Domestic Medicine - Chapters 54-55



CHAPTER LIV.
OF FAINTING FITS, AND OTHER CASES WHICH REQUIRE IMMEDIATE ASSISTANCE.

STRONG and healthy persons, who abound with blood, are often seized with 
sudden fainting fits, after violent excrcise, drinking freely of warm or 
strong liquors, exposure to great heat, intense application to study, or 
the like.

IN such cases the patient should be made to smell to some vinegar. His 
temples, forehead, and wrists ought at the same time to be bathed with 
vinegar mixed with an equal quantity of warm water; and two or three 
spoonfuls of vinegar, with four or five times as much water, may, if he 
can swallow, be poured into his mouth.

IF the fainting proves obstinate, or degenerates into a syncope, that is, 
an abolition of feeling and understanding, the patient must be bled. After 
the bleeding, a clyster will be proper, and then he should be kept easy 
and quiet, only giving him every half hour a cup or two of an infusion of 
any mild vegetable, with the addition of a little sugar and vinegar.

WHEN swoonings, which arise from this cause, occur frequently in the same 
person, he should, in order to escape them, confine himself to a light 
diet, consisting chiefly of bread, fruits, and other vegetables. His drink 
ought to be water, or small beer, and he should sleep but moderately, and 
take much exercise.

BUT fainting fits proceed much oftener from a defect, than an excess of 
blood. Hence they are very ready to happen after great evacuations of any 
kind, obstinate watching, want of appetite, or such like. In these an 
almost directly opposite course to that rnentioned. above must be pursued.

THE patient should be laid in bed, with his head low, and being covered, 
should have his legs, thighs, arms, and his whole body rubbed strongly 
with hot flannels. Hungary water, volatile salts, or strong smelling 
herbs, as rue, mint, or rosemary, may be held to his nose. His mouth may 
be wet with a little rum or brandy; and, if he can swallow, some hot wine, 
mixed with sugar and cinnamon, which is an excellent cordial, may be 
poured into his mouth. A compress of flannel dipt in hot wine or brandy 
must be applied to the pit of his stomach, and warm bricks, or bottles 
filled with hot water, laid to the feet.

AS soon as the patient is recovered a little, he should take some strong 
soup or broth, or a little bread or biscuit soaked in hot-spiced wine. To 
prevent the return or the fits, he ought to take often, but in small 
quantities, some light yet strengthening nourishment, as panado made with 
soup instead of water, new laid eggs lightly poached, chocolate, light 
roast meats, jellies, and such like.

THOSE fainting fits, which are the effect of bleeding, or of the violent 
operation of purges, belong to this class. Such as happen after artificial 
bleeding are seldom dangerous, generally terminating as soon as the 
patient is laid upon the bed; indeed persons subject to this kind should 
always be bled lying, in order to prevent it. Should the fainting, 
however, continue longer than usual, volatile spirits may be held to the 
nose, and rubbed on the temples, &C.

WHEN fainting is the effect of too strong or acrid purges or vomits, the 
patient must be treated in all respects as if he had taken poison. He 
should be made made to drink plentifully of milk, warm water, and oil, 
barley-water, or such like; emollient clysters will likewise be proper, 
and the patient's strength should afterwards be recruited, by giving him 
generous cordials, and anodyne medicines.

FAINTINGS are often occasioned by indigestion. This may either proceed 
from the quantity or quality of the food. When the former of these is the 
cause, the cure will be best performed by vomiting, which may be promoted 
by causing the patient to drink a weak infusion of camomile flowers, 
carduus benedictus, or the like. When the disorder proceeds from the 
nature of the food, the patient, as in the case of weakness, must be 
revived by strong smells, &c. after which he should be made to swallow a 
large quantity of light warm fluid, which may serve to drown, as it were, 
the offending matter, to soften its acrimony, and either to effect a 
discharge of it by vomiting, or force it down into the intestines.

EVEN disagreeable smells will sometimes occasion swoonings, especially in 
people of weak nerves. When this happens, the patient should be carried 
into the open air, have stimulating things held to his nose, and those 
substances which are disagreeable to him ought immediately to be removed. 
But we have already taken notice of swoonings which arise from nervous 
disorders, and shall therefore say no more upon that head.

FAINTING-FITS often happen in the progress of diseases. In the beginning 
of putrid diseases, they generally denote an oppression at stomach, or a 
mass of corrupted humours, and they cease after evacuations either by 
vomit or stool. When they occur at the beginning of malignant fevers, they 
indicate great danger. In each of these cases, vinegar used both 
externally and internally is the best remedy during the paroxysm, and 
plenty of lemon-juice and water after it. Swoonings which happen in 
diseases accompanied with great evacuations, must be treated like those 
which are owing to weakness, and the evacuations ought to be restrained. 
When they happen towards the end of a violent fit of an intermitting 
fever, or at that of each exacerbation of a continual fever, the patient 
must be supported by small draughts of wine and water.

DELICATE and hysteric women are very liable to swooning or fainting fits 
after delivery. These might be often prevented by generous cordials, and 
the admission of fresh air. When they are occasioned by excessive 
flooding, it ought by all means to be restrained. They are generally the 
effect of mere weakness or exhaustion. Dr. Engleman relates the case of a 
woman "in childbed, who, after being happily delivered, suddenly fainted, 
and lay upwards of a quarter of an hour apparently dead. A physician was 
sent for; her own maid, in the mean while, being out of patience at his 
delay, attempted to assist her herself, and extending herself upon her 
mistress, applied her mouth to her's, blew in as much breath as she 
possibly could, and in a very short time the exhausted woman awaked as out 
of a profound sleep; when proper things being given her, she soon 
recovered."

THE maid being asked how she came to think of this expedient, said she had 
seen it practiced at Altenburgh, by midwives, upon children with the 
happiest effect.

WE mention this case chiefly that other midwives may be induced to follow 
so laudable an example. Many children are born without any signs of life, 
and others expire soon after the birth, who might, without all doubt, by 
proper care, be restored, to life.

FROM whatever cause fainting fits proceed, fresh air is always of the 
greatest importance to the patient. By not attending to this circumstance, 
people often kill their friends while they are endeavouring to save them. 
Alarmed at the patient's situation, they call in a crowd of people to his 
assistance, or perhaps to witness his exit, whose breathing exhausts the 
air, and increases the danger. There is not the least doubt but this 
practice, which is very common among the lower sort of people, often 
proves fatal, especially to the delicate, and such persons as fall into 
fainting fits from mere exhaustion, or the violence of some disease. No 
more persons ought ever to be admitted into the room where a patient lies 
in a swoon than are absolutely necessary for his assistance, and the 
windows of the apartment should always be opened, at least as far as to 
admit a stream of fresh air.

PERSONS subject to frequent swoonings, or fainting fits, should neglect no 
means to remove the cause of them, as their consequences are always 
injurious to the constitution. Every fainting fit leaves the person in 
dejection and weakness; the secretions are thereby suspended, the humours 
disposed to stagnation, coagulations and obstructions are formed, and, if 
this motion of the blood be totally intercepted, or very considerably 
checked, polypuses are sometimes formed in the heart or larger vessels. 
The only kind of swoonings not to be dreaded are those which sometimes 
mark the crisis in fevers; yet even these ought, as soon as possible, to 
be removed.


OF INTOXICATION.

THE effects of intoxication are often fatal. No kind of poison kills more 
certainly than an overdose of ardent spirits. Sometimes by destroying the 
nervous energy, they put an end to life at once; but in general their 
effects are more slow, and in many respects similar to those of opium. 
Other kinds of intoxicating liquors may prove fatal when taken to excess, 
as well as ardent spirits; but they may generally be discharged by 
vomiting, which ought always to be excited when the stomach is overcharged 
with liquor.

MORE of those unhappy persons, who die intoxicated, lose their lives from 
an inability to conduct themselves, than from the destructive quality of 
the liquor. Unable to walk, they tumble down, and lie in some awkward 
posture, which obstructs the circulation or breathing, and often continue 
in this situation till they die. No drunk person should be left by 
himself, till his clothes have been loosened, and his body laid in such a 
posture as is most favourable for continuing the vital motions, 
discharging the contents of the stomach, &c. The best posture for 
discharging the contents of the stomach is to lay the person upon his 
belly; when asleep he may be laid on his side, with his head a little 
raised, and particular care must be taken that his neck be no way bent, 
twisted, or, have any thing too tight about it.

THE excessive degree of thirst occasioned by drinking strong liquors, 
often induces people to quench it by taking what is hurtful. I have known 
fatal consequences even from drinking freely of milk after a debauch of 
wine or sour punch; these acid liquors, together with the heat of the 
stomach, having coagulated the milk in such a manner that it could never 
be digested. The safest drink after a debauch is water with a toast, tea, 
infusions of balm, sage, barley-water, and such like. If the person wants 
to vomit, he may drink a weak infusion of camomile flowers, or lukewarm 
water and oil; but in this condition vomiting may generally be excited by 
only tickling the throat with the finger or a feather.

INSTEAD of giving a detail of all the different symptoms of intoxication 
which indicate danger, and proposing a general plan of treatment for 
persons in this situation, I shall briefly relate the history of a case, 
which lately fell under my own observation, wherein most of those symptoms 
usually reckoned dangerous concurred, and where the treatment was 
successful.

A YOUNG man, about fifteen years of age, had, for a hire, drank ten 
glasses of strong brandy. He soon after fell fast asleep, and continued in 
that situation for near twelve hours, till at length his uneasy manner of 
breathing, the coldness of the extremities, and other threatening 
symptoms, alarmed his friends and made them send for me. I found him still 
sleeping, his countenance ghastly, and his skin covered with a cold clammy 
sweat. Almost the only signs of life remaining, were, a deep laborious 
breathing, and a convulsive motion or agitation of his bowels.

I TRIED to rouse him, but in vain, by pinching, shaking, applying volatile 
spirits, and other stimulating things to his nose, &c. A few ounces of 
blood were likewise let from his arm, and a mixture of vinegar and water 
was poured into his mouth; but as he should not swallow, very little of 
this got into the stomach. None of these things having the least effect, 
and the danger seeming to increase, I ordered his legs to be put in warm 
water, and a sharp clyster to be immediately administered. This gave him a 
stool, and was the first thing that relieved him. It was afterwards 
repeated with the same happy effect, and seemed to be the cause of his 
recovery. He then began to shew some signs of life, took drink when it was 
offered him, and came gradually to his senses. He continued however, for 
several days weak and feverish, and complained much of a soreness in his 
bowels, which gradually went off, by means of a slender diet, and cool 
mucilaginous liquors.

THIS young man would probably have been suffered to die, without any 
assistance being called, had not a neighbour, a few days before, who had 
been advised to drink a bottle of spirits to cure him of an ague, expired 
under very similar circumstances.


OF SUFFOCATION AND STRANGLING.

THESE may sometimes proceed from an infraction of the lungs, produced by 
viscid clammy humours, or a spasmodic affection of the nerves of that 
organ.

PERSONS who feed grossly, and abound in rich blood are very liable to 
suffocating fits from the former of these causes. Such ought, as soon as 
they are attacked, to be bled, to receive an emollient clyster, and to 
take frequently a cup of diluting liquor with a little nitre in it. They 
should likewise receive the steams of hot vinegar into their lungs by 
breathing.

NERVOUS and asthmatic persons are most subject to spasmodic affections of 
the lungs. In this case the patient's legs should be immersed in warm 
water, and the steams of vinegar applied as above. Warm diluting liquors 
should likewise be drank; to a cup of which a tea-spoonful of the 
Paregoric elixir may occasionally be added. Burnt paper, feathers, or 
leather, may be held to the patient's nose, and fresh air should be freely 
admitted to him.

INFANTS are often suffocated by the carelessness or inattention of their 
nurses. These accidents are not always the effects of carelessness. I have 
known an infant over-laid by its mother being seized in the night with an 
hysteric fit. This ought to serve as a caution against employing hysteric 
woman as nurses; and should likewise teach such women never to lay an 
infant in the same bed with themselves, but in a small adjacent one. An 
infant when in bed should always be laid so that it cannot tumble down 
with its head under the bed-clothes; and when in a cradle, its face ought 
never to be covered. A small degree of attention to these two simple rules 
would save the lives of many infants, and prevent others from being 
rendered weak and sickly all their days by the injuries done to their 
lungs.

INSTEAD of laying down a plan for the recovery of infants who are 
suffocated, or over-laid, as it is termed by their nurses, I shall give 
the history of a case related by Monfieur Janin, of the Royal College of 
Surgery at Paris, as it was attended with success, and contains almost 
every thing that can be done on such occasions.

A NURSE having had the misfortune to over-lay a child, he was called in, 
and found the infant without any signs of life; no pulsation in the 
arteries, no respiration, the face livid, the eyes open, dull, and 
tarnished, the nose full of snivel, the mouth gaping, in short it was 
almost cold. Whilst some linen cloths and a parcel of ashes were warming, 
he had the boy unswathed, and laid him in a warm bed, and on the right 
side. He then was rubbed all over with fine linen, for fear of fretting 
his tender and delicate skin. As soon as the ashes had received their due 
degree of heat, Mr. Janin buried him in them, except the face, placed him 
on the side opposite to that on which he had been at first laid, and 
covered him with a blanket, He had a bottle of eau de luce in his pocket, 
which he presented to his nose from time to time; and between whiles some 
puffs of tobacco were blown up his nostrils; to these succeeded the 
blowing into his mouth, and squeezing tight his nose. Animal heat began 
thus to be excited gradually; the pulsations of the temporal artery were 
soon felt, the breathing became more frequent and free, and the eyes 
closed and opened alternately. At length the child fetched some cries 
expressive of his want of the breast, which, being applied to his mouth, 
he catched at it with avidity, and sucked as if nothing had happened to 
him. Though the pulsations of the arteries were by this time very well re-
established, and it was hot weather, yet Mr. Janin thought it adviseable 
to leave his little patient three quarters of an hour longer under the 
ashes. He was afterwards taken out, cleaned, and dressed as usual; to 
which a gentle sIeep succeeded, and he continued perfectly well,

MR. JANIN mentions likewise an example of a young man who had hanged 
himself through despair, to whom he administered help as effectually as in 
the preceding case.

MR. GLOVER, surgeon in Doctors Commons, London, relates the case of a 
person who was restored to life after twenty-nine minutes hanging, and 
continued in good health for many years after.

THE principal means used to restore this man to life were, opening the 
temporal artery and the external jugular; rubbing the back, mouth, and 
neck, with a quantity of volatile spirits and oil; administering the 
tobacco clyster by means of lighted pipes, and strong frictions of the 
legs and arms. This course had been continued for about four hours, when 
an incision was made into the wind-pipe, and air blown strongly through a 
canula into the lungs. About twenty minutes after this, the blood at the 
artery began to run down the face, and a slow pulse was just perceptlible 
at the wrist. The frictions were continued for some time longer: his pulse 
became more frequent, and his mouth and nose being irritated with spirit 
of sal ammoniac, he opened his eyes. Warm cordials were then administered 
to him, and in two days he was so well as to be able to walk eight miles.

THESE cases are sufficient to shew what may be done, for the recovery of 
those unhappy persons who strangle themselves in a fit of despair.


OF PERSONS WHO EXPIRE IN CONVULSION FITS.

CONVULSION FITS often constitute the last scene of acute or chronic 
disorders. When this is the case, there can remain but small hopes of the 
patient's recovery after expiring in a fit. But when a person, who appears 
to be in perfect health, is suddenly seized with a convulsion fit, and 
seems to expire, some attempts ought always to be made to restore him to 
life. Infants are most liable to convulsions, and are often carried off 
very suddenly by one or more fits about the time of teething. There are 
many well-authenticated accounts of infants having been restored to life, 
after they had to all appearance expired in convulsions; but we shall only 
relate the following instance mentioned by Dr. Johnson in his pamphlet on 
the practicability of recovering persons visibly dead.

IN the parish of St. Clemens, at Colchester, a child of six months old, 
lying upon its mother's lap, having had the breast, was seized with a 
strong convulsion fit, which lasted so long, and ended with so total a 
privation of motion in the body, lungs, and pulse, that it was deemed 
absolutely dead. It was accordingly stripped, laid out, the passing bell 
ordered to be tolled, and a coffin to be made; but a neigbouring 
gentlewoman who used to admire the child, hearing of its sudden death, 
hastened to the house, and upon examining the child found it not cold, its 
joints limber, and fancied that a glass she held to its mouth and nose was 
a little damped with the breath; upon which she took the child in her lap, 
sat down before the fire, rubbed it, and kept it in gentle agitation. In a 
quarter of an hour she felt the heart began to beat faintly; she then put 
a little of the mother's milk into its mouth, continued to rub its palms 
and soles, found the child began to move, and the milk was swallowed; and 
in another quarter of an hour she had the satisfaction of restoring to its 
disconsolate mother the babe quite recovered, eager to lay hold of the 
breast, and able to suck again. The child throve, had no more fits, is 
grown up, and at present alive.

THESE means, which are certainly in the power of every person, were 
sufficient to restore to life an infant to all appearance dead, and who, 
in all probability, but for the use of these simple endeavours, would have 
remained so. There are, however, many other things which might be done, in 
case the above should not succeed; as rubbing the body with strong 
spirits, covering it with warm ashes of salt, blowing air into the lungs, 
throwing up warm stimulating clysters, or the smoke of tobacco, into the 
intestines, and such like.

WHEN children are dead born, or expire soon after the birth, the same 
means ought to be used for their recovery, as if they had expired in 
circumstances similar to those mentioned above.

THESE directions may likewise be extended to adults, attention being 
always paid to the age and other circumstances of the patient.

THE foregoing cases and observations afford sufficent proof of the success 
which may attend the endeavours of persons totally ignorant of medicine, 
in assisting those who are suddenly deprived of life by any accident or 
disease. Many facts of a similar nature might be adduced were it 
necessary; but these, it is hoped, will be sufficient to call up the 
attention of the public, and to excite the humane and benevolent to exert 
their utmost endeavours for the preservation of their fellow men.

The society for the recovery of drowned persons, instituted at Amsterdam 
in the year 1767, had the satisfaction to find that not fewer than 150 
persons, in the space of four years, had been saved by the means pointed 
out by them, many of whom owed their preservation to peasants and people 
of no medical knowledge. But the means used with much efficacy in 
recovering drowned persons, are, with equal success, applicable to a 
number of cases where the powers of life seem in reality to be only 
suspended, and to remain capable of renewing all their functions, on being 
put into motion again. It is shocking to reflect, that for want of this 
consideration many persons have been committed to the grave, in whom the 
principles of life might have been revived.

THE cases wherein such endeavours are most likely to be attended with 
success, are all those called sudden deaths from an invisible cause, as 
apoplexies, hysterics, faintings, and many other disorders wherein persons 
in a moment sink down and expire. The various casualties in which they may 
be tried are, suffocations, from the suphureous damps of mines, coal-pits, 
&c.; the unwholesome air of long unopened wells or caverns; the noxious 
vapours arising arising from fermenting liquors; the steams of burning 
charcoal; sulphureous mineral acids; arsenical effluvia, &c.

THE various accidents of drowning, strangling, and apparent deaths, by 
blows, falls, hunger, cold, &c. likewise furnish opportunities of trying 
such endeavours. Those perhaps who to appearance are killed by lightning, 
or by any violent agitation of the passions, as fear, joy, surprise, and 
such like, might also be frequently recovered by the use of proper means, 
as blowing strongly into their lungs, &c.

THE means to be used for the recovery of persons suddenly deprived of life 
are nearly the same in all cases; they are practicable by every one who 
happens to be present at the accident, and require no great expence, and 
less skill. The great aim is to restore the warmth and vital motions. This 
may in general be attempted by means of heat, frictions, bleeding, blowing 
air into the lungs, administering clysters and generous cordials. These 
must be varied according to circumstances. Common sense, and the situation 
of the patient, will suggest the proper manner of conducting them. Above 
all we would recommend perseverance. People ought never to despair on 
account of discouraging circumstances; or to leave off their endeavours as 
long as there is the least hope of success. Where much good and no hurt 
can be done, no one ought to grudge his labour.

IT were greatly to be wished, that an institution, similar to that of 
Amsterdam, was established, upon a more extensive plan, in Great Britain; 
and that a reward was allowed to every one who should be instrumental in 
restoring to life a person seemingly dead. Men will do much for fame, but 
still more for money. Should no profit, however, be annexed to those 
benevolent offices, the heart-felt pleasure which a good man must enjoy, 
on reflecting that he has been the happy instrument of saving one of his 
fellow-creatures from an untimely grave, is itself a sufficient reward.

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



CHAPTER LV.
CAUTIONS CONCERNING COLD BATHING, AND DRINKING THE MINERAL WATERS.

AS it is now fashionable for persons of all ranks to plunge into the sea, 
and drink the mineral waters, I was delirous of rendering this work still 
more extensively useful, by the addition of some practical remarks on 
these active and useful medicines. Finding it impossible to bring these 
observations within so narrow a compass as not to swell the book, already 
too large, into an enormous size, I resolved to confine myself to a few 
hints or cautions; which may be of service to persons who bathe, or drink 
the mineral waters, without being able to put themselves under the care of 
a physician.

NO part of the practice of medicine is of greater importance, or merits 
more the attention of the physician, as many lives are lost, and numbers 
ruin their health, by cold bathing, and an imprudent use of the mineral 
waters. On some future occasion I may probably resume this subject, as I 
know not any work that contains a sufficient number of practical 
observations to regulate the patient's conduct in the use of these active 
and important medicines.

WE have indeed many books on the mineral waters, and some of them are 
written with much ingenuity; but they are chiefly employed in ascertaining 
the contents of the waters by chymical analysis. This, no doubt, has its 
use, but it is by no means of such importance as some may imagine. A man 
may know the chymical analysis of all the articles in the materia medica, 
without being able properly to apply any one of them in the cure of 
diseases. One page of practical observations is worth a whole volume of 
chymical analysis. But where are such observations to be met with? Few 
physicians are in a situation to make them, and fewer still are qualified 
for such a task. It can only be accomplished by practitioners who reside 
at the fountains, and who, possessing minds superior to local prejudices, 
are capable of distinguishing diseases with accuracy, and of forming a 
sound judgment respecting the genuine effects of medicines.

WITHOUT a proper discrimination with regard to the disease and the 
constitution of the patient, the most powerful medicine is more likely to 
do harm than good. Every one knows that the same physician who, by cold 
bathing, cured Augustus, by an imprudent use of the same medicine killed 
his heir. This induced the Roman senate to make laws for regulating the 
baths, and preventing the numerous evils which arose from an imprudent and 
promiscuous use of those elegant and fashionable pieces of luxury. But as 
no such laws exist in this country, every one does that which is right in 
his own eyes, and of course many must do wrong.

PEOPLE are apt to imagine that the simple element of water can do no hurt, 
and that they may plunge into it at any time with impunity. In this, 
however, they are much mistaken. I have known apoplexies occasioned by 
going into the cold bath, fevers excited by staying too long in it, and 
other maladies so much aggravated by its continued use, that they could 
never be wholly eradicated. Nor are examples wanting, either in ancient or 
modern times, of the baneful consequences which have arisen also from an 
injudicious application of the warm bath; but as warm baths are not so 
common in this country, and are seldom used but under the direction of a 
physician, I shall not enlarge on that part of the subject.

IMMERSION in cold water is a custom which lays claim to the most remote 
antiquity: indeed it must have been coeval with man himself. The necessity 
of water for the purposes of cleanliness, and the pleasure arising from 
its application to the body in hot countries, must very early have 
recommended it to the human species. Even the example of other animals was 
sufficient to give the hint to man. By instinct many of them are led to 
apply cold water in this manner; and some, when deprived of its use, have 
been known to languish, and even to die. But whether the practice of cold 
bathing arose from necessity, reasoning, or imitation, is an inquiry of no 
importance: our business is to point out the advantages which may be 
derived from it, and to guard people against an improper use of it.

THE cold bath recommends itself in a variety of cases; and is peculiarly 
benificial to the inhabitants of populous cities; who indulge in idleness, 
and lead sedentary lives. In persons of this description the action of the 
fluids is always too weak, which induces a languid circulation, a crude 
indigested mass of humours, and obstructions in the capillary vessels and 
glandular system. Cold water, from its gravity as well as its tonic power, 
is well calculated either to obviate or remove these symptoms. It 
accelerates the motion of the blood, promotes the different secretions, 
and gives permanent vigour to the solids. But all these important purposes 
will be more essentially answered by the application of salt water. This 
ought not only to be preferred on account of its superior gravity, but 
likewise for its greater power of stimulating the skin, which promotes the 
perspiration, and prevents the patient from catching cold.

IT is necessary, however, to observe, that cold bathing is more likely to 
prevent, than to remove obstructions of the glandular or lymphatic system. 
Indeed, when these have arrived at a certain pitch, they are not to be 
removed by any means. In this case the cold bath will only aggravate the 
symptoms, and hurry the unhappy patient into an untimely grave. It is 
therefore of the utmost importance, previous to the patient's entering 
upon the use of the cold bath, to determine whether or not he labours 
under any obstinate obstructions of the lungs or other viscera; and where 
this is the case, cold bathing ought strictly to be prohibited. The late 
celebrated Dr. Smollet has indeed said, that if he were persuaded he had 
an ulcer in the lungs, he would jump into the cold bath: but here the 
Doctor evidently shews more courage than discretion; and that he was more 
a man of wit than a physician, every one will allow. A nervous asthma, or 
an atrophy, may be mistaken for a pulmonary consumption; yet in the two 
former, the cold bath proves often beneficial, though I never knew it so 
in the latter. Indeed all the phthisical patients I ever saw, who had 
tried the cold bath, were 
evidently hurt by it.

IN what is called a plethoric state, or too great a fulness of the body, 
it is likewise dangerous to use the cold bath, without due preparation. In 
this case there is great danger of bursting a blood vessel, or occasioning 
an inflammation of the brain, or some of the viscera. This precaution is 
the more necessary to citizens, as most of them live full, and are of a 
gross habit. Yet what is very remarkable, these people resort in crouds 
every season to the sea-side, and plunge in the water without the least 
consideration. No doubt they often escape with impunity, but does this 
give a sancttion to the practice? Persons of this description ought by no 
means to bathe, unless the body has been previously prepared by suitable 
evacuations.

ANOTHER class of patients, who stand peculiarly in need of the bracing 
qualities of cold water, is the nervous. This includes a great number of 
the male, and almost all the female inhabitants of great cities. Yet even 
those persons ought to be cautious in using the cold bath. Nervous people 
have often weak bowels, and may, as well as others, be subject to 
congestions and obstructions of the viscera; and in this case they will 
not be able to bear the effects of the cold water. For them, therefore, 
and indeed for all delicate people, the best plan would be to accustom 
themselves to it by the most pleasing and gentle degrees. They ought to 
begin with the temperate bath, and gradually use it cooler, till at length 
the coldest proves quite agreeable. Nature revolts against all great 
transitions; and those who do violence to her dictates, have often cause 
to repent of their temerity.

WHEREVER cold bathing is practised, there ought likewise to be tepid baths 
for the purpose mentioned above. Indeed it is the practice of some 
countries to throw cold water over the patient as soon as he comes out of 
the warm bath; but though this may not injure a Russian peasant, we dare 
not recommend it to the inhabitants of this country. The ancient Greeks 
and Romans, we are told, when covered with sweat and dust, used to plunge 
into rivers, without receiving the smallest injury. Though they might 
often escape danger from this imprudent conduct, yet it was certainly 
contrary to sound reason. I have known many robust men throw away their 
lives by such an attempt. We would not however advise patients to go into 
the cold water when the body is chilly; as much exercise, at least, ought 
to be taken, as may excite a gentle glow all over the body, but by no 
means so as to overheat it. To young people, and particularly to children, 
cold bathing is of the least importance. Their lax fibres render its tonic 
powers peculiarly proper. It promotes their growth, increases their 
strength, and prevents a variety of diseases incident to chilhood. The 
celebrated Galen says, that immersion in cold water is fit only for the 
young of lions and bears: and recommends warm bathing, as conducive to the 
growth and strength of infants. How egregiously do the greatest men err 
whenever they lose sight of facts, and substitute reasoning in physic in 
place of observation and experience! Were infants early accustomed to the 
cold bath, it would seldom disagree with them; and we should see fewer 
instances of the scrofula, rickets, and other diseases, which prove fatal 
to many, and make others miserable for life. Sometimes indeed, these 
disorders render infants incapable of bearing the shock of cold water; but 
this is owing to their not having been early and regularly accustomed to 
it. It is however necessary here to caution young men against too frequent 
bathing; as I have known many fatal consequences result from the daily 
practice of plunging into rivers and continuing there too long.

THE most proper time of the day for using the cold bath is no doubt the 
morning, or at least before dinner; and the best mode, that of quick 
immersion,. As cold bathing has a constant tendency to propel the blood 
and other humours towards the head, it ought to be a rule always to wet 
that part as soon as possible. By due attention to this circumstance, 
there is reason to believe that violent head-achs, and other complaints, 
which frequently proceed from cold bathing, might be often prevented.

THE cold bath, when too long continued in, not only occasions an excessive 
flux of humours towards the head, but chills the blood, cramps the 
muscles, relaxes the nerves, and wholly defeats the intention of bathing. 
Hence, by not adverting to this circumstance, expert swimmers are often 
injured, and sometimes even lose their lives. All the beneficial purposes 
of cold bathing are answered by one single immersion; and the patient 
ought to be rubbed dry the moment he comes out of the water, and should 
continue to take exercise for some time after.

WHEN cold bathing occasions chilness, loss of appetite, listlessness, pain 
of the breast or bowels, a prostration of strength, or violent head-achs, 
it ought to be discontinued.

THOUGH these hints are by no means intended to point out all the cases 
where cold bathing may be hurtful; nor to illustrate its extensive utility 
as a medicine; yet it is hoped, they may serve to guard people against 
some of those errors into which from mere inattention they are apt to 
fall; and thereby not only endanger their own lives, but bring an 
excellent medicine into disrepute.


OF DRINKING THE MINERAL WATERS.

THE internal use of water, as a medicine, is no less an object of the 
physician's attention than the external. Pure elementary water is indeed 
the most inoffensive of all liquors, and constitutes. a principal part of 
the food of every animal. But this element is often impregnated with 
substances of a very active and penetrating nature; and of such an 
insiduous quality, that, while they promote certain secretions, and even 
alleviate some disagreeable symptoms, they weaken the powers of life, 
undermine the constitution, and lay the foundation of worse diseases than 
those which they were employed to remove. Of this every practitioner must 
have seen instances, and physicians of eminence have more than once 
declared that they have known more diseases occasioned than removed by the 
use of mineral waters. This, doubtless, has proceeded from the abuse of 
these powerful medicines, which evinces the necessity of using them with 
caution.

BY examining the contents of the mineral waters which are most used in 
this country, we shall be enabled to form an idea of the danger which may 
arise from an improper application of them either externally or 
internally, though it is to the latter of these that the present 
observations are chiefly confined.

THE waters most in use for medical purposes in Britain, are those 
impregnated with salts, sulphur, iron, and mephitic air, either 
separately, or variously combined. Of these the most powerful is the 
saline sulphureous water of Harrowgate, of which I have had more occasion 
to observe the pernicious consequences, when improperly used, than of any 
other. To this therefore the following remarks will more immediately 
relate, though they will be found applicable to all the purging waters in 
the kingdom which are strong enough to merit attention. The greatest class 
of mineral waters in this country is the Chalybeate. In many parts of 
Britain these are to be found in almost every field; but those chiefly in 
use, for medical purposes, are the purging chalybeates, as the waters of 
Scarborough, Cheltenham, Thorp Arch, Nevil Holt, &c. Of those which do not 
purge, the waters of Tunbridge stand in the highest repute. The saline 
purging waters, as those of Acton, Epsom, Kilburn, &c. are also in very 
general esteem; but the fountains most frequented by the sick in this 
country are those to which the minerals impart a certain degree of heat, 
as Bath, Bristol, Buxton, &c.

THE errors which so often defeat the intention of drinking the purgative 
mineral waters, and which so frequently prove injurious to the patient, 
proceed from the manner of using them, the quantity taken, the regimen 
pursued, or usng them in cases where they are not proper.

A VERY hurtful prejudice still prevails in this country, that all diseases 
must be cured by medicines taken into the stomach, and that the more 
violently these medicines operate, they are the more likely to have the 
desired effect. This opinion has proved fatal to thousands; and will in 
all probability, destroy many more before it can be wholly eradicated. 
Purging is often useful in acute diseases, and in chronical cases may pave 
the way for the operation of other medicines; but it will seldom perform a 
cure; and by exhausting the strength of the patient, will often leave him 
in a worse condition than it found him. That this is frequently the case 
with regard to the more active mineral waters, every person conversant in 
these matters will readily allow.

STRONG stimulants applied to the stomach and bowels for a length of time, 
must tend to weaken and destroy their energy; and what stimulants are more 
active than salt and sulphur, especially when these substances are 
intimately combined, and carried through the system by the penetrating 
medium of water? Those bowels must be strong indeed, which can withstand 
the daily operation of such active principles for months together, and not 
be injured. This, however, is the plan pursued by most of those who drink 
the purging mineral waters, and whose circumstances will permit the them 
to continue long enough at those fashionable places of resort.

MANY people imagine that every thing depends on the quantity of water 
taken, and that the more they drink they will the sooner get well. This is 
an egregious error; for while the unhappy patient thinks he is by this 
means eradicating his disorder, he is often, in fact, undermining the 
powers of life, and ruining his constitution. Indeed nothing can do this 
so effectually as weakening the powers of digestion by the improper 
application of strong stimulants. The very essence of health depends on 
the digestive organs performing their due functions, and the most tedious 
maladies are all connected with indigestion.

DRINKING the water in too great quantity, not only injures the bowels and 
occasions indigestion, but generally defeats the intention for which it is 
taken. The diseases for the cure of which mineral waters are chiefly 
celebrated, are mostly of the chronic kind; and it is well known that such 
diseases can only be cured by the slow operation of alteratives, or such 
medicines as act by inducing a gradual change in the habit. This requires 
length of time, and never can be effected by medicines which run off by 
stool, and operate chiefly on the first passages.

THOSE who wish for the cure of any obstinate malady from the mineral 
waters, ought to take them in such a manner as hardly to produce any 
effect whatever on the bowels. With this view a half pint glass may be 
drank at bed-time, and the same quantity an hour before breakfast, dinner, 
and supper. When I speak of drinking a glass of the water over-night, I 
must beg leave to caution those who follow this plan against eating heavy 
suppers. The late Dr. Daultry of York, who was the first that brought the 
Harrowgate-waters into repute, used to advise his patients to drink a 
glass before they went to bed; the consequence of which was, that having 
eat a flesh supper, and the water operating in the night, they were often 
tormented with gripes, and obliged to call for medical assistance. The 
dose, however, must vary according to circumstances. Even the quantity 
mentioned above will purge some persons, while others will drink twice as 
much without being in the least moved by it. Its operation on the bowels 
is the only standard for using the water as an alterative. No more ought 
to be taken than barely to move the body; nor is it always necessary to 
carry it this length, provided the water goes off by the other 
emunctories, and does not occasion a chilness, or flatulency in the 
stomach or bowels. When the water is intended to purge, the quantity 
mentioned above may be all taken before breakfast.

I WOULD not only caution patients who drink the purging mineral waters 
over night, to avoid heavy suppers, but also from eating heavy meals at 
any time. The stimulus of water, impregnated with salts, seems to create a 
false appetite. I have seen a delicate person, after drinking the 
Harrowgate waters of a morning, eat a breakfast sufficient to have served 
two ploughmen, devour a plentiful dinner of flesh and fish, and, to crown 
all, eat such a supper as might have satisfied a hungry porter. All this 
indeed the stomach seemed to crave, but this craving had better remain not 
quite satisfied, than that the stomach should be loaded with what exceeds 
its powers. To starve patients was never my plan, but I am clearly of 
opinion, that, in the use of all the purging mineral waters, a light and 
rather diluting diet is the most proper; and that no person, during such a 
course, ought to eat to the full extent to what his appetite craves.

TO promote the operation of mineral waters, and to carry them through the 
system, exercise is indispensably necessary. This may be taken in any 
manner that is most agreeable to the patient, but he ought never to carry 
it to excess. The best kinds of exercise are those connected with 
amusement. Every thing that tends to exhilarate the spirits, not only 
promotes the operation of the waters, but acts as a medicine. All who 
resort to the mineral waters ought therefore to leave every care behind, 
to mix with the company, and to make themselves as cheerful and happy as 
possible. From this conduct, assisted by the free and wholesome air of 
those fashionable places of resort, and also the regular and early hours 
which are usually kept, the patient often receives more benefit than from 
using the waters.

BUT the greatest errors in drinking the purging mineral waters arise from 
their being used in cases where they are absolutely improper, and adverse 
to the nature of the disease. When people hear of a wonderful cure having 
been performed by some mineral water, they immediately conclude that it 
will cure every thing, and, accordingly swallow it down, when they might 
as well take poison. Patients ought to be well informed, before they begin 
to drink the more active kinds of mineral waters, of the propriety of the 
course, and should never persist in using them when they are found to 
aggravate the disorder.

IN all cases where purging is indicated, the saline mineral waters will be 
found to fulfil this intention, better than any other medicine. Their 
operation, if taken in proper quantity, is generally mild; and they are 
neither found to irritate the nerves, nor debilitate the patient so much 
as the other purgatives.

AS a purgative, these waters are chiefly recommended in diseases of the 
first passages, accompanied with, or proceeding from, inactivity of the 
stomach and bowels, acidity, indigestion, vitiated bile, worms, putrid 
sordes, the piles, and jaundice. ln most cases of this kind, they are the 
best medicines that can be administered. But when used with this view, it 
is sufficient to take them twice, or at most, three times a week, so as to 
move the body three or four times; and it will be proper to continue this 
course for some weeks.

BUT the operation of the more active mineral waters is not confined to the 
bowels. They often promote the discharge of urine, and not unfrequently 
increase the perspiration. This shews that they are capable of penetrating 
into every part of the body, and of stimulating the whole system. Hence 
arises their efficacy in removing the most obstinate of all disorders, 
obstructions of the glandular and lymphatic system. Under this class is 
comprehended the scrofula or King's evil, indolet tumours, obstructions of 
the liver, spleen, kidnies, and mesenteric glands. When these great 
purposes are to be effected, the waters must be used in the gradual manner 
mentioned above, and persisted in for a length of time. It will be proper, 
however, now and then to discontinue their use for a few days.

THE next great class of diseases where mineral waters are found to be 
beneficial, are those of the skin, as the itch, scab, tetters, ringworms, 
scaly eruptions, leprosies, blotches, foul ulcers, &c. Though these may 
seem superficial, yet they are often the most obstinate which the 
physician has to encounter, and not unfrequently set his skill at 
defiance: But they will sometimes yield to the application of mineral 
waters for a sufficient length of time, and in most cases of this kind 
these waters deserve a trial. The saline sulphureous waters, such as those 
of Moffat in Scotland, and Harrowgate in England, are the most likely to 
succeed in diseases of the skin; but for this purpose it will be necessary 
not only to drink the waters, but likewise to use them externally.

TO enumerate more particularly the qualities of the different mineral 
waters, to specify those diseases in which they are respectively 
indicated, and to point out their proper modes of application, would be an 
useful, and by no means a disagreeable employment; but as the limits 
prescribed to these remarks, being only one sheet, will not allow me to 
treat the subject at more length, I shall conclude by observing, that 
whenever the mineral waters are found to exhaust the strength, depress the 
spirits, take away the appetite, excite fevers, distend the bowels, or 
occasion a cough, they ought to be discontinued.

THESE Cautions having been printed and sold separately for the 
accommodation of those who had purchased the former editions of this book, 
has induced some persons to consider them as a complete Treatise on sea-
bathing and drinking the mineral waters; whereas the author's sole 
intention was to furnish a few general hints to persons who frequent those 
fashionable places of resort, without putting themselves under the care of 
a physician. As he looks upon this subject however to be of the greatest 
importance to the sick, he pledges himself to treat it at more length on a 
future occasion.