a Matter to injure
+them then; a Circumstance that should make them very cautious and
+prudent in the Medicines they recur to. On the other Hand it also
+frequently happens, that their Constitutions alter for the better, after
+this critical Time of Life; their Fibres grow stronger; they find
+themselves sensibly more hearty and hardy; many former slight
+Infirmities disappear, and they enjoy a healthy and happy old Age. I
+have known several who threw away their Spectacles at the Age of
+fifty-two, or fifty-three, which they had used five or six Years before.
+
+The Regimen I have just directed, the Powder No. 24, and the Potion No.
+32, agree very well in almost all inveterate Discharges (I speak of the
+female Peasantry) at whatever Time of Life.
+
+
+
+ _Of Disorders attending Gravidation, or the Term of going with Child._
+
+
+Sec. 364. Gravidation is generally a less ailing or unhealthy State in the
+Country, than in very populous Towns. Nevertheless Country Women are
+subject, as well as Citizens, to Pains of the Stomach, to vomiting in a
+Morning, to Head-ach and Tooth-ach; but these Complaints very commonly
+yield to Bleeding, which is almost the only Remedy necessary [83] for
+pregnant Women.
+
+[83] Too great a Fulness of Blood is undoubtedly the Cause of all these
+     Complaints; but as there are different Methods of opposing this
+     Cause, the gentlest should always be preferred; nor should the
+     Constitution become habituated to such Remedies, as might either
+     impair the Strength of the Mother, or of her Fruit. Some Expedients
+     therefore should be thought of, that may compensate for the Want of
+     Bleeding, by enjoining proper Exercise in a clear Air, with a less
+     nourishing, and a less juicy Diet. _E. L._
+
+     This Note might have its Use sometimes, in the Cases of such
+     delicate and hysterical, yet pregnant Women, as are apt to suffer
+     from Bleeding, or any other Evacuation, though no ways immoderate.
+     But it should have been considered, that Dr. _Tissot_ was
+     professedly writing here to hearty active Country Wives, who are
+     very rarely thus constituted; and whom he might be unwilling to
+     confuse with such multiplied Distinctions and Directions, as would
+     very seldom be necessary, and might sometimes prevent them from
+     doing what was so. Besides which, this Editor might have seen, our
+     Author has hinted at such Cases very soon after. _K._
+
+Sec. 365. Sometimes after carrying too heavy Burthens; after too much or
+too violent Work; after receiving excessive Jolts, or having had a Fall,
+they are subject to violent Pains of the Loins, which extend down to
+their Thighs, and terminate quite at the Bottom of the Belly; and which
+commonly import, that they are in Danger of an Abortion, or Miscarrying.
+
+To prevent this Consequence, which is always dangerous, they should, 1,
+immediately go to Bed; and if they have not a Mattrass, they should lie
+upon a Bed stuffed with Straw, a Feather-bed being very improper in such
+Cases. They should repose, or keep themselves quite still in this
+Situation for several Days, not stirring, and speaking as little as
+possible.
+
+2, They should directly lose eight or nine Ounces of Blood from the Arm.
+
+3, They should not eat Flesh, Flesh-broth, nor Eggs; but live solely on
+Soups made of farinaceous or mealy Substances.
+
+4, They should take every two Hours half a Paper of the Powder No. 20;
+and should drink nothing but the Ptisan No. 2.
+
+Some sanguine robust Women are very liable to miscarry at a certain
+Time, or Stage, of their Pregnancy. This may be obviated by their
+bleeding some Days before that Time approaches, and by their observing
+the Regimen I have advised. But this Method would avail very little for
+delicate Citizens, who miscarry from a very different Cause; and whose
+Abortions are to be prevented by a very different Treatment.
+
+
+
+                     _Of Delivery, or Child-birth._
+
+
+Sec. 366. It has been observed that a greater Proportion of Women die in
+the Country in, or very speedily after, their Delivery, and that from
+the Scarcity of good Assistance, and the great Plenty of what is bad;
+and that a greater Proportion of those in Cities die after their Labours
+are effected, by a Continuance of their former bad Health.
+
+The Necessity there is for better instructed, better qualified Midwives,
+through a great Part of _Swisserland_, is but too manifest an
+Unhappiness, which is attended with the most fatal Consequences, and
+which merits the utmost Attention of the Government.
+
+The Errors which are incurred, during actual Labour, are numberless, and
+too often indeed are also irremediable. It would require a whole Book,
+expressly for that Purpose (and in some Countries there are such) to
+give all the Directions that are necessary, to prevent so many
+Fatalities: and it would be as necessary to form a sufficient Number of
+well-qualified Midwives to comprehend, and to observe them; which
+exceeds the Plan of the Work I have proposed. I shall only mark out one
+of the Causes, and the most injurious one on this Occasion: This is the
+Custom of giving hot irritating Things, whenever the Labour is very
+painful, or is slow; such as Castor, or its Tincture, Saffron, Sage,
+Rue, Savin, Oil of Amber, Wine, Venice Treacle, Wine burnt with Spices,
+Coffee, Brandy, Aniseed-Water, Walnut-Water, Fennel-Water, and other
+Drams or strong Liquors. All these Things are so many Poisons in this
+Respect, which, very far from promoting the Woman's Delivery, render it
+more difficult by inflaming the Womb (which cannot then so well contract
+itself) and the Parts, through which the Birth is to pass, in
+Consequence of which they swell, become more straitened, and cannot
+yield or be dilated. Sometimes these stimulating hot Medicines also
+bring on Haemorrhages, which prove mortal in a few Hours.
+
+Sec. 367. A considerable Number, both of Mothers and Infants, might be
+preserved by the directly opposite Method. As soon as a Woman who was in
+very good Health, just before the Approach of her Labour, being robust
+and well made, finds her Travail come on, and that it is painful and
+difficult; far from encouraging those premature Efforts, which are
+always destructive; and from furthering them by the pernicious Medicines
+I have just enumerated, the Patient should be bled in the Arm, which
+will prevent the Swelling and Inflammation; asswage the Pains; relax the
+Parts, and dispose every thing to a favourable Issue.
+
+During actual Labour no other Nourishment should be allowed, except a
+little Panada every three Hours, and as much Toast and Water, as the
+Woman chuses.
+
+Every fourth Hour a Glyster should be given, consisting of a Decoction
+of Mallows and a little Oil. In the Intervals between these Glysters she
+should be set over a kind of Stove, or in a pierced easy Chair,
+containing a Vessel in which there is some hot Water: the Passage should
+be gently rubbed with a little Butter; and Stapes wrung out of a
+Fomentation of simple hot Water, which is the most efficacious of any,
+should be applied over the Belly.
+
+The Midwives, by taking this Method, are not only certain of doing no
+Mischief, but they also allow Nature an Opportunity of doing Good: as a
+great many Labours, which seem difficult at time, terminate happily; and
+this safe and unprecipitate Manner of proceeding at least affords Time
+to call in further Assistance. Besides, the Consequences of such
+Deliveries are healthy and happy; when by pursuing the heating
+oppressing Practice, even though the Delivery be effected, both Mother
+and Infant have been so cruelly, though undesignedly, tormented, that
+both of them frequently perish.
+
+Sec. 368. I acknowledge these Means are insufficient, when the Child is
+unhappily situated in the Womb; or when there is an embarrassing
+Conformation in the Mother: though at least they prevent the Case from
+proving worse, and leave Time for calling in Men-Midwives, or other
+female ones, who may be better qualified.
+
+I beg leave again to remind the Midwives, that they should be very
+cautious of urging their Women to make any forced Efforts to forward the
+Birth, which are extremely injurious to them, and which may render a
+Delivery very dangerous and embarrassing, that might otherwise have been
+happily effected: and I insist the more freely on the Danger attending
+these unreasonable Efforts, and on the very great Importance of
+Patience, as the other very pernicious Practice is become next to
+universal amongst us.
+
+The Weakness, in which the labouring Woman appears, makes the
+By-standers fearful that she will not have Strength enough to be
+delivered; which they think abundantly justifies them in giving her
+Cordials; but this Way of Reasoning is very weak and chimerical. Their
+Strength, on such Occasions, is not so very speedily dissipated: the
+small light Pains sink them, but in Proportion as the Pains become
+stronger, their Strength arises; being never deficient, when there is no
+extraordinary and uncommon Symptom; and we may reasonably be assured,
+that in a healthy, well formed Woman, meer Weakness never prevents a
+Delivery.
+
+
+
+            _Of the Consequences of Labour, or Childbirth._
+
+
+Sec. 369. The most usual Consequences of Childbirth in the Country are, 1,
+An excessive Haemorrhage. 2, An Inflammation of the Womb. 3, A sudden
+Suppression of the _Lochia_, or usual Discharges after Delivery. And, 4,
+the Fever and other Accidents, resulting from the Milk.
+
+Excessive Bleedings or Floodings, should be treated according to the
+Manner directed Sec. 365: and if they are very excessive, Folds of Linen,
+which have been wrung out of a Mixture of equal Parts of Water and
+Vinegar, should be applied to the Belly, the Loins, and the Thighs:
+these should be changed for fresh moist ones, as they dry; and should be
+omitted, as soon as the Bleeding abates.
+
+Sec. 370. The Inflammation of the Womb is discoverable by Pains in all the
+lower Parts of the Belly; by a Tension or Tightness of the whole; by a
+sensible Increase of Pain upon touching it; a kind of red Stain or Spot,
+that mounts to the Middle of the Belly, as high as the Navel; which
+Spot, as the Disease increases, turns black, and then is always a mortal
+Symptom; by a very extraordinary Degree of Weakness; an astonishing
+Change of Countenance; a light _Delirium_ or Raving; a continual Fever
+with a weak and hard Pulse; sometimes incessant Vomitings; a frequent
+Hiccup; a moderate Discharge of a reddish, stinking, sharp Water;
+frequent Urgings to go to Stool; a burning kind of Heat of Urine; and
+sometimes an entire Suppression of it.
+
+Sec. 371. This most dangerous and frequently mortal Disease should be
+treated like inflammatory ones. After Bleeding, frequent Glysters of
+warm Water must by no Means be omitted; some should also be injected
+into the Womb, and applied continually over the Belly. The Patient may
+also drink continually, either of simple Barley-Water, with a Quarter of
+an Ounce of Nitre in every Pot of it, or of Almond Milk No. 4.
+
+Sec. 372. The total Suppression of the _Lochia_, the Discharges after
+Labour, which proves a Cause of the most violent Disorders, should be
+treated exactly in the same Manner: but if unhappily hot Medicines have
+been given, in order to force them down, the Case will very generally
+prove a most hopeless one.
+
+Sec. 373. If the Milk-fever run very high, the Barley Ptisan directed Sec.
+371, and Glysters, with a very light Diet, consisting only of Panada, or
+made of some other farinaceous Substances, and very thin, very generally
+remove it.
+
+Sec. 374. Delicate infirm Women, who have not all the requisite and
+necessary Attendance they want; and such as from Indigence are obliged
+to work too soon, are exposed to many Accidents, which frequently arise
+from a Want of due Perspiration, and an insufficient Discharge of the
+_Lochia_; and hence, the Separation of the Milk in their Breasts being
+disturbed, there are milky Congestions, or Knots as it were, which are
+always very painful and troublesome, and especially when they are formed
+more inwardly. They often happen on the Thighs, in which Case the Ptisan
+No. 58 is to be drank, and the Pultices No. 59 must be applied. These
+two Remedies gradually dissipate and remove the Tumour, if that may be
+effected without Suppuration. But if that proves impossible, and _Pus_,
+or Matter, is actually formed, a Surgeon must open the Abscess, and
+treat it like any other.
+
+Sec. 375. Should the Milk coagulate, or curdle as it were, in the Breast,
+it is of the utmost Importance immediately to attenuate or dissolve that
+Thickness, which would otherwise degenerate into a Hardness and prove a
+_Scirrhus_; and from a _Scirrhus_ in Process of Time a Cancer, that most
+tormenting and cruel Distemper.
+
+This horrible Evil however may be prevented by an Application to these
+small Tumours, as soon as ever they appear, For this Purpose nothing is
+more effectual than the Prescriptions No. 57 and 60; but under such
+menacing Circumstances, it is always prudent to take the best Advice, as
+early as possible.
+
+From the Moment these hard Tumours become excessively and obstinately
+so, and yet without any Pain, we should abstain from every Application,
+all are injurious; and greasy, sharp, resinous and spirituous ones
+speedily change the _Scirrhus_ into a Cancer. Whenever it becomes
+manifestly such, all Applications are also equally pernicious, except
+that of No. 60. Cancers have long been thought and found incurable; but
+within a few Years past some have been cured by the Remedy No. 57; which
+nevertheless is not infallible, though it should always be tried. [84]
+
+[84] The Use of Hemlock, which has been tried at _Lyons_, by all who
+     have had cancerous Patients, having been given in very large Doses,
+     has been attended with no Effect there, that merited the serious
+     Attention of Practitioners. Many were careful to obtain the Extract
+     from _Vienna_, and even to procure it from Dr. _Storck_ himself.
+     But now it appears to have had so little Success, as to become
+     entirely neglected. _E. L._
+
+     Having exactly translated in this Place, and in the Table of
+     Remedies, our learned Author's considerable Recommendation of the
+     Extract of Hemlock in Cancers, we think it but fair, on the other
+     Hand, to publish this Note of his Editor's against it; that the
+     real Efficacy or Inefficacy of this Medicine may at length be
+     ascertained, on the most extensive Evidence and Experience. As far
+     as my own Opportunities and Reflections, and the Experience of many
+     others, have instructed me on this Subject, it appears clear to
+     myself, that though the Consequences of it have not been constantly
+     unsuccessful with us, yet its Successes have come very short of its
+     Failures. Nevertheless, as in all such Cancers, every other
+     internal Medicine almost universally fails, we think with Dr.
+     _Tissot_ it should always be tried (from the meer Possibility of
+     its succeeding in some particular Habit and Circumstances) at least
+     till longer Experience shall finally determine against it. _K._
+
+Sec. 376. The Nipples of Women, who give Milk, are often fretted or
+excoriated, which proves very severely painful to them. One of the best
+Applications is the most simple Ointment, being a Mixture of Oil and Wax
+melted together; or the Ointment No. 66. Should the Complaint prove very
+obstinate, the Nurse ought to be purged, which generally removes it.
+
+
+
+
+                           __Chapter XXVII.__
+
+
+
+               _Medical Directions concerning Children._
+
+
+                             __Sect.__ 377.
+
+The Diseases of Children, and every Thing relating to their Health, are
+Objects which generally seem to have been too much neglected by
+Physicians; and have been too long confided to the Conduct of the most
+improper Persons for such a Charge. At the same Time it must be admitted
+their Health is of no little Importance; their Preservation is as
+necessary as the Continuance of the human Race; and the Application of
+the Practice of Physick to their Disorders is susceptible of nearer
+Approaches to Perfection, than is generally conceived. It seems to have
+even some Advantage over that Practice which regards grown Persons; and
+it consists in this, that the Diseases of Children are more simple, and
+less frequently complicated than those of Adults.
+
+It may be said indeed, they cannot make themselves so well understood,
+and meer Infants certainly not at all. This is true in Fact to a certain
+Degree, but not rigidly true; for though they do not speak our Language,
+they have one which we should contrive to understand. Nay every
+Distemper may be said, in some Sense, to have a Language of its own,
+which an attentive Physician will learn. He should therefore use his
+utmost Care to understand that of Infants, and avail himself of it, to
+increase the Means of rendering them healthy and vigorous, and to cure
+them of the different Distempers to which they are liable. I do not
+propose actually to compleat this Task myself, in all that Extent it may
+justly demand; but I shall set forth the principal Causes of their
+Distempers, and the general Method of treating them. By this Means I
+shall at least preserve them from some of the Mischiefs which are too
+frequently done them; and the lessening such Evils as Ignorance, or
+erroneous Practice, occasions, is one of the most important Purposes of
+the present Work.
+
+Sec. 378. Nearly all the Children who die before they are one Year, and
+even two Years, old, die _with_ Convulsions: People say they died _of_
+them, which is partly true, as it is in Effect, the Convulsions that
+have destroyed them. But then these very Convulsions are the
+Consequences, the Effects, of other Diseases, which require the utmost
+Attention of those, who are entrusted with the Care and Health of the
+little Innocents: as an effectual Opposition to these Diseases, these
+morbid Causes, is the only Means of removing the Convulsions. The four
+principal known Causes are, the _Meconium_; the Excrements contained in
+the Body of the Infant, at the Birth; _Acidities_, or sharp and sour
+Humours; the Cutting of the Teeth, and Worms. I shall treat briefly of
+each.
+
+
+
+                           _Of the Meconium._
+
+
+Sec.379. The Stomach and Guts of the Infant, at its Entrance into the
+World, are filled with a black Sort of Matter, of a middling
+Consistence, and very viscid or glutinous, which is called the
+_Meconium_. It is necessary this Matter should be discharged before the
+Infant sucks, since it would otherwise corrupt the Milk, and, becoming
+extremely sharp itself, there would result from their Mixture a double
+Source of Evils, to the Destruction of the Infant.
+
+The Evacuation of this Excrement is procured, 1, By giving them no Milk
+at all for the first twenty-four Hours of their Lives. 2, By making them
+drink during that Time some Water, to which a little Sugar or Honey must
+be added, which will dilute this _Meconium_, and promote the Discharge
+of it by Stool, and sometimes by vomiting.
+
+To be the more certain of expelling all this Matter, they should take
+one Ounce of Compound Syrup [85] of Succory, which should be diluted
+with a little Water, drinking up this Quantity within the Space of four
+or five Hours. This Practice is a very beneficial one, and it is to be
+wished it were to become general. This Syrup is greatly preferable to
+all others, given in such Cases, and especially to Oil of Almonds.
+
+[85] This Method (says the Editor and Annotator of _Lyons_) is useful,
+     whenever the Mother does not suckle her Child. Art is then obliged
+     to prove a Kind of Substitute to Nature, though always a very
+     imperfect one. But when a Mother, attentive to her own true
+     Interest, as well as her Infant's, and, listening to the Voice of
+     Nature and her Duty, suckles it herself, these Remedies [he adds]
+     seem hurtful, or at least, useless. The Mother should give her
+     Child the Breast as soon as she can. The first Milk, the
+     _Colostrum_, or _Strippings_, as it is called in Quadrupeds, which
+     is very serous or watery, will be serviceable as a Purgative; it
+     will forward the Expulsion of the _Meconium_, prove gradually
+     nourishing, and is better than Biscuits, or Panada, which (he
+     thinks) are dangerous in the first Days after the Birth. _E. L._
+
+     This Syrup of Succory being scarcely ever prepared with us, though
+     sufficiently proper for the Use assigned it here, I have retained
+     the preceding Note, as the Author of it directs these _Strippings_,
+     for the same Purpose, with an Air of certain Experience; and as
+     this Effect of them seems no Ways repugnant to the physical Wisdom
+     and Oeconomy of Nature, on such important Points. Should it in fact
+     be their very general Operation, it cannot be unknown to any Male
+     or Female Practitioner in Midwifery, and may save poor People a
+     little Expence, which was one Object of our humane Author's Plan.
+     The Oil Of _Ricinus_, corruptly called _Castor_ Oil (being
+     expressed from the Berries of the _Palma Christi_) is particularly
+     recommended by some late medical Writers from _Jamaica_, _&c._ for
+     this Purpose of expelling the _Meconium_, to the Quantity of a
+     small Spoonful. These Gentlemen also consider it as the most
+     proper, and almost specific Opener, in the dry Belly-ach of that
+     torrid Climate, which tormenting Disease has the closest Affinity
+     to the _Miserere_, or Iliac Passion, of any I have seen. The
+     Annotator's Objection to our Author's very _thin light_ Panada,
+     seems to be of little Weight. _K._
+
+Should the great Weakness of the Child seem to call for some
+Nourishment, there would be no Inconvenience in allowing a little
+Biscuit well boiled in Water, which is pretty commonly done, or a little
+very thin light Panada.
+
+
+
+                   _Of Acidities, or sharp Humours._
+
+
+Sec. 380. Notwithstanding the Bodies of Children have been properly emptied
+speedily after their Birth, yet the Milk very often turns sour in their
+Stomachs, producing Vomitings, violent Cholics, Convulsions, a
+Looseness, and even terminating in Death. There are but two Purposes to
+be pursued in such Cases, which are to carry off the sour or sharp
+Humours, and to prevent the Generation of more. The first of these
+Intentions is best effected by the Syrup of Succory [86] just mentioned.
+
+[86] Or, for Want of it, the solutive Syrup of Roses. _K._
+
+The Generation of further Acidities is prevented, by giving three Doses
+daily, if the Symptoms are violent, and but two, or even one only, if
+they are very moderate, of the Powder No. 61, drinking after it Bawm
+Tea, or a Tea of Lime-tree Leaves.
+
+Sec. 381. It has been a Custom to load Children with Oil of Almonds, [87]
+as soon as ever they are infested with Gripes: but it is a pernicious
+Custom, and attended with very dangerous Consequences. It it very true
+that this Oil sometimes immediately allays the Gripes, by involving, or
+sheathing up, as it were, the acid Humours, and somewhat blunting the
+Sensibility of the Nerves. But it proves only a palliative Remedy, or
+asswaging for a Time, which, far from removing, increases the Cause,
+since it becomes sharp and rancid itself; whence the Disorder speedily
+returns, and the more Oil the Infant takes, it is griped the more. I
+have cured some Children of such Disorders, without any other Remedy,
+except abstaining from Oil, which weakens their Stomachs, whence their
+Milk is less perfectly, and more slowly digested, and becomes more
+easily soured. Besides this Weakness of the Stomach, which thus
+commences at that very early Age, has sometimes an unhealthy Influence
+on the Constitution of the Child, throughout the Remainder of his Life.
+
+[87] The _Magnesia_ is an excellent Substitute in Children, for these
+     Oils Dr. _Tissot_ so justly condemns here. _K._
+
+A free and open Belly is beneficial to Children; now it is certain that
+the Oil very often binds them, in Consequence of its diminishing the
+Force and Action of the Bowels. There is scarcely any Person, who cannot
+observe this Inconvenience attending it; notwithstanding they all
+continue to advise and to give it, to obtain a very different Purpose:
+But such is the Power of Prejudice in this Case, and in so many others;
+People are so strongly pre-possessed with a Notion, that such a Medicine
+must produce such an Effect; that its never having produced it avails
+nothing with them, their Prejudice still prevails; they ascribe its Want
+of Efficacy to the Smallness of the Doses; these are doubled then, and
+notwithstanding its bad Effects are augmented, their obstinate Blindness
+continues.
+
+This Abuse of the Oil also disposes their Child to knotty hard Tumours,
+and at length often proves the first Cause of some Diseases of the Skin,
+whose Cure is extremely difficult.
+
+Hence it is evident, this Oil should be used on such Occasions but very
+seldom; and that it is always very injudicious to give it in Cholics,
+which arise from sharp and sour Humours in the Stomach, or in the
+Bowels.
+
+Sec. 382. Infants are commonly most subject to such Cholics during their
+earliest Months; after which they abate, in Proportion as their Stomachs
+grow stronger. They may be relieved in the Fit by Glysters of a
+Decoction of Chamomile Flowers, in which a Bit of Soap of the Size of a
+Hazel Nut is dissolved. A Piece of Flanel wrung out of a Decoction of
+Chamomile Flowers, with the Addition of some Venice Treacle, and applied
+hot over the Stomach and on the Belly, is also very beneficial, and
+relieving.
+
+Children cannot always take Glysters, the Continuance of which
+Circumstance might be dangerous to them; and every one is acquainted
+with the common Method of substituting Suppositories to them, whether
+they are formed of the smooth and supple Stalks of Vines, _&c._ of Soap,
+or of Honey boiled up to a proper Consistence.
+
+But one of the most certain Means to prevent these Cholics, which are
+owing to Children's not digesting their Milk, is to move and exercise
+them as much as possible; having a due Regard however to their tender
+Time of Life.
+
+Sec. 383. Before I proceed to the third Cause of the Diseases of Children,
+which is, the Cutting of their Teeth, I must take Notice of the first
+Cares their Birth immediately requires, that is the Washing of them the
+first Time, meerly to cleanse, and afterwards, to strengthen them.
+
+
+
+                         _Of washing Children._
+
+
+Sec. 384. The whole Body of an Infant just born is covered with a gross
+Humour, which is occasioned by the Fluids, in which it was suspended in
+the Womb. There is a Necessity to cleanse it directly from this, for
+which nothing is so proper as a Mixture of one third Wine, and two
+thirds Water; Wine alone would be dangerous. This Washing may be
+repeated some Days successively; but it is a bad Custom to continue to
+wash them thus warm, the Danger of which is augmented by adding some
+Butter to the Wine and Water, which is done too often. If this gross
+Humour, that covers the Child, seems more thick and glutinous than
+ordinary, a Decoction of Chamomile Flowers, with a little Bit of Soap,
+may be used to remove it. The Regularity of Perspiration is the great
+Foundation of Health; to procure this Regularity the Teguments, the
+Skin, must be strengthened; but warm Washing tends to weaken it. When it
+is of a proper Strength it always performs its Functions; nor is
+Perspiration disordered sensibly by the Alteration of the Weather. For
+this Reason nothing should be omitted, that may fix it in this State;
+and to attain so important an Advantage, Children should be washed, some
+few Days after their Birth, with cold Water, in the State it is brought
+from the Spring.
+
+For this Purpose a Spunge is employed, with which they begin, by washing
+first the Face, the Ears, the back Part of the Head (carefully avoiding
+the [88] _Fontanelle_, or Mould of the Head) the Neck, the Loins, the
+Trunck of the Body, the Thighs, Legs and Arms, and in short every Spot.
+This Method which has obtained for so many Ages, and which is practised
+at present by many People, who prove very healthy, will appear shocking
+to several Mothers; they would be afraid of killing their Children by
+it; and would particularly fail of Courage enough to endure the Cries,
+which Children often make, the first Time they are washed. Yet if their
+Mothers truly love them, they cannot give a more substantial Mark of
+their Tenderness to them, than by subduing their Fears and their
+Repugnance, on this important Head.
+
+[88] That Part of the Head where a Pulsation may be very plainly felt,
+     where the Bones are less hard, and not as yet firmly joined with
+     those about them.
+
+Weakly Infants [89] are those who have the greatest Need of being
+washed: such as are remarkably strong may be excused from it; and it
+seems scarcely credible (before a Person has frequently seen the
+Consequences of it) how greatly this Method conduces to give, and to
+hasten on, their Strength. I have had the Pleasure to observe, since I
+first endeavoured to introduce the Custom among us, that several of the
+most affectionate and most sensible Mothers, have used it with the
+greatest Success. The Midwives, who have been Witnesses of it; the
+Nurses and the Servants of the Children, whom they have washed, publish
+it abroad; and should the Custom become as general, as every thing seems
+to promise it will, I am fully persuaded, that by preserving the Lives
+of a great Number of Children, it will certainly contribute to check the
+Progress of Depopulation.
+
+[89] There is however a certain Degree of Weakness, which may very
+     reasonably deter us from this Washing; as when the Infant
+     manifestly wants Heat, and needs some Cordial and frequent
+     Frictions, to prevent its expiring from downright Feebleness; in
+     which Circumstances Washing must be hurtful to it. _Tissot._
+
+They should be washed very regularly every Day, in every Season, and
+every Sort of Weather; and in the fine warm Season they should be
+plunged into a large Pail of Water, into the Basins around Fountains, in
+a Brook, a River, or a Lake.
+
+After a few Days crying, they grow so well accustomed to this Exercise,
+that it becomes one of their Pleasures; so that they laugh all the Time
+of their going through it.
+
+The first Benefit of this Practice is, as I have already said, the
+keeping up their Perspiration, and rendering them less obnoxious to the
+Impressions of the Air and Weather: and it is also in Consequence of
+this first Benefit, that they are preserved from a great Number of
+Maladies, especially from knotty Tumours, often called Kernels; from
+Obstructions; from Diseases of the Skin, and from Convulsions, its
+general Consequence being to insure them firm, and even robust Health.
+
+Sec. 385. But Care should be taken not to prevent, or, as it were to undo,
+the Benefit this Washing procures them, by the bad Custom of keeping
+them too hot. There is not a more pernicious one than this, nor one that
+destroys more Children. They should be accustomed to light Cloathing by
+Day, and light Covering by Night, to go with their Heads very thinly
+covered, and not at all in the Day-time, after their attaining the Age
+of two Years. They should avoid sleeping in Chambers that are too hot,
+and should live in the open Air, both in Summer and Winter, as much as
+possible. Children who have been kept too hot in such Respects, are very
+often liable to Colds; they are weakly, pale, languishing, bloated and
+melancholy. They are subject to hard knotty Swellings, a Consumption,
+all Sorts of languid Disorders, and either die in their Infancy, or only
+grow up into a miserable valetudinary Life; while those who are washed
+or plunged into cold Water, and habitually exposed to the open Air, are
+just in the opposite Circumstances.
+
+Sec. 386. I must further add here, that Infancy is not the only Stage of
+Life, in which cold Bathing is advantagious. I have advised it with
+remarkable Success to Persons of every Age, even to that of seventy: and
+there are two Kinds of Diseases, more frequent indeed in Cities than in
+the Country, in which cold Baths succeed very greatly; that is, in
+Debility, or Weakness of the Nerves; and when Perspiration is
+disordered, when Persons are fearful of every Breath of Air, liable to
+Defluxions or Colds, feeble and languishing, the cold Bath
+re-establishes Perspiration; restores Strength to the Nerves; and by
+that Means dispels all the Disorders, which arise from these two Causes,
+in the animal Oeconomy. They should be used before Dinner. But in the
+same Proportion that cold Bathing is beneficial, the habitual Use, or
+rather Abuse, of warm Bathing is pernicious; they dispose the Persons
+addicted to them to the Apoplexy; to the Dropsy; to Vapours, and to the
+hypochondriacal Disease: and Cities, in which they are too frequently
+used, become, in some Measure, desolate from such Distempers.
+
+
+
+                     _Of the Cutting of the Teeth._
+
+
+Sec. 387. Cutting of the Teeth is often very tormenting to Children, some
+dying under the severe Symptoms attending it. If it proves very painful,
+we should during that Period, 1, Keep their Bellies open by Glysters
+consisting only of a simple Decoction of Mallows: but Glysters are not
+necessary, if the Child, as it sometimes happens then, has a Purging.
+
+2, Their ordinary Quantity of Food should be lessened for two Reasons;
+first, because the Stomach is then weaker than usual; and next, because
+a small Fever sometimes accompanies the Cutting.
+
+3, Their usual Quantity of Drink should be increased a little; the best
+for them certainly is an Infusion of the Leaves or Flowers, of the Lime
+or Linden-tree, to which a little Milk may be added.
+
+4, Their Gums should frequently be rubbed with a Mixture of equal Parts
+of Honey, and Mucilage of Quince-seeds; and a Root of March-Mallows, or
+of Liquorice, may be given them to chew.
+
+It frequently happens, that during Dentition, or the Time of their
+toothing, Children prove subject to Knots or Kernels.
+
+
+
+                              _Of Worms._
+
+
+Sec. 388. The _Meconium_, the Acidity of the Milk, and Cutting of the Teeth
+are the three great Causes of the Diseases of Children. There is also a
+fourth, Worms, which is likewise very often pernicious to them; but
+which, nevertheless, is not, at least not near so much, a general Cause
+of their Disorders, as it is generally supposed, when a Child exceeding
+two Years of Age proves sick. There are a great Variety of Symptoms,
+which dispose People to think a Child has Worms; though there is but one
+that demonstrates it, which is discharging them upwards or downwards.
+There is great Difference among Children too in this Respect, some
+remaining healthy, though having several Worms, and others being really
+sick with a few.
+
+They prove hurtful, 1, by obstructing the Guts, and compressing the
+neighbouring Bowels by their Size. 2, By sucking up the Chyle intended
+to nourish the Patient, and thus depriving him of his very Substance as
+well as Subsistence: and, 3, by irritating the Guts and even [90]
+gnawing them.
+
+[90] I have seen a Child about three Years old, whose Navel, after
+     swelling and inflaming, suppurated, and through a small Orifice
+     (which must have communicated with the Cavity of the Gut or the
+     Belly) discharged one of these Worms we call _teretes_, about three
+     Inches long. He had voided several by Stool, after taking some
+     vermifuge Medicines. The Fact I perfectly remember; and to the best
+     of my Recollection, the Ulcer healed some Time after, and the
+     Orifice closed: but the Child died the following Year of a putrid
+     Fever, which might be caused, or was aggravated, by Worms. _K._
+
+Sec. 389. The Symptoms which make it probable they are infested with Worms,
+are slight, frequent and irregular Cholics; a great Quantity of Spittle
+running off while they are fasting; a disagreeable Smell of their
+Breath, of a particular Kind, especially in the Morning; a frequent
+Itchiness of their Noses which makes them scratch or rub them often; a
+very irregular Appetite, being sometimes voracious, and at other Times
+having none at all: Pains at Stomach and Vomitings: sometimes a costive
+Belly; but more frequently loose Stools of indigested Matter; the Belly
+rather larger than ordinary, the rest of the Body meagre; a Thirst which
+no Drink allays; often great Weakness, and some Degree of Melancholy.
+The Countenance has generally an odd unhealthy Look, and varies every
+Quarter of an Hour; the Eyes often look dull, and are surrounded with a
+Kind of livid Circle: the White of the Eye is sometimes visible while
+they sleep, their Sleep being often attended with terrifying Dreams or
+_Deliriums_, and with continual Startings, and Grindings of their Teeth.
+Some Children find it impossible to be at Rest for a single Moment.
+Their Urine is often whitish, I have seen it from some as white as Milk.
+They are afflicted with Palpitations, Swoonings, Convulsions, long and
+profound Drowsiness; cold Sweats which come on suddenly; Fevers which
+have the Appearances of Malignity; Obscurities and even Loss of Sight
+and of Speech, which continue for a considerable Time; Palsies either of
+their Hands, their Arms, or their Legs, and Numbnesses. Their Gums are
+in a bad State, and as though they had been gnawed or corroded: they
+have often the Hickup, a small and irregular Pulse, Ravings, and, what
+is one of the least doubtful Symptoms, frequently a small dry Cough; and
+not seldom a Mucosity or Sliminess in their Stools: sometimes very long
+and violent Cholics, which terminate in an Abscess on the Outside of the
+Belly, from whence Worms issue. (See Note [90] p. 388.)
+
+Sec. 390. There are a great Multitude of Medicines against Worms. The [91]
+_Grenette_ or Worm-seed, which is one of the commonest, is a very good
+one. The Prescription No. 62, is also a very successful one; and the
+Powder No. 14 is one of the best. Flower of Brimstone, the Juice of
+_Nasturtium_, or Cresses, Acids and Honey Water have often been very
+serviceable; but the first three I have mentioned, succeeded by a Purge,
+are the best. No. 63 is a purging Medicine, that the most averse and
+difficult Children may easily take. But when, notwithstanding these
+Medicines, the Worms are not expelled, it is necessary to take Advice of
+some Person qualified to prescribe more efficacious ones. This is of
+considerable Importance, because, notwithstanding a great Proportion of
+Children may probably have Worms, and yet many of them continue in good
+Health, there are, nevertheless, some who are really killed by Worms,
+after having been cruelly tormented by them for several Years.
+
+[91] This Word occurs in none of the common Dictionaries; but suspecting
+     it for the _Semen Santonici_ of the Shops, I find the learned Dr.
+     _Bikker_ has rendered it so, in his very well received Translation
+     of this valuable Work into _Low Dutch_. _K._
+
+A Disposition to breed Worms always shews the Digestions are weak and
+imperfect; for which Reason Children liable to Worms should not be
+nourished with Food difficult to digest. We should be particularly
+careful not to stuff them with Oils, which, admitting such Oils should
+immediately kill some of their Worms, do yet increase that Cause, which
+disposes them to generate others. A long continued Use of Filings of
+Iron is the Remedy, that most effectually destroys this Disposition to
+generate Worms.
+
+
+
+                           _Of Convulsions._
+
+
+Sec. 391. I have already said, Sec. 378, that the Convulsions of Children are
+almost constantly the Effect of some other Disease, and especially of
+some of the four I have mentioned. Some other, though less frequent
+Causes, sometimes occasion them, and these may be reduced to the
+following.
+
+The first of them is the corrupted Humours, that often abound in their
+Stomachs and Intestines; and which, by their Irritation, produce
+irregular Motions throughout the whole System of the Nerves, or at least
+through some Parts of them; whence those Convulsions arise, which are
+merely involuntary Motions of the Muscles. These putrid Humours are the
+Consequence of too great a Load of Aliments, of unsound ones, or of
+such, as the Stomachs of Children are incapable of digesting. These
+Humours are also sometimes the Effect of a Mixture and Confusion of
+different Aliments, and of a bad Distribution of their Nourishment.
+
+It may be known that the Convulsions of a Child are owing to this Cause,
+by the Circumstances that have preceded them, by a disgusted loathing
+Stomach; by a certain Heaviness and Load at it; by a foul Tongue; a
+great Belly; by its bad Complexion, and its disturbed unrefreshing
+Sleep.
+
+The Child's proper Diet, that is, a certain Diminution of the Quantity
+of its Food; some Glysters of warm Water, and one Purge of No. 63, very
+generally remove such Convulsions.
+
+Sec. 392. The second Cause is the bad Quality of their Milk. Whether it be
+that the Nurse has fallen into a violent Passion, some considerable
+Disgust, great Fright or frequent Fear: whether she has eat unwholesome
+Food, drank too much Wine, spirituous Liquors, or any strong Drink:
+whether she is seized with a Descent of her monthly Discharges, and that
+has greatly disordered her Health; or finally whether she prove really
+sick: In all these Cases the Milk is vitiated, and exposes the Infant to
+violent Symptoms, which sometimes speedily destroy it.
+
+The Remedies for Convulsions, from this Cause, consist, 1, In letting
+the Child abstain from this corrupted Milk, until the Nurse shall have
+recovered her State of Health and Tranquillity, the speedy Attainment of
+which may be forwarded by a few Glysters; by gentle pacific Medicines;
+by an entire Absence of whatever caused or conduced to her bad Health;
+and by drawing off all the Milk that had been so vitiated.
+
+2, In giving the Child itself some Glysters: in making it drink
+plentifully of a light Infusion of the Lime-tree Flowers, in giving it
+no other Nourishment for a Day or two, except Panada and other light
+Spoon-meat, without Milk.
+
+3, In purging the Child (supposing what has been just directed to have
+been unavailable) with an Ounce, or an Ounce and a Half, of compound
+Syrup of Succory, or as much Manna. These lenient gentle Purges carry
+off the Remainder of the corrupted Milk, and remove the Disorders
+occasioned by it.
+
+Sec. 393. A third Cause which also produces Convulsions, is the feverish
+Distempers which attack Children, especially the Small-pocks and the
+Measles; but in general such Convulsions require no other Treatment, but
+that proper for the Disease, which has introduced them.
+
+Sec. 394. It is evident from what has been said in the Course of this
+Chapter, and it deserves to be attended to, that Convulsions are
+commonly a Symptom attending some other Disease, rather than an original
+Disease themselves: that they depend on many different Causes; that from
+this Consideration there can be no general Remedy for removing or
+checking them; and that the only Means and Medicines which are suitable
+in each Case, are those, which are proper to oppose the particular Cause
+producing them, and which I have already pointed out in treating of each
+Cause.
+
+The greater Part of the pretended Specifics, which are indiscriminately
+and ignorantly employed in all Sorts of Convulsions, are often useless,
+and still oftner prejudicial. Of this last Sort and Character are,
+
+1, All sharp and hot Medicines, spirituous Liquors, Oil of Amber,--other
+hot Oils and Essences, volatile Salts, and such other Medicines, as, by
+the Violence of their Action on the irritable Organs of Children, are
+likelier to produce Convulsions, than to allay them.
+
+2, Astringent Medicines, which are highly pernicious, whenever the
+Convulsions are caused by any sharp Humour, that ought to be discharged
+from the Body by Stool; or when such Convulsions are the Consequences of
+an [92] Effort of Nature, in Order to effect a _Crisis_: And as they
+almost ever depend on one or the other of these Causes, it follows that
+Astringents can very rarely, if ever, be beneficial. Besides that there
+is always some Danger in giving them to Children without a mature, a
+thorough Consideration of their particular Case and Situation, as they
+often dispose them to Obstructions.
+
+[92] This very important Consideration, on which I have treated pretty
+     largely, in the _Analysis_, seems not to be attended to in
+     Practice, as frequently as it ought. _K._
+
+3, The over early, and too considerable Use of Opiates, either not
+properly indicated, or continued too long, such as Venice Treacle,
+Mithridate, Syrup of Poppies (and it is very easy to run upon some of
+these Sholes) are also attended with the most embarrassing Events, in
+Regard to Convulsions; and it may be affirmed they are improper, for
+nine Tenths of those they are advised to. It is true they often produce
+an apparent Ease and Tranquillity for some Minutes, and sometimes for
+some Hours too; but the Disorder returns even with greater Violence for
+this Suspension, by Reason they have augmented all the Causes producing
+it; they impair the Stomach; they bind up the Belly; they lessen the
+usual Quantity of Urine; and besides, by their abating the Sensibility
+of the Nerves, which ought to be considered as one of the chief
+Centinels appointed by Nature, for the Discovery of any approaching
+Danger, they dispose the Patient insensibly to such Infarctions and
+Obstructions, as tend speedily to produce some violent and mortal Event,
+or which generate a Disposition to languid and tedious Diseases: and I
+do again repeat it, that notwithstanding there are some Cases, in which
+they are absolutely necessary, they ought in general to be employed with
+great Precaution and and Prudence. To mention the principal Indications
+for them in convulsive Cases, they are proper,
+
+1, When the Convulsions still continue, after the original Cause of them
+is removed.
+
+2, When they are so extremely violent, as to threaten a great and very
+speedy Danger of Life; and when they prove an Obstacle to the taking
+Remedies calculated to extinguish their Cause; and,
+
+3, When the Cause producing them is of such a Nature, as is apt to yield
+to the Force of Anodynes; as when, for Instance, they have been the
+immediate Consequence of a Fright.
+
+Sec. 395. There is a very great Difference in different Children, in
+Respect to their being more or less liable to Convulsions. There are
+some, in whom very strong and irritating Causes cannot excite them; not
+even excruciating Gripes and Cholics; the most painful Cutting of their
+Teeth; violent Fevers; the Small Pocks; Measles; and though they are, as
+it were, continually corroded by Worms, they have not the slightest
+Tendency to be convulsed. On the other Hand, some are so very obnoxious
+to Convulsions, or so easily _convulsible_, if that Expression may be
+allowed, that they are very often seized with them from such very slight
+Causes, that the most attentive Consideration cannot investigate them.
+This Sort of Constitution, which is extremely dangerous, and exposes the
+unhappy Subject of it, either to a very speedy Death, or to a very low
+and languid State of Life, requires some peculiar Considerations; the
+Detail of which would be the more foreign to the Design of this
+Treatise, as they are pretty common in Cities, but much less so in
+Country Places. In general cold Bathing and the Powder No. 14 are
+serviceable in such Circumstances.
+
+
+
+            _General Directions, with Respect to Children._
+
+
+Sec. 396. I shall conclude this Chapter by such farther Advice, as may
+contribute to give Children a more vigorous Constitution and
+Temperament, and to preserve them from many Disorders.
+
+First then, we should be careful not to cram them too much, and to
+regulate both the Quantity and the set Time of their Meals, which is a
+very practicable Thing, even in the very earliest Days of their Life;
+when the Woman who nurses them, will be careful to do it regularly.
+Perhaps indeed this is the very Age, when such a Regulation may be the
+most easily attempted and effected; because it is that Stage, when the
+constant Uniformity of their Way of living should incline us to suppose,
+that what they have Occasion for is most constantly very much the same.
+
+A Child who has already attained to a few Years, and who is surrendered
+up more to his own Exercise and Vivacity, feels other Calls; his Way of
+Life is become a little more various and irregular, whence his Appetite
+must prove so too. Hence it would be inconvenient to subject him over
+exactly to one certain Rule, in the Quantity of his Nourishment, or the
+Distance of his Meals. The Dissipation or passing off of his Nutrition
+being unequal, the Occasions he has for repairing it cannot be precisely
+dated and regular. But with Respect to very little Children in Arms, or
+on the Lap, a Uniformity in the first of these Respects, the Quantity of
+their Food, very consistently conduces to a useful Regularity with
+Respect to the second, the Times of feeding them. Sickness is probably
+the only Circumstance, that can warrant any Alteration in the Order and
+Intervals of their Meals; and then this Change should consist in a
+Diminution of their usual Quantity, notwithstanding a general and fatal
+Conduct seems to establish the very Reverse; and this pernicious Fashion
+authorizes the Nurses to cram these poor little Creatures the more, in
+Proportion as they have real Need of less feeding. They conclude of
+Course, that all their Cries are the Effects of Hunger, and the Moment
+an Infant begins, then they immediately stop his Mouth with his Food;
+without once suspecting, that these Wailings may be occasioned by the
+Uneasiness an over-loaded Stomach may have introduced; or by Pains whose
+Cause is neither removed nor mitigated, by making the Children eat;
+though the meer Action of eating may render them insensible to slight
+Pains, for a very few Minutes; in the first Place, by calling off their
+Attention; and secondly, by hushing them to sleep, a common Effect of
+feeding in Children, being in fact, a very general and constant one, and
+depending on the same Causes, which dispose so many grown Persons to
+sleep after Meals.
+
+A Detail of the many Evils Children are exposed to, by thus forcing too
+much Food upon them, at the very Time when their Complaints are owing to
+Causes, very different from Hunger, might appear incredible. They are
+however so numerous and certain, that I seriously wish sensible Mothers
+would open their Eyes to the Consideration of this Abuse, and agree to
+put an End to it.
+
+Those who overload them with Victuals, in Hopes of strengthening them,
+are extremely deceived; there being no one Prejudice equally fatal to
+such a Number of them. Whatever unnecessary Aliment a Child receives,
+weakens, instead of strengthening him. The Stomach, when over-distended,
+suffers in its Force and Functions, and becomes less able to digest
+thoroughly. The Excess of the Food last received impairs the Concoction
+of the Quantity, that was really necessary: which, being badly digested,
+is so far from yielding any Nourishment to the Infant, that it weakens
+it, and proves a Source of Diseases, and concurs to produce
+Obstructions, Rickets, the Evil, slow Fevers, a Consumption and Death.
+
+Another unhappy Custom prevails, with Regard to the Diet of Children,
+when they begin to receive any other Food besides their Nurse's Milk,
+and that is, to give them such as exceeds the digestive Power of their
+Stomachs; and to indulge them in a Mixture of such Things in their
+Meals, as are hurtful in themselves, and more particularly so, with
+Regard to their feeble and delicate Organs.
+
+To justify this pernicious Indulgence, they affirm it is necessary to
+accustom their Stomachs to every Kind of Food; but this Notion is highly
+absurd, since their Stomachs should first be strengthened, in Order to
+make them capable of digesting every Food; and crouding indigestible, or
+very difficultly digestible Materials into it, is not the Way to
+strengthen it. To make a Foal sufficiently strong for future Labour, he
+is exempted from any, till he is four Years old; which enables him to
+submit to considerable Work, without being the worse for it. But if, to
+inure him to Fatigue, he should be accustomed, immediately from his
+Birth, to submit to Burthens above his Strength, he could never prove
+any Thing but an utter Jade, incapable of real Service. The Application
+of this to the Stomach of a Child is very obvious.
+
+I shall add another very important Remark, and it is this, that the too
+early Work to which the Children of Peasants are forced, becomes of real
+Prejudice to the Publick. Hence Families themselves are less numerous,
+and the more Children that are removed from their Parents, while they
+are very young, those who are left are the more obliged to Work, and
+very often even at hard Labour, at an Age when they should exercise
+themselves in the usual Diversions and Sports of Children. Hence they
+wear out in a Manner, before they attain the ordinary Term of Manhood;
+they never arrive at their utmost Strength, nor reach their full
+Stature; and it is too common to see a Countenance with the Look of
+twenty Years, joined to a Stature of twelve or thirteen. In fact, they
+often sink under the Weight of such hard involuntary Labour, and fall
+into a mortal Degree of Wasting and Exhaustion.
+
+Sec. 397. Secondly, which indeed is but a Repetition of the Advice I have
+already given, and upon which I cannot insist too much, they must be
+frequently washed or bathed in cold Water.
+
+Sec. 398. Thirdly, they should be moved about and exercised as much as they
+can bear, after they are some Weeks old: the earlier Days of their
+tender Life seeming consecrated, by Nature herself, to a nearly total
+Repose, and to sleeping, which seems not to determine, until they have
+Need of Nourishment: so that, during this very tender Term of Life, too
+much Agitation or Exercise might be attended with mortal Consequences.
+But as soon as their Organs have attained a little more Solidity and
+Firmness, the more they are danced about (provided it is not done about
+their usual Time of Repose, which ought still to be very considerable)
+they are so much the better for it; and by increasing it gradually, they
+may be accustomed to a very quick Movement, and at length very safely to
+such, as may be called hard and hearty Exercise. That Sort of Motion
+they receive in Go-Carts, or other Vehicles, particularly contrived for
+their Use, is more beneficial to them, than what they have from their
+Nurses Arms, because they are in a better Attitude in the former; and it
+heats them less in Summer, which is a Circumstance of no small
+Importance to them; considerable Heat and Sweat disposing them to be
+ricketty.
+
+Sec. 399. Fourthly, they should be accustomed to breathe in the free open
+Air as much as possible.
+
+If Children have unhappily been less attended to than they ought, whence
+they are evidently feeble, thin, languid, obstructed, and liable to
+Scirrhosities (which constitute what is termed a ricketty or consumptive
+State) these four Directions duly observed retrieve them from that
+unhappy State; provided the Execution of them has not been too long
+delayed.
+
+Sec. 400. Fifthly, If they have any natural Discharge of a Humour by the
+Skin, which is very common with them, or any Eruption, such as Tetters,
+white Scurf, a Rashe, or the like, Care must be taken not to check or
+repel them, by any greasy or restringent Applications. Not a Year passes
+without Numbers of Children having been destroyed by Imprudence in this
+Respect; while others have been reduced to a deplorable and weakly
+Habit.
+
+I have been a Witness to the most unhappy Consequences of external
+Medicines applied for the Rashe and white Scurf; which, however
+frightful they may appear, are never dangerous; provided nothing at all
+is applied to them, without the Advice and Consideration of a truly
+skilful Person.
+
+When such external Disorders prove very obstinate, it is reasonable to
+suspect some Fault or Disagreement in the Milk the Child sucks; in which
+Case it should immediately be discontinued, corrected, or changed. But I
+cannot enter here into a particular Detail of all the Treatment
+necessary in such Cases.
+
+
+
+
+                           __Chapter XXVIII.__
+
+
+           _Directions with Respect to drowned Persons._ [93]
+
+
+[93] The Misfortune of a young Man drowned in bathing himself, at the
+     Beginning of the Season, occasioned the Publication of this Chapter
+     by itself in _June_, 1761. A few Days after, the like Misfortune
+     happened to a labouring Man; but he was happily taken out of the
+     water sooner than the first (who had remained about half an Hour
+     under it) and he was recovered by observing Part of the Advice this
+     Chapter contains; of which Chapter several Bystanders had
+     Copies.--This Note seems to be from the Author himself.
+
+                             __Sect.__ 401.
+
+Whenever a Person who has been drowned, has remained a Quarter of an
+Hour under Water, there can be no considerable Hopes of his Recovery:
+the Space of two or three Minutes in such a Situation being often
+sufficient to kill a Man irrecoverably. Nevertheless, as several
+Circumstances may happen to have continued Life, in such an unfortunate
+Situation, beyond the ordinary Term, we should always endeavour to
+afford them the most effectual Relief, and not give them up as
+irrecoverable too soon: since it has often been known, that until the
+Expiration of two, and sometimes even of three Hours, such Bodies have
+exhibited some apparent Tokens of Life.
+
+Water has sometimes been found in the Stomach of drowned Persons; at
+other times none at all. Besides, the greatest Quantity which has ever
+been found in it has not exceeded that, which may be drank without any
+Inconvenience; whence we may conclude, the meer Quantity was not mortal;
+neither is it very easy to conceive how drowned Persons can swallow
+Water. What really kills them is meer Suffocation, or the Interception
+of Air, of the Action of breathing; and the Water which descends into
+the Lungs, and which is determined there, by the Efforts they
+necessarily, though involuntarily make, to draw Breath, after they are
+under Water: for there absolutely does not any Water descend, either
+into the Stomach or the Lungs of Bodies plunged into Water, after they
+are dead; a Circumstance, which serves to establish a legal Sentence and
+Judgment in some criminal Cases, and Trials: This Water intimately
+blending itself with the Air in the Lungs, forms a viscid inactive Kind
+of Froth, which entirely destroys the Functions of the Lungs; whence the
+miserable Sufferer is not only suffocated, but the Return of the Blood
+from the Head being also intercepted, the Blood Vessels of the Brain are
+overcharged, and an Apoplexy is combined with the Suffocation. This
+second Cause, that is, the Descent of the Water into the Lungs, is far
+from being general, it having been evident from the Dissection of
+several drowned Bodies, that it really never had existed in them.
+
+Sec. 402. The Intention that should be pursued, is that of unloading the
+Lungs and the Brain, and of reviving the extinguished Circulation. For
+which Purpose we should, 1, immediately strip the Sufferer of all his
+wet Cloaths; rub him strongly with dry coarse Linnen; put him, as soon
+as possible, into a well heated Bed, and continue to rub him well a very
+considerable Time together.
+
+2, A strong and healthy Person should force his own warm Breath into the
+Patient's Lungs; and the Smoke of Tobacco, if some was at Hand, by Means
+of some Pipe, Chanel, Funnel or the like, that may be introduced into
+the Mouth. This Air or Fume, being forcibly blown in, by stopping the
+Sufferer's Nostrils close at the same Time, penetrates into the Lungs,
+and there rarifies by its Heat that Air, which blended with the Water,
+composed the viscid Spume or Froth. Hence that Air becomes disengaged
+from the Water, recovers its Spring, dilates the Lungs; and, if there
+still remains within any Principle of Life, the Circulation is renewed
+again that Instant.
+
+3, If a moderately expert Surgeon is at Hand, he must open the jugular
+Vein, or any large Vein in the Neck, and let out ten or twelve Ounces of
+Blood. Such a Bleeding is serviceable on many Accounts. First, merely as
+Bleeding, it renews the Circulation, which is the constant Effect of
+Bleeding in such Swoonings, as arise from an intercepted or suffocated
+Circulation. Secondly, it is that particular Bleeding, which most
+suddenly removes, in such Cases, the Infarction or Obstruction of the
+Head and Lungs; and, thirdly, it is sometimes the only Vessel, whence
+Blood will issue under such Circumstances. The Veins of the Feet then
+afford none; and those of the Arms seldom; but the Jugulars almost
+constantly furnish it.
+
+Fourthly, the Fume of Tobacco should be thrown up, as speedily and
+plentifully as possible, into the Intestines by the Fundament. There are
+very commodious Contrivances devised for this Purpose; but as they are
+not common, it may be effected by many speedy Means. One, by which a
+Woman's Life was preserved, consisted only in introducing the small Tube
+of a Tobacco Pipe well lighted up: the Head or Bowl of it was wrapped up
+in a Paper, in which several Holes were pricked, and through these the
+Breath was strongly forced. At the fifth Blast a considerable Rumbling
+was heard in the Woman's Belly; she threw up a little Water, and a
+Moment afterwards came to her Senses. Two Pipes may be thus lighted and
+applied, with their Bowls covered over; the Extremity of one is to be
+introduced into the Fundament; and the other may be blown through into
+the Lungs.
+
+Any other Vapour may also be conveyed up, by introducing a _Canula_, or
+any other Pipe, with a Bladder firmly fixed to it. This Bladder is
+fastened at its other End to a large Tin Funnel, under which Tobacco is
+to be lighted. This Contrivance has succeeded with me upon other
+Occasions, in which Necessity compelled me to invent and apply it.
+
+Fifthly, the strongest Volatiles should be applied to the Patient's
+Nostrils. The Powder of some strong dry Herb should be blown up his
+Nose, such as Sage, Rosemary, Rue, Mint, and especially Marjoram, or
+very well dried Tobacco; or even the Fume, the Smoke of these Herbs. But
+all these Means are most properly employed after Bleeding, when they are
+most efficacious and certain.
+
+Sixthly, as long as the Patient shews no Signs of Life, he will be
+unable to swallow, and it is then useless, and even dangerous, to pour
+much Liquid of any kind into his Mouth, which could do nothing but keep
+up, or increase Suffocation. It is sufficient, in such Circumstances, to
+instil a few Drops of some irritating Liquor, which might also be
+cordial and reviving. But as soon as ever he discovers any Motion, he
+should take, within the Space of one Hour, five or six common Spoonfuls
+of Oxymel of Squills diluted with warm Water: or if that Medicine was
+not to be had very speedily, a strong Infusion of the blessed Thistle,
+or _Carduus benedictus_, of Sage, or of Chamomile Flowers sweetened with
+Honey, might do instead of it: and supposing nothing else to be had,
+some warm Water, with the Addition of a little common Salt, should be
+given. Some Persons are bold enough to recommend Vomits in such Cases;
+but they are not without their Inconvenience; and it is not as a Vomit
+that I recommend the Oxymel of Squills in them.
+
+Seventhly, Notwithstanding the Sick discover some Tokens of Life, we
+should not cease to continue our Assistance; since they sometimes
+irrecoverably expire, after these first Appearances of recovering.
+
+And lastly, though they should be manifestly re-animated, there
+sometimes remains an Oppression, a Coughing and Feverishness, which
+effectually constitute a Disease: and then it becomes necessary
+sometimes to bleed them in the Arms; to give them Barley Water
+plentifully, or Elder-flower Tea.
+
+Sec. 403. Having thus pointed out such Means as are necessary, and truly
+effectual, in such unfortunate Accidents, I shall very briefly mention
+some others, which it is the general Custom to use and apply in the
+first Hurry.
+
+1, These unhappy People are sometimes wrapped up in a Sheep's, or a
+Calf's, or a Dog's Skin, immediately flead from the Animal: these
+Applications have sometimes indeed revived the Heat of the Drowned; but
+their Operations are more slow, and less efficacious, than the Heat of a
+well-warmed Bed; with the additional Vapour of burnt Sugar, and long
+continued Frictions with hot Flanels.
+
+2, The Method of rolling them in an empty Hogshead is dangerous, and
+mispends a deal of important Time.
+
+3, That also of hanging them up by the Feet is attended with Danger, and
+ought to be wholly discontinued. The Froth or Foam, which is one of the
+Causes of their Death, is too thick and tough to discharge itself, in
+Consequence of its own Weight. Nevertheless, this is the only Effect
+that can be expected, from this Custom of suspending them by the Feet;
+which must also be hurtful, by its tending to increase the Overfulness
+of the Head and of the Lungs.
+
+Sec. 404. It is some Years since a Girl of eighteen Years old was recovered
+[though it is unknown whether she remained under Water only a little
+Time or some Hours] who was motionless, frozen as it were, insensible,
+with her Eyes closed, her Mouth wide open, a livid Colour, a swoln
+Visage, a Tumour or bloating of the whole Body, which was overladen as
+it were, or Water-soaked. This miserable Object was extended on a Kind
+of Bed, of hot or very warm Ashes, quickly heated in great Kettles; and
+by laying her quite naked on these Ashes; by covering her with others
+equally hot; by putting a Bonnet round her Head, with a Stocking round
+her Neck stuffed with the same, and heaping Coverings over all this, at
+the End of half an Hour her Pulse returned, she recovered her Speech,
+and cried out, _I freeze, I freeze_: A little Cherry-Brandy was given
+her, and then she remained buried, as it were, eight Hours under the
+Ashes; being taken out of them afterwards without any other Complaint,
+except that of great Lassitude or Weariness, which went entirely off the
+third Day. This Method was undoubtedly so effectual, that it well
+deserves Imitation; but it should not make us inattentive to the others.
+Heated Gravel or Sand mixed with Salt, or hot Salt alone, would have
+been equally efficacious, and they have been found so.
+
+At the very Time of writing this, two young Ducks, who were drowned,
+have been revived by a dry Bath of hot Ashes. The Heat of a Dung-heap
+may also be beneficial; and I have just been informed, by a very
+creditable and sensible Spectator of it, that it effectually contributed
+to restore Life to a Man, who had certainly remained six Hours under
+Water.
+
+Sec. 405. I shall conclude these Directions with an Article printed in a
+little Work at _Paris_, about twenty Years since, by Order of the King,
+to which there is not the least Doubt, but that any other Sovereign will
+readily accede.
+
+    "Notwithstanding the common People are very generally disposed
+    to be compassionate, and may wish to give all Assistance to
+    drowned Persons, it frequently happens they do not, only because
+    they dare not; imagining they expose themselves by it to
+    Prosecutions. It is therefore necessary, that they should know,
+    and it cannot be too often repeated, in order to eradicate such
+    a pernicious Prejudice, that the Magistrates have never
+    interposed to prevent People from trying every possible Means to
+    recover such unfortunate Persons, as shall be drowned and taken
+    out of the Water. It is only in those Cases, when the Persons
+    are known to be absolutely and irrecoverably dead, that Justice
+    renders it necessary to seize their Bodies."
+
+
+
+
+                            __Chapter XXIX.__
+
+
+        _Of Substances stopt between the Mouth and the Stomach._
+
+
+                             __Sect.__ 406.
+
+The Food we take in descends from the Mouth through a very strait
+Passage or Chanel, called the _Oesophagus_, the Gullet, which, going
+parallel with the Spine or Backbone, joins to, or terminates at, the
+Stomach.
+
+It happens sometimes that different Bodies are stopt in this Chanel,
+without being able either to descend or to return up again; whether this
+Difficulty arises from their being too large; or whether it be owing to
+their having such Angles or Points, as by penetrating into, and adhering
+to the Sides of this membranous Canal, absolutely prevent the usual
+Action and Motion of it.
+
+Sec. 407. Very dangerous Symptoms arise from this Stoppage, which are
+frequently attended with a most acute Pain in the Part; and at other
+Times, with a very incommodious, rather than painful, Sensation;
+sometimes a very ineffectual Commotion at, or rising of, the Stomach,
+attended with great Anguish; and if the Stoppage be so circumstanced,
+that the _Glottis_ is closed, or the Wind-pipe compressed, a dreadful
+Suffocation is the Consequence: the Patient cannot breathe, the Lungs
+are quite distended; and the Blood being unable to return from the Head,
+the Countenance becomes red, then livid; the Neck swells; the Oppression
+increases, and the poor Sufferer speedily dies.
+
+When the Patient's Breathing is not stopt, nor greatly oppressed; if the
+Passage is not entirely blocked up, and he can swallow something, he
+lives very easily for a few Days, and then his Case becomes a particular
+Disorder of the _Oesophagus_, or Gullet. But if the Passage is
+absolutely closed, and the Obstruction cannot be removed for many Days,
+a terrible Death is the Consequence.
+
+Sec. 408. The Danger of such Cases does not depend so much on the Nature of
+the obstructing Substance, as on its Size, with Regard to that of the
+Passage of the Part where it stops, and of the Manner in which it forms
+the Obstruction; and frequently the very Food may occasion Death; while
+Substances less adapted to be swallowed are not attended with any
+violent Consequences, though swallowed.
+
+A Child of six Days old swallowed a Comfit or Sugar Plumb, which stuck
+in the Passage, and instantly killed it.
+
+A grown Person perceived that a Bit of Mutton had stopt in the Passage;
+not to alarm any Body he arose from Table; a Moment afterwards, on
+looking where he might be gone, he was found dead. Another was choaked
+by a Bit of Cake; a third by a Piece of the Skin of a Ham; and a fourth
+by an Egg, which he swallowed whole in a Bravo.
+
+A Child was killed by a Chesnut swallowed whole. Another died suddenly,
+choaked (which is always the Circumstance, when they die instantly after
+such Accidents) by a Pear which he had tossed up, and catched in his
+Mouth. A Woman was choaked with another Pear. A Piece of a Sinew
+continued eight Days in the Passage, so that it prevented the Patient
+from getting down any Thing else; at the Expiration of that Time it fell
+into the Stomach, being loosened by its Putridity: The Patient
+notwithstanding died soon after, being killed by the Inflammation,
+Gangrene and Weakness it had occasioned. Unhappily there occur but too
+many Instances of this Sort, of which it is unnecessary to cite more.
+
+Sec. 409. Whenever any Substance is thus detained in the Gullet, there are
+two Ways of removing it; that is either by extracting it, or pushing it
+down. The safest and most certain Way is always to extract or draw it
+out, but this is not always the easiest: and as the Efforts made for
+this Purpose greatly fatigue the Patient, and are sometimes attended
+with grievous Consequences; and yet if the Occasion is extremely urging,
+it may be eligible to thrust it down, if that is easier; and if there is
+no Danger from the obstructing Bodies Reception into the Stomach.
+
+The Substances which may be pushed down without Danger, are all common
+nourishing ones, as Bread, Meat, Cakes, Fruits, Pulse, Morsels of Tripe,
+and even Skin of Bacon. It is only very large Morsels of particular
+Aliments, that prove very difficult to digest; yet even such are rarely
+attended with any Fatality.
+
+Sec. 410. The Substances we should endeavour to extract or draw out, though
+it be more painful and less easy than to push them down, are all those,
+whose Consequences might be highly dangerous, or even mortal, if
+swallowed. Such are all totally indigestible Bodies, as Cork,
+Linen-Rags, large Fruit Stones, Bones, Wood, Glass, Stones, Metals; and
+more especially if any further Danger may be superadded to that of its
+Indigestibility, from the Shape, whether rough, sharp, pointed, or
+angular, of the Substance swallowed. Wherefore we should chiefly
+endeavour to extract Pins, Needles, Fish-bones, other pointed Fragments
+of Bones, Bits of Glass, Scissars, Rings, or Buckles.
+
+Nevertheless it has happened, that every one of these Substances have at
+one Time or another been swallowed, and the most usual Consequences of
+them are violent Pains of the Stomach, and in the Guts; Inflammations,
+Suppurations, Abscesses, a slow Fever, Gangrene, the _Miserere_ or Iliac
+Passion; external Abscesses, through which the Bodies swallowed down
+have been discharged; and frequently, after a long Train of Maladies, a
+dreadful Death.
+
+Sec. 411. When such Substances have not passed in too deep, we should
+endeavour to extract them with our Fingers, which often succeeds. If
+they are lower, we should make use of Nippers or a small _Forceps_; of
+which Surgeons are provided with different Sorts. Those which some
+Smoakers carry about them might be very convenient for such Purposes;
+and in Case of Necessity they might be made very readily out of two Bits
+of Wood. But this Attempt to extract rarely succeeds, if the Substance
+has descended far into the _Oesophagus_, and if the Substance be of a
+flexible Nature, which exactly applies itself to, and fills up the
+Cavity or Chanel of it.
+
+Sec. 412. If the Fingers and the Nippers fail, or cannot be duly applied,
+Crotchets, a Kind of Hooks, must be employed.
+
+These may be made at once with a pretty strong iron Wire, crooked at the
+End. It must be introduced in the flat Way, and for the better
+conducting of it, there should be another Curve or Hook at the End it is
+held by, to serve as a Kind of Handle to it, which has this further Use,
+that it may be secured by a String tied to it; a Circumstance not to be
+omitted in any Instrument employed on such Occasions, to avoid such ill
+Accidents as have sometimes ensued, from these Instruments slipping out
+of the Operators Hold. After the Crotchet has passed beyond and below
+the Substance, that obstructs the Passage, it is drawn up again, and
+hooks up with it and extracts that Impediment to swallowing.
+
+This Crotchet is also very convenient, whenever a Substance somewhat
+flexible, as a Pin or a Fishbone stick, as it were, across the Gullet:
+the Crotchet in such Cases seizing them about their middle Part, crooks
+and thus disengages them. If they are very brittle Substances, it serves
+to break them; and if any Fragments still stick within, some other Means
+must be used to extract them.
+
+Sec. 413. When the obstructing Bodies are small, and only stop up Part of
+the Passage; and which may either easily elude the Hook, or straiten it
+by their Resistance, a Kind of Rings may be used, and made either solid
+or flexible.
+
+The solid ones are made of iron Wire, or of a String of very fine brass
+Wire. For this Purpose the Wire is bent into a Circle about the middle
+Part of its Length, the Sides of which Circle do not touch each other,
+but leave a Ring, or hollow Cavity, of about an Inch Diameter. Then the
+long unbent Sides of the Wire are brought near each other; the circular
+Part or Ring is introduced into the Gullet, in order to be conducted
+about the obstructing Body, and so to extract it. Very flexible Rings
+may be made of Wool, Thread, Silk, or small Packthread, which may be
+waxed, for their greater Strength and Consistence. Then they are to be
+tied fast to a Handle of Iron-Wire, of Whale-bone, or of any flexible
+Wood; after which the Ring is to be introduced to surround the
+obstructing Substance, and to draw it out.
+
+Several of these Rings passed through one another are often made use of,
+the more certainly to lay hold of the obstructing Body, which may be
+involved by one, if another should miss it. This Sort of Rings has one
+Advantage, which is, that when the Substance to be extracted is once
+laid hold of, it may then, by turning the Handle, be retained so
+strongly in the Ring thus twisted, as to be moved every Way; which must
+be a considerable Advantage in many such Cases.
+
+Sec. 414. A fourth Material employed on these unhappy Occasions is the
+Sponge. Its Property of swelling considerably, on being wet, is the
+Foundation of its Usefulness here.
+
+If any Substance is stopt in the Gullet, but without filling up the
+whole Passage, a Bit of Sponge is introduced, into that Part that is
+unstopt, and beyond the Substance. The Sponge soon dilates, and grows
+larger in this moist Situation, and indeed the Enlargement of it may be
+forwarded, by making the Patient swallow a few Drops of Water; and then
+drawing back the Sponge by the Handle it is fastened to, as it is now
+too large to return through the small Cavity, by which it was conveyed
+in, it draws out the obstructing Body with it, and thus unplugs, as it
+were, and opens the Gullet.
+
+As dry Sponge may shrink or be contracted, this Circumstance has proved
+the Means of squeezing a pretty large Piece of it into a very small
+Space. It becomes greatly compressed by winding a String or Tape very
+closely about it, which Tape may be easily unwound and withdrawn, after
+the Sponge has been introduced. It may also be inclosed in a Piece of
+Whalebone, split into four Sticks at one End, and which, being endued
+with a considerable Spring, contracts upon the Sponge. The Whalebone is
+so smoothed and accommodated, as not to wound; and the Sponge is also to
+be safely tied to a strong Thread; that after having disengaged the
+Whalebone from it, the Surgeon may also draw out the Sponge at Pleasure.
+
+Sponge is also applied on these Occasions in another Manner. When there
+is no Room to convey it into the Gullet, because the obstructing
+Substance ingrosses its whole Cavity; and supposing it not hooked into
+the Part, but solely detained by the Straitness of the Passage, a pretty
+large Bit of Sponge is to be introduced towards the Gullet, and close to
+the obstructing Subtance: Thus applied, the Sponge swells, and thence
+dilates that Part of the Passage that is above this Substance. The
+Sponge is then withdrawn a little, and but a very little, and this
+Substance being less pressed upon above than below, it sometimes
+happens, that the greater Staitness and Contraction of the lower Part of
+the Passage, than of its upper Part, causes that Substance to ascend;
+and as soon as this first Loosening or Disengagement of it has happened,
+the total Disengagement of it easily follows.
+
+Sec. 415. Finally, when all these Methods prove unavailable, there remains
+one more, which is to make the Patient vomit; but this can scarcely be
+of any Service, but when such obstructing Bodies are simply engaged in,
+and not hooked or stuck into the Sides of the _Oesophagus_; since under
+this latter Circumstance vomiting might occasion further Mischief.
+
+If the Patient can swallow, a Vomiting may be excited with the
+Prescription No. 8, or with No. 34, or 35. By this Operation a Bone was
+thrown out, which had stopt in the Passage four and twenty Hours.
+
+When the Patient cannot swallow, an Attempt should be made to excite him
+to vomit by introducing into, and twirling about the feathery End of a
+Quill in, the Bottom of the Throat, which the Feather however will not
+effect, if the obstructing Body strongly compresses the whole
+Circumference of the Gullet; and then no other Resource is left, but
+giving a Glyster of Tobacco. A certain Person swallowed a large Morsel
+of Calf's Lights, which stopt in the Middle of the Gullet, and exactly
+filled up the Passage. A Surgeon unsuccessfully attempted various
+Methods to extract it; but another seeing how unavailable all of them
+were; and the Patient's Visage becoming black and swelled; his Eyes
+ready to start, as it were, out of his Head; and falling into frequent
+Swoonings, attended with Convulsions too, he caused a Glyster of an
+Ounce of Tobacco boiled to be thrown up; the Consequence of which was a
+violent Vomiting, which threw up the Substance that was so very near
+killing him.
+
+Sec. 416. A sixth Method, which I believe has never hitherto been
+attempted, but which may prove very useful in many Cases, when the
+Substances in the Passage are not too hard, and are very large, would be
+to fix a Worm (used for withdrawing the Charge of Guns that have been
+loaded) fast to a flexible Handle, with a waxed Thread fastened to the
+Handle, in Order to withdraw it, if the Handle slipt from the Worm; and
+by this Contrivance it might be very practicable, if the obstructing
+Substance was not too deep in the Passage of the Gullet, to extract
+it--It has been known that a Thorn fastened in the Throat, has been
+thrown out by laughing.
+
+Sec. 417. In the Circumstances mentioned Sec. 409, when it is more easy and
+convenient to push the obstructing Body downwards, it has been usual to
+make Use of Leeks, which may generally be had any where (but which
+indeed are very subject to break) or of a Wax-candle oiled, and but a
+very little heated, so as to make it flexible; or of a Piece of
+Whale-bone; or of Iron-Wire; one Extremity of which may be thickened and
+blunted in a Minute with a little melted Lead. Small Sticks of some
+flexible Wood may be as convenient for the same Use, such as the
+Birch-tree, the Hazel, the Ash, the Willow, a flexible Plummet, or a
+leaden Ring. All these Substances should be very smooth, that they may
+not give the least Irritation; for which Reason they are sometimes
+covered over with a thin Bit of Sheep's Gut. Sometimes a Sponge is
+fastened to one End of them, which, completely filling up the whole
+Passage, pushes down whatever Obstacle it meets with.
+
+In such Cases too, the Patient may be prompted to attempt swallowing
+down large Morsels of some unhurtful Substance, such as a Crust of
+Bread, a small Turnep, a Lettuce Stalk, or a Bullet, in Hopes of their
+carrying down the obstructing Cause with them. It must be acknowledged,
+however, that these afford but a feeble Assistance; and if they are
+swallowed without being well secured to a Thread, it may be apprehended
+they may even increase the Obstruction, by their own Stoppage.
+
+It has sometimes very happily, though rarely, occurred, that those
+Substances attempted to be detruded or thrust downwards, have stuck in
+the Wax-Candle, or the Leek, and sprung up and out with them: but this
+can never happen except in the Case of pointed Substances.
+
+Sec. 418. Should it be impossible to extract the Bodies mentioned Sec. 410,
+and all such as it must be dangerous to admit into the Stomach, we must
+then prefer the least of two Evils, and rather run the Hazard of pushing
+them down, than suffer the Patient to perish dreadfully in a few
+Moments. And we ought to scruple this Resolution the less, as a great
+many Instances have demonstrated, that notwithstanding several bad
+Consequences, and even a tormenting Death, have often followed the
+swallowing of such hurtful or indigestible Substances; yet at other
+times they have been attended with little or no Disorder.
+
+Sec. 419. One of these four Events is always the Case, after swallowing
+such Things. They either, 1, go off by Stool; or, 2, they are not
+discharged and kill the Patient. Or else, 3, they are discharged by
+Urine; or, 4, are visibly extruded to the Skin. I shall give some
+Instances of each of these Events.
+
+Sec. 420. When they are voided by Stool, they are either voided soon after
+they have been swallowed, and that without having occasional scarce any
+troublesome Symptom; or the voiding of them has not happened till a long
+Time after swallowing, and is preceded with very considerable Pain. It
+has been seen that a Bone of the Leg of a Fowl, a Peach-stone, the Cover
+of a small Box of Venice Treacle, Pins, Needles, and Coins of different
+Sorts, have been voided within a few Days after they had slipt down into
+the Stomach; and that with little or no Complaint. A small Flute, or
+Pipe also, four Inches long, which occasioned acute Pains for three
+Days, has been voided happily afterwards, besides, Knives, Razors, and
+one Shoe-buckle. I have seen but a few Days since a Child between two
+and three Years old, who swallowed a Nail above an Inch long, the Head
+of which was more than three Tenths of an Inch broad: it stopt a few
+Moments about the Neck, but descended while its Friends were looking for
+me; and was voided with a Stool that Night, without any bad Consequence.
+And still more lately I have known the entire Bone of a Chicken's Wing
+thus swallowed, which only occasioned a slight Pain in the Stomach for
+three or four Days.
+
+Sometimes such Substances are retained within for a long Time, not being
+voided till after several Months, and even Years, without the least ill
+Effect: and some of them have never either appeared, nor been complained
+of.
+
+Sec. 421. But the Event is not always so happy; and sometimes though they
+are discharged through the natural Passages, the Discharges have been
+preceded by very acute Pains in the Stomach, and in the Bowels. A Girl
+swallowed down some Pins, which afflicted her with violent Pains for the
+Space of six Years; at the Expiration of which Term she voided them and
+recovered. Three Needles being swallowed brought on Cholics, Swoonings
+and Convulsions for a Year after: and then being voided by Stool, the
+Patient recovered. Another Person who swallowed two, was much happier in
+suffering but six Hours from them; when they were voided by Stool, and
+he did well.
+
+It sometimes happens that such indigestible Substances, after having
+past all the Meanders, the whole Course of the Intestines, have been
+stopt in the Fundament, and brought on very troublesome Symptoms; but
+such however, as an expert Surgeon may very generally remove. If it is
+practicable to cut them, as it is when they happen to be thin Bones, the
+Jaw-bones of Fish, or Pins, they are then very easily extracted.
+
+Sec. 422. The second Event is, when these fatal Substances are never
+voided, but cause very embarrassing Symptoms which finally kill the
+Patient; and of these Cases there have been but too many Examples.
+
+A young Girl having swallowed some Pins, which she held in her Mouth,
+some of them were voided by Stool; but others of them pricked and
+pierced into her Guts, and even into the Muscles of her Belly, with the
+severest Pain; and killed her at the End of three Weeks.
+
+A Man swallowed a Needle, which pierced through his Stomach, and into
+his Liver, [94] and ended in a mortal Consumption.
+
+[94] I saw a very similar Instance and Event in a Lady's little
+     favourite Bitch, whole Body she desired to be opened, from
+     suspecting her to have been poisoned. But it appeared that a small
+     Needle with fine Thread, which she had swallowed, had passed out of
+     the Stomach into the _Duodenum_ (one of the Guts) through which the
+     Point had pierced and pricked and corroded the concave Part of the
+     Liver, which was all rough and putrid. The whole Carcase was
+     greatly bloated and extremely offensive, very soon after the poor
+     Animal's Death, which happened two or three Months after the
+     Accident, and was preceded by a great Wheezing, Restlessness and
+     Loss of Appetite. The Needle was rusty, but the Thread entire, and
+     very little altered. _K._
+
+A Plummet which slipt down, while the Throat of a Patient was searching,
+killed him at the End of two Years.
+
+It is very common for different Coins, and of different Metals, to be
+swallowed without any fatal or troublesome Effects. Even a hundred
+Luidores [95] have been swallowed, and all voided. Nevertheless these
+fortunate Escapes ought not to make People too secure and incautious on
+such Occasions, since such melancholy Consequences have happened, as may
+very justly alarm them. One single Piece of Money that was swallowed,
+entirely obstructed the Communication between the Stomach and the
+Intestines, and killed the Patient. Whole Nuts have often been
+inadvertently swallowed; but there have been some Instances of Persons
+in whom a Heap [96] of them has been formed, which proved the Cause of
+Death, after producing much Pain and Inquietude.
+
+[95] I knew a Man of the Name of _Poole_, who being taken in the same
+     Ship with me, 1717 or 18, by Pirates, had swallowed four Ginueas,
+     and a gold Ring, all which he voided some Days after without any
+     Injury or Complaint, and saved them. I forget the exact Number of
+     Days he retained them, but the Pirates staid with us from Saturday
+     Night to Thursday Noon. _K._
+
+[96] Many fatal Examples of this Kind may be seen in the _Philosophical
+     Transactions_; and they should caution People against swallowing
+     Cherry-stones, and still more against those of Prunes, or such as
+     are pointed, though not very acutely. _K._
+
+Sec. 423. The third Issue or Event is, when these Substances, thus
+swallowed down, have been discharged by Urine: but these Cases are very
+rare.
+
+A Pin of a middling Size has been discharged by Urine, three Days after
+it slipt down; and a little Bone has been expelled the same Way, besides
+Cherry-stones, Plumb-stones, and even one Peach-stone.
+
+Sec. 424. Finally, the fourth Consequence or Event is, when the
+indigestible Substances thus swallowed, have pierced through the Stomach
+or Intestines, and even to the Skin itself; and occasioning an Abscess,
+have made an Outlet for themselves, or have been taken out of the
+Abscess. A long Time is often required to effect this extraordinary
+Trajection and Appearance of them; sometimes the Pains they occasion are
+continual; in other Cases the Patient complains for a Time, after which
+the Pain ceases, and then returns again. The Imposthume, or Gathering,
+is formed in the Stomach, or in some other Part of the Belly: and
+sometimes these very Substances, after having pierced through the Guts,
+make very singular Routs, and are discharged very remotely from the
+Belly. One Needle that had been swallowed found its Way out, at the End
+of four Years, through the Leg; another at the Shoulder.
+
+Sec. 425. All these Examples, and many others of cruel Deaths, from
+swallowing noxious Substances, demonstrate the great Necessity of an
+habitual Caution in this Respect; and give in their Testimony against
+the horrid, I had almost said, the criminal Imprudence, of People's
+amusing themselves with such Tricks as may lead to such terrible
+Accidents; or even holding any such Substance in their Mouths, as by
+slipping down through Imprudence or Accident, may prove the Occasion of
+their Death. Is it possible that any one, without shuddering, can hold
+Pins or Needles in their Mouths, after reflecting on the dreadful
+Accidents, and cruel Deaths, that have thus been caused by them.
+
+Sec. 426. It has been shewn already, that Substances obstructing the
+Passage of the Gullet sometimes suffocate the Patient; that at other
+Times they can neither be extracted nor thrust down; but that they stop
+in the Passage, without killing the Patient, at least not immediately
+and at once. This is the Case when they are so circumstanced, as not to
+compress the _Trachaea_, the Wind-pipe, and not totally to prevent the
+swallowing of Food; which last Circumstance can scarcely happen, except
+the Obstruction has been formed by angular or pointed Bodies. The
+Stoppage of such Bodies is sometimes attended, and that without much
+Violence, with a small Suppuration, which loosens them; and then they
+are either returned upwards through the Mouth, or descend into the
+Stomach. But at other Times an extraordinary Inflammation is produced,
+which kills the Patient. Or if the Contents of the Abscess attending the
+Inflammation tend outwardly, a Tumour is formed on the external Part of
+the Neck, which is to be opened, and through whose Orifice the
+obstructing Body is discharged. In other Instances again they take a
+different Course, attended with little or no Pain, and are at length
+discharged by a Gathering behind the Neck, on the Breast, the Shoulder,
+or various other Parts.
+
+Sec. 427. Some Persons, astonished at the extraordinary Course and
+Progression of such Substances, which, from their Size, and especially
+from their Shape, seem to them incapable of being introduced into, and
+in some Sort, circulating through the human Body, without destroying it,
+are very desirous of having the Rout and Progression of such intruding
+Substances explained to them. To gratify such Inquirers, I may be
+indulged in a short Digression, which perhaps is the less foreign to my
+Plan; as in dissipating what seems marvelous, and has been thought
+supernatural in such Cases, I may demolish that superstitious Prejudice,
+which has often ascribed Effects of this Sort to Witchcraft; but which
+admit of an easy Explanation. This very Reason is the Motive that has
+determined me to give a further Extent to this Chapter.
+
+Wherever an Incision is made through the Skin, a certain Membrane
+appears, which consists of two Coats or _Laminae_, separated from each
+other by small Cells or Cavities, which all communicate together; and
+which are furnished, more or less, with Fat. There is not any Fat
+throughout the human Body, which is not inclosed in, or enveloped with,
+this Coat, which is called the adipose, fatty, or cellular Membrane.
+
+This Membrane is not only found under the Skin, but further plying and
+insinuating itself in various Manners, it is extended throughout the
+whole Body. It distinguishes and separates all the Muscles; it
+constitutes a Part of the Stomach, of the Guts, of the Bladder, and of
+all the _Viscera_ or Bowels. It is this which forms what is called the
+Cawl, and which also furnishes a Sheath or Envelopement to the Veins,
+Arteries, and Nerves. In some Parts it is very thick, and is abundantly
+replenished with Fat; in others it is very thin and unprovided with any;
+but wherever it extends, it is wholly insensible, or void of all
+Sensation, all Feeling.
+
+It may be compared to a quilted Coverlet, the Cotton, or other Stuffing
+of which, is unequally distributed; greatly abounding in some Places,
+with none at all in others, so that in these the Stuff above and below
+touch each other. Within this Membrane, or Coverlet, as it were, such
+extraneous or foreign Substances are moved about; and as there is a
+general Communication throughout the whole Extent of the Membrane, it is
+no ways surprizing, that they are moved from one Part to another very
+distant, in a long Course and Duration of Movement. Officers and
+Soldiers very often experience, that Bullets which do not pass through
+the Parts where they have entered, are transferred to very different and
+remote ones.
+
+The general Communication throughout this Membrane is daily demonstrated
+by Facts, which the Law prohibits; this is the Butchers inflating, or
+blowing up, the cellular Membrane throughout the whole Carcase of a
+Calf, by a small Incision in the Skin, into which they introduce a Pipe
+or the Nozzle of a small Bellows; and then, blowing forcibly, the Air
+evidently puffs up the whole Body of the Calf into this artificial
+Tumour or Swelling.
+
+Some very criminal Impostors have availed themselves of this wicked
+Contrivance, thus to bloat up Children into a Kind of Monsters, which
+they afterwards expose to View for Money.
+
+In this cellular Membrane the extravasated Waters of hydropic Patients
+are commonly diffused; and here they give Way to that Motion, to which
+their own Weight disposes them. But here I may be asked--As this
+Membrane is crossed and intersected in different Parts of it, by Nerves,
+Veins, Arteries, _&c._ the wounding of which unavoidably occasions
+grievous Symptoms, how comes it, that such do not ensue upon the
+Intrusion of such noxious Substances? To this I answer, 1, that such
+Symptoms do sometimes really ensue; and 2, that nevertheless they must
+happen but seldom, by Reason that all the aforesaid Parts, which
+traverse and intersect this Membrane, being harder than the Fat it
+contains; such foreign Substances must almost necessarily, whenever they
+rencounter those Parts, be turned aside towards the Fat which surrounds
+them, whose Resistance is very considerably less; and this the more
+certainly so, as these Nerves, _&c._ are always of a cylindrical
+Form.----But to return from this necessary Digression.
+
+Sec. 428. To all these Methods and Expedients I have already recommended on
+the important Subject of this Chapter, I shall further add some general
+Directions.
+
+1. It is often useful, and even necessary, to take a considerable
+Quantity of Blood from the Arm; but especially if the Patient's
+Respiration, or Breathing, is extremely oppressed; or when we cannot
+speedily succeed in our Efforts to remove the obstructing Substance; as
+the Bleeding is adapted to prevent the Inflammation, which the frequent
+Irritations from such Substances occasion; and as by its disposing the
+whole Body into a State of Relaxation, it might possibly procure an
+immediate Discharge of the offending Substance.
+
+2. Whenever it is manifest that all Endeavours, either to extract, or to
+push down the Substance stopt in the Passage, are ineffectual, they
+should be discontinued; because the Inflammation occasioned by
+persisting in them, would be as dangerous as the Obstruction itself; as
+there have been Instances of People's dying in Consequence of the
+Inflammation; notwithstanding the Body, which caused the Obstruction,
+had been entirely removed.
+
+3. While the Means already advised are making Use of, the Patient should
+often swallow, or if he cannot, he should frequently receive by
+Injection through a crooked Tube or Pipe, that may reach lower down than
+the _Glottis_, some very emollient Liquor, as warm Water, either alone
+or mixed with Milk, or a Decoction of Barley, of Mallows, or of Bran. A
+two-fold Advantage may arise from this; the first is, that these
+softening Liquors smooth and sooth the irritated Parts; and secondly, an
+Injection, strongly thrown in, has often been more successful in
+loosening the obstructing Body, than all Attempts with Instruments.
+
+4. When after all we are obliged to leave this in the Part, the Patient
+must be treated as if he had an inflammatory Disease; he must be bled,
+ordered to a Regimen, and have his whole Neck surrounded with emollient
+Pultices. The like Treatment must also be used, though the obstructing
+Substance be removed; if there is Room to suppose any Inflammation left
+in the Passage.
+
+5. A proper Degree of Agitation has sometimes loosened the inhering
+Body, more effectually than Instruments. It has been experienced that a
+Blow with the Fist on the Spine, the Middle of the Back, has often
+disengaged such obstructed and obstructing Bodies; and I have known two
+Instances of Patients who had Pins stopt in the Passage; and who getting
+on Horseback to ride out in Search of Relief at a neighbouring Village,
+found each of them the Pin disengaged after an Hour's riding: One spat
+it out, and the other swallowed it, without any ill Consequence.
+
+6. When there is an immediate Apprehension of the Patient's being
+suffocated; when bleeding him has been of no Service; when all Hope of
+freeing the Passage in time is vanished, and Death seems at Hand, if
+Respiration be not restored; the Operation of _Bronchotomy_, or opening
+of the Wind-pipe, must be directly performed; an Operation neither
+difficult to a tolerably knowing and expert Surgeon, nor very painful to
+the Patient.
+
+7. When the Substance that was stopt passes into the Stomach, the
+Patient must immediately be put into a very mild and smooth Regimen. He
+should avoid all sharp, irritating, inflaming Food; Wine, spirituous
+Liquors, all strong Drink, and Coffee; taking but little Nourishment at
+once, and no Solids, without their having been thoroughly well chewed.
+The best Diet would be that of farinaceous mealy Soups, made of various
+leguminous Grains, and of Milk and Water, which is much better than the
+usual Custom of swallowing different Oils.
+
+Sec. 429. The Author of Nature has provided, that in eating, nothing should
+pass by the _Glottis_ into the Wind-pipe. This Misfortune nevertheless
+does sometimes happen; at which very Instant there ensues an incessant
+and violent Cough, an acute Pain, with Suffocation; all the Blood being
+forced up into the Head, the Patient is in extreme Anguish, being
+agitated with violent and involuntary Motions, and sometimes dying on
+the Spot. A _Hungarian_ Grenadier, by Trade a Shoemaker, was eating and
+working at the same time. He tumbled at once from his Seat, without
+uttering a single Word. His Comrades called out for Assistance; some
+Surgeons speedily arrived, but after all their Endeavours he discovered
+no Token of Life. On opening the Body, they found a Lump, or large
+Morsel, of Beef, weighing two Ounces, forced into the Windpipe, which it
+plugged up so exactly, that not the least Air could pass through it into
+the Lungs.
+
+Sec. 430. In a Case so circumstanced, the Patient should be struck often on
+the Middle of the Back; some Efforts to vomit should be excited; he
+should be prompted to sneeze with Powder of Lilly of the Valley, Sage,
+or any cephalic Snuffs, which should be blown strongly up his Nose.
+
+A Pea, pitched into the Mouth in playing, entered into the Wind-pipe,
+and sprung out again by vomiting the Patient with Oil. A little Bone was
+brought up by making another sneeze, with powdered Lilly of the Valley.
+
+In short, if all these Means of assisting, or saving the Patient are
+evidently ineffectual, _Bronchotomy_ must be speedily performed (See No.
+6, of the preceding Section.) By this Operation, some Bones, a Bean, and
+a Fish-bone have been extracted, and the Patient has been delivered from
+approaching Death.
+
+Sec. 431. Nothing should be left untried, when the Preservation of human
+Life is the Object. In those Cases, when an obstructing Body can neither
+be disengaged from the Throat, the Passage to the Stomach, nor be
+suffered to remain there without speedily killing the Patient, it has
+been proposed to make an Incision into this Passage, the _Oesophagus_,
+through which such a Body is to be extracted; and to employ the like
+Means, when a Substance which had slipt even into the Stomach itself,
+was of a Nature to excite such Symptoms, as must speedily destroy the
+Patient.
+
+When the _Oesophagus_ is so fully and strongly closed, that the Patient
+can receive no Food by the Mouth, he is to be nourished by Glysters of
+Soup, Gelly, and the like.
+
+
+
+
+                            __Chapter XXX.__
+
+
+    _Of external Disorders, and such as require chirurgical
+    Application. Of Burns, Wounds, Contusions or Bruises:  Of
+    Sprains, Ulcers, frostbitten Limbs, Chilblains, Ruptures, Boils.
+    Of Fellons, Thorns or Splinters in the Fingers or Flesh; of
+    Warts, and of Corns._
+
+
+                             __Sect.__ 432.
+
+Labouring Countrymen are exposed in the Course of their daily Work, to
+many outward Accidents, such as Cuts, Contusions, _&c_. which, however
+considerable in themselves, very generally end happily; and that chiefly
+in Consequence of the pure and simple Nature of their Blood, which is
+generally much less acrimonious, or sharp, in the Country, than in great
+Towns or Cities. Nevertheless, the very improper Treatment of such
+Accidents, in the Country, frequently renders them, however light in
+themselves, very troublesome; and indeed, I have seen so many Instances
+of this, that I have thought it necessary to mark out here the proper
+Treatment of such Accidents, as may not necessarily require the Hand or
+Attendance of a Surgeon. I shall also add something very briefly,
+concerning some external Disorders, which at the same Time result from
+an inward Cause.
+
+
+
+                              _Of Burns._
+
+
+Sec. 433. When a Burn is very trifling and superficial, and occasions no
+Vesication or Blister, it is sufficient to clap a Compress of several
+Folds of soft Linen upon it, dipt in cold Water, and to renew it every
+Quarter of an Hour, till the Pain is entirely removed. But when the Burn
+has blistered, a Compress of very fine Linen, spread over with the
+Pomatum, No. 64, should be applied over it, and changed twice a Day.
+
+If the true Skin is burnt, and even the Muscles, the Flesh under it, be
+injured, the same Pomatum may be applied; but instead of a Compress, it
+should be spread upon a Pledget of soft Lint, to be applied very exactly
+over it, and over the Pledget again, a Slip of the simple Plaister No.
+65, which every Body may easily prepare; or, if they should prefer it,
+the Plaister No. 66.
+
+But, independently of these external Applications, which are the most
+effectual ones, when they are directly to be had; whenever the Burn has
+been very violent, is highly inflamed, and we are apprehensive of the
+Progress and the Consequences of the Inflammation, the same Means and
+Remedies must be recurred to, which are used in violent Inflammations:
+the Patient should be bled, and, if it is necessary, it should be
+repeated more than once, and he should be put into a Regimen; drink
+nothing but the Ptisans No. 2 and 4, and receive daily two simple
+Glysters.
+
+If the Ingredients for the Ointment, called _Nutritum_, are not at Hand
+to make the Pomatum No. 64; one Part of Wax should be melted in eight
+such Parts of Oil, to two Ounces of which Mixture the Yolk of an Egg
+should be added. A still more simple and sooner prepared Application, is
+that of one Egg, both the Yolk and the White, beat up with two common
+Spoonfuls of the sweetest Oil, without any Rankness. When the Pain of
+the Burn, and all its other Symptoms have very nearly disappeared, it is
+sufficient to apply the Sparadrap, or Oil-cloth No. 66.
+
+
+
+                              _Of Wounds._
+
+
+Sec. 434. If a Wound has penetrated into any of the Cavities, and has
+wounded any Part contained in the Breast, or in the Belly: Or if,
+without having entered into one of the Cavities, it has opened some
+great Blood-vessel; or if it has wounded a considerable Nerve, which
+occasions Symptoms much more violent, than would otherwise have
+happened; if it has penetrated even to and injured the Bone: in short,
+if any great and severe Symptom supervenes, there is an absolute
+Necessity for calling in a Surgeon. But whenever the Wound is not
+attended with any of these Circumstances; when it affects only the Skin,
+the fat Membrane beneath it, the fleshy Parts and the small Vessels, it
+may be easily and simply dressed without such Assistance; since, in
+general, all that is truly necessary in such Cases is, to defend the
+Wound from the Impressions of the Air; and yet not so, as to give any
+material Obstruction to the Discharge of the Matter, that is to issue
+from the Wound.
+
+Sec. 435. If the Blood does not particularly flow out of any considerable
+Vessel, but trickles almost equally from every Spot of the Wound, it may
+very safely be permitted to bleed, while some Lint is speedily
+preparing. As soon as the Lint is ready, so much of it may be introduced
+into the Wound as will nearly fill it, without being forced in; which is
+highly improper, and would be attended with the same Inconveniences as
+Tents and Dossils. It should be covered over with a Compress dipt in
+sweet Oil, or with the Cerecloth No. 65; though I prefer the Compress
+for the earliest Dressings: and the whole Dressing should be kept on,
+with a Bandage of two Fingers Breadth, and of a Length proportioned to
+the Size of the Part it is to surround: This should be rolled on tight
+enough to secure the Dressings, and yet so moderately, as to bring on no
+Inflammation.
+
+This Bandage with these Dressings are to remain on twenty-four or
+forty-eight Hours; Wounds being healed the sooner, for being less
+frequently drest. At the second Dressing all the Lint must be removed,
+which can be done with Ease, and with reasonable Speed, to the Wounded;
+and if any of it should stick close, in Consequence of the clogged and
+dried Blood, it should be left behind, adding a little fresh Lint to it;
+this Dressing in other Respects exactly resembling the first.
+
+When, from the Continuance of this simple Dressing, the Wound is become
+very superficial, it is sufficient to apply the Cerecloth, or Plaister,
+without any Lint.
+
+Such as have conceived an extraordinary Opinion of any medical Oils,
+impregnated with the Virtues of particular Plants, may, if that will
+increase their Satisfaction, make use of the common Oil of Yarrow, of
+Trefoil, of Lilies, of Chamomile, of Balsamines, or of red Roses; only
+being very careful, that such Oils are not become stale and rank.
+
+Sec. 436. When the Wound is considerable, it must be expected to inflame
+before Suppuration (which, in such a Case, advances more slowly) can
+ensue; which Inflammation will necessarily be attended with Pain, with a
+Fever, and sometimes with a Raving, or Wandering, too. In such a
+Situation, a Pultice of Bread and Milk, with the Addition of a little
+Oil, that it may not stick too close, must be applied instead of the
+Compress or the Plaister: which Pultice is to be changed, but without
+uncovering the Wound, thrice and even four times every Day.
+
+Sec. 437. Should some pretty considerable Blood-vessel be opened by the
+Wound, there must be applied over it, a Piece of Agaric of the Oak, No.
+67, with which no Country place ought to be unprovided. It is to be kept
+on, by applying a good deal of Lint over it; covering the whole with a
+thick Compress, and then with a Bandage a little tighter than usual. If
+this should not be sufficient to prevent the Bleeding from the large
+Vessel, and the Wound be in the Leg or Arm, a strong Ligature must be
+made above the Wound with a _Turniquet_, which is made in a Moment with
+a Skain of Thread, or of Hemp, that is passed round the Arm circularly,
+into the Middle of which is inserted a Piece of Wood or Stick of an Inch
+Thickness, and four or five Inches long; so that by turning round this
+Piece of Wood, any Tightness or Compression may be effected at Pleasure;
+exactly as a Country-man secures a Hogshead, or a Piece of Timber on his
+Cart, with a Chain and Ring. But Care must be taken, 1, to dispose the
+Skain in such a Manner, that it must always be two Inches wider than the
+Part it surrounds: and, 2, not to strain it so tight as to bring on an
+Inflammation, which might terminate in a Gangrene.
+
+Sec. 438. All the boasted Virtues of a Multitude of Ointments are downright
+Nonsense or Quackery. Art, strictly considered, does not in the least
+contribute to the healing of Wounds; the utmost we can do amounting only
+to our removing those Accidents, which are so many Obstacles to their
+Re-union. On this Account, if there is any extraneous Body in the Wound,
+such as Iron, Lead, Wood, Glass, Bits of Cloth or Linen, they must be
+extracted, if that can be very easily done; but if not, Application must
+be made to a good Surgeon, who considers what Measures are to be taken,
+and then dresses the Wound, as I have already advised.
+
+Very far from being useful, there are many Ointments that are pernicious
+on these Occasions; and the only Cases in which they should be used, are
+those in which the Wounds are distinguished with some particular
+Appearances, which ought to be removed by particular Applications: But a
+simple recent Wound, in a healthy Man, requires no other Treatment but
+what I have already directed, besides that of the general Regimen.
+
+Spirituous Applications are commonly hurtful, and can be suitable and
+proper but in a few Cases, which Physicians and Surgeons only can
+distinguish.
+
+When Wounds occur in the Head, instead of the Compress dipt in Oil, or
+of the Cerecloth, the Wound should be covered with a Betony Plaister;
+or, when none is to be had in time, with a Compress squeezed out of hot
+Wine.
+
+Sec. 439. As the following Symptoms, of which we should be most
+apprehensive, are such as attend on Inflammations, the Means we ought to
+have Recourse to are those which are most likely to prevent them; such
+as Bleeding, the usual Regimen, moderate Coolers and Glysters.
+
+Should the Wound be very inconsiderable in its Degree, and in its
+Situation, it may be sufficient to avoid taking any Thing heating; and
+above all Things to retrench the Use of any strong Drink, and of
+Flesh-meat.
+
+But when it is considerable, and an Inflammation must be expected, there
+is a Necessity for Bleeding; the Patient should be kept in the most
+quiet and easy Situation; he should be ordered immediately to a Regimen;
+and sometimes the Bleeding also must be repeated. Now all these Means
+are the more indispensably necessary, when the Wound has penetrated to
+some internal Part; in which Situation, no Remedy is more certain than
+that of an extremely light Diet. Such wounded Persons as have been
+supposed incapable of living many Hours, after Wounds in the Breast, in
+the Belly, or in the Kidnies, have been completely recovered, by living
+for the Course of several Weeks, on nothing but a Barley, or other
+farinaceous mealy, Ptisans, without Salt, without Soup, without any
+Medicine; and especially without the Use of any Ointments.
+
+Sec. 440. In the same Proportion that Bleeding, moderately and judiciously
+employed, is serviceable, in that very same an Excess of it becomes
+pernicious. Great Wounds are generally attended with a considerable Loss
+of Blood, which has already exhausted the wounded Person; and the Fever
+is often a Consequence of this copious Loss of Blood. Now if under such
+a Circumstance, Bleeding should be ordered and performed, the Patient's
+Strength is totally sunk; the Humours stagnate and corrupt; a Gangrene
+supervenes, and he dies miserably, at the End of two or three Days, of a
+_Series_ of repeated Bleedings, but not of the Wound. Notwithstanding
+the Certainty of this, the Surgeon frequently boasts of his ten, twelve,
+or even his fifteen Bleedings; assuring his Hearers of the insuperable
+Mortality of the Wound, since the letting out such a Quantity of Blood
+could not recover the Patient; when it really was that excessive
+artificial Profusion of it, that downright dispatched him.------The
+Pleasures of Love are very mortal ones to the Wounded.
+
+Sec. 441. The Balsams and vulnerary Plants, which have often been so highly
+celebrated for the Cure of Wounds, are very noxious, when taken
+inwardly; because the Introduction of them gives or heightens the Fever,
+which ought to have been abated.
+
+
+
+                      _Of Contusions, or Bruises._
+
+
+Sec. 442. A Contusion, which is commonly called a Bruise, is the Effect of
+the forcible Impression or Stroke of a Substance not sharp or cutting,
+on the Body of a Man, or any Animal; whether such an Impression be
+violently made on the Man, as when he is struck by a Stick, or by a
+Stone thrown at him; or whether the Man be involuntarily forced against
+a Post, a Stone, or any hard Substance by a Fall; or whether, in short,
+he is squeezed and oppressed betwixt two hard Bodies, as when his Finger
+is squeezed betwixt the Door and the Door-Post, or the whole Body jammed
+in betwixt any Carriage and the Wall. These Bruises, however, are still
+more frequent in the Country than Wounds, and commonly more dangerous
+too; and indeed the more so, as we cannot judge so exactly, and so soon,
+of the whole Injury that has been incurred; and because all that is
+immediately visible of it is often but a small Part of the real Damage
+attending it: since it frequently happens that no Hurt appears for a few
+successive Days; nor does it become manifest, until it is too late to
+admit of an effectual Cure.
+
+Sec. 443. It is but a few Weeks since a Cooper came to ask my Advice. His
+Manner of breathing, his Aspect, the Quickness, Smallness, and
+Irregularity of his Pulse, made me apprehensive at once, that some
+Matter was formed within his Breast. Nevertheless he still kept up, and
+went about, working also at some Part of his Trade. He had fallen in
+removing some Casks or Hogsheads; and the whole Weight of his Body had
+been violently impressed upon the right Side of his Breast.
+Notwithstanding this, he was sensible of no Hurt at first; but some Days
+afterwards he began to feel a dull heavy Pain in that Part, which
+continued and brought on a Difficulty of Breathing, Weakness, broken
+Sleep and Loss of Appetite. I ordered him immediately to Stillness and
+Repose, and I advised him to drink a Ptisan of Barley sweetened with
+Honey, in a plentiful Quantity. He regularly obeyed only the latter Part
+of my Directions: yet on meeting him a few Days after, he told me he was
+better. The very same Week, however, I was informed he had been found
+dead in his Bed. The Imposthume had undoubtedly broke, and suffocated
+him.
+
+Sec. 444. A young Man, run away with by his Horse, was forced with Violence
+against a Stable-Door, without being sensible of any Damage at the Time.
+But at the Expiration of twelve Days, he found himself attacked by some
+such Complaints, as generally occur at the Beginning of a Fever. This
+Fever was mistaken for a putrid one, and he was very improperly treated,
+for the Fever it really was, above a Month. In short, it was agreed at a
+Consultation, that Matter was collected in the Breast. In Consequence of
+this, he was more properly attended, and at length happily cured by the
+Operation for an _Empyema_, after languishing a whole Year. I have
+published these two Instances, to demonstrate the great Danger of
+neglecting violent Strokes or Bruises; since the first of these Patients
+might have escaped Death; and the second a tedious and afflicting
+Disorder, if they had taken, immediately after each Accident, the
+necessary Precautions against its Consequences.
+
+Sec. 445. Whenever any Part is bruised, one of two Things always ensues,
+and commonly both happen together; especially if the Contusion is pretty
+considerable: Either the small Blood-vessels of the contused Part are
+broken, and the Blood they contained is spread about in the adjoining
+Parts; or else, without such an Effusion of it, these Vessels have lost
+their Tone, their active Force, and no longer contributing to the
+Circulation, their Contents stagnate. In each of these Cases, if Nature,
+either without or with the Assistance of Art, does not remove the
+Impediment, an Inflammation comes on, attended with an imperfect,
+unkindly Suppuration, with Putrefaction and a Gangrene; without
+mentioning the Symptoms that arise from the Contusion of some particular
+Substance, as a Nerve, a large Vessel, a Bone, _&c._ Hence we may also
+conceive the Danger of a Contusion, happening to any inward Part, from
+which the Blood is either internally effused, or the Circulation wholly
+obstructed in some vital Organ. This is the Cause of the sudden Death of
+Persons after a violent Fall; or of those who have received the violent
+Force of heavy descending Bodies on their Heads; or of some violent
+Strokes, without any evident external Hurt or Mark.
+
+There have been many Instances of sudden Deaths after one Blow on the
+Pit of the Stomach, which has occasioned a Rupture of the Spleen.
+
+It is in Consequence of Falls occasioning a general slight Contusion, as
+well internal as external, that they are sometimes attended with such
+grievous Consequences, especially in old Men, where Nature, already
+enfeebled, is less able to redress such Disorders. And thus in Fact has
+it been, that many such, who had before enjoyed a firm State of Health,
+have immediately lost it after a Fall (which seemed at first to have
+affected them little or not at all) and languished soon after to the
+Moment of their Death, which such Accidents very generally accelerate.
+
+Sec. 446. Different external and internal Remedies are applicable in
+Contusions. When the Accident has occurred in a slight Degree, and there
+has been no great nor general Shock, which might produce an internal
+Soreness or Contusion, external Applications may be sufficient. They
+should consist of such Things as are adapted, first, to attenuate and
+resolve the effused and stagnant Blood, which shews itself so
+apparently; and which, from its manifest Blackness very soon after the
+Contusion, becomes successively brown, yellow, and greyish, in
+Proportions as the Magnitude of the Suffusion or Sealing decreases, till
+at last it disappears entirely, and the Skin recovers its Colour,
+without the Blood's having been discharged through the external Surface,
+as it has been insensibly and gradually dissolved, and been taken in
+again by the Vessels: And secondly, the Medicines should be such as are
+qualified to restore the Tone, and to recover the Strength of the
+affected Vessels.
+
+The best Application is Vinegar, diluted, if very sharp, with twice as
+much warm Water; in which Mixture Folds of Linnen are to be dipt, within
+which the contused Parts are to be involved; and these Folds are to be
+remoistened and re-applied every two Hours on the first Day.
+
+Parsley, Chervil, and Houseleek Leaves, lightly pounded, have also been
+successfully employed; and these Applications are preferable to Vinegar,
+when a Wound is joined to the Bruise. The Pultices, No. 68, may also be
+used with Advantage.
+
+Sec. 447. It has been a common Practice immediately to apply spirituous
+Liquors, such as Brandy, Arquebussade and [97] Alibour Water, and the
+like; but a long Abuse ought not to be established by Prescription.
+These Liquids which coagulate the Blood, instead of resolving it, are
+truly pernicious; notwithstanding they are sometimes employed without
+any visible Disadvantage on very slight Occasions. Frequently by
+determining the settled Blood towards the Insterstices of the Muscles,
+the fleshy Parts; or sometimes even by preventing the Effusion, or
+visible Settling of the Blood, and fixing it, as it were, within the
+bruised Vessels, they seem to be well; though this only arises from
+their concentring and concealing the Evil, which, at the End of a few
+Months, breaks forth again in a very troublesome Shape. Of this I have
+seen some miserable Examples, whence it has been abundantly evinced,
+that Applications of this Sort should never be admitted; and that
+Vinegar should be used instead of them. At the utmost it should only be
+allowed, (after there is Reason to suppose all the stagnant Blood
+resolved and resorbed into the Circulation) to add a third Part of
+Arquebusade Water to the Vinegar; with an Intention to restore some
+Strength to the relaxed and weakened Parts.
+
+[97] This, Dr. _Tissot_ informs me, is a Solution of white Vitriol and
+     some other Drugs in Spirit of Wine, and is never used in regular
+     Practice now. It has its Name from the Author of the Solution. _K._
+
+Sec. 448. It is still a more pernicious Practice to apply, in Bruises,
+Plaisters composed of greasy Substances, Rosins, Gums, Earths, _&c._ The
+most boasted of these is always hurtful, and there have been many
+Instances of very slight Contusions being aggravated into Gangrenes by
+such Plaisters ignorantly applied; which Bruises would have been
+entirely subdued by the Oeconomy of Nature, if left to herself, in the
+Space of four Days.
+
+Those Sacs or Suffusions of coagulated Blood, which are visible under
+the Skin, should never be opened, except for some urgent Reason; since
+however large they may be, they insensibly disappear and dissipate;
+instead of which Termination, by opening them, they sometimes terminate
+in a dangerous Ulceration.
+
+Sec. 449. The internal Treatment of Contusions is exactly the same with
+that of Wounds; only that in these Cases the best Drink is the
+Prescription, No. 1, to each Pot of which a Drachm of Nitre must be
+added.
+
+When any Person has got a violent Fall; has lost his Senses, or is
+become very stupid; when the Blood starts out of his Nostrils, or his
+Ears; when he is greatly oppressed, or his Belly feels very tight and
+tense, which import an Effusion of Blood either into the Head, the
+Breast or the Belly, he must, first of all, be bled upon the Spot, and
+all the Means must be recurred to, which have been mentioned Sec. 439,
+giving the wretched Patient the least possible Disturbance or Motion;
+and by all means avoiding to jog or shake him, with a Design to bring
+him to his Senses; which would be directly and effectually killing him,
+by causing a further Effusion of Blood. Instead of this the whole Body
+should be fomented, with some one of the Decoctions already mentioned:
+and when the Violence has been chiefly impressed on the Head, Wine and
+Water should be prefered to Vinegar.
+
+Falls attended with Wounds, and even a Fracture of the Skull, and with
+the most alarming Symptoms, have been cured by these internal Remedies,
+and without any other external Assistance, except the Use of the
+aromatic Fomentation, No. 68.
+
+A Man from _Pully-petit_ came to consult me some Months ago, concerning
+his Father, who had a high Fall out of a Tree. He had been twenty-four
+Hours without Feeling or Sense, and without any other Motion than
+frequent Efforts to vomit; and Blood had issued both from his Nose and
+Ears. He had no visible outward Hurt neither on his Head, nor any other
+Part; and, very fortunately for him, they had not as yet exerted the
+least Effort to relieve him. I immediately directed a plentiful Bleeding
+in the Arm; and a large Quantity of Whey sweetened with Honey to be
+drank, and to be also injected by Way of Glyster. This Advice was very
+punctually observed; and fifteen Days after the Father came to
+_Lausanne_, which is four Leagues from _Pully-petit_, and told me he was
+very well. It is proper, in all considerable Bruises, to open the
+Patient's Belly with a mild cooling Purge, such as No. 11, 23, 32, 49.
+The Prescription No. 24, and the honyed Whey are excellent Remedies,
+from the same Reason.
+
+Sec. 450. In these Circumstances, Wine, distiled Spirits, and whatever has
+been supposed to revive and to rouse, is mortal. For this Reason People
+should not be too impatient, because the Patients remain some Time
+without Sense or Feeling. The giving of Turpentine is more likely to do
+Mischief than Good; and if it has been sometimes serviceable, it must
+have been in Consequence of its purging the Patient, who probably then
+needed to be purged. The Fat of a Whale, (_Sperma caeti_) Dragons Blood,
+Crabs-Eyes, and Ointments of whatsoever Sort are at least useless and
+dangerous Medicine, if the Case be very hazardous; either by the
+Mischief they do, or the Good they prevent from being done. The proper
+Indication is to dilute the Blood, to render it more fluid and disposed
+to circulate; and the Medicines just mentioned produce a very contrary
+Effect.
+
+Sec. 451. When an aged Person gets a Fall, which is the more dangerous in
+Proportion to his Age and Grossness; notwithstanding he should not seem
+in the least incommoded by it, if he is sanguine and still somewhat
+vigorous, he should part with three or four Ounces of Blood. He should
+take immediately a few successive Cups of a lightly aromatic Drink,
+which should be given him hot; such, for Instance, as an Infusion of Tea
+sweetened with Honey, and he should be advised to move gently about. He
+must retrench a little from the usual Quantity of his Food, and accustom
+himself to very gentle, but very frequent, Exercise.
+
+Sec. 452. Sprains or Wrenches, which very often happen, produce a Kind of
+Contusion, in the Parts adjoining to the sprained Joint. This Contusion
+is caused by the violent Friction of the Bone against the neighbouring
+Parts; and as soon as the Bones are immediately returned into their
+proper Situation, the Disorder should be treated as a Contusion. Indeed
+if the Bones should not of themselves return into their proper natural
+Position, Recourse must be had to the Hand of a Surgeon.
+
+The best Remedy in this Case is absolute Rest and Repose, after applying
+a Compress moistened in Vinegar and Water, which is to be renewed and
+continued, till the Marks of the Contusion entirely disappear; and there
+remains not the smallest Apprehension of an Inflammation. Then indeed,
+and not before, a little Brandy or Arquebusade Water may be added to the
+Vinegar; and the Part (which is almost constantly the Foot) should be
+strengthened and secured for a considerable Time with a Bandage; as it
+might otherwise be liable to fresh Sprains, which would daily more and
+more enfeeble it: and if this Evil is overlooked too much in its
+Infancy, the Part never recovers its full Strength; and a small Swelling
+often remains to the End of the Patient's Life.
+
+If the Sprain is very slight and moderate, a Plunging of the Part into
+cold Water is excellent; but if this is not done at once immediately
+after the Sprain, or if the Contusion is violent, it is even hurtful.
+
+The Custom of rolling the naked Foot upon some round Body is
+insufficient, when the Bones are not perfectly replaced; and hurtful,
+when the Sprain is accompanied with a Contusion.
+
+It happens continually almost that Country People, who encounter such
+Accidents, apply themselves either to ignorant or knavish Imposters, who
+find, or are determined to find, a Disorder or Dislocation of the Bones,
+where there is none; and who, by their violent Manner of handling the
+Parts, or by the Plaisters they surround them with, bring on a dangerous
+Inflammation, and change the Patient's Dread of a small Disorder, into a
+very grievous Malady.
+
+These are the very Persons who have created, or indeed rather imagined,
+some impossible Diseases, such as the Opening, the Splitting of the
+Stomach, and of the Kidnies. But these big Words terrify the poor
+Country People, and dispose them to be more easily and effectually
+duped.
+
+
+
+                              _Of Ulcers._
+
+
+Sec. 453. Whenever Ulcers arise from a general Fault of the Blood, it is
+impossible to cure them, without destroying the Cause and Fuel of them.
+It is in Fact imprudent to attempt to heal them up by outward Remedies;
+and a real Misfortune to the Patient, if his Assistant effectually heals
+and closes them.
+
+But, for the greater Part, Ulcers in the Country are the Consequence of
+some Wound, Bruise, or Tumour improperly treated; and especially of such
+as have been dressed with too sharp, or too spirituous Applications.
+Rancid Oils are also one of the Causes, which change the most simple
+Wounds into obstinate Ulcers, for which Reason they should be avoided;
+and Apothecaries should be careful, when they compound greasy Ointments,
+to make but little at a Time, and the oftner, as a very considerable
+Quantity of any of them becomes rank before it is all sold;
+notwithstanding sweet fresh Oil may have been employed in preparing
+them.
+
+Sec. 454. What serves to distinguish Ulcers from Wounds, is the Dryness and
+Hardness of the Sides or Borders of Ulcers, and the Quality of the
+Humour discharged from them; which, instead of being ripe consistent
+Matter, is a Liquid more thin, less white, sometimes yielding a
+disagreable Scent, and so very sharp, that if it touch the adjoining
+Skin, it produces Redness, Inflammation, or Pustules there; sometimes a
+serpiginous, or Ring-worm like Eruption, and even a further Ulceration.
+
+Sec. 455. Such Ulcers as are of a long Duration, which spread wide, and
+discharge much, prey upon the Patient, and throw him into a slow Fever,
+which melts and consumes him. Besides, when an Ulcer is of a long
+Standing, it is dangerous to dry it up; and indeed this never should be
+done, but by substituting in the Place of one Discharge that is become
+almost natural, some other Evacuation, such as Purging from Time to
+Time.
+
+We may daily see sudden Deaths, or very tormenting Diseases, ensue the
+sudden drying up such Humours and Drains as have been of a long
+Continuance: and whenever any Quack (and as many as promise the speedy
+Cure of such, deserve that Title) assures the Patient of his curing an
+inveterate Ulcer in a few Days, he demonstrates himself to be a very
+dangerous and ignorant Intermeddler, who must kill the Patient, if he
+keeps his Word. Some of these impudent Impostors make use of the most
+corrosive Applications, and even arsenical ones; notwithstanding the
+most violent Death is generally the Consequence of them.
+
+Sec. 456. The utmost that Art can effect, with Regard to Ulcers, which do
+not arise from any Fault in the Humours, is to change them into Wounds.
+To this End, the Hardness and Dryness of the Edges of the Ulcer, and
+indeed of the whole Ulcer, must be diminished, and its Inflammation
+removed. But sometimes the Hardness is so obstinate, that this cannot be
+mollified any other Way, than by scarifying the Edges with a Lancet. But
+when it may be effected by other Means, let a Pledget spread with the
+Ointment, No. 69, be applied all over the Ulcer; and this Pledget be
+covered again with a Compress of several Folds, moistened in the Liquid,
+No. 70, which should be renewed three times daily; though it is
+sufficient to apply a fresh Pledget only twice.
+
+As I have already affirmed that Ulcers were often the Consequence of
+sharp and spirituous Dressings, it is evident such should be abstained
+from, without which Abstinence they will prove incurable.
+
+To forward the Cure, salted Food, Spices, and strong Drink should be
+avoided; the Quantity of Flesh-meat should be lessened; and the Body be
+kept open by a Regimen of Pulse, of Vegetables, and by the habitual Use
+of Whey sweetened with Honey.
+
+If the Ulcers are in the Legs, a very common Situation of them, it is of
+great Importance, as well as in Wounds of the same Parts, that the
+Patient should walk about but little; and yet never stand up without
+walking. This indeed is one of these Cases, in which those, who have
+some Credit and Influence in the Estimation of the People, should omit
+nothing to make them thoroughly comprehend the Necessity of confining
+themselves, some Days, to undisturbed Tranquillity and Rest; and they
+should also convince them, that this Term of Rest is so far from being
+lost Time, that it is likely to prove their most profitable Time of
+Life. Negligence, in this material Point, changes the slightest Wounds
+into Ulcers, and the most trifling Ulcers into obstinate and incurable
+ones: insomuch that there is scarcely any Man, who may not observe some
+Family in his Neighbourhood, reduced to the Hospital, [98] from their
+having been too inattentive to the due Care of some Complaint of this
+Sort.
+
+[98] This seems just the same as _coming on the Parish_, or being
+     received into an Alms house here; in Consequence of such an
+     incurable Disability happening to the poor working Father of a
+     Family. _K._
+
+I conclude this Article on Ulcers with repeating, that those which are
+owing to some internal Cause; or even such as happen from an external
+one, in Persons of a bad Habit of Body, frequently require a more
+particular Treatment.
+
+
+
+                           _Of Frozen Limbs._
+
+
+Sec. 457. It is but too common, in very rigorous Winters, for some Persons
+to be pierced with so violent a Degree of Cold, that their Hands or
+Feet, or sometimes both together are frozen at once, just like a Piece
+of Flesh-meat exposed to the Air.
+
+If a Person thus pierced with the Cold, dispose himself to walk about,
+which seems so natural and obvious a Means to get warm; and especially,
+if he attempts to [99] warm the Parts that have been frozen, his Case
+proves irrecoverable. Intolerable Pains are the Consequence, which Pains
+are speedily attended with an incurable Gangrene; and there is no Means
+left to save the Patient's Life, but by cutting off the gangrened Limbs.
+
+[99] The Reason of the Fatality of Heat, in these Cases, and of the
+     Success of an opposite Application, (See Sec. 459) seems strictly and
+     even beautifully analogous to what _Hippocrates_ has observed of
+     the Danger, and even Fatality, of all great and sudden Changes in
+     the human Body, whether from the Weather or otherwise. Whence this
+     truly great Founder of Physick, when he observes elsewhere, that
+     Diseases are to be cured by something contrary to their Causes,
+     very consistently advises, not a direct and violent Contrariety,
+     but a gradual and regulated one, a _Sub-contrariety_. _K._
+
+There was a very late and terrible Example of this, in the Case of an
+Inhabitant at _Cossonay_, who had both his Hands frozen. Some greasy
+Ointments were applied hot to them, the Consequence of which was, the
+Necessity of cutting off six of his Fingers.
+
+Sec. 458. In short, there is but one certain Remedy in such Cases, and this
+is to convey the Person affected into some Place where it does not
+freeze, but where, however, it is but very moderately hot, and there
+continually to apply, to the frozen Parts, Snow, if it be at hand; and
+if not, to keep washing them incessantly, but very gently (since all
+Friction would at this Juncture prove dangerous) in Ice-water, as the
+Ice thaws in the Chamber. By this Application the Patients will be
+sensible of their Feeling's returning very gradually to the Part, and
+that they begin to recover their Motion. In this State they may Safely
+be moved into a Place a little warmer, and drink some Cups of the Potion
+No. 13, or of another of the like Quality.
+
+Sec. 459. Every Person may be a competent judge of the manifest Danger of
+attempting to relieve such Parts by heating them, and of the Use of
+Ice-water, by a common, a daily Experience. Frozen Pears, Apples, and
+Radishes, being put into Water just about to freeze, recover their
+former State, and prove quickly eatable. But if they are put into warm
+Water, or into a hot Place, Rottenness, which is one Sort of Gangrene,
+is the immediate Effect. The following Case will make this right Method
+of treating them still more intelligible, and demonstrate its Efficacy.
+
+A Man was travelling to the Distance of six Leagues in very cold
+Weather; the Road being covered with Snow and Ice. His Shoes, not being
+very good, failed him on his March, so that he walked the three last
+Leagues bare-footed; and felt, immediately after the first Half League,
+sharp Pains in his Legs and Feet, which increased as he proceeded. He
+arrived at his Journey's End in a Manner nearly deprived of his lower
+Extremities. They set him before a great Fire, heated a Bed well, and
+put him into it. His Pains immediately became intolerable: he was
+incessantly in the most violent Agitations, and cried out in the most
+piercing and affecting Manner. A Physician, being sent for in the Night,
+found his Toes of a blackish Colour, and beginning to lose their
+Feeling. His Legs and the upper Part of his Feet, which were excessively
+swelled, of a purplish Red, and varied with Spots of a violet Colour,
+were still sensible of the most excruciating Pains. The Physician
+ordered in a Pail of Water from the adjoining River, adding more to it,
+and some Ice withal. In this he obliged the Patient to plunge his Legs;
+they were kept in near an Hour, and within that Time, the Pains became
+less violent. After another Hour he ordered a second cold Bath, from
+which the Patient perceiving still further Relief, prolonged it to the
+Extent of two Hours. During that Time, some Water was taken out of the
+Pail, and some Ice and Snow were put into it. Now his Toes, which had
+been black, grew red; the violet Spots in his Legs disappeared; the
+Swelling abated; the Pains became moderate, and intermitted. The Bath
+was nevertheless repeated six times; after which there remained no other
+Complaint, but that of a great Tenderness or extraordinary Sensibility
+in the Soles of his Feet, which hindered him from walking. The Parts
+were afterwards bathed with some aromatic Fomentations; and he drank a
+Ptisan of Sarsaparilla [one of Elder Flowers would have answered the
+same Purpose, and have been less expensive.] On the eighth Day from his
+Seizure he was perfectly recovered, and returned home on Foot on the
+fifteenth.
+
+Sec. 460. When cold Weather is extremely severe, and a Person is exposed to
+it for a long Time at once, it proves mortal, in Consequence of its
+congealing the Blood, and because it forces too great a Proportion of
+Blood up to the Brain; so that the Patient dies of a Kind of Apoplexy,
+which is preceded by a Sleepiness. In this Circumstance the Traveller,
+who finds himself drowsy, should redouble his Efforts to extricate
+himself from the eminent Danger he is exposed to. This Sleep, which he
+might consider as some Alleviation of his Sufferings, if indulged, would
+prove his last.
+
+Sec. 461. The Remedies in such Cases are the same with those directed in
+frozen Limbs. The Patient must be conducted to an Apartment rather cold
+than hot, and be rubbed with Snow or with Ice-water. There have been
+many well attested Instances of this Method; and as such Cases are still
+more frequent in more northern Climates, a Bath of the very coldest
+Water has been found the surest Remedy.
+
+Since it is known that many People have been revived, who had remained
+in the Snow, or had been exposed to the freezing Air during five, or
+even six successive Days, and who had discovered no one Mark of Life for
+several Hours, the utmost Endeavours should be used for the Recovery of
+Persons in the like Circumstances and Situation.
+
+
+
+                       _Of Kibes, or Chilblains._
+
+
+Sec. 462. These troublesome and smarting Complaints attack the Hands, Feet,
+Heels, Ears, Nose and Lips, those of Children especially, and mostly in
+Winter; when these Extremities are exposed to the sudden Changes from
+hot to cold, and from cold to hot Weather. They begin with an Inflation
+or kind of Swelling, which, at first, occasions but little Heat, Pain or
+Itching. Sometimes they do not exceed this first State, and go off
+spontaneously without any Application: But at other Times (which may be
+termed the second Degree of the Disorder, whether it happens from their
+being neglected, or improperly treated) their Heat, Redness, Itching and
+Pain increase considerably; so that the Patient is often deprived of the
+free Use of his Fingers by the Pain, Swelling and Numbness: in which
+Case the Malady is still aggravated, if effectual Means are not used.
+
+Whenever the Inflammation mounts to a still higher Degree, small
+Vesications or Blisters are formed, which are not long without bursting;
+when they leave a slight Excoriation, or Rawness, as it were, which
+speedily ulcerates, and frequently proves a very deep and obstinate
+Ulcer, discharging a sharp and ill-conditioned Matter.
+
+The last and most virulent Degree of Chilblains, which is not infrequent
+in the very coldest Countries, though very rare in the temperate ones,
+is, when the Inflammation degenerates into a Gangrene.
+
+Sec. 463. These Tumours are owing to a Fulness and Obstruction of the
+Vessels of the Skin, which occurs from this Circumstance, that the
+Veins, which are more superficial than the Arteries, being
+proportionably more affected and straitened by the Cold, do not carry
+off all the Blood communicated to them by the Arteries; and perhaps also
+the Particles or Atoms of Cold, which are admitted through the Pores of
+the Skin, may act upon our Fluids, as it does upon Water, and occasion a
+Congelation of them, or a considerable Approach towards it.
+
+If these Complaints are chiefly felt, which in Fact is the Case, rather
+on the extreme Parts than on others, it arises from two Causes, the
+principal one being, that the Circulation's being weaker at the
+Extremities than elsewhere, the Effect of those Causes, that may impair
+it, must be more considerably felt there. The second Reason is, because
+these Parts are more exposed to the Impressions from without than the
+others.
+
+They occur most frequently to Children, from their Weakness and the
+greater Tenderness and Sensibility of their Organs, which necessarily
+increases the Effect of external Impressions. It is the frequent and
+strong Alteration from Heat to Cold, that seems to contribute the most
+powerfully to the Production of Chilblains; and this Effect of it is
+most considerable, when the Heat of the Air is at the same Time blended
+with Moisture; whence the extreme and superficial Parts pass suddenly as
+it were, out of a hot, into a cold, Bath. A Man sixty Years of Age, who
+never before was troubled with Kibes, having worn, for some Hours on a
+Journey, a Pair of furred Gloves, in which his Hands sweated, felt them
+very tender, and found them swelled up with Blood: as the common Effect
+of the warm Bath is to soften and relax, and to draw Blood abundantly to
+the bathed Parts, whence it renders them more sensible.
+
+This Man, I say, thus circumstanced, was at that Age first attacked with
+Chilblains, which proved extremely troublesome; and he was every
+succeeding Winter as certainly infested with them, within Half an Hour
+after he left off his Gloves, and was exposed to a very cold Air.
+
+It is for this Reason, that several Persons are never infested with
+Chilblains, but when they use themselves to Muffs, which are scarcely
+known in hot Countries; nor are they very common among the more northern
+ones, in which the extraordinary Changes from Cold to Heat are very rare
+and unusual.
+
+Some People are subject to this troublesome Complaint in the Fall; while
+others have it only in the Spring. The Child of a labouring Peasant, who
+has a hard Skin, and one inured to all the Impressions of the Seasons
+and of the Elements, is, and indeed necessarily must be, less liable to
+Kibes, than the Child of a rich Citizen, whose Skin is often cherished,
+at the Expence of his Constitution. But even among Children of the same
+Rank in Life and Circumstances, who seem pretty much of the same
+Complexion, and live much in the same Manner; whence they might of
+Course be supposed equally liable to the same Impressions, and to the
+like Effects of them, there is, nevertheless, a very great Difference
+with Respect to their constitutional Propensity to contract Chilblains.
+Some are very cruelly tormented with them, from the setting in of
+Autumn, to the very End of the Spring: others have either none at all,
+or have them but very slightly, and for a very short Time. This
+Difference undoubtedly arises from the different Quality of their
+Humours, and the Texture of their whole Surface, but particularly from
+that of the Skin of their Hands; though we readily confess it is by no
+Means easy to determine, with Certainty and Precision, in what this
+Difference essentially consists.
+
+Children of a sanguine Complexion and delicate Skin are pretty generally
+subject to this Disorder, which is often regarded much too slightly,
+though it is really severe enough to engage our Attention more; since,
+even abstracted from the sharp Pains which smart these unhappy Children
+for several Months; it sometimes gives them a Fever, hinders them from
+sleeping, and yet confines them to their Bed, which is very prejudicial
+to their Constitutions. It also breaks in upon the Order of their
+different Duties and Employments; it interrupts their innocent salutary
+Pleasures; and sometimes, when they are obliged to earn their daily
+Bread by doing some Work or other, it sinks them down to Misery. I knew
+a young Man, who from being rendered incapable by Chilblains, of serving
+out his Apprenticeship to a Watch-maker, is become a lazy Beggar.
+
+Chilblains which attack the Nose, often leave a Mark that alters the
+Physiognomy, the Aspect of the Patient, for the Remainder of his Life:
+and the Hands of such as have suffered from very obstinate ones, are
+commonly ever sensible of their Consequences.
+
+Sec. 464. With Respect, therefore, to these afflicting Tumours and
+Ulcerations, we should, in the first Place, do our utmost to prevent
+them; and next exert our best Endeavours to cure such as we could not
+prevent.
+
+Sec. 465. Since they manifestly depend on the Sensibility of the Skin, the
+Nature of the Humours, and the Changes of the Weather from Heat to Cold,
+in Order to prevent them, in the first Place, the Skin must be rendered
+firmer or less tender. 2, That vicious Quality of the Temperament, which
+contributes to their Existence, must be corrected; and, 3, the Persons
+so liable must guard themselves as well as possible, against these
+Changes of the Weather.
+
+Now the Skin of the Hands, as well as that of the whole Body, may be
+strengthened by that Habit of washing or bathing in cold Water, which I
+have described at large, Sec. 384; and in Fact I have never seen Children,
+who had been early accustomed and inured to this Habit, as much
+afflicted with Chilblains as others. But still a more particular Regard
+should be had to fortify the Skin of the Hands, which are more obnoxious
+to this Disorder than the Feet, by making Children dip them in cold
+Water, and keep them for some Moments together in it every Morning, and
+every Evening too before Supper, from the very Beginning of the Fall. It
+will give the Children no Sort of Pain, during that Season, to contract
+this Habit; and when it is once contracted, it will give them no Trouble
+to continue it throughout the Winter, even when the Water is ready to
+freeze every where. They may also be habituated to plunge their Feet
+into cold Water twice or thrice a Week: and this Method, which might be
+less adapted for grown Persons, who had not been accustomed to it, must
+be without Objection with Respect to such Children, as have been
+accustomed to it; to whom all its Consequences must be useful and
+salutary.
+
+At the same Time Care must be taken not to defeat or lessen the Effect
+of the cold bathing, by suffering the Bather or Washer, to grow too warm
+between two Baths or Dippings; which is also avoiding the too speedy
+Successions of Heat and Cold. For this Purpose, 1, the Children must be
+taught never to warm their Hands before the Fire at such Times, and
+still less before the Stoves, which very probably are one of the
+principal Causes of Chilblains, that are less usual in Countries which
+use no such Stoves, and among those Individuals who make the least Use
+of them, where they are. Above all, the Use of _Cavettes_ (that is, of
+Seats or little Stairs, as it were, contrived between the Stove and the
+Wall) is prejudicial to Children, and even to grown People, upon several
+Accounts. 2, They should never accustom themselves to wear Muffs. 3, It
+would be also proper they should never use Gloves, unless some
+particular Circumstances require it; and I recommend this Abstinence
+from Gloves, especially to young Boys: but if any should be allowed
+them, let the Gloves be thin and smooth.
+
+Sec. 466. When Chilblains seem to be nourished by some Fault in the
+Temperament or Humours, the Consideration of a Physician becomes
+necessary, to direct a proper Method of removing or altering it. I have
+seen Children from the Age of three, to that of twelve or thirteen
+Years, in whom their Chilblains, raw and flead, as it were, for eight
+Months of the Year, seemed to be a particular Kind of Issue, by which
+Nature freed herself of an inconvenient Superfluity of Humours, when the
+Perspiration was diminished by the Abatement of the violent Heats. In
+such Cases I have been obliged to carry them through a pretty long
+Course of Regimen and Remedies; which, however, being necessarily
+various from a Variety of Circumstances, cannot be detailed here. The
+milder Preparations of Antimony are often necessary in such Cases; and
+some Purges conduce in particular ones to allay and to abridge the
+Disorder.
+
+Sec. 467. The first Degree of this Complaint goes off, as I have already
+said, without the Aid of Medicine; or should it prove somewhat more
+obstinate, it may easily be dissipated by some of the following
+Remedies. But when they rise to the second Degree, they must be treated
+like other Complaints from Congelation, or Frost-biting (of which they
+are the first Degree) with cold Water, Ice-water and Snow.
+
+No other Method or Medicine is nearly as efficacious as very cold Water,
+so as to be ready to freeze, in which the Hands are to be dipt and
+retained for some Minutes together, and several Times daily. In short it
+is the only Remedy which ought to be applied, when the Hands are the
+Parts affected; when the Patient has the Courage to bear this Degree of
+Cold; and when he is under no Circumstance which may render it
+prejudicial. It is the only Application I have used for myself, after
+having been attacked with Chilblains for some Years past, from having
+accustomed myself to too warm a Muff.
+
+There ensues a slight Degree of Pain for some Moments after plunging the
+Hand into Water, but it diminishes gradually. On taking the Hand out,
+the Fingers are numbed with the Cold, but they presently grow warm
+again; and within a Quarter of an Hour, it is entirely over.
+
+The Hands, on being taken out of the Water, are to be well dried, and
+put into Skin Gloves; after bathing three or four Times, their Swelling
+subsides, so that the Skin wrinkles: but by continuing the cold Bathing,
+it grows tight and smooth again; the Cure is compleated after using it
+three or four Days; and, in general, the Disorder never returns again
+the same Winter.
+
+The most troublesome raging Itching is certainly assuaged by plunging
+the Hands into cold Water.
+
+The Effect of Snow is, perhaps, still more speedy: the Hands are to be
+gently and often rubbed with it for a considerable Time; they grow hot,
+and are of a very high Red for some Moments, but entire Ease very
+quickly succeeds.
+
+Nevertheless, a very small Number of Persons, who must have extremely
+delicate and sensible Skins, do not experience the Efficacy of this
+Application. It seems too active for them; it affects the Skin much like
+a common blistering Plaister; and by bringing on a large flow of Humours
+there, it increases, instead of lessening the Complaint.
+
+Sec. 468. When this last Reason indeed, or some other Circumstance exists;
+such as the Child's Want of Courage, or its Affliction; the monthly
+Discharges in a Woman; a violent Cough; habitual Colics; and some other
+Maladies, which have been observed to be renewed or aggravated by the
+Influence of Cold at the Extremities, do really forbid this very cold
+Application, some others must be substituted.
+
+One of the best is to wear Day and Night, without ever putting it off, a
+Glove made of some smooth Skin, such as that of a Dog; which seldom
+fails to extinguish the Disorder in some Days time.
+
+When the Feet are affected with Chilblains, Socks of the same Skin
+should be worn; and the Patient keep close to his Bed for some Days.
+
+Sec. 469. When the Disorder is violent, the Use of cold Water prohibited,
+and the Gloves just recommended have but a slow Effect, the diseased
+Parts should be gently fomented or moistened several times a Day, with
+some Decoction, rather more than warm; which at the same time should be
+dissolving and emollient. Such is that celebrated Decoction of the
+Scrapings, the Peel of Radishes, whose Efficacy is still further
+increased, by adding one sixth Part of Vinegar to the Decoction.
+
+Another Decoction, of whose great Efficacy I have been a Witness, but
+which dies the Hands yellow for a few Days, is the Prescription No. 71.
+Many others may be made, of nearly the same Virtues, with all the
+vulnerary Herbs, and even with the _Faltranc_.
+
+Urine, which some boast of in these Cases, from their having used it
+with Success; and the Mixture of Urine and Lime-water have the like
+Virtues with the former Decoctions. [100]
+
+[100] Chilblains may also be advantageously washed with Water and Flower
+     of Mustard, which will concur, in a certain and easy Manner, both
+     to cleanse and to cure them. _E. L._
+
+As soon as the Hands affected are taken out of these Decoctions, they
+must be defended from the Air by Gloves.
+
+Sec. 470. Vapours or Steams are often more efficacious than Decoctions;
+whence instead of dipping the Hands into these already mentioned, we may
+expose them to their Vapours, with still more Success. That of hot
+Vinegar is one of the most powerful Remedies; those of [101] _Asphalt_,
+or of Turpentine have frequently succeeded too. It may be needless to
+add that the affected Parts must be defended from the Air, as well after
+the Steams as the Decoctions; since it is from this Cause of keeping off
+the Air, that the Cerecloths are of Service; and hence also the
+Application of Suet has sometimes answered.
+
+[101] This is or should be, the same with the _Bitumen Judaicum_,
+     formerly kept in the Shops; but which is never directed, except in
+     that strange Medley the _Venice_ Treacle, according to the old
+     Prescription. The best is found in _Egypt_, and on the _Red Sea_:
+     but a different Sort, from _Germany_, _France_, and _Swisserland_,
+     is now generally substituted here. _K._
+
+When the Distemper is subdued by the Use of Bathings or Steams, which
+make the Skin supple and soft, then it should be strengthened by washing
+the Parts with a little camphorated Brandy, diluted with an equal
+Quantity of Water.
+
+Sec. 471. When the Nose is affected with a Chilblain, the Steam of Vinegar,
+and an artificial Nose, or Covering for it, made of Dog-skin, are the
+most effectual Applications. The same Treatment is equally proper for
+the Ears and the Chin, when infested with them. Frequently washing these
+Parts in cold Water is a good Preservative from their being attacked.
+
+Sec. 472. Whenever the Inflammation rises very high, and brings on some
+Degree of a Fever, the Patient's usual Quantity of strong Drink and of
+Flesh-meat must be lessened; his Body should be kept open by a few
+Glysters; he should take every Evening a Dose of Nitre as prescribed,
+No. 20; and if the Fever proved strong, he should lose some Blood too.
+
+As many as are troubled with obstinate Chilblains, should always be
+denied the Use of strong Liquor and Flesh.
+
+Sec. 473. When this Distemper prevails in its third Degree, and the Parts
+are ulcerated; besides keeping the Patients strictly to the Regimen of
+Persons in a Way of Recovery, and giving them a Purge of Manna, the
+swelled Parts should be exposed to the Steams of Vinegar; the
+Ulcerations should be covered with a Diapalma Plaister; and the whole
+Part should be enveloped in a smooth soft Skin, or in thin Cerecloths.
+
+Sec. 474. The fourth Degree of this Disease, in which the Parts become
+gangrenous, must be prevented by the Method and Medicines which remove
+an Inflammation; but if unhappily a Gangrene has already appeared, the
+Assistance of a Surgeon proves indispensably necessary.
+
+
+
+                             _Of Ruptures._
+
+
+Sec. 475. _Hernias_ or Ruptures, which Country-People term _being bursten_,
+are a Disorder which sometimes occurs at the very Birth; though more
+frequently they are the Effects of violent crying, of a strong forcing
+Cough, or of repeated Efforts to vomit, in the first Months of Infancy.
+
+They may happen afterwards indiscriminately at every Age, either as
+Consequences of particular Maladies, or Accidents, or from Peoples'
+violent Exertions of their Strength. They happen much oftner to Men than
+Women; and the most common Sort, indeed the only one of which I propose
+to treat, and that but briefly, is that which consists in the Descent of
+a Part of the Guts, or of the Cawl, into the Bag or Cod-piece.
+
+It is not difficult to distinguish this Rupture. When it occurs in
+little Children, it is almost ever cured by making them constantly wear
+a Bandage which should be made only of Fustian, with a little Pillow or
+Pincushion, stuffed with Linen Rags, Hair or Bran. There should be at
+least two of these Bandages, to change them alternately; nor should it
+ever be applied, but when the Child is laid down on its Back, and after
+being well assured that the Gut or Cawl, which had fallen down, has been
+safely returned into the Cavity of the Belly; since without this
+Precaution it might occasion the worst Consequences.
+
+The good Effect of the Bandage may be still further promoted, by
+applying upon the Skin, and within the Plait or Fold of the Groin (under
+which Place the Rings, or Passage out of the Belly into the Bag lie)
+some pretty astringent or strengthening Plaister, such as that commonly
+used for Fractures, or that I have already mentioned, Sec. 144. Here we may
+observe by the Way, that ruptured Children should never be set on a
+Horse, nor be carried by any Person on Horseback, before the Rupture is
+perfectly cured.
+
+Sec. 476. In a more advanced Age, a Bandage only of Fustian is not
+sufficient; one must be procured with a Plate of Steel, even so as to
+constrain and incommode the Wearer a little at first: nevertheless it
+soon becomes habitual, and is then no longer inconvenient to them.
+
+Sec. 477. Ruptures sometimes attain a monstrous Size; and a great Part of
+the Guts fall down in to the _Scrotum_ or Bag, without any Symptom of an
+actual Disease. This Circumstance, nevertheless, is accompanied with
+very great Inconvenience, which disables Persons affected with it to
+work; and whenever the Malady is so considerable, and of a long Standing
+too, there are commonly some Obstacles that prevent a compleat Return of
+the Guts into the Belly. In this State indeed, the Application of the
+Bandage or Truss is impracticable, and the miserable Patients are
+condemned to carry their grievous Burthen for the Remainder of their
+Lives; which may however, be palliated a little by the Use of a
+Suspensory and Bag, adapted to the Size of the Rupture. This Dread of
+its increasing Magnitude is a strong Motive for checking the Progress of
+it, when it first appears. But there is another still stronger, which
+is, that Ruptures expose the Patient to a Symptom frequently mortal.
+This occurs when that Part of the Intestines fallen into the _Scrotum_
+inflames; when still increasing in its Bulk, and being extremely
+compressed, acute Pains come on: for now from the Increase of the
+Rupture's Extent, the Passage which gave Way to its Descent, cannot
+admit of its Return or Ascent; the Blood-vessels themselves being
+oppressed, the Inflammation increases every Moment; the Communication
+between the Stomach and the Fundament is often entirely cut off; so that
+nothing passes through, but incessant Vomitings come on [this being the
+Kind of _Miserere_, or Iliac Passion I have mentioned, Sec. 320] which are
+succeeded by the Hickup, Raving, Swooning, cold Sweats, and Death.
+
+Sec. 478. This Symptom supervenes in Ruptures, when the Excrements become
+hard in that Part of the Guts fallen into the _Scrotum_; when the
+Patient is overheated with Wine, Drams, an inflammatory Diet, _&c._ or
+when he has received a Stroke on the ailing Part, or had a Fall.
+
+Sec. 479. The best Means and Remedies are, 1, as soon as ever this Symptom
+or Accident is manifest, to bleed the Patient very plentifully, as he
+lies down in his Bed and upon his Back, with his Head a little raised,
+and his Legs somewhat bent, so that his Knees may be erect. This is the
+Attitude or Posture they should always preserve as much as possible.
+When the Malady is not too far advanced, the first Bleeding often makes
+a compleat Cure; and the Guts return up as soon as it is over. At other
+Times this Bleeding is less successful, and leaves a Necessity for its
+Repetition.
+
+2, A Glyster must be thrown up consisting of a strong Decoction of the
+large white Beet Leaves, with a small Spoonful or Pinch of common Salt,
+and a Bit of fresh Butter of the Size of an Egg.
+
+3, Folds of Linen dipt in Ice-water must be applied all over the Tumour,
+and constantly renewed every Quarter of an Hour. This Remedy, when
+immediately applied, has produced the most happy Effects; but if the
+Symptom has endured violently more than ten or twelve Hours, it is often
+too late to apply it; and then it is better to make Use of Flanels dipt
+in a warm Decoction of Mallow and Elder Flowers, shifting them
+frequently. It has been known however, that Ice-water, or Ice itself has
+succeeded as late as the third Day. [102]
+
+[102] Pieces of Ice applied between two Pieces of Linen, directly upon
+     the Rupture, as soon as possible after its first Appearance, is one
+     of those extraordinary Remedies, which we should never hesitate to
+     make immediate Use of. We may be certain by this Application, if
+     the Rupture is simple, and not complicated from some aggravating
+     Cause, to remove speedily, and with very little Pain, a Disorder,
+     that might be attended with the most dreadful Consequences. But the
+     Continuance of this Application must be proportioned to the
+     Strength of the Person ruptured, which may be sufficiently
+     estimated by the Pulse. _E. L._
+
+4, When these Endeavours are insufficient, Glysters of Tobacco Smoke
+must be tried, which has often redressed and returned Ruptures, when
+every Thing else had failed.
+
+5, And lastly, if all these Attempts are fruitless, the Operation must
+be resolved on, without losing a Moment's Time; as this local Disease
+proves sometimes mortal in the Space of two Days; but for this Operation
+an excellent Surgeon is indispensably necessary. The happy Consequence
+with which I have ordered it, in a most desperate Case since the first
+Edition of this Work, on the sixth Day after a Labour, has convinced me,
+still more than any former Observation I had made, that the Trial of it
+ought never to be omitted, when other Attempts have been unavailing. It
+cannot even hasten the Patient's Death, which must be inevitable without
+it, but it rather renders that more gentle, where it might fail to
+prevent it. When it is performed as Mr. _Levade_ effected it, in the
+Case I have just referred to, the Pain attending it is very tolerable
+and soon over.
+
+I shall not attempt to describe the Operation, as I could not explain
+myself sufficiently to instruct an ignorant Surgeon in it; and an
+excellent and experienced one must be sufficiently apprized of all I
+could say concerning it.
+
+A certain Woman in this Place, but now dead, had the great and impudent
+Temerity to attempt this Operation, and killed her Patients after the
+most excruciating Torments, and an Extirpation, or cutting away of the
+Testicle; which Quacks and ignorant Surgeons always do, but which a good
+Surgeon never does in this Operation. This is often the Custom too (in
+Country Places) of those Caitiffs, who perform this Operation without
+the least Necessity; and mercilessly emasculate a Multitude of Infants;
+whom Nature, if left to her own Conduct, or assisted only by a simple
+Bandage, would have perfectly cured; instead of which, they absolutely
+kill a great many, and deprive those of their Virility, who survive
+their Robbery and Violence. It were religiously to be wished such
+Caitiffs were to be duly, that is, severely punished; and it cannot be
+too much inculcated into the People, that this Operation (termed the
+_Bubonocele_) in the Manner it is performed by the best Surgeons, is not
+necessary; except in the Symptoms and Circumstances I have mentioned,
+and that the cutting off the Testicle never is so.
+
+
+
+                        _Of Phlegmons or Boils._
+
+
+Sec. 480. Every Person knows what Boils are at Sight, which are
+considerably painful when large, highly inflamed, or so situated as to
+incommode the Motions, or different Positions of the Body. Whenever
+their Inflammation is very considerable; when there are a great many of
+them at once, and they prevent the Patients from sleeping, it becomes
+necessary to enter them into a cooling Regimen; to throw up some opening
+Glysters; and to make them drink plentifully of the Ptisan, No. 2.
+Sometimes it is also necessary to bleed the Patient.
+
+Should the Inflammation be very high indeed, a Pultice of Bread and
+Milk, or of Sorrel a little boiled and bruised, must be applied to it.
+But if the Inflammation is only moderate, a Mucilage Plaister, or one of
+the simple Diachylon, may be sufficient. Diachylon with the Gums is more
+active and efficacious; but it so greatly augments the Pain of some
+Persons afflicted with Boils, that they cannot bear it.
+
+Boils, which often return, signify some Fault in the Temperament, and
+frequently one so considerable, that might dispose a Physician to be so
+far apprehensive of its Consequences, as to enquire into the Cause, and
+to attempt the Extinction of it. But the Detail of this is no Part nor
+Purpose of the present Work.
+
+Sec. 481. The Phlegmon, or Boil, commonly terminates in Suppuration, but a
+Suppuration of a singular Kind. It breaks open at first on its Top, or
+the most pointed Part, when some Drops of a _Pus_ like that of an
+Abscess comes out, after which the Germ, or what is called the Core of
+it may be discerned. This is a purulent Matter or Substance, but so
+thick and tenacious, that it appears like a solid Body; which may be
+drawn out entirely in the Shape of a small Cylinder, like the Pith of
+Elder, to the Length of some Lines of an Inch; sometimes to the Length
+of a full Inch, and even more. The Emission of this Core is commonly
+followed by the Discharge of a certain Quantity, according to the Size
+of the Tumour, of liquid Matter, spread throughout the Bottom of it. As
+soon as ever this Discharge is made, the Pain goes entirely off; and the
+Swelling disappears at the End of a few Days, by continuing to apply the
+simple Diachylon, or the Ointment No. 66.
+
+
+
+                       _Of Fellons or Whitlows._
+
+
+Sec. 482. The Danger of these small Tumours is much greater than is
+generally supposed. It is an Inflammation at the Extremity or End of a
+Finger, which is often the Effect of a small Quantity of Humour
+extravasated, or stagnant, in that Part; whether this has happened in
+Consequence of a Bruise, a Sting, or a Bite. At other times it is
+evident that it has resulted from no external Cause, but is the Effect
+of some inward one.
+
+It is distinguished into many Kinds, according to the Place in which the
+Inflammation begins; but the essential Nature of the Malady is always
+the same, and requires the same Sort of Remedies. Hence such as are
+neither Physicians nor Surgeons, may spare themselves the Trouble of
+enquiring into the Divisions of this Distemper; which, though they vary
+the Danger of it, and diversify the Manner of the Surgeons Operation,
+yet have no Relation to the general Treatment of it; the Power and
+Activity of which must be regulated by the Violence of the Symptoms.
+
+Sec. 483. This Disorder begins with a slow heavy Pain, attended by a slight
+Pulsation, without Swelling, without Redness, and without Heat; but in a
+little Time the Pain, Heat, and Pulsation or Throbbing becomes
+intolerable. The Part grows very large and red; the adjoining Fingers
+and the whole Hand swelling up. In some Cases a Kind of red and inflated
+Fuse or Streak may be observed, which, beginning at the affected Part,
+is continued almost to the Elbow; neither is it unusual for the Patients
+to complain of a very sharp Pain under the Shoulder; and sometimes the
+whole Arm is excessively inflamed and swelled. The Sick have not a Wink
+of Sleep, the Fever and other Symptoms quickly increasing. If the
+Distemper rises to a violent Degree indeed, a _Delirium_ and Convulsions
+supervene.
+
+This Inflammation of the Finger determines, either in Suppuration, or in
+a Gangrene. When the last of these occurs, the Patient is in very great
+Danger, if he is not very speedily relieved; and it has proved necessary
+more than once to cut off the Arm, for the Preservation of his Life.
+When Suppuration is effected, if the Matter lies very deep and sharp, or
+if the Assistance of a Surgeon has arrived too late, the Bone of the
+last _Phalanx_, or Row of Bones of the Finger, is generally carious and
+lost. But how gentle soever the Complaint has been, the Nail is very
+generally separated and falls off.
+
+Sec. 484. The internal Treatment in Whitlows, is the same with that in
+other inflammatory Distempers. The Patient must enter upon a Regimen
+more or less strict, in Proportion to the Degree of the Fever; and if
+this runs very high, and the Inflammation be very considerable, there
+may be a Necessity for several Bleedings.
+
+The external Treatment consists in allaying the Inflammation; in
+softening the Skin; and in procuring a Discharge of the Matter, as soon
+as it is formed. For this Purpose,
+
+1, The Finger affected is to be plunged, as soon as the Disorder is
+manifest, in Water a little more than warm: the Steam of boiling Water
+may also by admitted into it; and by doing these Things almost
+constantly for the first Day, a total Dissipation of the Malady has
+often been obtained. But unhappily it has been generally supposed, that
+such slight Attacks could have but very slight Consequences, whence they
+have been neglected until the Disorder has greatly advanced; in which
+State Suppuration becomes absolutely necessary.
+
+2, This Suppuration therefore may be forwarded, by continually involving
+the Finger, as it were, in a Decoction of Mallow Flowers boiled in Milk,
+or with a Cataplasm of Bread and Milk. This may be rendered still more
+active and ripening, by adding a few white Lilly Roots, or a little
+Honey. But this last must not be applied before the Inflammation is
+somewhat abated, and Suppuration begins; before which Term, all sharp
+Applications are very dangerous. At this Time, Yeast or Leaven may be
+advantagiously used, which powerfully promotes Suppuration. The Sorrel
+Pultice, mentioned Sec. 480, is also a very efficacious one.
+
+Sec. 485. A speedy Discharge of the ripe Matter is of considerable
+Importance, but this particularly requires the Attention of the Surgeon;
+as it is not proper to wait till the Tumour breaks and discharges of
+itself; and this the rather, as from the Skin's proving sometimes
+extremely hard, the Matter might be inwardly effused between the
+Muscles, and upon their Membranes, before it could penetrate through the
+Skin. For this Reason, as soon as Matter is suspected to be formed, a
+Surgeon should be called in, to determine exactly on the Time, when an
+Opening should be made; which had better be performed a little too soon
+than too late; and a little too deep, than not deep enough.
+
+When the Orifice has been made, and the Discharge is effected, it is to
+be dressed up with the Plaister No. 66, spread upon Linen, or with the
+Cerecloth; and these Dressings are to be repeated daily.
+
+Sec. 486. When the Whitlow is caused by a Humour extravasated very near the
+Nail, an expert Surgeon speedily checks its Progress, and cures it
+effectually by an Incision which lets out the Humour. Yet,
+notwithstanding this Operation is in no wise difficult, all Surgeons are
+not qualified to perform it, and but too many have no Idea at all of it.
+
+Sec. 487. Fungous, or, as it is commonly called, proud Flesh sometimes
+appears during the incarning or healing of the Incision. Such may be
+kept down with sprinkling a little _Minium_ (red Lead) or burnt Alum
+over it.
+
+Sec. 488. If a _Caries_, a Rottenness of the Bone, should be a Consequence,
+there is a Necessity for a Surgeon's Attendance, as much as if there was
+a Gangrene; for which Reason, I shall add nothing with Respect to either
+of these Symptoms; only observing, there are three very essential
+Remedies against the last; _viz._ the Bark, No. 14, a Drachm of which
+must be taken every two Hours; Scarifications throughout the whole
+gangrened Part; and Fomentations with a Decoction of the Bark, and the
+Addition of Spirit of Sulphur. This Medicine is certainly no cheap one;
+but a Decoction of other bitter Plants, with the Addition of Spirit of
+Salt, may sometimes do instead of it. And here I take leave to insist
+again upon it, that in most Cases of gangrened Limbs, it is judicious
+not to proceed to an Amputation of the mortified Part, till the Gangrene
+stops, which may be known by a very perceivable Circle, (and easily
+distinguished by the most ignorant Persons) that marks the Bounds of the
+Gangrene, and separates the living from the mortified Parts.
+
+
+
+  _Of Thorns, Splinters, or other pointed Substances piercing into the
+                            Skin, or Flesh._
+
+
+Sec. 489. It is very common for the Hands, Feet or Legs, to be pierced by
+the forcible Intrusion of small pointed Substances, such as Thorns or
+Prickles, whether of Roses, Thistles or Chestnuts, or little Splinters
+of Wood, Bone, _&c._
+
+If such Substances are immediately and entirely extracted, the Accident
+is generally attended with no bad Consequences; though more certainly to
+obviate any such, Compresses of Linen dipt in warm Water may be applied
+to the Part, or it may be kept a little while in a warm Bath. But if any
+such pointed penetrating Body cannot be directly extracted, or if a Part
+of it be left within, it causes an Inflammation, which, in its Progress,
+soon produces the same Symptoms as a Whitlow: or if it happens in the
+Leg, it inflames and forms a considerable Abscess there.
+
+Sec. 490. To prevent such Consequences, if the penetrating Substance is
+still near the Surface, and an expert Surgeon is at Hand, he must
+immediately make a small Incision, and thence extract it. But if the
+Inflammation were already formed, this would be useless, and even
+dangerous.
+
+When the Incision, therefore, is improper; there should be applied to
+the affected Part, (after conveying the Steam of some hot Water into it)
+either some very emollient Pultices of the Crumb of Bread, Milk and Oil,
+or some very emollient unctuous Matter alone, the Fat of a [103] Hare
+being generally employed in such Cases, and being indeed very effectual
+to relax and supple the Skin; and, by thus diminishing its Resistance,
+to afford the offensive penetrating Body an Opportunity of springing
+forth. Nothing however, but the grossest Prejudice, could make any one
+imagine, that this Fat attracted the Splinter, Thorn, or any other
+intruded Substance by any sympathetic Virtue; no other Sympathy in
+Nature being clearly demonstrated, except that very common one between
+wrong Heads, and absurd extravagant Opinions.
+
+[103] These Creatures perhaps are fatter in _Swisserland_, than we often
+     see them here. _K._
+
+It is absolutely necessary that the injured Part should be kept in the
+easiest Posture, and as immoveable as possible.
+
+If Suppuration has not been prevented by an immediate Extraction of the
+offending Substance, the Abscess should be opened as soon as ever Matter
+is formed. I have known very troublesome Events from its being too long
+delayed.
+
+Sec. 491. Sometimes the Thorn, after having very painfully penetrated
+through the Teguments, the Skin, enters directly into the Fat; upon
+which the Pain ceases, and the Patient begins to conclude no sharp
+prickling Substance had ever been introduced into the Part; and of
+Course supposes none can remain there. Nevertheless some Days after, or,
+in other Instances, some Weeks, fresh Pains are excited, to which an
+Inflammation and Abscess succeed, which are to be treated as usual, with
+Emollients, and seasonably opened.
+
+A Patient has been reduced to lose his Hand, in Consequence of a sharp
+Thorn's piercing into his Finger; from its having been neglected at
+first, and improperly treated afterwards.
+
+
+
+                              _Of Warts._
+
+
+Sec. 492. Warts are sometimes the Effects of a particular Fault in the
+Blood, which feeds and extrudes a surprizing Quantity of them. This
+happens to some Children, from four to ten Years old, and especially to
+those who feed most plentifully on Milk or Milk-meats. They may be
+removed by a moderate Change of their Diet, and the Pills prescribed No.
+18.
+
+But they are more frequently an accidental Disorder of the Skin, arising
+from some external Cause.
+
+In this last Case, if they are very troublesome in Consequence of their
+great Size, their Situation or their long Standing, they may be
+destroyed, 1, by tying them closely with a Silk Thread, or with a strong
+flaxen one waxed. 2, By cutting them off with a sharp Scissars or a
+Bistory, and applying a Plaister of Diachylon, with the Gums, over the
+cut Wart, which brings on a small Suppuration that may destroy or
+dissolve the Root of the Wart: and, 3, By drying, or, as it were,
+withering them up by some moderately corroding Application, such as that
+of the milky Juice of [104] Purslain, of Fig-leaves, of _Chelidonium_
+(Swallow-wort) or of Spurge. But besides these corroding vegetable Milks
+being procurable only in Summer, People who have very delicate thin
+Skins should not make Use of them, as they may occasion a considerable
+and painful Swelling. Strong Vinegar, charged with as much common Salt
+as it will dissolve, is a very proper Application to them. A Plaister
+may also be composed from Sal Ammoniac and some Galbanum, which being
+kneaded up well together and applied, seldom fails of destroying them.
+
+[104] Our Garden Purslain, though a very juicy Herb, cannot strictly be
+     termed milky. In the hotter Climates where it is wild, and grows
+     very rankly, they sometimes boil the Leaves and Stalks (besides
+     eating them as a cooling Salad) and find the whole an insipid
+     mucilaginous Pot-herb. But Dr. _Tissot_ observes to me, that its
+     Juice will inflame the Skin; and that some Writers on Diet, who
+     disapprove it internally, affirm they have known it productive of
+     bad Effects. Yet none such have ever happened to myself, nor to
+     many others, who have frequently eaten of it. Its Seeds have
+     sometimes been directed in cooling Emulsions. The Wart Spurge is a
+     very milky and common Herb, which flowers in Summer here. _K._
+
+The most powerful Corrosives should never be used, without the Direction
+of a Surgeon; and even then it is full as prudent not to meddle with
+them, any more than with actual Cauteries. I have lately seen some very
+tedious and troublesome Disorders and Ulcerations of the Kidnies, ensue
+the Application of a corrosive Water, by the Advice of a Quack. Cutting
+them away is a more certain, a less painful, and a less dangerous Way of
+removing them.
+
+Wens, if of a pretty considerable Size, and Duration, are incurable by
+any other Remedy, except Amputation.
+
+
+
+                              _Of Corns._
+
+
+Sec. 493. The very general or only Causes of Corns, are Shoes either too
+hard and stiff, or too small.
+
+The whole Cure consists in softening the Corns by repeated Washings and
+Soakings of the Feet in pretty hot Water; then in cutting them, when
+softened, with a Penknife or Scissars, without wounding the sound Parts
+(which are the more sensible, in Proportion as they are more extended
+than usual) and next in applying a Leaf of House-leek, of Ground-ivy, or
+of Purslain dipt in Vinegar, upon the Part. Instead of these Leaves, if
+any Person will give himself the little Trouble of dressing them every
+Day, he may apply a Plaister of simple Diachylon, or of Gum Ammoniacum
+softened in Vinegar.
+
+The Increase or Return of Corns can only be prevented, by avoiding the
+Causes that produce them.
+
+
+
+
+                            __Chapter XXXI.__
+
+
+    _Of some Cases which require immediate Assistance; such as
+    Swoonings; Haemorrhages, or involuntary Loss of Blood; Convulsion
+    Fitts, and Suffocations; the sudden Effects of great Fear; of
+    Disorders caused by noxious Vapours; of Poisons, and of acute
+    Pains._
+
+
+
+                            _Of Swoonings._
+
+
+                             __Sect.__ 494.
+
+There are many Degrees of Swooning, or fainting away: the slightest is
+that in which the Patient constantly perceives and understands, yet
+without the Power of speaking. This is called a Fainting, which happens
+very often to vapourish Persons, and without any remarkable Alteration
+of the Pulse.
+
+If the Patient entirely loses Sensation, or Feeling, and Understanding,
+with a very considerable Sinking of the Pulse, this is called a
+_Syncope_, and is the second Degree of Swooning.
+
+But if this _Syncope_ is so violent, that the Pulse seems totally
+extinguished; without any discernible Breathing; with a manifest
+Coldness of the whole Body; and a wanly livid Countenance, it
+constitutes a third and last Degree, which is the true Image of Death,
+that in Effect sometimes attends it, and it is called an _Asphixy_,
+which may signify a total Resolution.
+
+Swoonings result from many different Causes, of which I shall only
+enumerate the principal; and these are, 1, Too large a Quantity of
+Blood. 2, A Defect or insufficient Proportion of it, and a general
+Weakness. 3, A Load at and violent Disorders of the Stomach. 4, Nervous
+Maladies. 5, The Passions; and, 6, some Kinds of Diseases.
+
+
+
+             _Of Swoonings occasioned by Excess of Blood._
+
+
+Sec. 495. An excessive Quantity of Blood is frequently a Cause of Swooning;
+and it may be inferred that it is owing to this Cause, when it attacks
+sanguine, hearty and robust Persons; and more especially when it attacks
+them, after being combined with any additional or supervening Cause,
+that suddenly increased the Motion of the Blood; such as heating Meats
+or Drinks, Wine, spirituous Liquors: smaller Drinks, if taken very hot
+and plentifully, such as Coffee, Indian Tea, Bawm Tea and the like; a
+long Exposure to the hot Sun, or being detained in a very hot Place;
+much and violent Exercise; an over intense and assiduous Study or
+Application, or some excessive Passion.
+
+In such Cases, first of all the Patient should be made to smell to, or
+even to snuff up, some Vinegar; and his Forehead, his Temples and his
+Wrists should be bathed with it; adding an equal Quantity of warm Water,
+if at Hand. Bathing them with distilled or spirituous Liquids would be
+prejudicial in this Kind of Swooning.
+
+2, The Patient should be made, if possible, to swallow two or three
+Spoonfuls of Vinegar, with four or five Times as much Water.
+
+3, The Patient's Garters should be tied very tightly above his Knees; as
+by this Means a greater Quantity of Blood is retained in the Legs,
+whence the Heart may be less overladen with it.
+
+4, If the Fainting proves obstinate, that is, if it continues longer
+than a Quarter of an Hour, or degenerates into a _Syncope_, an Abolition
+of Feeling and Understanding, he must be bled in the Arm, which quickly
+revives him.
+
+5, After the Bleeding, the Injection of a Glyster will be highly proper;
+and then the Patient should be kept still and calm, only letting him
+drink, every half Hour, some Cups of Elder Flower Tea, with the Addition
+of a little Sugar and Vinegar.
+
+When Swoonings which result from this Cause occur frequently in the same
+Person, he should, in Order to escape them, pursue the Directions I
+shall hereafter mention, Sec. 544, when treating of Persons who superabound
+with Blood.
+
+The very same Cause, or Causes, which occasion these Swoonings, also
+frequently produce violent Palpitations, under the same Circumstances;
+the Palpitation often preceding or following the _Deliquium_, or
+Swooning.
+
+
+
+                 _Of Swoonings occasioned by Weakness._
+
+
+Sec. 496. If too great a Quantity of Blood, which may be considered as some
+Excess of Health, is sometimes the Cause of Swooning, this last is
+oftener the Effect of a very contrary Cause, that is, of a Want of
+Blood, or an Exhaustion of too much.
+
+This Sort of Swooning happens after great Haemorrhages, or Discharges of
+Blood; after sudden or excessive Evacuations, such as one of some Hours
+Continuance in a _Cholera Morbus_ (Sec. 321) or such as are more slow, but
+of longer Duration, as for Instance, after an inveterate _Diarrhoea_, or
+Purging; excessive Sweats; a Flood of Urine; such Excesses as tend to
+exhaust Nature; obstinate Wakefulness; a long Inappetency, which, by
+depriving the Body of its necessary Sustenance, is attended with the
+same Consequence as profuse Evacuations.
+
+These different Causes of Swooning should be opposed by the Means and
+Remedies adapted to each of them. A Detail of all these would be
+improper here; but the Assistances that are necessary at the Time of
+Swooning, are nearly the same for all Cases of this Class; excepting for
+that attending a great Loss of Blood, of which I shall treat hereafter:
+first of all, the Patients should be laid down on a Bed, and being
+covered, should have their Legs and Thighs, their Arms, and their whole
+Bodies rubbed pretty strongly with hot Flanels; and no Ligature should
+remain on any Part of them.
+
+2, They should have very spirituous Things to smell or snuff up, such as
+the Carmelite Water, Hungary Water, the [105] _English_ Salt, Spirit of
+Sal Ammoniac, strong smelling Herbs, such as Rue, Sage, Rosemary, Mint,
+Wormwood, and the like.
+
+[105] Dr. _Tissot_ informs me, that in _Swisserland_, they call a
+     volatile Salt of Vipers, or the volatile Salt of raw Silk, _Sel.
+     d'Angleterre_, of which one _Goddard_ made a Secret, and which he
+     brought into Vogue the latter End of the last Century. But he
+     justly observes at the same Time, that on the present Occasion
+     every other volatile Alkali will equally answer the Purpose; and
+     indeed the Smell of some of them, as the Spirit of Sal Ammoniac
+     with Quicklime, _Eau de Luce_, _&c._ seem more penetrating. _K._
+
+3, These should be conveyed into their Mouths; and they should be
+forced, if possible, to swallow some Drops of Carmelite Water, or of
+Brandy, or of some other potable Liquor, mixed with a little Water;
+while some hot Wine mixed with Sugar and Cinnamon, which makes one of
+the best Cordials, is getting ready.
+
+4, A Compress of Flanel, or of some other woollen Stuff, dipt in hot
+Wine, in which some aromatic Herb has been steeped, must be applied to
+the Pit of the Stomach.
+
+5, If the Swooning seems likely to continue, the Patient must be put
+into a well heated Bed, which has before been perfumed with burning
+Sugar and Cinnamon; the Frictions of the whole Body with hot Flanels
+being still continued.
+
+6, As soon as the Patient can swallow, he should take some Soup or
+Broth, with the Yolk of an Egg; or a little Bread or Biscuit; soaked in
+the hot spiced Wine.
+
+7, Lastly, during the whole Time that all other Precautions are taken to
+oppose the Cause of the Swooning, Care must be had for some Days to
+prevent any _Deliquium_ or Fainting, by giving them often, and but
+little at a time, some light yet strengthening Nourishment, such as
+Panada made with Soup instead of Water, new laid Eggs very lightly
+poached, light roast Meats with sweet Sauce, Chocolate, Soups of the
+most nourishing Meats, Jellies, Milk, _&c._
+
+Sec. 497. Those Swoonings, which are the Effect of Bleeding, or of the
+violent Operation of some Purge, are to be ranged in this Class.
+
+Such as happen after artificial Bleeding, are generally very moderate,
+commonly terminating as soon as the Patient is laid upon the Bed: and
+Persons subject to this Kind, should be bled lying down, in Order to
+prevent it. But should the Fainting continue longer than usual, some
+Vinegar smelt to, and a little swallowed with some Water, is a very good
+Remedy.
+
+The Treatment of such Faintings or Swoonings, as are the Consequences of
+too violent Vomits or Purges, may be seen hereafter Sec. 552.
+
+
+
+    _Of Faintings occasioned by a Load, or Uneasiness, at Stomach._
+
+
+Sec. 498. It has been already observed, Sec. 308, that Indigestions were
+sometimes attended with Swoonings, and indeed such vehement ones, as
+required speedy and very active Succour too, such as that of a Vomit.
+The Indigestion is sometimes less the Effect of the Quantity, than of
+the Quality, or the Corruption of the Food, contained in the Stomach.
+Thus we see there are some Persons, who are disordered by eating Eggs,
+Fish, Craw Fish, or any fat Meat; being thrown by them into
+inexpressible Anguish attended with Swooning too. It may be supposed to
+depend on this Cause, when these very Aliments have been lately eaten;
+and when it evidently neither depends on the other Causes I have
+mentioned; nor on such as I shall soon proceed to enumerate.
+
+We should in Cases of this Sort, excite and revive the Patients as in
+the former, by making them receive some very strong Smell, of whatever
+Kind is at hand; but the most essential Point is to make them swallow
+down a large Quantity of light warm Fluid; which may serve to drown, as
+it were, the indigested Matter; which may soften its Acrimony; and
+either effect the Discharge of it by vomiting, or force it down into the
+Chanel of the Intestines.
+
+A light Infusion of Chamomile Flowers, of Tea, of Sage, of Elder
+Flowers, or of _Carduus Benedictus_, operate with much the same
+Efficacy; though the Chamomile and Carduus promote the Operation of
+vomiting rather more powerfully; which warm Water alone will sometimes
+sufficiently do.
+
+The Swooning ceases, or at least, considerably abates in these Cases, as
+soon as ever the Vomiting commences. It frequently happens too, that,
+during the Swooning, Nature herself brings on certain _Nausea_, a
+Wambling and sickish Commotion of the Stomach, that revives or rouses
+the Patient for a Moment; but yet not being sufficient to excite an
+actual Vomiting, lets him soon sink down again into this temporary
+Dissolution, which often continues a pretty considerable Time; leaving
+behind it a Sickness at Stomach, Vertigos, and a Depression and Anxiety,
+which do not occur in the former Species of this Malady.
+
+Whenever these Swoonings from this Cause are entirely terminated, the
+Patient must be kept for some Days to a very light Diet, and take, at
+the same Time, every Morning fasting, a Dose of the Powder, No. 38,
+which relieves and exonerates the Stomach of whatever noxious Contents
+might remain in it; and then restores its natural Strength and
+Functions.
+
+Sec. 499. There is another Kind of Swooning, which also results from a
+Cause in the Stomach; but which is, nevertheless, very different from
+this we have just been treating of; and which requires a very different
+Kind of Assistance. It arises from an extraordinary Sensibility of this
+important Organ, and from a general Weakness of the Patient.
+
+Those subject to this Malady are valetudinary weakly Persons, who are
+disordered from many slight Causes, and whose Stomachs are at once very
+feeble and extremely sensible. They have almost continually a little
+Uneasiness after a Meal, though they should indulge but a little more
+than usual; or if they eat of any Food not quite so easy of Digestion,
+they have some Qualm or Commotion after it: Nay, should the Weather only
+be unfavourable, and sometimes without any perceivable assignable Cause,
+their Uneasiness terminates in a Swoon.
+
+Patients swooning, from these Causes, have a greater Necessity for great
+Tranquillity and Repose, than for any other Remedy; and it might be
+sufficient to lay them down on the Bed: But as the Bystanders in such
+Cases find it difficult to remain inactive Spectators of Persons in a
+Swoon, some spirituous Liquid may be held to their Nose, while their
+Temples and Wrists are rubbed with it; and at the same Time a little
+Wine should be given them. Frictions are also useful in these Cases.
+
+This Species of Swooning is oftener attended with a little Feverishness
+than the others.
+
+
+
+       _Of those Swoonings, which arise from nervous Disorders._
+
+
+Sec. 500. This Species of Swooning is almost wholely unknown to those
+Persons, for whom this Treatise is chiefly intended. Yet as there are
+some Citizens who pass a Part of their Lives in the Country; and some
+Country People who are unhappily afflicted with the Ailments of the
+Inhabitants of large Towns and Cities, it seemed necessary to treat
+briefly of them.
+
+By Disorders of the Nerves, I understand in this Place, only that Fault
+or Defect in them, which is the Cause of their exciting in the Body,
+either irregular Motions, that is, Motions without any external Cause,
+at least any perceivable one; and without our Will's consenting to the
+Production of them: or such Motions, as are greatly more considerable
+than they should be, if they had been proportioned to the Force of the
+Impression from without. This is very exactly that State, or Affection
+termed the _Vapours_; and by the common People, the _Mother_: And as
+there is no Organ unprovided with Nerves; and none, or hardly any
+Function, in which the Nerves have not their Influence; it may be easily
+comprehended, that the Vapours being a State or Condition, which arises
+from the Nerves exerting irregular involuntary Motions, without any
+evident Cause, and all the Functions of the Body depending partly on the
+Nerves; there is no one Symptom of other Diseases which the Vapours may
+not produce or imitate; and that these Symptoms, for the same Reason,
+must vary infinitely, according to those Branches of the Nerves which
+are disordered. It may also hence be conceived, why the Vapours of one
+Person have frequently no Resemblance to those of another: and why the
+Vapours of the very same Person, in one Day, are so very different from
+those in the next. It is also very conceivable that the Vapours are a
+certain, a real Malady; and that Oddity of the Symptoms, which cannot be
+accounted for, by People unacquainted with the animal Oeconomy, has been
+the Cause of their being considered rather as the Effect of a depraved
+Imagination, than as a real Disease. It is very conceiveable, I say,
+that this surprizing Oddity of the Symptoms is a necessary Effect of the
+Cause of the Vapours; and that no Person can any more prevent his being
+invaded by the Vapours, than he can prevent the Attack of a Fever, or of
+the Tooth-ach.
+
+Sec. 501. A few plain Instances will furnish out a more compleat Notion of
+the Mechanism, or Nature, of Vapours. An Emetic, a vomiting Medicine,
+excites the Act, or rather the Passion, the Convulsion of Vomiting,
+chiefly by the Irritation it gives to the Nerves of the Stomach; which
+Irritation produces a Spasm, a Contraction of this Organ. Now if in
+Consequence of this morbid or defective Texture of the Nerves, which
+constitutes the Vapours, those of the Stomach are excited to act with
+the same Violence, as in Consequence of taking a Vomit, the Patient will
+be agitated and worked by violent Efforts to vomit, as much as if he had
+really taken one.
+
+If an involuntary unusual Motion in the Nerves, that are distributed
+through the Lungs, should constrain and straiten the very little
+Vesicles, or Bladders, as it were, which admit the fresh Air at every
+Respiration, the Patient will feel a Degree of Suffocation; just as if
+that Straitening or Contraction of the Vesicles were occasioned by some
+noxious Steam or Vapour.
+
+Should the Nerves which are distributed throughout the whole Skin, by a
+Succession of these irregular morbid Motions, contract themselves, as
+they may from external Cold, or by some stimulating Application,
+Perspiration by the Pores will be prevented or checked; whence the
+Humours, which should be evacuated through the Pores of the Skin, will
+be thrown upon the Kidnies, and the Patient will make a great Quantity
+of thin clear Urine, a Symptom very common to vapourish People; or it
+may be diverted to the Glands of the Intestines, the Guts, and terminate
+in a watery _Diarrhoea_, or Looseness, which frequently proves a very
+obstinate one.
+
+Sec. 502. Neither are Swoonings the least usual Symptoms attending the
+Vapours: and we may be certain they spring from this Source, when they
+happen to a Person subject to the Vapours; and none of the other Causes
+producing them are evident, or have lately preceded them.
+
+Such Swoonings, however, are indeed very rarely dangerous, and scarcely
+require any medical Assistance. The Patient should be laid upon a Bed;
+the fresh Air should be very freely admitted to him; and he should be
+made to smell rather to some disagreeable and fetid, than to any
+fragrant, Substance. It is in such Faintings as these that the Smell of
+burnt Leather, of Feathers, or of Paper, have often proved of great
+Service.
+
+Sec. 503. Patients also frequently faint away, in Consequence of fasting
+too long; or from having eat a little too much; from being confined in
+too hot a Chamber; from having seen too much Company; from smelling too
+over-powering a Scent; from being too costive; from being too forcibly
+affected with some Discourse or Sentiments; and, in a Word, from a great
+Variety of Causes, which might not make the least Impression on Persons
+in perfect Health; but which violently operate upon those vapourish
+People, because, as I have said, the Fault of their Nerves consists in
+their being too vividly, too acutely affected; the Force of their
+Sensation being nowise proportioned to the external Cause of it.
+
+As soon as that particular Cause is distinguished from all the rest,
+which has occasioned the present Swooning; it is manifest that this
+Swooning is to be remedied by removing that particular Cause of it.
+
+
+
+               _Of Swoonings occasioned by the Passions._
+
+
+Sec. 504. There have been some Instances of Persons dying within a Moment,
+through excessive Joy. But such Instances are so very rare and sudden,
+that Assistance has seldom been sought for on this Occasion. The Case is
+otherwise with Respect to those produced from Rage, Vexation, and Dread
+or Horror. I shall treat in a separate Article of those resulting from
+great Fear; and shall briefly consider here such as ensue from Rage, and
+vehement Grief or Disappointment.
+
+Sec. 505. Excessive Rage and violent Affliction are sometimes fatal in the
+Twinkling of an Eye; though they oftener terminate in fainting only.
+Excessive Grief or Chagrine is especially accompanied with this
+Consequence; and it is very common to see Persons thus affected, sink
+into successive Faintings for several Hours. It is plainly obvious that
+very little Assistance can be given in such Cases: it is proper,
+however, they should smell to strong Vinegar; and frequently take a few
+Cups of some hot and temperately cordial Drink, such as Bawm Tea, or
+Lemonade with a little Orange or Lemon-peel.
+
+The calming asswaging Cordial, that has seemed the most efficacious to
+me, is one small Coffee Spoonful of a Mixture of three Parts of the
+Mineral Anodyne Liquor of _Hoffman_, [106] and one Part of the
+spirituous Tincture of Amber, which should be swallowed in a Spoonful of
+Water; taking after it a few Cups of such Drinks as I shall presently
+direct.
+
+[106] Our sweet Spirit of Vitriol is a similar, and as effectual a
+     Medicine. _K._
+
+It is not to be supposed that Swoonings or Faintings, from excessive
+Passions, can be cured by Nourishment. The physical State or Condition,
+into which vehement Grief throws the Body, is that, of all others, in
+which Nourishment would be most injurious to it: and as long as the
+Vehemence of the Affliction endures, the Sufferer should take nothing
+but some Spoonfuls of Soup or Broth, or a few Morsels of some light Meat
+roasted.
+
+Sec. 506. When Wrath or Rage has risen to so high a Pitch, that the human
+Machine, the Body, entirely exhausted, as it were, by that violent
+Effort, sinks down at once into excessive Relaxation, a Fainting
+sometimes succeeds, and even the most perilous Degree of it, a
+_Syncope_.
+
+It is sufficient, or rather the most that can be done here, to let the
+Patient be perfectly still a while in this State; only making him smell
+to some Vinegar. But when he is come to himself, he should drink
+plentifully of hot Lemonade, and take one or more of the Glysters No. 5.
+
+Sometimes there remain in these Cases Sicknesses at Stomach, Reachings
+to vomit, a Bitterness in the Mouth, and some vertiginous Symptoms which
+seem to require a Vomit. But such a Medicine must be very carefully
+avoided, since it may be attended with the most fatal Consequence; and
+Lemonade with Glysters generally and gradually remove these Swoonings.
+If the _Nausea_ and Sickness at Stomach continue, the utmost Medicine we
+should allow besides, would be that of No. 23, or a few Doses of No. 24.
+
+
+
+_Of symptomatical Swoonings, or such, as happen in the Progress of other
+                               Diseases._
+
+
+Sec. 507. Swoonings, which supervene in the Course of other Diseases, never
+afford a favourable Prognostic; as they denote Weakness, and Weakness is
+an Obstacle to Recovery.
+
+In the Beginning of putrid Diseases, they also denote an Oppression at
+Stomach, or a Mass of corrupt Humours; and they cease as soon as an
+Evacuation supervenes, whether by Vomit or Stool.
+
+When they occur at the Beginning of malignant Fevers, they declare the
+high Degree of their Malignancy, and the great Diminution of the
+Patient's natural Strength.
+
+In each of these Cases Vinegar, used externally and internally, is the
+best Remedy during the Exacerbation or Height of the Paroxysm; and
+Plenty of Lemon Juice and Water after it.
+
+Sec. 508. Swoonings which supervene in Diseases, accompanied with great
+Evacuations, are cured like those which are owing to Weakness; and
+Endeavours should be used to restrain or moderate the Evacuations.
+
+Sec. 509. Those who have any inward Abscess or Imposthume are apt to swoon
+frequently. They may sometimes be revived a little by Vinegar, but they
+prove too frequently mortal.
+
+Sec. 510. Many Persons have a slighter or a deeper Swooning, at the End of
+a violent Fit of an intermitting Fever, or at that of each Exacerbation
+of a continual Fever; this constantly shews the Fever has run very high,
+the Swooning having been the Consequence of that great Relaxation, which
+has succeeded to a very high Tension. A Spoonful or two of light white
+Wine, with an equal Quantity of Water, affords all the Succour proper in
+such a Case.
+
+Sec. 511. Persons subject to frequent Swoonings, should neglect nothing
+that may enable them to remove them when known; since the Consequences
+of them are always detrimental, except in some Fevers, in which they
+seem to mark the _Crisis_.
+
+Every swooning Fit leaves the Patient in Dejection and Weakness; the
+Secretions from the Blood are suspended; the Humours disposed to
+Stagnation; Grumosities, or Coagulations, and Obstructions are formed;
+and if the Motion of the Blood is totally intercepted, or considerably
+checked, _Polypus's_, and these often incurable, are formed in the
+Heart, or in the larger Vessels; the Consequences of which are dreadful,
+and sometimes give Rise to internal Aneurisms, which always prove
+mortal, after long Anxiety and Oppression.
+
+Swoonings which attack old People, without any manifest Cause, always
+afford an unfavourable Prognostic.
+
+
+
+           _Of Haemorrhages, or an involuntary Loss of Blood._
+
+
+Sec. 512. Haemorrhages of the Nose, supervening in inflammatory Fevers,
+commonly prove a favourable _Crisis_; which Bleeding we should carefully
+avoid stopping; except it becomes excessive, and seems to threaten the
+Patient's Life.
+
+As they scarcely ever happen in very healthy Subjects, but from a
+superfluous Abundance of Blood, it is very improper to check them too
+soon; lest some internal Stuffings and Obstructions should prove the
+Consequence.
+
+A Swooning sometimes ensues after the Loss of only a moderate Quantity
+of Blood. This Swooning stops the Haemorrhage, and goes off without any
+further Assistance, except the smelling to Vinegar. But in other Cases
+there is a Succession of fainting Fits, without the Blood's stopping;
+while at the same time slight convulsive Motions and Twitchings ensue,
+attended with a Raving, when it becomes really necessary to stop the
+Bleeding: and indeed, without waiting till these violent Symptoms
+appear, the following Signs will sufficiently direct us, when it is
+right to stop the Flux of Blood, or to permit its Continuance--As long
+as the Pulse is still pretty full; while the Heat of the Body is equally
+extended to the very Extremities; and the Countenance and Lips preserve
+their natural Redness, no ill Consequence is to be apprehended from the
+Haemorrhage, though it has been very copious, and even somewhat profuse.
+
+But whenever the Pulse begins to faulter and tremble; when the
+Countenance and the Lips grow pale, and the Patient complains of a
+Sickness at Stomach, it is absolutely necessary to stop the Discharge of
+Blood. And considering that the Operation of Remedies does not
+immediately follow the Exhibition or Application of them, it is safer to
+begin a little too early with them, than to delay them, though ever so
+little too long.
+
+Sec. 513. First of all then, tight Bandages, or Ligatures, should be
+applied round both Arms, on the Part they are applied over in order to
+Bleeding; and round the lower Part of both Thighs, on the gartering
+Place; and all these are to be drawn very tight, with an Intention to
+detain and accumulate the Blood in the Extremities.
+
+2, In Order to increase this Effect, the Legs are to be plunged in warm
+Water up to the Knees; for by relaxing the Blood-vessels of the Legs and
+Feet, they are dilated at the same time, and thence receive, and, in
+Consequence of the Ligatures above the Knees, retain the more Blood. If
+the Water were cold, it would repel the Blood to the Head; if hot, it
+would increase the Motion of it; and, by giving a greater Quickness to
+the Pulse, would even contribute to increase the Haemorrhage.
+
+As soon however, as the Haemorrhage is stopt, these Ligatures [on the
+Thighs] may be relaxed a little, or one of them be entirely removed;
+allowing the others to continue on an Hour or two longer without
+touching them: but great Precaution should be taken not to slacken them
+entirely, nor all at once.
+
+3, Seven or eight Grains of Nitre, and a Spoonful of Vinegar, in half a
+Glass of cool Water, should be given the Patient every half Hour.
+
+4, One Drachm of white Vitriol must be dissolved in two common Spoonfuls
+of Spring Water; and a Tent of Lint, or Bits of soft fine Linen dipt in
+this Solution, are to be introduced into the Nostrils, horizontally at
+first, but afterwards to be intruded upwards, and as high as may be, by
+the Assistance of a flexible Bit of Wood or Whale-bone. But should this
+Application be ineffectual, the Mineral Anodyne Liquor of _Hoffman_ is
+certain to succeed: and in the Country, where it often happens that
+neither of these Applications are to be had speedily, Brandy, and even
+Spirit of Wine, mixt with a third Part Vinegar, have answered entirely
+well, of which I have been a Witness.
+
+The Prescription No. 67, which I have already referred to, on the
+Article of Wounds, may also be serviceable on this Occasion. It must be
+reduced to Powder, and conveyed up the Nostrils as high as may be, on
+the Point or Extremity of a Tent of Lint, which may easily be covered
+with it. Or a Quill, well charged with the Powder, may be introduced
+high into the Nostrils, and its Countents be strongly blown up from its
+other Extremity: though after all the former Method is preferable.
+
+5, When the Flux of Blood is totally stopt, the Patient is to be kept as
+still and quiet as possible; taking great Care not to extract the Tent
+which remains in the Nose; nor to remove the Clots of coagulated Blood
+which fill up the Passage. The loosening and removing of these should be
+effected very gradually and cautiously; and frequently the Tent does not
+spring out spontaneously, till after many Days.
+
+Sec. 514. I have not, hitherto, said any thing of artificial Bleeding in
+these Cases, as I think it at best unserviceable; since, though it may
+sometimes have stopt the morbid Loss of Blood, it has at other times
+increased it. Neither have I mentioned Anodynes here, whose constant
+Effect is to determine a larger Quantity of Blood to the Head.
+
+Applications of cold Water to the Nape of the Neck ought to be wholly
+disused, having sometimes been attended with the most embarrassing
+Consequences.
+
+In all Haemorrhages, all Fluxes of Blood, great Tranquillity, Ligatures,
+and the Use of the Drinks No. 2 or 4, are very useful.
+
+Sec. 515. People who are very liable to frequent Haemorrhages, ought to
+manage themselves conformably to the Directions contained in the next
+Chapter, Sec. 544. They should take very little Supper; avoid all sharp and
+spirituous Liquors; Apartments that are over hot, and cover their Heads
+but very lightly.
+
+When a Patient has for a long time been subject to Haemorrhages, if they
+cease, he should retrench from his usual Quantity of Food; accustom
+himself to artificial Bleedings at proper Intervals; and take some
+gentle opening Purges, especially that of No. 24, and frequently a
+little Nitre in an Evening.
+
+
+
+                         _Of Convulsion Fits._
+
+
+Sec. 516. Convulsions are, in general, more terrifying than dangerous; they
+result from many and various Causes; and on the Removal or Extirpation
+of these, their Cure depends.
+
+In the very Fit itself very little is to be done or attempted.
+
+As nothing does shorten the Duration, nor even lessen the Violence, of
+an epileptic Fit, so nothing at all should be attempted in it; and the
+rather, because Means and Medicines often aggravate the Disease. We
+should confine our Endeavours solely to the Security of the Patient, by
+preventing him from giving himself any violent Strokes; by getting
+something, if possible, between his Teeth, such as a small Roller of
+Linen to prevent his Tongue from being hurt, or very dangerously
+squeezed and bruised, in a strong Convulsion.
+
+The only Case which requires immediate Assistance in the Fit, is, when
+it is so extremely violent, the Neck so swelled, and the Face so very
+red, that there is Room to be apprehensive of an Apoplexy, which we
+should endeavour to obviate, by drawing eight or ten Ounces of Blood
+from the Arm.
+
+As this terrible Disease is common in the Country, it is doing a real
+Service to the unfortunate Victims of it, to inform them how very
+dangerous it is to give themselves blindly up to take all the Medicines,
+which are cried up to them in such Cases. If there be any one Disease,
+which requires a more attentive, delicate, and exquisite Kind of
+Treatment, it is this very Disease. Some Species of it are wholly
+incurable: and such as may be susceptible of a Cure, require the utmost
+Care and Consideration of the most enlightned and most experienced
+Physicians: while those who pretend to cure all epileptic Patients, with
+one invariable Medicine, are either Ignorants, or Impostors, and
+sometimes both in one.
+
+Sec. 517. Simple Convulsion Fits, which are not epileptic, are frequently
+of a long Continuance, persevering, with very few and short Intervals,
+for Days and even for Weeks.
+
+The true genuine Cause should be investigated as strictly as possible,
+though nothing should be attempted in the Fit. The Nerves are, during
+that Term, in so high a Degree of Tension and Sensibility, that the very
+Medicines, supposed to be strongly indicated, often redouble the Storm
+they were intended to appease.
+
+Thin watery Liquors, moderately imbued with Aromatics, are the least
+hurtful, the most innocent Things that can be given; such as Bawm,
+Lime-tree, and Elder Flower Tea. A Ptisan of Liquorice Root only has
+sometimes answered better than any other.
+
+
+
+                 _Of suffocating, or strangling Fits._
+
+
+Sec. 518. These Fits (by whatever other Name they may be called) whenever
+they very suddenly attack a Person, whose Breathing was easy and natural
+just before, depend almost constantly on a Spasm or Contraction of the
+Nerves, in the Vesicles of the Lungs; or upon an Infarction, a Stuffing
+of the same Parts, produced by viscid clammy Humours.
+
+That Suffocation which arises from a Spasm is not dangerous, it goes off
+of itself, or it may be treated like Swoonings owing to the same Cause.
+See Sec. 502.
+
+Sec. 519. That Suffocation, which is the Effect of a sanguineous Fulness
+and Obstruction, may be distinguished by its attacking strong, vigorous,
+sanguine Persons, who are great Eaters, using much juicy nutritious
+Food, and strong Wine and Liquors, and who frequently eat and inflame
+themselves; and when the Fit has come on after any inflaming Cause; when
+the Pulse is full and strong, and the Countenance red.
+
+Such are cured, 1, by a very plentiful Discharge of Blood from the Arm,
+which is to be repeated, if necessary.
+
+2, By the Use of Glysters.
+
+3, By drinking plentifully of the Ptisan No. 1; to each Pot of which, a
+Drachm of Nitre is to be added; and,
+
+4, By the Vapour of hot Vinegar, continually received by Respiration or
+Breathing. See Sec. 55.
+
+Sec. 520. There is Reason to think that one of these Fits is owing to a
+Quantity of tough viscid Humours in the Lungs, when it attacks Persons,
+whose Temperament, and whose Manner of living are opposite to those I
+have just described; such as valetudinary, weakly, phlegmatic,
+pituitous, inactive, and squeamish Persons, who feed badly, or on fat,
+viscid, and insipid Diet, and who drink much hot Water, either alone, or
+in Tea-like Infusions. And these Signs of Suffocation, resulting from
+such Causes, are still more probable, if the Fit came on in rainy
+Weather, and during a southerly Wind; and when the Pulse is soft and
+small, the Visage pale and hollow.
+
+The most efficacious Treatment we can advise, is, 1, To give every half
+Hour half a Cup of the Potion, No. 8, if it can be readily had. 2, To
+make the Patient drink very plentifully of the Drink No. 12; and, 3, to
+apply two strong Blisters to the fleshy Parts of his Legs.
+
+If he was strong and hearty before the Fit, and the Pulse still
+continues vigorous, and feels somewhat full withall, the Loss of seven
+or eight Ounces of Blood is sometimes indispensably necessary. A Glyster
+has also frequently been attended with extraordinary good Effects.
+
+Those afflicted with this oppressing Malady are commonly relieved, as
+soon as they expectorate, and sometimes even by vomiting a little.
+
+The Medicine No. 25, a Dose of which may be taken every two Hours, with
+a Cup of the Ptisan No. 12, often succeeds very well.
+
+But if neither this Medicine, nor the Prescription of No. 8 are at Hand,
+which may be the Case in Country Places; an Onion of a moderate Size
+should be pounded in an Iron or Marble Mortar; upon this, a Glass of
+Vinegar is to be poured, and then strongly squeezed out again through a
+Piece of Linen. An equal Quantity of Honey is then to be added to it. A
+Spoonful of this Mixture, whose remarkable Efficacy I have been a
+Witness of, is to be given every half Hour.
+
+
+
+                   _Of the violent Effects of Fear._
+
+
+Sec. 521. Here I shall insert some Directions to prevent the ill
+Consequences of great Fear or Terror, which are very prejudicial at
+every Term of Life, but chiefly during Infancy.
+
+The general Effects of Terror, are a great Straitening or Contraction of
+all the small Vessels, and a Repulsion of the Blood into the large and
+internal ones. Hence follows the Suppression of Perspiration, the
+general Seizure or Oppression, the Trembling, the Palpitations and
+Anguish, from the Heart and the Lungs being overcharged with Blood; and
+sometimes attended with Swoonings, irremediable Disorders of the Heart,
+and Death itself. A heavy Drowsiness, Raving, and a Kind of furious or
+raging _Delirium_ happen in other Cases, which I have frequently
+observed in Children, when the Blood-vessels of the Neck were swelled
+and stuffed up; and Convulsions, and even the Epilepsy have come on, all
+which have proved the horrible Consequence of a most senseless and
+wicked Foolery or Sporting. One half of those Epilepsies which do not
+depend on such Causes, as might exist before the Child's Birth, are
+owing to this detestable Custom; and it cannot be too much inculcated
+into Children, never to frighten one another; a Point which Persons
+intrusted with their Education, ought to have the strictest Regard to.
+
+When the Humours that should have passed off by Perspiration, are
+repelled to the Intestines, a tedious and very obstinate Looseness is
+the frequent Consequence.
+
+Sec. 522. Our Endeavours should be directed, to re-establish the disordered
+Circulation; to restore the obstructed Perspiration; and to allay the
+Agitation of the Nerves.
+
+The popular Custom in these Cases has been to give the terrified Patient
+some cold Water directly; but when the Fright has been considerable,
+this is a very pernicious custom, and I have seen some terrible
+Consequences from it.
+
+They should, on the contrary, be conveyed into some very quiet
+Situation, leaving there but very few Persons, and such only as they are
+thoroughly familiar with. They should take a few Cups of pretty warm
+Drink, particularly of an Infusion of Lime-tree Flowers and Bawm. Their
+Legs should be put into warm Water, and remain there an Hour, if they
+will patiently permit it, rubbing them gently now and then, and giving
+them every half-quarter of an Hour, a small Cup of the said Drink. When
+their Composure and Tranquillity are returned a little, and their Skin
+seems to have recovered its wonted and general Warmth, Care should be
+taken to dispose them to sleep, and to perspire plentifully. For this
+Purpose they may be allowed a few Spoonfuls of Wine, on putting them
+into Bed, with one Cup of the former Infusion; or, which is more certain
+and effectual, a few Drops of _Sydenham's_ Liquid Laudanum, No. 44; but
+should that not be near at Hand, a small Dose of _Venice_ Treacle.
+
+Sec. 523. It sometimes happens that Children do not seem at first extremely
+terrified; but the Fright is renewed while they sleep, and with no small
+Violence. The Directions I have just given must then be observed, for
+some successive Evenings, before they are put to Bed.
+
+Their Fright frequently returns about the latter End of the Night, and
+agitates them violently every Day. The same Treatment should be
+continued in such Cases; and we should endeavour to dispose them to be
+a-sleep at the usual Hour of its Return.
+
+By this very Method, I have dissipated the dismal Consequences of Fear
+of Women in Child-bed, which is so commonly, and often speedily, mortal.
+
+If a Suffocation from this Cause is violent, there is sometimes a
+Necessity for opening a Vein in the Arm.
+
+These Patients should gradually be inured to an almost continual, but
+gentle, Kind of Exercise.
+
+All violent Medicines render those Diseases, which are the Consequences
+of great Fear, incurable. A pretty common one is that of an Obstruction
+of the Liver, which has been productive of a Jaundice. [107]
+
+[107] I have seen this actually verified by great and disagreeable
+     Surprize, attended indeed with much Concern, in a Person of
+     exquisite Sensations. _K._
+
+
+
+_Of Accidents or Symptoms produced by the Vapours of Coal, and of Wine._
+
+
+Sec. 524. Not a single Year passes over here, without the Destruction of
+many People by the Vapour of Charcoal, or of small Coal, and by the
+Steam or Vapour of Wine.
+
+The Symptoms by Coal occur, when [108] small Coal, and especially
+when [109] Charcoal is burnt in a Chamber close shut, which is direct
+Poison to a Person shut up in it. The sulphureous Oil, which is set at
+Liberty and diffused by the Action of Fire, expands itself through the
+Chamber; while those who are in it perceive a Disorder and Confusion in
+their Heads; contract Vertigos, Sickness at Stomach, a Weakness, and
+very unusual Kind of Numbness; become raving, convulsed and trembling;
+and if they fail of Presence of Mind, or of Strength, to get out of the
+Chamber, they die within a short Time.
+
+[108] _La Braise._
+
+[109] _Charbon._ Dr. _Tissot_ informs me, their Difference consists in
+     this, that the Charcoal is prepared from Wood burnt in a close or
+     stifled Fire; and that the small Coal is made of Wood (and of
+     smaller Wood) burnt in an open Fire, and extinguished before it is
+     reduced to the State of a Cinder. He says the latter is smaller,
+     softer, less durable in the Fire, and the Vapour of it less
+     dangerous than that of Charcoal.
+
+I have seen a Woman who had vertiginous Commotions in her Head for two
+Days, and almost continual Vomitings, from her having been confined less
+than six Minutes in a Chamber (and that notwithstanding, both one Window
+and one Door were open) in which there was a Chafing-dish with some
+burning Coals. Had the Room been quite close, she must have perished by
+it.
+
+This Vapour is narcotic or stupefying, and proves mortal in Consequence
+of its producing a sleepy or apoplectic Disorder, though blended, at the
+same time, with something convulsive; which sufficiently appears from
+the Closure of the Mouth, and the strict Contraction or Locking of the
+Jaws.
+
+The Condition of the Brain, in the dissected Bodies of Persons thus
+destroyed, proves that they die of an Apoplexy: notwithstanding it is
+very probable that Suffocation is also partly the Cause of their Deaths;
+as the Lungs have been found stuffed up with Blood and livid.
+
+It has also been observed in some other such Bodies, that Patients
+killed by the Vapour of burning Coals, have commonly their whole Body
+swelled out to one third more than their Magnitude, when living. The
+Face, Neck, and Arms are swelled out, as if they had been blown up; and
+the whole human Machine appears in such a State, as the dead Body of a
+Person would, who had been violently strangled; and who had made all
+possible Resistance for a long time, before he was overpowered.
+
+Sec. 525. Such as are sensible of the great Danger they are in, and retreat
+seasonably from it, are generally relieved as soon as they get into the
+open Air; or if they have any remaining Uneasiness, a little Water and
+Vinegar, or Lemonade, drank hot, affords them speedy Relief. But when
+they are so far poisoned, as to have lost their Feeling and
+Understanding, if there be any Means of reviving them, such Means
+consist,
+
+1, In exposing them to a very pure, fresh and open Air.
+
+2, In making them smell to some very penetrating Odour, which is
+somewhat stimulating and reviving, such as the volatile Spirit of Sal
+Ammoniac, the [110] _English_ Salt; and afterwards to surround them, as
+it were, with the Steam of Vinegar.
+
+[110] See Note [105] Page 495.
+
+3, In taking some Blood from their Arm.
+
+4, In putting their Legs into warm or hot Water, and chafing them well.
+
+5, In making them swallow, if practicable, much Lemonade, or Water and
+Vinegar, with the Addition of Nitre: and,
+
+6, In throwing up some sharp Glysters.
+
+As it is manifest there is something spasmodic in these Cases, it were
+proper to be provided with some antispasmodic Remedies, such as the
+Mineral Anodyne Liquid of _Hoffman_. Even Opium has sometimes been
+successfully given here, but it should be allowed to Physicians only to
+direct it in such Cases.
+
+A Vomit would be hurtful; and the Reachings to vomit arise only from the
+Oppression on the Brain.
+
+It is a common but erroneous Opinion, that if the Coal be suffered to
+burn for a Minute or so in the open Air, or in a Chimney, it is
+sufficient to prevent any Danger from the Vapour of it.
+
+Hence it amounts even to a criminal Degree of Imprudence, to sleep in a
+Chamber while Charcoal or small Coal is burning in it; and the Number of
+such imprudent Persons, as have never awaked after it, is so
+considerable, and so generally known too, that the Continuance of this
+unhappy Custom is astonishing.
+
+Sec. 526. The Bakers, who make Use of much small Coal, often keep great
+Quantities of it in their Cellars, which frequently abound so much with
+the Vapour of it, that it seizes them violently the Moment they enter
+into the Cellar. They sink down at once deprived of all Sensation, and
+die if they are not drawn out of it soon enough to be assisted,
+according to the Directions I have just given.
+
+One certain Means of preventing such fatal Accidents is, upon going into
+the Cellar to throw some flaming Paper or Straw into it, and if these
+continue to flame out and consume, there is no Reason for dreading the
+Vapour: but if they should be extinguished, no Person should venture in.
+But after opening the Vent-hole, a Bundle of flaming Straw must be set
+at the Door, which serves to attract the external Air strongly. Soon
+after the Experiment of the flaming Paper must be repeated, and if it
+goes out, more Straw is to be set on Fire before the Cellar Door.
+
+Sec. 527. Small Coal, burnt in an open Fire, is not near so dangerous as
+_Charcoal_, properly so called, the Danger of which arises from this,
+that in extinguishing it by the usual Methods, all those sulphureous
+Particles of it, in which its Danger consists, are concentred.
+Nevertheless, small Coal is not entirely deprived of all its noxious
+Quality, without some of which it could not strictly be Coal.
+
+The common Method of throwing some Salt on live Coals, before they are
+conveyed into a Chamber; or of casting a Piece of Iron among them to
+imbibe some Part of their deadly narcotic Sulphur, is not without its
+Utility; though by no means sufficient to prevent all Danger from them.
+
+Sec. 528. When the most dangerous Symptoms from this Cause disappear, and
+there remains only some Degree of Weakness, of Numbness, and a little
+Inappetency, or Loathing at Stomach, nothing is better than Lemonade
+with one fourth Part Wine, half a Cup of which should frequently be
+taken, with a small Crust of Bread.
+
+Sec. 529. The Vapour which exhales from Wine, and in general from all
+fermenting Liquors, such as Beer, Cyder, _&c._ contains something
+poisonous, which kills in the like Manner with the Vapour of Coal; and
+there is always some Danger in going into a Cellar, where there is much
+Wine in the State of Fermentation; if it has been shut up close for
+several Hours. There have been many Examples of Persons struck dead on
+entering one, and of others who have escaped out of it with Difficulty.
+
+When such unhappy Accidents occur, Men should not be successively
+exposed, one after another, to perish, by endeavouring to fetch out the
+first who sunk down upon his Entrance; but the Air should immediately be
+purified by the Method already directed, or by discharging some Guns
+into the Cellar; after which People may venture in with Precaution. And
+when the Persons unfortunately affected are brought out, they are to be
+treated like those, who were affected with the Coal-Vapour.
+
+I saw a Man, about eight Years since, who was not sensible of the
+Application of Spirit of Sal Ammoniac, till about an Hour after he was
+struck down, and who was entirely freed at last by a plentiful Bleeding;
+though he had been so insensible, that it was several Hours before he
+discovered a very great Wound he had, which extended from the Middle of
+his Arm to his Armpit, and which was made by a Hook intended to be used,
+in Case of a House catching Fire, to assist Persons in escaping from the
+Flames.
+
+Sec. 530. When subterraneous Caves that have been very long shut are
+opened; or when deep Wells are cleaned, that have not been emptied for
+several Years, the Vapours arising from them produce the same Symptoms I
+have mentioned, and require the same Assistance. They are to be cleansed
+and purified by burning Sulphur and Salt Petre in them, or Gunpowder, as
+compounded of both.
+
+Sec. 531. The offensive Stink of Lamps and of Candles, especially when
+their Flames are extinguished, operate like other Vapours, though with
+less Violence, and less suddenly. Nevertheless there have been Instances
+of People killed by the Fumes of Lamps fed with Nut Oil, which had been
+extinguished in a close Room. These last Smells or Fumes prove noxious
+also, in Consequence of their Greasiness, which being conveyed, together
+with the Air, into the Lungs, prevent their Respiration: And hence we
+may observe, that Persons of weak delicate Breasts find themselves
+quickly oppressed in Chambers or Apartments, illuminated with many
+Candles.
+
+The proper Remedies have been already directed, Sec. 525. The Steam of
+Vinegar is very serviceable in such Cases.
+
+
+
+                             _Of Poisons._
+
+
+Sec. 532. There are a great Number of Poisons, whose Manner of acting is
+not alike; and whose ill Effects are to be opposed by different
+Remedies: But Arsenic, or Ratsbane, and some particular Plants are the
+Poisons which are the most frequently productive of Mischief, in Country
+Places.
+
+Sec. 533. It is in Consequence of its excessive Acrimony, or violent Heat
+and Sharpness, which corrodes or gnaws, that Arsenic destroys by an
+excessive Inflammation, with a burning Fire as it were, most torturing
+Pains in the Mouth, Throat, Stomach, Guts; with rending and often bloody
+Vomitings, and Stools, Convulsions, Faintings, _&c._
+
+The best Remedy of all is pouring down whole Torrents of Milk, or, where
+there is not Milk, of warm Water. Nothing but a prodigious Quantity of
+such weak Liquids can avail such a miserable Patient. If the Cause of
+the Disorder is immediately known, after having very speedily taken down
+a large Quantity of warm Water, Vomiting may be excited with Oil, or
+with melted Butter, and by tickling the Inside of the Throat with a
+Feather. But when the Poison has already inflamed the Stomach and the
+Guts, we must not expect to discharge it by vomiting. Whatever is
+healing or emollient, Decoctions of mealy Pulse, of Barley, of Oatmeal,
+of Marsh-mallows, and Butter and Oil are the most suitable.
+
+As soon as ever the tormenting Pains are felt in the Belly, and the
+Intestines seem attacked, Glysters of Milk must be very frequently
+thrown up.
+
+If at the very Beginning of the Attack, the Patient has a strong Pulse,
+a very large Bleeding may be considerably serviceable by its delaying
+the Progress, and diminishing the Degree of Inflammation.
+
+And even though it should happen that a Patient overcomes the first
+Violence of this dreadful Accident, it is too common for him to continue
+in a languid State for a long Time, and sometimes for all the Remainder
+of his Life. The most certain Method of preventing this Misery, is to
+live for some Months solely upon Milk, and some very new laid Eggs, just
+received from the Hen, and dissolved or blended in the Milk, without
+boiling them.
+
+Sec. 534. The Plants which chiefly produce these unhappy Accidents are some
+Kinds of Hemlock, whether it be the Leaf or the Root, the Berries of the
+_Bella Donna_, or deadly Nightshade, which Children eat by mistake for
+Cherries; some Kind of Mushrooms, the Seed of the _Datura_, or the
+stinking Thorn-Apple.
+
+All the Poisons of this Class prove mortal rather from a narcotic, or
+stupefying, than from an acrid, or very sharp Quality. Vertigos,
+Faintings, Reachings to vomit, and actual Vomitings are the first
+Symptoms produced by them.
+
+The Patient should immediately swallow down a large Quantity of Water,
+moderately seasoned with Salt or with Sugar; and then a Vomiting should
+be excited as soon as possible by the Prescription No. 34 or 35: or, if
+neither of these is very readily procurable, with Radish-seed pounded,
+to the Quantity of a Coffee Spoonful, swallowed in warm Water, soon
+after forcing a Feather or a Finger into the Patient's Throat, to
+expedite the Vomiting.
+
+After the Operation of the Vomit, he must continue to take a large
+Quantity of Water, sweetened with Honey or Sugar, together with a
+considerable Quantity of Vinegar, which is the true Specific, or
+Antidote, as it were, against those Poisons: the Intestines must also be
+emptied by a few Glysters.
+
+Thirty-seven Soldiers having unhappily eaten, instead of Carrots, of the
+Roots of the _Oenanthe_; or Water-hemlock, became all extremely sick;
+when the Emetic, No. 34, with the Assistance of Glysters, and very
+plentiful drinking of warm Water, saved all but one of them, who died
+before he could be assisted.
+
+Sec. 535. If a Person has taken too much Opium; or any Medicine into which
+it enters, as _Venice_ Treacle, Mithridate, Diascordium, _&c._ whether
+by Imprudence, Mistake, Ignorance, or through any bad Design, he must be
+bled upon the Spot, and treated as if he had a sanguine Apoplexy, (See Sec.
+147) by Reason that Opium in Effect produces such a one. He should snuff
+up and inhale the Vapour of Vinegar plentifully, adding it also
+liberally to the Water he is to drink.
+
+
+
+                           _Of acute Pains._
+
+
+Sec. 536. It is not my Intention to treat here of those Pains, that
+accompany any evident known Disease, and which should be conducted as
+relating to such Diseases; nor of such Pains as infirm valetudinary
+Persons are habitually subject to; since Experience has informed such of
+the most effectual Relief for them: But when a Person sound and hale,
+finds himself suddenly attacked with some excessive Pain, in whatever
+Part it occurs, without knowing either the Nature, or the Cause of it,
+they may, till proper Advice can be procured,
+
+1, Part with some Blood, which, by abating the Fulness and Tension,
+almost constantly asswages the Pains, at least for some Time: and it may
+even be repeated, if, without weakening the Patient much, it has
+lessened the Violence of the Pain.
+
+2, The Patient should drink abundantly of some very mild temperate
+Drink, such as the Ptisan No. 2, the Almond Emulsion No. 4, or warm
+Water with a fourth or fifth Part Milk.
+
+3, Several emollient Glysters should be given.
+
+4, The whole Part that is affected, and the adjoining Parts should be
+covered with Cataplasms, or soothed with the emollient Fomentation, No.
+9.
+
+5, The warm Bath may also be advantagiously used.
+
+6, If notwithstanding all these Assistances, the Pain should still
+continue violent, and the Pulse is neither full nor hard, the grown
+Patient may take an Ounce of Syrup of Diacodium, or sixteen Drops of
+liquid Laudanum; and when neither of these are to be had, [111] an
+_English_ Pint of boiling Water must be poured upon three or four
+Poppy-heads with their Seeds, but without the Leaves, and this Decoction
+is to be drank like Tea.
+
+[111] _Une Quartette._
+
+Sec. 537. Persons very subject to frequent Pains, and especially to violent
+Head-achs, should abstain from all strong Drink; such Abstinence being
+often the only Means of curing them: And People are very often mistaken
+in supposing Wine necessary for as many as seem to have a weak Stomach.
+
+
+
+
+                           __Chapter XXXII.__
+
+
+
+       _Of Medicines taken by Way of Precaution, or Prevention._
+
+
+                             __Sect.__ 538.
+
+I Have pointed out, in some Parts of this Work, the Means of preventing
+the bad Effects of several Causes of Diseases; and of prohibiting the
+Return of some habitual Disorders. In the present Chapter I shall adjoin
+some Observations, on the Use of the principal Remedies, which are
+employed as general Preservatives; pretty regularly too at certain
+stated Times, and almost always from meer Custom only, without knowing,
+and often with very little Consideration, whether they are right or
+wrong.
+
+Nevertheless, the Use, the Habit of taking Medicines, is certainly no
+indifferent Matter: it is ridiculous, dangerous, and even criminal to
+omit them, when they are necessary, but not less so to take them when
+they are not wanted. A good Medicine taken seasonably, when there is
+some Disorder, some _Disarrangement_ in the Body, which would in a short
+time occasion a Distemper, has often prevented it. But yet the very same
+Medicine, if given to a Person in perfect Health, if it does not
+directly make him sick, leaves him at the best in a greater Propensity
+to the Impressions of Diseases: and there are but too many Examples of
+People, who having very unhappily contracted a Habit, a Disposition to
+take Physick, have really injured their Health, and impaired their
+Constitution, however naturally strong, by an Abuse of those Materials
+which Providence has given for the Recovery and Re-establishment of it;
+an Abuse which, though it should not injure the Health of the Person,
+would occasion those Remedies, when he should be really sick, to be less
+efficacious and serviceable to him, from their having been familiar to
+his Constitution; and thus he becomes deprived of the Assistance he
+would have received from them, if taken only in those Times and
+Circumstances, in which they were necessary for him.
+
+
+
+                             _Of Bleeding._
+
+
+Sec. 539. Bleeding is necessary only in these four Cases. 1, When there is
+too great a Quantity of Blood in the Body. 2, When there is any
+Inflammation, or an inflammatory Disease. 3, When some Cause supervenes,
+or is about to supervene, in the Constitution, which would speedily
+produce an Inflammation, or some other dangerous Symptom, if the Vessels
+were not relaxed by Bleeding. It is upon this Principle that Patients
+are bled after Wounds, and after Bruises; that Bleeding is directed for
+a pregnant Woman, if she has a violent Cough; and that Bleeding is
+performed, by Way of Precaution, in several other Cases. 4, We also
+advise Bleeding sometimes to asswage an excessive Pain, though such Pain
+is not owing to Excess of Blood, nor arises from an inflamed Blood; but
+in Order to appease and moderate the Pain by Bleeding; and thereby to
+obtain Time for destroying the Cause of it by other Remedies. But as
+these two last Reasons are in Effect involved or implied in the two
+first; it may be very generally concluded, that an Excess of Blood, and
+an inflamed State of it, are the only two necessary Motives for
+Bleeding.
+
+Sec. 540. An Inflammation of the Blood is known by the Symptoms
+accompanying those Diseases, which that Cause produces. Of these I have
+already spoken, and I have at the same time regulated the Practice of
+Bleeding in such Cases. Here I shall point out those Symptoms and
+Circumstances, which manifest an Excess of Blood.
+
+The first, then, is the general Course and Manner of the Patient's
+living, while in Health. If he is a great Eater, and indulges in juicy
+nutritious Food, and especially on much Flesh-meat; if he drinks rich
+and nourishing Wine, or other strong Drink, and at the same time enjoys
+a good Digestion; if he takes but little Exercise, sleeps much, and has
+not been subject to any very considerable Evacuation, he may well be
+supposed to abound in Blood. It is very obvious that all these Causes
+rarely occur in Country People; if we except only the Abatement of their
+Exercise, during some Weeks in Winter, which indeed may contribute to
+their generating more Blood than they commonly do.
+
+The labouring Country-man, for much the greater part of his Time, lives
+only on Bread, Water and Vegetables; Materials but very moderately
+nourishing, as one Pound of Bread probably does not make, in the same
+Body, more Blood than one Ounce of Flesh; though a general Prejudice
+seems to have established a contrary Opinion. 2, The total Stopping or
+long Interruption of some involuntary Bleeding or Haemorrhage, to which
+he had been accustomed. 3, A full and strong Pulse, and Veins visibly
+filled with Blood, in a Body that is not lean and thin, and when he is
+not heated. 4, A florid lively Ruddiness. 5, A considerable and unusual
+Numbness; Sleep more profound, of more Duration, and yet less tranquil
+and calm, than at other times; a greater Propensity than ordinary to be
+fatigued after moderate Exercise or Work; and a little Oppression and
+Heaviness from walking. 6, Palpitations, accompanied sometimes with very
+great Dejection, and even with a slight fainting Fit; especially on
+being in any hot Place, or after moving about considerably. 7, Vertigos,
+or Swimmings of the Head, especially on bowing down and raising it up at
+once, and after sleeping. 8, Frequent Pains of the Head, to which the
+Person was not formerly subject; and which seem not to arise from any
+Defect in the Digestions. 9, An evident Sensation of Heat, pretty
+generally diffused over the whole Body. 10, A smarting Sort of Itching
+all over, from a very little more Heat than usual. And lastly, frequent
+Haemorrhages, and these attended with manifest Relief, and more Vivacity.
+
+People should, notwithstanding, be cautious of supposing an unhealthy
+Excess of Blood, from any one of these Symptoms only. Many of them must
+concur; and they should endeavour to be certain that even such a
+Concurrence of them does not result from a very different Cause, and
+wholly opposite in Effect to that of an Excess of Blood.
+
+But when it is certain, from the whole Appearance, that such an Excess
+doth really exist, then a single, or even a second Bleeding is attended
+with very good Effects. Nor is it material, in such Cases, from what
+Part the Blood is taken.
+
+Sec. 541. On the other Hand, when these Circumstances do not exist,
+Bleeding is in no wise necessary: nor should it ever be practised in
+these following Conditions and Circumstances; except for some particular
+and very strong Reasons; of the due Force of which none but Physicians
+can judge.
+
+First, when the Person is in a very advanced Age, or in very early
+Infancy. 2, When he is either naturally of a weakly Constitution, or it
+has been rendered such by Sickness, or by some other Accident. 3, When
+the Pulse is small, soft, feeble, and intermits, and the Skin is
+manifestly pale. 4, When the Limbs, the Extremities of the Body, are
+often cold, puffed up and soft. 5, When their Appetite has been very
+small for a long time; their Food but little nourishing, and their
+Perspiration too plentiful, from great Exercise. 6, When the Stomach has
+long been disordered, and the Digestion bad, whence very little Blood
+could be generated. 7, When the Patient has been considerably emptied,
+whether by Haemorrhages, a Looseness, profuse Urine or Sweat: or when the
+_Crisis_ of some Distemper has been effected by any one of these
+Evacuations. 8, When the Patient has long been afflicted with some
+depressing Disease; and troubled with many such Obstructions as prevent
+the Formation of Blood. 9, Whenever a Person is exhausted, from whatever
+Cause. 10, When the Blood is in a thin, pale, and dissolved State.
+
+Sec. 542, In all these Cases, and in some others less frequent, a single
+Bleeding often precipitates the Patient into an absolutely incurable
+State, an irreparable Train of Evils. Many dismal Examples of it are but
+too obvious.
+
+Whatever, therefore, be the Situation of the Patient, and however
+naturally robust, that Bleeding, which is unnecessary, is noxious.
+Repeated, re-iterated Bleedings, weaken and enervate, hasten old Age,
+diminish the Force of the Circulation, thence fatten and puff up the
+Body; and next by weakening, and lastly by destroying, the Digestions,
+they lead to a fatal Dropsy. They disorder the Perspiration by the Skin,
+and leave the Patient liable to Colds and Defluxions: They weaken the
+nervous System, and render them subject to Vapours, to the hypochondriac
+Disorders, and to all nervous Maladies.
+
+The ill Consequence of a single, though erroneous Bleeding is not
+immediately discernible: on the contrary, when it was not performed in
+such a Quantity, as to weaken the Patient perceivably, it appears to
+have been rather beneficial. Yet I still here insist upon it, that it is
+not the less true that, when unnecessary, it is prejudicial; and that
+People should never bleed, as sometimes has been done, for meer Whim,
+or, as it were, for Diversion. It avails nothing to affirm, that within
+a few Days after it, they have got more Blood than they had before it,
+that is, that they weigh more than at first, whence they infer the Loss
+of Blood very speedily repaired. The Fact of their augmented Weight is
+admitted; but this very Fact testifies against the real Benefit of that
+Bleeding; hence it is a Proof, that the natural Evacuations of the Body
+are less compleatly made; and that Humours, which ought to be expelled,
+are retained in it. There remains the same Quantity of Blood, and
+perhaps a little more; but it is not a Blood so well made, so perfectly
+elaborated; and this is so very true, that if the thing were otherwise;
+if some Days after the Bleeding they had a greater Quantity of the same
+Kind of Blood, it would amount to a Demonstration, that more re-iterated
+Bleedings must necessarily have brought on an inflammatory Disease, in a
+Man of a robust Habit of Body.
+
+Sec. 543. The Quantity of Blood, which a grown Man may Part with, by Way of
+Precaution, is about ten Ounces.
+
+Sec. 544. Persons so constituted as to breed much Blood, should carefully
+avoid all those Causes which tend to augment it, (See Sec. 540, No. 1) and
+when they are sensible of the Quantity augmented, they should confine
+themselves to a light frugal Diet, on Pulse, Fruits, Bread and Water;
+they should often bathe their Feet in warm Water, taking Night and
+Morning the Powder No. 20; drink of the Ptisan No. 1; sleep but very
+moderately, and take much Exercise. By using these Precautions they may
+either prevent any Occasion for Bleeding, or should they really be
+obliged to admit of it, they would increase and prolong its good
+Effects. These are also the very Means, which may remove all the Danger
+that might ensue from a Person's omitting to bleed, at the usual Season
+or Interval, when the Habit, the Fashion of Bleeding had been
+inveterately established in him.
+
+Sec. 545. We learn with Horror and Astonishment, that some have been bled
+eighteen, twenty and even twenty-four times in two Days; and some
+others, some [112] hundred times, in the Course of some Months. Such
+Instances irrefragably demonstrate the continual Ignorance of their
+Physician or Surgeon; and should the Patient escape, we ought to admire
+the inexhaustible Resources of Nature, that survived so many murderous
+Incisions.
+
+[112] How shocking is this! and yet how true in some Countries! I have
+     been most certainly assured, that Bleeding has been inflicted and
+     repeated in the last sinking and totally relaxing Stage of a
+     Sea-Scurvy, whose fatal Termination it doubtless accelerated. This
+     did not happen in our own Fleet; yet we are not as yet Wholly
+     exempt on Shore, from some Abuse of Bleeding, which a few raw
+     unthinking Operators are apt to consider as a meer Matter of
+     Course. I have in some other Place stigmatized the Madness of
+     Bleeding in Convulsions, from manifest Exhaustion and Emptiness,
+     with the Abhorrence it deserves. _K._
+
+Sec. 546. The People entertain a common Notion, which is, that the first
+Time of bleeding certainly saves the Life of the Patient; but to
+convince them of the Falsity of this silly Notion, they need only open
+their Eyes, and see the very contrary Fact to this occur but too
+unhappily every Day; many People dying soon after their first Bleeding.
+Were their Opinion right, it would be impossible that any Person should
+die of the first Disease that seized him, which yet daily happens. Now
+the Extirpation of this absurd Opinion is really become important, as
+the Continuance of it is attended with some unhappy Consequences: their
+Faith in, their great Dependance on, the extraordinary Virtue of this
+first Bleeding makes them willing to omit it, that is, to treasure it up
+against a Distemper, from which they shall be in the greatest Danger;
+and thus it is deferred as long as the Patient is not extremely bad, in
+Hopes that if they can do without it then, they shall keep it for
+another and more pressing Occasion. Their present Disease in the mean
+time rises to a violent Height; and then they bleed, but when it is too
+late, and I have seen Instances of many Patients, who were permitted to
+die, that the first Bleeding might be reserved for a more important
+Occasion. The only Difference between the first Bleeding, and any
+subsequent one is, that the first commonly gives the Patient an Emotion,
+that is rather hurtful than salutary.
+
+
+
+                              _Of Purges._
+
+
+Sec. 547. The Stomach and Bowels are emptied either by Vomiting, or by
+Stools, the latter Discharge being much more natural than the first,
+which is not effected without a violent Motion, and one indeed to which
+Nature is repugnant. Nevertheless, there are some Cases, which really
+require this artificial Vomiting; but these excepted (some of which I
+have already pointed out) we should rather prefer those Remedies, which
+empty the Belly by Stool.
+
+Sec. 548. The Signs, which indicate a Necessity for Purging, are, 1, a
+disagreeable Tast or Savour of the Mouth in a Morning, and especially a
+bitter Tast; a foul, furred Tongue and Teeth, disagreable Eructations or
+Belchings, Windiness and Distension.
+
+2, A Want of Appetite which increases very gradually, without any Fever,
+which degenerates into a Disgust or total Aversion to Food; and
+sometimes communicates a bad Tast to the very little such Persons do
+eat.
+
+3, Reachings to vomit in a Morning fasting, and sometimes throughout the
+Day; supposing such not to depend on a Woman's Pregnancy, or some other
+Disorder, in which Purges would be either useless or hurtful.
+
+4, A vomiting up of bitter, or corrupted, Humours.
+
+5, A manifest Sensation of a Weight, or Heaviness in the Stomach, the
+Loins, or the Knees.
+
+6, A Want of Strength sometimes attended with Restlessness, ill Humour,
+or Peevishness, and Melancholy.
+
+7, Pains of the Stomach, frequent Pains of the Head, or Vertigos;
+sometimes a Drowsiness, which increases after Meals.
+
+8, Some Species of Cholics; irregular Stools which are sometimes very
+great in Quantity, and too liquid for many Days together; after which an
+obstinate Costiveness ensues.
+
+9, A Pulse less regular, and less strong, than what is natural to the
+Patient, and which sometimes intermits.
+
+Sec. 549. When these Symptoms, or some of them, ascertain the Necessity of
+purging a Person, not then attacked by any manifest Disease (for I am
+not speaking here of Purges in such Cases) a proper purging Medicine may
+be given him. The bad Tast in his Mouth; the continual Belchings; the
+frequent Reachings to vomit; the actual Vomitings and Melancholy
+discover, that the Cause of his Disorder resides in the Stomach, and
+shew that a Vomit will be of Service to him. But when such Signs or
+Symptoms are not evident, the Patient should take such purging or
+opening Remedies, as are particularly indicated by the Pains, whether of
+the Loins; from the Cholic; or by a Sensation of Weight or Heaviness in
+the Knees.
+
+Sec. 550. But we should abstain from either vomiting or purging, 1,
+Whenever the Complaints of the Patients are founded in their Weakness,
+and their being already exhausted, 2, When there is a general Dryness of
+the Habit, a very considerable Degree of Heat, some Inflammation, or a
+strong Fever. 3, Whenever Nature is exerting herself in some other
+salutary Evacuation; whence purging must never be attempted in critical
+Sweats, during the monthly Discharges, nor during a Fit of the Gout. 4,
+Nor in such inveterate Obstructions as Purges cannot remove, and really
+do augment. 5, Neither when the nervous System is considerably weakened.
+
+Sec. 551. There are other Cases again, in which it may be proper to purge,
+but not to give a Vomit. These Cases are, 1, When the Patient abounds
+too much with Blood, (See Sec. 540) since the Efforts which attend
+vomiting, greatly augment the Force of the Circulation; whence the
+Blood-vessels of the Head and of the Breast, being extremely distended
+with Blood, might burst, which must prove fatal on the Spot, and has
+repeatedly proved so. 2, For the same Reason they should not be given to
+Persons, who are subject to frequent Bleeding from the Nose, or to
+coughing up or vomiting of Blood; to Women who are subject to excessive
+or unseasonable Discharges of Blood, _&c._ from the _Vagina_, the Neck
+of the Womb; nor to those who are with Child. 3, Vomits are improper for
+ruptured Persons.
+
+Sec. 552. When any Person has taken too acrid, too sharp, a Vomit, or a
+Purge, which operates with excessive Violence; whether this consists in
+the most vehement Efforts and Agitations, the Pains, Convulsions, or
+Swoonings, which are their frequent Consequences; or whether that
+prodigious Evacuation and Emptiness their Operation causes, (which is
+commonly termed a _Super-purgation_) and which may hurry the Patient
+off; Instances of which are but too common among the lower Class of the
+People, who much too frequently confide themselves to the Conduct of
+ignorant Men-slayers: In all such unhappy Accidents, I say, we should
+treat these unfortunate Persons, as if they had been actually poisoned,
+by violent corroding Poisons, (See Sec. 533) that is, we should fill them,
+as it were, with Draughts of warm Water, Milk, Oil, Barley-water, Almond
+Milk, emollient Glysters with Milk, and the Yolks of Eggs; and also
+bleed them plentifully, if their Pains are excessive, and their Pulses
+strong and feverish.
+
+The Super-purgation, the excessive Discharge, is to be stopt, after
+having plied the Patient plentifully with diluting Drinks, by giving the
+calming Anodyne Medicines directed in the Removal of acute Pains, Sec. 536,
+No. 6.
+
+Flanels dipt in hot Water, in which some _Venice_ Treacle is dissolved,
+are very serviceable: and should the Evacuations by Stool be excessive,
+and the Patient has not a high Fever, and a parching Kind of Heat, a
+Morsel of the same Treacle, as large as a Nutmeg, may be dissolved in
+his Glyster.
+
+But should the Vomiting solely be excessive, without any Purging, the
+Number of the emollient Glysters with Oil and the Yolk of an Egg must be
+increased; and the Patient should be placed in a warm Bath.
+
+Sec. 553. Purges frequently repeated, without just and necessary
+Indications, are attended with much the same ill Effects as frequent
+Bleedings. They destroy the Digestions; the Stomach no longer, or very
+languidly, exerts its Functions; the Intestines prove inactive; the
+Patient becomes liable to very severe Cholics; the Plight of the Body,
+deprived of its salutary Nutrition, falls off; Perspiration is
+disordered; Defluxions ensue; nervous Maladies come on, with a general
+Languor; and the Patient proves old, long before the Number of his Years
+have made him so.
+
+Much irreparable Mischief has been done to the Health of Children, by
+Purges injudiciously given and repeated. They prevent them from
+attaining their utmost natural Strength, and frequently contract their
+due Growth. They ruin their Teeth; dispose young Girls to future
+Obstructions; and when they have been already affected by them, they
+render them still more obstinate.
+
+It is a Prejudice too generally received, that Persons who have little
+or no Appetite need purging; since this is often very false, and most of
+those Causes, which lessen or destroy the Appetite, cannot be removed by
+purging; though many of them may be increased by it.
+
+Persons whose Stomachs contain much glairy viscid Matter suppose, they
+may be cured by Purges, which seem indeed at first to relieve them: but
+this proves a very slight and deceitful Relief. These Humours are owing
+to that Weakness and Laxity of the Stomach, which Purges augment; since
+notwithstanding they carry off Part of these viscid Humours generated in
+it, at the Expiration of a few Days there is a greater Accumulation of
+them than before; and thus, by a Re-iteration of purging Medicines, the
+Malady soon becomes incurable, and Health irrecoverably lost. The real
+Cure of such Cases is effected by directly opposite Medicines. Those
+referred to, or mentioned, Sec. 272, are highly conducive to it.
+
+Sec. 554. The Custom of taking stomachic Medicines infused in Brandy,
+Spirit of Wine, Cherry Water, _&c._ is always dangerous; for
+notwithstanding the present immediate Relief such Infusions afford in
+some Disorders of the Stomach, they really by slow Degrees impair and
+ruin that Organ; and it may be observed, that as many as accustom
+themselves to Drams, go off, just like excessive Drinkers, in
+Consequence of their having no Digestion; whence they sink into a State
+of Depression and Languor, and die dropsical.
+
+Sec. 555. Either Vomits or Purges may be often beneficially omitted, even
+when they have some Appearance of seeming necessary, by abating one Meal
+a Day for some time; by abstaining from the most nourishing Sorts of
+Food; and especially from those which are fat; by drinking freely of
+cool Water, and taking extraordinary Exercise. The same Regimen also
+serves to subdue, without the Use of Purges, the various Complaints
+which often invade those, who omit taking purging Medicines, at those
+Seasons and Intervals, in which they have made it a Custom to take them.
+
+Sec. 556. The Medicines, No. 34 and 35, are the most certain Vomits. The
+Powder, No. 21, is a good Purge, when the Patient is in no wise
+feverish.
+
+The Doses recommended in the Table of Remedies are those, which are
+proper for a grown Man, of a vigorous Constitution. Nevertheless there
+are some few, for whom they may be too weak: in such Circumstances they
+may be increased by the Addition of a third or fourth Part of the Dose
+prescribed. But should they not operate in that Quantity, we must be
+careful not to double the Dose, much less to give a three-fold Quantity,
+which has sometimes been done, and that even without its Operation, and
+at the Risque of killing the Patient, which has not seldom been the
+Consequence. In Case of such purging not ensuing, we should rather give
+large Draughts of Whey sweetened with Honey, or of warm Water, in a Pot
+of which an Ounce, or an Ounce and a half of common Salt must be
+dissolved; and this Quantity is to be taken from time to time in small
+Cups, moving about with it.
+
+The Fibres of Country People who inhabit the Mountains, and live almost
+solely on Milk, are so little susceptible of Sensation, that they must
+take such large Doses to purge them, as would kill all the Peasantry in
+the Vallies. In the Mountains of _Valais_ there are Men who take twenty,
+and even twenty-four Grains of Glass of Antimony for a single Dose; a
+Grain or two of which were sufficient to poison ordinary Men.
+
+Sec. 557. Notwithstanding our Cautions on this important Head, whenever an
+urgent Necessity commands it, Purging must be recurred to at all Times
+and Seasons: but when the Season may be safely selected, it were right
+to decline Purging in the Extremities of either Heat or Cold; and to
+take the Purge early in the Morning, that the Medicines may find less
+Obstruction or Embarrassment from the Contents of the Stomach. Every
+other Consideration, with Relation to the Stars and the Moon, is
+ridiculous, and void of any Foundation. The People are particularly
+averse to purging in the Dog-days; and if this were only on Account of
+the great Heat, it would be very pardonable: but it is from an
+astrological Prejudice, which is so much the more absurd, as the real
+Dog-days are at thirty-six Days Distance from those commonly reckoned
+such; and it is a melancholy Reflection, that the Ignorance of the
+People should be so gross, in this Respect, in our enlightened Age; and
+that they should still imagine the Virtue and Efficacy of Medicines to
+depend on what Sign of the Zodiac the Sun is in, or in any particular
+Quarter of the Moon. Yet it is certain in this Point, they are so
+inveterately attached to this Prejudice, that it is but too common to
+see Country-People die, in waiting for the Sign or Quarter most
+favourable to the Operation and Effect of a Medicine, which was truly
+necessary five or six Days before either of them. Sometimes too that
+particular Medicine is given, to which a certain Day is supposed to be
+auspicious and favourable, in Preference to that which is most prevalent
+against the Disease. And thus it is, than an ignorant Almanack Maker
+determines on the Lives of the human Race; and contracts the Duration of
+them with Impunity.
+
+Sec. 558. When a Vomit or a Purge is to be taken, the Patient's Body should
+be prepared for the Reception of it twenty-four Hours beforehand; by
+taking very little Food, and drinking some Glasses of warm Water, or of
+a light Tea of some Herbs.
+
+He should not drink after a Vomit, until it begins to work; but then he
+should drink very plentifully of warm Water, or a light Infusion of
+Chamomile Flowers, which is preferable.
+
+It is usual, after Purges, to take some thin Broth or Soup during their
+Operation; but warm Water sweetened with Sugar or Honey, or an Infusion
+of Succory Flowers, would sometimes be more suitable.
+
+Sec. 559. As the Stomach suffers, in some Degree, as often as either a
+Vomit, or a Purge, is taken, the Patient should be careful how he lives
+and orders himself for some Days after taking them, as well in Regard to
+the Quantity as Quality of his Food.
+
+Sec. 560. I shall say nothing of other Articles taken by Way of Precaution,
+such as Soups, Whey, Waters, _&c._ which are but little used among the
+People; but confine myself to this general Remark, that when they take
+any of these precautionary Things, they should enter on a Regimen or Way
+of living, that may co-operate with them, and contribute to the same
+Purpose. Whey is commonly taken to refresh and cool the Body; and while
+they drink it, they deny themselves Pulse, Fruits, and Sallads. They eat
+nothing then, but the best and heartiest Flesh-meats they can come at;
+such Vegetables as are used in good Soups, Eggs, and good Wine;
+notwithstanding this is to destroy, by high and heating Aliments, all
+the attemperating cooling Effects expected from the Whey.
+
+Some Persons propose to cool and attemperate their Blood by Soups and a
+thin Diet, into which they cram Craw-fish, that heat considerably, or
+_Nasturtium_, Cresses which also heat, and thus defeat their own
+Purpose. Happily, in such a Case, the Error in one Respect often cures
+that in the other; and these Kinds of Soup, which are in no wise
+cooling, prove very serviceable, in Consequence of the Cause of the
+Symptoms, which they were intended to remove, not requiring any Coolers
+at all.
+
+The general physical Practice of the Community, which unhappily is but
+too much in Fashion, abounds with similar Errors. I will just cite one,
+because I have seen its dismal Effects. Many People suppose Pepper
+cooling, though their Smell, Taste, and common Sense concur to inform
+them of the contrary. It is the very hottest of Spices.
+
+Sec. 561. The most certain Preservative, and the most attainable too by
+every Man, is to avoid all Excess, and especially Excess in eating and
+in drinking. People generally eat more than thoroughly consists with
+Health, or permits them to attain the utmost Vigour, of which their
+natural Constitutions are capable. The Custom is established, and it is
+difficult to eradicate it: notwithstanding we should at least resolve
+not to eat, but through Hunger, and always under a Subjection to Reason;
+because, except in a very few Cases, Reason constantly suggests to us
+not to eat, when the Stomach has an Aversion to Food. A sober moderate
+Person is capable of Labour, I may say, even of excessive Labour of some
+Kinds; of which greater Eaters are absolutely incapable. Sobriety of
+itself cures such Maladies as are otherwise incurable, and may recover
+the most shattered and unhealthy Persons.
+
+
+
+
+                           __Chapter XXXIII.__
+
+
+                _Of Mountebanks, Quacks, and Conjurers._
+
+
+                             __Sect.__ 562.
+
+One dreadful Scourge still remains to be treated of, which occasions a
+greater Mortality, than all the Distempers I have hitherto described;
+and which, as long as it continues, will defeat our utmost Precautions
+to preserve the Healths and Lives of the common People. This, or rather,
+these Scourges, for they are very numerous, are Quacks; of which there
+are two Species: The Mountebanks or travelling Quacks, and those
+pretended Physicians in Villages and Country-Places, both male and
+female, known in _Swisserland_ by the Name of Conjurers, and who very
+effectually unpeople it.
+
+The first of these, the Mountebanks, without visiting the Sick, or
+thinking of their Distempers, sell different Medicines, some of which
+are for external Use, and these often do little or no Mischief; but
+their internal ones are much oftener pernicious. I have been a Witness
+of their dreadful Effects, and we are not visited by one of these
+wandering Caitiffs, whose Admission into our Country is not mortally
+fatal to some of its Inhabitants. They are injurious also in another
+Respect, as they carry off great Sums of Money with them, and levy
+annually some thousands of Livres, amongst that Order of the People, who
+have the least to spare. I have seen, and with a very painful Concern,
+the poor Labourer and the Artisan, who have scarcely possessed the
+common Necessaries of Life, borrow wherewithal to purchase, and at a
+dear Price, the Poison that was to compleat their Misery, by increasing
+their Maladies; and which, where they escaped with their Lives, has left
+them in such a languid and inactive State, as has reduced their whole
+Family to Beggary.
+
+Sec. 563. An ignorant, knavish, lying and impudent Fellow will always
+seduce the gross and credulous Mass of People, incapable to judge of and
+estimate any thing rightly; and adapted to be the eternal Dupes of such,
+as are base enough to endeavour to dazzle their weak Understandings; by
+which Method these vile Quacks will certainly defraud them, as long as
+they are tolerated. But ought not the Magistrates, the Guardians, the
+Protectors, the political Fathers of the People interpose, and defend
+them from this Danger, by severely prohibiting the Entrance of such
+pernicious Fellows into a Country, where Mens' Lives are very estimable,
+and where Money is scarce; since they extinguish the first, and carry
+off the last, without the least Possibility of their being in anywise
+useful to it. Can such forcible Motives as these suffer our Magistrates
+to delay _their_ Expulsion any longer, _whom_ there never was the least
+Reason for admitting?
+
+Sec. 564. It is acknowledged the Conjurers, the residing Conjurers, do not
+carry out the current Money of the Country, like the itinerant Quacks;
+but the Havock they make among their Fellow Subjects is without
+Intermission, whence it must be very great, as every Day in the Year is
+marked with many of their Victims. Without the least Knowledge or
+Experience, and offensively armed with three or four Medicines, whose
+Nature they are as thoroughly ignorant of, as of their unhappy Patients
+Diseases; and which Medicines, being almost all violent ones, are very
+certainly so many Swords in the Hands of raging Madmen. Thus armed and
+qualified, I say, they aggravate the slightest Disorders, and make those
+that are a little more considerable, mortal; but from which the Patients
+would have recovered, if left solely to the Conduct of Nature; and, for
+a still stronger Reason, if they had confided to the Guidance of her
+experienced Observers and Assistants.
+
+Sec. 565. The Robber who assassinates on the High-way, leaves the Traveller
+the Resource of defending himself, and the Chance of being aided by the
+Arrival of other Travellers: But the Poisoner, who forces himself into
+the Confidence of a sick Person, is a hundred times more dangerous, and
+as just an Object of Punishment.
+
+The Bands of Highwaymen, and their Individuals, that enter into any
+Country or District, are described as particularly as possible to the
+Publick. It were equally to be wished, we had also a List of these
+physical Impostors and Ignorants male and female; and that a most exact
+Description of them, with the Number, and a brief Summary of their
+murderous Exploits, were faithfully published. By this Means the
+Populace might probably be inspired with such a wholesome Dread of them,
+that they would no longer expose their Lives to the Mercy of such
+Executioners.
+
+Sec. 566. But their Blindness, with Respect to these two Sorts of
+maleficent Beings, is inconceivable. That indeed in Favour of the
+Mountebank is somewhat less gross, because as they are not personally
+acquainted with him, they may the more easily credit him with some Part
+of the Talents and the Knowledge he arrogates. I shall therefore inform
+them, and it cannot be repeated too often, that whatever ostentatious
+Dress and Figure some of these Impostors make, they are constantly vile
+Wretches, who, incapable of earning a Livelyhood in any honest Way, have
+laid the Foundation of their Subsistence on their own amazing Stock of
+Impudence, and that of the weak Credulity of the People; that they have
+no scientific Knowledge; that their Titles and Patents are so many
+Impositions, and inauthentic; since by a shameful Abuse, such Patents
+and Titles are become Articles of Commerce, which are to be obtained at
+very low Prices; just like the second-hand laced Cloaks which they
+purchase at the Brokers. That their Certificates of Cures are so many
+Chimeras or Forgeries; and that in short, if among the prodigious
+Multitudes of People who take their Medicines, some of them should
+recover, which it is almost physically impossible must not sometimes be
+the Case, yet it would not be the less certain, that they are a
+pernicious destructive Set of Men. A Thrust of a Rapier into the Breast
+has saved a Man's Life by seasonably opening an Imposthume in it, which
+might otherwise have killed him: and yet internal penetrating Wounds,
+with a small Sword, are not the less mortal for one such extraordinary
+Consequence. Nor is it even surprizing that these Mountebanks, which is
+equally applicable to Conjurers, who kill thousands of People, whom
+Nature alone, or assisted by a Physician, would have saved, should now
+and then cure a Patient, who had been treated before by the ablest
+Physicians. Frequently Patients of that Class, who apply to these
+Mountebanks and Conjurers (whether it has been, that they would not
+submit to the Treatment proper for their Distempers; or whether the real
+Physician tired of the intractable Creatures has discontinued his Advice
+and Attendance) look out for such Doctors, as assure them of a speedy
+Cure, and venture to give them such Medicines as kill many, and cure one
+(who has had Constitution enough to overcome them) a little sooner than
+a justly reputable Physician would have done. It is but too easy to
+procure, in every Parish, such Lists of their Patients, and of their
+Feats, as would clearly evince the Truth of whatever has been said here
+relating to them.
+
+Sec. 567. The Credit of this Market, this Fair-hunting Doctor, surrounded
+by five or six hundred Peasants, staring and gaping at him, and counting
+themselves happy in his condescending to cheat them of their very scarce
+and necessary Cash, by selling them, for twenty times more than its real
+Worth, a Medicine whose best Quality were to be only a useless one; the
+Credit, I say, of this vile yet tolerated Cheat, would quickly vanish,
+could each of his Auditors be persuaded, of what is strictly true, that
+except a little more Tenderness and Agility of Hand, he knows full as
+much as his Doctor; and that if he could assume as much Impudence, he
+would immediately have as much Ability, would equally deserve the same
+Reputation, and to have the same Confidence reposed in him.
+
+Sec. 568. Were the Populace capable of reasoning, it were easy to disabuse
+them in these Respects; but as it is, their Guardians and Conductors
+should reason for them. I have already proved the Absurdity of reposing
+any Confidence in Mountebanks, properly so called; and that Reliance
+some have on the Conjurers is still more stupid and ridiculous.
+
+The very meanest Trade requires some Instruction: A Man does not
+commence even a Cobler, a Botcher of old Leather, without serving an
+Apprenticeship to it; and yet no Time has been served, no Instruction
+has been attended to, by these Pretenders to the most necessary, useful
+and elegant Profession. We do not confide the mending, the cleaning of a
+Watch to any, who have not spent several Years in considering how a
+Watch is made; what are the Requisites and Causes of its going right;
+and the Defects or Impediments that make it go wrong: and yet the
+preserving and rectifying the Movements of the most complex, the most
+delicate and exquisite, and the most estimable Machine upon Earth, is
+entrusted to People who have not the least Notion of its Structure; of
+the Causes of its Motions; nor of the Instruments proper to rectify
+their Deviations.
+
+Let a Soldier discarded from his Regiment for his roguish Tricks, or who
+is a Deserter from it, a Bankrupt, a disreputable Ecclesiastic, a
+drunken Barber, or a Multitude of such other worthless People, advertize
+that they mount, set and fit up all Kinds of Jewels and Trinkets in
+Perfection; if any of these are not known; if no Person in the Place has
+ever seen any of their Work; or if they cannot produce authentic
+Testimonials of their Honesty, and their Ability in their Business, not
+a single Individual will trust them with two Pennyworth of false Stones
+to work upon; in short they must be famished. But if instead of
+professing themselves Jewellers, they post themselves up as Physicians,
+the Croud purchase, at a high Rate, the Pleasure of trusting them with
+the Care of their Lives, the remaining Part of which they rarely fail to
+empoison.
+
+Sec. 569. The most genuine and excellent Physicians, these extraordinary
+Men, who, born with the happiest Talents, have began to inform their
+Understandings from their earliest Youth; who have afterwards carefully
+qualified themselves by cultivating every Branch of Physic; who have
+sacrificed the best and most pleasurable Days of their Lives, to a
+regular and assiduous Investigation of the human Body; of its various
+Functions; of the Causes that may impair or embarrass them, and informed
+themselves of the Qualities and Virtues of every simple and compound
+Medicine; who have surmounted the Difficulty and Loathsomness of living
+in Hospitals among thousands of Patients; and who have added the medical
+Observations of all Ages and Places to their own; these few and
+extraordinary Men, I say, still consider themselves as short of that
+perfect Ability and consummate Knowledge, which they contemplate and
+wish for, as necessary to guarding the precious _Depositum_ of human
+Life and Health, confided to their Charge. Nevertheless we see the same
+inestimable Treasures, intrusted to gross and stupid Men, born without
+Talents; brought up without Education or Culture; who frequently can
+scarcely read; who are as profoundly ignorant of every Subject that has
+any Relation to Physic, as the Savages of _Asia_; who awake only to
+drink away; who often exercise their horrid Trade merely to find
+themselves in strong Liquor, and execute it chiefly when they are drunk:
+who, in short, became Physicians, only from their Incapacity to arrive
+at any Trade or Attainment! Certainly such a Conduct in Creatures of the
+human Species must appear very astonishing, and even melancholy, to
+every sensible thinking Man; and constitute the highest Degree of
+Absurdity and Extravagance.
+
+Should any Person duly qualified enter into an Examination of the
+Medicines they use, and compare them with the Situation and Symptoms of
+the Patients to whom they give them, he must be struck with Horror; and
+heartily deplore the Fate of that unfortunate Part of the human Race,
+whose Lives, so important to the Community, are committed to the Charge
+of the most murderous Set of Beings.
+
+Sec. 570. Some of these Caitiffs however, apprehending the Force and Danger
+of that Objection, founded on their Want of Study and Education, have
+endeavoured to elude it, by infusing and spreading a false, and indeed,
+an impudent impious Prejudice among the People, which prevails too much
+at present; and this is, that their Talents for Physic are a
+supernatural Gift, and, of Course, greatly superior to all human
+Knowledge. It were going out of my Province to expatiate on the
+Indecency, the Sin, and the Irreligion of such Knavery, and incroaching
+upon the Rights and perhaps the Duty of the Clergy; but I intreat the
+Liberty of observing to this respectable Order of Men, that this
+Superstition, which is attended with dreadful Consequences, seems to
+call for their utmost Attention: and in general the Expulsion of
+Superstition is the more to be wished, as a Mind, imbued with false
+Prejudices, is less adapted to imbibe a true and valuable Doctrine.
+There are some very callous hardened Villains among this murdering Band,
+who, with a View to establish their Influence and Revenue as well upon
+Fear as upon Hope, have horridly ventured so far as to incline the
+Populace to doubt, whether they received their boasted Gift and Power
+from Heaven or from Hell! And yet these are the Men who are trusted with
+the Health and the Lives of many others.
+
+Sec. 571. One Fact which I have already mentioned, and which it seems
+impossible to account for is, that great Earnestness of the Peasant to
+procure the best Assistance he can for his sick Cattle. At whatever
+Distance the Farrier lives, or some Person who is supposed qualified to
+be one (for unfortunately there is not one in _Swisserland_) if he has
+considerable Reputation in this Way, the Country-man goes to consult
+him, or purchases his Visit at any Price. However expensive the
+Medicines are, which the Horse-doctor directs, if they are accounted the
+best, he procures them for his poor Beast. But if himself, his Wife or
+Children fall sick, he either calls in no Assistance nor Medicines; or
+contents himself with such as are next at Hand, however pernicious they
+may be, though nothing the cheaper on that account: for certainly the
+Money, extorted by some of these physical Conjurers from their Patients,
+but oftner from their Heirs, is a very shameful Injustice, and calls
+loudly for Reformation.
+
+Sec. 572. In an excellent Memoir or Tract, which will shortly be published,
+on the Population of _Swisserland_, we shall find an important and very
+affecting Remark, which strictly demonstrates the Havock made by these
+immedical Magicians or Conjurers; and which is this: That in the common
+Course of Years, the Proportion between the Numbers and Deaths of the
+Inhabitants of any one Place, is not extremely different in City and
+Country: but when the very same epidemical Disease attacks the City and
+the Villages, the Difference is enormous; and the Number of Deaths of
+the former compared with that of the Inhabitants of the Villages, where
+the Conjurer exercises his bloody Dominion, is infinitely more than the
+Deaths in the City.
+
+I find in the second Volume of the Memoirs of the oeconomical Society of
+_Berne_, for the Year 1762, another Fact equally interesting, which is
+related by one of the most intelligent and sagacious Observers,
+concerned in that Work. "Pleurisies and Peripneumonies (he says)
+prevailed at _Cottens a la Cote_; and some Peasants died under them, who
+had consulted the Conjurers and taken their heating Medicines; while of
+those, who pursued a directly opposite Method, almost every one
+recovered."
+
+Sec. 573. But I shall employ myself no longer on this Topic, on which the
+Love of my Species alone has prompted me to say thus much; though it
+deserves to be considered more in Detail, and is, in Reality, of the
+greatest Consequence. None methinks could make themselves easy with
+Respect to it so much as Physicians, if they were conducted only by
+lucrative Views; since these Conjurers diminish the Number of those poor
+People, who sometimes consult the real Physicians, and with some Care
+and Trouble, but without the least Profit, to those Gentlemen. But what
+good Physician is mean and vile enough to purchase a few Hours of Ease
+and Tranquillity at so high, so very odious a Price?
+
+Sec. 574. Having thus clearly shewn the Evils attending this crying
+Nusance, I wish I were able to prescribe an effectual Remedy against it,
+which I acknowledge is far from being easy to do.
+
+The first necessary Point probably was to have demonstrated the great
+and public Danger, and to dispose the State to employ their Attention on
+this fatal, this mortal Abuse; which, joined to the other Causes of
+Depopulation, has a manifest Tendency to render _Swisserland_ a Desert.
+
+Sec. 575. The second, and doubtless the most effectual Means, which I had
+already mentioned is, not to admit any travelling Mountebank to enter
+this Country; and to set a Mark on all the Conjurers: It may probably
+also be found convenient, to inflict corporal Punishment on them; as it
+has been already adjudged in different Countries by sovereign Edicts. At
+the very least they should be marked with public Infamy, according to
+the following Custom practised in a great City in _France_. "When any
+Mountebanks appeared in _Montpellier_, the Magistrates had a Power to
+mount each of them upon a meagre miserable Ass, with his Head to the
+Ass's Tail. In this Condition they were led throughout the whole City,
+attended with the Shouts and Hooting of the Children and the Mob,
+beating them, throwing Filth and Ordure at them, reviling them, and
+dragging them all about."
+
+Sec. 576. A third conducive Means would be the Instructions and Admonition
+of the Clergy on this Subject, to the Peasants in their several
+Parishes. For this Conduct of the common People amounting, in Effect, to
+Suicide, to Self-murder, it must be important to convince them of it.
+But the little Efficacy of the strongest and repeated Exhortations on so
+many other Articles, may cause us to entertain a very reasonable Doubt
+of their Success on this. Custom seems to have determined, that there is
+nothing in our Day, which excludes a Person from the Title and
+Appellation of an honest or honourable Man, except it be meer and
+convicted Theft; and that for this simple and obvious Reason, that we
+attach ourselves more strongly to our Property, than to any Thing else.
+Even Homicide is esteemed and reputed honourable in many Cases. Can we
+reasonably then expect to convince the Multitude, that it is criminal to
+confide the Care of their Health to these Poisoners, in Hopes of a Cure
+of their Disorders? A much likelier Method of succeding on this Point
+would certainly be, to convince the deluded People, that it will cost
+them less to be honestly and judiciously treated, than to suffer under
+the Hands of these Executioners. The Expectation of a good and cheap
+Health-market will be apt to influence them more, than their Dread of a
+Crime would.
+
+Sec. 577. A fourth Means of removing or restraining this Nusance would be
+to expunge, from the Almanacs, all the astrological Rules relating to
+Physick; as they continually conduce to preserve and increase some
+dangerous Prejudices and Notions in a Science, the smallest Errors in
+which are sometimes fatal. I had already reflected on the Multitude of
+Peasants that have been lost, from postponing, or mistiming a Bleeding,
+only because the sovereign Decision of an Almanac had directed it at
+some other Time. May it not also be dreaded, to mention it by the Way,
+that the same Cause, the Almanacs, may prove injurious to their rural
+Oeconomy and Management; and that by advising with the Moon, who has no
+Influence, and is of no Consequence in Vegetation or other Country
+Business, they may be wanting in a due Attention to such other
+Circumstances and Regulations, as are of real Importance in them?
+
+Sec. 578. A fifth concurring Remedy against this popular Evil would be the
+Establishment of Hospitals, for the Reception of poor Patients, in the
+different Cities and Towns of _Swisserland_.
+
+There may be a great many easy and concurring Means of erecting and
+endowing such, with very little new Expence; and immense Advantages
+might result from them: besides, however considerable the Expenses might
+prove, is not the Object of them of the most interesting, the most
+important Nature? It is incontestably our serious Duty; and it would
+soon be manifest, that the Performance of it would be attended with more
+essential intrinsic Benefit to the Community, than any other Application
+of Money could produce. We must either admit, that the Multitude, the
+Body of the People is useless to the State, or agree, that Care should
+be taken to preserve and continue them. A very respectable _English_
+Man, who, after a previous and thorough Consideration of this Subject,
+had applied himself very assiduously and usefully on the Means of
+increasing the Riches and the Happiness of his Country-men, complains
+that in _England_, the very Country in which there are the most
+Hospitals, the Poor who are sick are not sufficiently assisted. What a
+deplorable Deficience of the necessary Assistance for such must then be
+in a Country, that is not provided with a single Hospital? That Aid from
+Surgery and Physic, which abounds in Cities, is not sufficiently
+diffused into Country-places: and the Peasants are liable to some simple
+and moderate Diseases, which, for Want of proper Care, degenerate into a
+State of Infirmity, that sinks them into premature Death.
+
+Sec. 579. In fine, if it be found impossible to extinguish these Abuses
+(for those arising from Quacks are not the only ones, nor is that Title
+applied to as many as really deserve it) beyond all Doubt it would be
+for the Benefit and Safety of the Public, upon the whole, entirely to
+prohibit the Art, the Practice of Physic itself. When real and good
+Physicians cannot effect as much Good, as ignorant ones and Impostors
+can do Mischief, some real Advantage must accrue to the State, and to
+the whole Species, from employing none of either. I affirm it, after
+much Reflection, and from thorough Conviction, that Anarchy in Medicine
+is the most dangerous Anarchy. For this Profession, when loosed from
+every Restraint, and subjected to no Regulations, no Laws, is the more
+cruel Scourge and Affliction, from the incessant Exercise of it; and
+should its Anarchy, its Disorders prove irremediable, the Practice of an
+Art, become so very noxious, should be prohibited under the severest
+Penalties: Or, if the Constitution of any Government was inconsistent
+with the Application of so violent a Remedy, they should order public
+Prayers against the Mortality of it, to be offered up in all the
+Churches; as the Custom has been in other great and general Calamities.
+
+Sec. 580. Another Abuse, less fatal indeed than those already mentioned
+(but which, however, has real ill Consequences, and at the best, carries
+out a great deal of Money from us, though less at the Expense of the
+common People, than of those of easy Circumstances) is that Blindness
+and Facility, with which many suffer themselves to be imposed upon, by
+the pompous Advertisements of some _Catholicon_, some universal Remedy,
+which they purchase at a high Rate, from some foreign Pretender to a
+mighty Secret or _Nostrum_. Persons of a Class or two above the Populace
+do not care to run after a Mountebank, from supposing they should
+depretiate themselves by mixing with the Herd. Yet if that very Quack,
+instead of coming among us, were to reside in some foreign City; if,
+instead of posting up his lying Puffs and Pretentions at the Corners of
+the Streets, he would get them inserted in the Gazettes, and
+News-papers; if, instead of selling his boasted Remedies in Person, he
+should establish Shops or Offices for that Purpose in every City; and
+finally, if instead of selling them twenty times above their real Value,
+he would still double that Price; instead of having the common People
+for his Customers, he would take in the wealthy Citizen, Persons of all
+Ranks, and from almost every Country. For strange as it seems, it is
+certain, that a Person of such a Condition, who is sensible in every
+other Respect; and who will scruple to confide his Health to the Conduct
+of such Physicians as would be the justest Subjects of his Confidence,
+will venture to take, through a very unaccountable Infatuation, the most
+dangerous Medicine, upon the Credit of an imposing Advertisement,
+published by as worthless and ignorant a Fellow as the Mountebank whom
+he despises, because the latter blows a Horn under his Window; and yet
+who differs from the former in no other Respects except those I have
+just pointed out.
+
+Sec. 581. Scarcely a Year passes, without one or another such advertized
+and vaunted Medicine's getting into high Credit; the Ravages of which
+are more or less, in Proportion to its being more or less in Vogue.
+Fortunately, for the human Species, but few of these _Nostrums_ have
+attained an equal Reputation with _Ailbaud_'s Powders, an Inhabitant of
+_Aix_ in _Provence_, and unworthy the Name of a Physician; who has
+over-run _Europe_ for some Years, with a violent Purge, the Remembrance
+of which will not be effaced before the Extinction of all its Victims. I
+attend now, and for a long time past, several Patients, whose Disorders
+I palliate without Hopes of ever curing them; and who owe their present
+melancholy State of Body to nothing but the manifest Consequences of
+these Powders; and I have actually seen, very lately, two Persons who
+have been cruelly poisoned by this boasted Remedy of his. A French
+Physician, as eminent for his Talents and his Science, as estimable from
+his personal Character in other Respects, has published some of the
+unhappy and tragical Consequences which the Use of them has occasioned;
+and were a Collection published of the same Events from them, in every
+Place where they have been introduced, the Size and the Contents of the
+Volume would make a very terrible one.
+
+Sec. 582. It is some Comfort however, that all the other Medicines thus
+puffed and vended have not been altogether so fashionable, nor yet quite
+so dangerous: but all posted and advertized Medicines should be judged
+of upon this Principle (and I do not know a more infallible one in
+Physics, nor in the Practice of Physic), that whoever advertises any
+Medicine, as a universal Remedy for all Diseases, is an absolute
+Impostor, such a Remedy being impossible and contradictory. I shall not
+here offer to detail such Proofs as may be given of the Verity of this
+Proposition: but I freely appeal for it to every sensible Man, who will
+reflect a little on the different Causes of Diseases; on the Opposition
+of these Causes; and on the Absurdity of attempting to oppose such
+various Diseases, and their Causes, by one and the same Remedy.
+
+As many as shall settle their Judgments properly on this Principle, will
+never be imposed upon by the superficial Gloss of these Sophisms
+contrived to prove, that all Diseases proceed from one Cause; and that
+this Cause is so very tractable, as to yield to one boasted Remedy. They
+will perceive at once, that such an Assertion must be founded in the
+utmost Knavery or Ignorance; and they will readily discover where the
+Fallacy lies. Can any one expect to cure a Dropsy, which arises from too
+great a Laxity of the Fibres, and too great an Attenuation or Thinness
+of the Blood, by the same Medicines that are used to cure an
+inflammatory Disease, in which the Fibres are too stiff and tense, and
+the Blood too thick and dense? Yet consult the News-papers and the
+Posts, and you will see published in and on all of them, Virtues just as
+contradictory; and certainly the Authors of such poisonous
+Contradictions ought to be legally punished for them.
+
+Sec. 583. I heartily wish the Publick would attend here to a very natural
+and obvious Reflection. I have treated in this Book, but of a small
+Number of Diseases, most of them acute ones; and I am positive that no
+competent well qualified Physician has ever employed fewer Medicines, in
+the Treatment of the Diseases themselves. Nevertheless I have prescribed
+seventy-one, and I do not see which of them I could retrench, or
+dispense with the Want of, if I were obliged to use one less. Can it be
+supposed then, that any one single Medicine, compound or simple, shall
+cure thirty times as many Diseases as those I have treated of?
+
+Sec. 584. I shall add another very important Observation, which doubtless
+may have occurred to many of my Readers; and it is this, that the
+different Causes of Diseases, their different Characters; the
+Differences which arise from the necessary Alterations that happen
+throughout their Progress and Duration; the Complications of which they
+are susceptible; the Varieties which result from the State of different
+Epidemics, of Seasons, of Sexes, and of many other Circumstances; that
+these Diversities, I say, oblige us very often to vary and change the
+Medicines; which proves how very ticklish and dangerous it is to have
+them directed by Persons, who have such an imperfect Knowledge of them,
+as those who are not Physicians must be supposed to have. And the
+Circumspection to be used in such Cases ought to be proportioned to the
+Interest the Assistant takes in the Preservation of the Patient; and
+that Love of his Neighbour with which he is animated.
+
+Sec. 585. Must not the same Arguments and Reflections unavoidably suggest
+the Necessity of an entire Tractability on the Part of the Patient, and
+his Friends and Assistants? The History of Diseases which have their
+stated Times of Beginning, of manifesting and displaying themselves; of
+arriving at, and continuing in their Height, and of decreasing; do not
+all these demonstrate the Necessity of continuing the same Medicines, as
+long as the Character of the Distemper is the same; and the Danger of
+changing them often, only because what has been given has not afforded
+immediate Relief? Nothing can injure the Patient more than this
+Instability and Caprice. After the Indication which his Distemper
+suggests, appears to be well deduced, the Medicine must be chosen that
+is likeliest to resist the Cause of it; and it must be continued as long
+as no new Symptom or Circumstance supervenes, which requires an
+Alteration of it; except it should be evident, that an Error had been
+incurred in giving it. But to conclude that a Medicine is useless or
+insignificant, because it does not remove or abate the Distemper as
+speedily, as the Impatience of the Sick would naturally desire it; and
+to change it for another, is as unreasonable, as it would be for a Man
+to break his Watch, because the Hand takes twelve Hours, to make a
+Revolution round the Dial-plate.
+
+Sec. 586. Physicians have some Regard to the State of the Urine of sick
+Persons, especially in inflammatory Fevers; as the Alterations occurring
+in it help them to judge of the Changes that may have been made in the
+Character and Consistence of the Humours in the Mass of Blood; and
+thence may conduce to determine the Time, in which it will be proper to
+dispose them to some Evacuation. But it is gross Ignorance to imagine,
+and utter Knavery and Imposture to persuade the Sick, that the meer
+Inspection of their Urine solely, sufficiently enables others to judge
+of the Symptoms and Cause of the Disease, and to direct the best
+Remedies for it. This Inspection of the Urine can only be of Use when it
+is duly inspected; when we consider at the same time the exact State and
+the very Looks of the Patient; when these are compared with the Degree
+of the Symptoms of the Malady; with the other Evacuations; and when the
+Physician is strictly informed of all external Circumstances, which may
+be considered as foreign to the Malady; which may alter or affect the
+Evacuations, such as particular Articles of Food, particular Drinks,
+different Medicines, or the very Quantity of Drink. Where a Person is
+not furnished with an exact Account of these Circumstances, the meer
+Inspection of the Urine is of no Service, it suggests no Indication, nor
+any Expedient; and meer common Sense sufficiently proves, and it may be
+boldly affirmed, that whoever orders any Medicine, without any other
+Knowledge of the Disease, than what an Inspection of the Urine affords,
+is a rank Knave, and the Patient who takes them is a Dupe.
+
+Sec. 587. And here now any Reader may very naturally ask, whence can such a
+ridiculous Credulity proceed, upon a Subject so essentially interesting
+to us as our own Health?
+
+In Answer to this it should be observed, that some Sources, some Causes
+of it seem appropriated merely to the People, the Multitude. The first
+of these is, the mechanical Impression of Parade and Shew upon the
+Senses. 2, The Prejudice they have conceived, as I said before, of the
+Conjurers curing by a supernatural Gift. 3, The Notion the Country
+People entertain, that their Distemper and Disorders are of a Character
+and Species peculiar to themselves, and that the Physicians, attending
+the Rich, know nothing concerning them. 4, The general Mistake that
+their employing the Conjurer is much cheaper. 5, Perhaps a sheepish
+shame-faced Timidity may be one Motive, at least with some of them. 6, A
+Kind of Fear too, that Physicians will consider their Cases with less
+Care and Concern, and be likely to treat them more cavalierly; a Fear
+which increases that Confidence which the Peasant, and which indeed
+every Man has in his Equal, being sounded in Equality itself. And 7, the
+Discourse and Conversation of such illiterate Empirics being more to
+their Tast, and more adapted to their Apprehension.
+
+But it is less easy to account for this blind Confidence, which Persons
+of a superior Class (whole Education being considered as much better are
+regarded as better Reasoners) repose in these boasted Remedies; and even
+for some Conjurer in Vogue. Nevertheless even some of their Motives may
+be probably assigned.
+
+The first is that great Principle of _Seity_, or _Selfness_, as it may
+be called, innate to Man, which attaching him to the Prolongation of his
+own Existence more than to any other thing in the Universe, keeps his
+Eyes, his utmost Attention, continually fixed upon this Object; and
+compels him to make it the very Point, the Purpose of all his Advances
+and Proceedings; notwithstanding it does not permit him to distinguish
+the safest Paths to it from the dangerous ones. This is the surest and
+shortest Way says some Collector at the Turnpike, he pays, passes, and
+perishes from the Precipices that occur in his Route.
+
+This very Principle is the Source of another Error, which consists in
+reposing, involuntarily, a greater Degree of Confidence in those, who
+flatter and fall in the most with us in our favourite Opinions. The well
+apprised Physician, who foresees the Length and the Danger of a Disease;
+and who is a Man of too much Integrity to affirm what he does not think,
+must, from a necessary Construction of the human Frame and Mind, be
+listened to less favourably, than he who flatters us by saying what we
+wish. We endeavour to elongate, to absent ourselves, from the
+Sentiments, the Judgment of the first; we smile, from Self-complacency,
+at those of the last, which in a very little time are sure of obtaining
+our Preference.
+
+A third Cause, which results from the same Principle is, that we give
+ourselves up the most readily to his Conduct, whose Method seems the
+least disagreeable, and flatters our Inclinations the most. The
+Physician who enjoins a strict Regimen; who insists upon some Restraints
+and Self-denials; who intimates the Necessity of Time and Patience for
+the Accomplishment of the Cure, and who expects a thorough Regularity
+through the Course of it, disgusts a Patient who has been accustomed to
+indulge his own Tast and Humour; the Quack, who never hesitates at
+complying with it, charms him. The Idea of a long and somewhat distant
+Cure, to be obtained at the End of an unpleasant and unrelaxing Regimen,
+supposes a very perilous Disease; this Idea disposes the Patient to
+Disgust and Melancholy, he cannot submit to it without Pain; and he
+embraces, almost unconsciously, merely to avoid this, an opposite System
+which presents him only with the Idea of such a Distemper, as will give
+Way to a few Doses of Simples.
+
+That Propensity to the New and Marvellous, which tyrannizes over so
+large a Proportion of our Species, and which has advanced so many absurd
+Persons and Things into Reputation, is a fourth and a very powerful
+Motive. An irksome Satiety, and a Tiresomeness, as it were, from the
+same Objects, is what our Nature is apt to be very apprehensive of;
+though we are incessantly conducted towards it, by a Perception of some
+Void, some Emptiness in ourselves, and even in Society too: But new and
+extraordinary Sensations rousing us from this disagreeable State, more
+effectually than any Thing else, we unthinkingly abandon ourselves to
+them, without foreseeing their Consequences.
+
+A fifth Cause arises from seven Eighths of Mankind being managed by, or
+following, the other Eighth; and, generally speaking, the Eighth that is
+so very forward to manage them, are the least fit and worthy to do it;
+whence all must go amiss, and absurd and embarrassing Consequences ensue
+from the Condition of Society. A Man of excellent Sense frequently sees
+only through the Eyes of a Fool, of an intriguing Fellow, or of a Cheat;
+in this he judges wrong, and his Conduct must be so too. A man of real
+Merit cannot connect himself with those who are addicted to caballing;
+and yet such are the Persons, who frequently conduct others.
+
+Some other Causes might be annexed to these, but I shall mention only
+one of them, which I have already hinted, and the Truth of which I am
+confirmed in from several Years Experience; which is, that we generally
+love those who reason more absurdly than ourselves, better than those
+who convince us of our own weak Reasoning.
+
+I hope the Reflexions every Reader will make on these Causes of our ill
+Conduct on this important Head, may contribute to correct or diminish
+it; and to destroy those Prejudices whose fatal Effects we may
+continually observe.
+
+
+[N. B. _The Multitude of_ all _the Objects of this excellent Chapter in
+this Metropolis, and doubtless throughout_ England, _were strong
+Inducements to have taken a little wholesome Notice of the Impostures of
+a few of the most pernicious. But on a second Perusal of this Part of
+the Original and its Translation, I thought it impossible (without
+descending to personal, nominal Anecdotes about the Vermin) to add any
+Thing material upon a Subject, which the Author has with such Energy
+exhausted. He even seems, by some of his Descriptions, to have taken
+Cognizance of a few of our most self-dignified itinerant Empirics; as
+these Genius's find it necessary sometimes to treat themselves with a
+little Transportation. In reality Dr._ _Tissot_ _has, in a very masterly
+Way, thoroughly dissected and displayed the whole_ Genus, _every Species
+of Quacks. And when he comes to account for that Facility, with which
+Persons of very different Principles from them, and of better
+Intellects, first listen to, and finally countenance such Caitiffs, he
+penetrates into some of the most latent Weaknesses of the human Mind;
+even such as are often Secrets to their Owners. It is difficult,
+throughout this Disquisition, not to admire the Writer; but impossible
+not to love the Man, the ardent Philanthropist. His Sentiment that--"A
+Man of real Merit cannot connect himself with those who are addicted to
+caballing,"--is exquisitely just, and so liberal, that it never entered
+into the Mind of any disingenuous Man, however dignified, in any
+Profession. Persons of the simplest Hearts and purest Reflections must
+shrink at every Consciousness of Artifice; and secretly reproach
+themselves for each Success, that has redounded to them at the Expence
+of Truth._] K.
+
+
+
+
+                           __Chapter XXXIV.__
+
+
+    _Containing Questions absolutely necessary to be answered
+    exactly by the Patient, who consults a Physician._
+
+
+                             __Sect.__ 588.
+
+Great Consideration and Experience are necessary to form a right
+Judgment of the State of a Patient, whom the Physician has not
+personally seen; even though he should receive the best Information it
+is possible to give him, at a Distance from the Patient. But this
+Difficulty is greatly augmented, or rather changed into an
+Impossibility, when his Information is not exact and sufficient. It has
+frequently happened to myself, that after having examined Peasants who
+came to get Advice for others, I did not venture to prescribe, because
+they were not able to give me a sufficient Information, in order to my
+being certain of the Distemper. To prevent this great Inconvenience, I
+subjoin a List of such Questions, as indispensably require clear and
+direct Answers.
+
+
+
+                          _General Questions._
+
+
+What is the Patient's Age?
+
+Is he generally a healthy Person?
+
+What is his general Course of Life?
+
+How long has he been sick?
+
+In what Manner did his present Sickness begin, or appear?
+
+Has he any Fever?
+
+Is his Pulse hard or soft?
+
+Has he still tolerable Strength, or is he weak?
+
+Does he keep his Bed in the Day Time, or quit it?
+
+Is he in the same Condition throughout the whole Day?
+
+Is he still, or restless?
+
+Is he hot, or cold?
+
+Has he Pains in the Head, the Throat, the Breast, the Stomach, the
+Belly, the Loins, or in the Limbs, the Extremities of the Body?
+
+Is his Tongue dry? does he complain of Thirst? of an ill Tast in his
+Mouth? of Reachings to vomit, or of an Aversion to Food?
+
+Does he go to stool often or seldom?
+
+What Appearance have his Stools, and what is their usual quantity?
+
+Does he make much Urine? What Appearance has his Urine, as to Colour and
+Contents? Are they generally much alike, or do they change often?
+
+Does he sweat?
+
+Does he expectorate, or cough up?
+
+Does he get Sleep?
+
+Does he draw his Breath easily?
+
+What Regimen does he observe in his Sickness?
+
+What Medicines has he taken?
+
+What Effects have they produced?
+
+Has he never had the same Distemper before?
+
+Sec. 589. The Diseases of Women and Children are attended with peculiar
+Circumstances; so that when Advice is asked for them, Answers must be
+given, not only to the preceding Questions, which relate to sick Persons
+in general; but also to the following, which regard these particularly.
+
+
+
+                   _Questions with Respect to Women._
+
+
+Have they arrived at their monthly Discharges, and are these regular?
+
+Are they pregnant? Is so, how long since?
+
+Are they in Child-bed?
+
+Has their Delivery been happily accomplished?
+
+Has the Mother cleansed sufficiently?
+
+Has her Milk come in due Time and Quantity?
+
+Does she suckle the Infant herself?
+
+Is she subject to the Whites?
+
+
+
+                   _Questions relating to Children._
+
+
+What is the Child's exact Age?
+
+How many Teeth has he cut?
+
+Does he cut them painfully?
+
+Is he any-wise ricketty, or subject to Knots or Kernels?
+
+Has he had the Small Pocks?
+
+Does the Child void Worms, upwards or downwards?
+
+Is his Belly large, swelled, or hard?
+
+Is his Sleep quiet, or otherwise?
+
+Sec. 590. Besides these general Questions, common in all the Diseases of
+the different Sexes and Ages, the Person consulting must also answer to
+those, which have a close and direct Relation to the Disease, at that
+very Time affecting the Sick.
+
+For Example, in the Quinsey, the Condition of the Throat must be exactly
+inquired into. In Diseases of the Breast, an Account must be given of
+the Patient's Pains; of his Cough; of the Oppression, and of his
+Breathing, and Expectoration. I shall not enter upon a more particular
+Detail; common Sense will sufficiently extend this Plan or Specimen to
+other Diseases; and though these Questions may seem numerous, it will
+always be easy to write down their Answers in as little Room, as the
+Questions take up here. It were even to be wished that Persons of every
+Rank, who occasionally write for medical Advice and Directions, would
+observe such a Plan or Succession, in the Body of their Letters. By this
+Means they would frequently procure the most satisfactory Answers; and
+save themselves the Trouble of writing second Letters, to give a
+necessary Explanation of the first.
+
+The Success of Remedies depends, in a very great Measure, on a very
+exact Knowledge of the Disease; and that Knowledge on the precise
+Information of it, which is laid before the Physician.
+
+
+
+
+                               __FINIS.__
+
+
+
+
+                                 _TABLE_
+
+
+    _Of the Prescriptions and Medicines, referred to in the
+    foregoing Treatise: Which, with the Notes beneath them, are to
+    be read before the taking, or Application, of any of the said
+    Medicines._
+
+
+As in Order to ascertain the Doses of Medicines, I have generally done
+it by Pounds, Ounces, Half-Ounces, _&c. &c._ and as this Method,
+especially to the common People, might prove a little too obscure and
+embarrassing, I have specified here the exact Weight of Water, contained
+in such Vessels or liquid Measures, as are most commonly used in the
+Country.
+
+The Pound which I mean, throughout all these Prescriptions, is that
+consisting of sixteen Ounces. These Ounces contain eight Drachms, each
+Drachm consisting of three Scruples, and each Scruple of twenty Grains;
+the medical Scruple of _Paris_ solely containing twenty-four Grains.
+
+The liquid Measure, the _Pot_ used at _Berne_, being that I always speak
+of, may be estimated, without any material Error, to contain three
+Pounds and a Quarter, which is equal to three Pints, and eight common
+Spoonfuls English Measure. But the exact Weight of the Water, contained
+in the Pot of _Berne_, being fifty-one Ounces and a Quarter only, it is
+strictly equal but to three Pints and six common Spoonfuls _English_.
+This however is a Difference of no Importance, in the usual Drinks or
+Aliments of the Sick.
+
+The small drinking Glass we talk of, filled so as not to run over,
+contains three Ounces and three Quarters. But filled, as we propose it
+should for the Sick, it is to be estimated only at three Ounces.
+
+The common middle sized Cup, though rather large than little, contains
+three Ounces and a Quarter. But as dealt out to the Sick, it should not
+be estimated, at the utmost, above three Ounces.
+
+The small Glass contains seven common Spoonfuls; so that a Spoonful is
+supposed to contain half an Ounce.
+
+The small Spoon, or Coffee Spoon, when of its usual Size and Cavity, may
+contain thirty Drops, or a few more; but, in the Exhibition of
+Medicines, it may be reckoned at thirty Drops. Five or six of these are
+deemed equal in Measure, to a common Soup-Spoon.
+
+The Bason or Porrenger, mentioned in the present Treatise, holds,
+without running over, the Quantity of five Glasses, which is equivalent
+to eighteen Ounces and three Quarters. It may be estimated however,
+without a Fraction, at eighteen Ounces: and a sick Person should never
+be allowed to take more than a third Part of this Quantity of
+Nourishment, at any one Time.
+
+The Doses in all the following Prescriptions are adjusted to the Age of
+an Adult or grown Man, from the Age of eighteen to that of sixty Years.
+From the Age of twelve to eighteen, two thirds of that Dose will
+generally be sufficient: and from twelve down to seven Years one half,
+diminishing this still lower, in Proportion to the greater Youth of the
+Patient: so that not more than one eighth of the Dose prescribed should
+be given to an infant of some Months old, or under one Year. But it must
+also be considered, that their different Constitutions will make a
+considerable Difference in adjusting their different Doses. It were to
+be wished, on this Account, that every Person would carefully observe
+whether a strong Dose is necessary to purge him, or if a small one is
+sufficient; as Exactness is most important in adjusting the Doses of
+such Medicines, as are intended to purge, or to evacuate in any other
+Manner.
+
+
+
+                                 No. 1.
+
+
+Take a Pugil or large Pinch between the Thumb and Fingers of Elder
+Flowers; put them into an earthen-ware Mug or Porrenger, with two Ounces
+of Honey, and an Ounce and a half of good Vinegar. Pour upon them three
+Pints and one Quarter of boiling Water. Stir it about a little with a
+Spoon to mix and dissolve the Honey; then cover up the Mug; and, when
+the Liquor is cold, strain it through a Linen Cloth.
+
+
+
+                                 No. 2.
+
+
+Take two Ounces of whole Barley, cleanse and wash it well in hot Water,
+throwing away this Water afterwards. Then boil it in five Chopins or
+_English_ Pints of Water, till the Barley bursts and opens. Towards the
+End of the boiling, throw in one Drachm and a half of Nitre [Salt Petre]
+strain it through a Linen Cloth, and then add to it one Ounce and a half
+of Honey, and one Ounce of Vinegar. [113]
+
+[113] This makes an agreeable Drink; and the Notion of its being windy is
+     idle; since it is so only to those, with whom Barley does not
+     agree. It may, where Barley is not procurable, be made from Oats.
+
+
+
+                                 No. 3.
+
+
+Take the same Quantity of Barley as before, and instead of Nitre, boil
+in it, as soon as the Barley is put in to boil, a Quarter of an Ounce of
+Cream of Tartar. Strain it, and add nothing else [114] to it.
+
+[114] In those Cases mentioned Sec. 241, 262, 280, instead of the Barley,
+     four Ounces of Grass Roots may be boiled in the same Quantity of
+     Water for half an Hour, with the Cream of Tartar.
+
+
+
+                                 No. 4.
+
+
+Take three Ounces of the freshest sweet Almonds, and one Ounce of Gourd
+or Melon Seed; bruise them in a Mortar, adding to them by a little at a
+time, one Pint of Water, then strain it through Linen. Bruise what
+remains again, adding gradually to it another Pint of Water, then
+straining; and adding Water to the Residue, till full three Pints at
+least of Water are thus used: after which it may again be poured upon
+the bruised Mass, stirred well about, and then be finally strained off.
+Half an Ounce of Sugar may safely be bruised with the Almonds and Seeds
+at first, though some weakly imagine it too heating; and delicate
+Persons may be allowed a little Orange Flower Water with it.
+
+
+
+                                 No. 5.
+
+
+Take two Pugils of Mallow Leaves and Flowers, cut them small, and pour a
+Pint of boiling Water upon them. After standing some time strain it,
+adding one Ounce of Honey to it. For Want of Mallows, which is
+preferable, a similar Glyster may be made of the Leaves of Mercury,
+Pellitory of the Wall, the Marsh-Mallows, the greater Mallows, from
+Lettuce, or from Spinage. A few very particular Consititutions are not
+to be purged by any Glyster but warm Water alone; such should receive no
+other, and the Water should not be very hot.
+
+
+
+                                 No. 6.
+
+
+Boil a Pugil of Mallow Flowers, in a Pint of Barley Water for a Glyster.
+
+
+
+                                 No. 7.
+
+
+Take three Pints of simple Barley Water, add to it three Ounces of the
+Juice of Sow-thistle, or of Groundsel, or of the greater Houseleek, or
+of Borage. [115]
+
+[115] These Juices are to be procured from the Herbs when fresh and very
+     young, if possible, by beating them in a Marble Mortar, or for Want
+     of such [or a wooden Mortar] in an Iron one, and then squeezing out
+     the Juice through a Linen Bag. It must be left to settle a little
+     in an earthen Vessel, after which the clear Juice must be decanted
+     gently off, and the Sediment be left behind.
+
+
+
+                                 No. 8.
+
+
+To one Ounce of Oxymel of Squills, add five Ounces of a strong Infusion
+of Elder Flowers.
+
+
+
+                                 No. 9.
+
+
+There are many different emollient Applications, which have very nearly
+the same Virtues. The following are the most efficacious.
+
+1, Flanels wrung out of a hot Decoction of Mallow Flowers.
+
+2, Small Bags filled with Mallow Flowers, or with those of Mullein, of
+Elder, of Camomile, of wild Corn Poppy, and boiled either in Milk or
+Water.
+
+3, Pultices of the same Flowers boiled in Milk and Water.
+
+4, Bladders half filled with hot Milk and Water, or with some emollient
+Decoction.
+
+5, A Pultice of boiled Bread and Milk, or of Barley or Rice boiled till
+thoroughly soft and tender.
+
+6, In the Pleurisy (See Sec. 89) the affected Part may be rubbed sometimes
+with Ointment of Marsh-mallows.
+
+
+
+                                No. 10.
+
+
+To one Ounce of Spirit of Sulphur, add six Ounces of Syrup of Violets,
+or for want of the latter, as much Barley Water, of a thicker
+Consistence than ordinary. [116]
+
+[116] Some Friends, says Dr. _Tissot_, whose judgment I greatly respect,
+     have thought the Doses of acid Spirit which I direct extremely
+     strong; and doubtless they are so, if compared with the Doses
+     generally prescribed, and to which I should have limited myself, if
+     I had not frequently seen their Insufficience. Experience has
+     taught me to increase them considerably; and, augmenting the Dose
+     gradually, I now venture to give larger Doses of them than have
+     ever been done before, and always with much Success; the same Doses
+     which I have advised in this Work not being so large as those I
+     frequently prescribe. For this Reason I intreat those Physicians,
+     who have thought them excessive, to try the acid Spirits in larger
+     Doses than those commonly ordered; and I am persuaded they will see
+     Reason to congratulate themselves upon the Effect. [117]
+
+[117] Our Author's _French_ Annotator has a Note against this Acid, which
+     I have omitted; for though I have given his Note Page 84 [with the
+     Substance of the immediately preceding one] to which I have also
+     added some Doubts of my own, from Facts, concerning the Benefit of
+     Acids in inflammatory Disorders of the Breast; yet with Regard to
+     the ardent, the putrid, the malignant Fever, and _Erisipelas_, in
+     which Dr. _Tissot_ directs this, I have no Doubt of its Propriety
+     (supposing no insuperable Disagreement to Acids in the
+     Constitution) and with Respect to their Doses, I think we may
+     safely rely on our honest Author's Veracity. Dr. _Fuller_ assures
+     us, a Gentleman's Coachman was recovered from the Bleeding Small
+     Pocks, by large and repeated Doses of the Oil of Vitriol, in
+     considerable Draughts of cold Water. _K._
+
+
+
+                                No. 11.
+
+
+Take two Ounces of Manna, and half an Ounce of Sedlitz Salt, or for want
+of it, as much Epsom Salt; dissolving them in four Ounces of hot Water,
+and straining them.
+
+
+
+                                No. 12.
+
+
+Take of Elder Flowers one Pugil, of Hyssop Leaves half as much. Pour
+three Pints of boiling Water upon them. After infusing some time,
+strain, and dissolve three Ounces of Honey in the Infusion.
+
+
+
+                                No. 13.
+
+
+Is only the same Kind of Drink made by omitting the Hyssop, and adding
+instead of it as much more Elder Flowers.
+
+
+
+                                No. 14.
+
+
+Let one Ounce of the best Jesuits Bark in fine Powder be divided into
+sixteen equal Portions.
+
+
+
+                                No. 15.
+
+
+Take of the Flowers of St. _John's_ Wort, of Elder, and of Melilot, of
+each a few Pinches; put them into the Bottom of an Ewer or Vessel
+containing five or six _English_ Pints, with half an Ounce of Oil of
+Turpentine, and fill it up with boiling Water.
+
+
+
+                                No. 16.
+
+
+Is only the Syrup of the Flowers of the wild red Corn Poppy.
+
+
+
+                                No. 17.
+
+
+Is only very clear sweet Whey, in every Pint of which one Ounce of Honey
+is to be dissolved.
+
+
+
+                                No. 18.
+
+
+Take of Castile or hard white Soap six Drachms; of Extract of Dandelion
+one Drachm and a half; of Gum Ammoniacum half a Drachm, and with Syrup
+of Maidenhair make a Mass of Pills, to be formed into Pills, weighing
+three Grains each.
+
+
+
+                                No. 19.
+
+
+Gargarisms may be prepared from a Decoction, or rather an Infusion, of
+the Leaves of Periwinkle, or of Red Rose-Leaves, or of Mallows. Two
+Ounces of Vinegar and as much Honey must be added to every Pint of it,
+and the Patient should gargle with it pretty hot. The deterging,
+cleansing Gargarisin referred to Sec. 112, is a light Infusion of the Tops
+of Sage, adding two Ounces of Honey to each Pint of it.
+
+
+
+                                No. 20.
+
+
+Is only one Ounce of powdered Nitre, divided into sixteen equal Doses.
+
+
+
+                                No. 21.
+
+
+Take of Jalap, of Senna, and of Cream of Tartar of each thirty Grains
+finely powdered; and let them be very well mixed. [118]
+
+[118] This, our Author observes, will work a strong Country-man very
+     well: by which however he does not seem to mean an Inhabitant of
+     the Mountains in _Valais_. See P. 547.
+
+
+
+                                No. 22.
+
+
+Take of _China_ Root, and of Sarsaparilla of each one Ounce and a half,
+of Sassafras Root, and of the Shavings of Guiacum, otherwise called
+_Lignum vitae_, of each one Ounce. Let the whole be cut very fine. Then
+put them into a glazed earthen Vessel; pouring upon them about five
+pints of boiling Water. Let them boil gently for an Hour; then take it
+from the Fire, and strain it off through Linen. This is called the
+Decoction of the Woods, and is often of different Proportions of these
+Ingredients, or with the Addition of a few others. More Water may, after
+the first boiling, be poured on the same Ingredients, and be boiled up
+into a small Decoction for common Drink.
+
+
+
+                                No. 23.
+
+
+Take one Ounce of the Pulp of Tamarinds, half a Drachm of Nitre, and
+four Ounces of Water; let them boil not more than one Minute, then add
+two Ounces of Manna, and when dissolved strain the Mixture off.
+
+
+
+                                No. 24.
+
+
+Is only an Ounce of Cream of Tartar, divided into eight equal Parts.
+
+
+
+                                No. 25.
+
+
+This Prescription is only the Preparation of Kermes mineral, otherwise
+called the Chartreusian Powder. Dr. _Tissot_ orders but one Grain for a
+Dose. It has been directed from one to three.
+
+
+
+                                No. 26.
+
+
+Take three Ounces of the common Burdock Root; boil it for half an Hour,
+with half a Drachm of Nitre, in three full Pints of Water.
+
+
+
+                                No. 27.
+
+
+Take half a Pinch of the Herbs prescribed No. 9, Article 2, and half an
+Ounce of hard white Soap shaved thin. Pour on these one Pint and a half
+of boiling Water, and one Glass of Wine. Strain the Liquor and squeeze
+it strongly out.
+
+
+
+                                No. 28.
+
+
+Take of the purest Quicksilver one Ounce; of Venice Turpentine half a
+Drachm, of the freshest Hog's Lard two Ounces, and let the whole be very
+well rubbed together into an Ointment. [119]
+
+[119] This Ointment should be prepared at the Apothecaries; the Receipt
+     of it being given here, only because the Proportions of the
+     Quicksilver and the Lard are not always the same in different
+     Places.
+
+
+
+                                No. 29.
+
+
+This Prescription is nothing but the yellow Basilicon.
+
+
+
+                                No. 30.
+
+
+Take of natural and factitious, or artificial Cinnabar, twenty-four
+Grains each; of Musk sixteen Grains, and let the whole be reduced into
+fine Powder, and very well mixed. [120]
+
+[120] This Medicine is known by the Name of _Cob's_ Powder; and as its
+     Reputation is very considerable, I did not chuse to omit it; though
+     I must repeat here what I have said Sec. 195--That the Cinnabar is
+     probably of little or no Efficacy; and there are other Medicines
+     that have also much more than the Musk; which besides is extremely
+     dear for poor People, as the requisite Doses of it, in very
+     dangerous Cases, would cost ten or twelve Shillings daily. The
+     Prescription, No. 31, is more effectual than the Musk; and instead
+     of the useless Cinnabar, the powerful Quicksilver may be given to
+     the Quantity of forty-five Grains. I have said nothing hitherto in
+     this Work of the red blossomed Mulberry Tree, which passes for a
+     real Specific, among some Persons, in this dreadful Malady. An
+     Account of it may be seen in the first Volume of the Oeconomical
+     Journal of _Berne_. It is my Opinion however, that none of the
+     Instances related there are satisfactory and decisive; its Efficacy
+     still appearing to me very doubtful.
+
+
+
+                                No. 31.
+
+
+Take one Drachm of _Virginia_ Snake Root in Powder; of Camphor and of
+Assa-foetida ten Grains each; of Opium one Grain, and with a sufficient
+Quantity of Conserve, or Rob of Elder, make a Bolus. [121]
+
+[121] When this is preferred to No. 30, of which Musk is an Ingredient,
+     the Grain of Opium should be omitted, except once or at most twice
+     in the twenty-four Hours. Two Doses of Quicksilver, of fifteen
+     Grains each, should be given daily in the Morning, in the Interval
+     between the other Bolus's.
+
+
+
+                                No. 32.
+
+
+Take three Ounces of Tamarinds. Pour on them one Pint of boiling Water,
+and after letting them boil a Minute or two, strain the Liquor through a
+Linen Cloth.
+
+
+
+                                No. 33.
+
+
+Take seven Grains of Turbith Mineral; and make it into a Pill or Bolus
+with a little Crumb of Bread. [122]
+
+[122] This Medicine makes the Dogs vomit and slaver abundantly. It has
+     effected many Cures after the _Hydrophobia_, the Dread of Water,
+     was manifest. It must be given three Days successively, and
+     afterwards twice a Week, for fifteen Days.
+
+
+
+                                No. 34.
+
+
+This is nothing but a Prescription of six Grains of Tartar [123] emetic.
+
+[123] When People are ignorant of the Strength of the Tartar emetic
+     (which is often various) or of the Patient's being easy or hard to
+     vomit, a Dose and a half may be dissolved in a Quart of warm Water,
+     of which he may take a Glass every Quarter of an Hour, whence the
+     Operation may be forwarded, or otherwise regulated, according to
+     the Number of Vomits or Stools. This Method, much used in _Paris_,
+     seems a safe and eligible one.
+
+
+
+                                No. 35.
+
+
+Take thirty-five Grains of Ipecacuanna, which, in the very strongest
+Constitutions, may be augmented to forty-five, or even to fifty Grains.
+
+
+
+                                No. 36.
+
+
+Prescribes only the common blistering Plaister; and the Note observes
+that very young Infants who have delicate Skins may have Sinapisms
+applied instead of Blisters; and made of a little old Leaven, kneaded up
+with a few Drops of sharp Vinegar.
+
+
+
+                                No. 37.
+
+
+Take of the Tops of _Chamaedrys_ or Ground Oak, of the lesser Centaury,
+of Wormwood and of Camomile, of each one Pugil. Pour on them three Pints
+of boiling Water; and suffering them to infuse until it is cold, strain
+the Liquor through a Linen Cloth, pressing it out strongly.
+
+
+
+                                No. 38.
+
+
+Take forty Grains of Rhubarb, and as much Cream of Tartar in Powder,
+mixing them well together.
+
+
+
+                                No. 39.
+
+
+Take three Drachms of Cream of Tartar, and one Drachm of Ipecacuanna
+finely powdered. Rub them well together, and divide them into six equal
+Parts.
+
+
+
+                                No. 40.
+
+
+Take of the simple Mixture one Ounce, of Spirit of Vitriol half an
+Ounce, and mix them. The Dose is one or two Tea Spoonfuls in a Cup of
+the Patient's common Drink. The simple Mixture is composed of five
+Ounces of Treacle Water camphorated, of three Ounces of Spirit of Tartar
+rectified, and one Ounce of Spirit of Vitriol. If the Patient has an
+insuperable Aversion to the Camphor, it must be omitted, though the
+Medicine is less efficacious without it. And if his Thirst is not very
+considerable, the simple Mixture may be given alone, without any further
+Addition of Spirit of Vitriol.
+
+
+
+                                No. 41.
+
+
+Take half a Drachm of _Virginia_ Snake-root, ten Grains of Camphor, and
+make them into a Bolus with Rob of Elder-Berries. If the Patient's
+Stomach cannot bear so large a Dose of Camphor, he may take it in
+smaller Doses and oftner, _viz._ three Grains, every two Hours. If there
+is a violent Looseness, Diascordium must be substituted instead of the
+Rob of Elder-berries.
+
+
+
+                                No. 42.
+
+
+Prescribes only the _Theriaca pauperum_, or poor Man's Treacle, in the
+Dose of a Quarter of an Ounce. The following Composition of it is that
+chiefly preferred by our Author. Take equal Parts of round Birthwort
+Roots, of Elecampane, of Myrrh, and of Rob or Conserve of
+Juniper-berries, and make them into an Electuary of a rather thin, than
+very stiff Consistence, with Syrup of Orange-peel.
+
+
+
+                                No. 43.
+
+
+The first of the three Medicines referred to in this Number, is that
+already directed, No. 37. The second is as follows.
+
+Take equal Parts of the lesser Centaury, of Wormwood, of Myrrh, all
+powdered, and of Conserve of Juniper-berries, making them up into a
+pretty thick Consistence with Syrup of Wormwood. The Dose is a Quarter
+of an Ounce; to be taken at the same Intervals as the Bark.
+
+For the third Composition--Take of the Roots of Calamus Aromaticus and
+Elecampane well bruised, two Ounces; of the Tops of the lesser Centaury
+cut small, a Pugil; of Filings of unrusted Iron two Ounces, of old white
+Wine, three Pints. Put them all into a wide necked Bottle, and set it
+upon Embers, or on a Stove, or by the Chimney, that it may be always
+kept hot. Let them infuse twenty-four Hours, shaking them well five or
+six Times; then let the Infusion settle, and strain it. The Dose is a
+common Cup every four Hours, four Times daily, and timing it one Hour
+before Dinner.
+
+
+
+                                No. 44.
+
+
+Take a Quarter of an Ounce of Cream of Tartar, a Pugil of common
+Camomile; boil them in twelve Ounces of Water for half an Hour, and
+strain it off.
+
+
+
+                                No. 45.
+
+
+Directs only the common Sal Ammoniac, from two Scruples to one Drachm
+for a Dose. The Note to it adds, that it may be made into a Bolus with
+Rob of Elder; and observes, that those feverish Patients, who have a
+weak delicate Stomach, do not well admit of this Salt; no more than of
+several others, which affect them with great Disorder and Anxiety.
+
+
+
+                                No. 46.
+
+
+The Powder. Take one Pugil of Camomile Flowers, and as much Elder
+Flowers, bruising them well; of fine Flour or Starch three Ounces; of
+Ceruss and of blue Smalt each half an Ounce. Rub the whole, and mix them
+well. This Powder may be applied immediately to the Part.
+
+The Plaister. Take of the Ointment called _Nutritum_, made with the
+newest sweet Oil, two Ounces; of white Wax three Quarters of an Ounce,
+and one Quarter of an Ounce of blue Smalt. Melt the Wax, then add the
+_Nutritum_ to it, after the Smalt finely powdered has been exactly
+incorporated with it; stirring it about with an Iron Spatula or Rod,
+till the whole is well mixed and cold. This is to be smoothly spread on
+Linen Cloth.
+
+A Quarter of an Ounce of Smalt may also be mixed exactly with two Ounces
+of Butter or Ointment of Lead, to be used occasionally instead of the
+Plaister.
+
+
+
+                                No. 47.
+
+
+Take one Ounce of Sedlitz, or for want of that, as much Epsom Salt, and
+two Ounces of Tamarinds: pour upon them eight Ounces of boiling Water,
+stirring them about to dissolve the Tamarinds. Strain it off; and divide
+it into two equal Draughts, to be given at the Interval of Half an Hour
+between the first and last.
+
+
+
+                                No. 48.
+
+
+Take of _Sydenham_'s Liquid Laudanum eighty Drops; of Bawm Water two
+Ounces and a half. If the first, or the second, Dose stops or
+considerably lessens the Vomiting, this [124] Medicine should not be
+further repeated.
+
+[124] The medical Editor at _Lyons_ justly notes here, that these eighty
+     Drops are a very strong Dose of liquid Laudanum; adding that it is
+     scarcely ever given at _Lyons_ in a greater Dose than thirty Drops;
+     and recommending a Spoonful of Syrup of Lemon-peel to be given with
+     it--But we must observe here in answer to this Note, that when Dr.
+     _Tissot_ directs this Mixture in the Iliac Passion Sec. 318, to
+     appease the Vomitings, Art. 3, he orders but one spoonful of this
+     Mixture to be taken at once, and an Interval of two Hours to be
+     observed between the first and second Repetition, which reduces
+     each Dose to sixteen Drops, and which is not to be repeated without
+     Necessity.
+
+
+
+                                No. 49.
+
+
+Dissolve three Ounces of Manna and twenty Grains of Nitre in twenty
+Ounces, or six Glasses, of sweet Whey.
+
+
+
+                                No. 50.
+
+
+To two Ounces of Syrup of Diacodium, or white Poppy Heads, add an equal
+Weight of Elder Flower Water, or, for want of it, of Spring Water.
+
+
+
+                                No. 51.
+
+
+Directs nothing but a Drachm of Rhubarb in Powder.
+
+
+
+                                No. 52.
+
+
+Take of _Sulphur vivum_, or of Flower of Brimstone, one Ounce; of Sal
+Ammoniac, one Drachm; of fresh Hogs Lard, two Ounces; and mix the whole
+very well in a Mortar.
+
+
+
+                                No. 53.
+
+
+Take two Drachms of crude Antimony and as much Nitre, both finely
+powdered and very well mixed; dividing the whole into eight equal
+Doses. [125]
+
+[125] This Medicine, which often occasions Cholics in some Persons of a
+     weakly Stomach, is attended with no such Inconvenience in strong
+     Country People; and has been effectual in some Disorders of the
+     Skin, which have baffled other Medicines--The Remainder of this
+     Note observes the great Efficacy of Antimony in promoting
+     Perspiration, and the extraordinary Benefit it is of to Horses in
+     different Cases.
+
+
+
+                                No. 54.
+
+
+Take of Filings of Iron, not the least rusty, and of Sugar, each one
+Ounce; of Aniseeds Powdered, half an Ounce. After rubbing then very well
+together, divide the Powder into twenty-four equal Portions; one of
+which is to be taken three times a Day an Hour before eating. [126]
+
+[126] The Prescriptions No. 54, 55, 56, are calculated against Distempers
+     which arise from Obstructions, and a Stoppage of the monthly
+     Discharges; which No. 55 is more particularly intended to remove;
+     those of 54 and 56 are most convenient, either when the Suppression
+     does not exist, or is not to be much regarded, if it does. This
+     Medicine may be rendered less unpalatable for Persons in easy
+     Circumstances, by adding as much Cinamon instead of Aniseeds; and
+     though the Quantity of Iron be small, it may be sufficient, if
+     given early in the Complaint; one, or at the most, two of these
+     Doses daily, being sufficient for a very young Maiden.
+
+
+
+                                No. 55.
+
+
+Take of Filings of sound Iron two Ounces; of Leaves of Rue, and of white
+Hoar-hound one Pugil each; of black Hellebore Root, one Quarter of an
+Ounce, and infuse the whole in three Pints of Wine in the Manner already
+directed, No. 43. The Dose of this is one small Cup three times a Day,
+an Hour before eating. [127]
+
+[127] I chuse to repeat here, the more strongly to inculcate so important
+     a Point, that in Women who have long been ill and languid, our
+     Endeavours must be directed towards the restoring of the Patient's
+     Health and Strength, and not to forcing down the monthly
+     Discharges, which is a very pernicious Practice. These will return
+     of Course, if the Patient is of a proper Age, as she grows better.
+     Their Return succeeds the Return of her Health, and should not,
+     very often cannot, precede it.
+
+
+
+                                No. 56.
+
+
+Take two Ounces of Filings of Iron; of Rue Leaves and Aniseed powdered,
+each half an Ounce. Add to them a sufficient Quantity of Honey to make
+an Electuary of a good Consistence. The Dose is a Quarter of an Ounce
+three times daily.
+
+
+
+                                No. 57.
+
+
+Take of the Extract of the stinking Hemlock, with the purple spotted
+Stalk, one Ounce. Form it into Pills weighing two Grains each; adding as
+much of the Powder of dry Hemlock Leaves, as the Pills will easily take
+up. Begin the Use of this Medicine by giving one Pill Night and Morning.
+Some Patients have been so familiarized to it, as to take at length Half
+an Ounce daily. [128]
+
+[128] Our learned and candid Author has a very long Note in this Place,
+     strongly in Favour of _Storck's_ Extract of Hemlock, in which it is
+     evident he credits the greater Part of the Cures affirmed by Dr.
+     _Storck_ to have been effected by it. He says he made some himself,
+     but not of the right Hemlock, which we think it very difficult to
+     mistake, from its peculiar rank fetid Smell, and its purple spotted
+     Stalk. After first taking this himself, he found it mitigated the
+     Pain of Cancers, but did not cure them. But then addressing himself
+     to Dr. _Storck_, and exactly following his Directions in making it,
+     he took of Dr. _Storck's_ Extract, and of his own, which exactly
+     resembled each other, to the Quantity of a Drachm and a half daily;
+     and finding his Health not in the least impaired by it, he then
+     gave it to several Patients, curing many scrophulous and cancerous
+     Cases, and mitigating others, which he supposes were incurable. So
+     that he seems fully persuaded Dr. _Storck's_ Extract is always
+     innocent [which in Fact, except in a very few Instances, none of
+     which were fatal, it has been] and he thinks it a Specific in many
+     Cases, to which nothing can be substituted as an equivalent Remedy;
+     that it should be taken with entire Confidence, and that it would
+     be absurd to neglect its Continuance.
+
+     The Translator of this Work of Dr. _Tissot's_ has thought it but
+     fair to give all the Force of this Note here, which must be his
+     own, as his Editor at _Lyons_ seems to entertain a very different
+     Opinion of the Efficacy of this Medicine; for which Opinion we
+     refer back to his Note, Sec. 375, of this Treatise, which the Reader
+     may compare with this of our Author's. _K._
+
+
+
+                                No. 58.
+
+
+Take of the Roots of Grass and of Succory well washed, each one Ounce.
+Boil them a Quarter of an Hour in a Pint of Water. Then dissolve in it
+Half an Ounce of Sedlitz, or of _Epsom_ Salt, and two Ounces of Manna;
+and strain it off to drink one Glass of it from Half Hour, to Half Hour,
+till its Effects are sufficient. It is to be repeated at the Interval of
+two or three Days.
+
+
+
+                                No. 59.
+
+
+Is a Cataplasm or Pultice made of Crumb of Bread, with Camomile Flowers
+boiled in Milk, with the Addition of some Soap, so that each Pultice may
+contain half a Quarter of an Ounce of this last Ingredient. And when the
+Circumstances of female Patients have not afforded them that regular
+Attendance, which the Repetition of the Pultice requires, as it should
+be renewed every three Hours, I have successfully directed the Hemlock
+Plaister of the Shops.
+
+
+
+                                No. 60.
+
+
+Take a sufficient Quantity of dry Hemlock Leaves. Secure them properly
+between two Pieces of thin Linen Cloth, so as to make a very flexible
+Sort of small Matrass, letting it boil a few Moments in Water, then
+squeeze it out and apply it to the affected Part. It must thus be
+moistened and heated afresh, and re-applied every two Hours.
+
+
+
+                                No. 61.
+
+
+Take of the Eyes of the Craw-fish, or of the true white Magnesia, two
+Drachms; of Cinnamon powdered four Grains. Rub them very well together,
+and divide the whole into eight Doses. One of these is to be given in a
+Spoonful of Milk, or of Water, before the Infant sucks.
+
+
+
+                                No. 62.
+
+
+Take of an Extract of Walnuts, made in Water, two Drachms; and dissolve
+it in half an Ounce of Cinnamon Water. Fifty Drops a Day of this
+Solution is to be given to a Child of two Years old; and after the whole
+has been taken, the Child should be purged. This Extract is to be made
+of the unripe Nuts, when they are of a proper Growth and Consistence for
+pickling.
+
+
+
+                                No. 63.
+
+
+Take of Rezin of Jalap two Grains. Rub it a considerable time with
+twelve or fifteen Grains of Sugar, and afterwards with three or four
+sweet Almonds; adding, very gradually, two common Spoonfuls of Water.
+Then strain it through clear thin Linen, as the Emulsion of Almonds was
+ordered to be. Lastly, add a Tea Spoonful of Syrup of Capillaire to it.
+This is no disagreable Draught, and may be given to a Child of two Years
+old: and if they are older, a Grain or two more of the Rezin may be
+allowed. But under two Years old, it is prudent to purge Children rather
+with Syrup of Succory, or with Manna.
+
+
+
+                                No. 64.
+
+
+Take of the Ointment called _Nutritum_ one Ounce; the entire Yolk of one
+small Egg, or the Half of a large one, and mix them well together. This
+_Nutritum_ may be readily made by rubbing very well together, and for
+some time, two Drachms of Ceruss [white Lead] half an Ounce of Vinegar,
+and three Ounces of common Oil.
+
+
+
+                                No. 65.
+
+
+Melt four Ounces of white Wax; add to it, if made in Winter two
+Spoonfuls of Oil; if in Summer none at all, or at most, not above a
+Spoonful. Dip in this Slips of Linen Cloth not worn too thin, and let
+them dry: or spread it thin and evenly over them.
+
+
+
+                                No. 66.
+
+
+Take of Oil of Roses one Pound; of red Lead half a Pound; of Vinegar
+four Ounces. Boil them together nearly to the Consistence of a Plaister;
+then dissolve in the liquid Mass an Ounce and a Half of yellow Wax, and
+two Drachms of Camphor, stirring the whole about well. Remove it then
+from the Fire, and spread it on Sheets or Slips of Paper, of what Size
+you think most convenient. The Ointment of _Chambauderie_, so famous in
+many Families on the Continent, is made of a Quarter of a Pound of
+yellow Wax, of the Plaister of three Ingredients (very nearly the same
+with No. 66) of compound Diachylon and of common Oil, of each the same
+Quantity, all melted together, and then stirred about well, after it is
+removed from the Fire, till it grows cold. To make a Sparadrap, or Oil
+Cloth, which is Linen, covered with, or dipt in an emplastic Substance
+or Ointment, it must be melted over again with the Addition of a little
+Oil, and applied to the Linen as directed at No. 65.
+
+
+
+                                No. 67.
+
+
+Gather in Autumn, 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,
+That 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 Bleedings; 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. [129]
+
+[129] Our Author attests his seeing the happiest Consequences from this
+     Application, which M. _Brossard_, a very eminent _French_ Surgeon,
+     first published; and declared his Preference of that Agaric which
+     sprung from those Parts of the Tree, from whence large Boughs had
+     been lopped.
+
+
+
+                                No. 68.
+
+
+Take four Ounces of Crumbs of Bread, a Pugil of Elder Flowers, and the
+same Quantity of those of Camomile, and of St. _John's_ Wort. Boil them
+into a Pultice in equal Quantities of Vinegar and Water.
+
+If Fomentations should be thought preferable, take the same Herbs, or
+some Pugils of the Ingredients for _Faltrank_: throw them into a Pint
+and a Half of boiling Water: and let them infuse some Minutes. Then a
+Pint of Vinegar is to be added, and Flanels or other woollen Cloths dipt
+in the Fomentation, and wrung out, are to be applied to the Part
+affected.
+
+For the aromatic Fomentations recommended Sec. 449, take Leaves of Betony
+and of Rue, Flowers of Rosemary or Lavender, and red Roses, of each a
+Pugil and a Half. Boil them for a Quarter of an Hour in a Pot with a
+Cover, with three Pints of old white Wine. Then strain off, squeezing
+the Liquor strongly from the Herbs, and apply it as already directed.
+
+
+
+                                No. 69.
+
+
+Directs only the Plaister of Diapalma. [130]
+
+[130] To spread this upon Lint as directed, Sec. 456, it must be melted down
+     again with a little Oil.
+
+
+
+                                No. 70.
+
+
+Directs only a Mixture of two Parts Water, and one Part of Vinegar of
+Litharge.
+
+
+
+                                No. 71.
+
+
+Take of the Leaves of Sow-bread, and of Camomile Tops, of each one
+Pugil. Put them into an earthen Vessel with half an Ounce of Soap, and
+as much Sal Ammoniac, and pour upon them three Pints of boiling Water.
+
+_N. B._ I conceive all the Notes to this Table, in which I have not
+mentioned the Editor at _Lyons_, nor subscribed with my initial Letter
+_K_, to come from the Author, having omitted nothing of them, but the
+Prices.
+
+
+
+
+                                 ERRATA.
+
+
+Page 4, Line 6, for _os_ read _of_. p. 16, l. 16, for _be_ read _me_. p.
+29, l. 12, after _it_ add . p. 49, l. 12, dele _and_ at the End of it.
+p. 51, in the running Title, for _Causss_ read _Causes_. ib. l. 2, dele
+_and_. ib. l. 7, dele _and_. p. 57, last line, for _hurtsul_ read
+_hurtful_. p. 67, l. 17, after _Water_, add, _may be placed within the
+Room_. p. 74, line last but two, after _never_, dele , p. 96, l. 11, for
+_Aiiment_ read _Ailment_. p. 106, l. 23, for the second _is_ read _has_.
+p. 126, l. 21, for _breath_ read _breathe_. p. 137, l. 13, for
+_Efflorescene_ read _Efflorescence_, p. 145, l. 1, for _Water_ read
+_Tea_. p. 148, l. 19, for _beomes_ read _becomes_. p. 163, l. 30. in the
+Note, for _occured_ read _occurred_; p. 171, l. 20, dele _and_. p. 189,
+l. 28, dele _of_. p. 199, l. 6, for _Paulmier_ read _Palmarius_, being
+the _Latinized_ Name of that _Physician_; as we say for _Fernel
+Fernelius, Holler Hollerius, &c._ _N. B._ His Powder for the Bite of a
+mad Dog consisted of equal Parts of Rue, Vervain, Plantain, Polypody,
+common Wormwood, Mugwort, Bastard Baum, Betony, St. _John's_ Wort, and
+lesser Centaury Tops, to which _Default_ adds Coraline.----p. 237, l. 2,
+for _Streakes_ read _Streaks_. p. 256, first line of the Note * _dele_
+the first _often_. p. 261, l. 15, for _happens_ read _happen_. p. 270,
+l. 12, dele _t_ in _Switsserland_. p. 282, l. 23, for _enters_ read
+_enter_. p. 283, l. 23, for _Stomach_ read _Stomachs_. p. 284, l. 12,
+for _it_ read _them_. p. 287, Note * l. 25, for _here_ read _there_. p.
+303, l. 14, for _doubtsul_ read _doubtful_. p. 311, l. 18, for _abate_
+read _abates_. p. 337, l. 7, for _glary_ read _glairy_. N. B. In the
+first Page that is folio'd 445 read 345. p. 346, l. 19, for _two_ read
+_too_. p. 351, l. 25, after Waters add, _such as Infusions of Tea, &c._
+p. 375, l. 7, for _two_ read _too_. p. 392, last line, for _Leaves_ read
+_Flowers_. p. 393, l. 26, after _them_, insert _and_. p. 397, l. 1 and
+2, for Temparrament read _Temperament_. p. 422, l. 6, between _several_
+and _Consequences_ insert _bad_. p. 454, l. 5, for _Diflocation_ read
+_Dislocation_. p. 459, l. 17, in _Ice-thaws_ dele - p. 466, l. 16, to
+_Constitution_ add _s_. p. 486, l. 29, after _or_ add _if_. p. 487, l.
+12, for _Parts_ read _Part_. p. 511, l. 12, for _not_ read _nor_. p.
+533, l. 12, for _arrives_ read _arises_. p. 542, l. 22, for _Patient_
+read _Patients_. p. 562, l. 14, for _fays_ read _says_. p. 573, l. 10,
+after _Cause_, dele _Comma_.
+
+
+
+
+    _Table_ _of the several Chapters, and their principal Contents._
+
+
+Introduction ---- Page 1
+The first Cause of Depopulation, Emigrations ---- _ib._
+The second Cause, Luxury ---- 6
+Third Cause, Decay of Agriculture ---- 10
+Fourth Cause, the pernicious Treatment of Diseases ---- 12
+Means for rendering this Treatise useful ---- 15
+Explanation of certain physical Terms, and Phrases ---- 26
+
+                              _Chapter I._
+
+_The most common Causes of popular Sickness_ ---- 31
+First Cause, excessive Labour ---- _ib._
+Second Cause, the Effect of cold Air, when a Person is hot ---- 33
+Third Cause, taking cold Drink, when in a Heat ---- _ib._ _&_ 34
+Fourth Cause, the Inconstancy and sudden Change of the Weather ---- 35
+Fifth Cause, the Situation of Dunghills, and Marshes, near inhabited
+Houses, and the bad confined Air in the Houses ---- 37
+Sixth Cause, Drunkenness ---- 38
+Seventh Cause, the Food of Country People ---- 39
+Eighth Cause, the Situation, or Exposure of Houses ---- 42
+Concerning the Drink of Country People ---- 43
+
+                              _Chap. II._
+
+_Of Causes which increase the Diseases of the People, with general
+Considerations_ ---- 47
+First Cause, the great Care employed to force the Sick to sweat, and the
+Methods taken for that Purpose  ---- _ib._ _&_ 48
+The Danger of hot Chambers ---- 49
+The Danger of hot Drinks and heating Medicines ---- 50
+Second Cause, the Quantity and Quality of the Food given sick Persons
+---- 53
+Third Cause, the giving Vomits and Purges at the Beginning of the
+Disease  ---- 57
+
+                              _Chap. III._
+
+_Concerning what should be done in the Beginning of Diseases, and the
+Diet in acute Diseases_  ---- 61
+Signs which indicate approaching Diseases; with Means to prevent them
+---- 62
+The common Regimen, or Regulations, for the Sick ---- 64
+The Benefits of ripe sound Fruits ---- 68
+Cautions and Means to be used, on Recovery ---- 73, 74
+
+                              _Chap. IV._
+
+_Of the Inflammation of the Breast_ ---- 77
+The Signs of this Disease ---- _ib._ _&_ 78
+The Advantage of Bleeding ---- 81
+Signs of Recovery ---- 85
+Of _Crises_, and the Symptoms that precede them ---- 86
+The Danger of Vomits, of Purges, and of Anodynes ---- 88
+Of the Suppression of Expectoration, and the Means to restore it.
+---- 89
+Of the Formation of _Vomicas_, or Imposthumes in the Lungs, and the
+Treatment of them ---- 90
+Of the Danger of Remedies, termed Balsamics ---- 103
+The Inefficacy of the Antihectic of _Poterius_ ---- 104
+Of an _Empyema_ ---- 105
+Of a Gangrene of the Lungs ---- 106
+Of a _Scirrhus_ of the Lungs ---- _ib._
+
+                               _Chap. V._
+
+_Of the Pleurisy_ ---- 108
+The Danger of heating Remedies ---- 112 to 115
+Of frequent, or habitual, Pleurisies ---- 116
+Of Goats Blood; the Soot of a stale Egg, and of the Wormwood of the
+Alps, in Pleurisies ---- 117, 118
+
+                              _Chap. VI._
+
+_Of Diseases of the Throat_ ---- 119
+Of their proper Treatment ---- 124
+Of the Formation of an Abscess there ---- 127
+Of swelled Ears, from the Obstruction of the parotid and maxillary
+Glands ---- 131
+Of the epidemic and putrid Diseases of the Throat, which prevailed in
+1761 at _Lausanne_ ---- 132
+
+                              _Chap. VII._
+
+_Of Colds_ ---- 139
+Different Prejudices concerning Colds ---- _ib._ _&_ 140
+The Danger of drinking much hot Water, and of strong spirituous Liquors,
+_&c._ ---- 146
+Means for strengthening and curing Persons very subject to Colds
+---- 148
+
+                             _Chap. VIII._
+
+_Of Diseases of the Teeth_ ---- 150
+
+                              _Chap. IX._
+
+_Of the Apoplexy_ ---- 158
+Of sanguine Apoplexy ---- _ib._ _&_ 159
+Of a serous, or watery, Apoplexy ---- 162
+Means to prevent relapsing into them ---- 164 _& seq._
+
+                               _Chap. X._
+
+_Of morbid Strokes of the Sun_ ---- 167
+
+                              _Chap. XI._
+
+_Of the Rheumatism_ ---- 177
+Of the acute Rheumatism, attended with a Fever ---- _ib._
+Of the flow, or chronical, without a Fever ---- 186
+The Danger of spirituous and greasy Remedies ---- 191, 192
+
+                              _Chap. XII._
+
+_Of the Bite of a mad Dog_ ---- 194
+
+                             _Chap. XIII._
+
+_Of the Small Pocks._ ---- 207
+Of the preceding Symptoms of this Disease ---- 209
+--The Danger of sweating Medicines ---- 217
+--The Treatment of the benign distinct Small Pocks ---- 220
+--The Use of Bleeding ---- 222
+--The Fever of Suppuration ---- 223
+--The Necessity of opening the ripe Pustules ---- 226
+--The Danger of Anodynes ---- 228
+Of the striking in of the Eruptions ---- 229
+Preparations for receiving it favorably ---- 230
+
+                              _Chap. XIV._
+
+_Of the Measles_ ---- 235
+Of their Treatment and the Means to prevent any of their bad
+Consequences, to ---- 243
+
+                              _Chap. XV._
+
+_Of the hot, or burning, Fever_ ---- 244
+
+                              _Chap. XVI._
+
+_Of putrid Fevers_ ---- 248
+
+                             _Chap. XVII._
+
+_Of malignant Fevers_ ---- 257
+The Danger of applying living Animals in them ---- 267
+
+                             _Chap. XVIII._
+
+_Of intermitting Fevers_ ---- 269
+--Spring and Autumn Intermittents ---- 272
+Method of Cure by the Bark ---- 275
+Method of treating the Patient in the Fit ---- 277
+Of other Febrifuges, besides the Bark ---- 278
+The Treatment of long and obstinate Intermittents ---- 279
+Of some very dangerous Intermittents ---- 284
+Of some periodical Disorders, which may be termed, Fevers disguised
+---- 285
+Of Preservatives from unwholesome Air ---- 286
+
+                              _Chap. XIX._
+
+_Of an_ Erisipelas, _or St._ Anthony's _Fire._ ---- 288
+Of a frequent or habitual _Erisipelas_ ---- 295
+Of the Stings or Bites of Animals ---- 296
+
+                              _Chap. XX._
+
+_Of Inflammations of the Breast, and of Bastard and bilious Pleurisies_
+---- 298
+--Of the false Inflammation of the Breast ---- 300
+--The false Pleurisy ---- 303
+
+                              _Chap. XXI._
+
+_Of Cholics_ ---- 306
+Of the inflammatory Cholic ---- 307
+--the bilious Cholic ---- 312
+--the Cholic from Indigestion, and of Indigestions ---- 314
+--the flatulent, or windy, Cholic ---- 317
+--the Cholic, from taking Cold ---- 319
+
+                             _Chap. XXII._
+
+_Of the_ Miserere, _or Iliac Passion, and of the_ Cholera Morbus
+---- 322
+The _Miserere_ ---- _ib._ _&_ 323
+The _Cholera Morbus_ ---- 327
+
+                             _Chap. XXIII._
+
+_Of a_ Diarrhoea, _or Looseness_ ---- 332
+
+                             _Chap. XXIV._
+
+_Of a Dysentery, or Bloody-Flux_ ---- 335
+The Symptoms of the Disease ---- 336
+The Remedies against it ---- 338
+Of the beneficial Use of ripe Fruits ---- 341
+Of the Danger of taking a great Number of popular Remedies in it
+---- 345
+
+                              _Chap. XXV._
+
+_Of the Itch_ ---- 347
+
+                             _Chap. XXVI._
+
+_Directions peculiar to the Sex_ ---- 352
+Of the monthly Customs ---- 353
+Of Gravidation, or going with Child ---- 365
+Of Labours or Deliveries, ---- 367
+Of their Consequences ---- 371
+Of a Cancer ---- 373
+
+                             _Chap. XXVII._
+
+_Directions with Regard to Children_ ---- 375
+Of the first Cause of their Disorders, the _Meconium_ ---- 377
+--the second, the souring of their Milk ---- 379
+--the Danger of giving them Oil ---- _ib._
+--Disorders from their Want of Perspiration, the Means of keeping it up,
+and of washing them in cold Water ---- 381 _&_ 382
+--the third Cause, the cutting of their Teeth ---- 386
+--the fourth Cause, Worms ---- 387
+Of Convulsions ---- 391
+Methods necessary to make them strong and hardy, with general Directions
+about them ---- 396 _& seq._
+
+                            _Chap. XXVIII._
+
+_Of Assistances for drowned Persons_ ---- 403
+
+                             _Chap. XXIX._
+
+_Of Substances stopt between the Mouth and the Stomach_ ---- 411
+
+                              _Chap. XXX._
+
+_Of Disorders requiring the Assistance of a Surgeon_ ---- 435
+Of Burns ---- 436
+Of Wounds ---- 437
+Of Bruises, and of Falls ---- 444
+Of Ulcers ---- 454
+Of frozen Limbs, or Joints ---- 458
+Of Chilblains ---- 462
+Of Ruptures ---- 474
+Of Phlegmons, or Boils ---- 480
+Of Fellons, or Whitlows ---- 481
+Of Thorns, Splinters, _&c._ in the Skin or Flesh ---- 486
+Of Warts ---- 488
+Of Corns ---- 490
+
+                             _Chap. XXXI._
+
+_Of some Cases which require immediate Assistance_ ---- 491
+Of Swoonings, from Excess of Blood ---- 492
+Of Swoonings, from great Weakness ---- 494
+Of Swoonings, occasioned by a Load on the Stomach ---- 497
+Of Swoonings, resulting from Disorders of the Nerves 500
+Of Swoonings, occasioned by the Passions ---- 504
+Of the Swoonings, which occur in Diseases ---- 506
+Of Haemorrhages, or Fluxes of Blood ---- 508
+Of Convulsion Fits ---- 512
+Of suffocating, or strangling Fits ---- 514
+Of the violent Effects of great Fear ---- 516
+Of Accidents produced by the Vapours of Charcoal, and of Wine ---- 519
+Of Poisons ---- 526
+Of acute and violent Pains ---- 529
+
+                             _Chap. XXXII._
+
+_Of giving Remedies by Way of Precaution_ ---- 531
+Of Bleeding ---- 532
+Of Purges ---- 540
+Remedies to be used after excessive Purging ---- 544
+Reflections on some other Remedies ---- 546, _&c._
+
+                            _Chap. XXXIII._
+
+_Of Quacks, Mountebanks, and Conjurers_ ---- 551
+
+                             _Chap. XXXIV._
+
+_Questions necessary to be answered by any Person, who goes to consult a
+Physician_ ---- 579
+The Table of Remedies ---- 584
+
+
+
+
+                           Transcription note
+
+
+Old and variant spellings, like _surprising_ / _surprizing_, Buttermilk
+/ _Butter-milk_, _Blood-vessels_ / _Blood-Vessels_, _Faltranc_ /
+_Faltrank_, _wholesome_ / _wholsome_, _fetid_ / _foetid_, _public_ /
+_publick_, _Physic_ / _Physick_, etc. have been preserved in the present
+transcription.
+
+In some cases of doubt, the present edition has been compared with scans
+of the 1766 edition printed by Donaldson, which differs slightly in
+setting, for instance having all names not capitalized, and corrects
+many typographic mistakes.
+
+Corrections listed in the Errata at the end of the book have been
+carried into this transcription (excepting those which are not relevant
+for the transcription, like those in running titles).
+
+Typographic errors, occurring at the following pages and lines in the
+original, have been corrected (negative numbers indicate lines from the
+bottom of the page):
+
+  - *p. 23, note *, l. -6* their Druggs --> their Drugs
+  - *p. 29, l. 12* thorough Attentention --> thorough Attention
+  - *p. 39, l. 2* btutal Souls --> brutal Souls
+  - *p. 48, l. 12-13* thick, and and that --> thick, and that
+  - *p. 55, l. -5* increases our Horrour --> increases our Horror
+  - *p. 61, l. 3-4* deserves a Patients Confidence --> deserves a
+    Patient's Confidence
+  - *p. 62, l. 16* Drink and Glisters --> Drink and Glysters
+  - *p. 87, l. -8* the loosening Glyster No. 5 --> the loosening Glyster
+    No. 5
+  - *p. 106, l. 1* Inflammamations --> Inflammations
+  - *p. 148, l. 21-22* Perspiraration --> Perspiration
+  - *p. 182, l. 19* Applications N. 9 --> Applications No. 9
+  - *p. 189, l. 1* the Powder No. 29 --> the Powder No. 29
+  - *p. 223, note *, l. 4* without the least peceiveable --> without the
+    least perceiveable
+  - *p. 226, l. 17-18* Relax-tion --> Relaxation
+  - *p. 244, l. 4-5* Dis-seases --> Diseases
+  - *p. 261, l. 15* Haemmorrhages --> Haemorrhages
+  - *p. 283, l. 14-15* Pre-Precription --> Prescription
+  - *p. 344, note +, l. -2* _missing closing quote conjecturally
+    inserted after_ instead of stumming or sulphurizing it,'
+  - *p. 353, l. 1* stance constitutes --> Circumstance constitutes
+  - *p. 355, l. 18* not pregant --> not pregnant
+  - *p. 383, l. 6* the back Bart of the Head --> the back Part of the
+    Head
+  - *p. 485, l. 13* checks it Progress --> checks its Progress
+  - *p. 495, l. 19* strong swelling Herbs --> strong smelling Herbs
+  - *p. 506, l. 15* Weakness is an Obstable --> Weakness is an Obstacle
+  - *p. 506, l. 19* an Evacution supervenes --> an Evacuation supervenes
+  - *p. 525, l. -2,-1* Never-vertheless --> Nevertheless
+  - *p. 560, l. -7* Villians --> Villains
+  - *p. 573, l. 6* some Evacution --> some Evacuation
+  - *p. 608. l. -7*  Temparrament --> Temperrament
+  - *p. 611, col. 2, l. 4* _Of a_ Diarrhaea --> _Of a_ Diarrhoea
+
+So has been corrected the punctuation:
+
+  - *p. xxii, last line, note*  published at _Lyons_. [missing period]
+  - *p. xxix, l. 10* _Infusion_ No. 1; [missing dot]
+  - *p. xxix, l. 13-14* Numbers 1. 2, and 4 --> Numbers 1, 2, and 4
+  - *p. 63, l. 15* of the Ptisans No. 1 [missing dot]
+  - *p. 84, l. -7, note* the Mixture, No. 10 [missing dot]
+  - *p. 88, l. 21* the purging Potion No. 11 [missing dot]
+  - *p. 89, l. 12* and drink plentifully of the Ptisan No. 2 [missing
+    dot]
+  - *p. 89, l. -7* should drink plentifully of the Ptisan No. 12
+    [missing dot]
+  - *p. 117, l. 12-13* or some of those Diet-Drinks No. 1, 2, 4; [dots
+    instead of commas]
+  - *p. 118, note *, l. 3* it in his late _Materia Medica._ K. [missing
+    period]
+  - *p. 173, l. -8* in Hunting in 1658. [additional comma]
+  - *p. 198, l. 16* 3. The Bites --> 3, The Bites
+  - *p. 203, note, l. 5* in many other Places. [missing period]
+  - *p. 231, note, l- 1* and the Note there. [comma instead of period]
+  - *p. 233, l. 10* sound and hearty Children). [missing period]
+  - *p. 265, l. -6* 12, As soon as the Distemper [period instead of
+    comma]
+  - *p. 320, last line of the note* or for suspending it. _K._ [missing
+    dot]
+  - *p. 371, l. 7* 2, An Inflammation [period instead of comma]
+  - *p. 531, l. -6* or wrong. [missing period]
+  - *p. 538, l. -9* Powder No. 20 [missing dot]
+  - *p. 601, first line of the note* The Prescriptions No. 54, 55, 56
+    [missing dot after No and periods instead of commas]
+
+The footnotes, marked in the text mostly by asterisks, symbols and
+alphabetic letters on a page by page basis, have been renumbered
+progressively throughout the book. The footnote * on page 256 does not
+appear to be referenced at any specific point on the printed page, and
+has been treated as footnote to the last word of the paragraph.
+
+Italics markup of abbreviations like _&c._, _K._, which was not always
+consistent in the original, has been retained as printed.
+
+The Greek letters _{alpha}_, _{beta}_, _{gamma}_ enumerating the
+prescriptions of Sec. 214 have been replaced by the Latin letters _a_, _b_,
+_c_ for better character set portability.
+
+
+
+
+
+End of the Project Gutenberg EBook of Advice to the people in general, with
+regard to their health, by Samuel Auguste David Tissot
+
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