Domestic Medicine - Chapters 31-34



CHAPTER XXXI.
OF THE CHOLERA MORBUS, AND OTHER EXCESSIVE DISCHARGES FROM
THE STOMACH AND BOWELS.

THE cholera morbus is a violent purging and vomiting, attended with 
gripes, sickness, and a constant desire to go to stool. It comes on 
suddenly, and is most common in autumn. There is hardly any disease that 
kills more quickly than this, when proper means are not used in due time 
for removing it.

CAUSES. - It is occasioned by a redundancy and putrid acrimony of the 
bile; cold; food that easily turns rancid or sour on the stomach; as 
butter, bacon, sweet-meats, cucumbers, melons, cherries, and other cold 
fruits. I have been twice brought to the gates of death by this disease, 
and both times it was occasioned by eating rancid bacon. It is sometimes 
the effect of strong acrid purges or vomits; or of poisonous substances 
taken into the stomach. It may likewise proceed from violent passions or 
affections of the mind as fear, anger, &c.

SYMPTOMS. - It is generally preceded by a cardialgia, or heart-burn, sour 
belchings, and flatulences, with pain of the stomach and intestines. To 
these succeed excessive vomiting, and purging of green, yellow, or 
blackish coloured bile, with a distention of the stomach, and violent 
griping pains. There is likewise a great thirst, with a very quick unequal 
pulse, and often a fixed acute pain about the region of the navel. As the 
disease advances, the pulse often sinks so low as to become quite 
imperceptible, the extremities grow cold, or cramped; and are often 
covered with a clammy sweat, the urine is obstructed, and there is a 
palpitation of the heart. Violent hiccuping, fainting, and convulsions, 
are the signs of approaching death.

MEDICINE. - At the beginning of this disease the efforts of Nature to 
expel the offending cause should be assisted, by promoting the purging and 
vomiting. For this pupose the patient must drink freely of diluting 
liquors; as whey, butter-milk, warm water, thin water gruel, small posset, 
or, what is perhaps preferable to any of them, very weak chicken broth. 
This should not only be drank plentifully to promote the vomiting, but a 
clyster of it given every hour in order to promote the purging.

AFTER these evacuations have been continued for some time, a decoction of 
toasted oat-bread may be drank to stop the vomiting. The bread should be 
toasted till it is of a brown colour, and afterwards boiled in spring-
water. If oat-bread cannot be had, wheat-bread, or oat-meal well toasted, 
may be used in its stead. If this does not put a stop to the vomiting, two 
table-spoonfuls of the saline julep, with ten drops of laudanum, may be 
taken every hour till it ceases.

THE vomiting and purging however ought never to be stopped too soon. As 
long as these discharges do not weaken the patient, they are salutary, and 
may be allowed to go on, or rather ought to be promoted. But when the 
patient is weakened by the evacuations, which may be known from the 
sinking of his pulse, &c. recourse must immediately be had to opiates, as 
recommended above; to which may be added strong wines, with spirituous 
cinnamon-waters, and other generous cordials. Warm negus, or strong wine-
whey, will likewise be necessary to support the patient's spirits, and 
promote the perspiration. His legs should be bathed in warm water, and 
afterwards rubbed with flannel cloths, or wrapped in warm blankets, and 
warm bricks applied to the soles of his feet. Flannels wrung out of warm 
spiritous fomentations should likewise be applied to the region of the 
stomach.

WHEN the violence of the disease is over, to prevent a relapse, it will be 
necessary, for some time, to continue the use of small doses of laudanum. 
Ten or twelve drops may be taken in a glass of wine, at least twice a-day, 
for eight or ten days. The patient's food ought to be nourishing, but 
taken in small quantities, and he should use moderate exercise. As the 
stomach and intestines are generally much weakened, an infusion of the 
bark, or other bitters, in small wine, sharpened with the elixir of 
vitriol, may be drank for some time.

THOUGH physicians are seldom called in due time in this disease, they 
ought not to despair of relieving the patient even in the most desperate 
circumstances. Of this I lately saw a very striking proof in an old man 
and his son, who had been both seized with it about the middle of the 
night. I did not see them till next morning, when they had much more the 
appearance of dead than of living men. No pulse could be felt, the 
extremities were cold and rigid; the countenance was ghastly, and the 
strength almost quite exhausted. Yet from this deplorable condition they 
were both recovered by the use of opiates and cordial medicines.


OF A DIARRHOEA, OR LOOSENESS.

A LOOSENESS, in many cases, is not to be considered as a disease, but 
rather as a salutary evacuation. It ought therefore never to be stopped 
unless when it continues too long, or evidently weakens the patient. As 
this however sometimes happens, we shall point out the most common causes 
of a looseness, with the proper method of treatment.

WHEN a looseness is occasioned by catching cold, or an obstructed 
perspiration, the patient ought to keep warm, to drink freely of weak 
diluting liquors, to bathe his feet and legs frequently in lukewarm water, 
to wear flannel next his skin, and to take every other method to restore 
the perspiration.

IN a looseness which proceeds from excess or repletion, a vomit is the 
proper medicine. Vomits not only cleanse the stomach, but promote all the 
secretions, which renders them of great importance in carrying off a 
debauch. Half a drachm of ipecacuanha in powder will answer this purpose 
very well. A day or two after the vomit, the same quantity of rhubarb may 
be taken, and repeated two or three times, if the looseness continues. The 
patient ought to live upon light vegetable food of easy digestion, and to 
drink whey, thin gruel, or barley-water.

A LOOSENESS, occasioned by the obstruction of any customary evacuation, 
generally requires bleeding. If that does not succeed, other evacuations 
may be substituted in the form of those which are obstructed. At the same 
time, every method is to be taken to restore the usual discharges, as not 
only the cure of the disease, but the patient's life, may depend on this.

A PERIODICAL looseness ought never to be stopped. It is always an effort 
of Nature to carry off some offending matter, which, if retained in the 
body, might have fatal effects. Children are very liable to this kind of 
looseness, especially while teething. It is however so far from being 
hurtful to them, that such children generally get their teeth with least 
trouble. If these loose stools should at any time prove sour or griping, a 
tea-spoonful of magnesia alba, with four or five grains of rhubarb, may be 
given to the child in a little panado, or any other food. This, if 
repeated three or four times, will generally correct the acidity, and 
carry off the griping stools.

A DIARRHOEA, or looseness, which proceeds from violent passions or 
affections of the mind, must be treated with the greatest caution. Vomits 
in this case are highly improper. Nor are purges safe, unless they be very 
mild, and given in small quantities. Opiates, and other antispasmodic 
medicines, are most proper. Ten or twelve drops of liquid laudanum maybe 
taken in a cup of valerian or penny-royal tea, every eight or ten hours, 
till the symptoms abate. Ease, cheerfulness, and tranquility of mind, are 
here of the greatest importance.

WHEN a looseness proceeds from acrid or poisonous substances taken into 
the stomach, the patient must drink large quantities of diluting liquors, 
with oil or fat broth, to promote vomiting and purging. Afterwards, if 
there be reason to suspect that the bowels are inflamed, bleeding will be 
necessary. Small doses of laudanum may Iikewise be taken to remove their 
irritation.

WHEN the gout, repelled from the extremities, occasions a looseness, it 
ought to be promoted by gentle doses of rhubarb, or other mild purgatives. 
The gouty matter is likewise to be solicited towards the extremities by 
warm fomentations, cataplasms, &c. The perspiration ought at the same time 
to be promoted by warm diluting liquors; as wine-whey, with spirits of 
hartshorn, or a few drops of liquid laudanum in it.

WHEN a looseness proceeds from worms, which may be known from the 
sliminess of the stools, mixed with pieces of decayed worms, &c. medicines 
must be given to kill and carry off these vermin, as the powder of tin 
with purges of rhubarb and calomel. Afterwards lime-water, either alone, 
or with a small quantity of rhubarb infused, will be proper to strengthen 
the bowels, and prevent the new generation of worms.

A LOOSENESS is often occasioned by drinking bad water. When this is the 
case, the disease generally proves epidemical. When there is reason to 
believe that this or any other disease proceeds from the use of 
unwholesome water, it ought immediately to be changed, or, if that cannot 
be done, it may be corrected by mixing with it quick-lime, chalk, or the 
like.

IN people whose stomachs are weak, violent exercise immediately after 
eating will occasion a looseness. Though the cure of this is obvious, yet 
it will be proper, besides avoiding violent exercise, to use such 
medicines as tend to brace and strengthen the stomach, as infusions of the 
bark, with other bitter and astringent ingredients, in white wine. Such 
persons ought likewise to take frequently a glass or two of old red port, 
or good claret.

FROM whatever cause a looseness proceeds, when it is found necessary to 
check it, the diet ought to consist of rice boiled with milk, and 
flavoured with cinnamon; rice-jelly; sago, with red port; and the Iighter 
sorts of flesh-meat roasted. The drink may be thin water-gruel, rice 
water, or weak broth made from lean veal, or with a sheep's head, as being 
more gelatinous than mutton, beef, or chicken broth.

PERSONS who, from a peculiar weakness, or too great an irritability of the 
bowels, are liable to frequent returns of this disease, should live 
temperately, avoiding crude summer fruits, all unwholesome food, and meats 
of hard digestion. They ought likewise to beware of cold, moisture, or 
whatever may obstruct the perspiration, and should wear flannel next their 
skin. All violent passions, as fear, anger, &c. are likewise carefully to 
be guarded against.


OF VOMITING.

VOMITING may proceed from various causes; as excess in eating and 
drinking; foulness of the stomach; the acrimony of the aliments; a 
translation of the morbific matter of ulcers, of the gout, the erysipelas, 
or other diseases to the stomach. It may llkewise proceed from a looseness 
having been too suddenly stopped; from the stoppage of any customary 
evacuation, as the bleeding piles, the menses, &c. from a weakness of the 
stomach, the cholic, the iliac passion, a rupture, a fit of the gravel, 
worms; or from any kind of poison taken into the stomach. It is an usual 
symptom of injuries done to the brain; as contusions, compressions, &c. It 
is likewise a symptom of wounds, or inflammations of the diaphragm, 
intestines, spleen, liver, kidneys, &c.

VOMITING may be occasioned by unusual motions; as falling, being drawn 
backwards in a cart or coach, &c. It may likewise be excited by violent 
passions, or by the idea of nauseous or disagreeable objects, especially 
of such things as have formerly produced vomiting. Sometimes it proceeds 
from a regurgitation of the bile into the stomach: in this case, what the 
patient vomits is generally of a yellow or greenish colour, and has a 
bitter taste. Persons who are subject to nervous affections are often 
suddenly seized with violent fits of vomiting. Lastly, vomiting is a 
common symptom of pregnancy. In this case it generally comes on about two 
weeks after the stoppage of the menses, and continues during the first 
three or four months.

WHEN vomiting proceeds from a foul stomach or indigestion, it is not to be 
considered as a disease, but as the cure of a disease. It ought therefore 
to be promoted by drinking lukewarm water, or thin gruel. If this does not 
put a stop to the vomiting, a dose of ipecacuanha may be taken, and worked 
off with weak camomile-tea.

WHEN the retrocession of the gout, or the obstruction of customary 
evacuations, occasion vomiting, all means must be used to restore these 
discharges; or if that cannot be effected, their place must be supplied by 
others, as bleeding, purging, bathing the extremities in warm water, 
opening issues, setons, perpetual blisters, &c.

WHEN vomiting is the effect of pregnancy, it may generally be mitigated by 
bleeding, and keeping the body gently open. The bleeding however ought to 
be in small quantities at a time, and the purgatives should be of the 
mildest kind, as figs, stewed prunes, manna, or senna. Pregnant women are 
most apt to vomit in the morning, immediately after getting out of bed, 
which is owing partly to the change of posture, but more to the emptiness 
of the stomach. It may generally be prevented by taking a dish of coffee, 
tea, or some light breakfast in bed. Pregnant women who are afflicted with 
vomiting ought be kept easy both in body and mind. They should neither 
allow their stomachs to be quite empty, nor should they eat much at once. 
Cold water is a very proper drink in this case; if the stomach be weak, a 
little brandy may be added to it. If the spirits are low, and the person 
apt to faint, a spoonful of cinnamon-water, with a little marmalade of 
quinces or oranges, may be taken.

IF vomiting proceeds from weakness of the stomach, bitters will be of 
service. Peruvian bark infused in wine or brandy, with as much rhubarb as 
will keep the body gently open, is an excellent medicine in this case. The 
elixir of vitriol is also a good medicine. It may be taken in the dose of 
fifteen or twenty drops, twice or thrice a-day, in a glass of wine or 
water. Habitual vomitings are sometimes alleviated by making oysters a 
principal part of diet.

A VOMITING, which proceeds from acidities in the stomach, is relieved by 
alkaline purges. The best medicine of this kind is the magnesia alba, a 
tea-spoonful of which may be taken in a dish of tea or a little milk, 
three or four times a-day, or oftener if necessary, to keep the body open.

WHEN vomiting proceeds from violent passions, or affections of the mind, 
all evacuants must be carefully avoided, especially vomits. These are 
exceeding dangerous. The patient in this case ought to be kept perfectly 
easy and quiet, to have the mind soothed, and to take some gentle cordial, 
as negus, or a little brandy and water, to which a few drops of laudanum 
may occasionally be added.

WHEN vomiting proceeds from spasmodic affections of the stomach, musk, 
castor, and other antispasmodic medicines, are of use. Warm and aromatic 
plasters have likewise a good effect. The stomach-plaster of the London or 
Edinburgh dispensatory may be applied to the pit of the stomach, or a 
plaster of theriaca, which will answer rather better. Aromatic medicines 
may likewise be taken inwardly, as cinnamon or mint tea, wine with 
spiceries boiled in it, &c. The region of the stomach may be rubbed with 
aether, or, if that cannot be had, with strong brandy, or other spirits. 
The belly should be fomented with warm water, or the patient immersed up 
to the breast in a warm bath.

I HAVE always found the saline draughts taken in the act of effervescence, 
of singular use in stopping a vomiting, from whatever cause it proceeded. 
These may be prepared by dissolving a drachm of the salt of tartar, in an 
ounce and half of fresh lemon juice, and adding to it an ounce of 
peppermint-water, the same quantity of simple cinnamon-water, and a little 
white sugar. This draught must be swallowed before the effervescence is 
quite over, and may be repeated every two hours, or oftener, if the 
vomiting be violent. A violent vomiting has sometimes been stopped by 
cupping on the region of the stomach after all other means had failed.

AS the least motion will often bring on the vomiting again, even after it 
has been stopped, the patient must avoid all manner of action. The diet 
must be so regulated as to sit easy upon the stomach, and nothing should 
be taken that is hard of digestion. We do not however mean that the 
patient should live entirely upon slops. Solid food, in this case, often 
sits easier on the stomach than liquids.



CHAPTER XXXII.
OF THE DIABETES, AND OTHER DISORDERS OF THE KIDNEYS. AND BLADDER.

THE diabetes is a frequent and excessive discharge of urine. It is seldom 
to be met with among young people; but often attacks persons in the 
decline of life, especially those who follow the more violent employments, 
or have been hard drinkers in their youth.

CAUSES. - A diabetes is often the consequence of acute diseases, as 
fevers, fluxes, &c. where the patient has suffered by excessive 
evacuations; it may also be occasioned by great fatigue, as riding long 
journies upon a hard-troting horse, carrying heavy burdens, running, &c. 
It may be brought on by hard drinking, or the use of strong stimulating 
diuretic medicines, as tincture of cantharides, spirits of turpentine, and 
such like. It is often the effect of drinking too great quantities of 
mineral waters. Many imagine that these will do them no service unless 
they be drank in great quantities, by which mistake it happens that they 
often occasion worse diseases than those they were intended to cure. In a 
word, this disease may either proceed from too great a laxity of the 
organs which secrete the urine, from something that stimulates the kidneys 
too much, or from a thin dissolved state of the blood, which makes too 
great a quantity of it run off by the urinary passages.

SYMPTOMS. - In a diabetes, the urine generally exceeds in quantity all the 
liquid food which the patient takes. It is thin and pale, of a sweetish 
taste, and an agreeable smell. The patient has a continual thirst, with 
some degree of fever; his mouth is dry, and he spits frequently a frothy 
spittle. The strength fails, the appetite decays, and the flesh wastes 
away till the patient is reduced to skin and bone. There is a heat of the 
bowels; and frequently the loins, testicles, and feet are swelled.

THIS disease may generally be cured at the beginning; but after it has 
continued long, the cure becomes very difficult. In drunkards, and very 
old people, a perfect cure is not to be expected.

REGIMEN. - Every thing that stimulates the urinary passages, or tends to 
relax the habit, must be avoided. For this reason the patient should live 
chiefly on solid food. His thirst may be quenched with acids; as sorrel, 
juice of lemon, or vinegar. The mucilaginous vegetables, as rice, sago, 
and salop, with milk, are the most proper food. Of animal substances, 
shell-fish are to be preferred; as oysters, crabs, &c.

THE drink may be Bristol-water. When that cannot be obtained, lime-water, 
in which a due proportion of oak-bark has been macerated, may be used. The 
white decoction, see Appendix, White Decoction, with isinglass dissolved 
in it, is likewise a very proper drink.

THE patient ought daily to take exercise, but it should be so gentle as 
not to fatigue him. He should lie upon a hard bed or matrass. Nothing 
hurts the kidneys more than lying too soft. A warm dry air, the use of the 
flesh-brush, and every thing that promotes perspiration, is of service. 
For this reason the patient ought to wear flannel next his skin. A large 
strengthening plaster may be applied to the back; or, what will answer 
better, a great part of the body may be wrapt in plaster.

MEDICINE. - Gentle purges, if the patient be not too much weakened by the 
disease, have a good effect. They may consist of rhubarb, with cardamom 
seeds, or any other spiceries, infused in wine, and may be taken in such 
quantity as to keep the body gently open.

THE patient must next have recourse to astringents and corroborants. Half 
a drachm of powder, made of equal parts of allum and the inspissated juice 
commonly called Terra Japonica, may be taken four times a-day, or oftener 
if the stomach will bear it. The allum must first be melted in a crucible; 
afterwards they may both be pounded together. Along with every dose of 
this powder the patient may take a tea-cupful of the tincture of roses; 
see Appendix, Tincture of Roses.

IF the patient's stomach cannot bear the allum in substance, whey may be 
made of it, and taken in the dose of a tea-cupful three or four times a-
day. The allum-whey is prepared by boiling two English quarts of milk over 
a slow fire, with three drachms of allum, till the curd separates.

OPIATES are of service in this disease, even though the patient rests 
well. They take off spasm and irritation, and at the same time lessen the 
force of the circulation. Ten or twelve drops of liquid laudanum may be 
taken in a cup of the patient's drink three or four times a-day.

THE best corroborants which we know are the Peruvian bark and wine. A 
drachm of bark may be taken in a glass of red port or claret three times a-
day. The medicine will be both more efficacious and less disagreeable, if 
fifteen or twenty drops of the acid elixir of vitriol be added to each 
dose. Such as cannot take the bark in substance may use the decoction, 
mixed with an equal quantity of red wine, and sharpened as above.

THERE is a disease pretty incident to labouring people in the decline of 
life, called an INCONTINENCY of urine. But this is entirely different from 
a diabetes, as the water passes off involuntarily by drops, and does not 
exceed the usual quantity. This disease is rather troublesome than 
dangerous. It is owing to a relaxation of the sphincter of the bIadder, 
and is often the effect of a palsy. Sometimes it proceeds from hurts, or 
injuries occasioned by blows, bruises, preternatural labours, &c. 
Sometimes it is the effect of a fever. It may likewise be occasioned by a 
long use of strong diuretics, or of stimulating medicines injected into 
the bladder.

THIS disease may be mitigated by the use of astringent and corroborating 
medicines, such as have been mentioned above; but we do not remember ever 
to have seen it cured.

IN an incontinency of urine, from whatever cause, a piece of sponge ought 
to be worn, or a bladder applied in such a manner as to prevent the urine 
from galling and excoriating the parts.


OF A SUPPRESSION OF URINE.

IT has already been observed, that a suppression of urine may proceed from 
various causes; as an inflammation of the kidneys, or bladder; small 
stones or gravel lodging in the urinary passages, hard faeces lying in the 
rectum, pregnancy, a spasm or contraction of the neck of the bladder, 
clotted blood in the bladder itself, a swelling of the haemorrhoidal 
veins, &c.

SOME of these cases require the catheter, both to remove the obstructing 
matter, and to draw off the urine; but as this instrument can only be 
managed with safety by persons skilled in surgery, we shall say nothing 
further of its use. A Bougee may be used by any cautious hand, and will 
often succeed better than the catheter.

WE would chiefly recommend, in all obstructions of urine, fomentations and 
evacuants. Bleeding, as far as the patient's strength will permit, is 
necessary, especially when there are symptoms of topical inflammation. 
Bleeding in this case not only abates the fever, by lessening the force of 
the circulation, but, by relaxing the solids, it takes off the spasm or 
stricture upon the vessels which occasioned the obstruction.

AFTER bleeding, fomentations must be used. These may either consist of 
warm water alone, or of decoctions of mild vegetables; as mallows, 
camomile-flowers, &c. Cloths dipped in these may either be applied to the 
part affected, or a large bladder filled with the decoction may be kept 
continually upon it. Some put the herbs themselves into a flannel bag, and 
apply them to the part, which is far from being a bad method. These 
continue longer warm than cloths dipped in the decoction, and at the same 
time keep the part equally moist.

IN all obstructions of urine, the body ought to be kept open. This is not 
however to be attempted by strong purgatives, but by emollient clysters, 
or gentle infusions of senna and manna. Clysters in this case not only 
open the body, but answer the purpose of an internal fomentation, and 
greatly assist in removing the spasms of the bladder and parts adjacent.

THE food must be light, and taken in small quantities. The drink may be 
weak broth, or decoctions and infusions of mucilaginous vegetables, as 
marsh-mallow roots, lime-tree buds, &c. A tea-spoonful of the sweet 
spirits of nitre, or a drachm of Castile soap, may be frequently put into 
the patients drink; and, if there be no inflammation, he may drink small 
gin-punch without acid.

PERSONS subject to a suppression of urine ought to live very temperate. 
Their diet should be light, and their liquor diluting. They should avoid 
all acids and austere wines, should take sufficient exercise, lie hard, 
and avoid study and sedentary occupations.


OF THE GRAVEL AND STONE.

WHEN small stones are lodged in the kidneys, or discharged along with the 
urine, the patient is said to be afflicted with the gravel. If one of 
these stones happens to make a lodgment in the bladder for some time, it 
accumulates fresh matter, and at length becomes too large to pass off with 
the urine. In this case the patient is said to have the stone.

CAUSES.-The stone and gravel may be occasioned by high living; the use of 
strong astringent wines; a sedentary life; lying too hot, soft, or too 
much on the back; the constant use of water impregnated with earthy or 
stony particles; aliments of an astringent or windy nature, &c. It may 
likewise proceed from an hereditary disposition. Persons in the decline of 
life, and those who have been much afflicted with the gout or rheumatism, 
are most liable to it.

SYMPTOMS - Small stones or gravel in the kidneys occasion pain in the 
loins; sickness; vomiting; and sometimes bloody urine. When the stone 
descends into the ureter, and is too large to pass along with ease, all 
the above symptoms are increased; the pain extends towards the bladder; 
the thigh and leg of the affected side are benumbed; the testicles are 
drawn upwards, and the urine is obstructed.

A STONE in the bladder is known from a pain, at the time, as well as 
before and after making water; from the urine coming away by drops, or 
stopping suddenly when it was running in a full stream; by a violent pain 
in the neck of the bladder upon motion, especlally on horseback, or in a 
carriage on a rough road; from a white, thick, copious, stinking, mucous 
sediment in the urine; from an itching in the top of the penis; from 
bloody urine; from an inclination to go to stool during the discharge of 
urine; from the patients passing his urine more easily when lying than in 
an erect posture; from a kind of convulsive motion occasioned by the sharp 
pain in discharging the last drops of the urine; and lastly, from sounding 
or searching with the catheter.

REGIMEN. - Persons afflicted with the gravel or stone should avoid 
aliments of a windy or heating nature, as salt meats, sour fruits, &c. 
Their diet ought chiefly to consist of such things as tend to promote the 
secretion of urine, and to keep the body open. Artichokes, asparagus, 
spinnage, lettuce, parsley, succory, purslane, turnips, potatoes, carrots, 
and radishes, may be safely eat. Onions, leeks, and cellery are, in this 
case, reckoned medicinal. The most proper drinks are whey, butter-milk, 
milk and water, barley-water; decoctions or infusions of the roots of 
marsh-mallows, parsley, liquorice, or of other mild mucilaginous 
vegetables, as linseed, lime-tree buds or leaves, &c. If the patient has 
been accustomed to generous liquors, he may drink small gin punch without 
acid.

GENTLE exercise is proper; but violent motion is apt to occasion bloody 
urine. We would therefore advise that it should be taken in moderation. 
Persons afflicted with gravel often pass a great number of stones after 
riding on horseback, or in a carriage; but those who have a stone in the 
bladder are seldom able to bear these kinds of exercise. Where there is a 
hereditary tendency to this disease, a sedentary life ought never to be 
indulged. Were people careful, upon the first symptoms of gravel, to 
observe a proper regimen of diet, and to take sufficient exercise, it 
might often be carried off, or, at least, prevented from increasing; but 
if the same course which occasioned the disease be persisted in, it must 
be aggravated.

MEDICINE. - In what is called a fit of the gravel, which is commonly 
occasioned by a stone sticking in the ureter or some part of the urinary 
passages, the patient must be bled, warm fomentations should likewise be 
applied to the part affected, emollient clysters administered, and 
diluting mucilaginous liquors drank, &c. The treatment of this case has 
been fully pointed out under the articles, inflammation of the kidneys and 
bladder, to which we refer.

DR. WHYTE advises patients who are subject to frequent fits of gravel in 
the kidneys, but have no stone in the bladder, to drink every morning, two 
or three hours before breakfast, an English pint of oyster or cockle-shell 
lime-water. The Doctor very justly observes, that though this quantity 
might be too small to have any sensible effect in dissolving a stone in 
the bladder, yet it may very probably prevent its growth.

WHEN a stone formed in the bladder, the Doctor recommends Alicant soap, 
and oyster or cockle-shell lime-water, see Appendix, Lime-Water, to be 
taken in the following manner: The patient must swallow every day, in any 
form that is least disagreeable, an ounce of the internal part of Alicant 
soap, and drink three or four English pints of oyster or cockle-shell lime-
water. The soap is to be divided into three doses; the largest to be taken 
fasting in the morning early; the second at noon; and the third at seven 
in the evening; drinking above each dose a large draught of the lime-
water; the remainder of which he may take any time betwixt dinner and 
supper, instead of other liquors.

THE patient should begin with a smaller quantity of the lime-water and 
soap than that mentioned above; at first an English pint of the former, 
and three drachms of the latter, may be taken daily. This quantity, 
however, he may increase by degrees, and ought to persevere in the use of 
these medicines, especially if he finds any abatement of his complaints, 
for several months; nay, if the stone be very large, for years. It may 
likewise be proper for the patient, if he be severely pained, not only to 
begin with the soap and lime-water in small quantities, but to take the 
second or third lime-water instead of the first. However, after he has 
been for some time accustomed to these medicines, he may not only take the 
first water, but, if he finds he can easily bear it, heighten its 
dissolving power still more by pouring it a second time on fresh calcined 
shells.

THE caustic alkali, or soap-lees, is the medicine chiefly in vogue at 
present for the stone. It is of a very acrid nature, and ought therefore 
to be given in some gelatinous or mucilaginous liquor; as veal broth, new 
milk, linseed-tea, a solution of gum-arabic, or a decoction of marsh-
mallow roots. The patient must begin with small doses of the lees, as 
thirty or forty drops, and increase by degrees, as far as the stomach will 
bear it. The caustic alkali may be prepared by mixing two parts of quick-
lime with one of potashes, and suffering them to stand till the lixivium 
be formed, which must be carefully filtrated before it be used. If the 
soiution does not happen readily, a small quantity of water may be added 
to the mixture.

THOUGH the soap-lees and lime-water are the most powerful medicines which 
have hitherto been discovered for the stone; yet there are some things of 
a more simple nature, which in certain cases are found to be beneficial, 
and therefore deserve a trial. An infusion of the seeds of daucus 
sylvestris, or wild carrot, sweetened with honey, has been found to give 
considerable ease in cases where the stomach could not bear any thing of 
an acrid nature. A decoction of raw coffee-berries taken morning and 
evening, to the quantity of eight or ten ounces, with ten drops of sweet 
spirit of nitre, has likewise been found very efficacious in bringing away 
large quantities of earthy matter in flakes. Honey is likewise found to be 
of considerable service, and may be taken in gruel, or in any other form 
that is more agreeable.

THE only other medicine which we shall mention is the uva ursi. It has 
been greatly extolled of late both for the gravel and stone. It seems, 
however, to be, in all respects, inferior to the soap and lime-water; but 
it is less disagreeable, and has frequently, to my knowIedge, relieved 
gravelly complaints. It is generally taken in powder from half a drachm to 
a whole drachm, two or three times a-day. It may however be taken to the 
quantity of seven or eight drachms a-day, with great safety and good 
effect.



CHAPTER XXXIII.
OF INVOLUNTARY DISCHARGES OF BLOOD.

SPONTANEOUS, or involuntary discharges of blood, often happen from various 
parts of the body. These however are so far from being always dangerous, 
that they prove often salutary. When such discharges are critical, which 
is frequently the case in fevers, they ought not to be stopped. Nor indeed 
is it proper at any time to stop them, unless they be so great as to 
endanger the patient's life. Most people, afraid of the smallest discharge 
of blood from any part of the body, fly immediately to the use of styptic 
and astringent medicines, by which means an inflammation of the brain, or 
some other fatal disease, is occasioned, which, had the discharge been 
allowed to go on, might have been prevented.

PERIODICAL discharges of blood, from whatever part of the body they 
proceed, must not be stopped. They are always the efforts of Nature to 
relieve her self; and fatal diseases have often been the consequence of 
obstructing them. It may indeed be sometimes necessary to check the 
violence of such discharges; but even this requires the greatest caution. 
Instances might be given where the stopping of a small periodical flux of 
blood, from one of the fingers, has proved fatal.

IN the early period of life, bleeding at the nose is very common. Those 
who are farther advanced in years are more liable to haemoptoe, or 
discharge of blood from the lungs. After the middle period of life, 
haemorrhoidal fluxes are most common; and in the decline of life, 
discharges of blood from the urinary passages.

INVOLUNTARY fluxes of blood may proceed from very different, and often 
from quite opposite causes. Sometimes they are owing to a particular 
construction of the body, as a sanguine temperament, laxity of the 
vessels, a plethoric habit, &c. At other times they proceed from a 
determination of the blood towards one particular part, as the head, the 
haemorrhoidal veins, &c. They may likewise proceed from an inflammatory 
disposition of the blood, in which case there is generally some degree of 
fever; this likewise happens when the flux is occasioned by an obstructed 
perspiration, or a stricture upon the skin, the bowels, or any particular 
part of the system.

BUT a dissolved state of the blood will likewise occasion haemorrhages. 
Thus, in putrid fevers, the dysentery, the scurvy, the malignant small-
pox, & c. there are often very great discharges of blood from different 
parts of the body. They may likewise be brought on by too liberal an use 
of medicines which tend to dissolve the blood, as cantharides, the 
volatile alkaline salts, &c. Food of an acrid or irritating quality may 
likewise occasion haemorrhages; as also strong purges and vomits, or any 
thing that greatly stimulates the bowels,

VIOLENT passions or agitations of the mind will likewise have this effect. 
These often cause bleeding at the nose, and I have known them sometimes to 
occasion an haemorrhage in the brain. Violent efforts of the body, by 
overstraining or hurting the vessels, may have the same effect, especially 
when the body is long kept in an unnatural posture, as hanging the head 
very low, &c.

THE cure of an haemorrhage must be adapted to its cause. When it proceeds 
from too much blood, or a tendency to inflammation, bleeding with gentle 
purges, and other evacuations, will be necessary. It will likewise be 
proper for the patient in this case to live chiefly upon a vegetable diet, 
to avoid all strong liquors, and food that is of an acrid, hot, or 
stimulating quality. The body should be kept cool, and the mind easy.

WHEN an haemorrhage is owing to a putrid or dissolved state of the blood, 
the patient ought to live chiefly upon acid fruits with milk, and 
vegetables of a nourishing nature, as sago, salop, &c. His drink may be 
wine diluted with water, and sharpened with the juice of lemon, vinegar, 
or spirits of vitriol. The best medicine in this case is the Peruvian 
bark, which may be taken according to the urgency of the symptoms.

WHEN a flux of blood is the effect of acrid food, or of strong stimulating 
medicines, the cure is to be effected by soft and mucilaginous diet. The 
patient may likewise take frequently about the bulk of a nutmeg of 
Locatelli's balsam, or the same quantity of sperma-ceti.

WHEN an obstructed perspiration, or a stricture upon any part of the 
system, is the cause of an haemorrhage, it may be removed by drinking warm 
diluting Iiquors, lying a-bed, bathing the extremities in warm water, &c.


BLEEDING AT THE NOSE.

BLEEDING at the nose is commonly preceded by some degree of quickness of 
the the pulse, flushing in the face, pulsation of the temporal arteries, 
heaviness in the head, dimness of the sight, heat and itching of the 
nostrils, &c.

TO persons who abound with blood this discharge is very salutary. It often 
cures a vertigo, the head-ach, a phrenzy, and even an epilepsy. In fevers, 
where there is a great determination of blood towards the head, it is of 
the utmost service. It is likewise beneficial in inflammations of the 
liver and spleen, and often in the gout and rheumatism. In all diseases 
where bleeding is necessary, a spontaneous discharge of blood from the 
nose is of much more service than the same quantity let with a lancet.

IN a discharge of blood from the nose, the great point is to determine 
whether it ought to be stopped or not. It is a common practice to stop the 
bleeding, without considering whether it be a disease, or the cure of the 
disease. This conduct proceeds from fear; but it has often bad, and 
sometimes fatal consequences.

WHEN a discharge of blood from the nose happens in an inflammatory 
disease, there is always reason to believe that it may prove salutary; and 
therefore it should be suffered to go on, at least as long as the patient 
is not weakened by it.

WHEN it happens to persons in perfect health, who are full of blood, it 
ought not to be suddenly stopped, especially if the symptoms of plethora, 
mentioned above, have preceded it. In this case it cannot be stopped 
without risking the patient's life.

IN fine, whenever bleeding at the nose relieves any bad symptom, and does 
not proceed so far as to endanger the patient"s life, it ought not to be 
stopped. But when it returns frequently, or continues till the pulse 
becomes low, the extremities begin to grow cold, the lips pale, or the 
patient complains of being sick, or faint, it must immediately be stopped.

FOR this purpose the patient should be set nearly upright, with his head 
reclining a little, and his legs immersed in water about the warmth of new 
milk. His hands ought likewise to be put in lukewarm water, and his 
garters may be tied a little tighter than usual. Ligatures may be applied 
to the arms, about the place where they are usually made for bleeding, and 
with nearly the same degree of tightness. These must be gradually 
slackened as the blood begins to stop, and removed entirely as soon as it 
gives over.

SOMETIMES dry lint put up the nostrils will stop the bleeding. When this 
does not succeed, dossils of lint dipped in strong spirits of wine, may be 
put up the nostrils, or if that cannot be had, they may be dipped in 
brandy. Blue vitriol dissolved in water may likewise be used for this 
purpose, or a tent dipped in the white of an egg well beat up, may be 
rolled in a powder made of equal parts of white sugar, burnt allum, and 
white vitriol, and put up the nostril from whence the blood issues.

INTERNAL medicines can hardly be of use here, as they have seldom time to 
operate. It may not however be amiss to give the patient half an ounce of 
Glauber's salt, and the same quantity of manna, dissolved in four or five 
ounces of barley-water. This may be taken at a draught, and repeated, if 
it does not operate, in a few hours. Ten or twelve grains of nitre may be 
taken in a glass of cold water and vinegar every hour, or oftener, if the 
stomach will bear it. If a stronger medicine be necessary, a tea-cupful of 
the tincture of roses, with twenty or thirty drops of the weak spirit of 
vitriol, may be taken every hour. When these things cannot be had, the 
patient may drink water, with a little common salt in it, or equal parts 
of water and vinegar.

IF the genitals be immersed for some time in cold water, it will generally 
stop a bleeding at the nose. I have seldom known this to fail.

SOMETIMES, when the bleeding is stopped outwardly, it continues inwardly. 
This is very troublesome, and requires particular attention, as the 
patient is apt to be suffocated with the blood, especially if he falls 
asleep, which he is very ready to do after losing a great quantity of 
blood.

WHEN the patient is in danger of suffocating from the blood getting into 
his throat, the passages may be stopped by drawing threads up the 
nostrils, and bringing them out at the mouth, Then fastening pieces of 
spunge, or small rolls of linen cloth to their extremities; afterwards 
drawing them back, and tying them on the outside with a sufficient degree 
of tightness.

AFTER the bleeding is stopped, the patient ought to be kept as easy and 
quiet as possible. He should not pick his nose, nor take away the tents or 
clotted blood, till they fall off of their own accord, and should not lie 
with his head low.

THOSE who are affected with frequent bleeding at the nose ought to bathe 
their feet often in warm water, and to keep them warm and dry. They ought 
to wear nothing tight about their necks, to keep their body as much in an 
erect posture as possible, and never to view any object obliquely. If they 
have too much blood, a vegetable diet, with now and then a cooling purge, 
is the safest way to lessen it.

BUT when the disease proceeds from a thin dissolved state of the blood, 
the diet should be rich and nourishing; as strong broths and jellies, sago-
gruel with wine and sugar, &c. Infusions of the Peruvian bark in wine 
ought likewise to be taken and persisted in for a considerable time.


OF THE BLEEDING AND BLIND PILES.

A DISCHARGE of blood from the hoemorrhoidal vessels is called the bleeding 
piles. When the vessels only swell, and discharge no blood, but are 
exceeding painful, the disease is called the blind piles.

PERSONS of a loose spungy fibre, of a bulky size, who live high, and lead 
a sedentary inactive life, are most subject to this disease. It is often 
owing to a hereditary disposition. Where this is the case, it attacks 
persons more early in life than when it is accidental. Men are more liable 
to it than women, especially those of a sanguine plethoric habit, or of a
melancholy disposition.

THE piles may be occasioned by an excess of bIood, by strong aloetic 
purges, high-seasoned food, drinking great quantities of sweet wines, the 
neglect of bleeding, or other customary evacuations, much riding, great 
costiveness, or any thing that occasions hard or difficult stools. Anger, 
grief, or other violent passions, will likewise occasion the piles. I have 
often known them brought on by cold, especially about the seat. A pair of 
thin breeches will excite the disorder in a person who is subject to it, 
and sometimes even in those who never had it before. Pregnant women are 
often afflicted with the piles.

A FLUX of blood from the anus is not always to be treated as a disease. It 
is even more salutary than bleeding at the nose, and often prevents or 
carries off diseases. It is peculiarly beneficial in the gout, rheumatism, 
asthma, and hypochondriacal complaints, and often proves critical in 
colics, and inflammatory fevers.

IN the management of the patient, regard must be had to his habit of body, 
his age, strength, and manner of living. A discharge which might be 
excessive and prove hurtful to one, may be very moderate, and even 
salutary to another. That only is to be esteemed dangerous which continues 
too long, and is in such quantity as to waste the patient's strength, hurt 
the digestion, nutrition, and other functions necessary to life.

WHEN this is the case, the discharge must be checked by a proper regimen, 
and astringent medicines. The DIET must be cool but nourishing, consisting 
chiefly of bread, milk, cooling vegetables and broths. The DRINK may be 
chalybeate water, orange-whey, decoctions or infusions of the astringent 
and mucilaginous plants, as the tormentil root, bistort, the marshmallow-
roots, &c.

OLD conserve of red roses is a very good medicine in this case. It may be 
mixed with new milk, and taken in the quantity of an ounce three or four 
times a-day . This medicine is in no great repute, owing to its being 
seldom taken in such quantity as to produce any effects; but when taken as 
here directed and duly persisted in, I have known it perform very 
extraordinary cures in violent haemorrhages, especially when assisted by 
the tincture of roses; a teacupful of which may be taken about an hour 
after every dose of the conserve.

THE Peruvian bark is likewise proper in this case, both as a strengthener 
and astringent. Half a drachm of it may be taken in a glass of red-wine, 
sharpened with a few drops of the elixir of vitriol, three or four times a-
day.

THE bleeding piles are sometimes periodical, and return regularly once a-
month, or once in three weeks. In this case they are always to be 
considered as a salutary discharge, and by no means to be stopped. Some 
have entirely ruined their health by stopping a periodical discharge of 
blood from the haemorrhoidal veins.

IN the blind piles bleeding is generally of use. The diet must be light 
and thin, and the drink cool and diluting. It is likewise necessary that 
the body be kept gently open. This may be done by small doses of the 
flowers of brimstone and cream of tartar. These may be mixed in equal 
quantities, and a tea-spoonful taken two or three times a-day, or oftener 
if necessary. Or an ounce of the flowers of brimstone and half an ounce of 
purified nitre may be mixed with three or four ounces of the lenitive 
electuary, and a tea-spoonful of it taken three or four times a-day.

EMOLLIENT clysters are here likewise beneficial; but there is sometimes 
such an astriction of the anus, that they cannot be thrown up. In this 
case I have known a vomit have very good effect.

WHEN the piles are exceeding painful and swelled, but discharge nothing, 
the patient must sit over the steams of warm water. He may likewise apply 
a linen cloth dipped in warm spirits of wine to the part, or poultices 
made of bread and milk, or of leeks fried with butter. If these do not 
produce a dischharge, and the piles appear large, leeches must be applied 
as near them as possible, or, it they will fix upon the piles themselves, 
so much the better. When leeches will not fix, the piles may be opened 
with a lancet. The operation is very easy, and is attended with no danger.

VARIOUS ointments, and other external applications, are recommended in the 
piles; but I do not remember to have seen any effects from these worth 
mentioning. Their principal use is to keep the part moist, which may be 
done as well by a soft poultice, or an emollient cataplasm. When the pain 
however is very great, a liniment made of two ounces of emollient ointment 
and half an ounce of liquid laudanum, beat up with the yolk of an egg, may 
be applied.


SPITTING OF BLOOD.

WE mean here to treat of that discharge of blood from the lungs only which 
is called an haemoptoe, or spitting of blood. Persons of a slender make, 
and a lax fibre, who have long necks and strait breasts, are most liable 
to this disease. It is most common in the spring, and generally attacks 
people before they arrive at the prime or middle period of life. It is a 
common observation, that those who have been subject to bleeding at the 
nose when young, are afterwards most liable to an haemoptoe.

CAUSES - An haemoptoe may proceed from excess of blood, from a peculiar 
weakness of the lungs, or a bad conformation of the breast. It is often 
occasioned by excessive drinking, running, wrestling, singing, or speaking 
aloud. Such as have weak lungs ought to avoid all violent exertions of 
that organ, as they value life. They should likewise guard against violent 
passions, excessive drinking, and every thing that occasions a rapid 
circulation of the blood.

THIS disease may likewise proceed from wounds of the lungs. These may 
either be received from without, or they may be occasioned by hard bodies 
getting unto the wind-pipe, and so falling down upon the lungs, and 
hurting that tender organ. The obstruction of any customary evacuation may 
occasion a spitting of blood; as neglect of bleeding or purging at the 
usual seasons, the stoppage of the bleeding piles in men, or the menses in 
women, &c. It may likewise proceed from a polypus, scirrhous concretions, 
or any thing that obstructs the circulation of the blood in the lungs. It 
is often the effect of a long and violent cough; in which case it is 
generally the forerunner of a consumption. A violent degree of cold 
suddenly applied to the external parts of the body will occasion an 
haemoptoe. It may likewise be occasioned by breathing air which is too 
much rarified to be able properly to expand the lungs. This is often the 
case with those who work in hot places, as furnaces, glass-houses, or the 
like. It may likewise happen to such as ascend to the top of very high 
mountains, as the Peak of Teneriff, &c.

SPITTING of blood is not always to be considered as a primary disease. It 
is often only a symptom, and in some diseases not an unfavourable one. 
This is the case in pleurisies, peripneumonies, and sundry other fevers. 
In a dropsy, scurvy, or consumption, it is a bad symptom, and shews that 
the lungs are ulcerated.

SYMPTOMS. - Spitting of blood is generally preceded by a sense of weight, 
and oppression of the breast, a dry tickling cough, hoarseness, and a 
difficulty of breathing. Sometimes it is ushered in with shivering, 
coldness of the extremities, costiveness, great lassitude, flatulence, 
pain of the back and loins, &c. As these shew a general stricture upon the 
vessels, and a tendency of the blood to inflammation, they are commonly 
the forerunners of a very copious discharge. The above symptoms do not 
attend a discharge of blood from the gums or fauces, by which means these 
may always be distinguished from an haemoptoe. Sometimes the blood that is 
spit up is thin and of a florid red colour; and at other times it is 
thick, and of a dark or blackish colour; nothing however can be inferred 
from this circumstance, but that the blood has lain a longer or shorter 
time in the breast before it was discharged.

SPITTING up of blood, in a strong healthy person, or a sound constitution, 
is not very dangerous; but when it attacks the tender and delicate, or 
persons of a weak lax fibre, it is with difficulty removed. When it 
proceeds from a scirrhous or polypus of the lungs, it is bad. The danger 
is greater when the discharge proceeds from the rupture of a large vessel 
than of a small one. When the extravasated blood is not spit up, but 
lodges in the breast, it corrupts, and greatly increases the danger. When 
the blood proceeds from an ulcer in the lungs, it is generally fatal.

REGIMEN. - The patient ought to be kept cool and easy. Every thing that 
heats the body or quickens the circulation, increases the danger. The mind 
ought likewise to be soothed, and every occasion of exciting the passions 
avoided. The diet should be soft, cooling and slender; as rice boiled with 
milk, small broths, barley-gruels, panado, &c. The diet, in this case, can 
scarce be too low. Even water-gruel is sufficient to support the patient 
for some days. All strong liquors must be avoided. The patient may drink 
milk and water, barley-water, whey, butter-milk, and such like. Every 
thing however should be drank cold, and in small quantities at a time. He 
should observe the strictest silence, or at least speak with a very low 
voice.

MEDICINE. - This, like the other involuntary discharges of blood, ought 
not to be suddenly stopped by astringent medicines. More mischief is often 
done by these than if it were suffered to go on. It may however proceed so 
far as to weaken the patient, and even endanger his life, in which case 
proper means must be used for restraining it.

THE body should be kept gently open by laxative diet; as roasted apples, 
stewed prunes, and such like. If these should not have the desired effect, 
a tea-spoonful of the lenitive electuary may be taken twice or thrice a-
day, as is found necessary. If the bleeding proves violent, ligatures may 
be applied to the extremities, as directed for a bleeding at the nose.

IF the patient be hot or feverish, bleeding and small doses of nitre will 
be of use; a scruple or half a drachm of nitre may be taken in a cup of 
his ordinary drink twice or thrice a-day. His drink may likewise be 
sharpened with acids, as juice of lemon, or a few drops of the spirit of 
vitriol; or he may take frequently a cup of the tincture of roses.

BATHING the feet and legs in lukewarm water has likewise a very good 
effect in this disease. Opiates too are sometimes beneficial; but these 
must be administered with caution. Ten or twelve drops of laudanum may be 
given in a cup of barley-water twice a-day, and continued for some time, 
provided they be found beneficial.

THE conserve of roses is likewise a very good medicine in this case, 
provided it be taken in sufficient quantity, and long enough persisted in. 
It may be taken to the quantity of three or four ounces a-day; and if the 
patient be troubled with a cough, it should be made into an electuary with 
balsamic syrup, and, a little of the syrup of poppies.

IF stronger astringents be necessary, fifteen or twenty drops of the acid 
elixir of vitriol may be given in a glass of water, three or four times a-
day.

THOSE who are subject to frequent returns of this disease, should avoid 
all excess. Their diet should be light and cool, consisting chiefly of 
milk and vegetables. Above all, let them be aware of vigorous efforts of 
the body, and violent agitations of the mind.


VOMITING OF BLOOD.

THIS is not so common as the other discharges of blood which have already 
been mentioned; but it is very dangerous, and requires particular 
attention.

VOMITING of blood is generally preceded by pain of the stomach, sickness, 
and nausea; and is accompanied with great anxiety, and frequent fainting 
fits.

THIS disease is sometimes periodical; in which case it is less dangerous. 
It often proceeds from an obstruction of the menses in women; and 
sometimes from the stopping of the haemorrhoidal flux in men. It may be 
occasioned by any thing that greatly stimulates or wounds the stomach, as 
strong vomits or purges, acrid poisons, sharp or hard substances taken 
into the stomach, &c. It is often the effect of obstructions in the liver, 
the spleen, or some of the other viscera. It may likewise proceed from 
external violence, as blows or bruises, or from any of the causes which 
produce inflammation. In hysteric women vomiting of blood is a very 
common, but by no means a dangerous symptom.

A GREAT part of the danger in this disease arises from the extravasated 
blood lodging in the bowels, and becoming putrid, by which means a 
dysentery or putrid fever may be occasioned. The best way of preventing 
this, is to keep the body gently open, by frequently exhibiting emollient 
clysters. Purges must not be given till the discharge is stopt, otherwise 
they will irritate the stomach, and increase the disorder. All the food 
and drink must be of a mild cooling nature, and taken in small quantities. 
Even drinking cold water has sometimes proved a remedy, but it will 
succeed better when sharpened with the spirits of vitriol. When there are 
signs of an inflammation, bleeding may be necessary; but the patient's 
weakness will seldom permit it. Opiates may be of use; but they must be 
given in very small doses, as four or five drops of liquid laudanum twice 
or thrice a-day.

AFTER the discharge is over, as the patient is generally troubled with 
gripes, occasioned by the acrimony of the blood Iodged in the intestines, 
gentle purges will be necessary.


OF BLOODY URINE.

THIS is a discharge of blood from the vessels of the kidneys or bladder, 
occasioned by their being either enlarged, broken, or eroded. It is more 
or less dangerous according to the different circumstances which attend it.

WHEN pure blood is voided suddenly without interruption and without pain, 
it proceeds from the kidneys; but if the blood be in small quantity, of 
dark colour, and emitted with heat and pain about the bottom of the belly, 
it proceeds from the bladder. When bloody urine is occasioned by a rough 
stone descending from the kidneys to the bladder, which wounds the 
ureters, it is attended with a sharp pain in the back, and difficulty of 
making water. If the coats of the bladder are hurt by a stone, and the 
bloody urine follows, it is attended with the most acute pain, and a 
previous stoppage of urine.

BLOODY urine may likewise be occasioned by falls, blows, the lifting or 
carrying of heavy burdens, hard riding, or any violent motion. It may also 
proceed from uIcers of the bladder, from a stone lodged in the kidneys, or 
from violent purges, or sharp diuretic medicines, especially cantharides.

BLOODY urine is always attended with some degree of danger; but it is 
peculiarly so when mixed with purulent matter as this shews an ulcer 
somewhere in the urinary passages. Sometimes this discharge proceeds from 
excess of blood, in which case it is rather to be considered as a salutary 
evacuation than a disease. If the discharge however be very great, it may 
may waste the patient's strength, and occasion an ill habit of body, a 
dropsy, or a consumption.

THE treatment of this disorder must be varied according to the different 
causes from which it proceeds.

WHEN it is owing to a stone in the bladder, the cure depends upon an 
operation; a description of which would be foreign to our purpose.

IF it be attended with plethora, and symptoms of inflammation, bleeding 
will be necessary. The body must likewise be kept open by emollient 
clysters, or purgative medicines; as cream of tartar, rhubarb, manna, or 
small doses of lenitive electuary.

WHEN bloody urine proceeds from a dissolved state of the blood, it is 
commonly the symptom of some malignant disease, as the small-pox, a putrid 
fever, or the like. In this case, the patient's life depends on the 
liberal use of the Peruvian bark and acids, as has already been shewn.

WHEN there is reason to suspect an ulcer In the kidneys or bladder, the 
patient's diet must be cool, and his drink of a soft, healing, balsamic 
quality, as decoctions of marsh-mallow roots with liquorice, solutions of 
gum-arabic, &c. Three ounces of marsh-mallow roots, and half an ounce of 
liquorice, may be boiled in two English quarts of water to one; two ounces 
of gum-arabic, and half an ounce of purified nitre, may be dissolved in 
the strained liquor, and a tea-cupful of it taken four or five times a-day.

THE early use of astringents in this disease has often bad consequences. 
When the flux is stopped too soon, the grumous blood, by being confined in 
the vessels, may produce inflammations, abscess, and ulcers. If however 
the case be urgent, or the patient seems to suffer from the loss of blood, 
gentle astringents may be necessary. In this case the patient may take 
three or four ounces of lime water, with half an ounce of the tincture of 
Peruvian bark, three times a-day.


OF THE DYSENTERY, OR BLOODY FLUX.

THIS disease prevails in the spring and autumn. It is most common in 
marshy countries, where, after hot and dry summers, it is apt to become 
epidemic. Persons are most liable to it who are much exposed to the night-
air, or who live in places where the air is confined and unwholesome. 
Hence it often proves fatal in camps, on shipboard, in jails, hospitals, 
and such like places.

CAUSES. - The dysentery may be occasioned by any thing that obstructs the 
perspiration, or renders the humours putrid; as damp beds, wet cloths, 
unwholesome diet, air, &c. But it is most frequently communicated by 
infection. This ought to make people extremely cautious in going near such 
persons as labour under the disease. Even the smell of the patient's 
excrements has been known to communicate the infection.

SYMPTOMS. - It is known by a flux of the belly, attended with violent pain 
of the bowels, a constant inclination to go to stool, and generally more 
or less blood in the stools. It begins, like other fevers, with chillness, 
loss of strength, a quick pulse, great thirst, and an inclination to 
vomit. The stools are at first greasy or frothy, afterwards they are 
streaked with blood, and, at last, have frequently the appearance of pure 
blood, mixed with filaments resembling bits of skin. Worms are sometimes 
passed both upwards and downwards through the whole course of the disease. 
When the patient goes to stool, he feels a bearing down, as if the whole 
bowels were falIing out, and sometimes a part of the intestine is actually 
protruded, which proves exceeding troublesome, especially in children. 
Flatulency is likewise a troublesome symptom, especially towards the end 
of the disease.

THIS disease may be distinguished from a diarrhoea or looseness, by the 
acute pain of the bowels, and the blood which generally appears in the 
stools. It may be distinguished from the cholera morbus by its not being 
attended with such violent and frequent fits of vomiting, &c.

WHEN the dysentery attacks the old, the delicate, or such as have been 
wasted by the gout, the scurvy, or other lingering diseases, it generally 
proves fatal. Vomiting and hiccuping are bad signs, as they shew an 
inflammation of the stomach. When the stools are green, black, or have an 
exceeding disagreeable cadaverous smell, the danger is very great, as it 
shows the disease to be of the putrid kind. It is an unfavourable symptom 
when clysters are immediately returned; but still more so, when the 
passage is so obstinately shut, that they cannot be injected. A feeble 
pulse, coldness of the extremities, with difficulty of swallowing, and 
convulsions, are signs of approaching death.

REGIMEN. - Nothing is of more importance in this disease than cleanliness. 
It contributes greatly to the recovery of the patient, and no less to the 
safety of such as attend him. In all contagious diseases the danger is 
increased and the infection spread by the neglect of cleanliness but in no 
one more than this. Every thing about the patient should be frequently 
changed. The excrements fhould never be suffered to continue in his 
chamber, but removed immediately, and buried under ground. A constant 
stream of fresh air should be admitted into the chamber; and it ought 
frequently to be sprinkled with vinegar, juice of lemon, or some other 
strong acid.

THE patient must not be discouraged, but his spirits kept up in hopes of a 
cure. Nothing tends more to render any putrid disease mortal, than the 
fears and apprehensions of the sick. All diseases of this nature have a 
tendency to sink and depress the spirits, and when that is increased by 
fears and alarms from those whom the patient believes to be persons of 
skill, it cannot fail to have the worst effects.

A FLANNEL waistcoat worn next the skin has often a very good effect in the 
dysentery. This promotes the perspiration without over-heating the body. 
Great caution however is necessary in leaving it off. I have often known a 
dysentery brought on by imprudently throwing off a flannel waistcoat 
before the season was sufficiently warm. For whatever purpose this piece 
of dress is worn, it should never be left off but in a warm season.

IN this disease the greatest attention must be paid to the patient's diet. 
Flesh, fish, and every thing that has a tendency to turn putrid or rancid 
on the stomach, must be abstained from. Apples boiled in milk, water-pap, 
and plain light pudding, with broth made of the gelatinous parts of 
animals, may be eat. Gelatinous broth not only answers the purpose of 
food, but likewise of medicine. I have often known dysenteries, which were 
not of a putrid nature, cured by it after pompous medicines had proved 
ineffectual. The manner of making this broth is, to take a sheep's head 
and feet with the skin upon them, and to burn the wool off with a hot 
iron; afterwards to boil them till the broth is quite a jelly. A little 
cinnamon or mace may be added, to give the broth an agreeable flavour, and 
the patient may take a little of it warm with toasted bread, three or four 
times a-day. A clyster of it may likewise be given twice a-day. Such as 
cannot use the broth made in this way, may have the head and feet skinned; 
but we have reason to believe that this hurts the medicine. It is not our 
business here to reason upon the nature and qualities of medicine, 
otherwise this might be shewn to possess virtues every way suited to the 
cure of a dysentery which does not proceed from a putrid state of the 
humours. One thing we know, which is preferable to all reasoning, that 
whole families have often been cured by it, after they had used many other 
medicines in vain. It will however be proper that the patient take a 
vomit, and a dose or two of rhubarb, before he begins to use the broth. It 
will likewise be necessary to continue the use of it for a considerable 
time, and to make it the principal food.

ANOTHER kind of food very proper in the dysentery, which may be used by 
such as cannot take the broth mentioned above, is made by boiling a few 
handfuls of fine flour, tied in a cloth, for six or seven hours, till it 
becomes as hard as starch. Two or three table-spoonfuls of this may be 
grated down, and boiled in such a quantity of new milk and water to be of 
the thickness of pap. This may be sweetened to the patient's taste, and 
taken for his ordinary food. The learned and humane Dr. Rutherford, late 
professor of medicine in the university of Edinburgh, used to mention this 
food in his public lectures with great encomiums. He directed it to be 
made by tying a pound or two of the finest flour, as tight as possible, in 
a linen rag, afterwards to dip it frequently in water, and to dridge the 
outside with flour, till a cake or crust was formed around it, which 
prevents the water from soaking into it while boiling. It is then to be 
boiled till it becomes a hard dry mass, as directed above. This, when 
mixed with milk and water, will not only answer the purpose of food, but 
may be given in clysters.

IN a putrid dysentery, the patient may be allowed to eat freely of most 
kinds of good ripe fruit; as apples, grapes, gooseberries, currant-
berries, strawberries, &c. These may either be eat raw or boiled, with or 
without milk, as the patient chuses. The prejudice against fruit in this 
disease is so great, that many beIieve it to be the common cause of 
dysenteries. This however is an egregious mistake. Both reason and 
experience shew, that good fruit is one of the best medicines, both for 
the prevention and cure of the dysentery. Good fruit is in every respect 
calculated to counteract that tendency to putrefaction, from whence the 
most dangerous kind of dysentery proceeds. The patient in such a case 
ought therefore to be allowed to eat as much fruit as he pleases, provided 
it be good. I lately saw a young man who had been seized with a dysentery 
in North America. Many things had been tried there for his relief, but to 
no purpose. At length, tired out with disappointments from medicine, and 
reduced to skin and bone, he came over to Britain, rather with a view to 
die among his relations, than with any hopes of a cure. After taking 
sundry medicines here with no better success than abroad, I advised him to 
leave off the use of drugs, and to trust entirely to a diet of milk and 
fruits, with gentle exercise. Strawberries was the only fruit he could 
procure at that season. These he eat with milk twice, and sometimes thrice 
a-day. The consequence was, that in a short time his stools were reduced 
from upwards of twenty in a day, to three or four, and sometimes not so 
many. He used the other fruits as they came a in, and was, in a few weeks, 
so well as to leave that part of' the country where I was, with a view to 
return to America.

THE most proper drink in this disorder is whey. The dysentery has often 
been cured by the use of clear whey alone. It may be taken both for drink, 
and in form of clyster. When whey cannot be had, barley-water sharpened 
with cream of tartar may be drank, or a decoction of barley and tamarinds; 
two ounces of the former and one of the latter may be boiled in two 
English quarts of water to one. Warm water-gruel, or water wherein hot 
iron has been frequently quenched, are all very proper, and may be drank 
in turns. Camomile-tea, if the stomach will bear it, is an exceeding 
proper drink. It both strengthens the stomach, and by its antiseptic 
quality tends to prevent a mortification of the bowels.

MEDICINE. - At the beginning of this disease it is always necessary to 
cleanse the first passages. For this purpose a vomit of ipecacuanha must 
be given, and wrought off with weak camomile-tea. Strong vomits are seldom 
necessary here. A scruple, or at most half a drachm of ipecacuanha, is 
generally sufficient for an adult, and sometimes a very few grains will 
suffice. The day after the vomit, half a drachm, or two scruples of 
rhubarb, must be taken; or, what will answer the purpose rather better, an 
ounce or an ounce and a half of Epsom salts. This dose may be repeated 
every other day for two or three times. Afterwards small doses of 
ipecacuanha may be taken for some time. Two or three grains of the powder 
may be mixed in a table-spoonful of the syrup of poppies, and taken three 
times a-day.

THESE evacuations, and the regimen prescribed above, will often be 
sufficient to effect a cure. Should it however happen otherwise, the 
following astringent medicines may be used.

A CLYSTER of starch or fat mutton-broth, with thirty or forty drops of 
liquid laudanum in it, may be administered twice a-day. At the same time 
an ounce of gum-arabic, and half an ounce of gum-tragacanth, may be 
dissolved in an English pint of barley-water, over a slow fire, and a 
table-spoonful of it taken every hour.

IF these have not the desired effect, the patient may take, four times a-
day, about the bulk of a nutmeg of the Japonic confection, drinking after 
it a teacupful of the decoction of logwood. See Appendix, Decoction of 
Logwood.

PERSONS who have been cured of this disease are very liable to suffer a 
relapse; to prevent which, great circumspection with respect to diet is 
necessary. The patient must abstain from all fermented liquors, except now 
and then a glass of good wine; but he must drink no kind of malt-liquor. 
He should likewise abstain from animal food, as fish and flesh, and live 
principally on milk and vegetables.

GENTLE exercise and wholesome air are likewise of importance. The patient 
should go to the country as soon as his strength will permit, and should 
take exercise daily on horseback, or in a carriage. He may likewise use 
bitters infused in wine or brandy, and may drink twice a-day a gill of 
lime-water mixed with an equal quantity of new milk.

WHEN dysenteries prevail, we would recommend a strict attention to 
cleanliness, a spare use of animal food, and the free use of sound ripe 
fruits, and other vegetables. The night air is to be carefully avoided, 
and all communication with the sick. Bad smells are likewise to be 
shunned, especially those which arise from putrid animal substances. The 
necessaries where the sick go are carefully to be avoided.

WHEN the first symptoms of the dysentery appear, the patient ought 
immediately to take a vomit, to go to bed, and drink plentifully of weak 
warm liquor, to promote a sweat. This, with a dose or two of rhubarb at 
the beginning, would often carry off the disease. In countries where 
dysenteries prevail, we would advise such as are liable to them, to take 
either a vomit or a purge every spring or autumn as a preventive.


OF THE COELIAC PASSION

THERE are sundry other fluxes of the belly, as the LIENTERY and COELIAC 
PASSION, which, though less dangerous than the dysentery, yet merit 
consideration. These diseases generally proceed from a relaxed state of 
the stomach and intestines, which is sometimes so great, that the food 
passes through them without almost any sensible alteration; and the 
patient dies merely from the want of nourishment.

WHEN the lientery or coeliac passion succeeds to a dysentery, the case is 
bad. They are always dangerous in old age, especially when the 
constitution has been broken by excess or acute diseases. If the stools be 
very frequent, and quite crude, the thirst great, with little urine, the 
mouth ulcerated, and the face marked with spots of different colours, the 
danger is very great.

THE treatment of the patient is in general the same as in the dysentery. 
In all obstinate fluxes of the belly, the cure must be attempted, by first 
cleansing the stomach and bowels with gentle vomits and purges; afterwards 
such a diet as has a tendency to heal and strengthen the bowels, with 
opiates and astringent medicines, will generally perfect the cure.

THE same observation holds with respect to a TENESMUS, or frequent desire 
of going to stool. This disease resembles the dysentery so much, both in 
its symptoms and method of cure, that we think it needless to insist upon 
it.



CHAPTER XXXIV.
OF THE HEAD-ACH.

ACHES and pains proceed from very different causes, and may effect any 
part of the body; but we shall point out those only which occur most 
frequently, and are attended with the greatest danger.

WHEN the head-ach is slight; and effects a particular part of the head 
only, it is called cephalalgia; when the whole head is affected, cephalea; 
and when on one side only, hemicrania. A fixed pain in the forehead, which 
may be covered with the end of the thum, is called the clavis hystericus.

THERE are also other distinctions. Sometimes the pain is internal, 
sometimes external, sometimes it is an original disease, and at other 
times only symptomatic. When the head-ach proceeds from a hot bilious 
habit, the pain is very acute and throbbing, with a considerable heat of 
the part affected. When from a cold phlegmatic habit, the patient 
complains of a dull heavy pain, and has a sense of coldness in the part. 
This kind of head-ach is sometimes attended with a degree of stupidity or 
folly.

WHATEVER obstructs the free circulation of the blood through the vessels 
of the head, may occasion a head-ach. In persons of a full habit, who 
abound with blood, or other humours, the head-ach often proceeds from the 
suppression of customary evacuations; as bleeding at the nose, sweating of 
the feet, &c. It may likewise proceed from any cause that determines a 
great flux of blood towards the head; as coldness of the extremities, or 
hanging down the head for a long time. Whatever prevents the return of the 
blood from the head will likewise occasion a head-ach; as looking long 
obliquely at any object, wearing any thing tight about the neck, or the 
like.

WHEN a head-ach proceeds from the stoppage of a running at the nose, there 
is a heavy, obtuse, pressing pain in the fore-part of the head, in which 
there seems to be such a weight, that the patient can scarce hold it up. 
When it is occasioned by the caustic matter of the venereal disease, it 
generally affects the skull, and often produces a caries of the bones.

SOMETIMES the head-ach proceeds from the repulsion, or retrocession of the 
gout, the erysipelas, the small-pox, measles, itch, or other eruptive 
diseases. What is called a hemicrania generally proceeds from crudities or 
indigestion. Inanition, or emptiness, will also occasion head-achs. I have 
often seen instances of this in nurses who gave suck too long, or who did 
not take a sufficient quantity of solid food.

THERE is likewise a most violent, fixed, constant, and almost intolerable 
head-ach, which occasions great debility both of body and mind, prevents 
sleep, destroys the appetite, causes a vertigo, dimness of sight, a noise 
in the ears, convulsions, epileptic fits, and sometimes vomiting, 
costiveness, coldness of the extremities, &c.

THE head-ach is often symptomatic in continual and intermittting fevers, 
especially quartans. It is likewise a very common symptom in hysteric and 
hypochondriac complaints.

WHEN a head-ach attends an acute fever, with pale urine, it is an 
unfavourable symptom. In excessive head-achs, coldness of the extremities 
is a bad sign.

WHEN the disease continues long, and is very violent, it often terminates 
in blindness, an apoplexy, deafness, a vertigo, the palsy, epilepsy, &c.

IN this disease the cool regimen in general is to be observed. The diet 
ought to consist of such emollient substances as will correct the acrimony 
of the humours, and keep the body open; as apples boiled in milk, spinage, 
turnips, and such like. The drink ought to be diluting; as barley-water, 
infusions of mild mucilaginous vegetables, decoctions of the sudorific 
woods, &c. The feet and legs ought to be kept warm, and frequently bathed 
in luke-warm water; the head should be shaved, and bathed with water and 
vinegar. The patient ought, as much as possible, to keep in an erect 
posture, and not to lie with his head too low.

WHEN the head-ach is owing to excess of blood, or an hot bilious 
constitution, bleeding is necessary. The patient may be bled in the 
jugular vein, and the operation repeated if there be occasion. Cupping 
also, or the application of leeches to the temples, and behind the ears, 
will be of service. Afterwards a blistering-plaster may be applied to the 
neck, behind the ears, or to any part of the head that is most affected. 
In some cases it will be proper to blister the whole head. In persons of a 
gross habit, issues or perpetual blisters will be of service. The body 
ought likewise to be kept open by gentle laxatives.

BUT when the head-ach proceeds from a copious vitiated serum stagnating in 
the membranes, either within or without the skull, with a dull, heavy, 
continual pain, which will neither yield to bleeding nor gentle laxatives, 
then more powerful purgatives are necessary, as pills made of aloes, resin 
of jalap, or the like. It will also be necessary in this case to blister 
the whole head, and to keep the back part of the neck open for a 
considerable time by a perpetual blister.

WHEN the head-ach is occasioned by the stoppage of a running at the nose, 
the patient should frequently smell to a bottle of volatile salts; he may 
likewise take snuff, or any thing that will irritate the nose, so as to 
promote a discharge from it; as the herb mastich, ground-ivy, &c.

A hemicrania, especially a periodical one, is generally owing to a 
foulness of the stomach, for which gentle vomits must be administered, as 
also purges of rhubarb. After the bowels have been sufficiently cleared, 
chalybeate waters, and such bitters as strengthen the stomach, will be 
necessary.

WHEN the head-ach arises from a vitiated state of the humours, as in the 
scurvy and venereal disease, the patient, after proper evacuations, must 
drink freely of the decoction of woods or the decoction of sarsaparilla, 
with raisins and liquorice. See Appendix, Decoction of Sarsaparilla. These 
promote perspiration, sweeten the humours, and, if duly persisted in, will 
produce very happy effects. When a collection of matter is felt under the 
skin, it must be discharged by an incision, otherwise it will render the 
bone carious.

WHEN the head-ach is so intolerable as to endanger the patient's life, or 
is attended with continual watching, delirium, &c. recourse must be had to 
opiates. These, after proper evacuations by clysters, or mild purgatives, 
may be applied both externally and internally. The affected part may be 
rubbed with Bate's anodyne balsam, or a cloth dipped in it may be applied 
to the part. The patient may, at the, same time, take twenty drops of 
laudanum, in a cup of valerian or penny-royal tea, twice or thrice a-day. 
This is only to be done in case of extreme pain. Proper evacuations ought 
always to accompany and follow the use of opiates. When the pain is very 
violent, and does not yield to small doses of laudanum, the quantity may 
be increased. I have known a patient in extreme pain take three hundred 
drops in twenty-four hours; but such doses ought only to be administered 
by a person of skill.

WHEN the patient cannot bear the loss of blood, his feet ought frequently 
to be bathed in luke-warm water, and well rubbed with a coarse cloth. 
Cataplasms with mustard or horseradish ought likewise to be applied to-
them. This course is peculiarly necessary when the pain proceeds from a 
gouty humour affecting the head.

WHEN the head-ach is occasioned by great heat, hard labour, or violent 
exercise of any kind, it may be allayed by cooling medicines; as the 
saline, draughts with nitre, and the like.

A LITTLE of Ward's essence, dropt into the palm of the hand and applied to 
the forehead, will sometimes remove a violent head-ach; and so will 
aether, when applied in the same manner.


OF THE TOOTH-ACH.

THIS disease is so well known, that it needs no description. It has great 
affinity with the rheumatism, and often succeeds pains of the shoulders 
and other parts of the body.

IT may proceed from obstructed perspiration, or any of the other causes of 
inflammation. I have often known the tooth-ach occasioned by neglecting 
some part of the usual coverings of the head, by sitting with the head 
bare near an open window, or exposing it any how to a draught of cold air. 
Food or drink taken either too hot or too cold is very hurtful to the 
teeth. Great quantities of sugar, or other sweet-meats, are likewise 
hurtful. Nothing is more destructive to the teeth than cracking nuts, or 
chewing any kind of hard substances. Picking the teeth with pins, needles, 
or any thing that may hurt the enamel with which they are covered, does 
great mischief, as the tooth is sure to be spoiled whenever the air gets 
into it. Breeding women are very subject to the tooth-ach, especially 
during the first three or four months of pregnancy. The tooth-ach often 
proceeds from scorbutic humours affecting the gums. In this case the teeth 
are sometimes wasted, and fall out without any considerable degree of 
pain. The more immediate cause of the tooth-ach is a rotten or carious 
tooth.

IN order to relieve the tooth-ach, we must first endeavour to draw off the 
humours from the part affected. This may be done by mild purgatives, 
scarifying the gums, or applying leeches to them, and bathing the feet 
frequently with warm water. The perspiration ought likewise to be 
promoted, by drinking freely of weak wine-whey, or other diluting liquors, 
with small doses of nitre. Vomits too have often an exceeding good effect 
in the tooth-ach. It is seldom safe to administer opiates, or any kind of 
heating medicines, or even to draw a tooth till proper evacuations have 
been premised; and these alone will often effect the cure.

IF this fails, and the pain and inflammation still increase, a suppuration 
may be expected, to promote which a toasted fig should be held between the 
gum and the cheek; bags filled with boiled camomile flowers, flowers of 
elder, or the like, may be applied near the part affected, with as great a 
degree of warmth as the patient can bear, and renewed as they grow cool: 
the patient may likewise receive the steams of warm water into his mouth, 
through an inverted funnel, or by holding his head over the mouth of a 
porringer filled with warm water, & c.

SUCH things as promote the discharge of saliva, or cause the patient to 
spit, are generally of service. For this purpose, bitter, hot, or pungent 
vegetables may be chewed; as gentian, calamus aromaticus, or pellitory of 
Spain. Allen recommends the root of yellow water flower-de-luce in this 
case. This root may either be rubbed upon the tooth, or a little of it 
chewed. Brookes says he hardly ever knew it fail to ease the tooth-ach. It 
ought however to be used with caution.

MANY other herbs, roots, and seeds, are recommended for curing the tooth-
ach; as the leaves or roots of millefoil or yarrow chewed, tobacco smoked 
or chewed, staves-acre, or the seeds of mustard chewed, &c. These bitter, 
hot, and pungent things, by occasioning a greater flow of saliva, 
frequently give ease in the tooth-ach.

OPIATES often relieve the tooth-ach. For this purpose a little cotton wet 
with laudanum may be held between the teeth, or a piece of sticking 
plaster, about the bigness of a shilling, with a bit of opium in the 
middle of it, of a size not to prevent the sticking of the other, may be 
laid on the temporal artery, where the pulsation is most sensible. De la 
Motte affirms, that there are few cases wherein this will not give reIief. 
If there be a hollow tooth, a small pill made of equal parts of camphire 
and opium, put into the hollow, is often beneficial. When this cannot be 
had, the hollow tooth may be filled with gum mastich, wax, Iead, or any 
substance that will stick in it, and keep out the external air.

FEW applications give more relief in the tooth-ach than blistering 
plasters. These may be applied betwixt the shoulders, but they have the 
best effect when put behind the ears, and made so large as to cover a 
great part of the lower-jaw.

AFTER all, when a tooth is carious, it is often impossible to remove the 
pain without extracting it; and, as a spoilt tooth never becomes sound 
again, it is prudent to draw it soon, lest it should affect the rest. 
Tooth-drawing, like bleeding, is very much practised by mechanics as well 
as persons of the medical profession. The operation however is not without 
danger, and ought always to be performed with care. A person unacquainted 
with the structure of the parts will be in danger of hurting the jaw-bone 
or of drawing a sound tooth instead of a rotten one. This may always be 
prevented by the operator striking upon the teeth with any piece of metal, 
as this never faiIs to excite the pain in the carious tooth.

WHEN the tooth-ach returns periodically, and the pain chiefly affects the 
gums, it may be cured by the bark.

SOME pretend to have found great benefit in the tooth-ach, from the 
application of an artificial magnet to the affected tooth. We shall not 
attempt to account for its mode of operation, but, if it be found to 
answer, though only in particular cases, it certainly deserves a trial, as 
it is attended with no expence, and cannot do any harm. Electricity has 
likewise been recommended, and particular instruments have been invented 
for sending a shock through the affected tooth.

PERSONS who have returns of the tooth-ach at certain seasons, as spring 
and autumn, might often prevent it by taking a purge at these times.

KEEPING the teeth clean has no doubt a tendency to prevent the tooth-ach. 
The best method of doing this is to wash them daily with salt and water, a 
decoction of the bark, or with cold water alone. All brushing and scraping 
of the teeth is dangerous, and, unless it be performed with great care, 
does mischief.


OF THE EAR-ACH.

THIS disorder chiefly affects the membrane which lines the inner cavity of 
the ear called the meatus auditorius. It is often so violent as to 
occasion great restlessness, anxiety, and even delirium. Sometimes 
epileptic fits, and other convulsive disorders, have been brought on by 
extreme pain in the ear.

THE ear-ach may proceed from any of the causes which produce inflammation. 
It often proceeds from a sudden suppression of perspiration, or from the 
head being exposed to cold when covered with sweat. It may also be 
occasioned by worms, or other insects getting into the ear, or being bred 
there; or from any hard body sticking in the ear. Sometimes it proceeds 
from the translation of morbific matter to the ear. This often happens in 
the decline of malignant fevers, and occasions deafness which is generally 
reckoned a favourable symptom.

WHEN the ear-ach proceeds from insects, or any hard body sticking in the 
ear, every method must be taken to remove them as soon as possible. The 
membranes may be relaxed by dropping into the ear oil of sweet almonds, or 
olive oil. Afterwards the patient should be made to sneeze, by taking 
snuff, or some strong sternutatory. If this should not force out the body, 
it must be extracted by art. I have seen insects, which had got into the 
ear, come out of their own accord upon pouring in oil, which is a thing 
they cannot bear.

WHEN the pain of the ear proceeds from inflammation, it must be treated 
like other topical inflammations, by a cooling regimen, and opening 
medicines. Bleeding at the beginning, either in the arm or jugular vein, 
or cupping in the neck, will be proper. The ear may likewise be fomented 
with steams of warm water, or flannel bags filled with boiled mallows and 
camomile flowers may be applied to it warm; or bladders filled with warm 
milk and water. An exceeding good method of fomenting the ear is to apply 
it close to the mouth of a jug filled with warm water, or a strong 
decoction of camomile flowers.

THE patient's feet should be frequently bathed in lukewarm water, and he 
ought to take small doses of nitre and rhubarb, viz. a scruple of the 
former, and ten grains of the latter, three times a-day. His drink may be 
whey, or decoctions of barley and liquorice with figs or raisins. The 
parts behind the ear ought frequently to be rubbed with camphorated oil, 
or a little of the volatile liniment.

WHEN the inflammation cannot be discussed, a poultice of bread and milk, 
or roasted onions, may be applied to the ear, and frequently renewed, till 
the abscess breaks, or can be opened. Afterwards the humours may be 
diverted from the part by gentle laxatives, blifters, or issues; but the 
discharge must not be suddenly dried up by any external application.


PAIN OF THE STOMACH, &c.

THIS may proceed from various causes; as indigestion; wind; the acrimony 
of the bile; sharp, acrid, or poisonous substances taken into the stomach, 
&c. It may likewise proceed from worms; the stoppage of customary 
evacuations; a translation of gouty matter to the stomach, the bowels, &c.

WOMEN in the decline of life are very liable to pains of the stomach and 
bowels, especially such as are afflicted with hysteric complaints. It is 
likewise very common to hypochondriac men of a sedentary and luxurious 
life. In such persons it often proves so extremely obstinate as to baffle 
all the powers of medicine.

WHEN the pain of the stomach is most violent after eating, there is reason 
to suspect that it proceeds from some fault either in the digestion or the 
food. In this case the patient ought to change his diet, till he finds 
what kind of food agrees best with his stomach, and should continue 
chiefly to use it. If a change of diet does not remove the complaint, the 
patient may take a gentle vomit, and afterwards a dose or two of rhubarb. 
He ought likewise to take an infusion of camomile flowers, or some other 
stomachic bitter, either in wine or water. I have often known exercise 
remove this complaint, especially sailing, or a long journey on horseback, 
or in a carriage.

WHEN a pain of the stomach proceeds from flatulency, the patient is 
constantly belching up wind, and feels an uneasy distention of the stomach 
after meals. This is a most deplorable disease, and is seldom thoroughly 
cured. In general, the patient ought to avoid all windy diet, and every 
thing that sours on the stomach, as greens, roots, &c. This rule, however 
admits of some exceptions. There are many instances of persons very much 
troubled with wind, who received great benefit from eating parched pease, 
though that grain is generally supposed to be of a windy nature. These are 
prepared by steeping or soaking pease in water, and afterwards drying them 
in a pot or kiln till they be be quite hard. They may be used at pleasure.

THIS complaint may likewise be greatly relieved by labour, especially 
digging, reaping, mowing, or any kind of active employment by which the 
bowels are alternately compressed and dilated. The most obstinate case of 
this kind I ever met with was in a person of a sedentary occupation, whom 
I advised after he had tried every kind of medicine in vain, to turn 
gardener; which he did, and has ever since enjoyed good health.

WHEN a pain of the stomach is occasioned by the swallowing of acrid or 
poisonous substances, they must be discharged by vomit; this may be 
excited by butter, oils, or other soft things, which sheath and defend the 
stomach from the acrimony of its contents.

WHEN pain of the stomach proceeds from a translation of gouty matter, warm 
cordials are necessary, as generorus wines, French brandy, &c. Some have 
drank a whole bottle of brandy or rum, in this case, in a few hours, 
without being in the least intoxicated, or even feeling the stomach warmed 
by it. It is impossible to ascertain the quantities necessary upon these 
occasions. This must be left to the feelings and discretion of the 
patient. The safer way however is, not to go too far. When there is an 
inclination to vomit, it may be promoted by drinking an infusion of 
camomile flowers, or carduus benedictus.

IF a pain of the stomach proceeds from the stoppage of customary 
evacuations, bleeding will be necessary, especially in sanguine and very 
full habits. It will likewise be of use to keep the body gently open by 
mild purgatives; as rhubarb or senna, &c. When this disease affects women, 
in the decline of life, after the stoppage of the menses, making an issue 
in the leg or arm will be of peculiar service.

WHEN the disease is occasioned by worms, they must be destroyed, or 
expelled by such means as are recommended in the following section.

WHEN the stomach is greatly relaxed and the digestion bad, which often 
occasion flatulencies, the acid elixir of vitriol will be of singular 
service. Fifteen or twenty drops of it may be taken in a glass of wine or 
water twice or thrice a-day.

PERSONS afflicted with flatulency are generally unhappy unless they be 
taking some purgative medicines; these, though they may give immediate 
ease, tend to weaken and relax the stomach and bowels, and consequently 
increase the disorder. Their best method is to mix purgatives and 
stomachics together. Equal parts of Peruvian bark and rhubarb may be 
infused in brandy or wine, and taken in such quantity as to keep the body 
gently open.