Domestic Medicine - Chapters 25-30



CHAPTER XXV.
OF THE ERYSIPELAS, OR ST. ANTHONY'S FIRE.

THIS disease, which in some parts of Britain is called the rose, attacks 
persons at any period of life, but is most common between the age of 
thirty and forty. Persons of a sanguine or plethoric habit are most liable 
to it. It often attacks young people, and pregnant women; and such as have 
once been afflicted with it are very liable to have it again. Sometimes it 
is a primary disease, and at other times only a symptom of some other 
malady. Every part of the body is liable to be attacked by an erysipelas, 
but it most frequently seizes the legs or face, especially the latter. It 
is most common in autumn, or when hot weather is succeeded by cold and wet.

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

CAUSES. - The erysipelas may be occasioned by violent passions or 
affections of the mind; as fear, anger, &c. When the body has been heated 
to a great degree, and is immediately exposed to the cold air, so that the 
perspiration is suddenly checked, an erysipelas will often ensue. It may 
also be occasioned by drinking to excess, by continuing too long in a warm 
bath or by any thing that overheats the blood. If any of the natural 
evacuations be obstructed, or in too small quantity, it may cause an 
erysipelas. The same effect will follow from the stoppage of artificial 
evacuations; as issues, setons, or the like.

SYMPTOMS.-The erysipelas attacks with shivering, thirst, loss of strength, 
pain in the head and back, heat, restlessness, and a quick pulse; to which 
may be added vomiting, and sometimes a delirium. On the second, third, or 
fourth day, the part swells, becomes red, and small pustules appear; at 
which time the fever generally abates.

WHEN the erysipelas seizes the foot, the parts contiguous swell, the skin 
shines; and, if the pain be violent, it will ascend to the leg, and will 
not bear to be touched.

WHEN it attacks the face, it swells, appears red, and the skin is covered 
with small pustules filled with clear water. One or both eyes are 
generally closed with the swelling; and there is a difficulty of 
breathing. If the mouth and nostrils be very dry, and the patient drowsy, 
there is reason to suspect an inflammation of the brain.

IF the erysipelas affects the breast, it swells and becomes exceedingly 
hard, with great pain, and is apt to suppurate. There is a violent pain in 
the arm-pit on the side affected, where an abscess is often formed.

IF in a day or two the swelling subsides, the heat and pain abate, the 
colour of the part turns yellow, and the cuticle breaks and falls off in 
scales, the danger is over.

WHEN the erysipelas is large, deep, and affects a very sensible part of 
the body, the danger is great. If the red colour changes into livid or 
black, it will end in a mortification. Sometimes the inflammation cannot 
be discussed, but comes to a suppuration, in which case fistulas, a 
gangrene, or mortification, often ensue.

SUCH as die of this disease are commonly carried off by the fever, which 
is attended with difficulty of breathing, and sometimes with a delirium 
and great drowsiness. They generally die about the seventh or eighth day.

REGIMEN. In the erysipelas, the patient must neither be kept too hot nor 
too cold, as either of these extremes will tend to make it retreat, which 
is always to be guarded against. When the disease is mild, it will be 
sufficient to keep the patient within doors, without confining him to his 
bed, and to promote the perspiration by diluting liquors, &c.

THE diet ought to be slender, and of a moderately cooling and moistening 
quality, as groat-gruel, panado, chicken or barley-broth, with cooling 
herbs and fruits, &c. avoiding flesh, fish, strong drink, spices, pickles, 
and all other things that may heat and inflame the blood; the drink may be 
a barley-water, an infusion of elder flowers, common whey, and such like.

BUT if the pulse be low and the spirits sunk, the patient must be 
supported with negus, and other things of a cordial nature. His food may 
be sago gruel with a little wine, and nourishing broths taken in small 
quantities, and often repeated. Great care however must be taken not to 
overheat him.

MEDICINE. - In this disease much mischief is often done by medicine, 
especially by external applications. People, when they see an 
inflammation, immediately think that something ought to be applied to it. 
This indeed is necessary in large phlegmons; but in an erysipelas the 
safer course is to apply nothing. Almost all ointments, salves, and 
plasters, being of a greasy nature, tend rather to obstruct and repel, 
than promote any discharge from the part. At the beginning of this 
disease, it is neither safe to promote a suppuration, nor to repel the 
matter too quickly.

THE erysipelas in many respects resembles the gout, and is to be treated 
with the greatest caution. Fine wool, or very soft flannel, are the safest 
applications to the part. These not only defend it from the external air, 
but likewise promote the perspiration; which has a great tendency to carry 
off the disease. In Scotland the common people generally apply a mealy 
cloth to the parts affected, which is far from being improper.

IT is common to bleed in the erysipelas; but this likewise requires 
caution. If however the fever be high, the pulse hard and strong, and the 
patient vigorous, it will be proper to bleed; but the quantity must be 
regulated by these circumstances, and the operation repeated as the 
symptoms may require. If the patient has been accustomed to strong 
liquors, and the disease attacks his head, bleeding is absolutely 
necessary.

BATHING the feet and legs frequently in lukewarm water, when the disease 
attacks the face or brain, has an excellent effect. It tends to make a 
derivation from the head, and seldom fails to relieve the patient. When 
bathing proves ineffectual, poultices, or sharp sinapisms may be applied 
to the soles of the feet for the same purpose.

IN cases where bleeding is requisite it is likewise necessary to keep the 
body open. This may be effected by emollient clysters, or small doses of 
nitre and rhubarb. Some indeed recommend very large doses of nitre in the 
erysipelas; but nitre seldom sits easy on the stomach when taken in large 
doses. It is however one of the best medicines when the fever and 
inflammation run high. Half a drachm of it, with four or five grains of 
rhubarb, may be taken in the patient's ordinary drink, four times a-day.

WHEN the erysipelas leaves the extremities, and seizes the head so as to 
occasion a delirium or stupor, it is absolutely necessary to open the 
body. If clysters and mild purgatives fail to have this effect, stronger 
ones must be given. Blistering-plasters must likewise be applied to the 
neck, or behind the ears, and sharp cataplasms laid to the soles of the 
feet.

WHEN the inflammation cannot be discussed, and the part has a tendency to 
ulcerate, it will then be proper to promote suppuration, which may be done 
by the application of ripening poultices with saffron, warm fomentations, 
and such like.

WHEN the black, livid, or bIue colour of the part shews a tendency to 
mortification, the Peruvian bark must be administered. It may be taken 
along with acids, as recommended in the small-pox, or in any other form 
more agreeable to the patient. It must not however be trifled with, as the 
patient's life is at stake. A drachm may be given every two hours, if the 
symptoms be threatening, and clothes dipped in warm camphorated spirits of 
wine, or the tincture of myrrh and aloes, may be applied to the part, and 
frequently renewed. It may likewise be proper in this case to apply 
poultices of the bark, or to foment the part affected with a strong 
decoction of it.

IN what is commonly caIled scorbutic erysipelas, which continues for a 
considerable time, it will only be necessary to give gentle laxatives, and 
such things as purify the blood, and promote the perspiration. Thus, after 
the inflammation has been checked by opening medicines, the decoction of 
woods may be drank, after which a course of bitters will be proper. See 
Appendix, Decoction of woods.

SUCH as are liable to frequent attacks of the erysipelas ought carefully 
to guard against all violent passions; to abstain from strong liquors, and 
all fat, viscid, and highly nourishing food. They should likewise take 
sufficient exercise, carefully avoiding the extremes of heat or cold. 
Their food should consist chiefly of milk, and such fruits, herbs and 
roots as are of a cooling quality; and their drink ought to be small-beer, 
whey, butter-milk, and such like. They should never suffer themselves to 
be long costive. If that cannot be prevented by suitable diet, it will be 
proper to take frequently a gentle dose of rhubarb, cream of tartar, the 
lenitive electuary, or some other purgative.



CHAPTER XXVI.
OF THE PHRENITIS OR INFLAMMATION OF THE BRAIN.

THIS is sometimes a primary disease, but oftener only a symptom of some 
other malady; as the inflammatory, eruptive, or spotted fever, &c. It is 
very common however as a primary disease in warm climates, and is most 
incident to persons about the prime or vigour of life. The passionate, the 
studious, and those whose nervous system is irritable in a high degree, 
are most liable to it.

CAUSES. - This disease is often occasioned by night-watching, especially 
when joined with hard study: It may likewise proceed from hard drinking, 
anger, grief, or anxiety. It is often occasioned by the stoppage of usual 
evacuations; as the bleeding piles in men, the customary discharges of 
women, &c. Such as imprudently expose themselves to the heat of the sun, 
especially by sleeping without doors in a hot season with their heads 
uncovered, are often suddenly seized with an inflammation of the brain, so 
as to awake quite delirious. When repellents are imprudently used in an 
erysipelas, an inflammation of the brain is sometimes the consequence. It 
may likewise be occasioned by external injuries, as blows or bruises upon 
the head, &c.

SYMPTOMS. - The symptoms which usually precede a true inflammation of the 
brain are pain of the head, redness of the eyes, a violent flushing of the 
the face, disturbed sleep or a total want of it, great dryness of the 
skin, costiveness, a retention of urine, a small dropping of blood from 
the nose, ringing of the ears, and extreme sensibility of the nervous 
system.

WHEN the inflammation is formed, the symptoms in general are similar to 
those of the inflammatory fever. The pulse indeed is often weak, 
irregular, and trembling; but sometimes it is hard and contracted. When 
the brain itself is inflamed, the pulse is always soft and low; but when 
the inflammation only affects the integuments of the brain, viz. the dura 
and pia matter, it is hard. A remarkable quickness of hearing is a common 
symptom of this disease; but that seldom continues long. Another usual 
symptom is a great throbbing or pulsation in the arteries of the neck and 
temples. Though the tongue is often black and dry, yet the patient seldom 
complains of thirst, and even refuses drink. The mind chiefly runs upon 
such objects as have before made a deep impression on it; and sometimes, 
from a sullen silence, the patient becomes all of a sudden quite 
outrageous.

A CONSTANT trembling, and starting of the tendons, is an unfavourable 
symptom, as are also a suppression of urine; a total want of sleep; a 
constant spitting; a grinding of the teeth, which last may be considered 
as a kind of convulsion. When a phrenitis succeeds an inflammation of the 
lungs, of the intestines, or of the throat, &c. it is owing to a 
translation of the disease from these parts to the brain, and generally 
proves fatal. This shews the necessity of proper evacuations, and the 
danger of repellents in all inflammatory diseases.

THE favourable symptoms are, a free perspiration, copious discharge of 
blood from the nose, the bleeding plies, a plentiful discharge of urine 
which lets fall a copious sediment. Sometimes the disease is carried off 
by a looseness and in women by an excessive flow of the menses.

AS this disease often proves fatal in a few days, it requires the most 
speedy applicatons. When it is prolonged, or improperly treated, it 
sometimes ends in madness, or a kind of stupidity which continues for life.

IN the cure, two things are chiefly to be attended to, viz. to lessen the 
quantity of blood in the brain, and to retard the circulation towards the 
head.

REGIMEN. - The patient ought to be kept very quiet. Company, noise, and 
every thing that affects the senses, or disturbs the imagination, 
increases the disease. Even too much light is hurtful; for which reason 
the patient's chamber ought to be a little darkened, and he should neither 
be kept too hot nor cold. It is not however necessary to exclude the 
company of an agreeable friend, as this has a tendency to sooth and quiet 
the mind. Neither ought the patient to be kept too much in the dark, lest 
it should occasion a gloomy melancholy, which is too often the consequence 
of this disease.

THE patient must, as far as possible, be soothed and humoured in every 
thing. Contradiction will ruffle his mind, and increase his malady. Even 
when he calls for things which are not to be obtained, or which might 
prove hurtful, he is not to be positively denied them, but rather put off 
with the promise of having them as they can be obtained, or by some other 
excuse. A little of any thing that the mind is set upon, though not quite 
proper, will hurt the patient less than a positive refusal. In a word, 
whatever he was fond of, or used to be delighted with when in health, may 
here be tried, as pleasing stories, soft music, or whatever has a tendency 
to sooth the passions, and compose the mind. Boerhaave proposes several 
mechanical experiments for this purpose; as the soft noise of water 
distilling by drops into a bason, and the patient trying to reckon them, 
&c. Any uniform sound, if low and continued, has a tendency to procure 
sleep, and consequently may be of service.

THE aliment ought to be light, consisting chiefly of farinaceous 
substances; as panado, and water-gruel sharpened with jelly of currants, 
or juice of lemons, ripe fruits roasted or boiled, jellies, preserves, &c. 
The drink small, diluting, and cooling; as whey, barley-water, or 
decoctions of barley and tamarinds, which latter not only render the 
liquor more palatable, but likewise more beneficial, as they are of an 
opening nature.

MEDICINES - In all inflammation of the brain, nothing more certainly 
relieves the patient than a free discharge of blood from the nose. When 
this comes of its own accord, it is by no means to be stopped, but rather 
promoted, by applying cloths dipped in warm water to the part. When 
bleeding at the nose does not happen spontaneously, it may be provoked, by 
putting a straw, or any other sharp body up the nostril.

BLEEDING in the temporal arteries greatly relieves the head; but as this 
operation cannot always be performed, we would recommend in its stead 
bleeding in the jugular veins. When the patient's pulse and spirits are so 
low, that he cannot bear bleeding with the lancet, leeches may be applied 
to the temples. These not only draw off the blood more gradually, but by 
being applied nearer to the part affected, generally give more immediate 
relief.

A DISCHARGE of blood from the haemorrhoidal veins is likewise of great 
service, and ought by all means to be promoted. if the patient has been 
subject to the bleeding piles, and that discharge has been stopped, every 
method must be tried to restore it; as the application of leeches to the 
parts, sitting over the steams of warm water, sharp clysters or 
suppositories made of honey, aloes, and rock-salt.

IF the inflammation of the brain be occasioned by the stoppage of 
evacuations either natural or artificial, as the menses, issues, setons, 
or such like, all means must be used to restore them as soon as possible, 
or to substitute others in their stead.

THE patient's body must be kept open by stimulating clysters or smart 
purges; and small quantities of nitre ought frequently to be mixed with 
his drink. Two or three drachms, or more, if the case be dangerous, may be 
used in the space of twenty-four hours.

THE head should be shaved and frequently rubbed with vinegar and rose-
water. Cloths dipped in this mixture may likewise be applied to the 
temples. The feet ought frequently to be bathed in lukewarm water, and 
soft poultices of bread and milk may be kept constantiy applied to them.

IF the disease proves obstinate, and does not yield to these medicines, it 
will be necessary to apply a blistering plaster to the whole head.



CHAPTER XXVII.
OF THE OPTHALMIA, OR, INFLAMMATION OF THE EYES.

THIS disease may be occasioned by external injuries; as blows, burns, 
bruises, and the like. It may likewise proceed from dust, quicklime, or 
other substances, getting into the eyes. It is often caused by the 
stoppage of customary evacuations; as the healing of old sores, drying up 
of issues, the suppressing of gentle morning sweats, or of sweating of the 
feet; &c. Long exposure to the night-air, especially in cold northerly 
winds, or whatever suddenly checks the perspiration, especially after the 
body has been much heated, is very apt to cause an inflammation of the 
eyes. Viewing snow or other white bodies for a long time, or looking 
stedfastly at the sun, a clear fire, or any bright object, will likewise 
occasion this malady. A sudden transition from darkness to very bright 
light will often have the same effect.

NOTHING more certainly occasions an inflammation of the eyes than night-
watching, especially reading or writing by candle-light. Drinking 
spirituous liquors, and excess of venery, are likewise very hurtful to the 
eyes. The acrid fumes of metals, and of several kinds of fuel, are also 
pernicious. Sometimes an inflammation of the eyes proceeds from a venereal 
taint, and often from a scrophulous or gouty habit. It may likewise be 
occasioned by hairs in the eye-lids turning inwards, and hurting the eyes. 
Sometimes the disease is epidemic, especially after wet seasons, and I 
have frequently known it prove infectious, particularly to those who lived 
in the same house with the patient. It may be occasioned by moist air, or 
living in low, damp houses, especially in persons who are not accustomed 
to such situations. In children it often proceeds from imprudently drying 
up of scabbed heads, a running behind the ears, or any other discharge of 
that kind. Inflammations of the eyes often succeed the small-pox or 
measles, especially in children of a scrophulous habit.

SYMPTOMS - An inflammation of the eyes is attended with acute pain, heat, 
redness, and swelling. The patient is not able to bear the light, and 
sometimes he feels a pricking pain, as if his eyes were pierced with a 
thorn. Sometimes he imagines his eyes are full of motes, or thinks he sees 
flies dancing before him. The eyes are filled with a scalding rheum, which 
rushes forth in great quantities, whenever the patient attempts to look 
up. The pulse is generally quick and hard, with some degree of fever. When 
the disease is violent, the neighbouring parts swell, and there is a 
throbbing or pulsation in the temporal arteries, &c.

A SLIGHT inflammation of the eyes, especially from an external cause, is 
easily cured; but when the disease is violent, and continues long, it 
often leaves specks upon the eyes, or dimness of sight, and some times 
total blindness.

IF the patient be seized with a looseness, it has a good effect; and when 
the inflammation passes from one eye to another, as it were by infection, 
it is no unfavourable symptom. But when the disease is accompanied with a 
violent pain of the head, and continues long, the patient is in danger of 
losing his sight.

REGIMEN. - The diet, unless in scrophulous cases, can hardly be too spare, 
especially at the beginning. The patient must abstain from every thing of 
a heating nature. His food should consist chiefly of mild vegetables, weak 
broths, and gruels. His drink may be barley-water, balm-tea, common whey, 
and such like.

THE patients chamber must be darkened, or his eyes shaded by a cover, so 
as to exclude the light, but not to press upon the eyes. He should not 
look at a candle, the fire, or any luminous object; and ought to avoid all 
smoke, as the fumes of tobacco, or any thing that may cause coughing, 
sneezing, or vomiting. He should be kept quiet, avoiding all violent 
efforts, either of body or mind, and encouraging sleep as much as possible.

MEDICINE. - This is one of those diseases wherein great hurt is often done 
by external applications. Almost every person pretends to be possessed of 
a remedy for the cure of sore eyes. These remedies generally consist of 
eye-waters, and ointments, with other external applications, which do 
mischief twenty times for once they do good. People ought therefore to be 
very cautious how they use such things, as even the pressure upon the eyes 
often increases the malady.

BLEEDING, in a violent inflammation of the eyes, is always necessary. This 
should be performed as near the part affected as possible. An adult may 
lose ten or twelve ounces of blood from the jugular vein, and the 
operation may be repeated according to the urgency of the symptoms. If it 
should not be convenient to bleed in the neck, the same quantity may be 
let from the arm, or any other part of the body.

LEECHES are often applied to the temples, or under the eyes, with good 
effect. The wounds must be suffered to bleed for some hours, and if the 
bleeding stop soon, it may be promoted by the application cloths dipt in 
warm water. In obstinate cases, It will be necessary to repeat this 
operation several times.

OPENING and diluting medicines are by no means to be neglected. The 
patient may take a small dose of Glauber's salts, and cream of tartar, 
every second or third day, or a decoction of tamarinds with senna. If 
these be not agreeable, gentle doses of rhubarb and nitre, a little of the 
lentitive electuary, or any other mild purgative, will answer the same 
end. The patient at the same time must drink freely of water-gruel, tea, 
whey, or any other diluting liquor. He ought likewise to take, at bed-
time, a large draught of very weak wine-whey, in order to promote 
perspiration. His feet and legs must frequently be bathed in luke-warm 
water, and his head shaved twice or thrice a-week, and afterwards washed 
in cold water. This has often a remarkable good effect.

IF the inflammation does not yield to these evacuations, blistering-
plasters must be applied to the temples, behind the ears, or upon the 
neck, and kept open for some time by the mild blistering ointment. I have 
seldom known these, if long enough kept open, fail to remove the most 
obstinate inflammation of the eyes; but, for this purpose, it is often 
necessary to continue the discharge for several weeks.

WHEN the disease has been of a long standing, I have seen very 
extraordinary effects from a seton in the neck, or betwixt the shoulders, 
especially the latter. It should be put upwards and downwards, or in the 
direction of the spine, and in the middle between the shoulder-blades. It 
may be dressed twice a-day with yellow basilicon. I have known patients, 
who had been blind for a considerable time, recover sight by means of a 
seton placed as above. When the seton is put across the neck, it soon 
wears out, and is both more painful and troublesome than between the 
shoulders; besides, it leaves a disagreeable mark, and does not discharge 
so freely.

WHEN the heat and pain of the eyes are very great, a poultice of bread and 
milk softened with sweet oil or fresh butter, may be applied to them, at 
least all night; and they may be bathed with lukewarm milk and water in 
the morning.

IF the patient cannot sleep, which is sometimes the case, he may take 
twenty or thirty drops of laudanum, or two spoonfuls of the syrup of 
poppies, over night, more or less according to his age, or the violence of 
the symptoms.

AFTER the inflammation is gone off, if the eyes still remain weak and 
tender, they may be bathed every night and morning with cold water and a 
little brandy, six parts of the former to one of the latter. A method 
should be contrived by which the eye can be quite immersed in the brandy 
and water, where it should be kept for some time. I have generally found 
this, or cold water and vinegar, as good a strengthener of the eyes as any 
of the most celebrated collyriums.

WHEN an inflammation of the eyes proceeds from a scrophulous habit, it 
generally proves very obstinate. In this case the patient's diet must not 
be too low, and he may be allowed to drink small negus, or now and then a 
glass of wine. The most proper medicine is the Peruvian bark, which may 
either be given in substance, or prepared in the following manner:

TAKE an ounce of bark in powder, with two drachms of Winter's's bark, and 
boil them in an English quart of water to a pint; when it has boiled 
nearly long enough, add half an ounce of liquorice-root sliced. Let the 
liquor be strained. Two, three, or four table-spoonfuls, according to the 
age of the patient, may be taken three or four times a-day. It is 
impossible to say how long this medicine should be continued, as the cure 
is sooner performed in some than in others; but in general it requires a 
considerable time to produce any lasting effects.

Dr. CHEYNE says, 'That Aethiops mineral never fails in obstinate 
inflammations of the eyes, even scrophulous ones, if given in a sufficient 
dose, and duly persisted in.' There is no doubt but this and other 
preparations of mercury may be of singular service in ophthalmias of long 
continuance, but they ought always to be administered with the greatest 
caution, or by persons of skill in physic.

IT will be proper frequently to look into the eyes, to see if any hairs be 
turned inwards, or pressing upon them. These ought to be removed by 
plucking them out with a pair of small pincers. Any foreign body lodged in 
the eye may be expeditously removed by passing a small hair pencil between 
the eye-lid and the ball of the eye. In some places, the peasants do this 
very effectually, by using their tongue in the same manner.

THOSE who are liable to frequent returns of this disease, ought constantly 
to have an issue in one or both arms. Bleeding or purging in the spring 
and autumn, will be very beneficial to such persons. They ought likewise 
to live with the greatest regularity, avoiding strong liquor, and every 
thing of a heating quality. Above all, let them avoid the night air and 
late studies. As most people are fond of using eye-waters and ointments in 
this and other diseases of the eyes, we have inserted some of the most 
approved forms of these medicines in the appendix. See Appendix, Eye-water 
and Eye-salve.



CHAPTER XXVIII.
OF THE QUINSEY, OR INFLAMMATION OF THE THROAT.

THIS disease is very common in Britain, and is frequently attended with 
great danger. It prevails in the winter and spring, and is most fatal to 
young people of a sanguine temperament.

CAUSES - In general it proceeds from the same causes as other inflammatory 
disorders, viz, an obstructed perspiration, or whatever heats or inflames 
the blood. An inflammation of the throat is often occasioned by omitting 
some parts of the covering usually worn about the neck, by drinking cold 
liquor when the body is warm, by riding or walking against a cold 
northerly wind, or any thing that greatly cools the throat, and parts 
adjacent. It may likewise proceed from the neglect of bleeding, purging, 
or any customary evacuation.

SINGING, speaking loud and long, or whatever strains the throat, may 
likewise cause an inflammation of that organ. I have often known the 
quinsey prove fatal to jovial companions, who, after sitting long in a 
warm room drinking hot liquors, and singing with vehemence, were so 
imprudent as to go abroad in the cold night-air. Sitting with wet feet, or 
keeping on wet cloths, are very apt to occasion this malady. It is 
likewise frequently occasioned by continuing long in a moist place, 
sitting near an open window, sleeping in a damp bed, sitting in a room 
that has been newly plastered, &c. I know people who never fail to have a 
sore throat if they sit even but a short time in a room that has been 
lately washed.

ACRID or irritating food may likewise inflame the throat, and occasion a 
quinsey. It may also proceed from bones, pins, or other sharp substances 
sticking in the throat, or from the caustic fumes of metals or minerals, 
as arsenic, antimony, &c. taken in by the breath. This disease is 
sometimes epidemic and infectious.

SYMPTOMS - The inflammation of the throat is evident from inspection, the 
parts appearing red and swelled; besides, the patient complains of pain in 
swallowing. His pulse is quick and hard, with other symptoms of a fever. 
If blood be let, it is generally covered with a tough coat of a whitish 
colour, and the patient spits a tough phlegm. As the swelling and 
inflammation increase, the breathing and swallowing become more difficult; 
the pain affects the ears; the eyes generally appear red; and the face 
swells. The patient is often obliged to keep himself in an erect posture, 
being in danger of suffocating; there is a constant nausea, or inclination 
to vomit, and the drink, instead of passing into the stomach, is often 
returned by the nose. The patient is frequently starved at last, merely 
from an inability to swallow any kind of food.

WHEN the breathing is laborious, with straitness of the breast, and 
anxiety, the danger is great. Though the pain in swallowing be very great, 
yet while the patient breathes easy, there is not so much danger. An 
external swelling is no unfavourable symptom; but if it suddenly falls, 
and the disease affects the breast, the danger is very great. When a 
quinsey is the consequence of some other disease, which has already 
weakened the patient, his situation is dangerous. A frothing at the mouth, 
with a swelled tongue, a pale, ghastly countenance, and coldness of the 
extremities, are fatal symptoms.

REGIMEN. - The regimen in this disease is in all respects the same as in 
the pleurisy, or peripneumony. The food must be light, and in small 
quantity, and the drink plentiful, weak, and diluting, mixed with acids.

IT is highly necessary that the patient be kept easy and quiet. Violent 
affections of the mind, or great efforts of the body, may prove fatal. He 
should not even attempt to speak but in a low voice. Such a degree of 
warmth as to promote a constant, gentle sweat, is proper. When the patient 
is in bed, his head ought to be raised a little higher than usual.

IT is peculiarly necessary that the neck be kept warm; for which purpose 
several folds of soft flannel may be wrapt round it. That alone will often 
remove a slight complaint of the throat, especially if applied in due 
time. We cannot here omit observing the propriety of a custom which 
prevails amongst the peasants of this country. When they feel any 
uneasiness of the throat, they wrap a stocking about it all night. So 
effectual is this remedy that in many places it passes for a charm, and 
the stocking is applied with particular ceremonies: The custom, however, 
is undoubtedly a good one, and should never be neglected. When the throat 
has been thus wrapt up all night it must not be exposed to the cold air 
through the day, but a handkerchief or a piece of flannel kept about it 
till the inflammation be removed.

THE jelly of black currants is a medicine very much in esteem for 
complaints of the throat; and indeed it is of some use. It should be 
almost constantly kept in the mouth, and swallowed down leisurely. It may 
likewise be mixed in the patient's drink, or taken any other way. When it 
cannot be obtained, the jelly of red currants, or of mulberries, may be 
used in its stead.

GARGLES for the throat are very beneficial. They may be made of sage-tea, 
with a little vinegar and honey, or by adding to half an English pint of 
the pectoral decoction two or three spoonfuls of honey, and the same 
quantity of currant jelly. This may be used three or four times a-day; and 
if the patient be troubled with tough viscid phlegm, the gargle may be 
rendered more sharp and cleansing, by adding to it a tea-spoonful of the 
spirit of sal ammoniac. Some recommend gargles made of a decoction of the 
leaves or bark of the blackberry bush; but where the jeIly can be had, 
these are unnecessary.

THERE is no disease wherein the benefit of bathing the feet and legs in 
lukewarm water is more apparent: That practice ought therefore never to be 
neglected. If people were careful to keep warm, to wrap up their throats 
with flannel, to bathe their feet and legs in warm water, and to use a 
spare diet, with diluting liquors, at the beginning of this disease, it 
would seldom proceed to a great height, or be attended with any danger; 
but when these precautions are neglected, and the disease becomes violent, 
more powerful medicines are necessary.

MEDICINE - An inflammation of the throat being a most accute and dangerous 
distemper, which sometimes takes off the patient very suddenly, it will be 
proper, as soon as the symptoms appear, to bleed in the arm, or rather in 
the jugular vein, and to repeat the operation if circumstances require.

THE body should likewise be kept gently open. This may either be done by 
giving the patient for his ordinary drink a decoction of figs and 
tamarinds, or small doses of rhubarb and nitre, as recommended in the 
erysipelas. These may be increased according to the age of the patient, 
and repeated till they have the desired effect.

I HAVE often known very good effects from a bit of sal prunel, or purified 
nitre, held in the mouth, and swallowed down as it melted. This promotes 
the discharge of saliva, by which means it answers the end of a gargle, 
while at the same time it abates the fever, by promoting the discharge of 
urine, &c.

THE throat ought likewise to be rubbed twice or thrice a day with a little 
of the volatile liniment. This seldom fails to produce some good effects. 
At the same time the neck ought to be carefully covered with wool or 
flannel, to prevent the cold from penetrating the skin, as this 
application renders it very tender. Many other external applications are 
reccommended in this disease, as a swallows nest, poultices made of the 
fungus called Jews ears, album Graecum, &c. But as we do not look upon any 
of these to be preferable to a common poultice of bread and milk, we shall 
take no farther notice of them.

SOME recommend the gum guaiacum as a specific in this disease. Half a dram 
of the gum in powder may be made into an electuary with the rob of 
elderberries, or the jelly of currants for a dose, and repeated 
occasionally

BLISTERING upon the neck or behind the ears in violent inflammations of 
the throat, is very beneficial; and in bad cases it will be necessary to 
lay a blistering-plaster quite across the throat, so as to reach from ear 
to ear. After the plasters are taken off, the parts ought to be kept 
running by the application of issue ointment, till the inflammation is 
gone; otherwise, upon their drying up, the patient will be in danger of a 
relapse.

WHEN the patient has been treated as above, a suppuration seldom happens. 
This however is sometimes the case in spite of all endeavours to prevent 
it. When the inflammation and swelling continue, and it is evident that a 
suppuration will ensue, it ought to be promoted by drawing the steam of 
warm water into the throat through a funnel, or the like. Soft poultices 
ought likewise to be applied outwardly, and the patient may keep a roasted 
fig constantly in his mouth.

IT sometimes happens, before the tumour breaks, that the swelling is so 
great, as entirely to prevent any thing from getting down into the 
stomach. In this case the patient must inevitably perish, unless he can be 
supported in some other way. This can only be done by nourishing clysters 
of broth, or gruel with milk, &c. Patients have often been supported by 
these for several days, till the tumour has broke; and afterwards they 
have recovered.

NOT only the swallowing, but the breathing, is often prevented by the 
tumour. In this case nothing can save the patient's life, but opening the 
trachea or wind-pipe. As that has been often done with success, no person, 
in such desperate circumstances, ought to hesitate a moment about the 
operation; but as it can only be performed by a surgeon, it is not 
necessary here to give any directions about it.

WHEN a difficulty of swallowing is not attended with an acute pain or 
inflammation, it is generally owing to an obstruction of the glands about 
the throat, and only requires that the part be kept warm, and the throat 
frequently gargled with something that may gently stimulate the glands, as 
a decoction of figs with vinegar and honey; to which may be added a little 
mustard, or a small quantity of spirits. But this gargle is never to be 
used where there are signs of an inflammation. This species of angina has 
various names among the common people, as the pap of the throat, the 
falling down of the almonds of the ears, &c. Accordingly, to remove it, 
they lift the patient up by the hair of the head, and thrust their fingers 
under the jaws, &c. all which practices are at best useless, and often 
hurtful.

THOSE who are subject to inflammations of the throat, in order to avoid 
that disease, ought to live temperate. Such as do not chuse to observe 
this rule, must have frequent recourse to purging and other evacuations, 
to discharge the superfluous humours. They ought likewise to beware of 
catching cold, and should abstain from aliment and medicines of an 
astringent or stimulating nature.

VIOLENT exercise, by increasing the motion and force of the blood, is apt 
to occasion an inflammation of the throat, especially if cold liquor be 
drank immediately after it, or the body suffered suddenly to cool. Those 
who would avoid this disease ought therefore, after speaking aloud, 
singing, running, drinking warm liquor, or doing any thing that may strain 
the throat, or increase the circulation of the blood towards it, to take 
care to cool gradually, and to wrap some additional coverings about their 
necks.

I HAVE often known persons who had been subject to sore throats, entirely 
freed from that complaint by only wearing a ribband, or a bit of flannel, 
constantly about their necks, or by wearing thicker shoes, a flannel 
waistcoat, or the like. These may seem trifling, but they have great 
effect. There is danger indeed in leaving them off after persons have been 
accustomed to them; but surely the inconveniency of using such things for 
life, is not to be compared with the danger that may attend the neglect of 
them.

SOMETIMES, after an inflammation, the glands of the throat continue 
swelled, and become hard and callous. This complaint is not easily 
removed, and is often rendered dangerous by the too frequent application 
of strong stimulating and styptic medicines. The best method is to keep it 
warm, and to gargle it twice a-day with a decoction of figs sharpened a 
little with the elixir or spirit of vitriol.


OF THE MALIGNANT QUINSEY, OR PUTRID, ULCEROUS SORE THROAT.

THIS kind of quinsey is but little known in the northern parts of Britain, 
though, for some time past, it has been very fatal in the more southern 
counties. Children are more liable to it than adults, females than males, 
and the delicate than those who are hardy and robust. It prevails chiefly 
in autumn, and is most frequent after a long course of damp, or sultry 
weather.

CAUSES - This is evidently a contagious distemper, and is generally 
communicated by infection. Whole families, and even entire villages, often 
receive the infection from one person. This ought to put people upon their 
guard against going near such patients as labour under the disorder; as by 
that means they endanger not only their own lives, but likewise those of 
their friends and connexions. Whatever tends to produce putrid or 
malignant fevers, may likewise occasion the putrid ulcerous sore throat, 
as unwholesome air, damaged provisions, neglect of cleanliness, &c.

SYMPTOMS - It begins with alternate fits of shivering and heat. The pulse 
is quick, but low and unequal, and generally continues so through the 
whole course of the disease. The patient complains greatly of weakness and 
oppression of the breast; his spirits are low and he is apt to faint away 
when set upright; he is troubled with a nausea, and often with a vomiting 
or purging. The two latter are most common in children. The eyes appear 
red and watery, and the face swells. The urine is at first pale and crude; 
but, as the disease advances, it turns more of a yellowish colour. The 
tongue is white, and generally moist, which distinguishes this from an 
inflammatory disease. Upon looking into the throat it appears swelled, and 
of a florid red colour. Pale or ash coloured spots, however, are here and 
there interspersed, and sometimes one broad patch or spot, of an irregular 
figure, and pale white colour, surrounded with florid red, only appears. 
These whitish spots or sloughs cover so many ulcers.

AN efflorescence, or eruption upon the neck, arms, breast, and fingers, 
about the second or third day, is a common symptom of this disease. When 
it appears, the purging and vomiting generally cease.

THERE is often a slight degree of delirium, and the face frequently 
appears bloated, and the inside of the nostrils red and inflamed. The 
patient complains of a disagreeable putrid smell, and his breath is very 
offensive.

THE putrid, ulcerous sore throat may be distinguished from the 
inflammatory by the vomiting and looseness with which it is generally 
ushered in; the foul ulcers in the throat covered with a white or livid 
coat; and by the excessive weakness of the patient; with other symptoms of 
a putrid fever.

UNFAVOURABLE symptoms are, an obstinate purging, extreme weakness, dimness 
of the sight, a livid or black colour of the spots, and frequent 
shiverings, with a weak, fluttering pulse. If the eruption upon the skin 
suddenly disppears, or becomes of a livid colour, with a discharge of 
blood from the nose or mouth, the danger is very great.

IF a gentle sweat break out about the third or fourth day, and continue 
with a slow firm and equal pulse; if the sloughs cast off in a kindly 
manner, and appear clean and florid at the bottom; and if the breathing is 
soft and free, with a lively colour of the eyes, there is reason to hope 
for a salutary crisis.

REGIMEN. - The patient must be kept quiet, and, for the most part, in bed, 
as he will be apt to faint when taken out of it. His food must be 
nourishing and restorative; as sago-gruel with red wine, jellies, strong 
broths, &c. His drink ought to be generous, and of an antiseptic quality; 
as red-wine negus, white-wine whey, and such like.

MEDICINE. - The medicine in this kind of quinsey is entirely different 
from that which is proper in the inflammatory. All evacuations, as 
bleeding, purging, &c. which weaken the patient, must be avoided. Cooling 
medicines, as nitre and cream of tartar, are likewise hurtful. 
Strengthening cordials alone can be used with safety; and these ought 
never to be neglected.

IF, at the beginning, there is a great a nausea, or inclination to vomit, 
the patient must drink an infusion of green tea, camomile flowers, or 
carduus benedictus, in order to cleanse the stomach. If these are not 
sufficient, he may take a few grains of the powder of ipecacuanha, or any 
other gentle vomit.

IF the disease is mild, the throat may be gargled with an infusion of sage 
and rose leaves, to a gill of which may be added a spoonful or two of 
honey, and as much vinegar as will make it agreeably acid; but when the 
symptoms are urgent, the sloughs large and thick, and the breath very 
offensive, the following gargle may be used:

TO six or seven ounces of the pectoral decoction, when boiling, add half 
an ounce of contrayerva-root; let it boil for some time, and afterwards 
strain the liquor; to which add two ounces of white-wine vinegar, an ounce 
of fine honey, and an ounce of the tincture of myrrh. This ought not only 
to be used as a gargle, but a little of it should frequently be injected 
with a syringe to clean the throat, before the patient takes any meat or 
drink. This method is peculiarly necessary for children, who cannot use a 
gargle.

IT will be of great benefit if the patient frequently receives into his 
mouth, through an inverted funnel, the steams of warm vinegar, myrrh, and 
honey.

BUT when the putrid symptoms run high, and the disease is attended with 
danger, the only medicine that can be depended upon is the Peruvian bark. 
It may be taken in substance, if the patient's stomach will bear it. If 
not, an ounce of bark grossly powdered, with two drachms of Virginian 
snake-root, may be boiled in an English pint and a half of water to half 
pint; to which a tea-spoonful of the elixir of vitriol may be added and an 
ordinary tea cupful of it taken every three or four hours. Blistering 
plasters are very beneficial in this disease, especially when the 
patient's pulse and spirits are low. They may be applied to the throat, 
behind the ears, or upon the back part of the neck.

SHOULD the vomiting prove troublesome, it will be proper to give the 
patient two table-spoonfuls of the saline julep every hour. Tea made of 
mint and a little cinnamon, will be very proper for his ordinary drink, 
especially if an equal quantity of red-wine be mixed with it.

IN case of a violent looseness, the size of a nutmeg of diascordium, or 
the japonic confection, may be taken two or three times a-day, or oftener 
if necessary.

IF a discharge of blood from the nose happens, the steams of warm vinegar 
may be received up the nostrils frequently; and the drink must be 
sharpened with spirits of vitriol, or tincture of roses.

IN case of a stranguary, the belly must be fomented with warm water, and 
emollient clysters given three or four times a-day.

AFTER the violence of the disease is over, the body should still be kept 
open with mild purgatives; as manna, senna, rhubarb, or the like.

IF great weakness and dejection of spirits, or night-sweats, with other 
symptoms of a consumption, should ensue, we would advise the patient to 
continue the use of the Peruvian bark, with the elixir of vitriol, and to 
take frequently a glass of generous wine. These, together with a milk-
diet, and riding on horseback, are the most likely means for recovering 
his strength.



CHAPTER XXIX.
OF COLDS AND COUGHS.

IT has already been observed, that colds are the effect of an obstructed 
perspiration; the common causes of which we have likewise endeavoured to 
point out, and shall not here repeat them. Neither shall we spend time in 
enumerating all the various symptoms of colds, as they are pretty 
generally known. It may not, however, be amiss to observe, that almost 
every cold is a kind of fever, which only differs in degree from some of 
those that have already been treated of.

NO age, sex, or constitution is exempted from this disease; neither is it 
in the power of any medicine or regimen to prevent it. The inhabitants of 
every climate are liable to catch cold, nor can even the greatest 
circumspection defend them at times from its attacks. Indeed, if the human 
body could be kept constantly in an uniform degree of warmth, such a thing 
as catching cold would be impossible. But as that cannot be effected by 
any means, the perspiration must be liable to many changes. Such changes, 
however, when small, do not affect the health; but, when great, they must 
prove hurtful.

WHEN oppression of the breast, a stuffing of the nose, unusual weariness, 
pain of the head, &c. give ground to believe that the perspiration is 
obstructed or, in other words, that the person has caught cold, he ought 
immediately to lessen his diet, at least the usual quantity of his solid 
food, and to abstain from all strong liquors. Instead of flesh-fish, eggs, 
milk, and other nourishing diet, he may eat light bread-pudding, veal or 
chicken broth, panado, gruels, and such like. His drink may be water-gruel 
sweetened with a little honey; an infusion of balm, or linseed sharpened 
with the juice of orange or lemon; a decoction of barley and liquorice 
with tamarinds, or any other cool, diluting, acid liquor.

ABOVE all, his supper should be light; as small posset, or water-gruel 
sweetened with honey, and a little toasted bread in it. If honey should 
disagree with the stomach, the gruel may be sweetened with treacle or 
coarse sugar, and sharpened with the jelly of currants. Those who have 
been accustomed to generous liquors may take wine-whey instead of gruel, 
which may be sweetened as above.

THE patient ought to lie longer than usual a-bed, and to encourage a 
gentle sweat, which is easily brought on towards morning, by drinking tea, 
or any kind of warm diluting liquor. I have often known this practice 
carry off a cold in one day, which in all probability, had it been 
neglected, would have cost the patient his life, or have confined him for 
some months. Would people sacrifice a little time to ease and warmth, and 
practise a moderate degree of abstinence when the first symptoms of a cold 
appear; we have reason to believe, that most of the bad effects, which 
flow from an obstructed perspiration, might be prevented. But, after the 
disease has gathered strength by delay, all attempts to remove it often 
prove vain. A pleurisy, a peripneumony, or a fatal consumption of the 
lungs, are the common effects of colds which have either been totally 
neglected or treated improperly.

MANY attempt to cure a cold by getting drunk. But this, to say no worse of 
it, is a very hazardous experiment. No doubt it may sometimes succeed, by 
suddenly restoring the perspiration, but when there is any degree of 
inflammation, which is frequently the case, strong liquors, instead of 
removing the malady, will increase it. By this means a common cold may be 
converted into an inflammatory fever.

WHEN those who labour for their daily bread have the misfortune to catch 
cold, they cannot afford to lose a day or two, in order to keep themselves 
warm, and take a little medicine; by which means the disorder is often so 
aggravated as to confine them for a long time, or even to render them ever 
after unable to sustain hard labour. But even such of the labouring poor 
as can afford to take care of themselves, are often too hardy to do it; 
they affect to despise colds, and as long as they can crawl about, scorn 
to be confined by what they call a common cold. Hence it is, that colds 
destroy such numbers of mankind. Like an enemy despised, they gather 
strength from delay, till, at length, they become invincible. We often see 
this verified in travellers, who, rather than lose a day in the 
prosecution of their business, throw away their lives by pursuing their 
journey, even in the severest weather, with this disease upon them.

IT is certain, however, that colds may be too much indulged. When a 
person, for every slight cold, shuts himself up in a warm room, and drinks 
quantities of warm liquor, it may occasion a general relaxation of the 
solids as will not be easily removed. It will therefore be proper, when 
the disease will permit, and the weather is mild, to join to the regimen 
mentioned above gentle exercise; as walking, riding on horseback, or in a 
carriage, &c. An obstinate cold, which no medicine can remove, will yield 
to gentle exercise and a proper regimen of the diet.

BATHING the feet and legs in warm water has a great tendency to restore 
the perspiration. But care must be taken that the water be not too warm, 
otherwise it will do hurt. It should never be much warmer than the blood, 
and the patient should go immediately to bed after using it. Bathing the 
feet in warm water, lying in bed, and drinking warm water-gruel, or other 
weak liquors, will sooner take off a spasm, and restore the perspiration, 
than all the hot sudorific medicines in the world. This is all that is 
necessary for removing a common cold; and if this course be taken at the 
beginning, it will seldom fail.

BUT when the symptoms do not yield to abstinence, warmth, and diluting 
liquors, there is reason to fear the approach of some other disease, as an 
inflammation of the breast, an ardent fever, or the like. If the pulse 
therefore be hard and frequent, the skin hot and dry, and the patient 
complains of his head or breast, it will be necessary to bleed, and to 
give the cooling powders recommended in the scarlet fever, every three or 
four hours, till they give a stool.

IT will likewise be proper to put a blistering plaster on the back, to 
give two table-spoonfuls of the saline mixture every two hours, and, in 
short, to treat the patient in all respects as for a slight fever. I have 
often seen this course, when observed at the beginning, remove the 
complaint in three days, when the patient had all the symptoms of an 
approaching ardent fever, or an inflammation of the breast.

THE chief secret of preventing colds lies in avoiding, as far as possible, 
all extremes either of heat or cold, and in taking care, when the body is 
heated, to let it cool gradually. These and other circumstances relating 
to this important subject, are so fully treated of under the Obstructed 
Perspiration, that it is needless here to resume the consideration of them.


OF A COMMON COUGH

A COUGH is generally the effect of a cold, which has either been 
improperly treated, or entirely neglected. When it proves obstinate, there 
is always reason to fear the consequences, as this shews a weak state of 
the lungs, and is often the forerunner of a consumption.

IF the cough be violent, and the patient young and strong, with a hard 
quick pulse, bleeding will be proper, but in weak and relaxed habits, 
bleeding rather prolongs the disease. When the patient spits freely, 
bIeeding is unnecessary, and sometimes hurtful, as it tends to lessen that 
discharge.

WHEN the cough is not attended with any degree of fever, and the spittle 
is viscid and tough, sharp pectoral medicines are to be administered; as 
gum ammoniac, squills, &c. Two table-spoonfuls of the solution of gum 
ammoniac may be taken three or four times a-day, more or less, according 
to the age and constitution of the patient. Squills may be given various 
ways; two ounces of the vinegar, the oxymel, or the syrup, may be mixed 
with the same quantity of simple cinnamon-water and an ounce of balsamic 
syrup. Two table-spoonfuls of this mixture may be taken three or four 
times a-day.

A SYRUP made of equal parts of lemon-juice, honey, and sugar-candy, is 
likewise very proper in this kind of cough. A table-spoonful of it may be 
taken at pleasure.

BUT when the defluxion is sharp and thin, these medicines rather do hurt. 
In this case gentle opiates, oils, and mucilages, are more proper. A cup 
of an infusion of wild poppy-leaves and marsh-mallow roots, or the flowers 
of colts-foot, may be taken frequently; or a tea-spoonful of the paregoric 
elixir may be put into the patient's drink twice a-day. Fuller's Spanish 
infusion is also a very proper medicine in this case, and may be taken in 
the quantity of a cupful three or four times a-day. See Appendix, Spanish 
Infusion.

WHEN a cough is occasioned by acrid humours tickling the throat and 
fauces, the patient should keep some soft pectoral lozenges almost 
constantly in his mouth; as the Pontefract liquorice cakes, barley-sugar, 
the common balsamic lozenges, Spanish juice, &c. These blunt the acrimony 
of the humours, and by taking off their stimulating quality, help to 
appease the cough. In a former edition of this book I recommended, for an 
obstinate tickling cough, an oily emulsion, made with the paregoric elixir 
of the Edinburgh Dispensatory, instead of the common alkaline spirit. I 
have since been told by several practitioners, that they found it to be an 
excellent medicine in this disorder, and every way deserving of the 
character which I had given it. Where this elixir is not kept, its place 
may be supplied by adding to the common oily emulsion, an adequate 
proportion of the Thebaic tincture, or liquid laudanum.

IN obstinate coughs, proceeding from a flux of humours upon the lungs, it 
will often be necessary, besides expectorating medicines, to have recourse 
to issues, setons, or some other drain. In this case I have often observed 
the most happy effects from a Burgundy-pitch plaster applied between the 
shoulders. I have ordered this simple remedy in the most obstinate coughs, 
in a great number of cases, and in many different constitutions, without 
ever knowing it fail to give relief, unless where there were evident signs 
of an ulcer in the lungs.

ABOUT the bulk of a nutmeg of Burgundy-pitch may be spread thin upon a 
piece of soft leather, about the size of the hand, and laid between the 
shoulder-blades. It may be taken off and wiped every three or four days, 
and ought to be renewed once a fortnight or three weeks. This is indeed a 
cheap and simple medicine, and consequently apt to be despised; but we 
will venture to affirm, that the whole materia medica does not afford an 
application more efficacious in almost every kind of cough. It has not 
indeed, always an immediate effect; but, if kept on for some time, it will 
succeed where most other medicines fail.

THE only inconveniency attending this plaster is the itching which it 
occasions; but surely this may be dispensed with, considering the 
advantage which the patient may expect to reap from the application; 
besides, when the itching becomes very uneasy, the plaster may be taken 
off, and the part rubbed with a dry cloth, or washed with a little warm 
milk and water. Some caution indeed is necessary in discontinuing the use 
of such a plaster; this however may be safely done by making it smaller by 
degrees, and at length quitting it altogether in a warm season. Some 
complain that the pitch plaster adheres too fast, while others find 
difficulty in keeping it on. This proceeds from the different kinds of 
pitch made use of, and likewise from the manner of making it. I generally 
find it answer best when mixed with a little bees-wax, and spread as cool 
as possible. The clear, hard, transparent pitch answers the purpose best.

BUT coughs proceed from many other causes besides defluxions upon the 
lungs. In these cases the cure is not to be attempted by pectoral 
medicines. Thus, in a cough, proceeding from a foulness and debility of 
the stomach, syrup, oils, mucilages, and all kinds of balsamic medicines 
do hurt. The stomach cough may be known from one that is owing to a fault 
in the lungs by this, that in the latter the patient coughs whenever he 
inspires, or draws in his breath fully; but in the former that does not 
happen.

THE cure of this cough depends chiefly upon cleansing and strengthening 
the stomach; for which purpose gentle vomits and bitter purgatives are 
most proper. Thus, after a vomit or two, the sacred tincture, as it is 
called, may be taken for a considerable time in the dose of one or two 
table-spoonfuls twice a-day, or as often as it is found necessary, to keep 
the body gently open. People may make this tincture themselves by infusing 
an ounce of hiera picra in an English pint of white-wine, letting it stand 
a few days, and then straining it. See Appendix, Hiera Picra.

IN coughs which proceed from a debility of the stomach, the Peruvian bark 
is likewise of considerable service. It may either be chewed, taken in 
powder, or made into a tincture along with other stomachic bitters.

A NERVOUS cough may only be removed by change of air, and proper exercise; 
to which may be added the use of gentle opiates. Instead of the 
saponacious pill, the paregoric elixir, &c. which are only opium 
disguised, ten, fifteen, twenty, or twenty-five drops of liquid laudanum, 
more or less, as circumstances require, may be taken at bed-time, or when 
the cough is most troublesome. Immersing the feet and hands in warm water 
will often appease the violence of a nervous cough.

WHEN a cough is only the symptom of some other malady, it is in vain to 
attempt to remove it without first curing the disease from which it 
proceeds. Thus when a cough is occasioned by teething, keeping the body 
open, scarifying the gums, or whatever facilitates the cutting of the 
teeth, likewise appeases the cough. In like manner, when worms occasion a 
cough, such medicines as remove these vermin will generally cure the 
cough; as bitter purgatives, oily clysters, and the like.

WOMEN, during the last months of pregnancy, are often greatly afflicted 
with a cough, which is generally relieved by bleeding, and keeping the 
body open. They ought to avoid all flatulent food, and to wear a loose 
easy dress.

A COUGH is not only a symptom, but is often likewise the forerunner of 
diseases. Thus, the gout is frequently ushered in by a very troublesome 
cough, which affects the patient for some days before the coming on of the 
fit. This cough is generally removed by a paroxysm of the gout, which 
should therefore be promoted, by keeping the extremities warm, drinking 
warm liquors, and bathing the feet and legs frequently in lukewarm water.


OF THE HOOPING COUGH, OR CHIN-COUGH.

THIS cough seldom affects adults, but proves often fatal to children. Such 
children as live upon thin watery diet, who breathe unwholesome air, and 
have too little exercise are most liable to this disease, and generally 
suffer most from it.

THE chin-cough is so well known, even to nurses, that a description of it 
is unnecessary. Whatever hurts the digestion, obstructs the perspiration, 
or relaxes the solids, disposes to this disease: Consequently its cure 
must depend upon cleansing and strengthening the stomach, bracing the 
solids, and, at the same time, promoting perspiration, and the different 
secretions.

THE diet must be light, and of easy digestion; for children, good bread 
made into pap or pudding, chicken-broth, with other light spoon-meats, are 
proper; but those who are farther advanced may be allowed sago gruel, and 
if the fever be not high, a little boiled chicken, or other white meats. 
The drink may be hyssop, or penny-royal tea, sweetened with honey or sugar-
candy, small wine-whey; or, if the patient be weak, he may sometimes be 
allowed a little negus.

ONE of the most effectual remedies in the chin-cough is change of air. 
This often removes the malady, even when the change seems to be from a 
purer to a less wholesome air. This may in some measure depend on the 
patient's being removed from the place where the infection prevails. Most 
of the diseases of children are infectious; nor is it at all uncommon to 
find the chin-cough prevailing in one town or village, when another, at a 
very small distance, is quite free from it. But whatever be the cause, we 
are sure of the fact. No time ought therefore to be lost in removing the 
patient at some distance from the place where he caught the disease, and, 
if possible, into a more pure and warm air. Some think the air ought not 
to be changed till the disease is on the decline; but there seems to be no 
sufficient reason for this opinion, as patients have been known to reap 
benefit from a change of air at all periods of the disease. It is not 
sufficient to take the patient out daily in a carriage. This seldom 
answers any good purpose; but often does hurt, by giving him cold.

WHEN the disease proves violent, and the patient is in danger of being 
suffocated by the cough, he ought to be bled, especially if there be a 
fever with a hard full pulse. But as the chief intention of bleeding is to 
prevent an inflammation of the lungs, and to render it more safe to give 
vomits, it will seldom be necessary to repeat the operation; yet if there 
be symptoms of an inflammation of the lungs, a second, or even a third 
bleeding may be requisite.

IT is generally reckoned a favourable symptom when a fit of coughing makes 
the patient vomit. This cleanses the stomach, and greatly relieves the 
cough. It will therefore be proper to promote this discharge, either by 
small doses of ipecacuanha, or the vomiting julep recommended in the 
Appendix. See Appendix, Vomiting Julep.

IT is very difficult to make children drink after a vomit. I have often 
seen them happily deceived, by infusing a scruple or half a drachm of the 
powder of ipecacuanha in a tea-pot, with half an English pint of boiling 
water. If this be disguised with a few drops of milk and a little sugar, 
they will imagine it tea, and drink it very greedily. A small tea-cupful 
of this may be given every quarter of an hour, or rather every ten 
minutes, till it operates. When the child begins to puke, there will be no 
occasion for drinking any more, as the water already on the stomach will 
be sufficient.

VOMITS not only cleanse the stomach, which in this disease is generally 
loaded with viscid phlegm, but they likewise promote the perspiration and 
other secretions; and ought therefore to be repeated according to the 
obstinacy of the disease. They should not however be strong; gentle vomits 
frequently repeated are both less dangerous, and more beneficial than 
strong ones.

THE body ought to be kept gently open. The best medicines for this purpose 
are rhubarb and its preparations, as the syrup, tincture, &c. Of these a 
tea-spoonful or two may be given to an infant twice or thrice a-day, as 
there is occasion. To such as are farther advanced, the dose must be 
proportionally increased, and repeated till it has the desired effect. 
Those who cannot be brought to take the bitter tincture, may have an 
infusion of senna and prunes, sweetened with manna, coarse sugar, or 
honey, or a few grains of rhubarb mixed with a tea-spoonful or two of 
syrup, or currant jelly, so as to disguise the taste. Most children are 
fond of syrups and jellies, and seldom refuse even a disagreeable medicine 
when mixed with them.

MANY people believe that oily, pectoral and balsamic medicines possess 
wonderful virtues for the cure of the chin-cough,and accordingly exhibit 
them plentifully to patients of every age and constitution, without 
considering that every thing of this nature must load the stomach, hurt 
the digestion, and of course aggravate the disorder. Dr. DUPLANIL says, he 
has seen many good effects from the kermes mineral in this complaint, the 
cough being frequently alleviated even by the first dose. The dose for a 
child of one year old, is a quarter of a grain dissolved in a cup of any 
liquid, repeated two or three times a-day. For a child of two years the 
dose is half a grain; and the quantity must be thus increased in 
proportion to the age of the patient.

THE millepedes, or woodlice, are greatly recommended for the cure of a 
chin-cough. Those who chuse to make use of these insects, may infuse two 
ounces of them bruised in an English pint of small white-wine for one 
night. Afterwards the liquor may be strained through a cloth, and a table-
spoonful of it given to the patient three or four times a-day.

OPIATES are sometimes necessary to allay the violence of the cough. For 
this purpose a little of the syrup of popies, or five, six or seven drops 
of laudanum, according to the age of the patient, may be taken in a cup of 
hyssop or penny-royal tea, and repeated occasionally. Some recommend the 
extract of hemlock as an extraordinary remedy in the hooping cough; but so 
far as I have I been able to observe, it is in no way superior to opium, 
which, when administered, will often relieve some of the most troublesome 
symptoms of this disorder.

THE garlic ointment is a well known remedy in North Britain for the chin-
cough. It is made by beating in a mortar garlic with an equal quantity of 
hogs lard. With this the soles of the feet may be rubbed twice or thrice a-
day; but the best method is to spread it upon it rag, and apply it in the 
form of plaster. It should be renewed every night and morning at least, as 
the garlic soon loses its virtue. This is an exceeding good medicine both 
in the chin-cough, and in most other coughs of an obstinate nature. It 
ought not however to be used when the patient is very hot or feverish, 
lest it should increase these symptoms.

THE feet should be bathed once every two or three days in lukewarm water; 
and a Burgundy-pitch plaster kept constantly betwixt the shoulders. But 
when the disease proves very violent, it will be necessary, instead of it, 
to apply a blistering plaster, and to keep the part open for some time 
with issue-ointment.

WHEN the disease is prolonged, and the patient is free from a fever, the 
Peruvian bark, and other bitters, are the most proper medicines. The bark 
may either be taken in substance, or in a decoction or infusion, as is 
most agreeable. For a child, ten, fifteen, or twenty grains, according to 
the age of the patient, may be given three or four times a-day. For an 
adult, half a drachm or two scruples will be proper. Some give the extract 
of the bark with cantharides; but to manage this requires a considerable 
attention. It is more safe to give a few grains of castor along with the 
bark. A child of six or seven years of age may take seven or eight grains 
of castor, with fifteen grains of powdered bark, for a dose. This may be 
made into a mixture with two or three ounces of any simple distilled 
water, and a little syrup, and taken three or four times a-day.



CHAPTER XXX.
INFLAMMATION OF THE STOMACH, AND OTHER VISCERA.

ALL inflammations of the bowels are dangerous, and require the most speedy 
assistance; as they frequently end in a suppuration, and sometimes in a 
mortification, which is certain death.

CAUSES. - An inflammation of the stomach may proceed from any of the 
causes which produce an inflammatory fever; as cold liquor drank while the 
body is warm, obstructed perspiration, or the sudden striking in of any 
eruption. It may likewise proceed from the acrimony of the bile, or from 
acrid and stimulating substances taken into the stomach; as strong vomits 
or purges, corrosive poisons, and such like.

WHEN the gout has been repelled from the extremities, either by cold or 
improper applications, it often occasions an inflammation of the stomach. 
Hard or indigestible substances taken into the stomach, as bones, the 
stones of fruit, &c. may likewise have that effect.

SYMPTOMS - It is attended with a fixed and burning heat in the stomach; 
great restlessness and anxiety; a small, quick, and hard pulse; vomiting, 
or at at least, a nausea and sickness; excessive thirst; coldness of the 
extremities, difficulty of breathing; cold clammy sweats; and sometimes 
convulsions and fainting fits. The stomach is swelled and often feels hard 
to the touch. One of the most certain signs of this disease is the sense 
of pain, which the patient feels upon taking any kind of food or drink, 
especially if it be either too hot or too cold.

WHEN the patient vomits every thing he eats or drinks, is extremely 
restless, has a hiccup, with an intermitting pulse, and frequent fainting 
fits, the danger is very great.

REGIMEN. - All acrimonious, heating, and irritating food and drink are 
carefully to be avoided. The weakness of the patient may deceive the by-
standers, and induce them to give him wines, spirits, or other cordials; 
but these never fail to increase the disease, and often occasion sudden 
death. The inclination to vomit may likewise impose on the attendants, and 
make them think a vomit necessary, but that too is almost certain death.

THE food must be given in small quantities, and should neither be quite 
cold, nor too hot. Thin gruel made of barley or oatmeal, light toasted 
bread dissolved in boiling water, or very weak chicken broth, are the most 
proper. The drink should be clear whey, barley-water, water in which 
toasted bread has been boiled, or decoctions of emollient vegetables; as 
liquorice and marsh-mallow roots, sarsaparilla, &c.

MEDICINE. - Bleeding in this disease is absolutely necessary, and is 
almost the only thing that can be depended on. When the disease proves 
obstinate, it will often be proper to repeat this operation several times, 
nor must the low state of the pulse deter us from doing so. The pulse 
indeed generally rises upon bleeding, and as long as that is the case, the 
operation is safe.

FREQUENT fomentations with lukewarm water, or a decoction of emollient 
vegetables, are likewise beneficial. Flannel cloths dipped in these must 
be applied to the region of the stomach, and removed as they grow cool. 
They must neither be applied too warm, nor be suffered to continue till 
they become quite cold, as either of these extremities would aggravate the 
disease.

THE feet and legs ought likewise to be frequently bathed in lukewarm 
water, and warm bricks or poultices may be applied to the soles of the 
feet. The warm bath, if it can be conveniently used, will be of great 
service.

IN this, and all other inflammations of the bowels, an epispastic, or 
blistering-plaster, applied over the part affected, is one of the best 
remedies I know. I have often used it, and do not recollect one instance 
wherein it did not give relief to the patient.

THE only internal medicines which we shall venture to recommend in this 
disease, are mild clysters. These may be made of warm water, or thin water-
gruel; and if the patient is costive, a little sweet oil, honey, or manna, 
may be added. Clysters answer the purpose of an internal fomentation, 
while they keep the body open, and at the same time nourish the patient, 
who is often, in this disease, unable to retain any food upon his stomach. 
For these reasons they must not be neglected, as the patient's life may 
depend on them.


INFLAMMATION OF THE INTESTINES.

THIS is one of the most painful and dangerous diseases that mankind is 
liable to. It generally proceeds from the same causes as the inflammation 
of the stomach; to which may be added costiveness, worms, eating unripe 
fruits, or great quantities of nuts, drinking hard windy malt liquors, as 
stale bottled beer or ale, sour wine, cyder, &c. it may likewise be 
occasioned by a rupture, by scirrhous tumours of the intestines, or by 
their opposite sides growing together.

THE inflammation of the intestines is denominated Iliac passion, 
Enteritis, &c. according to the name of the parts affected. The treatment 
however is nearly the same whatever part of the intestinal canal be the 
seat of the disease; we shall therefore omit these distinctions, lest they 
should perplex the reader.

THE symptoms here are nearly the same as in the foregoing disease; only 
the pain, if posslble, is more acute, and is situated lower. The vomiting 
is likewise more violent, and sometimes even the excrements, together with 
the clysters and suppositories, are discharged by the mouth. The patient 
is continually belching up wind, and has often an obstruction of his urine.

WHILE the pain shifts and the vomiting only returns at certain intervals, 
and while the clysters pass downwards, there is ground to hope; but when 
the clysters and faeces are vomited, and the patient is exceeding weak, 
with a low fluttering pulse, a pale countenance, and a disagreeable or 
stinking breath, there is great reason to fear that the consequences will 
prove fatal. Clammy sweats, black foetid stools, with a small intermitting 
pulse, and a total cessation of pain, are signs of a mortification already 
begun, and of approaching death.

REGIMEN. - The regimen in this disease is in general the same as in an 
inflammation of the stomach.The patient must be kept quiet, avoiding cold, 
and all violent passions of the mind. His food ought to be very light, and 
given in small quantities; his drink weak and diluting; as clear whey, 
barley-water, and such like.

MEDICINE. - Bleeding in this, as well as in the inflammation of the 
stomach, is of the greatest importance. It should be performed as soon as 
the symptoms appear, and repeated according to the strength of the 
patient, and the violence of the disease.

A BLISTERING plaster is here likewise to be applied immediateIy over the 
part where the most violent pain is. This not only relieves pain of the 
bowels, but even clysters and purgative medicines, which before had no 
effect, will operate when the blister begins to rise.

FOMENTATIONS and laxative clysters are by no means to be omitted. The 
patient's feet and legs should frequently be bathed in warm water; and 
cloths dipped in it applied to his belly. Bladders filled with warm water 
may likewise be applied to the region of the navel, and warm bricks, or 
bottles filled with warm water, to the soles of the feet. The clysters may 
be made of barley-water or thin gruel with salt, and softened with sweet 
oil or fresh butter. These may be administered every two or three hours, 
or oftener, if the patient continues costive.

IF the disease does not yield to clysters and fomentations, recourse must 
be had to pretty strong purgatives; but as these, by irritating the 
bowels, often increase their contraction, and by that means frustrate 
their own intention, it will be necessary to join them with opiates, 
which, by allaying the pain, and relaxing the spasmodic contractions of 
the guts, greatly assist the operation of purgatives in this case.

WHAT answers the purpose of opening the body very well, is a solution of 
the bitter purging salts. Two ounces of these may be dissolved in an 
English pint of warm water, or thin gruel, and a tea-cupful of it taken 
every half-hour till it operates. At the same time fifteen, twenty, or 
twenty-five drops of luadanum may be given in a glass of pepper-mint or 
simple cinnamon-water, to appease the irritation, and prevent the 
vomiting, &c.

ACIDS have often a very happy effect in staying the vomiting, and 
appeasing the other violent symptoms of this disease. It will therefore be 
of use to sharpen the patient's drink with cream of tartar, juice of 
lemon; or, when these cannot obtained, with vinegar.

BUT it often happens no liquid whatever will stay on the stomach. In this 
case the patient must take purging pills. I have generally found the 
following answer very well: Take jalap in powder, and vitriolated tartar, 
of each haIf a drachm, opium one grain, Castile soap as much as will make 
the the mass fit for pills. These must be taken at one dose, and if they 
do not operate in a few hours, the dose may be repeated.

IF a stool cannot be procured by any of the above means, It will be 
necessary to immerse the patient in warm water up to the breast. I have 
often seen this succeed when other means had been tried in vain. The 
patient must continue in the water as long as he can easily bear it 
without fainting, and if one immersion has not the desired effect, it may 
be repeated as soon as the patient's strength and spirits are recruited. 
It is more safe for him to go frequently into the bath than to continue 
too long at a time; and it is often necessary to repeat it several times 
before it has the desired effect.

IT has sometimes happened, after all other means of procuring a stool had 
been tried to no purpose, that this was brought about by immersing the 
patient's lower extremities in cold water, or making him walk upon a wet 
pavement, and dashing his legs and thighs with the cold water. This 
method, when others fail, at least merits a trial. It is indeed attended 
with some danger; but a doubtful remedy is better than none.

IN desperate cases it is common to give quicksilver. This may be given to 
the quantity of several ounces, or even a pound, but should not exceed 
that. When quicksilver is given in too large quantities, it defeats its 
own intention, as it pulls down the bottom of the stomach, which prevents 
it getting ever in the Pylorus. In this case the patient should be hung up 
by the heels, in order that the quicksilver may be discharged by his 
mouth. When there is reason to suspect a mortification of the guts, this 
medicine ought not to be tried. In that case it cannot cure the patient, 
and will only hasten his death. But when the obstruction is occasioned by 
any cause that can be removed by force, quicksilver is not only a proper 
medicine, but the best that can be adininistered, as it is the fittest 
body we know for making its way through the intestinal canal.

IF the disease proceed from a rupture, the patient must be laid with his 
head very low, and the intestines returned by gentle pressure with the 
hand. If this, with fomentations and clysters, should not succeed, 
recourse must be had to a surgical operation, which may give the patient 
relief.

SUCH as would avoid this excruciating and dangerous disease must take care 
never to be too long without a stool. Some who have died of it have had 
several pounds of hard, dry faeces taken out of their guts.

They should likewise beware of eating too freely of sour or unripe fruits, 
or drinking stale windy liquors, &c. I have known it brought on by living 
too much on baked fruits, which are seldom good. It likewise proceeds 
frequently from cold caught by wet clothes, &c. but especially from wet 
feet.


OF THE COLIC.

THE colic has a great resemblance to the two preceeding diseases, both in 
its symptoms and method of cure. It is generally attended with costiveness 
and accute pain of the bowels; and requires diluting diet, evacuations, 
fomentations, &c.

COLICS are variously denominated according to their causes, as the 
flatulent, the bilious, the hysteric, the nervous, &c. As each of these 
requires a particular method of treatment, we shall point out their most 
general symptoms, and the means to be used for their relief.

THE flatulent, or wind-colic, is generally occasioned by an indiscreet use 
of unripe fruits, meats of hard digestion, windy vegetables, fermenting 
liquors, and such like. It may likewise proceed from an obstructed 
perspiration, or catching cold. Delicate people, whose digestive powers 
are weak, are most liable to this kind of colic.

THE flatulent colic may either affect the stomach or intestines. It is 
attended with a painful stretching of the affected part. The patient feels 
a rumbling in his guts, and is generally relieved by a discharge of wind, 
either upwards or downwards. The pain is seldom confined to any particular 
part, as the vapour wanders from one division of the bowels to another 
till it finds a vent.

WHEN the disease proceeds from windy liquor, green fruit, sour herbs, or 
the like, the best medicine on the first appearance of the symptoms is a 
dram of brandy, gin or any good spirits. The patient should likewise sit 
with his feet upon a warm hearth-stone, or apply warm bricks to them; and 
warm cloths may be applied to his stomach and bowels.

THIS is the only colic wherein ardent spirits, spiceries, or any thing of 
a hot nature, may be ventured upon. Nor indeed are they to be used here 
unless at the very beginning, before any symptoms of inflammation appear. 
We have reason to believe, that a colic occasioned by wind or flatulent 
food might always be cured by spirits and warm liquors, if they were taken 
immediately upon perceiving the first uneasiness; but when the pain has 
continued for a considerable time, and there is reason to fear an 
inflammation of the bowels is already begun, all hot things are to be 
avoided as poison, and the patient is to be treated in the same manner as 
for the inflammation of the intestines.

SEVERAL kinds of food, as honey, eggs, &c. occasion colics in some 
particular constitutions. I have generally found, the best method of cure 
for these was to drink plentifully of small diluting liquors, as water-
gruel, small posset, water with toasted bread soaked in it, &c.

COLICS which proceed from excess and indigestion generally cure 
themselves, by occasioning vomiting or purging. These discharges are by no 
means to be stopped, but promoted by drinking plentifully of warm water, 
or weak posset. When their violence is over, the patient may take a dose 
of rhubarb, or any other gentle purge, to carry off the dregs of his 
debauch.

COLICS which are occasioned by wet feet, or catching cold, may generally 
be removed at the beginning, by bathing the feet and legs in warm water, 
and drinking such warm diluting liquors as will promote the perspiration, 
as weak wine-whey, or water-gruel with a small quantity of spirits in it.

THESE flatulent colics, which prevail so much among country people, might 
generally be prevented, were they careful to change their cloths when they 
get wet. They ought likewise to take a dram, or to drink some warm liquor 
after eating any kind of green trash. We do not mean to recommend the 
practice of dram-drinking, but in this case ardent spirits prove a real 
medicine, and indeed the best that can be administered. A glass of good 
pepper-mint water will have nearly the same effect as a glass of brandy, 
and in some cases is rather to be preferred.

The bilious colic is attended with very acute pains about the region of 
the navel. The patient complains of great thirst, and is generally 
costive. He vomits a hot, bitter, yellow-coulered bile, which being 
discharged, seems to afford some relief, but is quickly followed by the 
same violent pain as before. As the distemper advances, the propensity to 
vomit sometimes increases so as to become almost continual, and the proper 
motion of the intestines is so far perverted, that there are all the 
symptoms of an impending iliac passion.

IF the patient be young and strong, and the pulse full and frequent, it 
will be proper to bleed, after which clysters may be administered. Clear 
whey or gruel, sharpened with the juice of lemon, or cream of tartar, must 
be drank freely. Small chicken-broth, with a little manna dissolved in it, 
or a slight decoction of tamarinds, are likewise very proper, or any other 
thin, acid, opening liquor.

BESIDES bleeding and plentiful dilution, it will be necessary to foment 
the belly with cloths dipped in warm water, and if this should not 
succeed, the patient must be immersed up to the breast in warm water.

IN the bilious colic the vomiting is often very difficult to restrain. 
When this happens, the patient may drink a decoction of toasted bread, or 
an infusion of garden-mint in boiling water. Should these not have the 
desired effect, the saline draught, with a few drops of laudanum in it, 
may be given, and repeated according to the urgency of the symptoms.

A small quantity of Venice treacle may be spread in form of a cataplasm, 
and applied to the pit of the stomach. Clysters, with a proper quantity of 
Venice treacle or liquid laudanum in them, may likewise be frequently 
administered.

SUCH as are liable to frequent returns of the bilious colic should use 
flesh sparingly, and live chiefly upon a light vegetable diet. They should 
likewise take frequently a dose of cream of tartar with tamarinds, or any 
other cool acid purge.

THE hysteric colic bears a great resemblance to the bilious. It is 
attended with acute pains about the region of the stomach, vomiting, &c. 
But what the patient vomits in this case is commonly of a greenish colour. 
There is a great sinking of the spirits, with dejection of mind and 
difficulty of breathing, which are the characteristic symptoms of this 
disorder. Sometimes it is accompanied with the jaundice, but this 
generally goes off of its own accord in a few days.

IN this colic all evacuations, as bleeding, purging, vomiting, &c. do 
hurt. Everything that weakens the patient, or sinks the spirits, is to be 
avoided. If however the vomiting should prove violent, luke-warm water, or 
small posset, may be drank to cleanse the stomach. Afterwards the patient 
may take fifteen, twenty, or twenty-five drops of liquid laudanum in a 
glass of cinnamon-water. This may be repeated every ten or twelve hours 
till the symptoms abate.

THE patient may likewise take four or five of the foetid pills every six 
hours, and drink a cup of penny-royal tea after them. If asafoetida should 
prove disagreeable, which is sometimes the case, a tea-spoonful of the 
tincture of castor in a cup of pennyroyal tea, or thirty or forty drops of 
the balsam of Peru dropped upon a bit of loaf-sugar, may be taken in its 
stead. The anti-hysteric plaster may also be used, which has often a good 
effect. See Appendix, Anti-hysteric plaster.

THE nervous colic prevails among miners, smelters of lead, plumbers, the 
manufacturers of white lead, &c. It is very common in the cyder counties 
of England, and is supposed to be occasioned by the leaden vessels used in 
preparing that liquor. it is likewise a frequent disease in the West 
Indies, where it is termed the dry belly-ache.

NO disease of the bowels is attended with more excruciating pain than 
this. Nor is it soon at an end. I have known it continue eight or ten days 
with very little intermission, the body all the while continuing bound in 
spite of medicine, yet at length yield, and the patient recover. It 
generally however leaves the patient weak, and often ends in a palsy.

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

THE general treatment of this disease is so nearly the same with that of 
the iliac passion, or inflammation of the guts, that we shall not insist 
upon it. The body is to be opened by mild purgatives given in small doses, 
and frequently repeated, and their operation must be assisted by soft oily 
clysters, fomentations, &c. The castor oil is reckoned peculiarly proper 
in this disease. It may both be mixed with the clysters and given by the 
mouth.

THE Barbadoes tar is said to be an efficacious medicine in this complaint. 
It may be taken to the quantity of two drachms three times a-day, or 
oftener if the stomach will bear it. This tar, mixed with an equal 
quantity of strong rum, is likewise proper for rubbing the spine, in case 
any tingling, or other symptoms of a palsy are felt. When the tar cannot 
be obtained, the back may be rubbed with strong spirits, or a little oil 
of nutmegs or of rosemary.

IF the patient remains weak and languid after this disease, he must take 
exercise on horseback, and use an infusion of the Peruvian bark in wine. 
When the disease ends in a palsy, the Bath-waters are found to be 
extremely proper.

TO avoid this kind of colic, people must shun all sour fruits, acids, and 
austere liquors, &c. Those who work in lead ought never to go to their 
buriness fasting, and their food should be oily or fat. They may take a 
glass of sallad oil, with a little brandy or rum, every morning, but 
should never take spirits alone. Liquid aliment is best for them; as fat 
broths, &c. but low living is bad. They should frequently go a little out 
of the tainted air; and should never suffer themselves to be costive. In 
the West-Indies, and on the coast of Guinea, it has been found of great 
use, for preventing this colic, to wear a piece of flannel round the 
waist, and to drink an infusion of ginger by way of tea.

SUNDRY other kinds of this disease might be mentioned, but too many 
distinctions would tend only to perplex the reader. These already 
mentioned are the most material, and should indeed be attended to, as 
their treatment is very different. But even persons who are not in a 
condition to distinguish very accurately in these matters, may 
nevertheless be of great service to patients in colics of every kind, by 
only observing the following general rules, viz. To bathe the feet and 
legs in warm water; to apply bladders filled with warm water, or cloths 
dipped in it, to the stomach and bowels; to make the patient drink freely 
of diluting mucilaginous liquors and to give him an emollient clyster 
every two or three hours. Should these not succeed, the patient ought to 
be immersed in warm water.


INFLAMMATION OF THE KIDNEYS.

CAUSES. - This disease may proceed from any of those causes which produce 
an inflammatory fever. It may likewise be occasioned by wounds or bruises 
of the the kidneys; small stones or gravel lodging within them; by strong 
diuretic medicines; as spirits of turpentine, tincture of cantharides &c. 
Violent motion, as hard riding or walking, especially in hot weather, or 
whatever drives the blood too forcibly into the kidneys, may occasion this 
malady. It may likewise proceed from lying too soft, too much on the back, 
involuntary contractions, or spasms, in the urinary vessels, &c.

SYMPTOMS. - There is a sharp pain about the region of the kidneys, with 
some degree of fever, and a stupor or dull pain in the thigh of the 
affected side. The urine is at first clear, and afterwards of a reddish 
colour; but in the worst kind of the disease it generally continues pale, 
is passed with difficulty, and commonly in small quantities at a time. The 
patient feels great uneasiness when he endeavours to walk or sit upright. 
He lies with most ease on the affected side and has generally a nausea or 
vomiting resembling that which happens in the colic.

THIS disease however may be distinguished from the colic by the pain being 
seated farther back, and by the difficulty of passing urine with which it 
is constantly attended.

REGIMEN. - Every thing of a heating or stimulating nature is to be 
avoided. The food must be thin and light; as panado, small broths with 
mild vegetables, and the like. Emollient and thin liquors must be 
plentifully drank; as clear whey, or balm-tea sweetened with honey, 
decoctions of marsh-mallow roots, with barley and liquorice, &c. The 
patient, notwithstanding the vomiting, must constantIy keep sipping small 
quantities of these or other diluting liquors. Nothing so safely and 
certainly abates the inflammation, and expels the obstructing cause, as 
copious dilution. The patient must be kept easy, quiet, and free from 
cold, as long as any symptoms of inflammation remain.

MEDICINE. - Bleeding is generally necessary, especially at the beginning. 
Ten or twelve ounces may be let from the arm or foot with a lancet, and if 
the pain and inflammation continue, the operation may be repeated in 
twenty-four hours, especially if the patient be of a full habit. Leeches 
may likewise be applied to the haemorrhoidal veins, as a discharge from 
these will greatly relieve the patient.

CLOTHS dipped in warm water, or bladders filled with it, must be applied 
as near as possible to the part affected, and renewed as they grow cool. 
If the bladders be filled with a decoction of mallows and camomile 
flowers, to which a little saffron is added, mixed with about a third part 
of new milk, it will be still more beneficial.

EMOLLIENT clysters ought frequently to be administered; and if these do 
not open the body, a little salt and honey or manna may be added to them.

THE same course is to be followed where gravel or a stone is lodged in the 
kidney, but when the gravel or stone is separated from the kidney, and 
lodges in the Ureter - The Ureters are two long and small canaIs, one on 
each side, which carry the urine from the bason of the kidneys to the 
bladder. They are sometimes obstructed by small stones or gravel falling 
down from the kidneys, and lodging in them - it will be proper, besides 
the fomentations, to rub the small of the back with sweet oil, and to give 
gentle diuretics: as juniper-water sweetened with the syrup of marsh-
mallows; a tea-spoonful of the sweet spirits of nitre, with a few drops of 
laudanum, may now and then be put in a cup of the patient's drink. He 
ought likewise to take exercise on horseback, or in a carraige, if he be 
able to bear it.

WHEN the disease is protracted beyond the seventh or eighth day, and the 
patient complains of a stupor and heaviness of the part, has frequent 
returns of chillness, shivering, &c. there is reason to suspect that 
matter is forming in the kidney, and that an abcess will ensue.

WHEN matter in the urine shews that an ulcer is already formed in the 
kidney, the patient must be careful to abstain from all acrid, sour, and 
salted provisions; and to live chiefly upon mild mucilaginous herbs and 
fruits, together with the broth of young animals, made with barley and 
common pot-herbs, &c. His drink may be whey, and butter-milk that is not 
sour. The latter is by some reckoned a specific remedy in ulcers of the 
kidneys. To answer this character, however, it must be drank for a 
considerable time. Chalybeate waters have likewise been found beneficial 
in this disease. This medicine is easily obtained, as it is found in every 
part of Great-Britain. It must likewise be used for a considerable time, 
in order to produce any salutary effects.

THOSE who are liable to frequent returns of inflammation, or obstruction 
of the kidneys, must abstain from wines, especially such as abound with 
tartar; and their food ought to be light, and of easy digestion. They 
should use moderate exercise, and should not lie too hot, nor too much on 
ther back.


INFLAMMATION OF THE BLADDER.

THE inflammation of the bladder proceeds, in a great measure, from the 
same causes as that of the kidneys. It is known by an acute pain towards 
the bottom of the belly, and difficulty of passing urine, with some degree 
of fever, a constant inclination to go to stool, and a perpetual desire to 
make water.

THIS disease must be treated on the same principles as the one immediately 
preceding. The diet must be light and thin, and the drink of a cooling 
nature. Bleeding is very proper at the beginning, and in robust 
constitutions it will often be necessary to repeat it. The lower part of 
the belly should be fomented with water, or a decoction of mild 
vegetables; and emollient clysters ought frequently to be administered, &c.

THE patient should abstain from every thing that is of a hot, acrid, and 
stimulating quality, and should live entirely upon small broths, gruels, 
or mild vegetables.

A STOPPAGE of urine may proceed from other causes besides an inflammation 
of the bladder; as a swelling of the haemorrhoidal veins, hard faeces 
lodged in the rectum; a stone in the bladder, excrescences in the urinary 
passages, a palsy in the bladder, hysteric affections, &c. Each of these 
requires a particular treatment, which does not fall under our present 
consideration. We shall only observe, that in all of them, mild and gentle 
applications are the safest, as strong diuretic medicines, or things of an 
irritating nature, generally increase the danger. I have known some 
persons kill themselves by introducing probes into the urinary passages, 
to remove, as they thought, somewhat that obstructed the discharge of 
urine, and others bring on a violent inflammation of the bladder, by using 
strong diuretics, as oil of turpentine, &c. for that purpose.


INFLAMMATION OF THE LIVER.

THE liver is less subject to inflammation than most of the other viscera, 
as in it the circulation is slower; but when an inflammation does happen, 
it is with difficulty removed, and often ends in a suppuration or scirrhus.

CAUSES. - Besides the common causes of inflammation, we may here reckon 
the following, viz. excessive fatness, a scirrhus of the liver itself, 
violent shocks from strong vomits when the liver was before unsound, an 
adust or atrabiliarian state of the blood, any thing that suddenly cools 
the liver after it has been greatly heated, stones obstructing the course 
of the bile, drinking strong wines and spirituous liquors, using hot spicy 
aliment, obstinate hypochondriacal affections, &c.

SYMPTOMS. - This disease is known by a painful tension of the right side 
under the false ribs, attended with some degree of fever, a sense of 
weight, or fulness of the part, difficulty of breathing, loathing of food, 
great thirst, with a pale or yellowish colour of the skin and eyes.

THE symptoms here are various, according to the degree of inflammation, 
and likewise according to the particular part of the liver where the 
inflammation happens. Sometimes the pain is so inconsiderable, that an 
inflammation is not so much as suspected; but when it happens in the upper 
or convex part of the liver, the pain is more acute, the pulse quicker, 
and the patient is often troubled with a dry cough, a hiccup, and a pain 
extending to the shoulder, with difficulty of lying on the left side, &c.

THIS disease may be distinguished from the pleurisy by the pain being less 
violent, seated under the false ribs, the pulse not so hard, and by the 
difficulty of lying on the left side. It may be distinguished from the 
hysteric and hypochondriac disorders by the degree of fever with which it 
is always attended.

THIS disease, if properly treated, is seldom mortal. A constant hiccuping, 
violent fever, and excessive thirst, are bad symptoms. If it ends in a 
suppuration, and the matter cannot be discharged outwardly, the danger is 
great. When the scirrhus of the liver ensues, the patient, if he observes 
a proper regimen, may nevertheless live a number of years tolerably easy; 
but if he indulge in animal food and strong liquors, or take medicines of 
an acrid or irritating nature, the scirrhus will be converted into a 
cancer, which must infallibly prove fatal.

REGIMEN. - The same regimen is to be observed in this as in other 
inflammatory disorders. All hot things are to be carefully avoided, and 
cool diluting liquors, as whey, barley-water, &.c, drank freely. The food 
must be light and thin, and the body, as well as the mind, kept easy and 
quiet.

MEDICINE - Bleeding is proper at the beginning of this disease, and it 
will often be necessary, even though the pulse should not feel hard, to 
repeat it. All violent purgatives are to be avoided; the body, however, 
must be kept gently open. A decoction of tamarinds, with a little honey or 
manna, will answer this purpose very well. The side affected must be 
fomented in the manner directed in the foregoing diseases. Mild laxative 
clysters should be frequently administered; and, if the pain should 
notwithstanding continue violent, a blistering-plaster may be applied over 
the part affected.

MEDICINES which promote the secretion of urine have a very good effect 
here. For this purpose half a drachm of purified nitre, or a tea-spoonful 
of the sweet spirits of nitre, may be taken in a cup of the patient's 
drink three or four times a-day.

WHEN there is an inclination to sweat, it ought to be promoted, but not by 
warm sudorifics. The only thing to be used for that purpose is plenty of 
diluting liquors drank about the warmth of the human blood. Indeed the 
patient in this case, as well as in all other topical inflammations, ought 
to drink nothing that is colder than the blood.

IF the stools should be loose, and even streaked with blood, no means must 
be used to stop them, unless they be so frequent as to weaken the patient. 
Loose stools often prove critical, and carry off the disease.

IF an abcess or imposthume is formed in the liver, all methods should be 
tried to make it break and discharge itself outwardly, as fomentations, 
the application of poultices, ripening cataplasms, &c. Sometimes indeed 
the matter or an abcess comes away in the urine, and sometimes it is 
discharged by stool, but these are efforts of Nature which no means can 
promote. When the abcess bursts into the cavity of the abdomen at large, 
death must ensue; nor will the event be more favourable when the abscess 
is opened by an incision, unless in cases where the liver adheres to the 
peritonaeum, so as to form a bag for the matter, and prevent it from 
falling into the cavity of the abdomen; in which case opening the abscess 
by a sufficiently large incision will probably save the patient's life. I 
know a gentleman who has had several abscesses of the liver opened, and is 
now a strong and healthy man, though above eighty years of age.

IF the disorder, in spite of all endeavours to the contrary, should end in 
a scirrhus, the patient must be careful to regulate his diet, &c. in such 
a manner as not to aggravate the disease. He must not indulge in flesh, 
fish, strong liquors, or any highly seasoned or salted provisions; but 
should, for the most part, live on mild vegetables, as fruits and roots; 
taking gentle exercise, and drinking whey, barley-water, or butter-milk. 
If he takes any thing stronger, it should be fine mild ale, which is less 
heating than wines or spirits.

WE shall take no notice of inflammations of the other viscera. They must 
in general be treated upon the same principles as those already mentioned. 
The chief rule with respect to all of them, is to let blood, to avoid 
every thing that is strong, or of a heating nature, to apply warm 
fomentations to the part affected, and to cause the patient to drink a 
sufficient quantity of warm diluting liquors.