Domestic Medicine - Chapters 9-14



CHAPTER IX.
OF INFECTION.

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

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

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

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

THE common practice in country-places of inviting great numbers of people 
to funerals, and crowding them into the same apartment where the corpse 
lies, is another way of spreading infection. The infection does not always 
die with the patient. Every thing that comes into contact with his body, 
while alive, receives the contagion, and some of the them, as clothes, 
blankets, &c. will retain it for a long time. Persons who die of 
infectious disorders ought not to lie long unburied; and people should 
keep, as much as possible, at a distance from them.

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

INFECTIOUS diseases are often communicated by clothes. It is extremely 
dangerous to wear apparel which has been worn by the deceased, unless it 
has been well washed and fumigated, as infection may lodge a long time in 
it, and afterwards produce very tragical effects. This shews the danger of 
buying at random the clothes which have been used by other people.

INFECTIOUS disorders are frequently imported. Commerce, together with the 
riches of foreign climes, brings us also their diseases. These do often 
more than counterbalance all the advantages of that trade by means of 
which they are introduced. It is to be regretted, that so little care is 
commonly bestowed, either to prevent the introduction or spreading of 
infectious diseases. Some attention indeed is generally paid to the 
plague; but other diseases pass unregarded. Were the tenth part of the 
care taken to prevent the importation of diseases, that there is to 
prevent smuggling, it would be attended with many happy consequences. This 
might easily be done by appointing a physician at every considerable sea-
port, to inspect the ship's company, passengers, &c. before they came 
ashore, and, if any fever or other infectious disorder prevailed, to order 
the ship to perform a short quarantine, and to send the sick to some 
hospital or proper place to be cured. He might likewise order all the 
clothes, bedding, &c. which had been used by the sick during the voyage, 
to be either destroyed, or thoroughly cleansed by fumigation, &c., before 
any of it were sent ashore. A scheme of this kind, if properly conducted, 
would prevent many fevers, and other infectious diseases, from being 
brought by sailors into sea-port towns, and by this means diffused all 
over the country.

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

MANY are the causes which tend to diffuse infection through populous 
cities. The whole atmosphere of a large town is one contaminated mass, 
abounding with various kinds of infection, and must be pernicious to 
health. The best advice that we can give to such as are obliged to live in 
large cities, is, to chuse an open situation; to avoid narrow, dirty, 
crowded streets; to keep their own houses and offices clean; and to be as 
much abroad in the open air as their time will permit.

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

SUCH as wait upon the sick in infectious diseases, run very great hazard. 
They should stuff their noses with tobacco, or some other strong smelling 
herb, as rue, tansy, or the like. They ought likewise to keep the patient 
very clean, to sprinkle the room where he lies with vinegar, or other 
strong acids, frequently to admit a stream of fresh air into it, and to 
avoid the smell of his breath as much as they can. They ought never to go 
into company without having changed their clothes and washed their hands; 
otherwise, if the disease be infectious, they will in all probability 
carry the contagion along with them. There is reason to believe that 
infection is often conveyed from one place to another by the carelessness 
of the faculty themselves. Many physicians affect a familiar way of 
sitting upon the patient's bedside, and holding his arm for a considerable 
time. If the patient has the small-pox, or any other infectious disease, 
there is no doubt but the doctor's hands, clothes, &c. will carry away 
some of the infection; and, if he goes directly to visit another patient 
without washing his hands, changing his clothes, or being exposed to the 
open air, which is not seldom the case, is it any wonder that he should 
carry the disease along with him? Physicians not only endanger others, but 
also themselves, by this practice. And, indeed, they sometimes suffer for 
their want of care.

HOWEVER trifling it may appear to inconsiderate persons, we will venture 
to affirm, that a due attention to those things which tend to diffuse 
infection would be of great importance in preventing diseases. As most 
diseases are in some degree infectious, no one should continue long with 
the sick, except the necessary attendants. I mean not, however, by this 
caution, to deter those whose duty or office leads them to wait upon the 
sick, from such a laudable and necessary employment.

MANY things are in the power of the magistrate which would tend to prevent 
the spreading of infection; as the promoting of public cleanliness; 
removing jails, hospitals, burying grounds, and other places where 
infection may be generated, at a proper distance from great towns; 
widening the streets; pulling down useless walls; and taking all methods 
to promote a free circulation of air through every part of the town, &c. 
The ancients would not suffer even the Temples of their gods, where the 
sick resorted, to be built within the walls of a city. Public hospitals, 
or proper places of reception for the sick, provided they were kept clean, 
well ventilated, and placed in an open situation, would likewise tend to 
prevent the spreading of infection. Such places of reception would prevent 
the poor, when sick, from being visited by their idle or officious 
neighbours. They would likewise render it unnecessary for sick servants to 
be kept in their masters houses. Masters had better pay for having their 
servants taken care of in an hospital, than run the hazard of having an 
infectious disease diffused among a numerous family. Sick servants and 
poor people, when placed in hospltals, are not only less apt to diffuse 
infection among their neighbours, but have likewise the advantage of being 
well attended.

WE are not, however, to learn that hospitals, instead of preventing 
infection, may become the means of diffusing it. When they are placed in 
the middle of great towns; when numbers of patients are crowded together 
into small apartments; when there is a constant communication kept up 
between the citizens and the patients; and when cleanliness and 
ventilation are neglected, they become nests for hatching diseases, and 
every one who goes into them not only runs a risk of receiving infection 
himself, but likewise of communicating it to others. This, however, is not 
the fault of the hospitals, but of those who have the management of them. 
It were to be wished, that they were both more numerous, and upon a more 
respectable footing, as that would induce people to go into them with less 
reluctance. This is the more to be desired, because most of the putrid 
fevers and other infectious disorders break out among the poor, and are by 
them communicated to the better sort. Were proper attention paid to the 
first appearances of such disorders, and the patients early conveyed to an 
hospital, we should seldom see a putrid fever, which is almost as 
infectious as the plague, become epidemic.



CHAPTER X.
OF THE PASSIONS.

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


Of Anger.

THE passion of anger ruffles the mind, distorts the countenance, hurries 
on the circulation of the blood, and disorders the whole vital and animal 
functions. It often occasions fevers, and other accute diseases; and 
sometimes even sudden death. This passion is peculiarly hurtful to the 
delicate, and those of weak nerves. I have known such persons frequently 
lose their lives by a violent fit of anger, and would advise them to guard 
against the excess of this passion with the utmost care.

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

SUCH as value health should avoid violent gusts of anger, as they would 
the most deadly poison. Neither ought they to indulge resentment, but to 
endeavour at all times to keep their minds calm and serene. Nothing tends 
so much to the health of the body as a constant tranquillity of mind.


Of Fear.

THE influence of fear, both in occasioning and aggravating diseases, is 
very great. No man ought to be blamed for a decent concern about life; but 
too great a desire to preserve it, is often the cause of losing it. Fear 
and anxiety, by depressing the spirits, not only dispose us to diseases, 
but often render those diseases fatal which an undaunted mind would 
overcome.

SUDDEN fear has generally violent effects. Epileptic fits, and other 
convulsive disorders, are often occasioned by it. Hence the danger of that 
practice, so common among young people, of frightening one another. Many 
have lost their lives, and others have been tendered miserable, by frolics 
of this kind. It is dangerous to tamper with the human passions. The mind 
may easily be thrown into such disorder as never again to act with 
regularity.

BUT the gradual effects of fear prove most hurtful. The constant dread of 
some future evil, by dwelling upon the mind, often occasions the very evil 
itself. Hence it comes to pass, that so many die of those very diseases of 
which they long had a dread, or which had been impressed on their minds by 
some accident, or foolish prediction. This, for example, is often the case 
with women in child-bed. Many of those who die in that situation are 
impressed with the notion of their death a long time before it happens; 
and there is reason to believe, that this impression is often the cause of 
it.

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

IT seldom happens that two or three women, in a great town, die in child-
bed, but their death is followed by many others. Every woman of their 
acquaintance who is with child, dreads the same fate, and the disease 
becomes epidemical by the mere force of imagination. This should induce 
pregnant women to despise fear, and by all means to avoid those tattling 
gossips who are continually buzzing in their ears the misfortunes of 
others. Every thing that may in the least alarm a pregnant, or child-bed 
woman, ought with the greatest care to be guarded against.

MANY women have lost their lives in child-bed by the old superstitious 
custom, still kept up in most parts of Britain, of tolling the parish bell 
for every person who dies. People who think themselves in danger are very 
inquisitive; and if they come to know that the bell tolls for one who died 
in the same situation with themselves, what must be the consequence? At 
any rate they are apt to suppose that this is the case, and it will often 
be found a very difficult matter to persuade them of the contrary.

BUT this custom is not pernicious to child-bed women only. It is hurtful 
in many other cases. When low fevers, in which it is difficult to support 
the patient's spirits, prevail, what must be the effect of a funeral peal 
sounding five or six times a day in his ears? No doubt his imagination 
will suggest, that others died of the same disease under which he labours. 
This apprehension will have a greater tendency to depress his spirits, 
than all the cordials of which medicine can boast will have to raise them.

IF this useless piece of ceremony cannot be abolished, we ought to keep 
the sick as much from hearing it as possible, and from every other thing 
that may tend to alarm them. So far however is this from being generally 
attended to, that many make it their business to visit the sick, on 
purpose to whisper dismal stories in their ears. Such may pass for 
sympathising friends, but they ought rather to be considered as enemies. 
All who wish well to the sick, ought to keep such persons at the greatest 
distance from them.

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

KIND Heaven has, for the wisest ends, concealed from mortals their fate 
and we do not see what right any man has to announce the death of another, 
especially if such a declaration has a chance to kill him. Mankind are 
indeed very fond of prying into future events, and seldom fail to solicit 
the physician for his opinion. A doubtful answer, however, or one that may 
tend rather to encourage the hopes of the sick, is surely the most safe. 
This conduct could neither hurt the patient not the physician. Nothing 
tends more to destroy the credit of physic than those bold 
prognosticators, who, by the bye, are generally the most ignorant of the 
faculty. The mistakes which daily happen in this way are so many standing 
proofs of human vanity, and the weakness of science.

WE readily admit, that there are cases where the physician ought to give 
intimation of the patient's danger to some of his near connexions; though 
even this ought always to be done with the greatest caution: but it never 
can be necessary in any case that the whole town and country should know, 
immediately after the doctor has made his first visit, that he has no 
hopes of his patient's recovery. Persons whose impertinent curiosity leads 
them to question the physician with regard to the fate of his patients 
certainly deserve no better than an evasive answer.

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


Of Grief.

GRIEF is the most destructive of all the passions. Its effects are 
permanent, and when it sinks deep into the mind, it generally proves 
fatal. Anger and fear being of a more violent nature, seldom last long; 
but grief often changes into a fixed melancholy, which preys upon the 
spirits, and wastes the constitution. This passion ought not to be 
indulged. It may generally be conquered at the beginning; but when it has 
gained strength, all attempts to remove it are vain.

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

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

IT is utterly impossible, that any person of a dejected mind should enjoy 
health. Life may indeed be dragged out for a few years: But whoever would 
live to a good old age, must be good-humoured and cheerful. This indeed is 
not altogether in our own power; yet our temper of mind, as well as our 
actions, depend greatly upon ourselves. We can either associate with 
cheerful or melancholy companions, mingle in the amusements and offices of 
life, or sit still and brood over our calamities, as we choose. These, and 
many such things, are certainly in our power, and from these the mind 
generally takes its craft.

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

IT has already been oberved, that the body cannot be healthy unless it be 
exercised; neither can the mind. Indolence nourishes grief. When the mind 
has nothing else to think of but calamities, no wonder that it dwells 
there. Few people who pursue business with attention are hurt by grief. 
Instead therefore of abstracting ourselves from the world or business, 
when misfortunes happen, we ought to engage in it with more than usual 
attention, to discharge with double diligence the functions of our 
station, and to mix with friends of a cheerful and social temper.

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

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


Of Love.

LOVE is perhaps the strongest of all the passions; at least, when it 
becomes violent, it is less subject to the controul either of the 
understanding or will, than any of the rest. Fear, anger, and several 
other passions are necessary for the preservation of the individual, but 
love is necessary for the continuation of the species itself: It was 
therefore proper that this passion should be deeply rooted in the human 
breast.

THOUGH love be a strong passion, it is seldom so rapid in its progress as 
several of the others. Few persons fall desperately in love all at once. 
We would therefore advise every one, before he tampers with this passion, 
to consider well the probability of his being able to obtain the object of 
his love. When that is not likely, he should avoid every occasion of 
increasing it. He ought immediately to fly the company of the beloved 
object; to apply his mind attentively to business or study; to take every 
kind of amusement; and, above all, to endeavour, if possible, to find 
another object which may engage his affections, and which it may be in his 
power to obtain.

THERE is no passion with which people are so ready to tamper as love, 
although none is more dangerous. Some men make love for amusement, others 
from mere vanity, or on purpose to shew their consequence with the fair. 
This is perhaps the greatest piece of cruelty which any one can be guilty 
of. What we eagerly wish for, we easily credit. Hence the too credulous 
fair are often betrayed into a situation which is truly deplorable, before 
they are able to discover that the pretended lover was only in jest. But 
there is no jesting with this passion. When love is got to a certain 
height, it admits of no other cure but the possession of its object, 
which, in this case, ought always if possible to be obtained. The conduct 
of parents with regard to the disposal of their children in marriage is 
often very blameable. An advantageous match is the constant aim of 
parents; while their children often suffer a real martyrdom betwixt their 
inclinations and duty. The first thing which parents ought to consult, in 
disposing their children in marriage, is certainly their inclinations. 
Were due regard always paid to these, there would be fewer unhappy 
couples, and parents would not have so often cause to repent the severity 
of their conduct, after a ruined constitution, a lost character, or a 
distracted mind, has shewn them their mistake.


Of Religious Melancholy.

MANY persons of a religious turn of mind behave as if they thought it a 
crime to be cheerful. They imagine the whole of religion consists in 
certain mortifications, or denying themselves the smallest indulgence, 
even of the most innocent amusements. A perpetual gloom hangs upon their 
countenances, while the deepest melancholy preys upon their minds. At 
length the fairest prospects vanish, every thing puts on a dismal 
appearance, and those very objects which ought to give delight afford 
nothing but disgust. Life itself becomes a burden, and the unhappy wretch, 
persuaded that no evil can equal what he feels, often puts an end to his 
own miserable existence.

IT is great pity that ever religion should be so far perverted, as to 
become the cause of those very evils which it is defined to cure. Nothing 
can be better calculated than True Religion, to raise and support the mind 
of its votaries under every affliction that can befal them. It teaches 
them, that even the sufferings of this life are preparatory to the 
happiness of the next; and that all who persist in a course of virtue 
shall at length arrive at complete felicity.

PERSONS whose business it is to recommend religion to others, should 
beware of dwelling too much on gloomy subjects. That peace and 
tranquillity of mind, which true religion is calculated to inspire, is a 
more powerful argument in its favour, than all the terrors that can be 
uttered. Terror may indeed deter men from outward acts of wickedness; but 
can never inspire them with that love of God, and real goodness of heart, 
in which alone true religion consist.

TO conclude; the best way to counteract the violence of any passion, is to 
keep the mind closely engaged in some useful pursuit.



CHAPTER XI.
OF THE COMMON EVACUATIONS.

THE principal evacuations from the human body are those of stool, urine, 
and insensible perspiration. None of these can be long obstructed without 
impairing the health. When that which ought to be thrown out of the body 
is too long retained, it not only occasions a plethora, or too great 
fulness of the vessels, but acquires qualities which are hurtful to the 
health, as acrimony, putrescence, &c.


Of the Evacuation by Stool.

FEW things conduce more to the health than keeping the body regular. When 
the faeces lie too long in the bowels, they vitiate the humours; and when 
they are too soon discharged, the body is not sufficiently nourished. A 
medium is therefore to be desired; which can only be obtained by 
regularity in diet, sleep, and exercise. Whenever the body is not regular, 
there is reason to suspect a fault in one or other of these.

PERSONS who eat and drink at irregular hours, and who eat various kinds of 
food, and drink of several different liquors at every meal, have no reason 
to expect either that their digestion will be good, or their discharges 
regular. Irregularity in eating and drinking disturbs every part of the 
animal oeconomy, and never fails to occasion diseases. Either too much or 
too little food will have this effect. The former indeed generally 
occasions looseness, and the latter costiveness; but both have a tendency 
to hurt the health.

IT would be difficult to ascertain the exact number of stools which may be 
consistent with health, as these differ in the different periods of life, 
in different constitutions, and even in the same constitution under a 
different regimen of diet, exercise, &c. It is however generally allowed, 
that one stool a-day is sufficient for an adult, and that less is hurtful. 
But this, like most general rules, admits of many exceptions. I have known 
persons in perfect health who did not go to stool above once a-week. Such 
a degree of costiveness however is not safe; though the person who labours 
under it may for some time enjoy tolerable health, yet at length it may 
occasion diseases.

ONE method of procuring a stool every day is to rise betimes, and go 
abroad in the open air. Not only the posture in bed is unfavourable to 
regular stools, but also the warmth. This, by promoting the perspiration, 
lessens all the other discharges.

THE method recommended for this purpose by Mr. Locke, is likewise very 
proper, viz. to solicit nature by going regularly to stool every morning 
whether one has a call or not. Habits of this kind may be acquired, which 
will in time become natural.

PERSONS who have frequent recourse to medicines for preventing 
costiveness, seldom fail to ruin their constitution. Purging medicines 
frequently repeated weaken the bowels, hurt the digestion, and every dose 
makes way for another, till at length they become as necessary as daily 
bread. Those who are troubled with costiveness ought rather, if possible, 
to remove it by diet than drugs. They should likewise go thinly clothed, 
and avoid every thing of an astringent, or of an heating nature. The diet 
and other regimen necessary in this case will be found under the article 
Costiveness, where this state of the bowels is treated as a disease.

SUCH persons as are troubled with a habitual looseness, ought likewise to 
suit their diet to the nature of their complaint. They should use food 
which braces and strengthens the bowels, and which is rather of an 
astringent quality, as wheat-bread made of the finest flour, cheese, eggs, 
rice boiled in milk, &c. Their drink should be red port, claret, brandy 
and water in which toasted bread has been boiled, and such like.

AS a habitual looseness is often owing to an obstructed perspiration, 
persons affected with it ought to keep their feet warm, to wear flannel 
next to their skin, and take every other method to promote the 
perspiration. Further directions with regard to the treatment of this 
complaint will be found under the article Looseness.


Of Urine.

SO many things tend to change both the quantity and appearances of the 
urine, that it is very difficult to lay down any determined rules for 
judging of either. It has long been an observation among physicians, that 
the appearances of the urine are very uncertain, and very little to be 
depended on. No one will be surprised at this who considers how many ways 
it may be affected, and consequently have its appearance altered. The 
passions, the state of the atmosphere, the quantity and quality of the 
food, the exercise, the clothing, the state of the other evacuations, and 
numberless other causes, are sufficient to induce a change either in the 
quantity or appearance of the urine. Any one who attends to this, will be 
astonished at the impudence of those daring quacks, who pretend to find 
out diseases, and prescribe to patients from the bare inspection of their 
urine. These impostors, however, are very common all over Britain, and by 
the amazing credulity of of the populace, many of them amass considerable 
fortunes. Of all the medical prejudices which prevail in this country, 
that in favour of urine doctors is the strongest. The common people have 
still an unlimited faith in their skill, although it has been demonstrated 
that no one of them, unless he has been previously informed, is able to 
distinguish the urine of a horse from that of a man. Dr. Cheyne says, the 
urine ought to be equal to three-fourths of the liquid part of our 
aliment. But suppose any one were to take the trouble of measuring both, 
he would find that every thing which altered the degree of perspiration 
would alter this proportion, and likewise that different kinds of aliment 
would afford very different quantities of urine.

THOUGH for these, and other reasons, no rule can be given for judging of 
the precise quantity of urine which ought to be discharged, yet a person 
of common sense will seldom be at a loss to know when it is in either 
extreme.

AS a free discharge of urine not only prevents, but actually cures, many 
diseases, it ought by all means to be promoted; and every thing that may 
obstruct it should be carefully avoided. Both the secretion and discharge 
of urine are lessened by a sedentary life, sleeping on beds that are too 
soft and warm, food of a dry and heating quality, liquors which are 
astringent and heating, as red port, claret, and such like. Those who have 
reason to suspect that their urine is in too small quantity, or who have 
any symptoms of the gravel, ought not only to avoid these things, but 
whatever else they find has a tendency to lessen the quantity of their 
urine.

WHEN the urine is too long retained, it is not only resorbed, or taken up 
again into the mass of fluids, but by stagnating in the bladder it becomes 
thicker, the more watery parts flying off first, and the more gross and 
earthly remaining behind. By the constant tendency which these have to 
concrete, the formation of stones and gravel in the bladder is promoted. 
Hence it comes to pass, that indolent and sedentary people are much more 
liable to these diseases, than persons of a more active life.

MANY persons have lost their lives, and others have brought on very 
tedious, and even incurable disorders, by retaining their urine too long, 
from a false delicacy. When the bladder has been over-distended, it often 
loses its power of action altogether, or becomes paralytic, by which means 
it is rendered unable either to retain the urine, or expel it properly. 
The calls of Nature ought never to be postponed. Delicacy is doubtless a 
virtue; but that can never be reckoned true delicacy, which induces any 
one to risk his health, or hazard his life.

BUT the urine may be in too great as well as too small a quantity. This 
may be occasioned by drinking large quantities of weak watery liquors, by 
the excessive use of alkaline salts, or any thing that stimulates the 
kidnies, dilutes the blood, &c. This disorder very soon weakens the body, 
and induces a consumption. It is difficult to cure, but may be mitigated 
by strengthening diet and astringent medicines, such as are recommended 
under the article Diabetes, or excessive discharge of urine.


Of the Perspiration.

INSENSIBLE perspiration is generally reckoned the greatest of all the 
discharges from the human body. It is of so great importance to health, 
that few diseases attack us while it goes properly on; but when it is 
obstructed, the whole frame is soon disordered. This discharge however 
being less perceptible than any of the rest, is consequently less attended 
to. Hence it is, that acute fevers, rheumatisms, agues, &c. often proceed 
from obstructed perspiration before we are aware of its having taken place.

ON examining patients, we find most of them impute their diseases either 
to violent colds which they had caught, or to slight ones which had been 
neglected. For this reason, instead of a critical inquiry into the nature 
of the perspiration, its difference in different seasons, climates, 
constitutions, &c. we shall endeavour to point out the causes which most 
commonly obstruct it, and to shew how far they may be either avoided, or 
have their influence counter-acted by timely care. The want of a due 
attention to these, costs Britain annually some thousands of useful lives.


Changes in the Atmosphere.

ONE of the most common causes of obstructed perspiration, or catching 
cold, in this country, is the changeableness of the weather, or state of 
the atmosphere. There is no place where such changes happen more 
frequently than in Great-Britain. With us the degrees of heat and cold are 
not only very different in the different seasons of the year, but often 
change almost from one extreme to another in a few days, and sometimes 
even in the course of one day. That such changes must effect the state of 
the perspiration is obvious to every one. I never knew a more remarkable 
instance of the uncertainty of the weather in this country, than happened 
while I was writing these notes. This morning, August 14, 1783, the 
thermometer in the shade was down at fifty-three degrees, and a very few 
days ago it stood above eighty. No one who reflects on such great and 
sudden changes in the atmosphere will be surprised to find colds, coughs, 
rheums, with other affections of the breast and bowels, so common in this 
country.

THE best method of fortifying the body against the changes of the weather, 
is to be abroad every day. Those who keep most within doors are most 
liable to catch cold. Such persons generally render themselves so delicate 
as to feel even the slightest changes in the atmosphere, and by their 
pains, coughs, and oppressions of the breast, &c. they become a kind of 
living barometers.


Wet Clothes.

WET clothes not only, by their coldness, obstruct the perspiration, but 
their moisture, by being absorbed, or taken up into the body, greatly 
increases the danger. The most robust constitution is not proof against 
the danger arising from wet clothes; they daily occasion fevers, 
rheumatisms, and other fatal disorders, even in the young and healthy.

IT is impossible for people who go frequently abroad to avoid sometimes 
being wet. But the danger might generally be lessened, if not wholly 
prevented, by changing their clothes soon; when this cannot be done, they 
should keep in motion till they be dry. So far are many from taking this 
precaution, that they often sit or lie down in the fields with their 
clothes wet, and frequently sleep even whole nights in this condition. The 
frequent instances which we have of the fatal effects of this conduct 
ought certainly to deter others from being guilty of it.


Wet Feet.

EVEN wet feet often occasion fatal diseases. The colic, inflammations of 
the breast and of the bowels, the iliac passion, cholera morbus, &c. are 
often occasioned by wet feet. Habit will, no doubt, render this less 
dangerous; but it ought, as far as possible, to be avoided. The delicate, 
and those who are not accustomed to have their clothes or feet wet, should 
be careful in this respect.


Night Air.

THE perspiration is often obstructed by NIGHT AIR; even in summer, this 
ought to be avoided. The dews which fall plentifully after the hottest 
day, make the night more dangerous than when the weather is cool. Hence, 
in warm countries, the evening dews are more hurtful than where the 
climate is more temperate.

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


Damp Beds.

BEDS become damp, either from their not being used, standing in damp 
houses, or in rooms without fire. Nothing is more to be dreaded by 
travellers than damp beds, which are very common in all places where fuel 
is scarce. When a traveller, cold and wet, arrives at an inn, he may by 
means of a good fire, warm diluting liquor, and a dry bed, have the 
perspiration restored; but if he be put into a cold room, and laid on a 
damp bed, it will be more obstructed, and the worst consequences will 
ensue. Travellers should avoid inns which are noted for damp beds, as they 
would a house infected with the plague, as no man, however robust, is 
proof against the danger arising from them.

BUT inns are not the only places where damp beds are to be met with. Beds 
kept in private families for the reception of strangers are often equally 
dangerous. All kinds of linen and bedding, when not frequently used, 
become damp. How then is it possible that beds, which are not slept in 
above two or three times a-year, should be safe? Nothing is more common 
than to hear people complain of having caught cold by changing their bed. 
The reason is obvious: Were they careful never to sleep in a bed but what 
was frequently used, they would seldom find any ill consequences from a 
change.

NOTHING is more to be dreaded by a delicate person when on a visit, than 
being laid in a bed which is kept on purpose for strangers. That ill-
judged piece of complaisance becomes a real injury. All the bad 
consequences from this quarter might easily be prevented in private 
families, by causing their servants to sleep in the spare beds, and resign 
them to strangers when they come. In inns where the beds are used almost 
every night, nothing else is necessary than to keep the rooms well 
seasoned by frequent fires, and the linen dry.

THAT baneful custom said to be practised in many inns, of damping sheets, 
and pressing them in order to save washing, and afterwards laying them on 
the beds, ought, when discovered, to be punished with the utmost severity. 
It is really a species of murder, and will often prove as fatal as poison 
or gun-shot. Indeed no linen, especially if it has been washed in winter, 
ought to be used till it has been exposed for some time to the fire; nor 
is this operation less necessary for linen washed in summer, provided it 
has lain by for any length of time. This caution is the more needful, as 
gentlemen are often exceedingly attentive to what they eat or drink at an 
inn, yet pay no regard to a circumstance of much more importance. If a 
person suspects that his bed is damp, the simple precaution of taking off 
the sheets and lying in the blankets, with all, or most of his clothes on, 
will prevent all the danger. I have practised this for many years, and 
never have been hurt by damp beds, though no constitution, without care, 
is proof against their baneful influence.


Damp Houses.

DAMP houses frequently produce the like ill consequences; for this reason 
those who build should be careful to chuse a dry situation. A house which 
stands on a damp marshy soil or deep clay, will never be thoroughly dry. 
All houses, unless where the ground is exceeding dry, should have the 
first floor a little raised. Servants and others, who are obliged to live 
in cellars and sunk stories, seldom continue long in health: Masters ought 
surely to pay some regard to the health of their servants, as well as to 
their own.

NOTHING is more common than for people, merely to avoid some trifling 
inconveniency, to hazard their lives, by inhabiting a house almost as soon 
as the masons, plasterers, &c. have done with it: Such houses are not only 
dangerous from their dampness, but likewise from the smell of lime, paint, 
&c. The asthmas, consumptions, and other diseases of the lungs, so 
incident to people who work in these articles, are sufficient proof of 
their being unwholesome.

ROOMS are often rendered damp by an unseasonable piece of cleanliness; I 
mean the pernicious custom of washing them immediately before company is 
put into them. Most people catch cold, if they sit but but a very short 
time in a room that has been lately washed; the delicate ought carefully 
to avoid such a situation, and even the robust are not proof against its 
influence. People imagine if a good fire is made in a room after it has 
been washed, that there is no danger from sitting in it; but they must 
give me leave to say that this increases the danger. The evaporation 
excited by the fire generates cold, and renders the damp more active.


Sudden Transitions from Heat to Cold.

NOTHING so frequently obstructs the perspiration as SUDDEN TRANSITIONS 
from heat to cold. Colds are seldom caught, unless when people have been 
too much heated. Heat rarifies the blood, quickens the circulation, and 
increases the perspiration; but when these are suddenly checked, the 
consequences must be bad. It is indeed impossible for labourers not to be 
too hot upon some occasions; but it is generally in their power to let 
themselves cool gradually, to put on their clothes when they leave off 
work, to make choice of a dry place to rest themselves in, and to avoid 
sleeping in the open fields. These easy rules, if observed, would often 
prevent fevers and other fatal disorders

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

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

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

SITTING in a warm room, and drinking hot liquors till the pores are quite 
open, and immediately going into the cold air, is extremely dangerous., 
Colds, coughs, and inflammations of the breast, are the usual effects of 
this conduct. Yet nothing is more common than for people, after they have 
drank warm liquors for several hours, to walk or ride a number of miles in 
the coldest night, or to ramble about in the streets. The tap-rooms in 
London and other great towns, where such numbers of people spend their 
evenings, are highly pernicious. The breath of a number of people crowded 
into a low apartment, with the addition of fires, candles, the smoke of 
tobacco, and the fumes of hot liquor, &c, must not only render it hurtful 
to continue in such places, but dangerous to go out of them into a cold 
and chilly atmosphere.

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

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

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

THE result of all these observations is, that every one ought to avoid, 
with the utmost attention, all sudden transitions from heat to cold, and 
to keep the body in as uniform a temperature as possible; or, where that 
cannot be done, to take care to let it cool gradually.

PEOPLE may imagine that too strict an attention to these things would tend 
to render them delicate. So far however is this from being my design, that 
the very first rule proposed for preventing colds, is to harden the body, 
by enuring it daily to the open air.

I SHALL put an end to what relates to this part of my subject, by giving 
an abstract of the justly celebrated advice of Celsus, with respect to the 
preservation of health. " A man"' says he, who is blessed with good 
health, should confine himself to no particular rules, either with respect 
to regimen or medicine. He ought frequently to diversify his manner of 
living; to be sometimes in town, sometimes in the country; to hunt, sail, 
indulge himself in rest, but more frequently to use exercise. He ought to 
refuse no kind of food that is commonly used, but sometimes to eat more 
and sometimes less; sometimes to make one at an entertainment, and 
sometimes to forbear it; to make rather two meals a-day than one. and 
always to eat heartily, provided he can digest it. He ought neither too 
eagerly to pursue, nor too scrupulously to avoid, intercourse with the 
fair sex: Pleasures of this kind, rarely indulged, render the body alert 
and active, but when too frequently repeated, weak and languid. He should 
be careful in time of health not to destroy, by excesses of any kind, that 
vigour of constitution which should support him under sickness."



PART II - OF DISEASES.

CHAPTER XII.
OF THE KNOWLEDGE AND CURE OF DISEASES.

THE knowledge of diseases does not depend so much upon scientific 
principles as many imagine. It is chiefly the result of experience and 
observation. By attending the sick, and carefully observing the various 
occurrences in diseases, a great degree of accuracy may be acquired, both 
in distinguishing their symptoms, and in the application of medicines. 
Hence sensible nurses, and other persons who wait upon the sick, often 
discover a disease sooner than those who have been bred to physic. We do 
not however mean to insinuate that a medical education is of no use. It is 
doubtless of the greatest importance but it never can supply the place 
observation and experience

EVERY disease may be considered as an assemblage of symptoms, and must be 
distinguished by those which are most obvious and permanent. Instead 
therefore of giving a classical arrangement of diseases, according to the 
systematic method, it will be more suitable, in a performance of this 
nature, to give a full and accurate description of each particular disease 
as it occurs; and, where any of the symptoms of one disease have a near 
resemblance to those of another, to take notice of that circumstance, and 
at the same time to point out the peculiar or characteristic symptoms by 
which it may be distinguished. By a due attention to these, the 
investigation of diseases will be found to be a less difficult matter than 
most people would at first be ready to imagine.

A PROPER attention to the patient's age, sex, temper of mind, 
constitution, and manner of life, will, likewise greatly assist, both in 
the investigation and treatment of diseases.

IN childhood the fibres are lax and soft, the nerves extremely irritable,
and the fluids thin, whereas in old age the fibres are rigid, the nerves 
become almost insensible, and many of the vessels imperviable. These and 
other peculiarities render the diseases of the young and aged very 
different, and of course they must require a different method of treatment.

FEMALES are liable to many diseases which do not afflict the other sex: 
Besides, the nervous system being more irritable in them than in men, 
their diseases require to be treated with greater caution. They are less 
able to bear large evacuations; and all stimulating medicines ought to be 
administered to them with a sparing hand.

PARTICULAR constitutions not only dispose persons to peculiar diseases, 
but likewise render it necessary to treat these diseases in a peculiar 
manner.

A DELICATE person, for example, with weak nerves, who lives mostly within 
doors, must not be treated, under any disease, precisely in the same 
manner as one who is hardy and robust, and who is much exposed to the open 
air.

THE temper of mind ought to be carefully attended to in diseases. Fear, 
anxiety, and a fretful temper, both occasion and aggravate diseases. In 
vain do we apply medicines to the body to remove maladies which proceed 
from the mind. When it is affected, the best medicine is to sooth the 
passions, to divert the mind from anxious thought, and to keep the patient 
as easy and cheerful as possible.

ATTENTION ought likewise to be paid to the climate, or place where the 
patient lives, the air he breathes, his diet, &c. Such as live in low 
marshy situations are subject to many diseases which are unknown to the 
inhabitants of high countries. Those who breathe the impure air of cities 
have many maladies to which the more happy rustics are entire strangers. 
Persons who feed grossly, and indulge in strong liquors, are liable to 
diseases which do not affect the temperate and abstemious, &c.

IT has already been observed, that the different occupations and 
situations in life dispose men to peculiar diseases. It is therefore 
necessary to inquire into the patient's occupation, manner of life, &c. 
This will not only assist us in finding out the disease, but will likewise 
direct us in the treatment of it. It would be very imprudent to treat the 
laborious and the sedentary precisely in the same manner, even supposing 
them to labour under the same disease.

IT will likewise be proper to enquire, whether the disease be 
constitutional or accidental; whether it has been of long or short 
duration; whether it proceeds from any great and sudden alteration in the 
diet, manner of life, &c. The state of the patient's body, and of the 
other evacuations, ought also to be enquired into; and likewise whether he 
can with ease perform all the vital and animal functions, as breathing, 
digestion, &c.

LASTLY, it will be proper to enquire what diseases the patient has 
formerly been liable to, and what medicines mere most beneficial to him; 
if he has a strong aversion to any particular drug, &c.

AS many of the indications of cure may be answered by diet alone, it is 
always the first thing to be attended to in the treatment of diseases. 
Those who know no better, imagine that every thing which goes by the name 
of a medicine possesses some wonderful power or secret charm, and think, 
if the patient swallows enough of drugs, that he must do well. This 
mistake has many ill consequences. It makes people trust to drugs, and 
neglect their own endeavours; besides, it discourages all attempts to 
relieve the sick, where medicines cannot be obtained.

MEDICINES are no doubt useful in their place, and, when administered with 
prudence, they may do much good; but when they are put in place of every 
thing else, or administered at random, which is not seldom the case, they 
must do mischief. We would therefore wish to call the attention of mankind 
from the pursuit of secret medicines, to such things as they are 
acquainted with. The proper regulation of these may often do much good, 
and there is little danger of their ever doing hurt.

EVERY disease weakens the digestive powers. The diet ought therefore, in 
all diseases, to be light and of easy digestion. It would be as prudent 
for a person with a broken leg to attempt to walk, as for one in a fever 
to eat the same kind of food, and in the same quantity, as when he was in 
perfect health. Even abstinence alone will often cure a fever, especially 
when it has been occasioned by excess in eating or drinking.

IN all fevers attended with inflammation, as pleurisies, peripneumonies, 
&c. thin gruels, wheys, watery infusions of mucilaginous plants, roots, 
&c. are not only proper for the patient's food, but they are likewise the 
best medicines which can be administered.

IN fevers of a slow, nervous, or putrid kind, where there are no symptoms 
of inflammation, and where the patient must be supported with cordials, 
that intention can always be more effectually answered by nourishing diet 
and generous wines, than by any medicines yet known.

NOR is a proper attention to diet of less importance in chronic than in 
acute diseases. Persons afflicted with low spirits, wind, weak nerves, and 
other hypochondriacal affections, generally find more benefit from the use 
of solid food and generous liquors, than from all the cordial and 
carminative medicines which can be administered to them.

THE scurvy, that most obstinate malady, will sooner yield to a proper 
vegetable diet, than to all the boasted antiscorbutic remedies of the 
shops.

IN consumptions, when the humours are vitiated, and the stomach so much 
weakened as to be unable to digest the solid fibres of animals, or even to 
assimiIate the juices of vegetables, a diet consisting chiefly of milk 
will not only support the patient, but will often cure the disease after 
every other medicine has failed.

NOR is an attention to other things of less importance than to diet. The 
strange infatuation which has long induced people to shut up the sick from 
all communication with the external air, has done great mischief. Not only 
in fevers, but in many other diseases, the patient will receive more 
benefit from having the fresh air prudently admitted into his chamber, 
than from all the medicines which can be given him.

EXERCISE may likewise, in many cases, be considered as a medicine. 
Sailing, or riding on horseback, for example, will be of more service in 
the cure of consumptions, glandular obstructions, &c. than any medicine 
yet known. In diseases which proceed from a relaxed state of the solids, 
the cold bath, and other parts of the gymnastic regimen, will be found 
equally beneficial.

FEW things are of greater importance, in the cure of diseases, than 
cleanliness. When a patient is suffered to lie in dirty clothes, whatever 
perspires from his body is again resorbed, or taken up into it; which 
serves to nourish the disease, and increase the danger. Many diseases may 
be cured by cleanliness alone; most of them may be mitigated by it, and in 
all of them it is highly necessary both for the patient and those who 
attend him.

MANY other observations, were it necessary, might be adduced to prove the 
importance of a proper regimen in diseases. Regimen will often cure 
diseases without medicine, but medicine will seldom succeed where a proper 
regimen is neglected. For this reason, in the treatment of diseases, we 
have always given the first place to regimen. Those who are ignorant of 
medicine may confine themselves to it only. For others, who have more 
knowledge, we have recommended some of the most simple, but approved, 
forms of medicine in every disease. These, however, are never to be 
administered but by people of better understanding; nor even by them 
without the greatest precaution.



CHAPTER XIII.
OF FEVERS IN GENERAL.

AS more than one half of mankind is said to perish by fevers, it is of 
importance to be acquainted with their causes. The most general causes of 
fevers are, infection, errors in diet, unwholesome air, violent emotions 
of the mind, excess or suppression of usual evacuations, external or 
internal injuries, and extreme degrees of heat or cold. As most of these 
have already been treated of at considerable length, and their effects 
shewn, we shall not now resume the consideration of them, but shall only 
recommend it to all, as they would wish to avoid fevers and other fatal 
diseases, to pay the most punctual attention to these articles.

FEVERS are not only the most frequent of all diseases, but they are 
likewise the most complex: In the most simple species of fever there is 
always a combination of several different symptoms. The distinguishing 
symptoms of fever are, increased heat, frequency of pulse, loss of 
appetite, general debility, pain in the head, and a difficulty in 
performing some of the vital or animal-functions. The other symptoms 
usually attendant on fevers are, nausea, thirst, anxiety, delirium, 
weariness, wasting of the flesh, want of sleep, or the sleep disturbed and 
not refreshing.

WHEN the fever comes on gradually, the patient generally complains first 
of languor or listlessness, soreness of the flesh, or the bones, as the 
country people express it, heaviness of the head, loss of appetite, 
sickness, with clamminess of the mouth; after some time come on excessive 
heat, violent thirst, restlessness, &c.

WHEN the fever attacks suddenly, it always begins with an uneasy sensation 
of excessive cold, accompanied with debility and loss of appetite; 
frequently the cold is attended with shivering, oppression about the 
heart, and sickness at stomach, or vomiting.

FEVERS are divided into continual, remitting, intermitting, and such as 
are attended with cutaneous eruption or topical inflammation, as the small-
pox, erysipelas, &c. By a continual fever is meant that which never leaves 
the patient during the whole course of the disease, or which shews no 
remarkable increase or abatement in the symptoms. This kind of fever is 
likewise divided into acute, slow, and malignant. The fever is called 
acute when its progress is quick, and the symptoms violent; but when these 
are more gentle, it is generally denominated slow. When livid or petechial 
spots shew a putrid state of the humours, the fever is called malignant, 
putrid, or petechial.

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

AS a fever is only an effort of Nature to free herself from an offending 
cause, it is the business of those who have the care of the sick, to 
observe with diligence which way Nature points, and to endeavour to assist 
her operations. Our bodies are so framed, as to have a constant tendency 
to expel or throw off whatever is injurious to health. This is generally 
done by urine, sweat, stool, expectoration, vomit, or some other 
evacuation.

THERE is reason to believe, if the efforts of Nature, at the beginning of 
a fever, were duly attended to and promoted, it would seldom continue 
long; but when her attempts are either neglected or counteracted, it is no 
wonder if the disease proves fatal. There are daily instances of persons 
who, after catching cold, have all the symptoms of a beginning fever; but 
by keeping warm, drinking diluting liquors, bathing their feet in warm 
water, &c. the symptoms in a few hours disappear, and the danger is 
prevented. When fevers of a putrid kind threaten, the best method of 
obviating their effects is by repeated vomits.

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

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

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

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

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

THOUGH the patient in a fever has the greatest inclination for drink, yet 
he seldom has any appetite for solid food; hence the impropriety of urging 
him to take victuals is evident. Much solid food in a fever is every way 
hurtful. It oppresses nature, and, instead of nourishing the patient, 
serves only to feed the disease. What food the patient takes should be in 
small quantity, light, and of easy digestion. It ought to be chiefly of 
the vegetable kind, as panada, roasted apples, gruels, and such like.

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

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

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

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

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

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

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

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



CHAPTER XIV.
OF INTERMITTING FEVERS, OR AGUES.

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

THE several kinds of intermitting fevers take their names from the period 
in which the fit returns, as quotidian, tertian, quartan, &c.

CAUSES. - Agues are occasioned by effluvia from putrid stagnating water. 
This is evident from their abounding in rainy seasons, and being most 
frequent in countries where the soil is marshy, as in Holland, the Fens of 
Cambridgeshire, the Hundreds of Essex, &c. This disease may also be 
occasioned by eating too much stone fruit, by a poor watery diet, damp 
houses, evening dews, lying upon the damp ground, watching, fatigue, 
depressing passions, and the like. When the inhabitants of a high country 
remove to a low one, they are generally seized with intermitting fevers, 
and to such the disease is most apt to prove fatal. In a word, whatever 
relaxes the solids, diminishes the perspiration, or obstructs the 
circulation in the capillary or small vessels, disposes the body to agues.

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

REGIMEN. - While the fit continues, the patient ought to drink freely of 
water-gruel, orange-whey, weak camomile tea; or, if his spirits be low, 
small wine-whey, sharpened with the juice of lemon. All his drink should 
be warm, as that will assist in bringing on the sweat, and consequently, 
shorten the paroxysm. Dr. Lind says that twenty or twenty-five drops of 
laudanum put into a cup of the patient's drink, and given about half an 
hour after the commencement of the hot fit, promotes the sweat, shortens 
the fit, relieves the head, and tends greatly to remove the disease.

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

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

INTERMITTING fevers, under proper regimen, will often go off without 
medicine; and when the disease is mild, in an open dry country, there is 
seldom any danger from allowing it to take its course; but when the 
patient's strength seems to decline, or the paroxysms are so violent that 
his life is in danger, medicine ought immediately to be administered. This 
however should never be done till the disease be properly formed, that is 
to say, till the patient has had several fits of shaking and sweating.

MEDICINE. - The first thing to be done in the cure of an intermitting 
fever is to cleanse the stomach and bowels. This not only renders the 
application of other medicines more safe, but likewise more efficacious. 
In this disease, the stomach is generally loaded with cold viscid phlegm, 
and frequently great quantities of bile are discharged by vomit; which 
plainly points out the necessity of such evacuations. Vomits are therefore 
to be administered before the patient takes any other medicine. A dose of 
ipecacuanha will generally answer this purpose very well. A scruple or 
half a dram of the powder will be sufficient for an adult, and for a 
younger person the dose must be less in proportion. After the vomit begins 
to operate, the patient ought to drink plentifully of weak camomile-tea. 
The vomit should be taken two or three hours before the return of fit, and 
may be repeated at the distance of two or three days. Vomits not only 
cleanse the stomach, but increase the perspiration, and all the other 
secretions, which render them of such importance, that they often cure 
intermitting fevers without the assistance of any other medicine.

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

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

AFTER proper evacuations, the patient may safely use the Peruvian bark, 
which may be taken in any way that is most agreeable to him. No 
preparation of the bark seems to answer better than the most simple form 
in which it can be given, viz. in powder.

TWO ounces of the best Peruvian bark, finely powdered, may be divided into 
twenty-four doses. These may either be made into boluses, as they are 
used, with a little syrup of lemon, or mixed in a glass of red wine, a cup 
of camomile tea, water-gruel, or any other drink that is more agreeable to 
the patient. It has lately been observed, that the red bark is more 
powerful than that which has for some time been in common use. Its 
superior efficacy seems to arise from its being of a more perfect growth 
than the quill bark, and consequently more fully impregnated with the 
medical properties of the plant.

IN an ague which returns every day, one of the above doses may be taken 
every two hours during the interval of the fits. By this method the 
patient will be able to take five or six doses between each paroxysm. In a 
tertian, or third-day ague, it will be sufficient to take a dose every 
third hour during the interval, and in a quartan every fourth. If the 
patient cannot take so large a dose of the bark, he may divide each of the 
powders into two parts, and take one every hour, &c. For a young person, a 
smaller quantity of this medicine will be sufficient, and the dose must be 
adapted to the age, constitution, and violence of the symptoms. In 
intermitting fevers of an obstinate nature, I have found it necessary to 
throw in the bark much faster. Indeed the benefits arising from this 
medicine depend chiefly upon a large quantity of it being administered in 
a short time. Several ounces of bark given in a few days, will do more 
than as many pounds taken in the course of some weeks. When this medicine 
is intended either to stop a mortification, or cure an obstinate ague, it 
ought to be thrown in as fast as the stomach can possibly bear it. 
Inattention to this circumstance has hurt the reputation of one of the 
best medicines of which we are in possession.

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

AN ounce of gentian root, calamus aromaticus, and orange-peel, of each 
half an once, with three or four handfuls of camomile flowers, and an 
handful of coriander-seed, all bruised together in a mortar, may be used 
in form of infusion or tea. About half an handful of these ingredients may 
be put into a tea-pot, and an English pint of boiling water poured on 
them. A cup of this infusion drank three or four times a day will greatly 
promote the cure. Such patients as cannot drink the watery infusion, may 
put two handfuls of the same ingredients into a bottle of white wine, and 
take a glass of it twice or thrice a day. If patients drink freely of the 
above, or any other proper infusion of bitters, a smaller quantity of bark 
than is generally used will be sufficient to cure an ague. There is reason 
to believe, that sundry of our own plants or barks, which are very bitter 
and astringent, would succeed in the cure of intermittent fevers, 
especially when assisted by aromatics. But as the Peruvian bark has been 
long approved in the cure of this disease, and is now to be obtained at a 
very reasonable rate, it is of less importance to search after new 
medicines. We cannot however omit taking notice, that the Peruvian bark is 
very often adulterated, and that it requires considerable skill to 
distinguish between the genuine and the false. This ought to make people 
very cautious of whom they purchase it.

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

IN obstinate agues, the bark will be found much more efficacious when 
assisted by brandy, or other warm cordials, than taken alone. This I have 
had frequently occasion to observe in a country where intermittent fevers 
were endemical. The bark seldom succeeded unless assisted by snake-root, 
ginger, canella alba, or some other warm aromatic. When the fits are very 
frequent and violent, in which case the fever often approaches towards an 
inflammatory nature, it will be safer to keep out the aromatics, and to 
add salt of tartar in their stead. But in an obstinate tertian or quartan, 
in the end of autumn or beginning of winter, warm and cordial medicines 
are absolutely necessary. In obstinate agues, when the patient is old, the 
habit phelgmatic, the season rainy, the situation damp, or the like, it 
will be necessary to mix with two ounces of the bark, half an ounce of 
Virginian snake-root, and a quarter of an ounce of ginger, or some other 
warm aromatic; but when the symptoms are of an inflammatory nature, half 
an ounce of salt of wormwood or salt of tartar may be added to the above 
quantity of bark.

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

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

THOUGH nothing is more rational than the method of treating intermitting 
fevers, yet, by some strange infatuation, more charms and whimsical 
remedies are daily used for removing this than any other disease. There is 
hardly an old woman who is not in possession of a nostrum for stopping an 
ague; and it is amazing with what readiness their pretensions are 
believed. Those in distress eagerly grasp at any thing that promises 
sudden relief; but the shortest way is not always the best in the 
treatment of diseases. The only method to obtain a safe and lasting cure, 
is gradually to assist Nature in removing the cause of the disorder.

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

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

WHERE agues are endemical, even children are often afflicted with that 
disease. Such patients are very difficult to cure, as they can seldom be 
prevailed upon to take the bark, or any other disagreeable medicine. One 
method of rendering this medicine more palatable, is to make it into a 
mixture with distilled waters and syrup, and afterwards to give it an 
agreeable sharpness with the elixir or spirit of vitriol. This both 
improves the medicine, and takes off the nauseous taste. In cases where 
the bark cannot be administered, the saline mixture - See Appendix, Saline 
mixture. - may be given with advantage to children.

WINE-WHEY is very proper drink for a child in an ague; to half an English 
pint of which may be put a tea-spoonful of the spirit or hartshorn. 
Exercise is likewise of considerable service; and when the disease proves 
obstinate, the child ought, if possible, to be removed to a warm dry air. 
The food ought to be nourishing, and sometimes a little generous wine 
should be allowed.

TO children, and such as cannot swallow the bark, or when the stomach will 
not bear it, it may be given by clyster. Half an ounce of the extract of 
bark, dissolved in four ounces of warm water, with the addition of half an 
ounce of sweet oil, and six or eight drops of laudanum, is the form 
recommended by Dr. Lind for an adult, and this to be repeated every fourth 
hour, or oftener, as the occasion shall require. For children the quantity 
of extract and laudanum must be proportionally lessened. Children have 
been cured of agues by making them wear a waistcoat with powdered bark 
quilted between the folds of it; by bathing them frequently in a strong 
decoction of the bark, and by rubbing the spine with strong spirits, or 
with a mixture of equal parts of laudanum and the saponaceous liniment.

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

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

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