,advice to the people ,,advice to the ,,people in ,general1 with ,regard to their ,health3 ,but more particularly calculated for those1 who1 by their ,distance from regular ,physicians1 or other very experienced ,practitioners1 are the most unlikely to be seasonably provided with the best ,advice and ,assistance1 in acute ,diseases1 or upon any sudden inward or outward ,accident4 ,,with ,a ,table of the most cheap1 yet effectual ,remedies1 and the plainest ,directions for preparing them readily4 ,translated from the ,french ,edition of ,dr4 ,tissot's ,avis au ,peuple1 c4 ,printed at ,lyons2 with all his own ,notes2 a few of his medical ,editor's at ,lyons2 and several occasional ,notes1 adapted to this ,english ,translation1 ,by ,j4 ,kirkpatrick1 ,m4 ,d4 ,in the ,multitude of the ,people is the ,honour of a ,king2 and for the ,want of ,people cometh the ,destruction of the ,prince4 ,proverbs xiv1 #bh4 ---------------------------------------- ------------------------- ,,london3 ,printed for ,t4 ,becket and ,p4 ,a4 ,de ,hondt1 at ,tully's ,head1 near ,surry-,street1 in the ,strand4 ,m ,,dcc ,,lxv4 the ,translator's ,,preface4 ,though the great ,utility of those medical ,directions1 with which the following ,treatise is thoroughly replenished1 will be sufficiently evident to every plain and sensible ,peruser of it2 and the extraordinary ,reception of it on the ,continent is recited in the very worthy ,author's ,preface2 yet something1 it should seem1 may be pertinently added1 with ,regard to this ,translation of it1 by a ,person who has been strictly attentive to the ,original3 a ,work1 whose ,purpose was truly necessary and benevolent2 as the ,execution of it1 altogether1 is very happily accomplished4 ,it will be self evident1 ,i apprehend1 to every excellent ,physician1 that a radical ,knowledge of the ,principles1 and much ,experience in the ,exercise1 of their ,profession1 were necessary to accommodate such a ,work to the ,comprehension of those1 for whom it was more particularly calculated4 ,such ,gentlemen must observe1 that the certain ,axiom of ,nature's curing ,diseases1 which is equally true in our ,day1 as it was in that of ,hippocrates1 so habitually animates this ,treatise1 as not to require the least particular ,reference4 ,this ,hippocratic ,truth as certain 7though much less subject to general ,observation7 as that ,disease1 or ,age1 is finally prevalent over all sublunary ,life1 the most attentive ,physicians discern the soonest1 the most ingenuous readily confess3 and hence springs that wholesome ,zeal and ,severity1 with which ,dr4 ,tissot encounters such ,prejudices of poor illiterate ,persons1 as either oppose1 or very ignorantly precipitate1 her ,operations1 in her ,attainment of ,health4 ,these ,prejudices indeed may seem1 from this ,work1 to be still greater1 and perhaps grosser too1 in ,swisserland than among ourselves2 though it is certain there is but too much ,room for the ,application of his salutary ,cautions and ,directions1 even in this ,capital2 and doubtless abundantly more at great ,distances from it4 ,it may be very justly supposed1 for one ,instance1 that in most of those ,cases in the ,small ,pocks1 in which the ,mother undertakes the ,cure of her ,child1 or confides it to a ,nurse1 that ,saffron1 in a greater or less ,quantity1 and ,sack or ,mountain ,whey1 are generally still used in the ,sickening before ,eruption2 to accelerate that very ,eruption1 whose gradual ,appearance1 about the fourth ,day1 from that of ,seizure inclusive1 is so favourable and promising to the ,patient2 and the ,precipitation of which is often so highly pernicious to them4 ,most of1 or rather all1 his other ,cautions and ,corrections seem equally necessary here1 as often as the ,sick are similarly circumstanced1 under the different acute ,diseases in which he enjoins them4 ,without the least ,detraction however from this excellent ,physician1 it may be admitted that a few others1 in many other ,countries1 might have sufficient ,abilities and ,experience for the ,production of a like ,work1 on the same good ,plan4 ,this1 we find1 ,dr4 ,hirzel1 principal ,physician of ,zurich1 had in ,meditation1 when the present ,treatise appeared1 which he thought had so thoroughly fulfilled his own ,intention1 that it prevented his attempting to execute it4 ,but the great ,difficulty consisted in discovering a ,physician1 who1 with equal ,abilities1 ,reputation and ,practice1 should be qualified with that much rarer ,qualification of caring so much more for the ,health of those1 who could never pay him for it1 than for his own ,profit or ,ease1 as to determine him to project and to accomplish so necessary1 and yet so self-denying1 a ,work4 ,for as the ,simplicity he proposed in the ,style and ,manner of it1 by condescending1 in the plainest ,terms1 to the humblest ,capacities1 obliged him to depress himself1 by writing rather beneath the former ,treatises1 which had acquired him the ,reputation of medical ,erudition1 ,reasoning and ,elegance2 we find that the ,love of ,fame itself1 so stimulating even to many ingenuous ,minds1 was as impotent as that of ,wealth1 to seduce him from so benign1 so generous a ,purpose4 ,though1 upon ,reflection1 it is by no ,means strange to see wise ,men found their ,happiness1 which all however variously and even oppositely pursue1 rather in ,conscience1 than on ,applause2 and this naturally reminds us of that celebrated ,expression of ,cato1 or some other excellent ,ancient1 that he had rather be good1 than be reputed so4 ,however singular such a ,determination may now appear1 the ,number of reputable medical ,translators into different ,languages1 which this original ,work has employed on the ,continent1 makes it evident1 that real ,merit will1 sooner or later1 have a pretty general ,influence2 and induce many to imitate that ,example1 which they either could not1 or did not1 propose4 ,as the truly modest ,author has professedly disclaimed all ,applause on the ,performance1 and contented himself with hoping an ,exemption from ,censure1 through his ,readers' ,reflection on the peculiar ,circumstances and ,address of it2 well may his best1 his faithfullest ,translators1 whose ,merit and ,pains must be of a very secondary ,degree to his own1 be satisfied with a similar ,exemption3 especially when joined to the ,pleasure1 that must result from a ,consciousness of having endeavoured to extend the ,benefits of their ,author's ,treatise1 to ,multitudes of their own ,country and ,language4 ,for my own ,particular1 when after reading the ,introduction to the ,work1 and much of the ,sequel1 ,i had determined to translate it2 to be as just as possible to the ,author1 and to his ,english ,readers1 ,i determined not to interpolate any ,sentiment of my own into the ,text1 nor to omit one ,sentence of the ,original1 which1 besides its being ,detraction in its literal ,sense1 ,i thought might imply it in its worst1 its figurative one2 for which there was no ,room4 ,to conform as fully as possible to the ,plainness and ,perspicuity he proposed1 ,i have been pretty often obliged in the anatomical ,names of some ,parts1 and sometimes of the ,symptoms1 as well as in some pretty familiar1 though not entirely popular ,words1 to explain all such by the most common ,words ,i have heard used for them2 as after mentioning the ,diaphragm1 to add1 or ,midriff--the ,trachaea--or ,windpipe--acrimonious1 or very sharp1 and so of many others4 ,this may a little1 though but a little1 have extended the ,translation beyond the ,original2 as the great ,affinity between the ,french and ,latin1 and between the former and many ,latin ,words borrowed from the ,greek1 generally makes the same anatomical or medical ,term1 that is technical with us1 vernacular or common with them4 ,but this unavoidable ,tautology1 which may be irksome to many ,ears1 those medical ,readers1 for whom it was not intended1 will readily forgive1 from a ,consideration of the general ,address of the ,work3 while they reflect that meer ,style1 if thoroughly intelligible1 is least essential to those ,books1 which wholly consist of very useful1 and generally interesting1 ,matter4 ,as many of the ,notes of the ,editor of ,lyons1 as ,i have retained in this ,version 7having translated from the ,edition of ,lyons7 are subscribed ,e4 ,l4 ,i have dispensed with several1 some1 as evidently less within ,dr4 ,tissot's ,plan1 from tending to theorize1 however justly or practically1 where he must have had his own ,reasons for omitting to theorize3 a few others1 as manifestly needless1 from what the ,author had either premised1 or speedily subjoined1 on the very same ,circumstance3 besides a very few1 from their local ,confinement to the ,practice at ,lyons1 which lies in a ,climate somewhat more different from our own than that of ,lausanne4 ,it is probable nevertheless1 ,i have retained a few more than were necessary in a professed ,translation of the original ,work3 but wherever ,i have done this1 ,i have generally subjoined my ,motive for it2 of whatever ,consequence that may appear to the ,reader4 ,i have retained all the ,author's own ,notes1 with his ,name annexed to them2 or if ever the ,annotator was uncertain to me1 ,i have declared whose ,note ,i supposed it to be4 ,such as ,i have added from my own ,experience or ,observation are subscribed ,k1 to distinguish them from the others2 and that the ,demerit of any of them may neither be imputed to the learned ,author1 nor to his ,editor4 ,their principal ,recommendation1 or ,apology is1 that whatever ,facts ,i have mentioned are certainly true4 ,i have endeavoured to be temperate in their ,number and ,length1 and to imitate that strict ,pertinence1 which prevails throughout the ,author's ,work4 ,if any may have ever condescended to consider my ,way of writing1 they will conceive this ,restraint has cost me at least as much ,pains1 as a further ,indulgence of my own ,conceptions could have done4 ,the few ,prescriptions ,i have included in some of them1 have been so conducted1 as not to give the ,reader the least ,confusion with ,respect to those1 which the ,author has given in his ,table of ,remedies1 and which are referred to by numerical ,figures1 throughout the ,course of his ,book4 ,the moderate ,number of ,dr4 ,tissot's ,prescriptions1 in his ,table of ,remedies1 amounting but to seventy-one1 and the apparent ,simplicity of many of them1 may possibly disgust some ,admirers of pompous and compound ,prescription4 ,but his ,reserve1 in this important ,respect1 has been thoroughly consistent with his ,notion of ,nature's curing ,diseases2 which suggested to him the first1 the essential ,necessity of cautioning his ,readers against doing1 giving1 or applying any thing1 that might oppose her healing ,operations 7a most capital ,purpose of his ,work7 which important ,point being gained1 the mildest1 simplest and least hazardous ,remedies would often prove sufficient ,assistants to her4 ,nevertheless1 under more severe and tedious ,conflicts1 he is not wanting to direct the most potent and efficacious ones4 ,the ,circumstances of the poor ,subjects of his medical ,consideration1 became also a very natural ,object to him1 and was in no wise unworthy the ,regard of the humane ,translator of ,bilguer on ,amputations1 or rather against the crying ,abuse of them2 an excellent ,work1 that does real ,honour to them both2 and which can be disapproved by none1 who do not prefer the frequently unnecessary ,mutilation of the afflicted1 to the ,consumption of their own ,time1 or the ,contraction of their ,employment4 ,some ,persons may imagine that a ,treatise of this ,kind1 composed for the ,benefit of labouring ,people in ,swisserland1 may be little applicable to those of the ,british ,islands3 and this1 in a very few ,particulars1 and in a small ,degree1 may reasonably be admitted4 ,but as we find their common ,prejudices are often the very same2 as the ,swiss are the ,inhabitants of a colder ,climate than ,france1 and generally1 as ,dr4 ,tissot often observes1 accustomed to drink 7like ourselves7 more strong ,drink than the ,french ,peasantry2 and to indulge more in eating ,flesh too1 which the ,religion of ,berne1 like our own1 does not restrain2 the ,application of his ,advice to them will pretty generally hold good here4 ,where he forbids them ,wine and ,flesh1 all ,butchers ,meat1 and in most ,cases all ,flesh1 and all strong ,drink should be prohibited here3 especially when we consider1 that all his ,directions are confined to the ,treatment of acute ,diseases1 of which the very young1 the youthful1 and frequently even the robust are more generally the ,subjects4 ,besides1 in some few of the ,english ,translator's ,notes1 he has taken the ,liberty of moderating the ,coolers1 or the ,quantities of them 7which may be well adapted to the great ,heats and violent ,swiss ,summers he talks of7 according to the ,temperature of our own ,climate1 and the general ,habitudes of our own ,people4 ,it may be observed too1 that from the same ,motive1 ,i have sometimes assumed the ,liberty of dissenting from the ,text in a very few ,notes1 as for ,instance1 on the ,article of ,pastry1 which perhaps is generally better here than in ,swisserland 7where it may be no better than the coarse vile ,trash that is hawked about and sold to meer ,children7 as ,i have frequently1 in preparing for ,inoculation1 admitted the best ,pastry 7but not of ,meat7 into the limited ,diet of the ,subjects of ,inoculation1 and constantly without the least ill ,consequence4 ,thus also in ,note #gj ,page #bhg1 #bhh1 ,i have presumed to affirm the ,fact1 that a strong spirituous ,infusion of the ,bark has succeeded more speedily in some ,intermittents1 in particular ,habits1 than the ,bark in ,substance4 ,this ,i humbly conceive may be owing to such a ,menstruum's extracting the ,resin of the ,bark more effectually 7and so conveying it into the ,blood7 than the ,juices of the ,stomach and of the alimentary ,canal did1 or could4 ,for it is very conceivable that the ,crasis1 the ,consistence1 of the fibrous ,blood may sometimes be affected with a morbid ,laxity or ,weakness1 as well as the general ,system of the muscular ,fibres4 ,these and any other like ,freedoms1 ,i am certain the ,author's ,candour will abundantly pardon2 since ,i have never dissented for ,dissention's ,sake1 to the best of my ,recollection2 and have the ,honour of harmonizing very generally in ,judgment with him4 ,if one useful ,hint or ,observation occurs throughout my ,notes1 his ,benevolence will exult in that essential ,adherence to his ,plan1 which suggested it to me3 ,while an invariable ecchoing ,assentation throughout such ,notes1 when there really was any salutary ,room for doubting1 or for adding 7with ,respect to ourselves7 would discover a ,servility1 that must have disgusted a liberal manly ,writer4 ,one common good ,purpose certainly springs from the generous ,source1 and replenishes the many ,canals into which it is derived2 all the ,variety and little ,deviations of which may be considered as more expansive ,distributions of its ,benefits4 ,since the natural ,feelings of ,humanity generally dispose us1 but especially the more tender and compassionate ,sex1 to advise ,remedies to the poor ,sick2 such a ,knowledge of their real ,disease1 as would prevent their ,patrons1 ,neighbours and ,assistants from advising a wrong ,regimen1 or an improper or ill-timed ,medicine1 is truly essential to relieving them3 and such we seriously think the present ,work is capable of imparting1 to all commonly sensible and considerate ,perusers of it4 ,a ,vein of unaffected ,probity1 of manly ,sense1 and of great ,philanthropy1 concur to sustain the ,work3 ,and whenever the ,prejudices of the ,ignorant require a forcible ,eradication2 or the crude ,temerity and ,impudence of ,knaves and ,impostors cry out for their own ,extermination1 a happy ,mixture of strong ,argument1 just ,ridicule1 and honest ,severity1 give a poignant and pleasant ,seasoning to the ,work1 which renders it occasionally entertaining1 as it is continually instructive4 ,a general ,reader may be sometimes diverted with such ,customs and ,notions of the ,swiss ,peasants1 as are occasionally mentioned here3 and possibly our meerest ,rustics may laugh at the brave simple ,swiss1 on his introducing a ,sheep into the ,chamber of a very sick ,person1 to save the ,life of the ,patient1 by catching its own ,death4 ,but the humblest ,peasantry of both ,nations are agreed in such a ,number of their absurd unhealthy ,prejudices1 in the ,treatment of ,diseases1 that it really seemed necessary to offer our own the ,cautions and ,counsels of this principal ,physician1 in a very respectable ,protestant ,republick1 in ,order to prevent their ,continuance4 ,nor is it unreasonable to presume1 that under such a ,form of ,government1 if honestly administered upon its justest ,principles1 the ,people may be rather more tenderly regarded1 than under the ,pomp and ,rage of ,despotism1 or the ,oppression of some ,aristocracies4 ,besides the different ,conditions of #a ,persons1 to whom our ,author recommends the ,patronage and ,execution of his ,scheme1 in his ,introduction1 it is conceived this ,book must be serviceable to many young ,country ,practitioners1 and to great ,numbers of ,apothecaries1 by furnishing them with such exact and striking ,descriptions of each acute ,disease and its ,symptoms1 as may prevent their mistaking it for any other2 a ,deception which has certainly often been injurious1 and sometimes even fatal3 for it is dreadful but to contemplate the ,destruction or ,misery1 with which ,temerity and ,ignorance1 so frequently combined1 overwhelm the ,sick4 ,thus more ,success and ,reputation1 with the ,enjoyment of a better ,conscience1 would crown their ,endeavours1 by a more general ,recovery of1 or ,relief to1 their ,patients4 ,to effect this1 to improve every ,opportunity of eschewing medical ,evil1 and of doing medical ,good1 was the ,author's avowed ,intention2 which he informs us in his ,preface1 he has heard1 from some intelligent and charitable ,persons1 his ,treatise had effected1 even in some violent ,diseases4 ,that the same good ,consequences may every where attend the numerous ,translations of it1 must be the fervent ,wish of all1 except the ,quacks and ,impostors he so justly characterizes in his thirty-third ,chapter6 and particularly of all1 who may be distinguishably qualified1 like himself1 to1 --,look through ,nature up to ,nature's ,,god6 #a ,of all these the ,schoolmasters1 with us1 may seem the most reasonably exempted from this ,duty4 ,the ,,author's ,,dedication4 ,to the most ,illustrious1 the most ,noble and ,magnificent ,lords1 the ,lords ,president and ,counsellors of the ,chamber of ,health1 of the ,city and ,republick of ,berne4 ,most honourable ,lords1 ,when ,i first published the following ,work1 my utmost ,partiality to it was not sufficient to allow me the ,confidence of addressing it to ,your ,lordships4 ,but ,your continual ,attention to all the ,objects1 which have any ,relation to that important ,part of the ,administration of the ,state1 which has been so wisely committed to ,your ,care1 has induced ,you to take ,notice of it4 ,you have been pleased to judge it might prove useful1 and that an ,attempt must be laudable1 which tends to the ,extermination of erroneous and inveterate ,prejudices1 those cruel ,tyrants1 that are continually opposing the ,happiness of the ,people1 even under that ,form and ,constitution of ,government1 which is the best adapted to establish and to increase it4 ,your ,lordships ,approbation1 and the splendid ,marks of #b ,benevolence1 with which ,you have honoured me1 have afforded me a juster ,discernment of the ,importance of this ,treatise1 and have inclined me to hope1 most ,illustrious1 most ,noble1 and ,magnificent ,lords1 that ,you will permit this new ,edition of it to appear under the ,sanction of your ,auspices2 that while the ,publick is assured of ,your general ,goodness and ,beneficence1 it may also be informed of my profoundly grateful ,sense of them1 on the same ,occasion4 #b ,see the ,author's ,preface1 immediately following this ,dedication4 ,may the present ,endeavour then1 in fully corresponding to my ,wishes1 effectually realize ,your ,lordships utmost ,expectations from it2 while ,you condescend to accept this small ,oblation1 as a very unequal ,expression of that profound ,respect1 with which ,i have the ,honour to be1 ,most ,illustrious1 ,most ,noble1 and ,magnificent ,lords1 ,your most humble ,and most ,obedient ,servant1 ,,tissot4 ,lausanne1 ,dec4 #c1 #agfb4 ,,the ,,author's ,,preface4 ,if ,vanity too often disposes many to speak of themselves1 there are some ,occasions1 on which a total ,silence might be supposed to result from a still higher ,degree of it3 ,and the very general ,reception of the 99,advice to the ,people99 has been such1 that there would be ,room to suspect me of that most shocking ,kind of ,pride1 which receives ,applause with ,indifference 7as deeming its own ,merit ,superior to the greatest7 if ,i did not appear to be strongly impressed with a just ,sense of that great ,favour of the ,publick1 which has been so very obliging1 and is so highly agreable1 to me4 ,unfeignedly affected with the unhappy ,situation of the poor ,sick in ,country ,places in 99,swisserland991 where they are lost from a ,scarcity of the best ,assistance1 and from a fatal ,superfluity of the worst1 my sole ,purpose in writing this ,treatise has been to serve1 and to comfort them4 ,i had intended it only for a small ,extent of ,country1 with a moderate ,number of ,inhabitants2 and was greatly surprized to find1 that within five or six ,months after its ,publication1 it was become one of the most extensively published ,books in 99,europe992 and one of those ,treatises1 on a scientific ,subject1 which has been perused by the greatest ,number of ,readers of all ,ranks and ,conditions4 ,to consider such ,success with ,indifference1 were to have been unworthy of it1 which ,demerit1 at least on this ,account1 ,i cannot justly be charged with2 since ,indifference has not been my ,case1 who have felt1 as ,i ought1 this ,gratification of ,self-love2 and which1 under just and prudent ,restrictions1 may perhaps be even politically cherished2 as the ,delight naturally arising from having been approved1 is a ,source of that laudable ,emulation1 which has sometimes produced the most essential good ,consequences to ,society itself4 ,for my own particular1 ,i can truly aver1 that my ,satisfaction has been exquisitely heightened on this ,occasion1 as a ,lover of my ,species3 since judging from the ,success of this ,work 7a ,success which has exceeded my utmost ,expectations7 of the ,effects that may reasonably be expected from it1 ,i am happily conscious of that ,satisfaction1 or even ,joy1 which every truly honest ,man must receive1 from rendering essential good ,offices to others4 ,besides which1 ,i have enjoyed1 in its utmost ,extent1 that ,satisfaction which every grateful ,man must receive from the ,approbation and ,beneficence of his ,sovereign1 when ,i was distinguished with the precious ,medal1 which the illustrious ,chamber of ,health of the ,republick of ,berne honoured me with1 a few ,months after the ,publication of this ,treatise2 together with a ,letter still more estimable1 as it assured me of the extraordinary ,satisfaction the ,republick had testified on the ,impression of it2 a ,circumstance1 which ,i could not avoid this publick ,acknowledgement of1 without the greatest ,vanity and ,ingratitude4 ,this has also been a very influencing ,motive with me1 to exert my utmost ,abilities in perfecting this new ,edition1 in which ,i have made many ,alterations1 that render it greatly preferable to the first2 and of which ,amendments ,i shall give a brief ,account1 after saying somewhat of the ,editions1 which have appeared elsewhere4 ,the first is that1 which ,messrs4 99,heidegger991 the ,booksellers published in the 99,german99 ,language at 99,zurich991 about a ,year since4 ,i should have been highly delighted with the meer ,approbation of 99,m4 ,hirzel991 first ,physician of the ,canton of 99,zurich1 c499 whose superior and universal ,talents2 whose profound ,knowledge in the ,theory of ,physick2 and the ,extent and ,success of whose ,practice have justly elevated him among the small ,number of extraordinary ,men of our own ,times2 he having lately obtained the ,esteem and the ,thanks of all 99,europe199 for the ,history of one of her #c ,sages4 ,but ,i little expected the ,honour this ,gentleman has done me1 in translating the 99,advice to the ,people99 into his own ,language4 ,highly sensible nevertheless as ,i am of this ,honour1 ,i must always reflect with ,regret1 that he has consumed that important ,time1 in rendering my ,directions intelligible to his ,countrymen1 which he might have employed much more usefully1 in obliging the ,world with his own4 ,he has enriched his ,translation with an excellent ,preface1 which is chiefly employed in a just and beautiful ,portrait and ,contrast of the true1 and of the false ,physician2 with which ,i should have done myself the ,pleasure to have adorned the present #d ,edition2 if the ,size of this ,volume1 already too large1 had not proved an ,obstacle to so considerable an ,addition2 and if the ,manner1 in which 99,mr499 99,hirzel99 speaks of its ,author1 had permitted me with ,decency to publish his ,preface4 ,i have been informed by some ,letters1 that there have been two other 99,german99 ,translation of it2 but ,i am not informed by whom4 ,however1 99,m4 ,hirzel's99 ,preface1 his own ,notes1 and some ,additions with which ,i have furnished him1 renders his ,edition preferable to the first in 99,french991 and to the other 99,german99 ,translations already made4 #c ,le ,socrate rustique1 a ,work1 which every ,person should read4 #d ,this ,preface is indeed premised to this ,french ,edition1 but a ,translation of it was omitted1 to avoid extending the ,bulk and ,price of the ,work4 ,dr4 ,tissot must then have been ignorant of this ,addition1 when first published at ,lyons4 ,the ,second ,edition is that1 which the younger 99,didot991 the ,bookseller1 published towards the ,end of the ,winter at 99,paris994 ,he had requested me to furnish him with some ,additions to it1 which ,i could not readily comply with4 ,the ,third ,edition is a 99,dutch99 ,translation of it1 which will be very speedily published by 99,m4 ,renier ,aremberg991 ,bookseller at 99,rotterdam994 ,he had begun the ,translation from my first ,edition2 but having wrote to know whether ,i had not some ,additions to make1 ,i desired him to wait for the ,publication of this4 ,i have the good ,fortune to be very happy in my ,translators2 it being 99,m4 ,bikker991 a celebrated ,physician at 99,rotterdam99 7so very advantagiously known in other ,countries1 by his beautiful 99,dissertation on ,human ,nature991 throughout which ,genius and ,knowledge proceed ,hand in ,hand7 who will present his ,countrymen with the 99,advice to the ,people991 in their own ,language3 and who will improve it with such ,notes1 as are necessary for a safe and proper ,application of its ,contents1 in a ,climate1 different from that in which it was wrote4 ,i have also heard1 there has been an 99,italian99 ,translation of it4 ,after this ,account of the foreign ,editions1 ,i return to the present one1 which is the second of the original 99,french99 ,treatise4 ,i shall not affirm it is greatly corrected1 with ,respect to fundamental ,points3 for as ,i had advanced nothing in the first1 that was not established on ,truth and ,demonstration1 there was no ,room for ,correction1 with ,regard to any essential ,matters4 ,nevertheless1 in this ,i have made1 #a1 a great ,number of small ,alterations in the ,diction1 and added several ,words1 to render the ,work still more simple and perspicuous4 #b1 ,the typographical ,execution of this is considerably improved in the ,type1 the ,paper and ,ink1 the ,spelling1 ,pointing1 and ,arrangement of the ,work4 #c1 ,i have made some considerable ,additions1 which are of three ,kinds4 ,not a few of them are new ,articles on some of the ,subjects formerly treated of2 such as the ,articles concerning ,tarts and other ,pastry ,ware2 the ,addition concerning the ,regimen for ,persons1 in a ,state of ,recovery from ,diseases2 the ,preparation for the ,small ,pocks2 a long ,note on the ,jesuits ,bark2 another on acid ,spirits2 one on the ,extract of ,hemlock3 besides some new ,matter which ,i have inserted2 such as an ,article with ,regard to proper ,drinks2 one on the ,convulsions of ,infants2 one on ,chilblains2 another on ,punctures from ,thorns2 one upon the ,reason of the ,confidence reposed in ,quacks1 and the thirty-first ,chapter entirely3 in which ,i have extended the ,consideration of some former ,articles1 that seemed to me a little too succinct and short4 ,there are some ,alterations of this last1 this additional1 ,kind1 interspersed almost throughout the whole ,substance of this ,edition2 but especially in the two ,chapters relating to ,women and ,children4 ,the ,objects of the ,,xxxi ,chapter are such as require immediate ,assistance1 viz4 ,swoonings1 ,haemorrhages1 that is1 large spontaneous ,bleedings2 the ,attacks of ,convulsions1 and of ,suffocations2 the ,consequences of ,fright and ,terror2 ,disorders occasioned by unwholesome or deadly ,vapours2 the ,effects of ,poison1 and the sudden ,invasions of excessive ,pain4 ,the ,omission of this ,chapter was a very material ,defect in the original ,plan of this ,work4 ,the ,editor of it at ,paris was very sensible of this ,chasm1 or ,blank1 as it may be called1 and has filled it up very properly3 and if ,i have not made ,use of his ,supplement1 instead of enlarging myself upon the ,articles of which he has treated1 it has only been from a ,purpose of rendering the whole ,work more uniform2 and to avoid that odd ,diversity1 which seems scarcely to be avoided in a ,treatise composed by two ,persons4 ,besides which1 that ,gentleman has said nothing of the ,articles1 which employ the greatest ,part of that ,chapter1 99viz499 the ,swoonings1 the ,consequences of great ,fear1 and the noxious ,vapours4 ,before ,i conclude1 ,i ought to justify myself1 as well as possible1 to a great ,number of very respectable ,persons both here and abroad1 7to whom ,i can refuse nothing without great ,chagrine and ,reluctance7 for my not having made such ,additions as they desired of me4 ,this however was impossible1 as the ,objects1 in which they concurred1 were some chronical ,distempers1 that are entirely out of the ,plan1 to which ,i was strictly attached1 for many ,reasons4 ,the first is1 that it was my original ,purpose to oppose the ,errors incurred in ,country ,places1 in the ,treatment of acute ,diseases2 and to display the best ,method of conducting such1 as do not admit of waiting for the ,arrival of distant ,succour2 or of removing the ,patients to ,cities1 or large ,towns4 ,it is but too true indeed1 that chronical ,diseases are also liable to improper ,treatment in small ,country ,places3 but then there are both ,time and ,convenience to convey the ,patients within the ,reach of better ,advice2 or for procuring them the ,attendance of the best ,advisers1 at their own ,places of ,residence4 ,besides which1 such ,distempers are considerably less common than those to which ,i had restrained my ,views3 and they will become still less frequent1 whenever acute ,diseases1 of which they are frequently the ,consequences1 shall be more rationally and safely conducted4 ,the second ,reason1 which1 if alone1 would have been a sufficient one1 is1 that it is impossible to subject the ,treatment of chronical ,distempers to the ,capacity and ,conduct of ,persons1 who are not ,physicians4 ,each acute ,distemper generally arises from one ,cause2 and the ,treatment of it is simple and uniform2 since those ,symptoms1 which manifest the ,malady1 point out its ,cause and ,treatment4 ,but the ,case is very differently circumstanced in tedious and languid ,diseases2 each of which may depend on so many and various ,causes 7and it is only the real1 the true ,cause1 which ought to determine us in selecting its proper ,remedies7 that though the ,distemper and its ,appellation are evidently known1 a meer ,by-stander may be very remote from penetrating into its true ,cause2 and consequently be incapable of chusing the best ,medicines for it4 ,it is this precise and distinguishing ,discernment of the real particular ,cause 99or of the contingent ,concurrence of more than one99 that necessarily requires the ,presence of ,persons conversant in the ,study and the ,practice of all the ,parts of ,physick2 and which ,knowledge it is impossible for ,people1 who are ,strangers to such ,studies1 to arrive at4 ,moreover1 their frequent ,complexness2 the ,variety of their ,symptoms2 the different ,stages of these tedious ,diseases not exactly attended to even by many competent ,physicians the ,difficulty of ascertaining the different ,doses of ,medicines1 whose ,activity may make the smallest ,error highly dangerous1 c4 c4 are really such trying ,circumstances1 as render the fittest ,treatment of these ,diseases sufficiently difficult and embarrassing to the most experienced ,physicians1 and unattainable by those who are not ,physicians4 ,a third ,reason is1 that1 even supposing all these ,circumstances might be made so plain and easy1 as to be comprehended by every ,reader1 they would require a ,work of an excessive ,length2 and thence be disproportioned to the ,faculties of those1 for whom it was intended4 ,one single chronical ,disease might require as large a ,volume as the present one4 ,but finally1 were ,i to acknowledge1 that this ,compliance was both necessary and practicable1 ,i declare ,i find it exceeds my ,abilities2 and that ,i am also far from having sufficient ,leisure for the ,execution of it4 ,it is my ,wish that others would attempt it1 and may succeed in accomplishing it2 but ,i hope these truly worthy ,persons1 who have honoured me by proposing the ,achievement of it to myself1 will perceive the ,reasons for my not complying with it1 in all their ,force2 and not ascribe a ,refusal1 which arises from the very ,nature of the thing1 either to ,obstinacy1 or to any ,want of an ,inclination to oblige them4 ,i have been informed my ,citations1 or rather ,references1 have puzzled some ,readers4 ,it was difficult to foresee this1 but is easy to prevent it for the future4 ,the ,work contains ,citations only of two ,sorts2 one1 that points to the ,remedies prescribed2 and the other1 which refers to some ,passage in the ,book itself1 that serves to illustrate those ,passages in which ,i cite4 ,neither of these ,references could have been omitted4 ,the first is marked thus1 99,no499 with the proper ,figure to it1 as #a1 #b1 c4 ,this signifies1 that the ,medicine ,i direct is described in the ,table of ,remedies1 according to the ,number annexed to that ,character4 ,thus when we find directed1 in any ,page of the ,book1 the warm ,infusion 99,no4 #a992 in some other1 the ,ptisan 99,no4 #b992 or in a third1 the ,almond ,milk1 or ,emulsion 99,no4 #d991 it signifies1 that such ,prescriptions will be found at the ,numbers #a1 #b1 and #d2 and this ,table is printed at the ,end of the ,book4 ,if1 instead of forming this ,table1 and thus referring to the ,prescriptions by their ,numbers1 ,i had repeated each ,prescription as often as ,i directed it1 this ,treatise must have been doubled in ,bulk1 and insufferably tiresome to peruse4 ,i must repeat here1 what ,i have already said in the former ,edition1 that the #e ,prices of the ,medicines1 or of a great ,number of them1 are those at which the ,apothecaries may afford them1 without any ,loss1 to a ,peasant in humble ,circumstances4 ,but it should be remembered1 they are not set down at the full ,prices which they may handily demand2 since that would be unjust for some to insist on them at4 ,besides1 there is no ,kind of ,tax in 99,swisserland991 and ,i have no ,right to impose one4 #e ,the ,reasons for omitting the ,prices here1 may be seen ,page #bc of this ,translation4 ,the ,citations of the second ,kind are very plain and simple4 ,the whole ,work is divided into numbered ,paragraphs distinguished by the ,mark ,sec44 ,and not to swell it with needless ,repetitions1 when in one ,place ,i might have even pertinently repeated something already observed1 instead of such ,repetition at ,length1 ,i have only referred to the ,paragraph1 where it had been observed4 ,thus1 for ,example when we read ,page #ha1 ,sec4 #ej --99,when the ,disease is so circumstanced as we have described991 ,sec4 #df1-- this imports that1 not to repeat the ,description already given1 ,i refer the ,reader to that last ,sec4 for it4 ,the ,use of these ,citations is not the least ,innovation1 and extremely commodious and easy3 but were there only a single ,reader likely to be puzzled by them1 ,i ought not to omit this ,explanation of them1 as ,i can expect to be generally useful1 only in ,proportion as ,i am clear3 and it must be obvious1 that a ,desire of being extensively useful is the sole ,motive of this ,work4 ,i have long since had the ,happiness of knowing1 that some charitable and intelligent ,persons have applied the ,directions it contains1 with extraordinary ,success1 even in violent ,diseases3 ,and ,i shall arrive at the ,height of my ,wishes1 if ,i continue to be informed1 that it contributes to alleviate the ,sufferings1 and to prolong the ,days1 of my rational ,fellow ,creatures4 ,n4 ,b4 ,a ,small ,blank occurring conveniently here in the ,impression1 the ,translator of this ,work has employed it to insert the following proper ,remark1 viz4 ,whenever the ,tea or ,infusion of the ,lime-tree is directed in the ,body of the ,book1 which it often is1 the ,flowers are always meant1 and not the ,leaves2 though by an ,error of the ,press1 or perhaps rather by an ,oversight of the ,transcribers of this ,version1 it is printed ,leaves instead of ,flowers ,p4 #cib1 as noted and corrected in the ,errata4 ,these ,flowers are easily procurable here1 meerly for gathering1 in most ,country ,places in ,july1 as few ,walks1 ,vistas1 c4 are without these ,trees1 planted for the pleasant ,shade they afford1 and to keep off the ,dust in ,summer1 though the ,leaf drops rather too early for this ,purpose4 ,their ,flowers have an agreeable ,flavour1 which is communicated to ,water by ,infusion1 and rises with it in ,distillation4 ,they were1 to the best of my ,recollection1 an ,ingredient in the antiepileptic ,water of ,langius1 omitted in our late ,dispensatories of the ,college4 ,they are an ,ingredient in the antiepileptic ,powder1 in the ,list of ,medicines in the present ,practice of the ,hotel ,dieu at ,paris3 and we think were in a former ,prescription of our ,pulvis de ,gutteta1 or ,powder against ,convulsions4 ,indeed they are considered1 by many medical ,writers1 as a ,specific in all ,kinds of ,spasms and ,pains2 and ,hoffman affirms1 he knew a very tedious ,epilepsy cured by the ,use of an ,infusion of these ,flowers4 ,i also take this ,opportunity of adding1 that as this ,translation is intended for the ,attention and the ,benefit of the ,bulk of the ,inhabitants of the ,british ,empire1 ,i have been careful not to admit any ,gallicisms into it2 as such might render it either less intelligible1 or less agreeable to its ,readers4 ,if but a single one occurs1 ,i either have printed it1 or did intend it should be printed1 distinguishably in ,italics4 ,k4 ,introduction4 ,the ,decrease of the ,number of ,inhabitants1 in most of the ,states of ,europe1 is a ,fact1 which impresses every reflecting ,person1 and is become such a general ,complaint1 as is but too well established on plain ,calculations4 ,this ,decrease is most remarkable in ,country ,places4 ,it is owing to many ,causes2 and ,i shall think myself happy1 if ,i can contribute to remove one of the greatest of them1 which is the pernicious ,manner of treating sick ,people in ,country ,places4 ,this is my sole ,object1 tho' ,i may be excused perhaps for pointing out the other concurring ,causes1 which may be all included within these two general ,affirmations2 ,that greater ,numbers than usual emigrate from the ,country2 and that the ,people increase less every where4 ,there are many ,sorts of ,emigration4 ,some leave their ,country to enlist in the ,service of different ,states by ,sea and ,land2 or to be differently employ'd abroad1 some as ,traders1 others as ,domestics1 c4 ,military ,service1 by ,land or ,sea1 prevents ,population in various ,respects4 ,in the first ,place1 the ,numbers going abroad are always less1 often much less1 than those who return4 ,general ,battles1 with all the ,hazards and ,fatigues of ,war2 detached ,encounters1 bad ,provisions1 ,excess in drinking and eating1 ,diseases that are the ,consequences of ,debauches1 the ,disorders that are peculiar to the ,country2 epidemical1 pestilential or contagious ,distempers1 caused by the unwholsome ,air of ,flanders1 ,holland1 ,italy and ,hungary2 long ,cruises1 ,voyages to the ,east or ,west ,indies1 to ,guinea1 c4 destroy a great ,number of ,men4 ,the ,article of ,desertion also1 the ,consequences of which they dread on returning home1 disposes many to abandon their ,country for ever4 ,others1 on quitting the ,service1 take up with such ,establishments1 as it has occasionally thrown in their ,way2 and which necessarily prevent their ,return4 ,but in the second ,place1 supposing they were all to come back1 their ,country suffers equally from their ,absence2 as this very generally happens during that ,period of ,life1 when they are best adapted for ,propagation2 since that ,qualification on their ,return is impaired by ,age1 by ,infirmities and ,debauches3 and even when they do marry1 the ,children often perish as ,victims to the ,excesses and ,irregularities of their ,fathers3 they are weak1 languishing1 distempered1 and either die young1 or live incapable of being useful to ,society4 ,besides1 that the prevailing ,habit of ,libertinage1 which many have contracted1 prevents several of them from marrying at all4 ,but notwithstanding all these inconvenient ,consequences are real and notorious2 yet as the ,number of those1 who leave their ,country on these ,accounts1 is limited1 and indeed rather inconsiderable1 if compared with the ,number of ,inhabitants which must remain at home3 as it may be affirmed too1 that this relinquishing of their ,country1 may have been even necessary at some ,times1 and may become so again1 if the ,causes of ,depopulation should cease1 this kind of ,emigration is doubtless the least grievous of any1 and the last which may require a strict ,consideration4 ,but that abandoning of their ,country1 or ,expatriation1 as it may be termed1 the ,object of which is a ,change of the ,emigrants ,condition1 is more to be considered1 being more numerous4 ,it is attended with many and peculiar ,inconveniencies1 and is unhappily become an epidemical ,evil1 the ,ravages of which are still increasing2 and that from one simple ridiculous ,source1 which is this2 that the ,success of one ,individual determines a hundred to run the same ,risque1 ninety and nine of whom may probably be disappointed4 ,they are struck with the apparent ,success of one1 and are ignorant of the ,miscarriage of others4 ,suppose a hundred ,persons might have set out ten ,years ago1 to seek their ,fortune1 as the saying is1 at the ,end of six ,months they are all forgotten1 except by their ,relations2 but if one should return the same ,year1 with more ,money than his own ,fortune1 more than he set out with2 or if one of them has got a moderate ,place with little ,work1 the whole ,country rings with it1 as a ,subject of general ,entertainment4 ,a ,croud of young ,people are seduced by this and sally forth1 because not one reflects1 that of the ninety nine1 who set out with the hundredth ,person1 one half has perished1 many are miserable1 and the ,remainder come back1 without having gained any thing1 but an ,incapacity to employ themselves usefully at home1 and in their former ,occupations3 and having deprived their ,country of a great many ,cultivaters1 who1 from the ,produce of the ,lands1 would have attracted considerable ,sums of ,money1 and many comfortable ,advantages to it4 ,in short1 the very small ,proportion who succeed1 are continually talked of2 the ,croud that sink are perpetually forgot4 ,this is a very great and real ,evil1 and how shall it be prevented8 ,it would be sufficient perhaps to publish the extraordinary ,risque1 which may be easily demonstrated3 ,it would require nothing more than to keep an exact yearly ,register of all these ,adventurers1 and1 at the ,expiration of six1 eight1 or ten ,years1 to publish the ,list1 with the ,fate1 of every ,emigrant4 ,i am greatly deceived1 or at the ,end of a certain ,number of ,years1 we should not see such ,multitudes forsake their native ,soil1 in which they might live comfortably by working1 to go in ,search of ,establishments in others2 the ,uncertainty of which1 such ,lists would demonstrate to them2 and also prove1 how preferable their ,condition in their own ,country would have been1 to that they have been reduced to4 ,people would no longer set out1 but on almost certain ,advantages3 fewer would undoubtedly emigrate1 more of whom1 from that very ,circumstance1 must succeed4 ,meeting with fewer of their ,country-men abroad1 these fortunate few would oftner return4 ,by this ,means more ,inhabitants would remain in the ,country1 more would return again1 and bring with them more ,money to it4 ,the ,state would be more populous1 more rich and happy2 as the ,happiness of a ,people1 who live on a fruitful ,soil1 depends essentially on a great ,number of ,inhabitants1 with a moderate ,quantity of pecuniary ,riches4 ,but the ,population of the ,country is not only necessarily lessened1 in ,consequence of the ,numbers that leave it2 but even those who remain increase less1 than an equal ,number formerly did4 ,or1 which amounts to the same ,thing1 among the same ,number of ,persons1 there are fewer ,marriages than formerly2 and the same ,number of ,marriages produce fewer ,christenings4 ,i do not enter upon a ,detail of the ,proofs1 since merely looking about us must furnish a sufficient ,conviction of the ,truth of them4 ,what then are the ,causes of this8 ,there are two capital ones1 ,luxury and ,debauchery1 which are ,enemies to ,population on many ,accounts4 ,luxury compells the wealthy ,man1 who would make a ,figure2 and the ,man of a moderate ,income1 but who is his equal in every other ,respect1 and who will imitate him1 to be afraid of a numerous ,family2 the ,education of which must greatly contract that ,expence he had devoted to ,parade and ,ostentation3 ,and besides1 if he must divide his ,estate among a great many ,children1 each of them would have but a little1 and be unable to keep up the ,state and the ,train of the ,father's4 ,since ,merit is unjustly estimated by exterior ,shew and ,expence1 one must of ,course endeavour to attain for himself1 and to leave his ,children in1 a ,situation capable of supporting that ,expence4 ,hence the fewer ,marriages of ,people who are not opulent1 and the fewer ,children among ,people who marry4 ,luxury is further prejudicial to the ,increase of the ,people1 in another ,respect4 ,the irregular ,manner of ,life which it introduces1 depresses ,health2 it ruins the ,constitutions1 and thus sensibly affects ,procreation4 ,the preceding ,generation counted some ,families with more than twenty ,children3 the living one less than twenty ,cousins4 ,very unfortunately this ,way of thinking and acting1 so preventive of ,increase1 has extended itself even into ,villages3 and they are no longer convinced there1 that the ,number of ,children makes the ,riches of the ,countryman4 ,perhaps the next ,generation will scarcely be acquainted with the ,relation of ,brotherhood4 ,a third ,inconvenience of ,luxury is1 that the ,rich retreat from the ,country to live in ,cities2 and by multiplying their ,domestics there1 they drain the former4 ,this augmented ,train is prejudicial to the ,country1 by depriving it of ,cultivaters1 and by diminishing ,population4 ,these ,domestics1 being seldom sufficiently employed1 contract the ,habit of ,laziness2 and they prove incapable of returning to that ,country ,labour1 for which ,nature intended them4 ,being deprived of this ,resource they scarcely ever marry1 either from apprehending the ,charge of ,children1 or from their becoming ,libertines2 and sometimes1 because many ,masters will not employ married ,servants4 ,or should any of them marry1 it is often in the ,decline of ,life1 whence the ,state must have the fewer ,citizens4 ,idleness of itself weakens them1 and disposes them to those ,debauches1 which enfeeble them still more4 ,they never have more than a few ,children1 and these sickly2 such as have not ,strength to cultivate the ,ground2 or who1 being brought up in ,cities1 have an ,aversion to the ,country4 ,even those among them who are more prudent1 who preserve their ,morals1 and make some ,savings1 being accustomed to a ,city ,life1 and dreading the ,labour of a ,country one 7of the ,regulation of which they are also ignorant7 chuse to become little ,merchants1 or ,tradesmen2 and this must be a ,drawback from ,population1 as any ,number of ,labourers beget more ,children than an equal ,number of ,citizens2 and also by ,reason1 that out of any given ,number1 more ,children die in ,cities1 than in the ,country4 ,the same ,evils also prevail1 with ,regard to female ,servants4 ,after ten or twelve ,years ,servitude1 the ,maid-,servants in ,cities cannot acquit themselves as good ,country ,servants3 and such of them as chuse this ,condition1 quickly fail under that ,kind or ,quantity of ,work1 for which they are no longer constituted4 ,should we see a ,woman married in the ,country1 a ,year after leaving ,town1 it is easy to observe1 how much that ,way of living in the ,country has broke her4 ,frequently their first ,child-bed1 in which ,term they have not all the ,attendance their ,delicacy demands1 proves the ,loss of their ,health2 they remain in a ,state of ,languor1 of ,feebleness1 and of ,decay3 they have no more ,children2 and this renders their ,husbands unuseful towards the ,population of the ,state4 ,abortions1 ,infants carried out of their ,country after a concealed ,pregnancy1 and the ,impossibility of their getting ,husbands afterwards1 are frequently the ,effects of their ,libertinage4 ,it is to be apprehended too these bad ,effects are rather increasing with us2 since1 either for want of sufficient ,numbers1 or from oeconomical ,views1 it has become a ,custom1 instead of ,women ,servants1 to employ ,children1 whose ,manners and whole ,constitutions are not yet formed2 and who are ruined in the same ,manner1 by their ,residence in ,town1 by their ,laziness1 by bad ,examples1 and bad ,company4 ,doubtless much remains still unsaid on these important ,heads2 but besides my ,intention not to swell this ,treatise immoderately1 and the many ,avocations1 which prevent me from launching too far into what may be less within the ,bounds of ,medicine1 ,i should be fearful of digressing too far from my ,subject4 ,what ,i have hitherto said however1 ,i think cannot be impertinent to it2 since in giving ,advice to the ,people1 with ,regard to their ,health1 it was necessary to display to them the ,causes that impaired it3 though what ,i might be able to add further on this ,head1 would probably be thought more remote from the ,subject4 ,i shall add then but a single ,hint on the ,occasion4 ,is it not practicable1 in ,order to remedy those ,evils which we cannot prevent1 to select some particular ,part or ,canton of the ,country1 wherein we should endeavour by ,rewards1 #ast4 ,irremoveably to fix all the ,inhabitants4 #b;dly4 ,to encourage them by other ,rewards to a plentiful and legitimate ,increase4 ,they should not be permitted to go out of it1 which must prevent them from being exposed to the ,evils ,i have mentioned4 ,they should by no means intermarry with any ,strangers1 who might introduce such ,disorders among them4 ,thus very probably this ,canton1 after a certain ,time1 would become even over-peopled1 and might send out ,colonies to the others4 ,one ,cause1 still more considerable than those we have already mention'd1 has1 to this very ,moment1 prevented the ,increase of the ,people in ,france4 ,this is the ,decay of ,agriculture4 ,the ,inhabitants of the ,country1 to avoid serving in the ,militia2 to elude the ,days-,service impos'd by their ,lords1 and the ,taxes2 and being attracted to the ,city by the ,hopes of ,interest1 by ,laziness and ,libertinage1 have left the ,country nearly deserted4 ,those who remain behind1 either not being encouraged to work1 or not being sufficient for what there is to do1 content themselves with cultivating just as much as is absolutely necessary for their ,subsistence4 ,they have either lived single1 or married but late2 or perhaps1 after the ,example of the ,inhabitants of the ,cities1 they have refused to fulfil their ,duty to ,nature1 to the ,state1 and to a ,wife4 ,the ,country deprived of ,tillers1 by this ,expatriation and ,inactivity1 has yielded nothing2 and the ,depopulation of the ,state has daily increased1 from the reciprocal and necessary ,proportion between ,subsistence and ,population1 and because ,agriculture alone can increase ,subsistence4 ,a single ,comparison will sufficiently evince the ,truth and the ,importance of these ,principles1 to those who have not seen them already divulged and demonstrated in the ,works of the #f ,friend of ,man4 #f ,the ,marquis of ,mirabeau4 ,an old ,roman1 who was always ready to return to the ,cultivation of his ,field1 subsisted himself and his ,family from one ,acre of ,land4 ,a ,savage1 who neither sows nor cultivates1 consumes1 in his single ,person1 as much ,game as requires fifty ,acres to feed them4 ,consequently ,tullus ,hostilius1 on a thousand ,acres1 might have five thousand ,subjects3 while a ,savage ,chief1 limited to the same ,extent of ,territory1 could scarcely have twenty3 such an immense ,disproportion does ,agriculture furnish1 in ,favour of ,population4 ,observe these two great ,extremes4 ,a ,state becomes dispeopled or peopled in that ,proportion1 by which it recedes from one of these ,methods1 and approaches to the other4 ,indeed it is evident1 that wherever there is an ,augmentation of ,subsistence1 an ,increase of ,population will soon follow2 which again will still further facilitate the ,increase of ,provisions4 ,in a ,state thus circumstanced ,men will abound1 who1 after they have furnished sufficient ,numbers for the ,service of ,war1 of ,commerce1 of ,religion1 and for ,arts and ,professions of every kind1 will further also furnish a ,source for ,colonies1 who will extend the ,name and the ,prosperity of their ,nation to distant ,regions4 ,there will ensue a ,plenty of ,commodities1 the ,superfluity of which will be exported to other ,countries1 to exchange for other ,commodities1 that are not produced at home2 and the ,balance1 being received in ,money1 will make the ,nation rich1 respectable by its ,neighbours1 and happy4 ,agriculture1 vigorously pursued1 is equal to the ,production of all these ,benefits2 and the present ,age will enjoy the ,glory of restoring it1 by favouring and encouraging ,cultivaters1 and by forming ,societies for the ,promotion of ,agriculture4 ,i proceed at length to the fourth ,cause of ,depopulation1 which is the ,manner of treating sick ,people in the ,country4 ,this has often affected me with the deepest ,concern4 ,i have been a ,witness1 that ,maladies1 which1 in themselves1 would have been gentle1 have proved mortal from a pernicious ,treatment3 ,i am convinced that this ,cause alone makes as great a ,havock as the former2 and certainly it requires the utmost ,attention of ,physicians1 whose ,duty it is to labour for the ,preservation of ,mankind4 ,while we are employing our assiduous ,cares on the more polished and fashionable ,part of them in ,cities1 the larger and more useful ,moiety perish in the ,country2 either by particular1 or by highly epidemical1 ,diseases1 which1 within a few ,years past1 have appeared in different ,villages1 and made no small ,ravages4 ,this afflicting ,consideration has determined me to publish this little ,work1 which is solely intended for those ,patients1 who1 by their ,distance from ,physicians1 are deprived of their ,assistance4 ,i shall not give a ,detail of my ,plan1 which is very simple1 in this ,part2 but content myself with affirming1 ,i have used my utmost ,care to render it the most useful ,i possibly could3 and ,i dare hope1 that if ,i have not fully displayed its utmost ,advantages1 ,i have at least sufficiently shewn those pernicious ,methods of treating ,diseases1 that should incontestably be avoided4 ,i am thoroughly convinced1 the ,design might be accomplished more compleatly than ,i have done it2 but those who are so capable of1 do not attempt1 it3 ,i happen to be less timid2 and ,i hope that thinking ,persons will rather take it in good part of me1 to have published a ,book1 the composing of which is rather disagreeable from its very ,facility2 from the minute ,details1 which however are indispensable2 and from the ,impossibility of discussing any ,part of it 7consistently with the ,plan7 to the ,bottom of the ,subject2 or of displaying any new and useful ,prospect4 ,it may be compared1 in some ,respects1 to the ,works of a spiritual ,guide1 who was to write a ,catechism for little ,children4 ,at the same time ,i am not ignorant there have already been a few ,books calculated for ,country ,patients1 who are remote from ,succour3 but some of these1 tho' published with a very good ,purpose1 produce a bad ,effect4 ,of this kind are all ,collections of ,receipts or ,remedies1 without the least ,description of the ,disease2 and of ,course without just ,directions for the ,exhibition1 or ,application1 of them4 ,such1 for ,example1 is the famous ,collection of ,madam ,fouquet1 and some more in the same manner4 ,some others approach towards my ,plan2 but many of them have taken in too many ,distempers1 whence they are become too voluminous4 ,besides1 they have not dwelt sufficiently upon the ,signs of the ,diseases2 upon their ,causes2 the general ,regimen in them1 and the ,mismanagement of them4 ,their ,receipts are not generally as simple1 and as easy to prepare1 as they ought to be4 ,in short1 the greater ,part of their ,writers seem1 as they advanced1 to have grown tired of their melancholy ,task1 and to have hurried them out too expeditiously4 ,there are but two of them1 which ,i must name with ,respect1 and which being proposed on a ,plan very like my own1 are executed in a superior ,manner1 that merits the highest ,acknowlegements of the ,publick4 ,one of these ,writers is ,m4 ,rosen1 first ,physician of the ,kingdom of ,sweden2 who1 some ,years since1 employed his just ,reputation to render the best ,services to his ,country ,men4 ,he has made them retrench from the ,almanacs those ridiculous ,tales2 those extraordinary ,adventures2 those pernicious astrological ,injunctions1 which there1 as well as here1 answer no ,end1 but that of keeping up ,ignorance1 ,credulity1 ,superstition1 and the falsest ,prejudices on the interesting ,articles of ,health1 of ,diseases1 and of ,remedies4 ,he has also taken ,care to publish simple plain ,treatises on the most popular ,distempers2 which he has substituted in the ,place of the former ,heap of ,absurdities4 ,these concise ,works however1 which appear annually in their ,almanacs1 are not yet translated from the ,swedish1 so that ,i was unqualified to make any ,extracts from them4 ,the other is the ,baron ,van ,swieten1 first ,physician to their ,imperial ,majesties1 who1 about two ,years since1 has effected for the ,use of the ,army1 what ,i now attempt for sick ,people in the ,country4 ,though my ,work was greatly advanced1 when ,i first saw his1 ,i have taken some ,passages from it3 and had our ,plans been exactly alike1 ,i should imagine ,i had done the ,publick more ,service by endeavouring to extend the ,reading of his ,book1 than by publishing a new one4 ,nevertheless1 as he is silent on many ,articles1 of which ,i have treated diffusively2 as he has treated of many ,distempers1 which did not come within my ,plan2 and has said nothing of some others which ,i could not omit2 our two ,works1 without entering into the ,particulars of the superior ,merit of the ,baron's1 are very different1 with ,regard to the ,subject of the ,diseases2 tho' in such as we have both considered1 ,i account it an ,honour to me to find1 we have almost constantly proceeded upon the same ,principles4 ,the present ,work is by no means addressed to such ,physicians1 as are thoroughly accomplished in their ,profession2 yet possibly1 besides my particular medical ,friends1 some others may read it4 ,i beg the ,favour of all such fully to consider the ,intention1 the ,spirit1 of the ,author1 and not to censure him1 as a ,physician1 from the ,composition of this ,book4 ,i even advise them here rather to forbear perusing it2 as a ,production1 that can teach them nothing4 ,such as read1 in order to criticize1 will find a much greater ,scope for exercising that ,talent on the other ,pamphlets ,i have published4 ,it were certainly unjust that a ,performance1 whose sole abstracted ,object is the ,health and ,service of my ,countrymen1 should subject me to any disagreeable ,consequences3 and a ,writer may fairly plead an ,exemption from any ,severity of ,censure1 who has had the ,courage to execute a ,work1 which cannot pretend to a ,panegyric4 ,having premised thus much in general1 ,i must enter into some ,detail of those ,means1 that seem the most likely to me1 to facilitate the beneficial ,consequences1 which1 ,i hope1 may result to others1 from my present ,endeavours4 ,i shall afterwards give an ,explanation of some ,terms which ,i could not avoid using1 and which1 perhaps1 are not generally understood4 ,the ,title of ,advice to the ,people1 was not suggested to me by an ,illusion1 which might persuade me1 this ,book would become a ,piece of ,furniture1 as it were1 in the ,house of every ,peasant4 ,nineteen out of twenty will probably never know of its ,existence4 ,many may be unable to read1 and still more unable to understand1 it1 plain and simple as it is4 ,i have principally calculated it for the ,perusal of intelligent and charitable ,persons1 who live in the ,country2 and who seem to have1 as it were1 a ,call from ,providence1 to assist their less intelligent poor ,neighbours with their ,advice4 ,it is obvious1 that the first ,gentlemen ,i have my ,eye upon1 are the ,clergy4 ,there is not a single ,village1 a ,hamlet1 nor even the ,house of an ,alien in the ,country1 that has not a ,right to the good ,offices of some one of this ,order2 ,and ,i assure myself there are a great ,number of them1 who1 heartily affected with the ,distress of their ailing ,flocks1 have wished many hundred ,times1 that it were in their ,power to give their ,parishioners some bodily ,help1 at the very ,time they were disposing them to prepare for ,death2 or so far to delay the ,fatality of the ,distemper1 that the ,sick might have an ,opportunity of living more religiously afterwards4 ,i shall think myself happy1 if such truly respectable ,ecclesiastics shall find any ,resources in this ,performance1 that may conduce to the ,accomplishment of their beneficent ,intentions4 ,their ,regard1 their ,love for their ,people2 their frequent ,invitations to visit their principal ,neighbours2 their ,duty to root out all unreasonable ,prejudices1 and ,superstition2 their ,charity1 their ,learning2 the ,facility1 with which their general ,knowlege in ,physics1 qualifies them to comprehend thoroughly all the medical ,truths1 and ,contents of this ,piece1 are so many ,arguments to convince me1 that they will have the greatest ,influence to procure that ,reformation1 in the ,administration of ,physick to poor ,country ,people1 which is so necessary1 so desirable1 an ,object4 ,in the next ,place1 ,i dare assure myself of the ,concurrence of ,gentlemen of ,quality and ,opulence1 in their different ,parishes and ,estates1 whose ,advice is highly regarded by their ,inferiors2 who are so powerfully adapted to discourage a wrong1 and to promote a right ,practice1 of which they will easily discern all the ,advantages4 ,the many ,instances ,i have seen of their entering1 with great ,facility1 into all the ,plan and ,conduct of a ,cure2 their ,readiness and even ,earnestness to comfort the ,sick in their ,villages2 and the ,generosity with which they prevent their ,necessities1 induce me to hope1 from judging of these ,i have not the ,pleasure to know1 by those whom ,i have1 that they will eagerly embrace an ,opportunity of promoting a new ,method of doing good in their ,neighbourhood4 ,real ,charity will apprehend the great ,probability there is of doing ,mischief1 tho' with the best ,intention1 for want of a proper ,knowledge of material ,circumstances2 and the very ,fear of that ,mischief may sometimes suspend the ,exercise of such ,charity2 notwithstanding it must seize1 with the most humane ,avidity1 every ,light that can contribute to its own beneficent ,exertion4 ,thirdly1 ,persons who are rich1 or at least in easy ,circumstances1 whom their ,disposition1 their ,employments1 or the ,nature of their ,property1 fixes in the ,country1 where they are happy in doing good1 must be delighted to have some proper ,directions for the ,conduct and ,effectuation of their charitable ,intentions4 ,in every ,village1 where there are any ,persons1 of these three ,conditions1 they are always readily apprized of the ,distempers in it1 by their poor ,neighbours coming to intreat a little ,soup1 ,venice ,treacle1 ,wines1 ,biscuits1 or any thing they imagine necessary for their sick ,folks4 ,in ,consequence of some ,questions to the ,bystanders1 or of a ,visit to the sick ,person1 they will judge at least of what kind the ,disease is2 and by their prudent ,advice they may be able to prevent a ,multitude of ,evils4 ,they will give them some ,nitre instead of ,venice ,treacle2 ,barley1 or sweet ,whey1 in lieu of ,soup4 ,they will advise them to have ,recourse to ,glysters1 or ,bathings of their ,feet1 rather than to ,wine2 and order them ,gruel rather than ,biscuits4 ,a man would scarcely believe1 'till after the ,expiration of a few ,years1 how much ,good might be effected by such proper ,regards1 so easily comprehended1 and often repeated4 ,at first indeed there may be some ,difficulty in eradicating old ,prejudices1 and inveterately bad ,customs2 but whenever these were removed1 good ,habits would strike forth full as strong ,roots1 and ,i hope that no ,person would be inclined to destroy them4 ,it may be unnecessary to declare1 that ,i have more ,expectation from the ,care and ,goodness of the ,ladies1 than from those of their ,spouses1 their ,fathers1 or ,brothers4 ,a more active ,charity1 a more durable ,patience1 a more domestic ,life2 a ,sagacity1 which ,i have greatly admired in many ,ladies both in ,town and ,country1 that disposes them to observe1 with great ,exactness2 and to unravel1 as it were1 the secret ,causes of the ,symptoms1 with a ,facility that would do ,honour to very good ,practioners1 and with a ,talent adapted to engage the ,confidence of the ,patient3--,all these1 ,i say1 are so many characteristical ,marks of their ,vocation in this important and amicable ,duty2 nor are there a few1 who fulfil it with a ,zeal1 that merits the highest ,commendation1 and renders them excellent ,models for the ,imitation of others4 ,those who are intrusted with the ,education of ,youth1 may also be supposed sufficiently intelligent to take some ,part in this ,work2 and ,i am satisfied that much ,good might result from their undertaking it4 ,i heartily wish1 they would not only study to distinguish the ,distemper 7in which the principal1 but by no means an insuperable ,difficulty consists2 and to which ,i hope ,i have considerably put them in the ,way7 but ,i would have them learn also the ,manner of applying ,remedies4 ,many of them have2 ,i have known some who bleed1 and who have given ,glysters very expertly4 ,this however all may easily learn2 and perhaps it would not be imprudent1 if the ,art of bleeding well and safely were reckoned a necessary ,qualification1 when they are examined for their ,employment4 ,these ,faculties1 that of estimating the ,degree of a ,fever1 and how to apply and to dress ,blisters1 may be of great ,use within the ,neighbourhood of their ,residence4 ,their ,schools1 which are not frequently over-crouded1 employ but a few of their daily ,hours2 the greater part of them have no ,land to cultivate2 and to what better ,use can they apply their ,leisure1 than to the ,assistance and ,comfort of the ,sick8 ,the moderate ,price of their ,service may be so ascertained1 as to incommode no ,person2 and this little ,emolument might render their own ,situation the more agreeable3 besides which1 these little ,avocations might prevent their being drawn aside sometimes1 by ,reason of their ,facility and frequent ,leisure1 so as to contract a ,habit of drinking too often4 ,another ,benefit would also accrue from accustoming them to this kind of ,practice1 which is1 that being habituated to the ,care of sick ,people1 and having frequent ,occasions to write1 they would be the better qualify'd1 in difficult ,cases1 to advise with those1 who were thought further necessary to be consulted4 ,doubtless1 even among ,labourers1 there may be many1 for some such ,i have known1 who being endued with good natural ,sense and ,judgment1 and abounding with ,benevolence1 will read this ,book with ,attention1 and eagerly extend the ,maxims and the ,methods it recommends4 ,and finally ,i hope that many ,surgeons1 who are spread about the ,country1 and who practice ,physic in their ,neighbourhood1 will peruse it2 will carefully enter into the ,principles established in it1 and will conform to its ,directions2 tho' a little different perhaps from such as they may have hitherto practiced4 ,they will perceive a ,man may learn at any ,age1 and of any ,person2 and it may be hoped they will not think it too much ,trouble to reform some of their ,notions in a ,science1 which is not properly within their ,profession 7and to the ,study of which they were never instituted7 by those of a ,person1 who is solely employed in it1 and who has had many ,assistances of which they are deprived4 ,midwives may also find their ,attendance more efficacious1 as soon as they are thoroughly disposed to be better informed4 ,it were heartily to be wished1 that the greater ,part of them had been better instructed in the ,art they profess4 ,the ,instances of ,mischief that might have been avoided1 by their being better qualify'd1 are frequent enough to make us wish there may be no ,repetition of them1 which it may be possible to prevent4 ,nothing seems impossible1 when ,persons in ,authority are zealously inclined to prevent every such ,evil2 and it is time they should be properly informed of one so essentially hurtful to ,society4 ,the ,prescriptions ,i have given consist of the most simple ,remedies1 and ,i have adjoined the ,manner of preparing them so fully1 that ,i hope no ,person can be at any ,loss in that ,respect4 ,at the same time1 that no one may imagine they are the less useful and efficacious for their ,simplicity1 ,i declare1 they are the same ,i order in the ,city for the most opulent ,patients4 ,this ,simplicity is founded in ,nature3 the ,mixture1 or rather the ,confusion1 of a ,multitude of ,drugs is ridiculous4 ,if they have the very same ,virtues1 for what ,purpose are they blended8 ,it were more judicious to confine ourselves to that1 which is the most effectual4 ,if their ,virtues are different1 the ,effect of one destroys1 or lessens1 the ,effect of the other2 and the ,medicine ceases to prove a ,remedy4 ,i have given no ,direction1 which is not very practicable and easy to execute2 nevertheless it will be discernible1 that some few are not calculated for the ,multitude1 which ,i readily grant4 ,however ,i have given them1 because ,i did not lose ,sight of some ,persons2 who1 tho' not strictly of the ,multitude1 or ,peasantry1 do live in the ,country1 and cannot always procure a ,physician as soon1 or for as long a ,time1 as they gladly would4 ,a great ,number of the ,remedies are entirely of the ,country ,growth1 and may be prepared there2 but there are others1 which must be had from the ,apothecaries4 ,i have set down the ,price #g at which ,i am persuaded all the ,country ,apothecaries will retail them to a ,peasant1 who is not esteemed a rich one4 ,i have marked the ,price1 not from any ,apprehension of their being imposed on in the ,purchase1 for this ,i do not apprehend2 but1 that seeing the ,cheapness of the ,prescription1 they may not be afraid to buy it4 ,the necessary ,dose of the ,medicine1 for each ,disease1 may generally be purchased for less ,money than would be expended on ,meat1 ,wine1 ,biscuits1 and other improper things4 ,but should the ,price of the ,medicine1 however moderate1 exceed the ,circumstances of the ,sick1 doubtless the ,common ,purse1 or the ,poors-,box will defray it3 moreover there are in many ,country ,places ,noblemens ,houses1 some of whom charitably contribute an annual ,sum towards buying of ,medicines for poor ,patients4 ,without adding to which ,sum1 ,i would only intreat the ,favour of each of them to alter the ,objects of it1 and to allow their sick ,neighbours the ,remedies and the ,regimen directed here1 instead of such as they formerly distributed among them4 #g ,this oeconomical ,information was doubtless very proper1 where our judicious and humane ,author published it2 but notwithstanding his excellent ,motives for giving it1 we think it less necessary here1 where many ,country ,gentlemen furnish themselves with larger or smaller ,medicine ,chests1 for the ,benefit of their poor sick ,neighbours2 and in a ,country1 where the settled parochial ,poor are provided with ,medicines1 as well as other ,necessaries1 at a parochial ,expence4 ,besides1 tho' we would not suppose our ,country ,apothecaries less considerate or kind than others1 we acknowledge our ,apprehension1 that in such ,valuation of their ,drugs 7some of which often vary in their ,price7 might dispose a few of them1 rather to discountenance the ,extension of a ,work1 so well intended and executed as ,dr4 ,tissot's2 a ,work1 which may not be wholly unuseful to some of the most judicious among them1 and will be really necessary for the rest4 ,k4 ,it may still be objected1 that many ,country ,places are very distant from large ,towns2 from which ,circumstance a poor ,peasant is incapable of procuring himself a seasonable and necessary ,supply in his ,illness4 ,i readily admit1 that1 in ,fact1 there are many ,villages very remote from such ,places as ,apothecaries reside in4 ,yet1 if we except a few among the ,mountains1 there are but very few of them above three or four ,leagues from some little ,town1 where there always lives some ,surgeon1 or some ,vender of ,drugs4 ,perhaps however1 even at this ,time1 indeed1 there may not be many thus provided2 but they will take care to furnish themselves with such ,materials1 as soon as they have a good ,prospect of selling them1 which may constitute a small1 but new1 ,branch of ,commerce for them4 ,i have carefully set down the ,time1 for which each ,medicine will keep1 without spoiling4 ,there is a very frequent ,occasion for some particular ones1 and of such the ,school-masters may lay in a ,stock4 ,i also imagine1 if they heartily enter into my ,views1 they will furnish themselves with such ,implements1 as may be necessary in the ,course of their ,attendance4 ,if any of them were unable to provide themselves with a sufficient ,number of good ,lancets1 an ,apparatus for ,cupping1 and a ,glyster ,syringe 7for want of which last a ,pipe and ,bladder may be occasionally substituted7 the ,parish might purchase them1 and the same ,instruments might do for the succeeding ,school-master4 ,it is hardly to be expected1 that all ,persons in that ,employment would be able1 or even inclined1 to learn the ,way of using them with ,address2 but one ,person who did1 might be sufficient for whatever ,occasions should occur in this ,way in some contiguous ,villages2 with very little ,neglect of their ,functions among their ,scholars4 ,daily ,instances of ,persons1 who come from different ,parts to consult me1 without being capable of answering the ,questions ,i ask them1 and the like ,complaints of many other ,physicians on the same ,account1 engaged me to write the last ,chapter of this ,work4 ,i shall conclude this ,introduction with some ,remarks1 necessary to facilitate the ,knowledge of a few ,terms1 which were unavoidable in the ,course of it4 ,the ,pulse commonly beats in a ,person in good ,health1 from the ,age of eighteen or twenty to about sixty six ,years1 between sixty and seventy ,times in a ,minute4 ,it sometimes comes short of this in old ,persons1 and in very young ,children it beats quicker3 until the ,age of three or four ,years the ,difference amounts at least to a third2 after which it diminishes by ,degrees4 ,an intelligent ,person1 who shall often touch and attend to his own ,pulse1 and frequently to other ,peoples1 will be able to judge1 with sufficient ,exactness1 of the ,degree of a ,fever in a sick ,person4 ,if the ,strokes are but one third above their ,number in a healthy ,state1 the ,fever is not very violent3 which it is1 as often as it amounts to half as many more as in ,health4 ,it is very highly dangerous1 and may be generally pronounced mortal1 when there are two ,strokes in the ,time of one4 ,we must not however judge of the ,pulse1 solely by its ,quickness1 but by its ,strength or ,weakness2 its ,hardness or ,softness2 and the ,regularity or ,irregularity of it4 ,there is no ,occasion to define the strong and the feeble ,pulse4 ,the ,strength of it generally affords a good ,prognostic1 and1 supposing it too strong1 it may easily be lowered4 ,the weak ,pulse is often very menacing4 ,if the ,pulse1 in meeting the ,touch1 excites the ,notion of a dry ,stroke1 as though the ,artery consisted of ,wood1 or of some ,metal1 we term it hard2 the opposite to which is called soft1 and generally promises better4 ,if it be strong and yet soft1 even though it be quick1 it may be considered as a very hopeful ,circumstance4 ,but if it is strong and hard1 that commonly is a ,token of an ,inflammation1 and indicates ,bleeding and the cooling ,regimen4 ,should it be1 at the same time1 small1 quick and hard1 the ,danger is indeed very pressing4 ,we call that ,pulse regular1 a continued ,succession of whole ,strokes are made in equal ,intervals of ,time2 and in which ,intervals1 not a single ,stroke is wanting 7since if that is its ,state1 it is called an intermitting ,pulse47 ,the ,beats or ,pulsations are also supposed to resemble each other so exactly in ,quality too1 that one is not strong1 and the next alternately feeble4 ,as long as the ,state of the ,pulse is promising2 ,respiration or ,breathing is free2 the ,brain does not seem to be greatly affected2 while the ,patient takes his ,medicines1 and they are attended with the ,consequence that was expected2 and he both preserves his ,strength pretty well1 and continues sensible of his ,situation1 we may reasonably hope for his ,cure4 ,as often as all1 or the greater ,number of these characterizing ,circumstances are wanting1 he is in very considerable ,danger4 ,the ,stoppage of ,perspiration is often mentioned in the ,course of this ,work4 ,we call the ,discharge of that ,fluid which continually passes off through the ,pores of the ,skin1 ,transpiration2 and which1 though invisible1 is very considerable4 ,for if a ,person in ,health eats and drinks to the ,weight of eight ,pounds daily1 he does not discharge four of them by ,stool and ,urine together1 the ,remainder passing off by insensible ,transpiration4 ,it may easily be conceived1 that if so considerable a ,discharge is stopt1 or considerably lessened2 and if this ,fluid1 which ought to transpire through the ,skin1 should be transfered to any inward ,part1 it must occasion some dangerous ,complaint4 ,in fact this is one of the most frequent ,causes of ,diseases4 ,to conclude very briefly--,all the ,directions in the following ,treatise are solely designed for such ,patients1 as cannot have the ,attendance of a ,physician4 ,i am far from supporting1 they ought to do instead of one1 even in those ,diseases1 of which ,i have treated in the fullest ,manner2 and the ,moment a ,physician arrives1 they ought to be laid aside4 ,the ,confidence reposed in him should be entire1 or there should be none4 ,the ,success of the ,event is founded in that4 ,it is his ,province to judge of the ,disease1 to select ,medicines against it2 and it is easy to foresee the ,inconveniences that may follow1 from proposing to him to consult with any others1 preferably to those he may chuse to consult with2 only because they have succeeded in the ,treatment of another ,patient1 whose ,case they suppose to have been nearly the same with the present ,case4 ,this were much the same1 as to order a ,shoemaker to make a ,shoe for one ,foot by the ,pattern of another ,shoe1 rather than by the ,measure he has just taken4 ,n4 ,b4 ,though a great ,part of this judicious ,introduction is less applicable to the political ,circumstances of the ,british ,empire1 than to those of the ,government for which it was calculated2 we think the good ,sense and the unaffected ,patriotism which animate it1 will supersede any ,apology for our translating it4 ,the serious ,truth is this1 that a thorough ,attention to ,population seems never to have been more expedient for ourselves1 than after so bloody and expensive1 though such a glorious and successful ,war3 while our enterprizing ,neighbours1 who will never be our ,friends1 are so earnest to recruit their ,numbers2 to increase their ,agriculture2 and to force a ,vent for their ,manufactures1 which cannot be considerably effected1 without a sensible ,detriment to our own4 ,besides which1 the unavoidable ,drain from the ,people here1 towards an effectual ,cultivation1 ,improvement1 and ,security of our ,conquests1 demands a further ,consideration4 ,k4 ,,advice ,,to ,,the ,,people1 ,with ,respect to their ,,health4 99,chapter ,i499 ,of the most usual ,causes of popular ,maladies4 ,sect4 #a4 ,the most frequent ,causes of ,diseases commonly incident to ,country ,people are1 #a4 ,excessive ,labour1 continued for a very considerable ,time4 ,sometimes they sink down at once in a ,state of ,exhaustion and ,faintness1 from which they seldom recover3 but they are oftener attacked with some inflammatory ,disease2 as a ,quinsey1 a ,pleurisy1 or an ,inflammation of the ,breast4 ,there are two ,methods of preventing these ,evils3 one is1 to avoid the ,cause which produces them2 but this is frequently impossible4 ,another is1 when such excessive ,labour has been unavoidable1 to allay their ,fatigue1 by a free ,use of some temperate refreshing ,drink2 especially by sweet ,whey1 by ,butter-milk1 or by #h ,water1 to a ,quart of which a ,wine-glass of ,vinegar may be added2 or1 instead of that1 the expressed ,juice of ,grapes not fully ripe1 or even of ,goosberries or ,cherries3 which wholesome and agreeable ,liquors are refreshing and cordial4 ,i shall treat1 a little lower1 of inflammatory ,disorders4 ,the ,inanition or ,emptiness1 though accompanied with ,symptoms different from the former1 have yet some ,affinity to them with ,respect to their ,cause1 which is a kind of general ,exsiccation or ,dryness4 ,i have known some cured from this ,cause by ,whey1 succeeded by tepid ,baths1 and afterwards by ,cow's ,milk3 for in such ,cases hot ,medicines and high ,nourishment are fatal4 #h ,this supposes they are not greatly heated1 as well as fatigued1 by their ,labour or ,exercise1 in which ,circumstance free and sudden ,draughts of cooling ,liquors might be very pernicious3 and it evidently also supposes these ,drinks to be thus given1 rather in ,summer1 than in very cold ,weather1 as the ,juice of the unripe ,grapes1 and the other fresh ,fruits sufficiently ascertain the ,season of the ,year4 ,we think the ,addition of ,vinegar to their ,water will scarcely ever be necessary in this or the adjoining ,island1 on such ,occasions4 ,the ,caution recommended in this ,note is abundantly enforced by ,dr4 ,tissot1 ,sec4 #d3 but considering the ,persons1 to whom this ,work is more particularly addressed1 we were willing to prevent every ,possibility of a ,mistake1 in so necessary1 and sometimes so vital a ,point4 ,k4 ,sec4 #b4 ,there is another ,kind of ,exhaustion or ,emptiness1 which may be termed real ,emptiness1 and is the ,consequence of great ,poverty1 the ,want of sufficient ,nourishment1 bad ,food1 unwholesome ,drink1 and excessive ,labour4 ,in ,cases thus circumstanced1 good ,soups and a little ,wine are very proper4 ,such happen however very seldom in this ,country3 ,i believe they are frequent in some others1 especially in many ,provinces of ,france4 ,sec4 #c4 ,a second and very common ,source of ,disorders arises1 from ,peoples' lying down and reposing1 when very hot1 in a cold ,place4 ,this at once stops ,perspiration1 the ,matter of which being thrown upon some internal ,part1 proves the ,cause of many violent ,diseases1 particularly of ,quinseys1 ,inflammations of the ,breast1 ,pleurisies1 and inflammatory ,cholics4 ,these ,evils1 from this ,cause1 may always be avoided by avoiding the ,cause1 which is one of those that destroy a great ,number of ,people4 ,however1 when it has occurred1 as soon as the first ,symptoms of the ,malady are perceiveable1 which sometimes does not happen till several ,days after1 the ,patient should immediately be bled2 his ,legs should be put into ,water moderately hot1 and he should drink plentifully of the tepid ,infusion marked ,no4 #a4 ,such ,assistances frequently prevent the ,increase of these ,disorders2 which1 on the contrary1 are greatly aggravated1 if hot ,medicines are given to sweat the ,patient4 ,sec4 #d4 ,a third ,cause is drinking cold ,water1 when a ,person is extremely hot4 ,this acts in the same ,manner with the second2 but its ,consequences are commonly more sudden and violent4 ,i have seen most terrible ,examples of it1 in ,quinseys1 ,inflammations of the ,breast1 ,cholics1 ,inflammations of the ,liver1 and all the ,parts of the ,belly1 with prodigious ,swellings1 ,vomitings1 ,suppressions of ,urine1 and inexpressible ,anguish4 ,the most available ,remedies in such ,cases1 from this ,cause1 are1 a plentiful ,bleeding at the ,onset1 a very copious ,drinking of warm ,water1 to which one fifth ,part of ,whey should be added2 or of the ,ptisan ,no4 #b1 or of an ,emulsion of ,almonds1 all taken warm4 ,fomentations of warm ,water should also be applied to the ,throat1 the ,breast and ,belly1 with ,glysters of the same1 and a little ,milk4 ,in this ,case1 as well as in the preceding one1 7,sec4 #c47 a ,semicupium1 or ,half-bath of warm ,water has sometimes been attended with immediate ,relief4 ,it seems really astonishing1 that labouring ,people should so often habituate themselves to this pernicious ,custom1 which they know to be so very dangerous to their very ,beasts4 ,there are none of them1 who will not prevent their ,horses from drinking while they are hot1 especially if they are just going to put them up4 ,each of them knows1 that if he lets them drink in that ,state1 they might possibly burst with it2 nevertheless he is not afraid of incurring the like ,danger himself4 ,however1 this is not the only ,case1 in which the ,peasant seems to have more ,attention to the ,health of his ,cattle1 than to his own4 ,sec4 #e4 ,the fourth ,cause1 which indeed affects every ,body1 but more particularly the ,labourer1 is1 the ,inconstancy of the ,weather4 ,we shift all at once1 many times a ,day1 from ,hot to ,cold1 and from ,cold to ,hot1 in a more remarkable ,manner1 and more suddenly1 than in most other ,countries4 ,this makes ,distempers from ,defluxion and ,cold so common with us3 and it should make us careful to go rather a little more warmly cloathed1 than the ,season may seem to require2 to have ,recourse to our ,winter-cloathing early in ,autumn1 and not to part with it too early in the ,spring4 ,prudent ,labourers1 who strip while they are at ,work1 take care to put on their ,cloaths in the ,evening when they return home4 #i ,those1 who from ,negligence1 are satisfied with hanging them upon their ,country ,tools1 frequently experience1 on their ,return1 the very unhappy ,effects of it4 ,there are some1 tho' not many ,places1 where the ,air itself is unwholsome1 more from its particular ,quality1 than from its ,changes of ,temperature1 as at ,villeneuve1 and still more at ,noville1 and in some other ,villages situated among the ,marshes which border on the ,rhone4 ,these ,countries are particularly subject to intermitting ,fevers2 of which ,i shall treat briefly hereafter4 #i ,this good ,advice is enforced in a ,note1 by the ,editor of ,lyons1 who observes1 it should be still more closely attended to1 in ,places1 where ,rivers1 ,woods or ,mountains retain1 as it were1 a considerable ,humidity2 and where the ,evenings are1 in every ,season1 cold and moist4--,it is a very proper ,caution too in our own variable ,climate1 and in many of our ,colonies in ,north ,america4 ,k4 ,sec4 #f4 ,such sudden ,changes are often attended with great ,showers of ,rain1 and even cold ,rain1 in the ,middle of a very hot ,day2 when the ,labourer who was bathed1 as it were1 in a hot ,sweat1 is at once moistened in cold ,water2 which occasions the same ,distempers1 as the sudden ,transition from ,heat to ,cold1 and requires the same ,remedies4 ,if the ,sun or a hot ,air succeed immediately to such a ,shower1 the ,evil is considerably lighter3 but if the ,cold continues1 many are often greatly incommoded by it4 ,a ,traveller is sometimes thoroughly and unavoidably wet with ,mud2 the ill ,consequence of which is often inconsiderable1 provided he changes his ,cloaths immediately1 when he sets up4 ,i have known fatal ,pleurisies ensue from omitting this ,caution4 ,whenever the ,body or the ,limbs are wet1 nothing can be more useful than bathing them in warm ,water4 ,if the ,legs only have been wet1 it may be sufficient to bath them4 ,i have radically1 thoroughly1 cured ,persons subject to violent ,cholics1 as often as their ,feet were wet1 by persuading them to pursue this ,advice4 ,the ,bath proves still more effectual1 if a little ,soap be dissolved in it4 ,sec4 #g4 ,a fifth ,cause1 which is seldom attended to1 probably indeed because it produces less violent ,consequences1 and yet is certainly hurtful1 is the common ,custom in all ,villages1 of having their ,ditches or ,dunghills directly under their ,windows4 ,corrupted ,vapours are continually exhaling from them1 which in ,time cannot fail of being prejudicial1 and must contribute to produce putrid diseases4 ,those who are accustomed to the ,smell1 become insensible of it3 but the ,cause1 nevertheless1 does not cease to be unwholesomly active2 and such as are unused to it perceive the ,impression in all its ,force4 ,sec4 #h4 ,there are some ,villages1 in which1 after the ,curtain ,lines are erased1 watery marshy ,places remain in the ,room of them4 ,the ,effect of this is still more dangerous1 because that putrify'd ,water1 which stagnates during the hot ,season1 suffers its ,vapours to exhale more easily1 and more abundantly1 than that in the ,curtain ,lines did4 ,having set out for ,pully le ,grand1 in #agei1 on ,account of an epidemical putrid ,fever which raged there1 ,i was sensible1 on traversing the ,village1 of the ,infection from those ,marshes2 nor could ,i doubt of their being the ,cause of this ,disease1 as well as of another like it1 which had prevailed there five ,years before4 ,in other ,respects the ,village is wholesomly situated4 ,it were to be wished such ,accidents were obviated by avoiding these stagnated ,places2 or1 at least1 by removing them and the ,dunghils1 as far as possible from the ,spot1 where we live and lodge4 ,sec4 #i4 ,to this ,cause may also be added the ,neglect of the ,peasants to air their ,lodgings4 ,it is well known that too close an ,air occasions the most perplexing malignant ,fevers2 and the poor ,country ,people respire no other in their own ,houses4 ,their ,lodgings1 which are very small1 and which notwithstanding inclose1 7both ,day and ,night7 the ,father1 ,mother1 and seven or eight ,children1 besides some ,animals1 are never kept open during six ,months in the ,year1 and very seldom during the other six4 ,i have found the ,air so bad in many of these ,houses1 that ,i am persuaded1 if their ,inhabitants did not often go out into the free open ,air1 they must all perish in a little ,time4 ,it is easy1 however1 to prevent all the ,evils arising from this ,source1 by opening the ,windows daily3 so very practicable a ,precaution must be followed with the happiest ,consequences4 ,sec4 #aj4 ,i consider ,drunkenness as a sixth ,cause1 not indeed as producing epidemical ,diseases1 but which destroys1 as it were1 by ,retail1 at all times1 and every where4 ,the poor ,wretches1 who abandon themselves to it1 are subject to frequent ,inflammations of the ,breast1 and to ,pleurisies1 which often carry them off in the ,flower of their ,age4 ,if they sometimes escape through these violent ,maladies1 they sink1 a long ,time before the ordinary ,approach of old ,age1 into all its ,infirmities1 and especially into an ,asthma1 which terminates in a ,dropsy of the ,breast4 ,their ,bodies1 worn out by ,excess1 do not comply and concur1 as they ought1 with the ,force or ,operation of ,remedies2 and ,diseases of ,weakness1 resulting from this ,cause1 are almost always incurable4 ,it seems happy enough1 that ,society loses nothing in parting with these ,subjects1 who are a ,dishonour to it2 and whose brutal ,souls are1 in some ,measure1 dead1 long before their ,carcases4 ,sec4 #aa4 ,the ,provisions of the common ,people are also frequently one ,cause of popular ,maladies4 ,this happens #ast1 whenever the ,corn1 not well ripened1 or not well got in1 in bad #aj ,harvests1 has contracted an unwholesome ,quality4 ,fortunately however this is seldom the ,case2 and the ,danger attending the ,use of it1 may be lessened by some ,precautions1 such as those of washing and drying the ,grain completely2 of mixing a little ,wine with the ,dough1 in kneading it2 by allowing it a little more ,time to swell or rise1 and by baking it a little more4 #b;dly1 ,the fairer and better saved ,part of the ,wheat is sometimes damaged in the ,farmers ,house2 either because he does not take due ,care of it1 or because he has no convenient ,place to preserve it1 only from one ,summer to the next4 ,it has often happened to me1 on entering one of these bad ,houses1 to be struck with the ,smell of ,wheat that has been spoiled4 ,nevertheless1 there are known and easy ,methods to provide against this by a little ,care2 though ,i shall not enter into a ,detail of them4 ,it is sufficient to make the ,people sensible1 that since their chief ,sustenance consists of ,corn1 their ,health must necessarily be impaired by what is bad4 #c;dly1 ,that ,wheat1 which is good1 is often made into bad ,bread1 by not letting it rise sufficiently2 by baking it too little1 and by keeping it too long4 ,all these ,errors have their troublesome ,consequences on those who eat it2 but in a greater ,degree on ,children and ,valetudinarians1 or weakly ,people4 #aj ,thus ,i have ventured to translate ,etes 7,summers7 to apply it to this and the neighbouring ,islands4 ,their ,harvests in ,swisserland perhaps are earlier1 and may occur in ,august1 and that of some particular ,grain1 probably still earlier4 ,k4 ,tarts or ,cakes may be considered as an ,abuse of ,bread1 and this in some ,villages is increased to a very pernicious ,height4 ,the ,dough is almost constantly bad1 and often unleavened1 ill baked1 greasy1 and stuffed with either fat or sour ,ingredients1 which compound one of the most indigestible ,aliments imaginable4 ,women and ,children consume the most of this ,food1 and are the very ,subjects for whom it is the most improper3 little ,children especially1 who live sometimes for many successive ,days on these ,tarts1 are1 for the greater ,part1 unable to digest them perfectly4 ,hence they receive a #aa ,source of ,obstructions in the ,bowels of the ,belly1 and of a slimy ,viscidity or ,thickishness1 throughout the ,mass of ,humours1 which throws them into various ,diseases from ,weakness2 slow ,fevers1 a ,hectic1 the ,rickets1 the ,king's ,evil1 and ,feebleness2 for the miserable ,remainder of their ,days4 ,probably indeed there is nothing more unwholesome than ,dough not sufficiently leavened1 ill-baked1 greasy1 and soured by the ,addition of ,fruits4 ,besides1 if we consider these ,tarts in an oeconomical ,view1 they must be found inconvenient also for the ,peasant on that ,account4 #aa ,the ,abuse just mentioned can scarcely be intended to forbid the moderate ,use of good ,pastry1 the ,dough of which is well raised and well baked1 the ,flower and other ,ingredients sound1 and the ,paste not overcharged with ,butter1 even though it were sweet and fresh4 ,but the ,abuse of ,alum and other pernicious ,materials introduced by our ,bakers1 may too justly be considered as one horrible ,source of those ,diseases of ,children1 c4 which our humane and judicious ,author mentions here4 ,what he adds1 concerning the ,pastries being rendered still more unwholesome by the sour ,fruits sometimes baked in it1 is true with ,respect to those ,children and others1 who are liable to ,complaints from ,acidities abounding in the ,bowels2 and for all those who are ricketty or scrophulous1 from a cold and viscid ,state of their ,humours4 ,but as to healthy sanguine ,children1 who are advanced and lively1 and others of a sanguine or bilious ,temperament1 we are not to suppose a moderate ,variety of this ,food injurious to them2 when we consider1 that the ,sharpness and ,crudity of the ,fruit is considerably corrected by the long ,application of ,fire2 and that they are the ,produce of ,summer1 when bilious ,diseases are most frequent4 ,this suggests however no bad ,hint against making them immoderately sweet4 ,k4 ,some other ,causes of ,maladies may also be referred to the ,article of ,food1 tho' less grievous and less frequent1 into a full ,detail of which it is very difficult to enter3 ,i shall therefore conclude that ,article with this general ,remark2 that it is the ,care which ,peasants usually take in eating slowly1 and in chewing very well1 that very greatly lessens the ,dangers from a bad ,regimen3 and ,i am convinced they constitute one of the greatest ,causes of that ,health they enjoy4 ,we may further add indeed the ,exercise which the ,peasant uses1 his long abiding in the open ,air1 where he passes three fourths of his ,life2 besides 7which are also considerable ,advantages7 his happy ,custom of going soon to ,bed1 and of rising very early4 ,it were to be wished1 that in these ,respects1 and perhaps on many other ,accounts1 the ,inhabitants of the ,country were effectually proposed as ,models for reforming the ,citizens4 ,sec4 #ab4 ,we should not omit1 in enumerating the ,causes of ,maladies among ,country ,people1 the ,construction of their ,houses1 a great many of which either lean1 as it were1 close to a higher ,ground1 or are sunk a little in the ,earth4 ,each of these ,situations subjects them to considerable ,humidity2 which is certain greatly to incommode the ,inhabitants1 and to spoil their ,provisions1 if they have any ,quantity in ,store2 which1 as we have observed1 is another1 and not the least important1 ,source of their ,diseases4 ,a hardy ,labourer is not immediately sensible of the bad ,influence of this moist and marshy ,habitation2 but they operate at the long ,run1 and ,i have abundantly observed their most evident bad ,effects1 especially on ,women in ,child-bed1 on ,children1 and in ,persons recovering of a preceding ,disease4 ,it would be easy to prevent this ,inconvenience1 by raising the ,ground on which the ,house stood1 some1 or several1 ,inches above the ,level of the adjacent ,soil1 by a ,bed of ,gravel1 of small ,flints1 pounded ,bricks1 ,coals1 or such other ,materials2 and by avoiding to build immediately close to1 or1 as it were1 under a much higher ,soil4 ,this ,object1 perhaps1 may well deserve the ,attention of the ,publick2 and ,i earnestly advise as many as do build1 to observe the necessary ,precautions on this ,head4 ,another1 which would cost still less ,trouble1 is to give the ,front of their ,houses an ,exposure to the ,south-,east4 ,this ,exposure1 supposing all other ,circumstances of the ,building and its ,situation to be alike1 is both the most wholesome and advantageous4 ,i have seen it1 notwithstanding1 very often neglected1 without the least ,reason being assigned for not preferring it4 ,these ,admonitions may possibly be thought of little ,consequence by three fourths of the ,people4 ,i take the ,liberty of reminding them1 however1 that they are more important than they may be supposed2 and so many ,causes concur to the ,destruction of ,men1 that none of the ,means should be neglected1 which may contribute to their ,preservation4 ,sec4 #ac4 ,the ,country ,people in ,swisserland drink1 either #a1 pure ,water1 #b1 some ,wine1 #c1 ,perry1 made from wild ,pears1 or sometimes ,cyder from ,apples1 and1 #d1 a small ,liquor which they call ,piquette1 that is ,water1 which has fermented with the ,cake or ,husks of the ,grapes1 after their ,juice has been expressed4 ,water however is their most general ,drink2 ,wine rarely falling in their ,way1 but when they are employed by rich ,folks2 or when they can spare ,money enough for a ,debauch4 ,fruit ,wines and the #ab ,piquettes are not used in all ,parts of the ,country2 they are not made in all ,years2 and keep but for some ,months4 #ab ,this ,word's occurring in the plural ,number will probably imply1 the ,swiss make more than one ,species of this small ,drink1 by pouring ,water on the ,cake or ,remainder of their other ,fruits1 after they have been expressed2 as our ,people in the ,cyder1 and perhaps in the ,perry1 ,counties1 make what they call ,cyderkin1 ,perkin1 c4 ,it should seem too from this ,section1 that the laborious ,countrymen in ,swisserland drink no ,malt ,liquor1 though the ,ingredients may be supposed to grow in their ,climate4 ,now ,beer1 of different ,strength1 making the greater ,part of our most common ,drink1 it may be proper to observe here1 that when it is not strong and heady1 but a middling well-brewed ,small-beer1 neither too new1 nor hard or sour1 it is full as wholesome a ,drink for laborious ,people in ,health as any other1 and perhaps generally preferable to ,water for such2 which may be too thin and light for those who are unaccustomed to it2 and more dangerous too1 when the labouring ,man is very hot1 as well as thirsty4 ,the holding a ,mouthful of any weak cold ,liquor in the ,mouth without swallowing 'till it becomes warm1 there1 and spurting it out before a ,draught is taken down would be prudent2 and in ,case of great ,heat1 to take the requisite ,quantity rather at two ,draughts1 with a little ,interval between them1 than to swallow the ,whole precipitately at one1 would be more safe1 and equally refreshing1 though perhaps less grateful4 ,k4 ,our ,waters in general1 are pretty good2 so that we have little ,occasion to trouble ourselves about purifying them2 and they are well known in those ,provinces where they are chiefly and necessarily used4 #ac ,the pernicious ,methods taken to improve or meliorate1 as it is falsely called1 bad ,wines1 are not as yet sufficiently practiced among us1 for me to treat of them here3 and as our ,wines are not hurtful1 of themselves1 they become hurtful only from their ,quantity4 ,the ,consumption of made ,wines and ,piquettes is but inconsiderable1 and ,i have not hitherto known of any ill ,effects from them1 so that our ,liquors cannot be considered as ,causes of ,distempers in our ,country2 but in ,proportion to our ,abuse of them by ,excess4 ,the ,case is differently circumstanced in some #ad other ,countries2 and it is the ,province of ,physicians who reside in them1 to point out to their ,country-,men the ,methods of preserving their ,health2 as well as the proper and necessary ,remedies in their ,sickness4 #ac ,the bad ,quality of ,water is another common ,cause of ,country ,diseases2 either where the ,waters are unwholesome1 from the ,soils in which they are found1 as when they flow through1 or settle1 on ,banks of ,shells2 or where they become such1 from the ,neighbourhood of1 or ,drainings from ,dunghills and ,marshes4 ,when ,water is unclear and turbid1 it is generally sufficient to let it settle in order to clear itself1 by dropping its ,sediment4 ,but if that is not effected1 or if it be slimy or muddy1 it need only be poured into a large ,vessel1 half filled with fine ,sand1 or1 for want of that1 with ,chalk2 and then to shake and stir it about heartily for some ,minutes4 ,when this ,agitation is over1 the ,sand1 in falling to the ,bottom of the ,vessel1 will attract some of the ,foulness suspended in the ,water4 ,or1 which is still better1 and very easy to do1 two large ,vessels may be set near together1 one of which should be placed considerably higher than the other4 ,the highest should be half filled with ,sand4 ,into this the turbid1 or slimy muddy ,water is to be poured2 whence it will filter itself through the ,body of ,sand1 and pass off clear by an ,opening or ,orifice made at the ,bottom of the ,vessel2 and fall from thence into the lower one1 which serves as a ,reservoir4 ,when the ,water is impregnated with ,particles from the ,beds of ,selenites1 or of any ,spar 7which ,water we call hard1 because ,soap will not easily dissolve in it1 and ,puls and other farinaceous ,substances grow hard instead of soft1 after boiling in it7 such ,water should be exposed to the ,sun1 or boiled with the ,addition of some ,puls1 or leguminous ,vegetables1 or ,bread toasted1 or untoasted4 ,when ,water is in its putrid ,state1 it may be kept till it recovers its natural sweet one3 but if this cannot be waited for1 a little ,sea ,salt should be dissolved in it1 or some ,vinegar may be added1 in which some grateful aromatic ,plant has been infused4 ,it frequently happens1 that the publick ,wells are corrupted by foul ,mud at the ,bottom1 and by different ,animals which tumble in and putrify there4 ,drinking ,snow-water should be avoided1 when the ,snow is but lately fallen1 as it seems to be the ,cause of those swelling wenny ,throats in the ,inhabitants of some ,mountains2 and of endemic ,cholics in many ,persons4 ,as ,water is so continually used1 great ,care should be taken to have what is good4 ,bad ,water1 like bad ,air1 is one of the most general ,causes of ,diseases2 that which produces the greater ,number of them1 the most grieveous ones2 and often introduces such as are epidemical4 ,e4 ,l4 i4e4 the ,editor of ,lyons4 #ad ,many ,persons1 ,with a ,design to preserve their ,wines1 add ,shot to them1 or ,preparations of ,lead1 ,alum1 c4 ,the ,government should forbid1 under the most severe ,penalties1 all such ,adulterations1 as tend to introduce the most painful ,cholics1 ,obstruction1 and a long ,train of ,evils1 which it sometimes proves difficult to trace to this peculiar ,cause2 while they shorten the lives of1 or cruelly torment1 such over credulous ,purchasers1 as lay in a ,stock of bad ,wines1 or drink of them1 without distinction1 from every ,wine ,merchant or ,tavern4 ,e4 ,l4 ,this ,note1 from the ,editor at ,lyons1 we have sufficient ,reason for retaining here4 ,k4 ,chapter ,,ii4 ,of the ,causes which aggravate the ,diseases of the ,people4 ,general ,considerations4 ,sect4 #ad4 ,the ,causes already enumerated in the first ,chapter occasion ,diseases2 and the bad ,regimen1 or ,conduct of the ,people1 on the ,invasion of them1 render them still more perplexing1 and very often mortal4 ,there is a prevailing ,prejudice among them1 which is every ,year attended with the ,death of some ,hundreds in this ,country1 and it is this--,that all ,distempers are cured by ,sweat2 and that to procure ,sweat1 they must take ,abundance of hot and heating things1 and keep themselves very hot4 ,this is a ,mistake in both ,respects1 very fatal to the ,population of the ,state2 and it cannot be too much inculcated into ,country ,people2 that by thus endeavouring to force ,sweating1 at the very ,beginning of a ,disease1 they are with great ,probability1 taking ,pains to kill themselves4 ,i have seen some ,cases1 in which the continual ,care to provoke this ,sweating1 has as manifestly killed the ,patient1 as if a ,ball had been shot through his ,brains2 as such a precipitate and untimely ,discharge carries off the thinner ,part of the ,blood1 leaving the ,mass more dry1 more viscid and inflamed4 ,now as in all acute ,diseases 7if we except a very few1 and those too much less frequent7 the ,blood is already too thick2 such a ,discharge must evidently increase the ,disorder1 by co-operating with its ,cause4 ,instead of forcing out the watery1 the thinner ,part of the ,blood1 we should rather endeavour to increase it4 ,there is not a single ,peasant perhaps1 who does not say1 when he has a ,pleurisy1 or an ,inflammation of his ,breast1 that his ,blood is too thick1 and that it cannot circulate4 ,on seeing it in the ,bason after ,bleeding1 he finds it black1 dry1 burnt2 these are his very ,words4 ,how strange is it then1 that common ,sense should not assure him1 that1 far from forcing out the ,serum1 the watery ,part1 of such a ,blood by sweating1 there is a ,necessity to increase it8 ,sec4 #ae4 ,but supposing it were as certain1 as it is erroneous1 that ,sweating was beneficial at the ,beginning of ,diseases1 the ,means which they use to excite it would not prove the less fatal4 ,the first ,endeavour is1 to stifle the ,patient with the ,heat of a close ,apartment1 and a ,load of ,covering4 ,extraordinary ,care is taken to prevent a ,breath of fresh ,air's squeezing into the ,room2 from which ,circumstance1 the ,air already in it is speedily and extremely corrupted3 and such a ,degree of ,heat is procured by the ,weight of the ,patient's ,bed-cloaths1 that these two ,causes alone are sufficient to excite a most ardent ,fever1 and an ,inflammation of the ,breast1 even in a healthy ,man4 ,more than once have ,i found myself seized with a ,difficulty of breathing1 on entering such ,chambers1 from which ,i have been immediately relieved1 on obliging them to open all the ,windows4 ,persons of ,education must find a ,pleasure1 ,i conceive1 in making ,people understand1 on these ,occasions1 which are so frequent1 that the ,air being more indispensably necessary to us1 if possible1 than ,water is to a ,fish1 our ,health must immediately suffer1 whenever that ceases to be pure2 in assuring them also1 that nothing corrupts it sooner than those ,vapours1 which continually steam from the ,bodies of many ,persons inclosed within a little ,chamber1 from which the ,air is excluded4 ,the ,absurdity of such ,conduct is a self-evident ,certainty4 ,let in a little fresh ,air on these miserable ,patients1 and lessen the oppressing ,burthen of their ,coverings1 and you generally see upon the ,spot1 their ,fever and ,oppression1 their ,anguish and ,raving1 to abate4 ,sec4 #af4 ,the second ,method taken to raise a ,sweat in these ,patients is1 to give them nothing but hot things1 especially ,venice ,treacle1 ,wine1 or some #ae ,faltranc1 the greater ,part of the ,ingredients of which are dangerous1 whenever there is an evident ,fever2 besides ,saffron1 which is still more pernicious4 ,in all feverish ,disorders we should gently cool1 and keep the ,belly moderately open2 while the ,medicines just mentioned both heat and bind2 and hence we may easily judge of their inevitable ill ,consequences4 ,a healthy ,person would certainly be seized with an inflammatory ,fever1 on taking the same ,quantity of ,wine1 of ,venice ,treacle1 or of ,faltranc1 which the ,peasant takes now and then1 when he is attacked by one of these ,disorders4 ,how then should a sick ,person escape dying by them8 ,die indeed he generally does1 and sometimes with astonishing ,speed4 ,i have published some dreadful ,instances of such ,fatality some ,years since1 in another ,treatise4 ,in fact they still daily occur1 and unhappily every ,person may observe some of them in his own ,neighbourhood4 #ae ,this ,word1 which must be of ,german1 not of ,french ,extraction1 strictly signifies1 ,drink for a ,fall1 as we say ,pulvis ad ,casum1 c4 ,powder for a ,fall1 or a supposed inward ,bruise4 ,dr4 ,tissot informs me1 it is otherwise called the vulnerary ,herbs1 or the ,swiss ,tea2 and that it is an injudicious ,farrago or ,medley of ,herbs and ,flowers1 blended with ,bitters1 with stimulating1 harsh and astringent ,ingredients1 being employed indiscriminately in all their ,distempers by the ,country ,people in ,swisserland4 ,k4 ,sec4 #ag4 ,but ,i shall be told perhaps1 that ,diseases are often carried off by ,sweat1 and that we ought to be guided by ,experience4 ,to this ,i answer1 it is very true1 that ,sweating cures some particular ,disorders1 as it were1 at their very ,onset1 for ,instance1 those ,stitches that are called spurious or false ,pleurisies1 some rheumatic ,pains1 and some ,colds or ,defluxions4 ,but this only happens when the ,disorders depend solely and simply on stopt or abated ,perspiration1 to which such ,pain instantly succeeds2 where immediately1 before the ,fever has thickened the ,blood1 and inflamed the ,humours2 and where before any internal ,infarction1 any ,load1 is formed1 some warm ,drinks are given1 such as ,faltranc and ,honey2 which1 by restoring ,transpiration1 remove the very ,cause of the ,disorder4 ,nevertheless1 even in such a ,case1 great ,care should be had not to raise too violent a ,commotion in the ,blood1 which would rather restrain1 than promote1 ,sweat1 to effect which ,elder-flowers are in my ,opinion preferable to ,faltranc4 ,sweating is also of ,service in ,diseases1 when their ,causes are extinguished1 as it were1 by plentiful ,dilution3 then indeed it relieves1 by drawing off1 with itself1 some ,part of the distempered ,humours2 after which their grosser ,parts have passed off by ,stool and by ,urine3 besides which1 the ,sweat has also served to carry off that extraordinary ,quantity of ,water1 we were obliged to convey into the ,blood1 and which was become superfluous there4 ,under such ,circumstances1 and at such a ,juncture1 it is of the utmost ,importance indeed1 not to check the ,sweat1 whether by ,choice1 or for ,want of ,care4 ,there might often be as much ,danger in doing this1 as there would have been in endeavouring to force a ,sweat1 immediately upon the ,invasion of the ,disorder2 since the arresting of this ,discharge1 under the preceding ,circumstances1 might frequently occasion a more dangerous ,distemper1 by repelling the ,humour on some inward vital ,part4 ,as much ,care therefore should be taken not to check1 imprudently1 that ,evacuation by the ,skin1 which naturally occurs towards the ,conclusion of ,diseases1 as not to force it at their ,beginning2 the former being almost constantly beneficial1 the latter as constantly pernicious4 ,besides1 were it even necessary1 it might be very dangerous to force it violently2 since by heating the ,patients greatly1 a vehement ,fever is excited2 they become scorched up in a ,manner1 and the ,skin proves extremely dry4 ,warm ,water1 in short1 is the best of ,sudorifics4 ,if the ,sick are sweated very plentifully for a ,day or two1 which may make them easier for some ,hours2 these ,sweats soon terminate1 and cannot be excited again by the same ,medicines4 ,the ,dose thence is doubled1 the ,inflammation is increased1 and the ,patient expires in terrible ,anguish1 with all the ,marks of a general ,inflammation4 ,his ,death is ascribed to his ,want of ,sweating2 when it really was the ,consequence of his ,sweating too much at first2 and of his taking ,wine and hot ,sudorifics4 ,an able ,swiss ,physician had long since assured his ,countrymen1 that ,wine was fatal to them in ,fevers2 ,i take leave to repeat it again and again1 and wish it may not be with as little ,success4 ,our ,country ,folks1 who in ,health1 naturally dislike red ,wine1 prefer it when ,sick2 which is wrong1 as it binds them up more than white ,wine4 ,it does not promote ,urine as well2 but increases the ,force of the circulating ,arteries1 and the ,thickness of the ,blood1 which were already too considerable4 ,sec4 #ah4 ,their ,diseases are also further aggravated by the ,food that is generally given them4 ,they must undoubtedly prove weak1 in ,consequence of their being sick2 and the ridiculous ,fear of the ,patients' dying of ,weakness1 disposes their ,friends to force them to eat2 which1 increasing their ,disorder1 renders the ,fever mortal4 ,this ,fear is absolutely chimerical2 never yet did a ,person in a ,fever die merely from ,weakness4 ,they may be supported1 even for some ,weeks1 by ,water only2 and are stronger at the ,end of that ,time1 than if they had taken more solid ,nourishment2 since1 far from strengthening them1 their ,food increases their ,disease1 and thence increases their ,weakness4 ,sec4 #ai4 ,from the first ,invasion of a ,fever1 ,digestion ceases4 ,whatever solid ,food is taken corrupts1 and proves a ,source of ,putridity1 which adds nothing to the ,strength of the ,sick1 but greatly to that of the ,distemper4 ,there are in fact a thousand ,examples to prove1 that it becomes a real ,poison3 and we may sensibly perceive these poor ,creatures1 who are thus compelled to eat1 lose their ,strength1 and fall into ,anxiety and ,ravings1 in ,proportion as they swallow4 ,sec4 #bj4 ,they are also further injured by the ,quality1 as well as the ,quantity1 of their ,food4 ,they are forced to sup strong ,gravey ,soups1 ,eggs1 ,biscuits1 and even ,flesh1 if they have but just ,strength and ,resolution to chew it4 ,it seems absolutely impossible for them to survive all this ,trash4 ,should a ,man in perfect ,health be compelled to eat stinking ,meat1 rotten ,eggs1 stale sour ,broth1 he is attacked with as violent ,symptoms1 as if he had taken real ,poison1 which1 in ,effect1 he has4 ,he is seized with ,vomiting1 ,anguish1 a violent ,purging1 and a ,fever1 with ,raving1 and eruptive ,spots1 which we call the ,purple ,fever4 ,now when the very same ,articles of ,food1 in their soundest ,state1 are given to a ,person in a ,fever1 the ,heat1 and the morbid ,matter already in his ,stomach1 quickly putrify them2 and after a few ,hours produce all the abovementioned ,effects4 ,let any ,man judge then1 if the least ,service can be expected from them4 ,sec4 #ba4 ,it is a ,truth established by the first of ,physicians1 above two thousand ,years past1 and still further ratified by his ,successors1 that as long as a sick ,person has a bad ,humour or ,ferment in his ,stomach1 his ,weakness increases1 in ,proportion to the ,food he receives4 ,for this being corrupted by the infected ,matter it meets there1 proves incapable of nourishing1 and becomes a conjunct or additional ,cause of the ,distemper4 ,the most observing ,persons constantly remark1 that whenever a feverish ,patient sups1 what is commonly called some good ,broth1 the ,fever gathers ,strength and the ,patient ,weakness4 ,the giving such a ,soup or ,broth1 though of the freshest soundest ,meat1 to a ,man who has a high ,fever1 or putrid ,humours in his ,stomach1 is to do him exactly the same service1 as if you had given him1 two or three ,hours later1 stale putrid ,soup4 ,sec4 #bb4 ,i must also affirm1 that this fatal ,prejudice1 of keeping up the ,patients' ,strength by ,food1 is still too much propagated1 even among those very ,persons1 whose ,talents and whose ,education might be expected to exempt them from any such gross ,error4 ,it were happy for ,mankind1 and the ,duration of their ,lives would generally be more extended1 if they could be thoroughly persuaded of this medical1 and so very demonstrable1 ,truth2--,that the only things which can strengthen sick ,persons are those1 which are able to weaken their ,disease2 but their ,obstinacy in this ,respect is inconceivable3 it is another ,evil superadded to that of the ,disease1 and sometimes the more grievous one4 ,out of twenty sick ,persons1 who are lost in the ,country1 more than two ,thirds might often have been cured1 if being only lodged in a ,place defended from the ,injuries of the ,air1 they were supplied with ,abundance of good ,water4 ,but that most mistaken ,care and ,regimen ,i have been treating of1 scarcely suffers one of the twenty to survive them4 ,sec4 #bc4 ,what further increases our ,horror at this enormous ,propensity to heat1 dry up1 and cram the sick is1 that it is totally opposite to what ,nature herself indicates in such ,circumstances4 ,the burning ,heat of which they complain2 the ,dryness of the ,lips1 ,tongue and ,throat2 the flaming high ,colour of their ,urine2 the great ,longing they have for cooling things2 the ,pleasure and sensible ,benefit they enjoy from fresh ,air1 are so many ,signs1 or rather ,proofs1 which cry out with a loud ,voice1 that we ought to attemperate and cool them moderately1 by all means4 ,their foul ,tongues1 which shew the ,stomach to be in the like ,condition2 their ,loathing1 their ,propensity to vomit1 their utter ,aversion to all solid ,food1 and especially to ,flesh2 the disagreeable ,stench of their ,breath2 their ,discharge of fetid ,wind upwards and downwards1 and frequently the extraordinary ,offensiveness of their ,excrements1 demonstrate1 that their ,bowels are full of putrid ,contents1 which must corrupt all the ,aliments superadded to them2 and that the only thing1 which can prudently be done1 is to dilute and attemper them by plentiful ,draughts of refreshing cooling ,drinks1 which may promote an easy ,discharge of them4 ,i affirm it again1 and ,i heartily wish it may be thoroughly attended to1 that as long as there is any ,taste of ,bitterness1 or of ,putrescence2 as long as there is a ,nausea or ,loathing1 a bad ,breath1 ,heat and ,feverishness with fetid ,stools1 and little and high-coloured ,urine2 so long all flesh1 and ,flesh-,soup1 ,eggs1 and all kind of ,food composed of them1 or of any of them1 and all ,venice ,treacle1 ,wine1 and all heating things are so many absolute ,poisons4 ,sec4 #bd4 ,i may possibly be censured as extravagant and excessive on these ,heads by the ,publick1 and even by some ,physicians3 but the true and enlightened ,physicians1 those who attend to the ,effects of every ,particular1 will find on the contrary1 that far from exceeding in this ,respect1 ,i have rather feebly expressed their own ,judgment1 in which they agree with that of all the good ones1 who have existed within more than two thousand ,years2 that very ,judgment which ,reason approves1 and continual ,experience confirms4 ,the ,prejudices ,i have been contending against have cost ,europe some ,millions of ,lives4 ,sec4 #be4 ,neither should it be omitted1 that even when a ,patient has very fortunately escaped ,death1 notwithstanding all this ,care to obtain it1 the ,mischief is not ended2 the ,consequences of the high ,aliments and heating ,medicines being1 to leave behind the ,seed1 the ,principle1 of some low and chronical ,disease2 which increasing insensibly1 bursts out at length1 and finally procures him the ,death he has even wished for1 to put an ,end to his tedious ,sufferings4 ,sec4 #bf4 ,i must also take ,notice of another dangerous common ,practice2 which is that of purging1 or vomiting a ,patient1 at the very ,beginning of a ,distemper4 ,infinite ,mischiefs are occasioned by it4 ,there are some ,cases indeed1 in which evacuating ,medicines1 at the ,beginning of a ,disease1 are convenient and even necessary4 ,such ,cases shall be particularly mentioned in some other ,chapters3 but as long as we are unacquainted with them1 it should be considered as a general ,rule1 that they are hurtful at the ,beginning2 this being true very often2 and always1 when the ,diseases are strictly inflammatory4 ,sec4 #bg4 ,it is hoped by their ,assistance1 at that ,time1 to remove the ,load and ,oppression of the ,stomach1 the ,cause of a ,disposition to vomit1 of a dry ,mouth1 of ,thirst1 and of much ,uneasiness2 and to lessen the ,leaven or ,ferment of the ,fever4 ,but in this ,hope they are very often deceived2 since the ,causes of these ,symptoms are seldom of a ,nature to yield to these ,evacuations4 ,by the extraordinary ,viscidity or ,thickness of the ,humours1 that foul the ,tongue1 we should form our ,notions of those1 which line the ,stomach and the ,bowels4 ,it may be washed1 gargled and even scraped to very little good ,purpose4 ,it does not happen1 until the ,patient has drank for many ,days1 and the ,heat1 the ,fever and the great ,siziness of the ,humours are abated1 that this ,filth can he thoroughly removed1 which by ,degrees separates of itself4 ,the ,state of the ,stomach being conformable to that of the ,tongue1 no ,method can effectually scour and clean it at the ,beginning3 but by giving refreshing and diluting ,remedies plentifully1 it gradually frees itself2 and the ,propensity to vomit1 with its other ,effects and ,uneasinesses1 go off naturally1 and without ,purges4 ,sec4 #bh4 ,neither are these ,evacuations only negatively wrong1 merely from doing no ,good2 for considerable ,evil positively ensues from the ,application of those acrid irritating ,medicines1 which increase the ,pain and ,inflammation2 drawing the ,humours upon those ,parts that were already overloaded with them2 which by no means expel the ,cause of the ,disease1 that not being at this time fitted for ,expulsion1 as not sufficiently concocted or ripe3 and yet which1 at the same ,time1 discharge the thinnest ,part of the ,blood1 whence the ,remainder becomes more thick2 in short which carry off the useful1 and leave the hurtful ,humours behind4 ,sec4 #bi4 ,the ,vomit especially1 being given in an inflammatory ,disease1 and even without any ,distinction in all acute ones1 before the ,humours have been diminished by ,bleeding1 and diluted by plentiful small ,drinks1 is productive of the greatest ,evils2 of ,inflammations of the ,stomach1 of the ,lungs and ,liver1 of ,suffocations and ,frenzies4 ,purges sometimes occasion a general ,inflammation of the ,guts1 which #af terminates in ,death4 ,some ,instances of each of these terrible ,consequences have ,i seen1 from blundering ,temerity1 ,imprudence and ,ignorance4 ,the ,effect of such ,medicines1 in these ,circumstances1 are much the same with those we might reasonably expect1 from the ,application of ,salt and ,pepper to a dry1 inflamed and foul ,tongue1 in ,order to moisten and clean it4 #af ,it is pretty common to hear of ,persons recovering from ,inflammations of the ,bowels1 or ,guts1 which our ,author more justly and ingenuously considers as general ,passports to ,death3 for it is difficult to conceive1 that a real and considerable ,inflammation of such thin1 membranous1 irritable ,parts1 lined with such putrescent ,humours and ,contents1 and in so hot and close a ,situation1 could be restored to a sound and healthy ,state so often as ,rumour affirms it4 ,this makes it so important a ,point1 to avert every ,tendency to an ,inflammation of these feculent ,parts1 as to justify a ,bleeding directed1 solely1 from this ,precaution1 and which might have been no otherwise indicated by a ,disease1 attended with any ,symptom1 that threatened such an ,inflammation4 ,but when a ,person recovers1 there can be no anatomical ,search for such ,inflammations1 or its ,effects1 the real or imaginary ,cure of which may well amaze the ,patient1 and must greatly redound to the ,honour of his ,prescriber2 so that there may be ,policy sometimes in giving a moderate ,disease a very bad ,name4 ,k4 ,sec4 #cj4 ,every ,person of sound plain ,sense is capable of perceiving the ,truth of whatever ,i have advanced in this ,chapter3 and there would be some ,degree of ,prudence1 even in those who do not perceive the real good ,tendency of my ,advice1 not to defy nor oppose it too hardily4 ,the ,question relates to a very important ,object2 and in a ,matter quite foreign to themselves1 they undoubtedly owe some ,deference to the ,judgment of ,persons1 who have made it the ,study and ,business of their whole ,lives4 ,it is not to myself that ,i hope for their ,attention1 but to the greatest ,physicians1 whose feeble ,instrument and ,eccho ,i am4 ,what ,interest have any of us in forbidding sick ,people to eat1 to be stifled1 or to drink such heating things as heighten their ,fever8 ,what ,advantage can accrue to us from opposing the fatal ,torrent1 which sweeps them off8 ,what ,arguments can persuade ,people1 that some thousand ,men of ,genius1 of ,knowledge1 and of ,experience1 who pass their ,lives among a ,croud and ,succession of ,patients2 who are entirely employed to take ,care of them1 and to observe all that passes1 have been only amusing and deceiving themselves1 on the ,effects of ,food1 of ,regimen and of ,remedies8 ,can it enter into any sensible ,head1 that a ,nurse1 who advises ,soup1 an ,egg1 or a ,biscuit1 deserves a ,patient's ,confidence1 better than a ,physician who forbids them8 ,nothing can be more disagreeable to the latter1 than his being obliged to dispute continually in ,behalf of the poor ,patients2 and to be in constant ,terror1 lest this mortally officious ,attendance1 by giving such ,food as augments all the ,causes of the ,disease1 should defeat the ,efficacy of all the ,remedies he administers to remove it2 and should fester and aggravate the ,wound1 in ,proportion to the ,pains he takes to dress it4 ,the more such absurd ,people love a ,patient1 the more they urge him to eat1 which1 in ,effect1 verifies the ,proverb of killing one with ,kindness4 ,chapter ,,iii4 ,of the ,means that ought to be used1 at the ,beginning of ,diseases2 and of the ,diet in acute ,diseases4 ,sect4 #ca4 ,i have clearly shewn the great ,dangers of the ,regimen1 or ,diet1 and of the principal ,medicines too generally made ,use of by the ,bulk of the ,people1 on these ,occasions4 ,i must now point out the actual ,method they may pursue1 without any ,risque1 on the ,invasion of some acute ,diseases1 and the general ,diet which agrees with them all4 ,as many as are desirous of reaping any ,benefit from this ,treatise1 should attend particularly to this ,chapter2 since1 throughout the other ,parts of it1 in ,order to avoid ,repetitions1 ,i shall say nothing of the ,diet1 except the particular ,distemper shall require a different one1 from that of which ,i am now to give an exact ,detail4 ,and whenever ,i shall say in general1 that a ,patient is to be put upon a ,regimen1 it will signify1 that he is to be treated according to the ,method prescribed in this ,chapter2 and all such ,directions are to be observed1 with ,regard to ,air1 ,food1 ,drink and ,glysters2 except when ,i expressly order something else1 as different ,ptisans1 ,glysters1 c4 ,sec4 #cb4 ,the greater ,part of ,diseases 7by which ,i always understand acute and feverish ones7 often give some ,notice of their ,approach a few ,weeks1 and1 very commonly1 some ,days before their actual ,invasion2 such as a light ,lassitude1 or ,weariness1 ,stiffness or ,numbness2 less ,activity than usual1 less ,appetite1 a small ,load or ,heaviness at ,stomach2 some ,complaint in the ,head2 a profounder ,degree of ,sleep1 yet less composed1 and less refreshing than usual2 less ,gayety and ,liveliness2 sometimes a light ,oppression of the ,breast1 a less regular ,pulse2 a ,propensity to be ,cold2 an ,aptness to sweat2 and sometimes a ,suppression of a former ,disposition to sweat4 ,at such a ,term it may be practicable to prevent1 or at least considerably to mitigate1 the most perplexing ,disorders1 by carefully observing the four following ,points4 #a4 ,to omit all violent ,work or ,labour1 but yet not so1 as to discontinue a gentle easy ,degree of ,exercise4 #b4 ,to bring the ,complainant to content himself without any1 or with very little1 solid ,food2 and especially to renounce all ,flesh1 ,flesh-broth1 ,eggs and ,wine4 #c4 ,to drink plentifully1 that is to say1 at least three ,pints1 or even four ,pints daily1 by small ,glasses at a ,time1 from half hour to half hour1 of the ,ptisans ,no4 #a and #b1 or even of warm ,water1 to each ,quart of which may be added half a ,glass of ,vinegar4 ,no ,person can be destitute of this very attainable ,assistance4 ,but should there be a ,want even of ,vinegar1 a few ,grains of common #ag ,salt may be added to a ,quart of warm ,water for ,drink4 ,those who have ,honey will do well to add two or three ,spoonfuls of it to the ,water4 ,a light ,infusion of ,elder ,flowers1 or of those of the ,linden1 the ,lime-tree1 may also be advantageously used1 and even well settled and clear sweet ,whey4 #ag ,this ,direction of our ,author's1 which may surprize some1 probably arises from his preferring a small ,quantity of the marine ,acid to no ,acid at all3 ,for though a great ,proportion of ,salt1 in saving and seasoning ,flesh and other ,food1 generally excites ,thirst1 yet a little of it seems to have rather a different ,effect1 by gently stimulating the salivary ,glands3 ,and we find that ,nature very seldom leaves the great diluting ,element wholly void of this quickening1 antiputrescent ,principle4 ,k4 #d4 ,let the ,person1 affected with such previous ,complaints1 receive ,glysters of warm ,water1 or the ,glyster ,no4 #e4 ,by pursuing these ,precautions some grievous ,disorders have often been happily rooted out3 and although they should not prove so thoroughly efficacious1 as to prevent their ,appearance1 they may at least be rendered more gentle1 and much less dangerous4 ,sec4 #cc4 ,very unhappily ,people have taken the directly contrary ,method4 ,from the ,moment these previous1 these forerunning ,complaints are perceived1 they allow themselves to eat nothing but gross ,meat1 ,eggs1 or strong ,meat-,soups4 ,they leave off ,garden-,stuff and ,fruits1 which would be so proper for them2 and they drink heartily 7under a ,notion of strengthening the ,stomach and expelling ,wind7 of ,wine and other ,liquors1 which strengthen nothing but the ,fever1 and expel what ,degree of ,health might still remain4 ,hence all the ,evacuations are restrained2 the ,humours causing and nourishing the ,diseases are not at all attempered1 diluted1 nor rendered proper for ,evacuation4 ,nay1 on the very contrary1 they become more sharp1 and more difficult to be discharged3 while a sufficient ,quantity of diluting refreshing ,liquor1 asswages and separates all ,matters foreign to the ,blood1 which it purifies2 and1 at the ,expiration of some ,days1 all that was noxious in it is carried off by ,stool1 by ,urine1 or by ,sweat4 ,sec4 #cd4 ,when the ,distemper is further advanced1 and the ,patient is already seized with that ,coldness or ,shuddering1 in a greater or less ,degree1 which ushers in all ,disease2 and which is commonly attended with an universal ,oppression1 and ,pains over all the ,surface of the ,body2 the ,patient1 thus circumstanced1 should be put to ,bed1 if he cannot keep up2 or should sit down as quietly as possible1 with a little more ,covering than usual3 he should drink every ,quarter of an ,hour a small ,glass of the ,ptisan1 ,no4 #a or #b1 warm2 or1 if that is not at ,hand1 of some one of those ,liquids ,i have recommended ,sec4 #cb4 ,sec4 #ce4 ,these ,patients earnestly covet a great ,load of covering1 during the ,cold or ,shivering2 but we should be very careful to lighten them as soon as it abates2 so that when the succeeding ,heat begins1 they may have no more than their usual ,weight of ,covering4 ,it were to be wished perhaps1 they had rather less4 ,the ,country ,people lie upon a ,feather-bed1 and under a downy ,coverlet1 or ,quilt1 that is commonly extremely heavy2 and the ,heat which is heightened and retained by ,feathers1 is particularly troublesome to ,persons in a ,fever4 ,nevertheless1 as it is what they are accustomed to1 this ,custom may be complied with for one ,season of the ,year3 but during our ,heats1 or whenever the ,fever is very violent1 they should lie on a ,pallet 7which will be infinitely better for them7 and should throw away their ,coverings of ,down1 so as to remain covered only with ,sheets1 or something else1 less injurious than ,feather-,coverings4 ,a ,person could scarcely believe1 who had not been1 as ,i have1 a ,witness of it1 how much ,comfort a ,patient is sensible of1 in being eased of his former ,coverings4 ,the ,distemper immediately puts on a different ,appearance4 ,sec4 #cf4 ,as soon as the ,heat after the ,rigor1 or ,coldness and ,shuddering1 approaches1 and the ,fever is manifestly advanced1 we should provide for the ,patient's ,regimen4 ,and #a1 ,care should be taken that the ,air1 in the ,room where he lies1 should not be too hot1 the mildest ,degree of ,warmth being very sufficient2 that there be as little ,noise as possible1 and that no ,person speak to the ,sick1 without a ,necessity for it4 ,no external ,circumstance heightens the ,fever more1 nor inclines the ,patient more to a ,delirium or ,raving1 than the ,persons in the ,chamber1 and especially about the ,bed4 ,they lessen the ,spring1 the elastic and refreshing ,power1 of the ,air2 they prevent a ,succession of fresh ,air2 and the ,variety of ,objects occupies the ,brain too much4 ,whenever the ,patient has been at ,stool1 or has made ,urine1 these ,excrements should be removed immediately4 ,the ,windows should certainly be opened ,night and ,morning1 at least for a ,quarter of an ,hour each ,time2 when also a ,door should be opened1 to promote an entire ,renovation or ,change of the ,air in the ,room4 ,nevertheless1 as the ,patient should not be exposed at any ,time to a ,stream or ,current of ,air1 the ,curtains of his ,bed should be drawn on such ,occasions2 and1 if he lay without any1 ,chairs1 with ,blankets or ,cloaths hung upon them1 should be substituted in the ,place of ,curtains1 and surround the ,bed2 while the ,windows continued open1 in ,order to defend the ,patient from the ,force of the rushing ,air4 ,if the ,season1 however1 be rigidly cold1 it will be sufficient to keep the ,windows open1 but for a few ,minutes1 each ,time4 ,in ,summer1 at least one ,window should be set open ,day and ,night4 ,the pouring a little ,vinegar upon a red-hot ,shovel also greatly conduces to restore the ,spring1 and correct the ,putridity1 of the ,air4 ,in our greatest ,heats1 when that in the ,room seems nearly scorching1 and the sick ,person is sensibly and greatly incommoded by it1 the ,floor may be sprinkled now and then2 and ,branches of ,willow or ,ash-trees dipt a little in ,pails of ,water may be placed within the ,room4 ,sec4 #cg4 #b4 ,with ,respect to the ,patient's ,nourishment1 he must entirely abstain from all ,food2 but he may always be allowed1 and have daily prepared1 the following ,sustenance1 which is one of the wholesomest1 and indisputably the simplest one4 ,take half a ,pound of ,bread1 a ,morsel of the freshest ,butter about the ,size only of a ,hazel ,nut 7which may even be omitted too7 three ,pints and one quarter of a ,pint of ,water4 ,boil them 'till the ,bread be entirely reduced to a thin ,consistence4 ,then strain it1 and give the ,patient one eighth ,part of it every three1 or every four1 ,hours2 but still more rarely1 if the ,fever be vehemently high4 ,those who have ,groats1 ,barley1 ,oatmeal1 or ,rice1 may boil and prepare them in the same ,manner1 with some ,grains of ,salt4 ,sec4 #ch4 ,the ,sick may also be sometimes indulged1 in lieu of these different ,spoon-,meats1 with raw ,fruits in ,summer1 or in ,winter with ,apples baked or boiled1 or ,plumbs and ,cherries dried and boiled4 ,persons of ,knowledge and ,experience will be very little1 or rather not at all1 surprized to see various ,kinds of ,fruit directed in acute ,diseases2 the ,benefit of which they may here have frequently seen4 ,such ,advice can only disgust those1 who remain still obstinately attached to old ,prejudices4 ,but could they prevail on themselves to reflect a little1 they must perceive1 that these ,fruits which allay ,thirst2 which cool and abate the ,fever2 which correct and attemper the putrid and heated ,bile2 which gently dispose the ,belly to be rather open1 and promote the ,secretion and ,discharge of the ,urine1 must prove the properest ,nourishment for ,persons in acute ,fevers4 ,hence we see1 as it were by a strong ,admonition from ,nature herself1 they express an ardent ,longing for them2 and ,i have known several1 who would not have recovered1 but for their eating secretly large ,quantities of those ,fruits they so passionately desired1 and were refused4 ,as many however1 as are not convinced by my ,reasoning in this ,respect1 may at least make a ,tryal of my ,advice1 on my ,affirmation and ,experience2 when ,i have no doubt but their own will speedily convince them of the real ,benefit received from this ,sort of ,nourishment4 ,it will then be evident1 that we may safely and boldly allow1 in all continual ,fevers1 ,cherries red and black1 ,strawberries1 the best cured ,raisins1 ,raspberries1 and ,mulberries2 provided that all of them be perfectly ripe4 ,apples1 ,pears and ,plumbs are less melting and diluting1 less succulent1 and rather less proper4 ,some kinds of ,pears however are extremely juicy1 and even watery almost1 such as the ,dean or ,valentia ,pear1 different ,kinds of the ,buree ,pear2 the ,st4 ,germain1 the ,virgoleuse2 the green sugary ,pear1 and the ,summer ,royal1 which may all be allowed2 as well as a little ,juice of very ripe ,plumbs1 with the ,addition of ,water to it4 ,this last ,i have known to asswage ,thirst in a ,fever1 beyond any other ,liquor4 ,care should be taken1 at the same ,time1 that the ,sick should never be indulged in a great ,quantity of any of them at once1 which would overload the ,stomach1 and be injurious to them2 but if they are given a little at a ,time and often1 nothing can be more salutary4 ,those whose ,circumstances will afford them ,china ,oranges1 or ,lemons1 may be regaled with the ,pulp and ,juice as successfully2 but without eating any of their ,peel1 which is hot and inflaming4 ,sec4 #ci4 #c4 ,their ,drink should be such as allays ,thirst1 and abates the ,fever2 such as dilutes1 relaxes1 and promotes the ,evacuations by ,stool1 ,urine and ,perspiration4 ,all these which ,i have recommended in the preceding ,chapters1 jointly and severally possess these ,qualities4 ,a ,glass or a ,glass and a half of the ,juice of such ,fruits as ,i have just mentioned1 may also be added to three full ,pints of ,water4 ,sec4 #dj4 ,the ,sick should drink at least twice or thrice that ,quantity daily1 often1 and a little at once1 between three or four ,ounces1 every ,quarter of an ,hour4 ,the ,coldness of the ,drink should just be taken off4 ,sec4 #da4 #d4 ,if the ,patient has not two ,motions in the #bd ,hours2 if the ,urine be in small ,quantity and high coloured2 if he rave1 the ,fever rage1 the ,pain of the ,head and of the ,loins be considerable1 with a ,pain in the ,belly1 and a ,propensity to vomit1 the ,glyster ,no4 #e should be given at least once a ,day4 ,the ,people have generally an ,aversion to this kind of ,remedy2 notwithstanding there is not any more useful in feverish ,disorders1 especially in those ,i have just recounted2 and one ,glyster commonly gives more ,relief1 than if the ,patient had drank four or five ,times the ,quantity of his ,drinks4 ,the ,use of ,glysters1 in different ,diseases1 will be properly ascertained in the different ,chapters1 which treat of them4 ,but it may be observed in this ,place1 that they are never to be given at the very ,time the ,patient is in a ,sweat1 which seems to relieve him4 ,sec4 #db4 #e4 ,as long as the ,patient has sufficient ,strength for it1 he should sit up out of ,bed one ,hour daily1 and longer if he can bear it2 but at least half an ,hour4 ,it has a ,tendency to lessen the ,fever1 the ,head-ach1 and a ,light-headiness1 or ,raving4 ,but he should not be raised1 while he has a hopeful ,sweating2 though such ,sweats hardly ever occur1 but at the ,conclusion of ,diseases1 and after the ,sick has had several other ,evacuations4 ,sec4 #dc4 #f4 ,his ,bed should be made daily while he sits up2 and the ,sheets of the ,bed1 as well as the ,patient's ,linen1 should be changed every two ,days1 if it can be done with ,safety4 ,an unhappy ,prejudice has established a contrary1 and a really dangerous1 ,practice4 ,the ,people about the ,patient dread the very ,thought of his rising out of ,bed2 they let him continue there in nasty ,linen loaden with putrid ,steams and ,humours2 which contribute1 not only to keep up the ,distemper1 but even to heighten it into some ,degree of ,malignity4 ,i do again repeat it here1 that nothing conduces more to continue the ,fever and ,raving1 than confining the ,sick constantly to ,bed1 and witholding him from changing his foul ,linen3 by relieving him from both of which ,circumstances ,i have1 without the ,assistance of any other ,remedy1 put a ,stop to a continual ,delirium of twelve ,days uninterrupted ,duration4 ,it is usually said1 the ,patient is too weak1 but this is a very weak ,reason4 ,he must be in very nearly a dying ,condition1 not to be able to bear these small ,commotions1 which1 in the very ,moment when he permits them1 increase his ,strength1 and immediately after abate his ,complaints4 ,one ,advantage the ,sick gain by sitting up a little out of ,bed1 is the increased ,quantity of their ,urine1 with greater ,facility in passing it4 ,some have been observed to make none at all1 if they did not rise out of ,bed4 ,a very considerable ,number of acute ,diseases have been radically1 effectually1 cured by this ,method1 which mitigates them all4 ,where it is not used1 as an ,assistance at least1 ,medicines are very often of no ,advantage4 ,it were to be wished the ,patient and his ,friends were made to understand1 that ,distempers were not to be expelled at once with rough and precipitate ,usage2 that they must have their certain ,career or ,course2 and that the ,use of the violent ,methods and ,medicines they chuse to employ1 might indeed abridge the ,course of them1 by killing the ,patient2 yet never otherwise shortened the ,disease2 but1 on the contrary1 rendered it more perplexing1 tedious and obstinate2 and often entailed such unhappy ,consequences on the ,sufferer1 as left him feeble and languid for the rest of his ,life4 ,sec4 #dd4 ,but it is not sufficient to treat1 and1 as it were1 to conduct the ,distemper properly4 ,the ,term of ,recovery from a ,disease requires considerable ,vigilance and ,attention1 as it is always a ,state of ,feebleness1 and1 thence1 of ,depression and ,faintness4 ,the same ,kind of ,prejudice which destroys the ,sick1 by compelling them to eat1 during the ,violence of the ,disease1 is extended also into the ,stage of ,convalescence1 or ,recovery2 and either renders it troublesome and tedious2 or produces fatal ,relapses1 and often chronical ,distempers4 ,in ,proportion to the ,abatement1 and in the ,decline1 of the ,fever1 the ,quantity of ,nourishment may be gradually increased3 but as long as there are any ,remains of it1 their ,qualities should be those ,i have already recommended4 ,whenever the ,fever is compleatly terminated1 some different ,foods may be entered upon2 so that the ,patient may venture upon a little white ,meat1 provided it be tender2 some #ah ,fish2 a little ,flesh-,soup1 a few ,eggs at times1 with ,wine property diluted4 ,it must be observed at the same ,time1 that those very proper ,aliments which restore the ,strength1 when taken moderately1 delay the perfect ,cure1 if they exceed in ,quantity1 tho' but a little2 because the ,action of the ,stomach being extremely weakened by the ,disease and the ,remedies1 is capable only1 as yet1 of a small ,degree of ,digestion2 and if the ,quantity of its ,extents exceed its ,powers1 they do not digest1 but become putrid4 ,frequent ,returns of the ,fever supervene2 a continual ,faintishness2 ,head-achs2 a heavy ,drowsiness without a ,power of ,sleeping comfortably2 flying ,pains and ,heats in the ,arms and ,legs2 ,inquietude2 ,peevishness2 ,propensity to ,vomit2 ,looseness2 ,obstructions1 and sometimes a slow ,fever1 with a ,collection of ,humours1 that comes to ,suppuration4 ,all these bad ,consequences are prevented1 by the recovering ,sick contenting themselves1 for some ,time1 with a very moderate ,share of proper ,food4 ,we are not nourished in ,proportion to the ,quantity we swallow1 but to that we digest4 ,a ,person on the mending ,hand1 who eats moderately1 digests it and grows strong from it4 ,he who swallows abundantly does not digest it1 and instead of being nourished and strengthened1 he withers insensibly away4 #ah ,the most allowable of these are ,whitings1 ,flounders1 ,plaice1 ,dabbs1 or ,gudgeons2 especially such of the last as are taken out of clear current ,streams with gravelly ,bottoms4 ,salmon1 ,eels1 ,carp1 all the ,skate kind1 ,haddock1 and the like1 should not be permitted1 before the ,sick return to their usual ,diet when in ,health4 ,k4 ,sec4 #de4 ,we may reduce1 within the few following ,rules1 all that is most especially to be observed1 in ,order to procure a compleat1 a perfect ,termination of acute ,diseases2 and to prevent their leaving behind them any ,impediments to ,health4 #a4 ,let these who are recovering1 as well as those who are actually sick1 take very little ,nourishment at a time1 and take it often4 #b4 ,let them take but one sort of ,food at each ,meal1 and not change their ,food too often4 #c4 ,let them chew whatever solid ,victuals they eat1 very carefully4 #d4 ,let them diminish their ,quantity of ,drink4 ,the best for them in general is ,water1 #ai with a fourth or third ,part of white ,wine4 ,too great a ,quantity of ,liquids at this time prevents the ,stomach from recovering its ,tone and ,strength2 impairs ,digestion2 keeps up ,weakness2 increases the ,tendency to a ,swelling of the ,legs2 sometimes even occasions a slow ,fever2 and throws back the ,person recovering into a languid ,state4 #ai ,we have known many who had an ,aversion to ,water1 and with whom1 on that very ,account1 it might probably agree less1 find ,water very grateful1 in which a thoroughly baked and hot1 not burnt1 ,slice of ,bread had been infused1 untill it attained the ,colour of fine clear ,small-beer1 or light ,amber coloured ,beer1 and we never saw any ,inconvenience result from it4 ,doubtless pure1 untoasted elemental ,water may be preferable for those who like1 and have been accustomed to it4 ,k4 #e4 ,let them go abroad as often as they are able1 whether on ,foot1 in a ,carriage1 or on ,horseback4 ,this last ,exercise is the healthiest of all1 and three fourths of the labouring ,people in this ,country1 who have it in their ,power to procure it without ,expense1 are in the wrong to neglect it4 ,they1 who would practice it1 should mount before their principal ,meal1 which should be about ,noon1 and never ride after it4 ,exercise taken before a ,meal strengthens the ,organs of ,digestion1 which is promoted by it4 ,if the ,exercise is taken soon after the ,meal1 it impairs it4 #f4 ,as ,people in this ,state are seldom quite as well towards ,night1 in the ,evening they should take very little ,food4 ,their ,sleep will be the less disturbed for this1 and repair them the more1 and sooner4 #g4 ,they should not remain in ,bed above seven1 or eight ,hours4 #h4 ,the ,swelling of the ,legs and ,ancles1 which happens to most ,persons at this time1 is not dangerous1 and generally disappears of itself2 if they live soberly and regularly1 and take moderate ,exercise4 #i4 ,it is not necessary1 in this ,state1 that they should go constantly every ,day to ,stool2 though they should not be without one above two or three4 ,if their ,costiveness exceeds this ,term1 they should receive a ,glyster the third ,day1 and even sooner1 if they are heated by it1 if they feel puffed up1 are restless1 and have any ,pains in the ,head4 #aj4 ,should they1 after some time1 still continue very weak2 if their ,stomach is disordered2 if they have1 from time to time1 a little irregular ,fever1 they should take three ,doses daily of the ,prescription ,no4 #ad4 which fortifies the ,digestions1 recovers the strength1 and drives away the ,fever4 #aa4 ,they must by no means return to their ,labour too soon4 ,this erroneous ,habit daily prevents many ,peasants from ever getting perfectly well1 and recovering their former ,strength4 ,from not having been able to confine themselves to ,repose and ,indolence for some ,days1 they never become as hearty hardy ,workmen as they had been3 and this premature hasty ,labour makes them lose in the ,consequence1 every following ,week of their ,lives1 more time than they ever gained1 by their over-early resuming of their ,labour4 ,i see every ,day weakly ,labourers1 ,vineroons1 and other ,workmen1 who date the ,commencement of their ,weakness from that of some acute ,disease1 which1 for want of proper ,management through the ,term of their ,recovery1 was never perfectly cured4 ,a ,repose of seven or eight ,days1 more than they allowed themselves1 would have prevented all these ,infirmities2 notwithstanding it is very difficult to make them sensible of this4 ,the ,bulk1 the ,body of the ,people1 in this and in many other ,cases1 look no further than the present ,day2 and never extend their ,views to the following one4 ,they are for making no ,sacrifice to ,futurity2 which nevertheless must be done1 to render it favourable to us4 ,chapter ,,iv4 ,of an ,inflammation of the ,breast4 ,sect4 #df4 ,the ,inflammation of the ,breast1 or ,peripneumony1 or a ,fluxion upon the ,breast1 is an ,inflammation of the ,lungs1 and most commonly of one only1 and consequently on one ,side4 ,the ,signs by which it is evident1 are a ,shivering1 of more or less ,duration1 during which the ,person affected is sometimes very restless and in great ,anguish1 an essential and inseparable symptom2 and which has helped me more than once to distinguish this ,disease certainly1 at the very ,instant of its ,invasion4 ,besides this1 a considerable ,degree of ,heat succeeds the ,shivering1 which ,heat1 for a few ensuing ,hours1 is often blended as it were1 with some ,returns of ,chilliness4 ,the ,pulse is quick1 pretty strong1 moderately full1 hard and regular1 when the ,distemper is not very violent2 but small1 soft and irregular1 when it is very dangerous4 ,there is also a ,sensation of ,pain1 but rather light and tolerable1 in one ,side of the ,breast2 sometimes a kind of straitning or ,pressure on the ,heart2 at other times ,pains through the whole ,body1 especially along the ,reins2 and some ,degree of ,oppression1 at least very often2 for sometimes it is but very inconsiderable4 ,the ,patient finds a ,necessity of lying almost continually upon his ,back1 being able to lie but very rarely upon either of his ,sides4 ,sometimes his ,cough is dry1 and then attended with the most ,pain2 at other times it is accompanied with a ,spitting or ,hawking up1 blended with more or less ,blood1 and sometimes with pure sheer ,blood4 ,there is also some ,pain1 or at least a ,sensation of ,weight and ,heaviness in the ,head3 and frequently a ,propensity to rave4 ,the ,face is almost continually flushed and red3 though sometimes there is a ,degree of ,paleness and an ,air of ,astonishment1 at the ,beginning of the ,disease1 which portend no little ,danger4 ,the ,lips1 the ,tongue1 the ,palate1 the ,skin are all dry2 the ,breath hot2 the ,urine little and high coloured in the first ,stage3 but more plentiful1 less flaming1 and letting fall much ,sediment afterwards4 ,there is a frequent ,thirst1 and sometimes an ,inclination to vomit2 which imposing on the ignorant ,assistants1 have often inclined them to give the ,patient a ,vomit1 which is mortal1 especially at this ,juncture4 ,the ,heat becomes universal4 ,the ,symptoms are heightened almost every ,night1 during which the ,cough is more exasperated1 and the ,spitting or ,expectoration in less ,quantity4 ,the best ,expectoration is of a middling ,consistence1 neither too thin1 nor too hard and tough1 like those which are brought up at the ,termination of a ,cold2 but rather more yellow1 and mixed with a little ,blood1 which gradually becomes still less1 and commonly disappears entirely1 before the seventh ,day4 ,sometimes the ,inflammation ascends along the ,wind-pipe1 and in some ,measure suffocates the ,patient1 paining him considerably in ,swallowing1 which makes him think he has a sore ,throat4 ,sec4 #dg4 ,whenever the ,disease is very violent at first1 or increases to be such1 the ,patient cannot draw his ,breath1 but when he sits up4 ,the ,pulse becomes very small and very quick2 the ,countenance livid1 the ,tongue black2 the ,eyes stare wildly2 and he suffers inexpressible ,anguish1 attended with incessant ,restlessness and ,agitation in his ,bed4 ,one of his ,arms is sometimes affected with a sort of ,palsy2 he raves without ,intermission2 can neither thoroughly wake nor sleep4 ,the ,skin of his ,breast and of his ,neck is covered 7especially in close sultry ,weather1 and when the ,distemper is extremely violent7 with livid ,spots1 more or less remarkable1 which should be called petechial ones1 but are improperly termed the pourpre1 or purple4 ,the natural ,strength becomes exhausted2 the ,difficulty of breathing increases every ,moment2 he sinks into a ,lethargy1 and soon dies a terrible ,death in ,country ,places1 by the very ,effects of the inflaming ,medicines they employ on such ,occasions4 ,it has been known in ,fact1 that the ,use of them has raised the ,distemper to such a ,height1 that the very ,heart has been rent open1 which the ,dissection of the ,body has demonstrated4 ,sec4 #dh4 ,if the ,disease rushes on at once1 with a sudden and violent ,attack2 if the ,horror1 the ,cold and ,shivering last many ,hours1 and are followed with a nearly scorching ,degree of ,heat2 if the ,brain is affected from the very ,onset2 if the ,patient has a small ,purging1 attended with a ,tenesinus1 or straining to ,stool1 often termed a ,needy2 if he abhors the ,bed2 if he either sweat excessively1 or if his ,skin be extremely dry2 if his natural ,manner and ,look are considerably changed2 and if he spits up with much ,difficulty1 the ,disease is extremely dangerous4 ,sec4 #di4 ,he must directly1 from the first ,seizure in this ,state1 be put upon a ,regimen1 and his ,drink must never be given cold4 ,it should either be the ,barley ,water ,no4 #b1 the ,almond ,emulsion ,no4 #d1 or that of ,no4 #g4 ,the ,juices of the ,plants1 which enter into the last of these ,drinks1 are excellent ,remedies in this ,case2 as they powerfully attenuate1 or melt down1 the viscid thick ,blood1 which causes the ,inflammation4 ,the ,advantage of ,bleeding3 ,as long as the ,fever keeps up extremely violent2 while the ,patient does not expectorate sufficiently2 continues raving2 has a violent ,head-ach1 or raises up pure ,blood1 the ,glyster ,no4 #e must be given thrice1 or at least twice1 in twenty four ,hours4 ,however the principal ,remedy is ,bleeding4 ,as soon as ever the preceding cold ,assault is over1 twelve ,ounces of ,blood must be taken away at once2 and1 if the ,patient be young and strong1 fourteen or even sixteen4 ,this plentiful ,bleeding gives him more ,ease1 than if twenty four ,ounces had been drawn1 at three different ,times4 ,sec4 #ej4 ,when the ,disease is circumstanced as described 7,sec4 #df7 that first ,bleeding makes the ,patient easy for some ,hours2 but the ,complaint returns2 and to obviate its ,violence1 as much as possible1 we must1 except things promise extremely well1 repeat the ,bleeding four ,hours after the first1 taking again twelve ,ounces of ,blood1 which pretty often proves sufficient4 ,but if1 about the ,expiration of eight or ten ,hours1 it appears to kindle up again1 it must be repeated a third1 or even a fourth ,time4 ,yet1 with the ,assistance of other proper ,remedies1 ,i have seldom been obliged to bleed a fourth ,time1 and have sometimes found the two first ,bleedings sufficient4 ,if the ,disease has been of several ,days ,duration1 when ,i have first been called2 if the ,fever is still very high2 if there be a ,difficulty of ,breathing2 if the ,patient does not expectorate at all1 or brings up too much ,blood2 without being too solicitous about the ,day of the ,disease1 the ,patient should be bled1 though it were on the tenth4 #bj ,sec4 #ea4 ,in this1 and in all other inflammatory ,diseases1 the ,blood is in a very thick viscid ,state3 and almost immediately on its being drawn1 a white tough ,skin1 somewhat like ,leather1 is formed on its ,top1 which most ,people have seen1 and which is called the pleuritic ,crust4 ,it is thought a promising ,appearance1 when at each ,bleeding it seems less hard1 and less thick1 than it was at the preceding ones3 and this is very generally true1 if the ,sick feels himself1 at the same ,time1 sensibly better3 but whoever shall attend solely to the ,appearance of the ,blood1 will find himself often deceived4 ,it will happen1 even in the most violent ,inflammation of the ,breast1 that this ,crust is not formed1 which is supposed to be a very unpromising ,sign4 ,there are also1 in this ,respect1 many odd ,appearances1 which arise from the smallest ,circumstances2 so that we must not regulate the ,repetitions of our bleeding1 solely by this ,crust3 and in general we must not be over credulous in supposing1 that the ,appearances in the ,blood1 received into the ,bason1 can enable us to determine1 with ,certainty1 of its real ,state in the ,body4 #bj ,we should however1 with the greater ,circumspection 7of how much the longer standing the ,disease has been1 and by how much the more difficult the viscous ,humours are to be melted down and dislodged7 attend to the ,coction of the ,matter of ,expectoration2 which ,nature does not often easily effect1 and which she effects the more imperfectly and slowly1 the weaker he is4 ,her last ,efforts have often been attended with such high ,paroxysms1 as have imposed even upon very competent ,physicians1 and have made them open a ,vein a few ,hours before the ,patients' ,death1 from their ,pulses being strong1 hard and frequent4 ,excessive ,weakness is the ,sign1 by which we may discover such unavailing ,efforts to be the last4 ,e4 ,l4 ,sec4 #eb4 ,when the sick ,person is in the ,condition described 7,sec4 #dg7 the ,bleeding is not only unattended with ,ease2 but sometimes it is also pernicious1 by the sudden ,weakness to which it reduces him4 ,generally in such a ,case all ,medicines and ,means are insignificant3 and it is a very bad ,sign in this ,disease1 when this ,discharge is not attended with ,ease and ,benefit to the ,sick2 or when there are some ,circumstances1 which oblige us to be sparing of it4 ,sec4 #ec4 ,the ,patient's ,legs should every ,day1 for one half ,hour1 be put into a ,bath of warm ,water1 wrapping him up closely2 that the ,cold may not check that ,perspiration1 which the ,bath promotes4 ,sec4 #ed4 ,every two ,hours he should take two ,spoonfuls of the ,mixture ,no4 #h1 which promotes all the ,discharges1 and chiefly that of ,expectoration4 ,sec4 #ee4 ,when the ,oppression and ,straitness are considerable1 and the ,cough dry1 the ,patient may receive the ,vapour of boiling ,water1 to which a little ,vinegar has been added4 ,there are two ways of effecting this2 either by placing below his ,face1 after setting him up1 a ,vessel filled with such boiling hot ,water1 and covering the ,patient's ,head and the ,vessel with a ,linen ,cloth1 that may inclose the ,steam2 or else by holding before his ,mouth a ,spunge dipped in the same boiling ,liquor4 ,this last ,method is the least effectual1 but it fatigues the ,patient considerably less4 ,when this bad ,symptom is extremely pressing1 ,vinegar alone should be used without ,water2 and the ,vapour of it has often saved ,patients1 who seemed to have one ,foot in the ,grave3 but it should be continued for several ,hours4 ,sec4 #ef4 ,the outward ,remedies directed in ,no4 #i4 are also applied with ,success to the ,breast1 and to the ,throat4 ,sec4 #eg4 ,when the ,fever is extremely high1 the ,sick should take every ,hour1 a ,spoonful of the ,mixture ,no4 #aj4 in a ,cup of the ,ptisan #ba but without diminishing on this ,account the usual ,quantity of his other ,drinks1 which may be taken immediately after it4 #ba ,the ,use of ,acids1 in ,inflammations of the ,breast1 requires no little ,consideration4 ,whenever the sick ,person has an ,aversion to them2 when the ,tongue is moist1 the ,stomach is heavy and disordered1 and the ,habit and ,temperament of the ,patient is mild and soft2 when the ,cough is very sharp without great ,thirst1 we ought to abstain from them4 ,but when the ,inflammation is joined to a dry ,tongue1 to great ,thirst1 ,heat and ,fever1 they are of great ,service4 ,slices of ,china ,oranges sprinkled with ,sugar may be given first2 a light ,limonade may be allowed afterwards2 and at last small ,doses of the ,mixture1 ,no4 #aj4 if it becomes necessary4 ,e4 ,l4--,i have chosen to retain this ,note of the ,editor of ,lyons1 from having frequently seen the ,inefficacy1 and sometimes1 ,i have even thought1 the ill ,effects of ,acids in ,peripneumonies and ,pleurisies1 in a ,country far ,south of ,swisserland2 and where these ,diseases are very frequent1 acute and fatal4 ,on the other hand ,i shall add the ,substance of what ,dr4 ,tissot says on this ,head in a ,note to his ,table of ,remedies1 wherein he affirms1 that he has given in this ,disease very large ,doses of them1 rising gradually from small ones1 and always with great ,success2 intreating other ,physicians to order this ,acid 7the ,spirit of ,sulphur7 in the same large ,doses which he directs in this ,chapter1 and assuring himself of their thanks1 for its good ,consequences--,now the only ill ,effect ,i can surmize here1 from shewing this ,diversity of ,opinion in these two learned ,physicians1 and my own ,doubts1 is1 that the ,subjects of this ,disease in ,country ,places may prove somewhat confused and irresolute by it1 in their ,conduct in such ,cases4 ,but as all of us certainly concur in the great ,intention of doing all possible ,good1 by the extensive ,publication of this ,treatise1 ,i shall take leave to observe that in this ,disease1 and in ,pleurisies1 more solid ,benefit has been received in ,carolina1 ,virginia1 c4 from the ,use of the ,seneka ,rattle-snake ,root1 than from any other ,medicine whatever4 ,bleeding indeed is necessarily premised to it2 but it has often saved the ,necessity of many repeated ,bleedings4 ,this ,medicine1 which is termed in ,latin1 the ,polygala ,virginiana1 is certainly rather of a saponaceous attenuating ,quality1 and betrays not any ,marks of ,acidity1 being rather moderately acrid4 ,there will be ,occasion to mention it more particularly in the subsequent ,chapter1 as such a ,liberty can need no ,apology to any philosophical ,physician4 ,k4 ,sec4 #eh4 ,as long as the ,patient shall grow worse1 or only continue equally bad1 the same ,medicines are to be repeated4 ,but if on the third ,day 7tho' it rarely happens so soon7 or fourth1 or fifth1 the ,disease takes a more favourable ,turn2 if the ,exasperation returns with less ,violence2 the ,cough be less severe2 the ,matter coughed up less bloody3 if ,respiration becomes easier2 the ,head be less affected2 the ,tongue not quite so dry2 if the high ,colour of the ,urine abates1 and its ,quantity be increased1 it may be sufficient then to keep the ,patient carefully to his ,regimen1 and to give him a ,glyster every ,evening4 ,the ,exasperation that occurs the fourth ,day is often the highest4 ,sec4 #ei4 ,this ,distemper is most commonly terminated and carried off by ,expectoration1 and often by ,urine1 which on the seventh1 the ninth1 or the eleventh ,day1 and sometimes on the ,days between them1 begins to let fall a plentiful ,sediment1 or ,settling1 of a pale red ,colour1 and sometimes real ,pus or ripe ,matter4 ,these ,discharges are succeeded by ,sweats1 which are as serviceable then1 as they were injurious at the ,beginning of the ,disease4 ,sec4 #fj4 ,some ,hours before these ,evacuations appear1 there come on1 and not seldom1 some very alarming ,symptoms1 such as great ,anguish2 ,palpitations1 some ,irregularity in the ,pulse2 an increased ,oppression2 convulsive ,motions 7this being what is called the ,crisis1 the ,height1 or ,turn of the ,distemper7 but they are no ways dangerous1 provided they do not occasion any improper ,treatment4 ,these ,symptoms depend on the morbid and purulent ,matter1 which1 being dislodged1 circulates with the ,humours1 and irritates different ,parts1 until the ,discharge of it has fairly begun2 after which all such ,symptoms disappear1 and ,sleep generally ensues4 ,however ,i cannot too strongly insist on the ,necessity of great ,prudence in such ,circumstances4 ,sometimes it is the ,weakness of the ,patient1 and at other times ,convulsions1 or some other ,symptoms1 that terrify the ,by-standers4 ,if1 which is most generally the ,case1 the absurd ,practice of directing particular ,remedies for such ,accidents takes place1 such as spirituous ,cordials1 ,venice ,treacle1 ,confections1 ,castor and ,rue2 the ,consequence is1 that ,nature being disturbed in her ,operations1 the ,crisis or ,turn is not effected2 the ,matter which should be discharged by ,stool1 by ,urine1 or by ,sweat1 is not discharged out of the ,body2 but is thrown upon some internal or external part of it4 ,should it be on some inward part1 the ,patient either dies at once2 or another ,distemper succeeds1 more troublesome and incurable than the first4 ,should it be expelled to some outward part1 the ,danger indeed is less2 and as soon as ever such a ,tumour appears1 ripening ,pultices should be apply'd to bring it to a ,head1 after which it should immediately be opened4 ,sec4 #fa4 ,in order to prevent such unhappy ,consequences1 great ,care must be taken1 whenever such terrifying ,symptoms come on1 about the ,time of the ,crisis to make no ,change in the ,diet1 nor in the ,treatment of the ,patient2 except in giving him the loosening ,glyster ,no4 #e2 and applying every two ,hours a ,flannel1 squeezed out of warm ,water1 which may cover all the ,belly1 and in a ,manner go round the ,body behind the ,reins4 ,the ,quantity of his ,drink may also be increased a little2 and that of his ,nourishment lessened1 as long as this high and violent ,state continues4 ,sec4 #fb4 ,i have not spoken of ,vomits or ,purges1 as being directly contrary to the ,nature of this ,disease4 ,anodynes1 or ,opiates1 to procure ,sleep are also1 in general1 very improper4 ,in a few ,cases1 however1 they may possibly be useful2 but these ,cases are so very difficult to be sufficiently distinguished1 that ,opiates should never be admitted in this ,disease1 without the ,presence and ,advice of a ,physician4 ,i have seen many ,patients1 who have been thrown into an incurable ,hectic1 by taking them improperly4 ,when the ,disease is not received in a mortal ,degree1 nor has been injudiciously treated1 and proceeds in a benign regular ,manner1 the ,patient may be called very well and safe by the fourteenth ,day2 when he may1 if he has an ,appetite1 be put upon the ,diet of ,people who are recovering4 ,but if he still retains an ,aversion to ,food2 if his ,mouth is foul and furred1 and he is sensible of some ,heaviness in his ,head1 he should take the purging ,potion ,no4 #aa4 ,sec4 #fc4 ,bleedings from the ,nose occur sometimes naturally in this ,disease1 even after repeated ,bleedings by ,art2 these are very benign and favourable1 and are commonly attended with more ,ease and ,relief than artificial ,bleedings4 ,such voluntary ,discharges may sometimes be expected1 when the ,patient is sensibly mended in many ,respects after the ,use of the ,lancet2 and yet complains of a great ,pain in his ,head1 accompanied with quick sparkling ,eyes1 and a ,redness of the ,nose4 ,nothing should be done to stop these voluntary ,bleedings1 since it would be very dangerous3 ,for when ,nature has fulfilled her ,intention by them1 they cease of themselves4 ,at other times1 but more rarely1 the ,distemper is carried off by a natural ,purging1 attended with moderate ,pain1 and the ,discharge of bilious ,matter4 ,sec4 #fd4 ,if the ,expectoration1 or hawking up of ,matter1 stops very suddenly1 and is not speedily attended with some other ,evacuation2 the ,oppression and ,anguish of the ,patient immediately return1 and the ,danger is great and pressing4 ,if the ,distemper1 at this ,juncture1 is not of many ,days standing2 if the ,patient is a strong ,person2 if he has not as yet been plentifully bled2 if there be still some ,blood mixed with the ,humour he expectorates2 or if the ,pulse be strong and hard1 he should be bled immediately in the ,arm2 and constantly receive the ,steam of hot ,water and ,vinegar by the ,mouth1 and drink plentifully of the ,ptisan ,no4 #b1 something hotter than ordinary4 ,but if his ,circumstances1 after this ,suppression1 are different from these just mentioned2 instead of bleeding him1 two ,blisters should be applied to the ,legs2 and he should drink plentifully of the ,ptisan ,no4 #ab4 ,the ,causes which oftenest produce this ,suppression of his ,expectoration are1 #a1 a sharp and sudden cold ,air4 #b1 too hot a one4 #c1 over hot ,medicines4 #d1 excessive ,sweating4 #e1 a ,purge prematurely and injudiciously timed4 and #f1 some immoderate ,passion of the ,mind4 ,sec4 #fe4 ,when the ,sick has not been sufficiently bled1 or not soon enough2 and even sometimes1 which ,i have seen1 when he has been greatly weakened by excessive ,bleeding2 so that the ,discharges by ,stool1 ,urine1 ,expectoration and ,perspiration1 have not been sufficiently made2 when these ,discharges have been confused by some other ,cause2 or the ,disease has been injudiciously treated2 then the ,vessels that have been inflamed1 do not unload themselves of the ,humours1 which stuff up and oppress them3 but there happens in the ,substance of the affected ,lung1 the same ,circumstance we see daily occur on the ,surface of the ,body4 ,if an inflammatory ,tumour or ,swelling does not disperse itself1 and disappears insensibly1 it forms an ,imposthume or ,abscess4 ,thus exactly also in the inflamed ,lung1 if the ,inflammation is not dissipated1 it forms an ,abscess1 which1 in that part1 is called a ,vomica3 and the ,matter of that ,abscess1 like the external ones1 remains often long inclosed in its ,sac or ,bag1 without bursting open its ,membrane or ,case1 and discharging the ,matter it contains4 ,sec4 #ff4 ,if the ,inflammation was not very deeply seated in the inward ,substance of the diseased ,lung2 but was extended to its ,surface1 that is1 very near the ,ribs1 the ,sac will burst on the ,surface of the ,lung2 and the ,matter contained in it must be discharged into the ,cavity1 or ,hollowness of the ,breast1 between the ,lung1 the ,ribs1 and the ,diaphragm or ,midriff1 which is the ,membrane that divides the ,breast and the ,belly4 ,but when the ,inflammation is considerably deeper1 the ,imposthume bursts withinside of the ,lung itself4 ,if its ,orifice1 or ,opening is so small1 that but little can get out at once2 if the ,quantity of all the ,matter be inconsiderable1 and the ,patient is at the same ,time pretty strong1 he coughs up the ,matter1 and is very sensibly relieved4 ,but if this ,vomica be large1 or if its ,orifice is wide1 and it throws out a great ,quantity of ,matter at once2 or if the ,patient is very weak1 he dies the ,moment it bursts1 and that sometimes when it is least expected4 ,i have seen one ,patient so circumstanced expire1 as he was conveying a ,spoonful of ,soup to his ,mouth2 and another1 while he was wiping his ,nose4 ,there was no present ,symptom in either of these ,cases1 whence a ,physician might suppose them likelier to die at that ,instant1 than for some ,hours before4 ,the ,pus1 or ,matter1 is commonly discharged through the ,mouth after ,death1 and the ,bodies very soon become putrified4 ,sec4 #fg4 ,we call that ,vomica which is not burst1 an occult or hidden1 and that which is1 an evident or open one4 ,it is of considerable ,importance to treat exactly and clearly of this ,topic2 as a great ,number of ,country ,people die of these ,imposthumes1 even without a ,suspicion of the ,cause of their ,death4 ,i had an ,instance of it some ,days since1 in the ,school-master of a ,village4 ,he had an occult and very considerable ,vomica in the left ,lung1 which was the ,consequence of an ,inflammation of the ,breast1 that had been treated improperly at the ,beginning4 ,he seemed to me not likely to live twenty four ,hours2 and really died in the ,night1 after inexpressible ,anguish4 ,sec4 #fh4 ,whatever ,distemper is included within the ,breast of a living ,patient1 is neither an ,object of the ,sight or ,touch whence these ,vomicas1 these inward ,tumours1 are so often unknown1 and indeed unsuspected4 ,the ,evacuations that were necessary for the ,cure1 or sometimes for the ,prevention1 of them1 have not taken place1 during the first fourteen ,days4 ,at the ,end of this ,term1 the ,patient1 far from being cured1 is not very considerably relieved2 but1 on the contrary1 the ,fever continues to be pretty high1 with a ,pulse continually quick2 in general soft and weak2 though sometimes pretty hard1 and often fluctuating1 or1 as it were1 waving4 ,his ,breathing is still difficult and oppressed2 with small cold ,shudderings from ,time to ,time2 an ,exasperation of the ,fever2 flushed ,cheeks1 dry ,lips1 and ,thirst4 ,the ,increase of these ,symptoms declare1 that ,pus or ,matter is thoroughly formed3 the ,cough then becomes more continual2 being exasperated with the least ,motion2 or as soon as ever the ,patient has taken any ,nourishment4 ,he can repose only on the ,side affected4 ,it often happens indeed1 that he cannot lie down at all2 but is obliged to be set up all ,day2 sometimes even without daring to lean a little upon his ,loins1 for fear of increasing the ,cough and ,oppression4 ,he is unable to sleep2 has a continual ,fever1 and his ,pulse frequently intermits4 ,the ,fever is not only heightened every ,evening2 but the smallest ,quantity of ,food1 the gentlest ,motion1 a little ,coughing1 the lightest ,agitation of the ,mind1 a little more than usual ,heat in the ,chamber1 ,soup either a little too strong1 or a little too salt1 increase the ,quickness of his ,pulse the ,moment they occur1 or are given4 ,he is quite restless1 has some short ,attacks of the most terrible ,anguish1 accompanied and succeeded by ,sweatings on his ,breast1 and from his whole ,countenance4 ,he sweats sometimes the whole ,night2 his ,urine is reddish1 now frothy1 and at other times oily1 as it were4 ,sudden ,flushings1 hot as ,flames1 rise into his whole ,visage4 ,the greater ,number of the ,sick are commonly sensible of a most disagreeable ,taste in their ,mouth2 some of old strong ,cheese2 others of rotten ,eggs2 and others again of stinking ,meat1 and fall greatly away4 ,the ,thirst of some is unquenchable2 their ,mouths and ,lips are parched2 their ,voice weak and hoarse2 their ,eyes hollow1 with a kind of ,wildness in their ,looks4 ,they have a general ,disgust to all ,food2 and if they should ask for some particular ,nourishment without seeing it1 they reject it the ,moment it is brought them2 and their ,strength at length seems wholly exhausted4 ,besides these ,symptoms1 a little ,inflation1 or ,bloatedness1 as it were1 is sometimes observed on the ,breast1 towards the ,side affected2 with an almost insensible ,change of ,colour4 ,if the ,vomica be situated at the ,bottom of the affected ,lobe of the ,lungs1 and in its internal ,part1 that is1 nearly in the ,middle of the ,breast1 some ,puffiness or light ,swelling may be perceived in some ,bodies1 by gently pressing the ,pit of the ,stomach2 especially when the ,patient coughs4 ,in short1 according to the ,observations of a ,german ,physician1 if one strike the open ,hand on the ,breast1 covered only with a ,shirt1 it retains in the ,spot1 which is directly opposite to the ,vomica1 a flat heavy ,sound1 as if one struck a ,piece of ,flesh2 while in striking on the other ,side it gives a clear loud ,sound1 as from a ,drum4 ,i still doubt however1 whether this ,observation will generally hold true2 and it would be hazardous to affirm there is no ,abscess in a ,breast1 which does not return this heavy ,sound4 ,sec4 #fi4 ,when a ,vomica is formed1 as long as it is not emptied1 all the ,symptoms ,i have already enumerated increase1 and the ,vomica grows in ,size3 the whole ,side of the ,lung affected sometimes becomes a ,bag or ,sac of ,matter4 ,the sound ,side is compressed2 and the ,patient dies after dreadful ,anguish1 with the ,lung full of ,pus1 and without having ever brought up any4 ,to avoid such fatal ,consequences1 it is necessary to procure the ,rupture and ,discharge of this inward ,abscess1 as soon as we are certain of its ,existence3 ,and as it is safer it should break within the ,lobe affected1 from whence it may be discharged by hawking up2 than that it should burst and void itself into the ,cavity of the ,breast1 for ,reasons ,i shall give hereafter1 we must endeavour1 that this ,rupture may be effected within the internal ,substance of the ,lungs4 ,sec4 #gj4 ,the most effectual ,methods to procure this are1 #a4 ,to make the ,patient continually receive1 by his ,mouth1 the ,vapour of warm ,water4 #b4 ,when by this ,means that part of the ,sac or ,abscess is softened1 where we could wish the ,rupture of it to happen1 the ,patient is to swallow a large ,quantity of the most emollient ,liquid2 such as ,barley ,water1 ,almond ,milk1 light ,veal ,broth1 or ,milk and ,water4 ,by this ,means the ,stomach is kept always full3 so that the ,resistance to the ,lungs being considerable on that ,side1 the ,abscess and its ,contents will naturally be pressed towards the ,side of the ,wind-pipe1 as it will meet with less ,resistance there4 ,this fulness of the ,stomach will also incline the ,patient to cough1 which may concur to produce a good ,event4 ,hence1 #c1 we should endeavour to make the ,patient cough1 by making him smell to some ,vinegar1 or even snuff up a little2 or by injecting into his ,throat1 by the ,means of a small ,syringe or ,pipe1 such as ,children make out of short ,pieces of ,elder-,boughs1 a little ,water or ,vinegar4 #d4 ,he should be advised to bawl out aloud1 to read loud1 or to laugh heartily2 all which ,means contribute to burst open the ,abscess1 as well as those two following ones4 #e4 ,let him take every two ,hours a ,soup-,ladle of the ,potion ,no4 #h4 #f4 ,he should be put into a ,cart1 or some other ,carriage2 but not before he has drank plentifully of such ,liquors as ,i have just mentioned3 after which the ,shaking and ,jolting in the ,carriage have sometimes immediately procured that ,rupture1 or breaking of the ,bag or ,abscess1 we wished for4 ,sec4 #ga4 ,some ,years since ,i saw a ,country ,maid ,servant1 who was left in a languishing ,condition after an ,inflammation of the ,breast2 without any ,person's suspecting her ,ailment4 ,this ,woman being put into a ,cart1 that was sent for a ,load of ,hay2 one of the ,wheels run violently against a ,tree3 she swooned away1 and at the same ,time brought up a great ,quantity of digested ,matter4 ,she continued to bring up more2 during which ,i was informed of her ,case1 and of the ,accident1 which effectually cured her4 ,a ,swiss ,officer1 who served in ,piedmont1 had been in a languid ,state of ,health for some ,months2 and returned home to set himself down as easily as he could1 without conceiving any considerable ,hopes of ,recovery4 ,upon entering into his own ,country1 by the ,way of ,mount ,bernard2 and being obliged to go some ,paces on ,foot1 he fell down2 and remained in a ,swoon above a ,quarter of an ,hour3 during which ,time he threw up a large ,quantity of ,matter1 and found himself that very ,moment very greatly relieved4 ,i ordered him a proper ,diet1 and suitable ,medicines3 his ,health became perfectly established2 and the ,preservation of his ,life was principally owing to this lucky ,fall4 ,many ,persons afflicted with a ,vomica1 faint away the very ,instant it breaks4 ,some sharp ,vinegar should be directly held to their ,nose4 ,this small ,assistance is generally sufficient1 where the bursting of it is not attended with such ,appearances as shew it to be mortal1 in which ,case every ,application is insignificant4 ,sec4 #gb4 ,if the sick ,person was not extremely weak before the ,bursting of the ,abscess2 if the ,matter was white1 and well conditioned2 if the ,fever abates after it2 if the ,anguish1 ,oppression and ,sweats terminate2 if the ,cough is less violent2 if the ,patient is sensibly easier in his ,situation or ,posture2 if he recovers his ,sleep and ,appetite2 if his usual ,strength returns2 if the ,quantity he expectorates1 or brings up1 becomes daily and gradually less2 and if his ,urine is apparently better1 we may have ,room to hope1 that by the ,assistance of these ,remedies ,i shall immediately direct1 he may be radically1 compleatly cured4 ,sec4 #gc4 ,but if on the contrary2 when his ,strength is exhausted before the bursting of the ,abscess2 when the ,matter is too thin and transparent1 brown1 green1 yellow1 bloody and of an ,offensive ,smell2 if the ,pulse continues quick and weak2 if the ,patient's ,appetite1 ,strength and ,sleep do not improve1 there remains no hope of a ,cure1 and the best ,medicines are ineffectual3 ,nevertheless we ought to make some ,tryal of them4 ,sec4 #gd4 ,they consist of the following ,medicines and ,regulations4 #a4 ,give every four ,hours a little ,barley or ,rice ,cream4 #b4 ,if the ,matter brought up is thick and glewy1 so that it is very difficult to be loosened and discharged1 give every two ,hours a ,soup-ladle of the ,potion ,no4 #h2 and between the giving these two1 let the ,patient take every half ,hour a ,cup of the ,drink ,no4 #ac4 #c4 ,when the ,consistence of the ,matter is such1 that there is no ,occasion for these ,medicines to promote the ,discharge of it1 they must be omitted2 tho' the same ,sort and ,quantity of ,food are to be continued2 but with the ,addition of an equal ,quantity of ,milk2 or1 which would be still more beneficial1 instead of this ,mixture1 we should give an equal ,quantity of sweet ,milk1 taken from a good ,cow1 which1 in such a ,case1 may compose the whole ,nourishment of the ,patient4 #d4 ,he should take four ,times a ,day1 beginning early in the ,morning1 and at the ,distance of two ,hours1 a ,dose of the ,powder ,no4 #ad1 diluted in a little ,water1 or made into a ,bolus1 or ,morsel1 with a little ,syrup or ,honey4 ,his common ,drink should be ,almond ,emulsion1 commonly called ,almond ,milk1 or ,barley ,water1 or fresh ,water with a fourth part ,milk4 #e4 ,he should air and exercise every ,day on ,horseback1 or in a ,carriage1 according as his ,strength and his ,circumstances will allow him4 ,but of all ,sorts of ,exercise1 that upon a trotting ,horse is1 beyond all ,comparison1 the very best1 and the easiest to be procured by every ,body2 provided the ,disease be not too far advanced2 since in such a ,situation1 any ,exercise1 that was only a little violent1 might prove pernicious4 ,sec4 #ge4 ,the ,multitude1 who are generally illiterate1 seldom consider any thing as a ,remedy1 except they swallow it4 ,they have but little ,confidence in ,regimen1 or any ,assistance in the ,way of ,diet1 and consider ,riding on ,horseback as wholly useless to them4 ,this is a dangerous ,mistake1 of which ,i should be glad to undeceive them3 since this ,assistance1 which appears so insignificant to them1 is probably the most effectual of any3 it is that in ,fact1 without which they can scarcely expect a ,cure1 in the highest ,degrees of this ,disease3 it is that1 which perhaps alone may recover them1 provided they take no improper ,food4 ,in brief it is considered1 and with ,reason1 as the real ,specific for this ,disease4 ,sec4 #gf4 ,the ,influence of the ,air is of more ,importance in this ,disorder1 than in any others2 for which ,reason great ,care should be taken to procure the best1 in the ,patient's ,chamber4 ,for this ,purpose it should often be ventilated1 or have an ,admission of fresh ,air1 and be sweetened from ,time to ,time1 tho' very lightly1 with a little good ,vinegar2 and in the ,season it should be plentifully supplied with agreeable ,herbs1 ,flowers and ,fruits4 ,should the ,sick be unfortunately situated1 and confined in an unwholsome ,air1 there can be but little ,prospect of curing him1 without altering it4 ,sec4 #gg4 ,out of many ,persons affected with these ,disorders1 some have been cured by taking nothing whatsoever but ,butter-milk2 others by ,melons and ,cucumbers only2 and others again by ,summer ,fruits of every ,sort4 ,nevertheless1 as such ,cases are singular1 and have been but few1 ,i advise the ,patient to observe the ,method ,i have directed here1 as the surest4 ,sec4 #gh4 ,it is sufficient if he have a ,stool once in two1 or even in three1 ,days4 ,hence1 there is no ,reason for him1 in this ,case1 to accustom himself to ,glysters3 they might excite a ,looseness1 which may be very dangerous4 ,sec4 #gi4 ,when the ,discharge of the ,matter from the ,breast diminishes1 and the ,patient is perceivably mended in every ,respect1 it is a ,proof that the ,wound in the ,abscess is deterged1 or clean1 and that it is disposed to heal up gradually4 ,if the ,suppuration1 or ,discharge1 continues in great ,quantity2 if it seems but of an indifferent ,consistence2 if the ,fever returns every ,evening1 it may be apprehended1 that the ,wound1 instead of healing1 may degenerate into an ,ulcer1 which must prove a most embarrassing ,consequence4 ,under such a ,circumstance1 the ,patient would fall into a confirmed ,hectic1 and die after some ,months ,sickness4 ,sec4 #hj4 ,i am not acquainted with any better ,remedy1 in such a dangerous ,case1 than a ,perseverance in these already directed1 and especially in moderate ,exercise on ,horseback4 ,in some of them indeed ,recourse may be had to the sweet ,vapours of some vulnerary ,herbs in hot ,water1 with a little ,oil of ,turpentine1 as directed ,no4 #ae4 ,i have seen them succeed2 but the safest ,way is to consult a ,physician1 who may examine and consider1 if there is not some particular ,circumstance combined with the ,disease1 that proves an ,obstacle to the ,cure of it4 ,if the ,cough prevents the ,patient from ,sleeping1 he may take in the ,evening two or three ,table ,spoonfuls of the ,prescription ,no4 #af1 in a ,glass of ,almond ,milk or ,barley ,water4 ,sec4 #ha4 ,the very same ,causes which suddenly suppress the ,expectoration1 in an ,inflammation of the ,breast1 may also check the ,expectoration from a ,vomica already begun3 in which ,circumstance the ,patient is speedily afflicted with an ,oppression and ,anguish1 a ,fever and evident ,feebleness4 ,we should immediately endeavour to remove this ,stoppage1 by the ,vapour of hot ,water2 by giving a ,spoonful of the ,mixture ,no4 #c every ,hour2 by a large ,quantity of the ,ptisan ,no4 #ab1 and by a proper ,degree of ,motion or ,exercise4 ,as soon as ever the ,expectoration returns1 the ,fever and the other ,symptoms disappear4 ,i have seen this ,suppression in strong ,habits quickly followed with an ,inflammation about the ,seat of the ,vomica1 which has obliged me to bleed1 after which the ,expectoration immediately returned4 ,sec4 #hb4 ,it happens sometimes1 that the ,vomica is entirely cleansed2 the ,expectoration is entirely finished1 or drained off1 the ,patient seems well1 and thinks himself compleatly cured3 but soon after1 the ,uneasiness1 ,oppression1 ,cough and ,fever are renewed1 because the ,membrane or ,bag of the ,vomica fills again3 again it empties itself1 the ,patient expectorates for some ,days1 and seems to recover4 ,after some ,time however1 the same ,scene is repeated2 and this ,vicissitude1 or ,succession1 of moderate and of bad ,health1 often continues for some ,months and even some ,years4 ,this happens when the ,vomica is emptied1 and is gradually deterged2 so that its ,membranes1 or ,sides touch or approach each other2 but without cicatrizing or healing firmly2 and then there drops or leaks in very gradually fresh ,matter4 ,for a few ,days this seems no ways to incommode the ,patient2 but as soon as a certain ,quantity is accumulated1 he is visited again with some of the former ,symptoms1 'till another ,evacuation ensues4 ,people thus circumstanced1 in this ,disease1 sometimes appear to enjoy a tolerable ,share of ,health4 ,it may be considered as a kind of internal ,issue1 which empties and cleanses itself from ,time to ,time2 pretty frequently in some ,constitutions1 more slowly in others2 and under which some may attain a good middling ,age4 ,when it arrives however at a very considerable ,duration1 it proves incurable4 ,in its earliest ,state1 it gives way sometimes to a ,milk-diet1 to riding on ,horseback2 and to the ,medicine ,no4 #ad4 ,sec4 #hc4 ,some may be surprized1 that in treating of an ,abscess of the ,lungs1 and of the ,hectic1 which is a ,consequence of it1 ,i say nothing of those ,remedies1 commonly termed ,balsamics1 and so frequently employed in them1 for ,instance1 ,turpentines1 ,balsam of ,peru1 of ,mecca1 ,frankincense1 ,mastich1 ,myrrh1 ,storax and ,balsam of ,sulphur4 ,i shall however say briefly here 7because it is equally my ,design to destroy the ,prejudice of the ,people1 in favour of improper ,medicines1 and to establish the ,reputation of good ones7 that ,i never in such ,cases made use of these ,medicines2 because ,i am convinced1 that their ,operation is generally hurtful in such ,cases2 because ,i see them daily productive of real ,mischief2 that they protract the ,cure1 and often change a slight ,disorder into an incurable ,disease4 ,they are incapable of perfect ,digestion1 they obstruct the finest ,vessels of the ,lungs1 whose ,obstructions we should endeavour to remove2 and evidently occasion1 except their ,dose be extremely small1 ,heat and ,oppression4 ,i have very often seen to a ,demonstration1 that ,pills compounded of ,myrrh1 ,turpentine and ,balsam of ,peru1 have1 an ,hour after they were swallowed1 occasioned a ,tumult and ,agitation in the ,pulse1 high ,flushings1 ,thirst and ,oppression4 ,in short it is demonstrable to every unprejudiced ,person1 that these ,remedies1 as they have been called1 are truly prejudicial in this ,case2 and ,i heartily wish ,people may be disabused with ,respect to them1 and that they may lose that ,reputation so unhappily ascribed to them4 ,i know that many ,persons1 very capable in other ,respects1 daily make use of them in these ,distempers3 such however cannot fail of disusing them1 as soon as they shall have observed their ,effects1 abstracted from the ,virtues of the other ,medicines to which they add them1 and which mitigate the ,danger of them4 ,i saw a ,patient1 whom a foreign ,surgeon1 who lived at ,orbe1 attempted to cure of a ,hectic with melted ,bacon1 which aggravated the ,disease4 ,this ,advice seemed1 and certainly was1 absurd2 nevertheless the ,balsamics ordered in such ,cases are probably not more digestible than fat ,bacon4 ,the ,powder ,no4 #ad possesses whatever these ,balsamics pretend to3 it is attended with none of the ,inconveniencies they produce2 and has all the good ,qualities ascribed to them4 ,notwithstanding which1 it must not be given while the ,inflammation exists2 nor when it may revive again2 and no other ,aliment should be mixed with the ,milk4 ,the famous ,medicine called the ,antihectic1 7,antihecticum ,poterii7 has not1 any more than these ,balsamics1 the ,virtues ascribed to it in such ,cases4 ,i very often give it in some obstinate ,coughs to ,infants with their ,milk1 and then it is very useful3 but ,i have seldom seen it attended with considerable ,effects in grown ,persons2 and in the present ,cases ,i should be fearful of its doing ,mischief4 ,sec4 #hd4 ,if the ,vomica1 instead of breaking within the ,substance of the ,lungs affected1 should break without it1 the ,pus must be received into the ,cavity of the ,breast4 ,we know when that has happened1 by the ,sensation or ,feeling of the ,patient2 who perceives an uncommon1 a singular kind of ,movement1 pretty generally accompanied with a ,fainting4 ,the ,oppression and ,anguish cease at once2 the ,fever abates2 the ,cough however commonly continues1 tho' with less ,violence1 and without any ,expectoration4 ,but this seeming ,amendment is of a short ,duration1 since from the daily ,augmentation of the ,matter1 and its becoming more acrid or sharp1 the ,lungs become oppressed1 irritated and eroded4 ,the ,difficulty of ,breathing1 ,heat1 ,thirst1 ,wakefulness1 ,distaste1 and ,deafness1 return1 with many other ,symptoms unnecessary to be enumerated1 and especially with frequent ,sinkings and ,weakness4 ,the ,patient should be confined to his ,regimen1 to retard the ,increase of the ,disease as much as possible2 notwithstanding no other effectual ,remedy remains1 except that of opening the ,breast between two of the ,ribs1 to discharge the ,matter1 and to stop the ,disorder it occasions4 ,this is called the ,operation for the ,empyema4 ,i shall not describe it here1 as it should not be undertaken but by ,persons of ,capacity and ,experience1 for whom this ,treatise was not intended4 ,i would only observe1 it is less painful than terrifying2 and that if it is delayed too long1 it proves useless1 and the ,patient dies miserably4 ,sec4 #he4 ,we may daily see external ,inflammations turn gangrenous1 or mortify4 ,the same ,thing occurs in the ,lungs1 when the ,fever is excessive1 the ,inflammation either in its own ,nature1 extremely violent1 or raised to such a ,height by hot ,medicines4 ,intolerable ,anguish1 extreme ,weakness1 frequent ,faintings1 ,coldness of the ,extremities1 a livid and foetid thin ,humour brought up instead of concocted ,spitting1 and sometimes blackish ,stripes on the ,breast1 sufficiently distinguish this miserable ,state4 ,i have smelt in one ,case of this ,kind1 where the ,patient had been attacked with this ,disease 7after a forced ,march on ,foot1 having taken some ,wine with ,spices to force a ,sweat7 his ,breath so horribly stinking1 that his ,wife had many ,sinkings from attending him4 ,when ,i saw him1 ,i could discern neither ,pulse nor ,intellect1 and ordered him nothing4 ,he died an ,hour afterwards1 about the ,beginning of the third ,hour4 ,sec4 #hf4 ,an ,inflammation may also become hard1 when it forms what we call a ,scirrhus1 which is a very hard ,tumour1 indolent1 or unpainful4 ,this is known to occur1 when the disease has not terminated in any of those ,manners ,i have represented2 and where1 tho' the ,fever and the other ,symptoms disappear1 the ,respiration1 or ,breathing1 remains always a little oppressed2 the ,patient still retains a troublesome ,sensation in one ,side of his ,breast2 and has from ,time to ,time a dry ,cough1 which increases after ,exercise1 and after eating4 ,this ,malady is but seldom cured2 though some ,persons attacked with it last many ,years1 without any other considerable ,complaint4 ,they should avoid all ,occasions of over-heating themselves2 which might readily produce a new ,inflammation about this ,tumour1 the ,consequences of which would be highly dangerous4 ,sec4 #hg4 ,the best ,remedies against this ,disorder1 and from which ,i have seen some good ,effects1 are the medicated ,whey ,no4 #ag1 and the ,pills ,no4 #ah4 ,the ,patient may take twenty ,pills1 and a ,pint and a half of the ,whey every ,morning for a long ,continuance2 and receive inwardly1 now and then1 the ,vapour of hot ,water4 ,sec4 #hh4 ,each ,lung1 in a perfect ,state of ,health1 touches the ,pleura1 the ,membrane1 that lines the ,inside of the ,breast2 though it is not connected to it4 ,but it often happens1 after an ,inflammation of the ,breast1 after the ,pleurisy1 and in some other ,cases1 that these two ,parts adhere closely to each other1 and are never afterwards separated4 ,however this is scarcely to be considered as a ,disease2 and remains commonly unknown1 as the ,health is not impaired by it1 and nothing is ever prescribed to remove it4 ,nevertheless ,i have seen a few ,cases1 in which this ,adhesion was manifestly prejudicial4 ,chapter ,v4 ,of the ,pleurisy4 ,sect4 #hi4 ,the ,pleurisy1 which is chiefly known by these four ,symptoms1 a strong ,fever1 a ,difficulty of ,breathing1 a ,cough1 and an acute ,pain about the ,breast2 the ,pleurisy1 ,i say1 is not a different ,malady from the ,peripneumony1 or ,inflammation of the ,breast1 the ,subject of the preceding ,chapter2 so that ,i have very little to say of it1 particularly1 or apart4 ,sec4 #ij4 ,the ,cause of this ,disease then is exactly the same with that of the former1 that is1 an ,inflammation of the ,lungs2 but an ,inflammation1 that seems rather a little more external4 ,the only considerable ,difference in the ,symptoms is1 that the ,pleurisy is accompanied with a most acute ,pain under the ,ribs1 and which is commonly termed a ,stitch4 ,this ,pain is felt indifferently over every ,part of the ,breast2 though more commonly about the ,sides1 under the more fleshy ,parts of the ,breast1 and oftenest on the right ,side4 ,the ,pain is greatly increased whenever the ,patient coughs or draws in the ,air in breathing2 and hence a ,fear of increasing it1 by making some ,patients forbear to cough or respire1 as much as they possibly can2 and that aggravates the ,disease1 by stopping the ,course of the ,blood in the ,lungs1 which are soon overcharged with it4 ,hence the ,inflammation of this ,bowel becomes general2 the ,blood mounts up to the ,head2 the ,countenance looks deeply red1 or as it were livid2 the ,patient becomes nearly suffocated1 and falls into the ,state described ,sec4 #dg4 ,sometimes the ,pain is so extremely violent1 that if the ,cough is very urgent at the same ,time1 and the ,sick cannot suppress or restrain it1 they are seized with ,convulsions1 of which ,i have seen many ,instances1 but these occur almost always to ,women2 though they are much less subject than ,men to this ,disease1 and indeed to all inflammatory ones4 ,it may be proper however to observe here1 that if ,women should be attacked with it1 during their monthly ,discharges1 that ,circumstance should not prevent the repeated and necessary ,bleedings1 nor occasion any ,alteration in the ,treatment of the ,disease4 ,and hence it appears1 that the ,pleurisy is really an ,inflammation of the ,lungs1 accompanied with acute ,pain4 ,sec4 #ia4 ,i am sensible that sometimes an ,inflammation of the ,lungs is communicated also to that ,membrane1 which lines the ,inside of the ,breast2 and which is called the ,pleura2 and from thence to the ,muscles1 the fleshy ,parts1 over and between the ,ribs4 ,this however is not very frequently the ,case4 ,sec4 #ib4 ,spring is commonly the ,season most productive of ,pleurisies3 in general there are few in ,summer3 notwithstanding that in the ,year #agfb1 there were a great many during the hottest ,season1 which then was excessively so4 ,the ,disease usually begins with a violent ,shivering1 succeeded by considerable ,heat1 with a ,cough1 an ,oppression1 and sometimes with a sensible ,straitning1 or ,contraction1 as it were1 all over the ,breast2 and also with a ,head-ach1 a ,redness of the ,cheeks1 and with ,reachings to vomit4 ,the ,stitch does not always happen at the very first ,onset2 often not 'till after several ,hours from the first ,complaint2 sometimes not before the second1 or even the third ,day4 ,sometimes the ,patient feels two ,stitches1 in different ,parts of the ,side2 though it seldom happens that they are equally sharp1 and the lightest soon ceases4 ,sometimes also the ,stitch shifts its ,place1 which promises well1 if the ,part first attacked by it continues perfectly free from ,pain3 but it has a bad ,appearance1 if1 while the first is present1 another also supervenes1 and both continue4 ,the ,pulse is usually very hard in this ,distemper2 but in the dreadful ,cases described ,sec4 #dg and #ij1 it becomes soft and small4 ,there often occur at1 or very quickly after1 the ,invasion1 such an ,expectoration1 or hawking up1 as happens in an ,inflammation of the ,breast2 at other ,times there is not the least ,appearance of it1 whence such are named dry ,pleurisies1 which happen pretty often4 ,sometimes the ,sick cough but little1 or not at all4 ,they often lie more at ,ease upon the ,side affected1 than on the sound one4 ,the ,progress of this ,disease advances exactly like that described in the preceding ,chapter3 for how can they differ considerably8 and the ,treatment of both is the same4 ,large ,haemorrhages1 or ,bleedings from the ,nose1 frequently happen1 to the great ,relief of the ,patient2 but sometimes such ,discharges consist of a kind of corrupted ,blood1 when the ,patient is very ill1 and these portend ,death4 ,sec4 #ic4 ,this ,distemper is often produced by drinking cold ,water1 while a ,person is hot2 from which ,cause it is sometimes so violent1 as to kill the ,patient in three ,hours4 ,a young ,man was found dead at the ,side of the ,spring1 from which he had quenched his ,thirst3 neither indeed is it uncommon for ,pleurisies to prove mortal within three ,days4 ,sometimes the ,stitch disappears1 whence the ,patient complains less2 but at the same ,time his ,countenance changes2 he grows pale and sad2 his ,eyes look dull and heavy1 and his ,pulse grows feeble4 ,this signifies a ,translation of the ,disease to the ,brain1 a ,case which is almost constantly fatal4 ,there is no ,disease in which the critical ,symptoms are more violent1 and more strongly marked1 than in this4 ,it is proper this should be known1 as it may prevent or lessen our excessive ,terror4 ,a perfect ,cure supervenes sometimes1 at the very ,moment when ,death was expected4 ,sec4 #id4 ,this ,malady is one of the most common and the most destroying kind1 as well from its own violent ,nature1 as through the pernicious ,treatment of it in ,country ,places4 ,that ,prejudice1 which insists on curing all ,diseases by ,sweating1 entirely regulates their ,conduct in treating a ,pleurisy2 and as soon as a ,person is afflicted with a ,stitch1 all the hot ,medicines are immediately set to ,work4 ,this mortal ,error destroys more ,people than ,gunpowder2 and it is by so much the more hurtful1 as the ,distemper is of the most violent kind2 and because1 as there is commonly not a ,moment to be lost1 the whole depends on the ,method immediately recurred to4 ,sec4 #ie4 ,the proper ,manner of treating this ,disease1 is exactly the same in all ,respects1 with that of the ,peripneumony2 because1 ,i again affirm1 it is the very same ,disease4 ,hence the ,bleedings1 the softening and diluting ,drinks1 the ,steams1 the ,glysters1 the ,potion ,no4 #h1 and the emollient ,poultices are the real ,remedies4 ,these last perhaps are still more effectual in the ,pleurisy2 and therefore they should be continually applied over the very ,stitch4 ,the first ,bleeding1 especially if there has been a considerable ,discharge1 almost constantly abates the ,stitch1 and often entirely removes it3 though it more commonly returns1 after an ,intermission of some ,hours1 either in the same ,spot1 or sometimes in another4 ,this shifting of it is rather favourable1 especially if the ,pain1 that was first felt under the ,breast1 shifts into the ,shoulders1 to the ,back1 the ,shoulder-blade1 or the ,nape of the ,neck4 ,when the ,stitch is not at all abated1 or only a little2 or if1 after having abated1 it returns as violently as at first1 and especially if it returns in the same ,spot1 and the ,height of the other ,symptoms continue1 ,bleeding must be repeated4 ,but if a sensible ,abatement of the ,stitch continues2 and if1 though it returns1 it should be in a smaller ,degree1 and by ,intervals1 or in these ,places ,i have mentioned above2 if the ,quickness1 or the ,hardness of the ,pulse1 and all the other ,symptoms are sensibly diminished1 this repeated ,bleeding may sometimes be omitted4 ,nevertheless1 in a very strong ,subject1 it seems rather prudent not to omit it1 since in such ,circumstances it can do no ,mischief2 and a considerable ,hazard may sometimes be incurred by the ,omission4 ,in very high and dangerous ,pleurisies a frequent ,repetition of bleeding is necessary2 except some ,impediment to it should arise from the particular ,constitution of the ,patient1 or from his ,age1 or some other ,circumstances4 ,if1 from the ,beginning of the ,disease1 the ,pulse is but a little quicker and harder than in a healthy ,state2 if it is not manifestly strong2 if the ,head-ach and the ,stitch are so moderate as to prove supportable2 if the ,cough is not too violent2 if there is no sensible ,oppression or ,straitness1 and the ,patient expectorate1 or cough up1 ,bleeding may be omitted4 ,with ,respect to the administering of other ,remedies1 the same ,directions are to be exactly followed1 which have been already given in the preceding ,chapter1 to which the ,reader is referred from ,sec4 #ec to #ff4 ,sec4 #if4 ,when the ,disease is not very acute and pressing1 ,i have often cured it in a very few ,days by a single ,bleeding1 and a large ,quantity of a ,tea or ,infusion of ,elder-flowers1 sweetened with ,honey4 ,it is in some ,cases of this kind1 that we often find the ,water ,faltranc succeed1 with the ,addition of some ,honey1 and even of ,oil3 though the ,drink ,i have just directed is considerably preferable4 ,that ,drink which is compounded of equal ,quantities of ,wine and ,water1 with the ,addition of much ,venice ,treacle1 annually destroys a great ,number of ,people in the ,country4 ,sec4 #ig4 ,in those dry ,pleurisies1 in which the ,stitch1 the ,fever1 and the ,head-ach are strong and violent2 and where the ,pulse is very hard and very full1 with an excessive ,dryness of the ,skin and of the ,tongue1 ,bleeding should be frequently repeated1 and at small ,intervals from each other4 ,this ,method frequently cures the ,disease effectually1 without using any other ,evacuation4 ,sec4 #ih4 ,the ,pleurisy terminates1 like any other inward ,inflammation1 either by some ,evacuation2 by an ,abscess2 in a ,mortification2 or in a ,scirrhosity or hard ,tumour2 and it often leaves ,adhesions in the ,breast4 ,the ,gangrene or ,mortification sometimes appears on the third ,day1 without having been preceded by very vehement ,pains4 ,in such ,cases the dead ,body often looks very black1 especially in the ,parts near the ,seat of the ,disease3 and in such the more superstitious ascribe it to some supernatural ,cause2 or draw some unhappy ,presage from it1 with ,respect to those who are yet unattacked by it4 ,this ,appearance however is purely a natural ,consequence1 quite simple1 and cannot be otherwise2 and the hot ,regimen and ,medicines are the most prevailing ,causes of it4 ,i have seen it thus circumstanced in a ,man in the ,flower of his ,age1 who had taken ,venice ,treacle in ,cherry ,water1 and the ,ingredients of ,faltranc infused in ,wine4 ,sec4 #ii4 ,vomicas are sometimes the ,consequences of ,pleurisies2 but their particular ,situation disposes them more to break #bb outwardly2 which is the most frequent ,cause of an ,empyema ,sec4 #hd4 ,to prevent this1 it is highly proper to apply1 at the first ,invasion of the ,disease1 to the ,spot where the ,pain chiefly rages1 a small ,plaister1 which may exactly fit it2 since if the ,pleurisy should terminate in an ,abscess or ,imposthume1 the purulent ,matter will be determined to that ,side4 #bb ,that is1 into the ,cavity of the ,breast1 rather than within the ,substance of the ,lungs4 ,as soon then as it is foreseen that an ,abscess is forming 7see ,sec4 #fh7 we should erode1 by a light ,caustic1 the ,place where it is expected2 and as soon as it is removed1 ,care should be taken to promote ,suppuration there4 ,by this ,means we may entertain a reasonable ,hope1 that the ,mass of ,matter will incline its ,course to that ,spot1 where it will meet with the least ,resistance1 and be discharged from thence4 ,for this ,heap of ,matter is often accumulated between the ,pleura1 and the ,parts which adhere to it4 ,this is the ,advice of a very #bc great ,physician2 but ,i must inform the ,reader1 there are many ,cases1 in which it can be of no ,service2 neither ought it to be attempted1 but by ,persons of undoubted ,abilities4 #bc ,this is1 undoubtedly1 ,baron ,van ,swieten1 with whom he had premised1 he agreed considerably1 in all the ,diseases they had both treated of4 ,k4 ,with ,regard to the ,scirrhosity1 or ,hardness1 and to the ,circumstances of ,adhesions1 ,i can add nothing to what ,i have said in ,sec4 #hf and #hg4 ,sec4 #ajj4 ,it has been observed that some ,persons1 who have been once attacked by this ,disease1 are often liable to ,relapses of it1 especially such as drink hard4 ,i knew one ,man1 who reckoned up his ,pleurisies by ,dozens4 ,a few ,bleedings1 at certain proper ,intervals1 might prevent these frequent ,returns of it2 which1 joined to their excessive ,drinking1 make them languid and stupid1 in the very ,flower of their ,age4 ,they generally fall into some ,species of an ,asthma1 and from that into a ,dropsy1 which proves the melancholy1 though not an improper1 ,conclusion of their ,lives4 ,such as can confine themselves to some proper ,precautions1 may also prevent these frequent ,returns of this ,disease1 even without bleeding2 by a temperate ,regimen2 by abstaining from ,time to ,time1 from eating ,flesh and drinking ,wine2 at which ,times they should drink ,whey1 or some of those ,diet-,drinks ,no4 #a1 #b1 #d2 and by bathing their ,legs sometimes in warm ,water2 especially in those ,seasons1 when this ,disease is the most likely to return4 ,sec4 #aja4 ,two ,medicines greatly esteemed in this ,disease among the ,peasantry1 and even extolled by some ,physicians1 are the ,blood of a wild ,he ,goat1 and the #bd ,soot in an ,egg4 ,i do not contest the ,cure or ,recovery of many ,persons1 who have taken these ,remedies2 notwithstanding it is not less true1 that both of them1 as well as the ,egg in which the ,soot is taken1 are dangerous3 ,for which ,reason it is prudent1 at least1 never to make use of them2 as there is great ,probability1 they may do a little ,mischief2 and a ,certainty that they can do no ,good4 ,the ,genipi1 or #be ,wormwood of the ,alps1 has also acquired great ,reputation in this ,disease1 and occasioned many ,disputes between some very zealous ,ecclesiastics1 and a justly celebrated ,physician4 ,it seems not difficult however to ascertain the proper ,use of it4 ,this ,plant is a powerful ,bitter2 it heats and excites ,sweat3 it seems clear1 that1 from such ,consequences1 it should never be employed in a ,pleurisy1 while the ,vessels are full1 the ,pulse hard1 the ,fever high1 and the ,blood inflamed4 ,in all such ,circumstances it must aggravate the ,disease2 but towards the ,conclusion of it1 when the ,vessels are considerably emptied1 the ,blood is diluted1 and the ,fever abated1 it may then be recurred to2 but with a constant ,recollection that it is hot1 and not to be employed without ,reflection and ,prudence4 #bf #bd ,this1 with great ,probability1 means that small black ,substance often visible in a rotten ,egg1 which is undoubtedly of a violent1 or even poisonous ,quality4 ,dr4 ,tissot terms it expressly--la suie dans un ,oeuf4 ,k4 #be ,dr4 ,lewis1 who has not taken ,notice of this ,species of ,wormwood in his ,improvement of ,quincy's ,dispensatory1 has mentioned it in his late ,materia ,medica4 ,k4 #bf ,this being a proper ,place for directing the ,seneka ,rattle ,snake ,root1 ,i shall observe1 that the best ,way of exhibiting it is in ,decoction1 by gradually simmering and boiling two ,ounces of it in gross ,powder1 in two ,pints and a half of ,water1 to a ,pint and a quarter2 and then giving three ,spoonfuls of it to a grown ,person1 every six ,hours4 ,if the ,stitch should continue1 or return1 after taking it1 ,bleeding1 which should be premised to it1 must be occasionally repeated2 though it seldom proves necessary1 after a few ,doses of it4 ,it greatly promotes ,expectoration1 keeps the ,body gently open1 and sometimes operates by ,urine and by ,sweat2 very seldom proving at all emetic in ,decoction4 ,the ,regimen of ,drinks directed here in ,pleurisies are to be given as usual4 ,dr4 ,tennant1 the ,introducer of this valuable ,medicine1 confided solely in it1 in ,bastard ,peripneumonies1 without ,bleeding1 ,blistering1 or any other ,medicines4 ,k4 ,chapter ,,vi4 ,of the ,diseases of the ,throat4 ,sect4 #ajb4 ,the ,throat is subject to many ,diseases3 ,one of the most frequent and the most dangerous1 is that ,inflammation of it1 commonly termed a ,quinsey4 ,this in ,effect is a ,distemper of the same ,nature with an ,inflammation of the ,breast2 but as it occurs in a different ,part1 the ,symptoms1 of ,course1 are very different4 ,they also vary1 not a very little1 according to the different ,parts of the ,throat which are inflamed4 ,sec4 #ajc4 ,the general ,symptoms of an ,inflammation of the ,throat are1 the ,shivering1 the subsequent ,heat1 the ,fever1 the ,head-ach1 red high-coloured ,urine1 a considerable ,difficulty1 and sometimes even an ,impossibility1 of swallowing any thing whatever4 ,but if the nearer ,parts to the ,glottis1 that is1 of the ,entrance into the ,windpipe1 or ,conduit through which we breathe1 are attacked1 ,breathing becomes excessively difficult2 the ,patient is sensible of extreme ,anguish1 and great ,approaches to ,suffocation2 the ,disease is then extended to the ,glottis1 to the ,body of the ,wind-pipe1 and even to the ,substance of the ,lungs1 whence it becomes speedily fatal4 ,the ,inflammation of the other ,parts is attended with less ,danger2 and this ,danger becomes still less1 as the ,disease is more extended to the outward and superficial ,parts4 ,when the ,inflammation is general1 and seizes all the internal ,parts of the ,throat1 and particularly the ,tonsils or ,almonds1 as they are called1 the ,uvula1 or ,process of the ,palate1 and the ,basis1 or remotest deepest ,part of the ,tongue1 it is one of the most dangerous and dreadful ,maladies4 ,the ,face is then swelled up and inflamed2 the whole ,inside of the ,throat is in the same ,condition2 the ,patient can get nothing down2 he breathes with a ,pain and ,anguish1 which concur1 with a ,stuffing or ,obstruction in his ,brains1 to throw him into a kind of furious ,delirium1 or ,raving4 ,his ,tongue is bloated up1 and is extended out of his ,mouth2 his ,nostrils are dilated1 as tho' it were to assist him in his ,breathing2 the whole ,neck1 even to the ,beginning of the ,breast1 is excessively tumified or swelled up2 the ,pulse is very quick1 very weak1 and often intermits2 the miserable ,patient is deprived of all his ,strength1 and commonly dies the second or third ,day4 ,very fortunately this ,kind1 or ,degree of it1 which ,i have often seen in ,languedoc1 happens very rarely in ,swisserland1 where the ,disease is less violent2 and where ,i have only seen ,people die of it1 in ,consequence of its being perniciously treated2 or by ,reason of some accidental ,circumstances1 which were foreign to the ,disease itself4 ,of the ,multitude of ,patients ,i have attended in this ,disorder1 ,i have known but one to fail under it1 whose ,case ,i shall mention towards the ,close of this ,chapter4 ,sec4 #ajd4 ,sometimes the ,disease shifts from the internal to the external ,parts3 the ,skin of the ,neck and ,breast grows very red1 and becomes painful1 but the ,patient finds himself better4 ,at other ,times the ,disorder quits the ,throat2 but is transferred to the ,brain1 or upon the ,lungs4 ,both these ,translations of it are mortal1 when the best ,advice and ,assistance cannot be immediately procured2 and it must be acknowledged1 that even the best are often ineffectual4 ,sec4 #aje4 ,the most usual kind of this ,disease is that which affects only the ,tonsils 7the ,almonds7 and the ,palate2 or rather its ,process1 commonly called the ,palate4 ,it generally first invades one of the ,tonsils1 which becomes enlarged1 red and painful1 and does not allow the afflicted to swallow1 but with great ,pain4 ,sometimes the ,disorder is confined to one ,side2 but most commonly it is extended to the ,uvula1 7the ,palate7 from whence it is extended to the other ,tonsil4 ,if it be of a mild kind1 the ,tonsil first affected is generally better1 when the second is attacked4 ,whenever they are both affected at once1 the ,pain and the ,anguish of the ,patient are very considerable2 he cannot swallow1 but with great ,difficulty and ,complaint2 and the ,torment of this is so vehement1 that ,i have seen ,women affected with ,convulsions1 as often as they endeavoured to swallow their ,spittle1 or any other ,liquid4 ,they continue1 even for several ,hours sometimes1 unable to take any thing whatever2 all the upper inward ,part of the ,mouth1 the ,bottom of the ,palate1 and the descending ,part of the ,tongue become lightly red1 or inflamed4 ,a considerable ,proportion of ,persons under this ,disease swallow ,liquids more difficultly than ,solids2 by ,reason that ,liquids require a greater ,action of some ,part of the ,muscles1 in order to their being properly directed into their ,conduit or ,chanel4 ,the ,deglutition 7the ,swallowing7 of the ,spittle is attended with still more ,uneasiness than that of other ,liquids1 because it is a little more thick and viscid1 and flows down with less ,ease4 ,this ,difficulty of swallowing1 joined to the ,quantity thence accumulated1 produces that almost continual hawking up1 which oppresses some ,patients so much the more1 as the ,inside of their ,cheeks1 their whole ,tongue1 and their ,lips are often galled1 and even flead as it were4 ,this also prevents their ,sleeping1 which however seems no considerable ,evil2 ,sleep being sometimes but of little ,service in ,diseases attended with a ,fever2 and ,i have often seen those1 who thought their ,throats almost entirely well in the ,evening1 and yet found them very bad after some ,hours ,sleep4 ,the ,fever1 in this ,species of the ,disease1 is sometimes1 very high2 and the ,shivering often endures for many ,hours4 ,it is succeeded by considerable ,heat1 and a violent ,head-ach1 which yet is sometimes attended with a ,drowsiness4 ,the ,fever is commonly pretty high in the ,evening1 though sometimes but inconsiderable1 and by the ,morning perhaps there is none at all4 ,a light ,invasion of this ,disease of the ,throat often precedes the ,shivering2 though most commonly it does not become manifest 'till after it1 and at the same ,time when the ,heat comes on4 ,the ,neck is sometimes a little inflated1 or puffed up2 and many of the ,sick complain of a pretty smart ,pain in the ,ear of that ,side1 which is most affected4 ,i have but very seldom observed that they had it in both4 ,sec4 #ajf4 ,the ,inflammation either disappears by ,degrees1 or an ,abscess is formed in the ,part which was chiefly affected4 ,it has never happened1 at least within my ,knowledge1 that this ,sort of the ,disease1 prudently treated1 has ever terminated either in a ,mortification1 or a ,scirrhus3 but ,i have been a ,witness to either of these supervening1 when ,sweating was extorted in the ,beginning of it1 by hot ,medicines4 ,it is also very rare to meet with those highly dangerous ,translations of this ,disease upon the ,lungs1 such as are described in that ,species of it from ,sec4 #ajc1 #ajd4 ,it is true indeed it does not occur more frequently1 even in that ,species1 whenever the ,disease is thrown out upon the more external ,parts4 ,sec4 #ajg4 ,the ,treatment of the ,quinsey1 as well as of all other inflammatory ,diseases1 is the same with that of an ,inflammation of the ,breast4 ,the ,sick is immediately to be put upon a ,regimen2 and in that ,sort described ,sec4 #ajc1 ,bleeding must be repeated four or five ,times within a few ,hours2 and sometimes there is a ,necessity to recur still oftner to it4 ,when it assaults the ,patient in the most vehement ,degree1 all ,medicines1 all ,means1 are very generally ineffectual2 they should be tried however4 ,we should give as much as can be taken of the ,drinks ,no4 #b and #d4 ,but as the ,quantity they are able to swallow is often very inconsiderable2 the ,glyster ,no4 #e should be repeated every three ,hours2 and their ,legs should be put into a ,bath of warm ,water1 thrice a ,day4 ,sec4 #ajh4 ,cupping ,glasses1 with ,scarification1 applied about the ,neck1 after bleeding twice or thrice1 have often been experienced to be highly useful4 ,in the most desperate ,cases1 when the ,neck is excessively swelled1 one or two deep ,incisions made with a ,razor1 on this external ,tumour1 have sometimes saved a ,patient's ,life4 ,sec4 #aji4 ,in that kind1 and those ,circumstances1 of this ,disease described ,sec4 #aje we must have very frequent ,recourse to ,bleeding2 and it should never be omitted1 when the ,pulse is very perceivably hard and full4 ,it is of the utmost ,consequence to do it instantaneously2 since it is the only ,means to prevent the ,abscess1 which forms very readily1 if ,bleeding has been neglected1 only for a few ,hours4 ,sometimes it is necessary to repeat it a second ,time1 but very rarely a third4 ,this ,disease is frequently so gentle and mild1 as to be cured without ,bleeding1 by the ,means of much good ,management4 ,but as many as are not ,masters of their own ,time1 nor in such an easy ,situation1 as to be properly attended1 ought1 without the least ,hesitation1 to be bled directly1 which is sometimes sufficient to remove the ,complaint2 especially if1 after ,bleeding1 the ,patient drinks plentifully of the ,ptisan ,no4 #b4 ,in this light ,degree of the ,disease1 it may suffice to bathe the ,legs1 and to receive a ,glyster1 once a ,day each2 the first to be used in the ,morning1 and the last in the ,evening4 ,besides the general ,remedies against ,inflammations1 a few particular ones1 calculated precisely for this ,disease1 may be applied in each kind or ,degree of it4 ,the best are1 first the emollient ,poultices1 ,no4 #i1 laid over the whole ,neck4 #bg ,some have highly extolled the ,application of ,swallows ,nests in this ,disease2 and though ,i make no ,objection to it1 ,i think it certainly less efficacious than any of those which ,i direct4 #bg ,the ,english avail themselves considerably1 in this ,disease1 of a ,mixture of equal ,parts of ,sallad ,oil1 and ,spirit of ,sal ,ammoniac2 or of ,oil and ,spirit of ,hartshorn1 as a ,liniment and ,application round the ,neck4 ,this ,remedy corresponds with many ,indications2 and deserves1 perhaps1 the first ,place amongst local ,applications against the inflammatory ,quinsey4 ,e4 ,l4 #b4 ,of the ,gargarisms 7,no4 #ai7 a great ,variety may be prepared1 of pretty much the same ,properties1 and of equal ,efficacy4 ,those ,i direct here are what have succeeded best with me and they are very simple4 #bh #bh ,dr4 ,pringle is apprehensive of some ill ,effects from ,acids in ,gargarisms which is probably from their supposed repelling ,property and prefers a ,decoction of ,figs in ,milk and ,water1 to which he adds a small ,quantity of ,spirit of ,sal ,ammoniac4 ,e4 ,l4 #c4 ,the ,steam of hot ,water1 as directed ,sec4 #ee1 should be repeated five or six ,times a ,day2 a ,poultice should be constantly kept on1 and often renewed2 and the ,patient should often gargle4 ,there are some ,persons1 besides ,children1 who cannot gargle themselves3 and in fact the ,pain occasioned by it makes it the more difficult4 ,in such a ,case1 instead of gargling1 the same ,gargarism 7,no4 #ai7 may be injected with a small ,syringe4 ,the ,injection reaches further than ,gargling1 and often causes the ,patient to hawk up a considerable ,quantity of glarey ,matter 7which has grown still thicker towards the ,bottom of the ,throat7 to his sensible ,relief4 ,this ,injection should be often repeated4 ,the little hollowed ,pipes of ,elder ,wood1 which all the ,children in the ,country can make1 may be conveniently employed for this ,purpose4 ,the ,patient should breathe out1 rather than inspire1 during the ,injection4 ,sec4 #aaj4 ,whenever the ,disease terminates without ,suppuration1 the ,fever1 the ,head-ach1 the ,heat in the ,throat1 and the ,pain in swallowing1 begin to abate from the fourth ,day1 some times from the third1 often only from the fifth2 and from such ,period that ,abatement increases at a great ,rate2 so that at the ,end of two1 three1 or four ,days1 on the sixth1 seventh1 or eighth1 the ,patient is entirely well4 ,some few however continue to feel a light ,degree of ,pain1 and that only on one ,side1 four or five ,days longer1 but without a ,fever1 or any considerable ,uneasiness4 ,sec4 #aaa4 ,sometimes the ,fever and the other ,symptoms abate1 after the ,bleeding and other ,remedies2 without any subsequent ,amendment in the ,throat1 or any ,signs of ,suppuration4 ,in such ,cases we must chiefly persist in the ,gargarisms and the ,steams2 and where an experienced and dexterous ,surgeon can be procured1 it were proper he should scarify the inflamed ,tonsils4 ,these discharge1 in such ,cases1 a moderate ,quantity of ,blood2 and this ,evacuation relieves1 very readily1 as many as make use of it4 ,sec4 #aab4 ,if the ,inflammation is no ways disposed to disperse1 so that an ,abscess is forming1 which almost ever happens1 if it has not been obviated at the ,invasion of the ,disease2 then the ,symptoms attending the ,fever continue1 though raging a little less after the fourth ,day3 the ,throat continues red1 but of a less florid and lively ,redness3 a ,pain also continues1 though less acute1 accompanied sometimes with ,pulsations1 and at other ,times intirely without any2 of which it is proper to take ,notice3 the ,pulse commonly grows a little softer2 and on the fifth or sixth ,day1 and sometimes sooner1 the ,abscess is ready to break4 ,this may be discovered by the ,appearance of a small white and soft ,tumour1 when the ,mouth is open1 which commonly appears about the ,centre or ,middle of the ,inflammation4 ,it bursts of itself2 or1 should it not1 it must be opened4 ,this is effected by strongly securing a ,lancet to one ,end of a small ,stick or ,handle1 and enveloping1 or wrapping up the whole ,blade of it1 except the ,point and the ,length of one fourth or a third of an ,inch1 in some ,folds of soft ,linnen2 after which the ,abscess is pierced with the ,point of this ,lancet4 ,the ,instant it is opened1 the ,mouth is filled with the ,discharge of a ,quantity of ,pus1 of the most intolerable ,savour and ,smell4 ,the ,patient should gargle himself after the ,discharge of it with the detersive1 or cleansing ,gargarism ,no4 #ai4 ,it is surprising sometimes to see the ,quantity of ,matter discharged from this ,imposthumation4 ,in general there is but one2 though sometimes ,i have seen two of them4 ,sec4 #aac4 ,it happens1 and not seldom1 that the ,matter is not collected exactly in the ,place1 where the ,inflammation appeared1 but in some less exposed and less visible ,place3 whence a ,facility of swallowing is almost entirely restored2 the ,fever abates2 the ,patient sleeps2 he imagines he is cured1 and that no ,inconvenience remains1 but such as ordinarily occurs in the earliest ,stage of ,recovery4 ,a ,person who is neither a ,physician1 nor a ,surgeon1 may easily deceive himself1 when in this ,state4 ,but the following ,signs may enable him to discover that there is an ,abscess1 viz4 ,a certain ,inquietude and general ,uneasiness2 a ,pain throughout the ,mouth2 some ,shiverings from ,time to ,time2 frequently sharp1 but short and transient1 ,heat3 a ,pulse moderately soft1 but not in a natural ,state2 a ,sensation of ,thickness and ,heaviness in the ,tongue2 small white ,eruptions on the ,gums1 on the ,inside of the ,cheek1 on the ,inside and ,outside of the ,lips1 and a disagreeable ,taste and ,odour4 ,sec4 #aad4 ,in such ,cases ,milk or warm ,water should frequently be retained in the ,mouth2 the ,vapour of hot ,water should be conveyed into it2 and emollient ,cataplasms may be applied about the ,neck4 ,all these ,means concur to the softening and breaking of the ,abscess4 ,the ,finger may also be introduced to feel for its ,situation2 and when discovered1 the ,surgeon may easily open it4 ,i happened once to break one under my ,finger1 without having made the least ,effort to do it4 ,warm ,water may be injected pretty forcibly1 either by the ,mouth or the ,nostrils3 this sometimes occasions a kind of ,cough1 or certain ,efforts which tend to break it4 ,i have seen this happen even from laughing4 ,as to the rest1 the ,patient should not be too anxious or uneasy about the ,event4 ,i never saw a single ,instance of a ,person's dying of a ,quinsey of this kind1 after the ,suppuration is truly effected2 neither has it happened perhaps after the ,time it is forming for ,suppuration4 ,sec4 #aae4 ,the glairy ,matter with which the ,throat is over-charged1 and the very ,inflammation of that ,part1 which1 from its ,irritation1 produces the same ,effect1 as the ,introduction of a ,finger into it1 occasions some ,patients to complain of incessant ,propensities to vomit4 ,we must be upon our ,guard here1 and not suppose that this ,heart-,sickness1 as some have called it1 results from a ,disorder of1 or a ,load within1 the ,stomach1 and that it requires a ,vomit for its ,removal4 ,the giving one here would often prove a very unfortunate ,mistake4 ,it might1 in a high ,inflammation1 further aggravate it2 or we might be obliged 7even during the ,operation of the ,vomit7 to bleed1 in order to lessen the ,violence of the ,inflammation4 ,such ,imprudence with its bad ,consequences1 often leaves the ,patient1 even after the ,disease is cured1 in a ,state of ,languor and ,weakness for a considerable ,time4 ,nevertheless1 there are some particular ,disorders of the ,throat1 attended with a ,fever1 in which a ,vomit may be prudently given4 ,but this can only be1 when there is no ,inflammation1 or after it is dispersed2 and there still remains some putrid ,matter in the first ,passages4 ,of such ,cases ,i shall speak hereafter4 #bi #bi ,in ,diseases of the ,throat1 which have been preceded by such ,excesses in ,food or strong ,drink1 as occur too often in many ,countries1 when the ,patient has very strong ,reachings to vomit1 and the ,tongue is moist at the same ,time2 we should not hesitate1 after appeasing the first ,symptoms of the ,inflammation by sufficient ,bleedings1 c4 to assist the ,efforts of ,nature1 and to give a small ,dose of ,tartar emetic1 dissolved in some ,spoonfuls of ,water4 ,this ,remedy in this ,case1 promotes the ,dispersion of the ,inflammation1 beyond any other4 ,e4 ,l4 ,sec4 #aaf4 ,we often see in ,swisserland a ,disorder different from these of the ,throat1 of which we have just treated2 though1 like these1 attended with a ,difficulty of swallowing4 ,it is termed in ,french the ,oreillons1 and often the ,ourles1 or swelled ,ears4 ,it is an ,overfulness and ,obstruction of those ,glands and their ,tubes1 which are to furnish the ,saliva or ,spittle2 and particularly of the two large ,glands which lie between the ,ear and the ,jaw2 which are called the ,parotides2 and of two under the ,jaw1 called the ,maxillares4 ,all these being considerably swelled in this ,disease1 do not only produce a great ,difficulty of swallowing2 but also prevent the ,mouth from opening2 as an ,attempt to do it is attended with violent ,pain4 ,young ,children are much more liable to this ,disease than grown ,persons4 ,being seldom attended with a ,fever1 there is no ,occasion for ,medicines3 ,it is sufficient to defend the ,parts affected from the external ,air2 to apply some proper ,poultice over them2 to lessen the ,quantity of their ,food considerably1 denying them ,flesh and ,wine2 but indulging them plentifully in some light warm ,liquid1 to dilute their ,humours and restore ,perspiration4 ,i cured myself of this ,disorder in #aged1 by drinking nothing1 for four ,days1 but ,balm ,tea1 to which ,i added one fourth part ,milk1 and a little ,bread4 ,the same ,regimen has often cured me of other light ,complaints of the ,throat4 ,sec4 #aag4 ,in the ,spring of #agfa1 there were an astonishing ,number of ,persons attacked with ,disorders of the ,throat1 of two different ,kinds4 ,some of them were seized with that common ,sort which ,i have already described4 ,without adding any thing more particularly1 in ,respect to this ,species1 it happened frequently to grown ,persons1 who were perfectly cured by the ,method already recited4 ,the other ,species1 on which ,i shall be more particular in this ,place 7because ,i know they have abounded in some ,villages1 and were very fatal7 invaded ,adults1 or grown ,persons also1 but especially ,children1 from the ,age of one ,year1 and even under that1 to the ,age of twelve or thirteen4 ,the first ,symptoms were the same with those of the common ,quinsey1 such as the ,shivering1 the ensuing ,heat or ,fever1 ,dejection1 and a ,complaint of the ,throat3 but the following ,symptoms distinguished these from the common inflammatory ,quinseys4 #a4 ,the ,sick had often something of a ,cough1 and a little ,oppression4 #b4 ,the ,pulse was quicker1 but less hard1 and less strong1 than generally happens in ,diseases of the ,throat4 #c4 ,the ,patients were afflicted with a sharp1 stinging and dry ,heat1 and with great ,restlessness4 #d4 ,they spat less than is usual in a common ,quinsey2 and their ,tongues were extremely dry4 #e4 ,though they had some ,pain in swallowing1 this was not their principal ,complaint1 and they could drink sufficiently4 #f4 ,the ,swelling and ,redness of the ,tonsils1 of the ,palate1 and of its ,process were not considerable2 but the parotid and maxillary ,glands1 and especially the former1 being extremely swelled and inflamed1 the ,pain they chiefly complained of1 was this outward one4 #g4 ,when the ,disease proved considerably dangerous1 the whole ,neck swelled2 and sometimes even the ,veins1 which return the ,blood from the ,brain1 being overladen1 as it were1 the ,sick had some ,degree of ,drowsiness1 and of a ,delirium1 or ,raving4 #h4 ,the ,paroxysms1 or ,returns1 of the ,fever were considerably irregular4 #i4 ,the ,urine appeared to be less inflamed1 than in other ,diseases of the ,throat4 #aj4 ,bleeding and other ,medicines did not relieve them1 as soon as in the other kind2 and the ,disease itself continued a longer ,time4 #aa4 ,it did not terminate in a ,suppuration like other ,quinsies1 but sometimes the ,tonsils were ulcerated4 #ab4 #cj ,almost every ,child1 and indeed a great many of the grown ,persons assaulted with this ,disease1 threw out1 either on the first ,day1 or on some succeeding one1 within the first six ,days1 a certain ,efflorescence1 or ,eruptions1 resembling the ,measles considerably in some1 but of a less lively ,colour1 and without any ,elevation1 or rising above the ,skin4 ,it appeared first in the ,face1 next in the ,arms1 and descended to the ,legs1 ,thighs and ,trunk2 disappearing gradually at the ,end of two or three ,days1 in the same ,order it had observed in breaking out4 ,a few others 7,i have seen but five ,instances of it7 suffered the most grievous ,symptoms before the ,eruption2 and threw out the genuine purpura1 or white miliary ,eruption4 #cj ,this seems to have been the same kind of ,quinsey1 of which ,drs4 ,huxham1 ,fothergil1 ,cotton and others wrote1 though under different ,appellations4 ,k4 #ac4 ,as soon as these ,efflorescences or ,eruptions appeared1 the ,sick generally found themselves better4 ,that1 last mentioned1 continued four1 five1 or six ,days1 and frequently went off by ,sweats4 ,such as had not these ,ebullitions1 which was the ,case of many ,adults1 were not cured without very plentiful ,sweats towards the ,termination of the ,disease3 those which occurred at the ,invasion of it being certainly unprofitable1 and always hurtful4 #ad4 ,i have seen some ,patients1 in whom the ,complaint of the ,throat disappeared entirely1 without either ,eruptions or ,sweats3 but such still remained in very great ,inquietude and ,anguish1 with a quick and small ,pulse4 ,i ordered them a sudorific ,drink1 which being succeeded by the ,eruption1 or by ,sweating1 they found themselves sensibly relieved4 #ae4 ,but whether the ,sick had1 or had not1 these external ,rednesses or ,eruptions1 every one of them parted with their ,cuticle or ,scarf ,skin1 which fell off1 in large ,scales1 from the whole ,surface of the ,body3 so great was the ,acrimony or ,sharpness of that ,matter1 which was to be discharged through the ,skin4 #af4 ,a great ,number suffered a singular ,alteration in their ,voice1 different from that which occurs in common ,quinsies1 the ,inside of their ,nostrils being extremely dry4 #ag4 ,the ,sick recovered with more ,difficulty after this1 than after the common ,quinsies3 and if they were negligent or irregular1 during their ,recovery2 particularly1 if they exposed themselves too soon to the ,cold1 a ,relapse ensued1 or some different ,symptoms2 such as a ,stuffing with ,oppression1 a ,swelling of the ,belly1 windy ,swellings in different ,parts2 ,weakness1 ,loathings1 ,ulcerations behind the ,ears1 and something of a ,cough and ,hoarseness4 #ah4 ,i have been sent for to ,children1 and also to some young ,folks1 who1 at the ,end of several ,weeks1 had been taken with a general ,inflammation of the whole ,body1 attended with great ,oppression1 and a considerable ,abatement of their ,urine1 which was also high-coloured and turbid1 or without ,separation4 ,they seemed also in a very singular ,state of ,indifference1 or ,disregard1 with ,respect to any ,object1 or ,circumstance4 ,i recovered every one of them entirely by ,blisters1 and the ,powder ,no4 #be4 ,the first ,operation of this ,medicine was to vomit them3 to this succeeded a ,discharge by ,urine1 and at last very plentiful ,sweating1 which compleated the ,cure4 ,two ,patients only1 of a bad ,constitution1 who were a little ricketty1 and disposed to glandular ,scirrhosity or ,knottiness1 relapsed and died1 after being recovered of the ,disease itself for some ,days4 ,sec4 #aah4 ,i have bled some adult ,persons1 and made ,use of the cooling ,regimen1 as long as there was an evident ,inflammation3 it was necessary after this to unload the first ,passages2 and at last to excite moderate ,sweats4 ,the same ,powders ,no4 #be have often effected both these ,discharges1 and with entire ,success4 ,in other ,cases ,i have made ,use of ,ipecacuanha1 as directed ,no4 #ce4 ,in some ,subjects there did not appear any inflammatory ,symptom2 and the ,distemper resulted solely from a ,load of putrid ,matter in the first ,passages4 ,some ,patients also discharged ,worms4 ,in such ,cases ,i never bled2 but the ,vomit had an excellent ,effect1 at the very ,onset of the ,disease2 it produced a perceivable ,abatement of all the ,symptoms2 ,sweating ensued very kindly and naturally1 and the ,patient recovered entirely a few ,hours after4 ,sec4 #aai4 ,there were some ,places1 in which no ,symptom or ,character of ,inflammation appeared2 and in which it was necessary to omit ,bleeding1 which was attended with bad ,consequences4 ,i never directed ,infants to be bled4 ,after opening the first ,passages1 ,blisters and diluting ,drinks proved their only ,remedies4 ,a simple ,infusion of ,elder ,flowers1 and those of the ,lime ,tree1 has done great ,service to those who drank plentifully of it4 ,sec4 #abj4 ,i am sensible that in many ,villages a great ,number of ,persons have died1 with a prodigious ,inflation or ,swelling of the ,neck4 ,some have also died in the ,city1 and among others a young ,woman of twenty ,years of ,age1 who had taken nothing but hot sweating ,medicines and red ,wine1 and died the fourth ,day1 with violent ,suffocations1 and a large ,discharge of ,blood from the ,nose4 ,of the great ,number ,i have seen in ,person1 only two died4 ,one was a little ,girl of ten ,months old4 ,she had an ,efflorescence which very suddenly disappeared3 at this ,time ,i was called in2 but the ,humour had retreated to the ,breast1 and rendered her ,death inevitable4 ,the other was a strong ,youth from sixteen to seventeen ,years old1 whose sudden ,attack from the ,disease manifested1 from the very ,beginning1 a violent ,degree of it4 ,nevertheless1 the ,symptoms subsiding1 and the ,fever nearly terminating1 the ,sweats which approached would probably have saved him4 ,but he would not suffer them to have their ,course1 continually stripping himself quite naked4 ,the ,inflammation was immediately repelled upon the ,lungs1 and destroyed him within the ,space of thirty ,hours4 ,i never saw a ,person die with so very dry a ,skin4 ,the ,vomit affected him very little upwards1 and brought on a purging4 ,his own bad ,conduct seems to have been the ,occasion of his ,death2 and may this serve as one ,example of it4 ,sec4 #aba4 ,i chose to expatiate on this ,disease1 as it may happen to reach other ,places1 where it may be useful to have been apprized of its ,marks1 and of its ,treatment1 which agrees as much with that of putrid ,fevers1 of which ,i shall speak hereafter1 as with that of the inflammatory ,diseases ,i have already considered3 since in some ,subjects the ,complaint of the ,throat has evidently been a ,symptom of a putrid ,fever1 rather than of the chiefly apparent ,disease1 a ,quinsey4 #ca ,sec4 #abb4 ,disorders of the ,throat are1 with ,respect to particular ,persons1 an habitual ,disease returning every ,year1 and sometimes oftner than once a ,year4 ,they may be prevented by the same ,means1 which ,i have directed for the ,preservation from habitual ,pleurisies ,sec4 #ajj2 and by defending the ,head and the ,neck from the ,cold2 especially after being heated by ,hunting1 or any violent ,exercise1 or even by singing long and loud1 which may be considered as an extraordinary ,exercise of some of the ,parts affected in this ,disease4 #ca ,i reserve some other interesting ,reflections on this ,disease1 for the second ,edition of my ,treatise on ,fevers2 and the ,editor at ,paris has very well observed1 that it has some ,relation to the gangrenous sore ,throat1 which has been epidemical these twenty ,years past1 in many ,parts of ,europe4----,this ,note is from ,dr4 ,tissot himself4 ,chapter ,,vii4 ,of ,colds4 ,sect4 #abc4 ,there are many erroneous ,prejudices1 with ,regard to ,colds1 all of which may be attended with pernicious ,consequences4 ,the first is1 that a ,cold is never dangerous2 an ,error which daily destroys the ,lives of many4 ,i have already complained of it for many ,years past2 and ,i have since beheld a ,multitude of such ,examples of it1 as have but too sufficiently warranted my ,complaints4 ,no ,person however1 it is certain1 dies merely of a ,cold1 as long as it is nothing but a ,cold simply2 but when1 from ,inattention and ,neglect1 it is thrown upon1 and occasions ,distempers of the ,breast1 it may1 and often does1 prove mortal4 ,colds destroy more than ,plagues1 was the ,answer of a very sagacious and experienced ,physician to one of his ,friends1 who1 being asked1 how he was in ,health1 replied1 ,very well1 ,i have nothing but a ,cold4 ,a second erroneous ,prejudice is1 that ,colds require no ,means1 no ,medicines1 and that they last the longer for being nursed1 or tampered with4 ,the last ,article may be true indeed1 with ,respect to the ,method1 in which the ,person affected with them treats them2 but the ,principle itself is false4 ,colds1 like other ,disorders1 have their proper ,remedies2 and are removed with more or less ,facility1 as they are conducted better or worse4 ,sec4 #abd4 ,a third ,mistake is1 that they are not only considered as not dangerous1 but are even supposed wholesome too4 ,doubtless a ,man had better have a ,cold than a more grievous ,disease2 though it must be still better to have neither of them4 ,the most that can reasonably be said and admitted on this ,point1 is1 that when a checked1 or an obstructed ,perspiration becomes the ,cause of a ,distemper1 it is fortunate that it produces rather a ,cold1 than any very dreadful ,disease1 which it frequently does3 though it were to be wished1 that neither the ,cause1 nor its ,effect existed4 ,a ,cold constantly produces some ,disorder or ,defect in the ,functions of some ,part or ,parts of the ,body1 and thus becomes the ,cause of a ,disease4 ,it is indeed a real ,disorder itself1 and which1 when in a violent ,degree1 makes a very perceivable ,assault upon our whole ,machine4 ,colds1 with their ,defluxions1 considerably weaken the ,breast1 and sooner or later considerably impair the ,health4 ,persons subject to frequent ,colds are never robust or strong2 they often sink into languid ,disorders2 and a frequent ,aptitude to take ,cold is a ,proof1 that their ,perspiration may be easily checked and restrained2 whence the ,lungs become oppressed and obstructed1 which must always be attended with considerable ,danger4 ,sec4 #abe4 ,we may be convinced of the ,weakness and ,fallacy of these ,prejudices1 by considering attentively the ,nature of ,colds2 which are nothing else than the very ,diseases already described in the three preceding ,chapters1 though in their greatest ,degree only4 ,a ,cold in ,truth is almost constantly an inflammatory ,disease2 a light ,inflammation of the ,lungs1 or of the ,throat2 of the ,membrane or very thin ,skin1 which lines the ,nostrills1 and the ,inside of certain ,cavities in the ,bones of the ,cheeks and ,forehead4 ,these ,cavities communicate with the ,nose1 in such a ,manner1 that when one ,part of this ,membrane is affected with an ,inflammation1 it is easily communicated to the other ,parts4 ,sec4 #abf4 ,it is scarcely necessary to describe the ,symptoms of a ,cold1 and it may be sufficient to remark1 #a4 ,that their chief ,cause is the same with that1 which most commonly produces the ,diseases already treated of1 that is1 an obstructed ,perspiration1 and a ,blood somewhat inflamed4 #b4 ,that whenever these ,diseases affect great ,numbers1 many ,colds prevail at the same ,time4 #c4 ,that the ,symptoms which manifest a violent ,cold1 greatly resemble those which precede or usher in these ,diseases4 ,people are rarely attacked by great ,colds1 without a shivering and ,fever2 which last sometimes continues for many ,days4 ,there is a ,cough1 a dry ,cough1 for some ,time2 after which some ,expectoration ensues2 which allays the ,cough1 and lightens the ,oppression2 at which ,time the ,cold may be said to be maturated1 or ripe4 ,there are pretty often slight ,stitches1 but unfixed or flying about1 with a little ,complaint of the ,throat4 ,when the ,nostrills happen to be the ,seat of the ,disorder1 which is then very improperly termed a ,cold of the ,brain1 it is often attended with a vehement ,head-ach2 which sometimes depends on an ,irritation of the ,membrane1 that lines the ,cavities in the ,bone of the ,forehead1 or the maxillary ,sinusses1 that is1 the ,cavities in the ,jaws3 ,at first the ,running from the ,nose is very clear2 thin and sharp2 afterwards1 in ,proportion to the ,abatement of the ,inflammation1 it becomes thicker2 and the ,consistence and ,colour of it resemble those of what others cough up4 ,the ,smell1 the ,taste and the ,appetite are commonly impaired by it4 ,sec4 #abg4 ,colds seem to be of no certain ,duration or ,continuance4 ,those of the ,head or ,brain generally last but a few ,days2 of the ,breast longer4 ,some ,colds nevertheless terminate in four or five ,days4 ,if they extend beyond this ,term they prove really hurtful4 #a4 ,because the ,violence of the ,cough disorders the whole ,machine2 and particularly1 by forcing up the ,blood to the ,head4 #b4 ,by depriving the ,person afflicted of his usual ,sleep1 which is almost constantly diminished by it4 #c4 ,by impairing the ,appetite1 and confusing the ,digestion1 which is unavoidably lessened by it4 #d4 ,by weakening the very ,lungs1 by the continual ,agitations from ,coughing2 whence all the ,humours being gradually determined towards them1 as the weakest ,part1 a continual ,cough subsists4 ,hence also they become overcharged with ,humours1 which grow viscid there2 the ,respiration is overloaded and oppressed2 a slow ,fever appears2 ,nutrition almost ceases2 the ,patient becomes very weak2 sinks into a ,wasting2 an obstinate ,wakefulness and ,anguish1 and often dies in a short ,time4 #e4 ,by ,reason that the ,fever1 which almost constantly accompanies great ,cold1 concurs to wear the body down4 ,sec4 #abh4 ,wherefore1 since a ,cold is a ,disease of the same kind with ,quinsies1 ,peripneumonies and ,inflammations of the ,breast1 it ought to be treated in the same ,manner4 ,if it is a violent one1 ,blood should be taken from the ,arm1 which may considerably shorten its ,duration3 and this becomes most essentially necessary1 whenever the ,patient is of a sanguineous ruddy ,complexion1 abounds with ,blood1 and has a strong ,cough1 and great ,head-ach4 ,the ,drinks ,no4 #a1 #b1 #c1 #d1 should be very plentifully used4 ,it is advantagious to bathe the ,feet in warm ,water every ,night at going to ,bed4 #cb ,in a ,word1 if the ,patient is put into a ,regimen1 the ,cure is very speedily effected4 #cb ,it frequently happens1 that the ,bathings alone remove the ,head-ach1 and the ,cough too1 by relaxing the lower ,parts1 and the entire ,surface of the ,body4 ,if the ,patient is costive1 he should receive ,glysters of warm ,water1 in which some ,bran has been boiled1 with the ,addition of a little common ,soap or ,butter4 ,e4 ,l4 ,sec4 #abi4 ,the ,disorder indeed1 however1 is often so very slight1 that it may be thought to require very little1 if any1 medical ,treatment1 and may be easily cured without ,physick1 by abstaining from ,flesh1 ,eggs1 ,broth1 and ,wine2 from all ,food that is sharp1 fat and heavy2 and by dieting upon ,bread1 ,pulse1 ,fruit1 and ,water2 particularly by eating little or no ,supper2 and drinking1 if thirsty1 a simple ,ptisan of ,barley1 or an ,infusion of ,elder ,flowers1 with the ,addition of a third or fourth ,part of ,milk4 ,bathing the ,feet1 and the ,powder ,no4 #bj contribute to dispose the ,patient to sleep4 ,five ,tea-,cups of an ,infusion of the ,red1 or wild ,poppy ,leaves may also be ventured on safely4 ,sec4 #acj4 ,when the ,fever1 ,heat and ,inflammation wholly disappear2 when the ,patient has kept to his ,regimen for some ,days1 and his ,blood is well diluted1 if the ,cough and ,want of ,sleep still continues1 he may take in the ,evening a ,dose of ,storax #cc ,pill1 or of ,venice ,treacle with ,elder ,flower ,tea1 after bathing his ,feet4 ,these ,remedies by stilling the ,cough1 and restoring ,perspiration1 frequently cure the ,cold in the ,space of one ,night4 ,i confess at the same ,time1 ,i have seen bad ,consequences from such ,opiates1 when given too early in the ,complaint4 ,it is also necessary1 when they are given1 that the ,patient should have supt but very moderately1 and that his ,supper should be digested4 #cc ,under these ,circumstances of a tickling ,cough from a ,cold1 without a ,fever1 and with very little ,inflammation1 ,i have known great and very frequent ,success1 from a ,dose of ,elixir paregoricum1 taken at ,bed-time1 after a very light thin ,supper4 ,if the ,patient be sanguine1 strong and costive1 ,bleeding in a suitable ,quantity1 and a gently opening ,potion1 or purging ,glyster1 may be prudently premised to it4 ,grown ,persons may take from #cj to #hj1 or even #ajj ,drops of it1 in ,barley ,water1 or any other pectoral ,drink2 and ,children in the ,chincough from five to twenty ,drops2 half an ,ounce of it by ,measure containing about one ,grain of ,opium1 which is the ,quantity contained in less than quite six ,grains of the ,storax ,pill2 this last being a very available pectoral ,opiate too in ,coughs from a ,distillation1 in more adult ,bodies1 who may also prefer a ,medicine in that small ,size1 and ,form4 ,k4 ,sec4 #aca4 ,an immense ,number of ,remedies are cried up for the ,cure of ,colds2 such as ,ptisans of ,apples or ,pippins1 of ,liquorice1 of dry ,raisins1 of ,figs1 of ,borage1 of ,ground-,ivy1 of ,veronica or ,speedwell1 of ,hysop1 of ,nettles1 c4 c4 ,i have no ,design to depreciate them2 as all of them may possibly be useful3 ,but unfortunately1 those who have seen any particular one of them succeed in one ,case1 readily conclude it to be the most excellent of them all2 which is a dangerous ,error1 because no one ,case is a sufficient ,foundation to decide upon3 which besides none are qualified to do1 who have not often seen a great ,number of such ,cases2 and who do not so attentively observe the ,effects of different ,medicines1 as to determine on those which most frequently agree with the ,disorder2 and which1 in my ,judgment1 are those ,i have just enumerated4 ,i have known a ,tea or ,infusion of ,cherry ,stalks1 which is not a disagreeable ,drink1 to cure a very inveterate ,cold4 ,sec4 #acb4 ,in ,colds of the ,head or ,brain1 the ,steam of warm ,water alone1 or that in which ,elder ,flowers1 or some other mild aromatic ,herbs1 have been boiled1 commonly afford a pretty speedy ,relief4 ,these are also serviceable in ,colds fallen on the ,breast4 ,see ,sec4 #ee4 ,it has been a ,practice1 though of no very long standing1 to give the ,fat of a ,whale in these ,cases2 but this is a very crude indigestible kind of ,fat1 and greasy oily ,medicines seldom agree with ,colds4 ,besides1 this ,whales' ,fat is very disagreeable and rancid1 that is rank2 so that it were better to forbear using it3 ,i have sometimes seen ill ,effects from it1 and rarely any good ones4 #cd #cd ,this seems but too applicable to the very popular ,use of ,spermaceti1 c4 in such ,cases1 which can only grease the ,passage to the ,stomach2 must impair its digestive ,faculty1 and cannot operate against the ,cause of a ,cold2 though that ,cure of it1 which is effected by the ,oeconomy of ,nature in due ,time1 is often ascribed to such ,medicines1 as may rather have retarded it4 ,k4 ,sec4 #acc4 ,such ,persons as abate nothing of the usual ,quantity of their ,food1 when seized with a ,cold1 and who swallow down large ,quantities of hot ,water1 ruin their ,health4 ,their ,digestion ceases2 the ,cough begins to affect the ,stomach1 without ceasing to afflict the ,breast2 and they incur a ,chance of sinking into the ,condition described ,sec4 #abg1 ,no4 #d4 ,burnt ,brandy and spiced ,wine are very pernicious in the ,beginning of ,colds1 and the ,omission of them must be a very prudent ,omission4 ,if any good ,effects have ever been known to attend the ,use of them1 it has been towards the going off of the ,cold2 when the ,disorder maintained its ,ground1 solely from the ,weakness of the ,patient4 ,whenever this is the ,case1 there is not the least ,room for farther ,relaxation2 but the ,powders ,no4 #ad1 should be taken every ,day in a little ,wine2 and should the ,humours seem likely to be thrown upon the ,lungs1 ,blisters ought to be applied to the fleshy ,part of the ,legs4 ,sec4 #acd4 ,drams1 or ,liqueurs1 as they are called in ,french1 agree so very little in this last ,state1 that frequently a very small ,quantity of them revives a ,cold that was just expiring4 ,there really are some ,persons who never drink them without taking ,cold1 which is not to be wondered at1 as they occasion a light ,inflammation in the ,breast1 which is equivalent to a ,cold or ,distillation4 ,nevertheless1 ,people in this ,disorder should not expose themselves to violent cold ,weather1 if there is a ,possibility of avoiding it3 though they should equally guard too against excessive ,heat4 ,those1 who inclose themselves in very hot ,rooms1 never get quite cured2 and how is it possible they should be cured in such a ,situation8 ,such ,rooms1 abstracted from the ,danger of coming out of them1 produce ,colds in the same ,manner that ,drams do1 by producing a light inflammation in the ,breast4 ,sec4 #ace4 ,persons subject to frequent ,colds1 which ,habits are sometimes termed fluxionary1 or liable to ,distillations1 imagine1 they ought to keep themselves very hot4 ,this is an ,error which thoroughly destroys their ,health4 ,such a ,disposition to take ,cold arises from two ,causes2 either because their ,perspiration is easily impaired2 or sometimes from the ,weakness of the ,stomach or the ,lungs1 which require particular ,remedies4 ,when the ,complaint arises from the ,perspiration's being easily disturbed and lessened1 the hotter they keep themselves1 the more they sweat1 and increase their ,complaint the more4 ,this incessantly warm ,air lets down and weakens the whole ,machine1 and more particularly the ,lungs2 where the ,humours finding less ,resistance1 are continually derived1 and are accumulated there4 ,the ,skin1 being constantly bathed in a small ,sweat1 becomes relaxed1 soft1 and incapable of compleating its ,functions3 from which ,failure the slightest ,cause produces a total ,obstruction of ,perspiration2 and a ,multitude of languid ,disorders ensue4 ,these ,patients thus circumstanced1 redouble their ,precautions against the ,cold1 or even the ,coolness of the ,air1 while their utmost ,cautions are but so many effectual ,means to lower their ,health2 and this the more certainly1 as their ,dread of the free ,air necessarily subjects them to a sedentary ,life1 which increases all their ,symptoms2 while the hot ,drinks they indulge in1 compleat their ,severity4 ,there is but one ,method to cure ,people thus situated2 that is1 by accustoming them gradually to the ,air2 to keep them out of hot ,chambers2 to lessen their ,cloathing by ,degrees2 to make them sleep cool2 and to let them eat or drink nothing but what is cold1 ,ice itself being wholesome in their ,drink3 to make them use much ,exercise2 and finally1 if the ,disorder be inveterate1 to give them for a considerable ,time the ,powder ,no4 #ad1 and make them use the cold ,bath4 ,this ,method succeeds equally too with those1 in whom the ,disease originally depended on a ,weakness of the ,stomach1 or of the ,lungs3 and in fact1 at the ,end of a certain ,period1 these three ,causes are always combined4 ,some ,persons who have been subject1 for many ,years1 to catch ,colds throughout the ,winter2 and who1 during that ,season1 never went out1 and drank every thing warm1 have been evidently the better1 during the ,winter of #agfa1 and #agfb1 for the ,direction ,i have given here4 ,they now walk out every ,day2 drink their ,liquids cold2 and by this ,means entirely escape ,colds1 and enjoy perfect ,health4 ,sec4 #acf4 ,it is more customary indeed in ,town1 than in the ,country1 to have different ,troches1 and ,compositions in the ,mouth4 ,i am not for excluding this ,habit2 though ,i think nothing is so efficacious as ,juice of ,liquorice2 and provided a sufficient ,dose be taken1 it affords certain ,relief4 ,i have taken an ,ounce and a half in one ,day1 and have felt the good ,consequences of it very remarkably4 ,chapter ,,viii4 ,of ,diseases of the ,teeth4 ,sect4 #acg4 ,the ,diseases of the ,teeth1 which are sometimes so tedious and so violent1 as to cause obstinate ,wakefulness1 a considerable ,degree of ,fever1 ,raving1 ,inflammations1 ,abscesses1 ,rottenness of the ,bones1 ,convulsions and ,faintings1 depend on three principal ,causes4 #a4 ,on a ,caries or ,rottenness of the ,teeth4 #b4 ,on an ,inflammation of the ,nerves of the ,teeth1 or of the ,membrane which invests and covers them2 and which affects the ,membrane of the ,gums4 #c4 ,a cold ,humour or ,defluxion that is determined to the ,teeth1 and to their ,nerves and ,membrane4 ,sec4 #ach4 ,in the first of these ,cases1 the ,caries having eat down to1 and exposed the naked ,nerve1 the ,air1 ,food and ,drink irritate1 or1 as it were sting it2 and this irritation is attended with ,pain more or less violent4 ,every thing that increases the ,motion or ,action of the affected ,part1 as ,exercise1 ,heat or ,food1 will be attended with the same ,consequence4 ,when the ,tooth is greatly decayed1 there is no other ,cure besides that by extracting it1 without which the ,pain continues2 the ,breath becomes very offensive2 the ,gum is eat down2 the other ,teeth1 and sometimes even the ,jaw-bone1 are infected with the ,rottenness3 besides1 that it prevents the ,use of the other ,teeth1 which are infected with a kind of tartarous ,matter1 and decay4 ,but when the ,disorder is less considerable1 the ,progress of it may sometimes be restrained1 by burning the ,tooth with a hot ,iron1 or by filling it with ,lead1 if it is fitted to receive and to retain it4 ,different corroding ,liquids are sometimes used on these ,occasions1 ,aqua fortis itself1 and ,spirit of ,vitriol3 but such ,applications are highly dangerous1 and ought to be excluded4 ,when the ,patients1 from ,dread1 reject the ,operations just mentioned1 a little ,oyl of ,cloves may be applied1 by introducing a small ,pellet of ,cotton1 dipt in it1 to the rotten hollow ,tooth2 which often affords considerable ,ease1 and ,respite4 ,some make use of a ,tincture of ,opium1 or ,laudanum1 after the same ,manner2 and indeed these two ,medicines may be used together in equal ,quantities4 ,i have often succeeded with ,hoffman's mineral anodyne ,liquor2 which seemed indeed1 for a few ,moments1 to increase the ,pain2 but ,ease generally ensues after spitting a little ,time4 ,a ,gargarism made of the ,herb ,argentina2 that is ,silver-weed or wild ,tansey1 in ,water1 frequently appeases the ,pain that results from a ,caries of the ,teeth3 and in such ,cases many ,people have found themselves at ,ease1 under a constant ,use of it4 ,it certainly is an ,application that cannot hurt1 and is even beneficial to the ,gums4 ,others have been relieved by rubbing their ,faces over with ,honey4 ,sec4 #aci4 ,the second ,cause is the ,inflammation of the ,nerve within the ,substance1 or of the ,membrane on the ,outside1 of the ,tooth4 ,this is discovered by the ,patient's ,temperament1 ,age and ,manner of living4 ,they who are young1 sanguine1 who heat themselves much1 whether by ,labour1 by their ,food1 their ,drink1 by sitting up late1 or by any other ,excess3 they who have been accustomed to any ,discharges or ,eruptions of ,blood1 whether natural or artificial1 and who cease to have them as usual1 are much exposed to the ,tooth-ach1 from this ,cause4 ,this ,pain1 or rather ,torment1 if in an acute ,degree1 commonly happens very suddenly1 and often after some heating ,cause4 ,the ,pulse is strong and full2 the ,countenance considerably red2 the ,mouth extremely hot3 there is often a pretty high ,fever1 and a violent ,head-ach4 ,the ,gums1 or some ,part of them1 become inflamed1 swelled1 and sometimes an ,abscess appears4 ,at other times the ,humours throw themselves upon the more external ,parts2 the ,cheek swells1 and the ,pain abates4 ,when the ,cheek swells1 but without any ,diminution of the ,pain1 it then becomes an ,augmentation1 but no essential ,change1 of the ,disorder4 ,sec4 #adj4 ,in this ,species of the ,disease1 we must have ,recourse to the general ,method of treating inflammatory ,disorders1 and direct ,bleeding1 which often produces immediate ,ease1 if performed early4 ,after ,bleeding1 the ,patient should gargle with ,barley ,water1 or ,milk and ,water2 and apply an emollient ,cataplasm to the ,cheek4 ,if an ,abscess or little ,imposthume appears1 the ,suppuration or ripening of it is to be promoted1 by holding continually in the ,mouth some hot ,milk1 or ,figs boiled in some ,milk3 and as soon as ever it seems ripe1 it should be opened1 which may be done easily1 and without any ,pain4 ,the ,disorder1 when depending on this ,cause1 is sometimes not so violent1 but of a longer ,duration1 and returns whenever the ,patient heats himself2 when he goes to ,bed2 when he eats any heating ,food1 or ,drink1 ,wine or ,coffee4 ,in this ,case he should be bled1 without which his other ,medicines will have little ,effect2 and he should bathe his ,feet in warm ,water for some ,evenings successively1 taking one ,dose of the ,powder ,no4 #bj4 ,entire ,abstinence from ,wine and ,meat1 especially at ,night1 has cured several ,persons of inveterate and obstinate ,maladies of the ,teeth4 ,in this ,species of ,tooth-ach1 all hot ,remedies are pernicious2 and it often happens that ,opium1 ,venice ,treacle1 and ,storax ,pills1 are so far from producing the ,relief expected from them1 that they have aggravated the ,pain4 ,sec4 #ada4 ,when the ,disease arises from a cold ,distillation1 or ,humour1 tending to these ,parts1 it is commonly 7though equally painful7 attended with less violent ,symptoms4 ,the ,pulse is neither strong1 full nor quick2 the ,mouth is less heated1 and less swelled4 ,in such ,cases1 the afflicted should be purged with the ,powder ,no4 #ba1 which has sometimes perfectly cured very obstinate ,complaints of this ,sort4 ,after purging they should make ,use of the ,diet ,drink of the ,woods ,no4 #bb4 ,this has cured ,tooth-achs1 which have baffled other ,attempts for many ,years2 but it must be added1 this ,drink would be hurtful in the ,disease from a different ,cause4 ,blisters to the ,nape of the ,neck1 or #ce elsewhere1 it matters not greatly where1 have often extraordinary good ,effects1 by diverting the ,humour1 and restoring a compleat ,perspiration4 ,in short in this ,species1 we may employ1 not only with ,safety1 but with ,success 7especially after due purging7 ,pills of ,storax1 ,opium and ,venice ,treacle4 ,acrid sharp ,remedies1 such as hard spun #ce ,tobacco1 ,root of ,pellitory of ,spain1 c4 by exciting much ,spitting1 discharge part of the ,humour which causes the ,disease1 and hence diminish the ,pain4 ,the ,smoke of ,tobacco also succeeds now and then in this ,disorder1 whether this happens from the ,discharge of the ,rheum or ,spittle it occasions2 or whether it is owing to any anodyne ,efficacy of this ,plant1 in which it resembles ,opium4 #ce ,a small ,blister behind the ,ear of the affected ,side1 or both ,ears1 has very often removed the ,pain1 when from a ,defluxion4 ,it is pretty common for the ,subjects of this ,disease to be very costive1 during the ,exacerbations of it1 which ,i have sometimes experienced to be pretty regularly and severely quotidian1 for a ,week or two4 ,the ,custom of smoking ,tobacco very often1 which the ,violence of this ,pain has sometimes introduced1 often disposes to a ,blackened and premature ,decay of the ,teeth1 to which the ,chewers of it are less obnoxious3 and this ,difference may result from some particles of its chemical ,oil rising by ,fumigation1 and being retained in the ,teeth1 which ,particles are not extracted by ,mastication4 ,but with ,regard to the habitual ,use of this very acrid and internally violent ,herb1 for1 but chiefly after1 this ,disease1 it should be considered well1 whether in some ,constitutions it may not pave the ,way to a more dangerous one1 than it was introduced to remove4 ,k4 ,sec4 #adb4 ,as this last ,cause is often the ,consequence of a ,weakness in the ,stomach1 it daily happens that we see some ,people1 whose ,disorder from this ,cause is augmented1 in ,proportion as they indulge in a cooling1 refreshing ,way of living4 ,the ,increase of the ,disorder disposes them to increase the ,dose of what they mistake for its ,remedy1 in ,proportion to which their ,pain only increases4 ,there is a ,necessity that such ,persons should alter this ,method2 and make use of such ,medicines as are proper to strengthen the ,stomach1 and to restore ,perspiration4 ,the ,powder ,no4 #ad4 has often produced the best ,consequences1 when ,i have ordered it in these ,cases2 and it never fails to dissipate the ,tooth-ach very speedily1 which returns periodically at stated ,days and ,hours4 ,i have also cured some ,persons who never drank ,wine1 by advising them to the ,use of it4 ,sec4 #adc4 ,but besides the ,diseases of the ,teeth1 that are owing to these three principal ,causes1 which are the most common ones2 there are some very tedious and most tormenting ,disorders of them1 that are occasioned by a general ,acrimony1 or great ,sharpness1 of the ,mass of ,blood1 and which are never cured by any other ,medicines but such1 as are proper to correct that ,acrimony4 ,when it is of a scorbutic ,nature1 the wild ,horse-radish 7,pepperwort7 ,water ,cresses1 ,brooklime1 ,sorrel1 and ,wood-sorrell correct and cure it4 ,if it is of a different ,nature1 it requires different ,remedies4 ,but very particular ,details do not come within the ,plan of this ,work4 ,as the ,malady is of the chronical or tedious kind1 it allows ,time to consider and consult more particularly about it4 ,the ,gout and the ,rheumatism are sometimes transferred to the ,teeth1 and give ,rise to the most excruciating ,pains2 which must be treated like the ,diseases from which they arise4 ,sec4 #add4 ,from what has been said on this ,disorder1 the ,reader will discern1 in what that imaginary ,oddness may consist1 which has been ascribed to it1 from the same ,application's relieving one ,person in it1 and not affording the least ,relief to another4 ,now the plain ,reason of this is1 that these ,applications are always directed1 without an exact ,knowledge of the particular ,cause of the ,disease1 in different ,subjects and ,circumstances2 whence the ,pain from a rotten ,tooth1 is treated like that from an ,inflammation2 that from an ,inflammation1 like the ,pain from a cold ,humour or ,fluxion2 and this last like a ,pain caused by a scorbutic ,acrimony3 so that the ,disappointment is not in the least surprizing4 ,perhaps ,physicians themselves do not always attend distinctly enough to the ,nature of each particular ,disorder3 and even when they do1 they content themselves with directing some of the less potent ,medicines1 which may be inadequate to accomplish the necessary ,effect4 ,if the ,distemper truly be of an inflammatory ,disposition1 ,bleeding is indispensible to the ,cure4 ,it happens in ,fact1 with ,regard to the ,diseases of the ,teeth1 as well as to all other ,diseases1 that they arise from different ,causes2 and if these ,causes are not opposed by ,medicines suited to them1 the ,disease1 far from being cured1 is aggravated4 ,i have cured violent ,tooth-achs1 of the lower ,jaw1 by applying a ,plaister of ,meal1 the ,white of an ,egg1 ,brandy and ,mastich1 at the ,corner of that ,jaw1 over the ,spot where the ,pulsation of the ,artery may be perceived3 and ,i have also mitigated the most excruciating ,pains of the ,head1 by applying the same ,plaister upon the temporal ,artery4 ,chapter ,,ix4 ,of the ,apoplexy4 ,sect4 #ade4 ,every ,person has some ,idea of the ,disease termed an ,apoplexy1 which is a sudden ,privation or ,loss of all ,sense1 and of all voluntary ,motion2 the ,pulse at the same ,time being kept up1 but ,respiration or ,breathing1 being oppressed4 ,i shall treat of this ,disease only in a brief ,manner1 as it is not common in our ,country ,villages2 and as ,i have expatiated on it in a different ,manner in a ,letter to ,dr4 ,haller1 published in #agfa4 ,sec4 #adf4 ,this ,disease is generally distinguished into two ,kinds1 the sanguineous and serous ,apoplexy4 ,each of them results from an ,overfulness of the ,blood ,vessels of the ,brain1 which presses upon1 and prevents or impairs the ,functions of the ,nerves4 ,the whole ,difference between these two ,species consists in this1 that the sanguineous ,apoplexy prevails among strong robust ,persons1 who have a rich1 heavy1 thick and inflammable ,blood1 and that in a large ,quantity2 in which ,circumstance it becomes a genuine inflammatory ,distemper4 ,the serous1 or humoral ,apoplexy invades ,persons of a less robust ,constitution2 whose ,blood is more dilute or watery2 and rather viscid1 or lightly gelatinous1 than heavy or rich2 whole ,vessels are in a more relaxed ,state2 and who abound more in other ,humours than in red ,blood4 ,sec4 #adg4 ,when the first kind of this ,disease exists in its most violent ,degree1 it is then sometimes termed1 an apoplectic ,stroke1 or thundering ,apoplexy1 which kills in a ,moment or instantaneously1 and admits of no ,remedies4 ,when the ,assault is less violent1 and we find the ,patient with a strong1 full and raised ,pulse1 his ,visage red and bloated1 and his ,neck swelled up2 with an oppressed and loud hoarse ,respiration2 being sensible of nothing1 and capable of no other ,motions1 except some ,efforts to vomit1 the ,case is not always equally desperate4 ,we must therefore immediately1 #a4 ,entirely uncover the ,patient's ,head1 covering the rest of his ,body but very lightly2 procure him instantly very fresh free ,air1 and leave his ,neck quite unbound and open4 #b4 ,his ,head should be placed as high as may be1 with his ,feet hanging down4 #c4 ,he must lose from twelve to fifteen ,ounces of ,blood1 from a free open ,orifice in the ,arm3 the ,strength or ,violence with which the ,blood sallies out1 should determine the ,surgeon to take a few ,ounces more or less4 ,it should be repeated to the third or fourth ,time1 within the ,space of three or four ,hours2 if the ,symptoms seem to require it1 either in the ,arm1 or in the ,foot4 #d4 ,a ,glyster should be given of a ,decoction of the first emollient opening ,herbs that can be got1 with four ,spoonfuls of ,oil1 one ,spoonful of ,salt3 and this should be repeated every three ,hours4 #e4 ,if it is possible1 he should be made to swallow ,water plentifully1 in each ,pot of which three ,drams of ,nitre are to be dissolved4 #f4 ,as soon as the ,height and ,violence of the ,pulse abates2 when his ,breathing becomes less oppressed and difficult1 and his ,countenance less inflamed1 he should take the ,decoction ,no4 #bc2 or1 if it cannot be got ready in ,time1 he should take three ,quarters of an ,ounce of ,cream of ,tartar1 and drink ,whey plentifully after it4 ,this ,medicine succeeded extremely well with me in a ,case1 where ,i could not readily procure any other4 #g4 ,he should avoid all strong ,liquor1 ,wine1 distilled ,spirit1 whether inwardly or by outward ,application1 and should even be prevented from #cf smelling them4 #cf ,i have been very authentically assured of the ,death of a hale ,man1 which happened in the very ,act of pouring out a large ,quantity of distilled ,spirits1 by ,gallons or ,bucketfulls1 from one ,vessel into another4 ,k4 #h4 ,the ,patient should be stirred1 moved1 or even touched1 as little as it is possible3 in a ,word every ,thing must be avoided that can give him the least ,agitation4 ,this ,advice1 ,i am sensible1 is directly contrary to the common ,practice2 notwithstanding which it is founded in ,reason1 approved by ,experience1 and absolutely necessary4 ,in ,fact1 the whole ,evil results from the ,blood being forced up with too much ,force1 and in too great a ,quantity1 to the ,brain2 which being thence in a ,state of ,compression1 prevents every ,movement and every ,influence of the ,nerves4 ,in ,order1 therefore1 to re-establish these ,movements1 the ,brain must be unloaded1 by diminishing the ,force of the ,blood4 ,but strong ,liquors1 ,wines1 ,spirits1 volatile ,salts1 all ,agitation and ,frictions augment it1 and by that very ,means increase the ,load1 the ,embarrassment of the ,brain1 and thus heighten the ,disease itself4 ,on the contrary1 every ,thing that calms the ,circulation1 contributes to recall ,sensation and voluntary ,motion the sooner4 #i4 ,strong ,ligatures should be made about the ,thighs under the ,ham3 ,by this ,means the ,blood is prevented in its ,ascent from the ,legs1 and less is carried up to the ,head4 ,if the ,patient seems gradually1 and in ,proportion as he takes proper ,medicines1 to advance into a less violent ,state1 there may be some ,hopes4 ,but if he rather grows worse after his earliest ,evacuations1 the ,case is desperate4 ,sec4 #adh4 ,when ,nature and ,art effect his ,recovery1 his ,senses return3 though there frequently remains a little ,delirium or ,wandering for some ,time2 and almost always a paralytic ,defect1 more or less1 of the ,tongue1 the ,arm1 the ,leg1 and the ,muscles of the same ,side of the ,face4 ,this ,palsy sometimes goes off gradually1 by the ,help of cooling ,purges from ,time to ,time1 and a ,diet that is but very moderately and lightly nourishing4 ,all hot ,medicines are extremely hurtful in this ,case1 and may pave the ,way to a repeated ,attack4 ,a ,vomit might be even fatal1 and has been more than once so4 ,it should be absolutely forbidden2 nor should we even promote1 by ,draughts of warm ,water1 the ,efforts of the ,patient to vomit4 ,they do not any ways depend on any ,humour or ,mass in the ,stomach2 but on the ,oppression and ,embarrassment of the ,brain3 and the more considerable such ,efforts are1 the more such ,oppression is increased3 by ,reason that as long as they continue1 the ,blood cannot return from the ,head1 by which ,means the ,brain remains overcharged4 ,sec4 #adi4 ,the other ,species of ,apoplexy is attended with the like ,symptoms1 excepting the ,pulse not being so high nor strong2 the ,countenance being also less red1 sometimes even pale2 the ,breathing seems less oppressed2 and sometimes the ,sick have a greater ,facility to vomit1 and discharge more upwards4 ,as this ,kind of the ,disease attacks ,persons who abound less in ,blood2 who are less strong1 and less heated or inflamed1 ,bleeding is not often at all necessary3 at least the ,repetition of it is scarcely ever so3 and should the ,pulse have but a small ,fulness1 and not the least unnatural ,hardness1 ,bleeding might even be pernicious4 #a4 ,the ,patient however should be placed as was directed in the former ,mode of this ,disease2 though it seems not equally necessary here4 #b4 ,he should receive a ,glyster1 but without ,oil1 with double the ,quantity of ,salt1 and a ,bit of ,soap of the ,size of a small ,egg2 or with four or five ,sprigs of ,hedge ,hyssop4 ,it may be repeated twice a ,day4 #c4 ,he should be purged with the ,powder ,no4 #d4 #cg #cg ,vomits which are so pernicious in the sanguineous ,apoplexy1 where the ,patient's ,countenance and ,eyes are inflamed2 and which are also dangerous or useless1 when a ,person has been very moderate in his ,meals1 or is weakened by ,age or other ,circumstances1 and whole ,stomach is far from being overloaded with ,aliment1 are nevertheless very proper for gross ,feeders1 who are accustomed to exceed at ,table1 who have ,indigestions1 and have a ,mass of viscid glairy ,humours in their ,stomachs2 more especially1 if such a one has a little while before indulged himself excessively1 whence he has vomited without any other evident ,cause1 or at least had very ,strong ,nauseas1 or ,loathings4 ,in brief1 ,vomits are the true ,specific for ,apoplexies1 occasioned by any narcotic or stupifying ,poisons1 the pernicious ,effects of which cease1 the ,moment the ,persons so poisoned vomit them up4 ,an attentive ,consideration of what has occurred to the ,patient before his ,seizure2 his small natural ,propensity to this ,disease1 and great and incessant ,loathings1 render it manifest1 whether it has been caused by such ,poisons1 or such poisonous ,excesses4 ,in these two ,last ,cases a double ,dose of ,tartar emetic should be dissolved in a ,goblet or ,cup of ,water1 of which the ,patient should immediately take a large ,spoonful2 which should be repeated every ,quarter of an ,hour1 till it operates4 ,e4 ,l4 #d4 ,his common ,drink may be a ,strong ,infusion of ,leaves of ,balm4 #e4 ,the ,purge should be repeated the third ,day4 #f4 ,blisters should immediately be applied to the fleshy ,part of the ,legs1 or between the ,shoulder ,blades4 #ch #ch ,these ,blisters may be preceded by ,cupping with ,scarification on the ,nape of the ,neck4 ,this ,remedy1 often used by the ancient ,physicians1 but too little practiced in ,france1 is one of the most speedy1 and not the least efficacious1 ,applications in both sanguine and serous ,apoplexies4 ,e4 ,l4 #g4 ,should ,nature seem disposed to relieve herself by ,sweatings1 it should be encouraged2 and ,i have often known an ,infusion of the ,carduus benedictus1 or blessed ,thistle1 produce this ,effect very successfully4 ,if this ,method be entered upon1 the ,sweat ought to be kept up 7without stirring if possible7 for many ,days4 ,it has then sometimes happened1 that at the ,end of nine ,days1 the ,patient has been totally freed from the ,palsy1 which commonly succeeds this ,species of the ,apoplexy1 just as it does the other4 ,sec4 #aej4 ,persons who have been attacked with either kinds of this ,disease are liable to subsequent ones2 each of which is more dangerous than that preceding3 whence an ,endeavour to obviate or prevent such ,relapses becomes of the utmost ,importance4 ,this is to be effected in each ,sort by a very exact1 and rather severe ,diet1 even to diminishing the usual ,quantity of the ,patient's ,food2 the most essential ,precaution1 to be observed by any who have been once assaulted with it1 being entirely to leave off ,suppers4 ,indeed those1 who have been once attacked with the first1 the sanguineous ,apoplexies1 should be still more exact1 more upon their ,guard1 than the others4 ,they should deny themselves whatever is rich and juicy1 hot or aromatic1 sharp1 ,wine1 distilled ,liquors and ,coffee4 ,they should chiefly confine themselves to ,garden-,stuff1 ,fruits and ,acids2 such should eat but little ,flesh1 and only those called white2 taking every ,week two or three ,doses of the ,powder ,no4 #bd1 in a ,morning fasting1 in a ,glass of ,water4 ,they should be purged twice or thrice a ,year with the ,draught ,no4 #bc2 use daily ,exercise2 avoid very hot ,rooms1 and the violent ,heat of the ,sun4 ,they should go to ,bed betimes1 rise early1 never lie in ,bed above eight ,hours3 and if it is observed that their ,blood increases considerably1 and has a ,tendency towards the ,head1 they should be bled without ,hesitation3 and for some ,days restrain themselves entirely to a thin and low ,regimen1 without taking any solid ,food4 ,in these ,circumstances warm ,bathings are hurtful4 ,in the other1 the serous1 ,apoplexy1 instead of purging with ,no4 #bc1 the ,patient should take the ,purge ,no4 #ba4 ,sec4 #aea4 ,the same ,means1 that are proper to prevent a ,relapse1 might also obviate or keep off a primary or first ,assault1 if employed in ,time3 for notwithstanding it may happen very suddenly1 yet this ,disease foreshews itself many ,weeks1 sometimes many ,months1 nay even ,years beforehand1 by ,vertigos1 ,heaviness of the ,head2 small ,defects of the ,tongue or ,speech2 short and momentary ,palsies1 sometimes of one1 sometimes of another1 ,part3 sometimes by ,loathings and ,reachings to vomit2 without supposing any ,obstruction or ,load in the first ,passages1 or any other ,cause in the ,stomach1 or the adjoining ,parts4 ,there happens also some particular ,change in the ,looks and ,visage not easy to be described3 sharp and short ,pains about the ,region of the ,heart2 an ,abatement of the ,strength1 without any discernible ,cause of it4 ,besides there are still some other ,signs1 which signify the ,ascent of the ,humours too much to the ,head1 and shew1 that the ,functions of the ,brain are embarrassed4 ,some ,persons are liable to certain ,symptoms and ,appearances1 which arise from the same ,cause as an ,apoplexy2 and which indeed may be considered as very light benign ,apoplexies1 of which they sustain many ,attacks1 and yet without any considerable ,annoyance of their ,health4 ,the ,blood1 all at once as it were1 flushes up to their ,heads3 they appear heedless or blundering2 and have sometimes ,disgusts and ,nauseas1 and yet without any ,abatement of their ,understanding1 their ,senses1 or ,motion of any ,sort4 ,tranquillity of ,mind and ,body1 once ,bleeding1 and a few ,glysters usually carry it off soon after its ,invasion4 ,the ,returns of it may be prevented by the ,regimen directed ,sec4 #aej2 and especially by a frequent ,use of the ,powder ,no4 #bd4 ,at the long ,run however1 one of these ,attacks commonly degenerates into a mortal ,apoplexy3 though this may be retarded for a very long ,time by an exact ,regimen1 and by avoiding all strong ,commotions of the ,mind1 but especially that of ,anger or violent ,rage4 ,chapter ,x4 ,of the violent ,influence1 or ,strokes1 of the ,sun4 ,sect4 #aeb4 ,this ,appellation is applied to those ,disorders1 which arise from too violent an ,influence of the ,heat of the ,sun1 immediately upon the ,head2 and which in one ,word may be termed ,insolation4 ,if we consider that ,wood1 ,stone and ,metals1 when long exposed to the ,sun1 become very hot1 and that even in temperate ,climates1 to such a ,degree1 that they can scarcely be touched without some ,sensation of burning1 we may easily conceive the ,risk a ,person undergoes1 in having his ,head exposed to the same ,degree of ,heat4 ,the ,blood-,vessels grow dry1 the ,blood itself becomes condensed or thickened1 and a real ,inflammation is formed1 which has proved mortal in a very little ,time4 ,it was this ,distemper1 a ,stroke of the ,sun1 which killed ,manasses the ,husband of ,judith4 ',for as he was among the ,labourers who bound up the ,sheafs in the ,fields1 the ,heat struck upon his ,head1 and he was taken ill2 he went to ,bed and he died4' ,the ,signs which precede and attend this ,disease are1 being exposed in a ,place where the ,sun shines forth with great ,force and ,ardour2 a violent ,head-ach1 attended with a very hot and extremely dry ,skin3 the ,eyes are also dry and red1 being neither able to remain open1 nor yet to bear the ,light2 and sometimes there is a kind of continual and involuntary ,motion in the ,eyelid2 while some ,degree of ,relief is perceivable from the ,application of any cooling ,liquor4 ,it often happens that some cannot possibly sleep2 and at other times they have a great ,drowsiness1 but attended with outrageous ,wakenings3 there is a very strong ,fever2 a great ,faintness1 and a total ,disrelish and ,loathing4 ,sometimes the ,patient is very thirsty1 and at other times not at all3 and the ,skin of his ,face often looks as though it were burnt4 ,sec4 #aec4 ,people may be affected with the ,disease from this ,cause1 at two different ,seasons of the ,year2 that is1 either in the ,spring1 or during the very raging ,heats2 but their ,events are very different4 ,country ,people and ,labourers are but little liable to the former4 ,they chiefly affect the ,inhabitants of ,cities1 and delicate ,persons1 who have used very little ,exercise in the ,winter1 and abound with superfluous ,humours4 ,if thus circumstanced they expose themselves to the ,sun1 as even in the ,spring he attains a considerable ,force2 and1 by the ,course of ,life they have led1 their ,humours are already much disposed to mount to the ,head2 while the ,coolness of the ,soil1 especially when it has rained1 prevents their ,feet from being so easily warmed2 the ,power of the ,sun acts upon their ,head like a ,blister1 attracting a great ,quantity of ,humours to it4 ,this produces excruciating ,pains of the ,head1 frequently accompanied with quick and violent ,shootings1 and with ,pain in the ,eyes2 notwithstanding this ,degree of the ,malady is seldom dangerous4 ,country ,people1 and even such ,inhabitants of ,cities and ,towns1 as have not forbore to exercise themselves in ,winter1 have no ,sort of ,dread of these ,strokes of the ,sun1 in the ,spring of the ,year4 ,its ,summer ,strokes are much more vehement and troublesome1 and assault ,labourers and ,travellers1 who are for a long ,time exposed to the ,fervour of it4 ,then it is that the ,disease is aggravated to its highest ,pitch1 those who are thus struck often dying upon the ,spot4 ,in the hot ,climates this ,cause destroys many in the very ,streets1 and makes dreadful ,havock among ,armies on the ,march1 and at ,sieges4 ,some tragical ,effects of it1 on such ,occasions1 are seen even in the temperate ,countries4 ,after having marched a whole ,day in the ,sun1 a ,man shall fall into a ,lethargy1 and die within some ,hours1 with the ,symptoms of raving ,madness4 ,i have seen a ,tyler in a very hot ,day1 complaining to his ,comrade of a violent ,pain in his ,head1 which increased every ,moment almost2 and at the very ,instant when he purposed to retire out of the ,sun1 he sunk down dead1 and fell down from the ,house he was slating4 ,this same ,cause produces very often in the ,country some most dangerous ,phrenzies1 which are called there hot or burning ,fevers4 ,every ,year furnishes but too many of them4 ,sec4 #aed4 ,the ,vehemence of the ,sun is still more dangerous to those1 who venture to sleep exposed to it4 ,two ,mowers who fell asleep on a ,haycock1 being wakened by some others1 immediately on waking1 staggered1 and pronouncing a few incoherent unmeaning ,words1 died4 ,when the ,violence of ,wine and that of the ,sun are combined1 they kill very suddenly3 nor is there a single ,year in which ,peasants are not found dead on the ,highroads2 who being drunk endeavoured to lie down in some ,corner1 where they perished by an ,apoplexy1 from the ,heat of the ,sun and of strong ,drink4 ,those of them who escape so speedy and premature a ,death1 are subject for the ,remainder of their ,lives1 to chronical1 or tedious ,head-achs2 and to suffer some little ,disorder and ,confusion in their ,ideas4 ,i have seen some ,cases1 when after violent ,head-achs of some ,days ,continuance1 the ,disease has been transferred to the ,eyelids1 which continued a long ,time red and distended1 so that they could not be kept asunder or open4 ,it has also been known1 that some ,persons have been struck by the ,sun into a ,delirium or ,raving1 without a ,fever1 and without complaining of a ,head-ach4 ,sometimes a ,gutta ,serena has been its ,consequence2 and it is very common to see ,people1 whose long ,continuance under the strong ,light and ,influence of the ,sun1 has made such an ,impression upon the ,eyes1 as presents them with different ,bodies flying about in the ,air1 which distract and confuse their ,sight4 ,a ,man of forty two ,years of ,age1 having been exposed for several ,hours to the violent ,heat of the ,sun1 with a very small ,cap or ,bonnet2 and having past the following ,night in the open ,air1 was attacked the next ,day with a most severe ,head-ach1 a burning ,fever1 ,reachings to vomit1 great ,anguish1 and red and sparkling ,eyes4 ,notwithstanding the best ,assistance of several ,physicians1 he became phrenitic on the fifth ,day1 and died on the ninth4 ,suppurated ,matter was discharged from his ,mouth1 one of his ,nostrils1 and his right ,ear1 a few ,hours before his ,death2 upon ,dissection a small ,abscess was found within the ,skull2 and the whole ,brain1 as well as all the ,membranes inclosing it1 were entirely corrupted4 ,sec4 #aee4 ,in very young ,children1 who are not1 or never should be1 exposed for any long ,time to such excessive ,heat 7and whom a slight ,cause will often affect7 this ,malady discovers itself by a heavy deep ,drowsiness1 which lasts for several ,days2 also by incessant ,ravings mingled with ,rage and ,terror1 much the same as when they are affected with violent ,fear3 and sometimes by convulsive ,twitchings2 by ,head-achs which returned at certain ,periods1 and continual ,vomitings4 ,i have seen ,children1 who1 after a ,stroke of the ,sun1 have been harrassed a long ,time with a little ,cough4 ,sec4 #aef4 ,old ,men who often expose themselves imprudently to the ,sun1 are little apprized of all the ,danger they incur by it4 ,a certain ,person1 who purposely sunned himself for a considerable ,time1 in the clear ,day of an intermitting tertian ,fever1 underwent the ,assault of an ,apoplexy1 which carried him off the following ,day4 ,and even when the ,disease may not be so speedy and violent1 yet this ,custom 7of sunning in hot ,weather7 certainly disposes to an ,apoplexy1 and to ,disorders of the ,head4 ,one of the slightest ,effects of much solar ,heat upon the ,head is1 to cause a ,defluxion from the ,brain1 a ,swelling of the ,glands of the ,neck1 and a ,dryness of the ,eyes1 which sometimes continues for a considerable ,term after it4 ,sec4 #aeg4 ,the effect of too much culinary1 or common ,fire1 is of the same ,quality with that of the ,sun4 ,a ,man who fell asleep with his ,head directly opposite1 and probably1 very near to the ,fire1 went off in an ,apoplexy1 during his ,nap4 ,sec4 #aeh4 ,the ,action of too violent a ,sun is not only pernicious1 when it falls upon the ,head2 but it is also hurtful to other ,parts2 and those who continue long exposed to it1 though their ,heads should not be affected1 experience violent ,pains1 a disagreeable ,sensation of ,heat1 and a considerable ,stiffness in the ,parts that have been1 in some ,manner1 parched by it2 as in the ,legs1 the ,knees1 the ,thighs1 ,reins and ,arms2 and sometimes they prove feverish4 ,sec4 #aei4 ,in contemplating the ,case of a ,patient1 ,sun-struck1 as we may term it1 we must endeavour to distinguish1 whether there may not be also some other joint ,causes concurring to the ,effect4 ,a ,traveller1 a labouring ,man1 is often as much affected by the ,fatigue of his ,journey1 or of his ,labour1 as he is by the ,influence of solar ,heat4 ,sec4 #afj4 ,it is necessary to set about the ,cure of this ,disease1 as soon as ever we are satisfied of its ,existence3 for such as might have been easily preserved by an early ,application1 are considerably endangered by a ,neglect of it4 ,the ,method of treating this is very much the same1 with that of the inflammatory ,diseases already mentioned2 that is1 by ,bleeding1 and cooling ,medicines of various ,kinds in their ,drinks1 by ,bathings1 and by ,glysters4 ,and #a4 ,if the ,disease be very high and urgent1 a large ,quantity of ,blood should be taken away1 and occasionally repeated4 ,lewis the ,,xiv4 was bled nine ,times to prevent the ,fatality of a ,stroke of the ,sun1 which he received in ,hunting in #afeh4 #b4 ,after ,bleeding1 the ,patient's ,legs should be plunged into warm ,water4 ,this is one of the ,applications that affords the most speedy ,relief2 and ,i have seen the ,head-ach go off and return again1 in ,proportion to the ,repetition1 and the ,duration1 of these ,bathings of the ,legs4 ,when the ,disorder is highly dangerous1 it will be necessary to treat the ,patient with ,semicupia1 or warm ,baths1 in which he may sit up to his ,hips2 and in the most dangerous ,degrees of it1 even to bathe the whole ,body3 but the ,water in this ,case1 as well as in ,bathings of the ,feet1 should be only sensibly warm3 the ,use of hot would be highly pernicious4 #c4 ,glysters made from a ,decoction of any of the emollient ,herbs are also very effectual4 #d4 ,the ,patient should drink plentifully of ,almond ,emulsion ,no4 #d2 of ,limonade1 which is a ,mixture of the ,juice of ,lemons and ,water1 7and is the best ,drink in this ,disease7 of ,water and ,vinegar1 which is a very good ,substitute for ,limonade2 and of1 what is still more efficacious1 very clear ,whey1 with the ,addition of a little ,vinegar4 ,these various ,drinks may all be taken cold2 ,linen ,cloths dipt in cold ,water and ,vinegar of ,roses may be applied to the ,forehead1 the ,temples1 or all over the ,head1 which is equivalent to every other ,application used upon such ,occasions4 ,those which are the most cried up1 are the ,juice of ,purslain1 of ,lettuce1 of ,houseleek1 and of ,vervain4 ,the ,drink ,no4 #cb is also serviceable1 taken every ,morning fasting4 ,sec4 #afa4 ,cold ,baths have sometimes recovered ,persons out of such violent ,symptoms1 from this ,cause1 as have been almost quite despaired of4 ,a ,man twenty ,years of ,age1 having been a very long ,time exposed to the scorching ,sun1 became violently delirious1 without a ,fever1 and proved really mad4 ,after repeated ,bleedings1 he was thrown into a cold ,bath1 which was also frequently repeated2 pouring cold ,water1 at the same ,time1 upon his ,head4 ,with such ,assistance he recovered1 though very gradually4 ,an ,officer who had rode ,post for several ,days successively1 in very hot ,weather1 swooned away1 immediately on dismounting2 from which he could not be recovered by the ordinary ,assistance in such ,cases4 ,he was saved however1 in ,consequence of being plunged into a ,bath of freezing ,water4 ,it should be observed however1 that in these ,cases the cold ,bath should never be recurred to1 without previous ,bleeding4 ,sec4 #afb4 ,it is past ,doubt1 that if a ,person stands still in the violent ,heat of the ,sun1 he is more liable to be struck with it1 than if he walks about2 and the ,use of white ,hats1 or of some ,folds of clean white ,paper under a black one1 may sensibly contribute to prevent any ,injury from the considerable ,heat of the ,sun2 though it is a very incompetent ,defence against a violent ,degree of it4 ,the natural ,constitution1 or even that ,constitution1 which has been formed from long ,custom and ,habit1 make a very great ,difference between the ,effects of solar ,heat on different ,persons4 ,people insensibly accustom themselves to the ,impressions of it1 as they do to those of all the other ,bodies and ,elements1 which are continually acting upon us2 and by ,degrees we arrive at a ,power of sustaining his violent ,heat with ,impunity3 just as others arrive at the ,hardiness of bearing the most rigid ,colds1 with very little ,complaint or ,inconvenience4 ,the human ,body is capable of supporting many more ,violences and ,extremes1 than it commonly does4 ,its natural ,force is scarcely ever ascertained among civilized ,nations2 because their ,education generally tends to impair and lessen it1 and always succeeds in this ,respect4 ,if we were inclined to consider a purely natural1 a simply physical ,man1 we must look for him among savage ,nations2 where only we can discover what we are able to be1 and to bear4 ,we certainly could not fail of being ,gainers1 by adopting their corporal ,education2 neither does it seem as yet to have been infallibly demonstrated1 that we should be great ,losers in commuting our moral ,education for theirs4 #ci #ci ,as some may think an ,apology necessary for a ,translation of this ,chapter on a ,disease1 which never1 or very seldom1 exists in this or the adjacent ,island1 ,i shall observe here1 that1 abstracted from the ,immorality of a narrow and local ,solicitude only for ourselves1 we are politically interested as a ,nation always in ,trade1 and often at ,war 7and whose ,subjects are extended into very distant and different ,climates7 to provide against a sudden and acute ,distemper1 to which our ,armies1 our ,sailors and ,colonies are certainly often exposed4 ,a ,fatality from this ,cause is not restrained to our ,islands within the ,tropic1 where several ,instances of it have occurred during the late ,war3 but it has also been known to prevail as far ,northward as ,pensylvania1 in their ,summers1 and even in their ,harvests4 ,i once received a sensible ,scald on the ,back of my ,thumb1 from the ,sun suddenly darting out through a clear ,hole1 as it were1 in a ,cloud1 after a short and impetuous ,shower in ,summer2 which ,scald manifestly blistered within some ,minutes after4 ,had this concentrated ,ray been darted on my bare ,head1 the ,consequence might have been more dangerous2 or perhaps as fatal as some of the ,cases recorded by ,dr4 ,tissot1 in this ,chapter4 ,k4 ,chapter ,,xi4 ,of the ,rheumatism4 ,sect4 #afc4 ,the ,rheumatism may exist either with or without a ,fever4 ,the first of these may be classed among the ,diseases1 of which ,i have already treated2 being an ,inflammation which is manifested by a violent ,fever1 preceded by ,shivering1 a subsequent ,heat1 hard ,pulse1 and a ,head-ach4 ,sometimes indeed an extraordinary ,coldness1 with general ,uneasiness and ,inquietude1 exists several ,days before the ,fever is perceived4 ,on the second or third ,day1 and sometimes even on the first1 the ,patient is seized with a violent ,pain in some ,part of his ,body1 but especially about the ,joints1 which entirely prevents their ,motion1 and which is often accompanied with ,heat1 ,redness and a ,swelling of the ,part4 ,the ,knee is often the first ,part attacked1 and sometimes both the ,knees at once4 ,when the ,pain is fixed1 an ,abatement of the ,fever frequently happens2 though in some other ,persons it continues for several ,days1 and increases every ,evening4 ,the ,pain diminishes in one ,part after a ,duration of some ,days1 and then invades some other4 ,from the ,knee it descends to the ,foot1 or mounts to the ,hip1 to the ,loins1 the ,shoulder-blades1 ,elbow1 ,wrist1 the ,nape of the ,neck1 and frequently is felt in the intermediate ,parts4 ,sometimes one ,part is quite free from ,pain1 when another is attacked2 at other ,times many ,parts are seized nearly at the same ,instant2 and ,i have sometimes seen every ,joint afflicted at once4 ,in this ,case the ,patient is in a very terrible ,situation1 being incapable of any ,motion1 and even dreading the ,assistance of his ,attendants1 as he can scarcely admit of touching1 without a sensible ,aggravation of his ,pains4 ,he is unable to bear even the ,weight of the ,bed-clothes1 which must be1 as it were1 arched over his ,limbs by a proper ,contrivance1 to prevent their ,pressure3 and the very walking across the ,chamber increases his ,torments4 ,the ,parts in which they are the most excruciating1 and obstinate1 are the ,region of the ,loins1 the ,hips1 and the ,nape or hinder ,part of the ,neck4 ,sec4 #afd4 ,this ,disease is also often extended over the ,scalp and the ,surface of the ,head2 and there the ,pains are excessive4 ,i have seen them affect the ,eyelids and the ,teeth with inexpressible ,torment4 ,as long as the ,distemper is situated in the more external ,parts1 the ,patient1 however painful his ,situation may prove1 is in no great ,danger1 if he be properly treated3 but if by some ,accident1 some ,error1 or by any latent ,cause1 the ,disease be repelled upon an internal ,part or ,organ1 his ,case is extremely dangerous4 ,if the ,brain is attacked1 a frantic raging ,delirium is the ,consequence2 if it falls upon the ,lungs1 the ,patient is suffocated3 and if it attacks the ,stomach or the ,bowels1 it is attended with the most astonishing ,pains1 which are caused by the ,inflammation of those ,parts1 and which ,inflammation1 if violent1 is #dj speedily fatal4 ,about two ,years since ,i was called to a robust ,man1 whose ,guts were already in a gangrenous ,state1 which was the ,consequence of a ,rheumatism1 that first attacked one ,arm and one ,knee2 the ,cure of which had been attempted by sweating the ,patient with some hot ,remedies4 ,these indeed brought on a plentiful ,sweat2 but the inflammatory ,humour seized the ,intestines1 whose ,inflammation degenerated into a ,gangrene1 after a ,duration of the most acute ,pain for thirty-six ,hours2 his ,torments terminating in ,death two ,hours after ,i saw him4 #dj ,see ,note #af to ,page #ei4 ,sec4 #afe4 ,this ,malady however is often in a less violent ,degree2 the ,fever is but moderate1 and ceases entirely when the ,pain begins2 which is also confined to one1 or not more than two ,parts4 ,sec4 #aff4 ,if the ,disease continues fixed1 for a considerable ,time1 in one ,joint1 the ,motion of it is impaired for ,life4 ,i have seen a ,person1 who has now a wry ,neck1 of twenty ,years standing1 in ,consequence of a ,rheumatism in the ,nape of the ,neck2 and ,i also saw a poor young ,man from ,jurat1 who was ,bed-ridden1 and who had lost the ,motion of one ,hip and both ,knees4 ,he could neither stand nor sit1 and there were but a few ,postures in which he could even lie in ,bed4 ,sec4 #afg4 ,an obstructed ,perspiration1 an inflammatory ,thickness of the ,blood1 constitute the most general ,cause of the ,rheumatism4 ,this last concurring ,cause is that we must immediately encounter2 since1 as long as that subsists1 ,perspiration cannot be perfectly re-established1 which follows of ,course1 when the ,inflammation is cured4 ,for which ,reason this ,distemper must be conducted like the other inflammatory ones1 of which ,i have already treated4 ,sec4 #afh4 ,as soon as it is sufficiently manifest1 the ,glyster ,no4 #e1 should be injected2 and twelve ,ounces of ,blood be taken from the ,arm an ,hour after4 ,the ,patient is to enter upon a ,regimen1 and drink plentifully of the ,ptisan ,no4 #b1 and of ,almond ,milk or ,emulsion ,no4 #d4 ,as this last ,medicine may be too costly in ,country ,places for the poor ,peasantry2 they may drink1 in ,lieu of it1 very clear ,whey1 sweetened with a little ,honey4 ,i have known a very severe ,rheumatism cured1 after twice bleeding1 without any other ,food or ,medicine1 for the ,space of thirteen ,days4 ,the ,whey also may be happily used by ,way of ,glyster4 ,sec4 #afi4 ,if the ,distemper is not considerably asswaged by the first ,bleeding1 it should be repeated some ,hours after4 ,i have ordered it four ,times within the first two ,days2 and some ,days after ,i have even directed a fifth ,bleeding4 ,but in general the ,hardness of the ,pulse becomes less after the second3 and notwithstanding the ,pains may continue as severe as before1 yet the ,patient is sensible of less ,inquietude4 ,the ,glyster must be repeated every ,day1 and even twice a ,day1 if each of them is attended only with a small ,discharge2 and particularly if there be a violent ,head-ach4 ,in such ,cases as are excessively painful1 the ,patient can scarcely dispose himself into a proper ,attitude or ,posture to receive ,glysters3 and in such ,circumstances his ,drinks should be made as opening as possible2 and a ,dose of the ,cream of ,tartar ,no4 #bd should be given ,night and ,morning4 ,this very ,medicine1 with the ,assistance of ,whey1 cured two ,persons ,i advised it to1 of rheumatic ,pains1 of which they had been infested with frequent ,returns for many ,years1 and which were attended with a small ,fever4 ,apples coddled1 ,prunes stewed1 and well ripened ,summer ,fruits are the properest ,nourishment in this ,disease4 ,we may save the ,sick a good deal of ,pain1 by putting one strong ,towel always under their ,back1 and another under their ,thighs1 in order to move them the more easily4 ,when their ,hands are without ,pain1 a third ,towel hung upon a ,cord1 which is fastened across the ,bed1 must considerably assist them in moving themselves4 ,sec4 #agj4 ,when the ,fever entirely disappears1 and the ,hardness of the ,pulse is removed1 ,i have ordered the ,purge ,no4 #bc with a very good ,effect2 and if it is attended with five or six ,motions1 the ,patient is very sensibly relieved4 ,the ,day but one after it may be repeated successfully1 and a third ,time1 after an ,interval of a greater ,number of ,days4 ,sec4 #aga4 ,when the ,pains are extremely violent1 they admit of no ,application3 ,vapour-,baths however may be employed1 and provided they are often used1 and for a considerable ,time1 they prove very efficacious4 ,the ,purpose of these ,baths is only to convey the ,steam of boiling ,water to the ,parts affected2 which may always easily be effected1 by a ,variety of simple and easy ,contrivances2 the ,choice of which must depend on the different ,circumstances and ,situation of the ,sick4 ,whenever it is possible1 some of the emollient ,applications ,no4 #i1 should be continually employed4 ,a half ,bath1 or an entire ,bath of warm ,water1 in which the ,patient should remain an ,hour1 after sufficient ,bleedings and many ,glysters1 affords the greatest ,relief4 ,i have seen a ,patient1 under the most acute ,pains of the ,loins1 of the ,hips1 and of one ,knee1 put into one4 ,he continued still under extreme ,torment in the ,bath1 and on being taken out of it3 but an ,hour after he had been put to ,bed1 he sweated1 to an incredible ,quantity1 for thirty six ,hours1 and was cured4 ,the ,bath should never be made use of1 until after repeated ,bleedings1 or at least other equivalent ,evacuations3 for otherwise timed1 it would aggravate the ,disease4 ,sec4 #agb4 ,the ,pains are generally most severe in the ,night2 whence it has been usual to give composing soporific ,medicines4 ,this however has been very erroneous1 as ,opiates really augment the ,cause of the ,disease1 and destroy the ,efficacy of the proper ,remedies3 and1 even not seldom1 far from asswaging the ,pains1 they increase them4 ,indeed they agree so little in this ,disease1 that even the ,patient's natural ,sleep at the ,invasion of this ,complaint1 is rather to his ,detriment4 ,they feel1 the very ,moment they are dropping asleep1 such violent ,jirks as awaken them with great ,pain3 or if they do sleep a few ,minutes1 the ,pains are stronger when they awake4 ,sec4 #agc4 ,the ,rheumatism goes off either by ,stool1 by turbid thick ,urine which drops a great ,proportion of a yellowish ,sediment1 or by ,sweats3 and it generally happens that this last ,discharge prevails towards the ,conclusion of the ,disease4 ,it may be kept up by drinking an ,infusion of ,elder ,flowers4 ,at the ,beginning however ,sweating is pernicious4 ,sec4 #agd4 ,it happens also1 though but very seldom1 that ,rheumatisms determine by depositing a sharp ,humour upon the ,legs2 where it forms ,vesications1 or a kind of ,blisterings2 which burst open and form ,ulcers1 that ought not to be healed and dried up too hastily2 as this would occasion a speedy ,return of the rheumatic ,pains4 ,they are disposed to heal naturally of themselves1 by the ,assistance of a temperate regular ,diet1 and a few gentle ,purges4 ,sec4 #age4 ,sometimes again1 an ,abscess is formed either in the affected ,part1 or in some neighbouring one4 ,i have seen a ,vineyard ,dresser1 who after violent ,pains of the ,loins1 had an ,abscess in the upper ,part of the ,thigh1 which he neglected for a long ,time4 ,when ,i saw him1 it was of a monstrous ,size4 ,i ordered it to be opened1 when at once above three ,pots of #da ,matter rushed out of it3 but the ,patient1 being exhausted1 died some ,time after it4 #da ,this1 according to our ,author's ,estimation of the ,pot-,measure at ,berne1 which is that he always means1 and which he says contains exactly 7of ,water we suppose7 fifty one ,ounces and a ,quarter 7though without a material ,error it may be computed at three ,pounds and a ,quarter7 will amount at least to nine ,pounds and three ,quarters of ,matter1 supposing this no heavier than ,water4 ,by ,measure it will want but little of five of our ,quarts3 a very extraordinary ,discharge indeed of ,pus at once1 and not unlikely to be attended by the ,event which soon followed4 ,k4 ,another ,crisis of the ,rheumatism has happened by a kind of ,itch1 which breaks out upon all the ,parts adjacent to the ,seat of this ,disease4 ,immediately after this ,eruption the ,pains vanish2 but the ,pustules sometimes continue for several ,weeks4 ,sec4 #agf4 ,i have never observed the ,pains to last1 with considerable ,violence1 above fourteen ,days1 in this ,species of the ,rheumatism2 though there remains a ,weakness1 ,numbness1 and some ,inflation1 or ,puffing1 of the adjoining ,parts3 and it will also be many ,weeks1 and sometimes even ,months2 especially if the ,distemper attacked them in the ,fall1 before the ,sick recover their usual ,strength4 ,i have known some ,persons1 who1 after a very painful ,rheumatism1 have been troubled with a very disagreeable ,sensation of ,lassitude2 which did not go off till after a great ,eruption1 all over the ,body1 of little ,vesications or ,blisterings1 full of a watery ,humour2 many of them burst open1 and others withered and dried up without bursting4 ,sec4 #agg4 ,the ,return of ,strength into the ,parts affected may be promoted by ,frictions ,night and ,morning1 with ,flannel or any other woollen ,stuff2 by using ,exercise2 and by conforming exactly to the ,directions given in the ,chapter on ,convalescence1 or ,recovery from acute ,diseases4 ,the ,rheumatism may also be prevented by the ,means ,i have pointed out1 in treating of ,pleurisies and ,quinsies4 ,sec4 #agh4 ,sometimes the ,rheumatism1 with a ,fever1 invades ,persons who are not so sanguine1 or abounding in ,blood2 or whose ,blood is not so much disposed to ,inflammation2 those whose ,flesh and ,fibres are softer2 and in whose ,humours there is more ,thinness and ,sharpness1 than ,viscidity and ,thickness4 ,bleeding proves less necessary for ,persons so constituted1 notwithstanding the ,fever should be very strong4 ,some ,constitutions require more ,discharges by ,stool2 and after they are properly evacuated1 some ,blisters should be applied1 which often afford them a sensible ,relief as soon as ever they begin to operate4 ,nevertheless they should never be used where the ,pulse is hard4 ,the ,powder ,no4 #be answers very well in these ,cases4 ,sec4 #agi4 ,there is another ,kind of ,rheumatism1 called chronical1 or lasting4 ,it is known by the following ,characters or ,marks4 #a4 ,it is commonly unattended with a ,fever4 #b4 ,it continues a very long ,time4 #c4 ,it seldom attacks so many ,parts at once as the former4 #d4 ,frequently no visible ,alteration appears in the affected ,part1 which is neither more hot1 red1 or swelled than in its healthy ,state2 though sometimes one or other of these ,symptoms is evident4 #e4 ,the former1 the inflammatory1 ,rheumatism assaults strong1 vigorous1 robust ,persons3 but this rather invades ,people arrived at a certain ,period of ,life1 or such as are weak and languishing4 ,sec4 #ahj4 ,the ,pain of the chronical ,rheumatism1 when left to itself1 or injudiciously treated1 lasts sometimes many ,months1 and even ,years4 ,it is particularly and extremely obstinate1 when it is exerted on the ,head1 the ,loins1 or on the ,hip1 and along the ,thighs1 when it is called the ,sciatica4 ,there is no ,part indeed which this ,pain may not invade2 sometimes it fixes itself in a small ,spot1 as in one ,corner of the ,head2 the ,angle of the ,jaw2 the ,extremity of a ,finger2 in one ,knee2 on one ,rib1 or on the ,breast1 where it often excites ,pains1 which make the ,patient apprehensive of a ,cancer4 ,it penetrates also to the internal ,parts4 ,when it affects the ,lungs1 a most obstinate ,cough is the ,consequence2 which degenerates at length into very dangerous ,disorders of the ,breast4 ,in the ,stomach and ,bowels it excites most violent ,pains like a ,cholic2 and in the ,bladder1 ,symptoms so greatly resembling those of the ,stone1 that ,persons1 who are neither deficient in ,knowlege nor ,experience1 have been more than once deceived by them4 ,sec4 #aha4 ,the ,treatment of this chronical ,rheumatism does not vary considerably from that of the former4 ,nevertheless1 in the first ,place1 if the ,pain is very acute1 and the ,patient robust1 a single ,bleeding at the ,onset is very proper and efficacious4 #b4 ,the ,humours ought to be diluted1 and their ,acrimony or ,sharpness should be diminished1 by a very plentiful ,use of a ,ptisan of #db ,burdock ,roots ,no4 #bf4 #c4 ,four or five ,days after drinking abundantly of this1 the purging #dc ,powder ,no4 #ba may be taken with ,success4 ,in this ,species of the ,rheumatism1 a certain ,medicine is sometimes found serviceable4 ,this has acquired some ,reputation1 particularly in the ,country1 where they bring it from1 ,geneva2 under the ,title of the ,opiate for the ,rheumatism1 tho' ,i cannot say for what ,reason2 as it is indeed neither more nor less than the ,electuary ,caryocostinum1 which may be procured at our ,apothecaries4 ,i shall observe however1 that this ,medicine has done ,mischief in the inflammatory ,rheumatism1 and even in this1 as often as the ,persons afflicted with it are feeble1 thin and of a hot ,temperament2 and either when they have not previously taken diluting ,drinks1 or when it has been used too long4 ,for1 in such a ,circumstance1 it is apt to throw the ,patient into an irrecoverable ,weakness4 ,the ,composition consists of the hottest ,spices1 and of very sharp ,purgatives4 #db ,half a ,pint of a pretty strong ,infusion of the ,leaves of ,buckbean1 which grows wild here1 taken once a ,day rather before ,noon1 has also been found very serviceable in that ,species of a chronical ,rheumatism1 which considerably results from a scorbutic ,state of the ,constitution4 ,k4 #dc ,another very good ,purge1 in this ,kind of ,rheumatism1 may also be compounded of the best ,gum ,guiacum in ,powder from #cj to #dj ,grains2 dissolved in a little ,yolk of a fresh ,egg2 adding from #f to #aj ,grains of ,jallap powdered1 and from #c to #e ,grains of powdered ,ginger1 with as much plain or sorrel ,water1 as will make a purging ,draught for a stronger or weaker grown ,patient4 ,should the ,pains frequently infest the ,stomach1 while the ,patient continues costive1 and there is no other ,fever than such a small symptomatic one1 as may arise solely from ,pain1 he may safely take1 if grown up1 from #cj to #de ,drops of the volatile ,tincture of ,gum ,guiacum1 in any diluting ,infusion1 that may not coagulate or separate the ,gum4 ,it generally disposes at first to a gentle ,diaphoresis or ,sweat1 and several ,hours after to one1 and sometimes to a second ,stool1 with little or no ,griping4 ,k4 ,sec4 #ahb4 ,when general ,remedies have been used1 and the ,disorder still continues1 ,recourse should be had to such ,medicines1 as are available to restore ,perspiration2 and these should be persisted in for a considerable ,time4 ,the ,pills ,no4 #ah1 with a strong ,infusion of ,elder ,flowers1 have often succeeded in this ,respect3 and then after a long ,continuance of diluting ,drinks1 if the ,fever is entirely subdued2 if the ,stomach exerts its ,functions well2 the ,patient is no ways costive2 if he is not of a dry ,habit of ,body2 and the ,part affected remains without ,inflammation1 the ,patient may safely take the ,powder ,no4 #bi1 at ,night going to ,bed1 with a ,cup or two of an ,infusion of ,carduus benedictus1 or the blessed ,thistle1 and a ,morsel of ,venice ,treacle of the ,size of a ,hazel ,nut1 or a ,filberd4 ,this ,remedy brings on a very copious ,sweating1 which often expells the #dd ,disease4 ,these ,sweats may be rendered full more effectual1 by wrapping up the affected ,part in a ,flanel dipt in the ,decoction ,no4 #bg4 #dd ,gum ,guaiacum1 given from six to ten ,grains ,morning and ,night1 is often very successful in these ,cases4 ,it may be made into ,pills or ,bolusses with the ,rob of ,elder1 or with the ,extract of ,juniper4 ,e4 ,l4 ,sec4 #ahc4 ,but of all these ,pains1 the ,sciatica is one of the most tedious and obstinate4 ,nevertheless ,i have seen the greatest ,success1 from the ,application of seven or eight ,cupping-,glasses on the tormented ,part2 by which1 without the ,assistance of any other ,remedy1 ,i have cured1 in a few ,hours1 ,sciaticas of many ,years standing1 which had baffled other ,remedies4 ,blisters1 or any such stimulating ,plaisters1 as bring on a ,suppuration and ,discharge from the afflicted ,part1 contribute also frequently to the ,cure2 tho' less effectually than ,cupping1 which should be repeated several ,times4 ,green ,cere-cloth1 commonly called ,oil-cloth1 7whether the ,ingredients be spread on ,taffety or on ,linen7 being applied to the diseased ,part1 disposes it to sweat abundantly1 and thus to discharge the sharp ,humour which occasions the ,pain4 ,sometimes both these ,applications1 but especially that spread on ,silk 7which may be applied more exactly and closely to the ,part1 and which is also spread with a different ,composition7 raise a little ,vesication on the ,part as ,blisters do4 ,a ,plaister of ,quicklime and ,honey blended together has cured inveterate ,sciaticas4 ,oil of ,eggs has sometimes succeeded in such ,cases4 ,a ,seton has also been successfully made in the lower ,part of the ,thigh4 ,finally some ,pains1 which have not yielded to any of these ,applications1 have been cured by actual burning1 inflicted on the very ,spot1 where the most violent ,pain has been felt2 except some particular ,reason1 drawn from an anatomical ,knowlege of the ,part1 should determine the ,surgeon not to apply it there4 ,the ,scull or ,head should never be cauterized with a burning ,iron4 ,sec4 #ahd4 ,the hot ,baths of ,bourbon1 ,plombiers1 ,aix-la-,chapelle and many others are often very efficacious in these chronical ,pains3 notwithstanding ,i really think1 there is no rheumatic ,pain that may not be cured without them4 ,the common ,people substitute to these a ,bath made of the ,husk of ,grapes1 after their ,juice is expressed1 which cures some by making them sweat abundantly4 ,cold ,baths however are the best to keep off this ,disease2 but then they cannot always be safely ventured on4 ,many ,circumstances render the ,use of them impracticable to particular ,persons4 ,such as are subject to this chronical ,rheumatism1 would do very well to rub their whole ,bodies every ,morning1 if they could1 but especially the afflicted ,parts1 with ,flanel4 ,this ,habit keeps up ,perspiration beyond any other ,assistance2 and indeed sometimes even increases it too much4 ,it would be serviceable too1 if such ,subjects of this cruel ,disease wore ,flanel all over their ,skin1 during the ,winter4 ,after a violent ,rheumatism1 ,people should long be careful to avoid that cold and moist ,air1 which disposes them to relapse4 ,sec4 #ahe4 ,rheumatic ,people have too frequent a ,recourse to very improper and hurtful ,medicines1 in this ,distemper1 which daily produce very bad ,consequences4 ,such are spirituous ,medicines1 ,brandy1 and ,arquebusade ,water4 ,they either render the ,pain more obstinate and fixed1 by hardening the ,skin2 or they repell the ,humour to some inward ,part4 ,and ,instances are not wanting of ,persons who have died suddenly1 from the ,application of ,spirit of ,wine upon the ,parts1 that were violently afflicted with the ,rheumatism4 ,it also happens sometimes that the ,humour1 having no ,outlet through the ,skin1 is thrown internally on the ,bone and affects it4 ,a very singular ,fact occurred in this ,respect1 an ,account of which may be serviceable to some ,persons afflicted with the ,disease4 ,a ,woman at ,night was chaffing the ,arm of her ,husband1 who had the ,rheumatism there1 with ,spirit of ,wine2 when a very lucky ,accident prevented the ,mischief she might have occasioned by it4 ,the ,spirit of ,wine took ,fire from the ,flame of the ,candle she made use of1 and burned the diseased ,part4 ,it was drest of ,course1 and the ,suppuration that attended it1 entirely cured the ,rheumatism4 ,sharp and greasy ,unctions or ,ointments produce very bad ,effects1 and are equally dangerous4 ,a ,caries1 a ,rottenness of the ,bones1 has ensued upon the ,use of a ,medicine called1 ,the ,balsam of ,sulphur with ,turpentine4 ,i was consulted in #agej1 three ,days before her ,decease1 about a ,woman1 who had long endured acute rheumatic ,pains4 ,she had taken various ,medicines1 and1 among the rest1 a considerable ,quantity of a ,ptisan1 in which ,antimony was blended with some purging ,medicines1 and a greasy spirituous ,balsam had been rubbed into the ,part4 ,the ,fever1 the ,pains1 and the ,dryness of the ,skin soon increased2 the ,bones of the ,thighs and ,arms became carious3 and in moving the ,patient no more than was necessary for her ,relief and ,convenience1 without taking her out of her ,bed1 both ,thighs and one ,arm broke4 ,so dreadful an ,example should make ,people cautious of giving or applying ,medicines inconsiderately1 even in such ,diseases1 as appear but trifling in themselves4 ,i must also inform the ,readers1 there are some rheumatic ,pains1 which admit of no ,application2 and that almost every ,medicine aggravates them4 ,in such ,cases the afflicted must content themselves with keeping the ,parts affected from the ,impressions of the ,air1 by a ,flanel1 or the ,skin of some ,animal with the ,fur on4 ,it is also more advisable sometimes to leave a sufferable and inveterate ,pain to itself1 especially in old or weakly ,people1 than to employ too many ,medicines1 or such violent ones1 as should affect them more importantly than the ,pains did4 ,sec4 #ahf4 ,if the ,duration of the ,pains fixed in the same ,place1 should cause some ,degree of ,stiffness in the ,joint affected1 it should be exposed twice a ,day to the ,vapour of warm ,water1 and dried well afterwards with hot ,linen3 then it should be well chaffed1 and lastly touched over with ,ointment of ,marsh-mallows4 ,pumping1 if superadded to this ,vapour1 considerably increases its ,efficacy4 ,i directed1 for a ,case of this ,sort1 a very simple ,machine of white ,tin1 or ,lattin1 which combined the ,application of the ,steam and the ,pump4 ,sec4 #ahg4 ,very young ,children are sometimes subject to such violent and extended ,pains1 that they cannot bear touching in any ,part1 without excessive ,crying4 ,we must be careful to avoid mistaking these ,cases1 and not to treat them like ,rheumatisms4 ,they sometimes are owing to ,worms1 and go off when these have been discharged4 ,chapter ,,xii4 ,of the ,bite of a mad ,dog4 ,sect4 #ahh4 ,men may contract the particular and raging ,symptom1 which is very generally peculiar to this ,disease from this ,cause1 and even without any ,bite2 but this happens very rarely indeed4 ,it is properly a ,distemper belonging to the canine ,genus1 consisting of the three ,species of ,dogs1 ,wolves1 and ,foxes1 to whom only it seems inherent and natural2 scarcely ever arising in other ,animals1 without its being inflicted by them4 ,whenever there occurs one of them who breeds it1 he bites others1 and thus the ,poison1 the ,cause of this terrible ,disease1 is diffused4 ,other ,animals besides the canine ,species1 and ,men themselves being exposed to this ,accident1 do sometimes contract the ,disease in all its ,rage and ,horror3 though it is not to be supposed1 that this is always an unfailing ,consequence4 ,sec4 #ahi4 ,if a ,dog who used to be lively and active1 becomes all at once moapish and morose2 if he has an ,aversion to eat2 a particular and unusual ,look about his ,eyes2 a ,restlessness1 which appears from his continually running to and fro1 we may be apprehensive he is likely to prove mad2 at which very ,instant he ought to be tied up securely1 that it may be in our ,power to destroy him as soon as the ,distemper is evident4 ,perhaps it might be even still safer to kill him at once4 ,whenever the ,malady is certain1 the ,symptoms heighten pretty soon4 ,his ,aversion to ,food1 but especially to ,drink1 grows stronger4 ,he no longer seems to know his ,master1 the ,sound of his ,voice changes2 he suffers no ,person to handle or approach him2 and bites those who attempt it4 ,he quits his ordinary ,habitation1 marching on with his ,head and his ,tail hanging downwards2 his ,tongue lolling half out1 and covered with ,foam or ,slaver1 which indeed not seldom happens indifferently to all ,dogs4 ,other ,dogs scent him1 not seldom at a considerable ,distance1 and fly him with an ,air of ,horror1 which is a certain ,indication of his ,disease4 ,sometimes he contents himself with biting only those who happen to be near him3 while at other ,times becoming more enraged1 he springs to the right and left on all ,men and ,animals about him4 ,he hurries away with manifest ,dread from whatever ,waters occur to him3 at length he falls down as spent and exhausted2 sometimes he rises up again1 and drags himself on for a little ,time1 commonly dying the third1 or1 at the latest1 on the fourth ,day after the manifest ,appearance of the ,disease1 and sometimes even sooner4 ,sec4 #aij4 ,when a ,person is bit by such a ,dog1 the ,wound commonly heals up as readily1 as if it was not in the least poisonous3 but after the ,expiration of a longer or shorter ,term1 from three ,weeks to three ,months2 but most commonly in about six ,weeks1 the ,person bitten begins to perceive1 in the ,spot that was bit1 a certain dull obtuse ,pain4 ,the ,scar of it swells1 inflames1 bursts open1 and weeps out a sharp1 foetid1 and sanious1 or somewhat bloody ,humour4 ,at the same ,time the ,patient becomes sad and melancholy3 he feels a kind of ,indifference1 ,insensibility1 and general ,numbness2 an almost incessant ,coldness2 a ,difficulty of breathing2 a continual ,anguish1 and ,pains in his ,bowels4 ,his ,pulse is weak and irregular1 his sleep restless1 turbid1 and confused with ,ravings2 with starting up in ,surprize1 and with terrible ,frights4 ,his ,discharges by ,stool are often much altered and irregular1 and small cold ,sweats appear at very short ,intervals4 ,sometimes there is also a slight ,pain or ,uneasiness in the ,throat4 ,such is the first ,degree of this ,disease1 and it is called by some ,physicians the dumb ,rage1 or ,madness4 ,sec4 #aia4 ,its second ,degree1 the confirmed or downright ,madness1 is attended with the following ,symptoms4 ,the ,patient is afflicted with a violent ,thirst1 and a ,pain in drinking4 ,soon after this he avoids all ,drink1 but particularly ,water1 and within some ,hours after1 he even abhors it4 ,this ,horror becomes so violent1 that the bringing ,water near his ,lips1 or into his ,sight1 the very ,name of it1 or of any other ,drink2 the ,sight of ,objects1 which1 from their ,transparence1 have any ,resemblance of ,water1 as a ,looking ,glass1 c4 afflicts him with extreme ,anguish1 and sometimes even with ,convulsions4 ,they continue however still to swallow 7though not without violent ,difficulty7 a little ,meat or ,bread1 and sometimes a little ,soup4 ,some even get down the liquid ,medicines that are prescribed them1 provided there be no ,appearance of ,water in them2 or that ,water is not mentioned to them1 at the same ,time4 ,their ,urine becomes thick and high-coloured1 and sometimes there is a ,suppression or ,stoppage of it4 ,the ,voice either grows hoarse1 or is almost entirely abolished3 but the ,reports of the bitten barking like ,dogs are ridiculous and superstitious ,fictions1 void of any ,foundation2 as well as many other ,fable1 that have been blended with the ,history of this ,distemper4 ,the ,barking of ,dogs however is very disagreeable to them4 ,they are troubled with short ,deliriums or ,ravings1 which are sometimes mixed with ,fury4 ,it is at such times that they spit all around them2 that they attempt also to bite1 and sometimes unhappily effect it4 ,their ,looks are fixed1 as it were1 and somewhat furious1 and their ,visage frequently red4 ,it is pretty common for these miserable ,patients to be sensible of the ,approach of their raging ,fit1 and to conjure the ,bystanders to be upon their ,guard4 ,many of them never have an ,inclination to bite4 ,the increasing ,anguish and ,pain they feel become inexpressible3 they earnestly wish for ,death2 and some of them have even destroyed themselves1 when they had the ,means of effecting it4 ,sec4 #aib4 ,it is with the ,spittle1 and the ,spittle only1 that this dreadful ,poison unites itself4 ,and here it may be observed1 #a1 ,that if the ,wounds have been made through any of the ,patient's ,cloaths1 they are less dangerous than those inflicted immediately on the naked ,skin4 #b1 ,that ,animals who abound in ,wool1 or have very thick ,hair1 are often preserved from the mortal ,impression of the ,poison2 because in these various ,circumstances1 the ,cloaths1 the ,hair1 or the ,wool have wiped1 or even dried up1 the ,slaver of their ,teeth4 #c1 ,the ,bites inflicted by an infected ,animal1 very soon after he has bitten many others1 are less dangerous than the former ,bites1 because their ,slaver is lessened or exhausted4 #d1 ,if the ,bite happens in the ,face1 or in the ,neck1 the ,danger is greater1 and the ,operation of the ,venom is quicker too2 by ,reason the ,spittle of the ,person so bit is sooner infected4 #e1 ,the higher the ,degree of the ,disease is advanced1 the ,bites become proportionably more dangerous4 ,from what ,i have just mentioned here it may be discerned1 why1 of many who have been bitten by the same ,sufferer1 some have been infected with this dreadful ,disease1 and others not4 ,sec4 #aic4 ,a great ,number of ,remedies have been highly cried up1 as famous in the ,cure of this ,disease2 and1 in ,swisserland particularly1 the ,root of the ,eglantine or wild ,rose1 gathered at some particular times1 under the favorable ,aspects of the ,moon1 and dried with some extraordinary ,precautions4 ,there is also the ,powder of ,palmarius of calcined ,egg ,shells1 that of the ,lichen terrestris1 or ,ground ,liverwort1 with one third ,part of ,pepper1 a ,remedy long celebrated in ,england2 ,powder of ,oyster-,shells2 of ,vervain2 bathing in ,salt ,water2 ,st4 ,hubert's ,key1 c4 c4 ,but the ,death of a ,multitude of those who have been bitten1 notwithstanding their taking the greatest ,part of all these boasted ,antidotes2 and the ,certainty of no one's escaping1 who had been attacked with the high raging ,symptom1 the ,hydrophobia1 have demonstrated the ,inefficacy of them all1 to all ,europe4 ,it is incontestable that to the ,year #agcj1 not a single ,patient escaped1 in whom the ,disease was indisputably manifest2 and that every ,medicine then employed against it was useless4 ,when ,medicines had been given before the great ,symptom appeared1 in some of those who took them1 it afterwards appeared1 in others not4 ,the same different ,events occurred also to others who were bitten1 and who took not the least ,medicine2 so that upon the whole1 before that ,date1 no ,medicine seemed to be of any ,consequence4 ,since that ,time1 we have had the ,happiness to be informed of a certain ,remedy1 which is ,mercury1 joined to a few others4 ,sec4 #aid4 ,in short there is a ,necessity for destroying or expelling the ,poison itself1 which ,mercury effects1 and is consequently the ,counter-poison of it4 ,that poison produces a general ,irritation of the ,nerves2 this is to be removed or asswaged by ,antispasmodics3 so that in ,mercury1 or ,quicksilver1 joined to ,antispasmodics1 consists the whole that is indicated in the ,cure of this ,disease4 ,there really have been many ,instances of ,persons cured by these ,medicines1 in whom the ,distemper had been manifest in its ,rage and ,violence2 and as many as have unfortunately received the ,cause of it in a ,bite1 should be firmly persuaded1 that in taking these ,medicines1 and using all other proper ,precautions1 they shall be entirely secured from all its ill ,consequences4 ,those also in whom the ,rage and ,fury of this ,distemper is manifest1 ought to use the same ,medicines1 with entire #de ,hope and ,confidence1 which may justly be founded on the many ,cures effected by them4 ,it is acknowledged however1 that they have proved ineffectual in a few ,cases2 but what ,disease is there1 which does not sometimes prove incurable8 #de ,this ,advice is truly prudent and judicious2 ,hope1 as ,i have observed on a different ,occasion1 being a powerful1 though impalpable1 ,cordial3 and in such perilous ,situations1 we should excite the most agreeable ,expectations we possibly can in the ,patient2 that ,nature1 being undepressed by any desponding melancholy ones1 may exert her ,functions the more firmly1 and co-operate effectually with the ,medicines1 against her internal ,enemy4 ,k4 ,sec4 #aie4 ,the very ,moment after receiving the ,bite1 is it happens to be in the ,flesh1 and if it can safely be effected1 all the ,part affected should be cut #df away4 ,the ,ancients directed it to be cauterized1 or burnt with a red hot ,iron 7meer ,scarification being of very little ,effect7 and this ,method would very probably prove effectual4 ,it requires more ,resolution1 however1 than every ,patient is endued with4 ,the ,wound should be washed and cleansed a considerable ,time with warm ,water1 with a little ,sea-,salt dissolved in it4 ,after this into the ,lips and ,edges of the ,wound1 and into the ,surface of the ,part all about it1 should be rubbed a ,quarter of an ,ounce of the ,ointment ,no4 #bh2 and the ,wound should be dressed twice daily1 with the soft lenient ,ointment ,no4 #bi1 to promote ,suppuration2 but that of ,no4 #bh is to be used only once a ,day4 #df ,i knew a brave worthy ,gentleman abroad1 who above forty ,years past thus preserved his ,life1 after receiving the ,bite of a large ,rattle-,snake1 by resolutely cutting it and the ,flesh surrounding it out1 with a sharp pointed ,penknife4--,perhaps those who would not suffer the ,application of the actual ,cautery1 that is1 of a red hot ,iron 7which certainly promises well for a ,cure7 might be persuaded to admit of a potential ,cautery1 where the ,bite was inflicted on a fleshy ,part4 ,though even this is far from being unpainful1 yet the ,pain coming on more gradually1 is less terrifying and horrid4 ,and when it had been applied quickly after1 and upon the ,bite1 and kept on for #c or #d ,hours1 the ,discharge1 after cutting the ,eschar1 would sooner ensue1 and in more ,abundance1 than that from the actual ,cautery2 the only ,preference of which seems to consist in its being capable perhaps of absorbing1 or otherwise consuming1 all the poisonous ,saliva at once4 ,this ,issue should be dressed afterwards according to our ,author's ,direction2 and in the gradual healing of the ,ulcer1 it may be properly deterged by adding a little ,praecipitate to the ,digestive4 ,neither would this interfere with the ,exhibition of the ,tonquin ,powder ,no4 #cj1 nor the antispasmodic ,bolus ,no4 #ca1 if they should be judged necessary4 ,and these perhaps might prove the most certain ,means of preventing the mortal ,effects of this singular animal ,poison1 which it is so impossible to analyze1 and so extremely difficult to form any material ,idea of2 but which is not the ,case of some other ,poisons4 ,k4 ,in point of ,regimen1 the ,quantity of ,nourishment should be less than usual1 particularly in the ,article of #dg ,flesh3 he should abstain from ,wine1 spirituous ,liquors1 all ,sorts of ,spices and hot inflaming ,food4 ,he should drink only ,barley-,water1 or an ,infusion of the ,flowers of the ,lime-tree4 ,he should be guarded against ,costiveness by a soft relaxing ,diet1 or by ,glysters1 and bathe his ,legs once a ,day in warm ,water4 ,every third ,day one ,dose of the ,medicine ,no4 #cj should be taken2 which is compounded of ,mercury1 that counterworks the ,poison1 and of ,musk which prevents the ,spasms1 or convulsive ,motions4 ,i confess at the same ,time that ,i have less ,dependance on the ,mercury given in this ,form1 and think the rubbing in of its ,ointment considerably more efficacious1 which ,i should hope may always prevent the ,fatality of this dreadful1 surprizing ,disease4 #dh #dg ,it seems not amiss to try the ,effects of a solely vegetable ,diet 7and that perhaps consisting more of the acescent than alcalescent ,herbs and ,roots7 in this ,disease1 commencing immediately from the ,bite of a known mad ,dog4 ,these carnivorous ,animals1 who naturally reject all vegetable ,food1 are the only primary ,harbingers or ,breeders of it2 though they are capable of transmitting it by a ,bite to graminivorous and granivorous ones4 ,the ,virtue of ,vinegar in this ,disease1 said to have been accidentally discovered on the ,continent1 seems not to have been hitherto experienced amongst us2 yet in ,case of such a morbid ,accident it may require a ,tryal2 tho' not so far1 as to occasion the ,omission of more certainly experienced ,remedies1 with some of which it might be improper4 ,k4 #dh ,the great ,usefulness of mercurial ,frictions1 we may even say1 the certain ,security which they procure for the ,patients1 in these ,cases1 provided they are applied very soon after the ,bite1 have been demonstrated by their ,success in ,provence1 at ,lyons1 at ,montpellier1 at ,pondacherry1 and in many other ,places4 ,neither have these happy ,events been invalidated by any ,observations or ,instances to the contrary4 ,it cannot therefore be too strongly inculcated to those who have been bitten by venomous ,animals1 to comply with the ,use of them4 ,they ought to be used in such a ,quantity1 and after such a ,manner1 as to excite a moderate ,salivation1 for fifteen1 twenty1 or even thirty ,days4 ,e4 ,l4 ,though this ,practice may justly be pursued from great ,caution1 when no ,cautery had been speedily applied to1 and no such ,discharge had been obtained from1 the bitten ,part2 yet wherever it had1 this long and depressing ,salivation1 ,i conceive1 would be very seldom necessary2 and might be hurtful to weak ,constitutions4 ,k4 ,sec4 #aif4 ,if the raging ,symptom1 the ,dread of ,water1 has already appeared1 and the ,patient is strong1 and abounds with ,blood1 he should1 #a1 be bled to a considerable ,quantity1 and this may be repeated twice1 thrice1 or even a fourth ,time1 if ,circumstances require it4 #b1 ,the ,patient should be put1 if possible1 into a warm ,bath2 and this should be used twice daily4 #c1 ,he should every ,day receive two1 or even three of the emollient ,glysters ,no4 #e4 #d1 ,the ,wound and the ,parts adjoining to it should be rubbed with the ,ointment ,no4 #bh1 twice a ,day4 #e1 ,the whole ,limb which contains the ,wound should be rubbed with ,oil1 and be wrapped up in an oily ,flanel4 #f1 ,every three ,hours a ,dose of the ,powder ,no4 #cj1 should be taken in a ,cup of the ,infusion of ,lime-tree and ,elder ,flowers4 #g1 ,the ,prescription ,no4 #ca1 is to be given every ,night1 and to be repeated in the ,morning1 if the ,patient is not easy1 washing it down with the same ,infusion4 #h1 ,if there be a great ,nauseousness at ,stomach1 with a ,bitterness in the ,mouth1 give the ,powder ,no4 #ce1 which brings up a copious ,discharge of glewy and bilious ,humours4 #i1 ,there is very little ,occasion to say any thing relating to the ,patient's ,food1 in such a ,situation4 ,should he ask for any1 he may be allowed ,panada1 light ,soup1 ,bread1 ,soups made of farinaceous or mealy ,vegetables1 or a little ,milk4 ,sec4 #aig4 ,by the ,use of these ,remedies the ,symptoms will be observed to lessen1 and to disappear by ,degrees2 and finally ,health will be re-established4 ,but if the ,patient should long continue weak1 and subject to ,terrors1 he may take a ,dose of the ,powder ,no4 #ad1 thrice a ,day4 ,sec4 #aih4 ,it is certain that a ,boy1 in whom the raging ,symptom of ,this ,disease had just appeared1 was perfectly cured1 by bathing all about the wounded ,part with ,sallad-,oil1 in which some ,camphire and ,opium were dissolved2 with the ,addition of repeated ,frictions of the ,ointment ,no4 #bh1 and making him take some ,eau de luce with a little ,wine4 ,this ,medicine1 a ,coffee-,cup of which may be given every four ,hours1 allayed the great ,inquietude and ,agitation of the ,patient2 and brought on a very plentiful ,sweat1 on which all the ,symptoms vanished4 ,sec4 #aii4 ,dogs may be cured by rubbing in a triple ,quantity of the same ,ointment directed for ,men1 and by giving them the ,bolus ,no4 #cc4 ,but both these ,means should be used as soon as ever they are bit4 ,when the great ,symptom is manifest1 there would be too much ,danger in attempting to apply one1 or to give the other2 and they should be immediately killed4 ,it might be well however to try if they would swallow down the ,bolus1 on its being thrown to them4 ,as soon as ever ,dogs are bit1 they should be safely tied up1 and not let loose again1 before the ,expiration of three or four ,months4 ,sec4 #bjj4 ,a false and dangerous ,prejudice has prevailed with ,regard to the ,bites from ,dogs1 and it is this--,that if a ,dog who had bit any ,person1 without being mad at the ,time of his biting1 should become mad afterwards1 the ,person so formerly bitten1 would prove mad too at the same ,time4 ,such a ,notion is full as absurd1 as it would be to affirm1 that if two ,persons had slept in the same ,bed1 and that one of them should take the ,itch1 the ,small-,pocks1 or any other contagious ,disease1 ten or twelve ,years afterwards1 that the other should also be infected with that he took1 and at the same ,time too4 ,of two ,circumstances1 whenever a ,person is bit1 one must certainly be4 ,either the ,dog which gives the ,bite1 is about to be mad himself1 in which ,case this would be evident in a few ,days2 and then it must be said the ,person was bitten by a mad ,dog3 ,or else1 that the ,dog was absolutely sound1 having neither conceived1 or bred in himself1 nor received from without the ,cause1 the ,principle1 of ,madness3 in which last ,case ,i ask any ,man in his ,senses1 if he could communicate it4 ,no ,person1 no ,thing imparts what it has not4 ,this false and crude ,notion excites those who are possessed with it to a dangerous ,action3 they exercise that ,liberty the ,laws unhappily allow them of killing the ,dog2 by which ,means they are left uncertain of his ,state1 and of their own ,chance4 ,this is a dreadful ,uncertainty1 and may be attended with embarrassing and troublesome ,consequences1 independant of the ,poison itself4 ,the reasonable ,conduct would be to secure and observe the ,dog very closely1 in ,order to know certainly whether he is1 or is not1 mad4 ,sec4 #bja4 ,it is no longer necessary to represent the ,horror1 the ,barbarity and ,guilt of that cruel ,practice1 which prevailed1 not very long since1 of suffocating ,persons in the ,height of this ,disease1 with the ,bed-cloaths1 or between ,matrasses4 ,it is now prohibited in most ,countries2 and doubtless will be punished1 or1 at least ought to be1 even in those where as yet it is not4 ,another ,cruelty1 of which we hope to see no repeated ,instance1 is that of abandoning those miserable ,patients to themselves1 without the least ,resource or ,assistance3 a most detestable ,custom even in those ,times1 when there was not the least ,hope of saving them2 and still more criminal in our ,days1 when they may be recovered effectually4 ,i do again affirm1 that it is not very often these afflicted ,patients are disposed to bite2 and that even when they are1 they are afraid of doing it2 and request the ,bystanders to keep out of their ,reach3 ,so that no ,danger is incurred2 or where there is any1 it may easily be avoided by a few ,precautions4 ,chapter ,,xiii4 ,of the ,small-,pocks4 ,sect4 #bjb4 ,the ,small-,pocks is the most frequent1 the most extensive of all ,diseases2 since out of a hundred ,persons there are not more than #di four or five exempted from it4 ,it is equally true however1 that if it attacks almost every ,person1 it attacks them but once1 so that having escaped through it1 they are always secure from #ej it4 ,it must be acknowleged1 at the same ,time1 to be one of the most destructive ,diseases2 for if in some ,years or ,seasons1 it proves to be of a very mild and gentle ,sort1 in others it is almost as fatal as the ,plague3 it being demonstrated1 by calculating the ,consequences of its most raging1 and its gentlest ,prevalence1 that it kills one seventh of the ,number it attacks4 #di ,as far as the ,number of inoculated ,persons1 who remained entirely uninfected 7some very few after a second ,inoculation7 has enabled me1 ,i have calculated the ,proportion naturally exempted from this ,disease1 though residing within the ,influence of it1 to be full #be in #ajjj4 ,see ,analysis of ,inoculation1 ,ed4 #b;d4 ,p4 #aeg4 ,note 994 ,k4 #ej ,it has sometimes been observed 7and the ,observation has been such1 as not to be doubted7 that a very mild distinct ,small-,pocks has sometimes invaded the same ,person twice3 ,but such ,instances are so very rare1 that we may very generally affirm1 those who have once had it1 will never have it again4 ,e4 ,l4----,in ,deference to a few particular ,authorities1 ,i have also supposed such a repeated ,infection4 7,analysis of ,inoculation1 ,ed4 #b;d4 ,p4 #dc47 though ,i have really never seen any such myself2 nor ever heard more than two ,physicians affirm it1 one at ,versailles1 and another in ,london2 the last of whom declared1 he took it upon the ,credit of a ,country ,physician1 thoroughly acquainted with this ,disease1 and a ,witness to the ,repetition of it4 ,hence we imagine the ,editor of this ,work at ,lyons might have justly termed this ,re-infection extremely rare1 which would have a ,tendency to reconcile the ,subjects of the ,small-,pocks1 more generally1 to the most salutary ,practice of ,inoculation4 ,doubtless some other eruptive ,fevers1 particularly1 the ,chicken ,pocks1 ,crystals1 c4 have been often mistaken for the real ,small-,pocks by incompetent ,judges1 and sometimes even by ,persons better qualified1 yet who were less attentive to the ,symptoms and ,progress of the former4 ,but whoever will be at the ,pains to read ,dr4 ,paux' ,parallele de la petite verole naturalle avec l'artificielle1 or a practical ,abstract of ,part of it in the ,monthly ,review4 ,vol4 ,,xxv4 ,p4 #cjg to #caa1 will find such a just1 clear and useful ,distinction of them1 as may prevent many future ,deceptions on this frequently interesting ,subject4 ,k4 ,sec4 #bjc4 ,people generally take the ,small-,pocks in their ,infancy1 or in their ,childhood4 ,it is very seldom known to attack only one ,person in one ,place3 its ,invasions being very generally epidemical1 and seizing a large ,proportion of those who have not suffered it4 ,it commonly ceases at the ,end of some ,weeks1 or of some ,months1 and rarely ever appears again in the same ,place1 until four1 five or six ,years after4 ,sec4 #bjd4 ,this ,malady often gives some ,intimation of its ,approach1 three or four ,days before the ,appearance of the ,fever1 by a little ,dejection2 less ,vivacity and ,gaiety than usual2 a great ,propensity to sweat2 less ,appetite2 a slight ,alteration of the ,countenance1 and a kind of pale livid ,colour about the ,eyes3 ,notwithstanding which1 in ,children of a lax and phlegmatic ,constitution1 ,i have known a moderate ,agitation of their ,blood1 7before their ,shivering approached7 give them a #ea ,vivacity1 ,gaiety1 and a rosy ,improvement of their ,complexion1 beyond what ,nature had given them4 #ea ,the same ,appearances very often occur in such ,subjects by ,inoculation1 before actual ,sickening1 as ,i have observed and instanced1 ,ed4 #ast4 ,p4 #fb1 ,ed4 #b4 ,p4 #ge1 #gf4 ,k4 ,certain short ,vicissitudes of ,heat or ,coldness succeed the former introductory ,appearances1 and at length a considerable ,shivering1 of the ,duration of one1 two1 three or four ,hours3 ,this is succeeded by violent ,heat1 accompanied with ,pains of the ,head1 ,loins1 ,vomiting1 or at least with a frequent ,propensity to vomit4 ,this ,state continues for some ,hours1 at the ,expiration of which the ,fever abates a little in a ,sweat1 which is sometimes a very large one3 the ,patient then finds himself better1 but is notwithstanding cast down1 torpid or heavy1 very squeamish1 with a ,head-ach and ,pain in the ,back1 and a ,disposition to be drowsy4 ,the last ,symptom indeed is not very common1 except in ,children1 less than seven or eight ,years of ,age4 ,the ,abatement of the ,fever is of small ,duration2 and some ,hours after1 commonly towards the ,evening1 it returns with all its ,attendants1 and terminates again by ,sweats1 as before4 ,this ,state of the ,disease lasts three or four ,days2 at the ,end of which ,term1 and seldom later1 the first ,eruptions appear among the ,sweat1 which terminates the ,paroxysm or ,return of the ,fever4 ,i have generally observed the earliest ,eruption to appear in the ,face1 next to that on the ,hands1 on the fore ,part of the ,arms2 on the ,neck1 and on the upper ,part of the ,breast4 ,as soon as this ,eruption appears1 if the ,distemper is of a gentle ,kind and ,disposition1 the ,fever almost entirely vanishes3 the ,patient continues to sweat a little1 or transpire2 the ,number of ,eruptions increases1 others coming out on the ,back1 the ,sides1 the ,belly1 the ,thighs1 the ,legs1 and the ,feet4 ,sometimes they are pushed out very numerously even to the ,soles of the ,feet2 where1 as they increase in ,size1 they often excite very sharp ,pain1 by ,reason of the great ,thickness and ,hardness of the ,skin in these ,parts4 ,frequently on the first and second ,day of ,eruption 7speaking hitherto always of the mild ,kind and ,degree of the ,disease7 there returns again a very gentle ,revival of the ,fever about the ,evening1 which1 about the ,termination of it1 is attended with a considerable and final ,eruption3 though as often as the ,fever terminates perfectly after the earliest ,eruption1 a very distinct and very small one is a pretty certain ,consequence4 ,for though the ,eruption is already1 or should prove only moderate1 the ,fever1 as ,i have before said1 does not totally disappear2 a small ,degree of it still remaining1 and heightening a little every ,evening4 ,these ,pustules1 or ,efflorescences1 on their first ,appearance1 are only so many very little red ,spots1 considerably resembling a ,flea-bite2 but distinguishable by a small white ,point in the ,middle1 a little raised above the rest1 which gradually increases in ,size1 with the ,redness extended about it4 ,they become whiter1 in ,proportion as they grow larger2 and generally upon the sixth ,day1 including that of their first ,eruption1 they attain their utmost ,magnitude1 and are full of ,pus or ,matter4 ,some of them grow to the ,size of a ,pea1 and some still a little larger2 but this never happens to the greatest ,number of them4 ,from this ,time they begin to look yellowish1 they gradually become dry1 and fall off in brown ,scales1 in ten or eleven ,days from their first ,appearance4 ,as their ,eruption occurred on different ,days1 they also wither and fall off successively4 ,the ,face is sometimes clear of them1 while ,pustules still are seen upon the ,legs1 not fully ripe1 or suppurated3 and those in the ,soles of the ,feet often remain much longer4 ,sec4 #bje4 ,the ,skin is of ,course extended or stretched out by the ,pustules2 and after the ,appearance of a certain ,quantity1 all the ,interstices1 or ,parts between the ,pustules1 are red and bright1 as it were1 with a proportionable ,inflation or ,swelling of the ,skin4 ,the ,face is the first ,part that appears bloated1 from the ,pustules there first attaining their utmost ,size3 and this inflation is sometimes so considerable1 as to look monstrous2 the like happens also to the ,neck1 and the ,eyes are entirely closed up by it4 ,the ,swelling of the ,face abates in ,proportion to the scabbing and drying up of the ,pustules2 and then the ,hands are puffed up prodigiously4 ,this happens successively to the ,legs1 the ,tumour or ,swelling1 being the ,consequence of the ,pustules attaining their utmost ,size1 which happens by ,succession1 in these different ,parts4 ,sec4 #bjf4 ,whenever there is a very considerable ,eruption1 the ,fever is heightened at the ,time of ,suppuration1 which is not to be wondered at2 one single ,boil excites a ,fever3 ,how is it possible then that some hundred1 nay some thousand of these little ,abscesses should not excite one8 ,this ,fever is the most dangerous ,period1 or ,time of the ,disease1 and occurs between the ninth and the thirteenth ,days2 as many ,circumstances vary the ,term of ,suppuration1 two or three ,days4 ,at this painful and perilous ,season then1 the ,patient becomes very hot1 and thirsty3 he is harrassed with ,pain2 and finds it very difficult to discover a favourable easy ,posture4 ,if the ,malady runs very high1 he has no ,sleep2 he raves1 becomes greatly oppressed1 is seized with a heavy ,drowsiness2 and when he dies1 he dies either suffocated or lethargic1 and sometimes in a ,state compounded of both these ,symptoms4 ,the ,pulse1 during this ,fever of ,suppuration1 is sometimes of an astonishing ,quickness1 while the ,swelling of the ,wrists makes it seem1 in some ,subjects1 to be very small4 ,the most critical and dangerous ,time is1 when the ,swellings of the ,face1 ,head and ,neck are in their highest ,degree4 ,whenever the ,swelling begins to fall1 the ,scabs on the ,face to dry supposing neither of these to be too sudden and premature1 for the visible ,quantity of the ,pustules and the ,skin to shrivel1 as it were1 the ,quickness of the ,pulse abates a little1 and the ,danger diminishes4 ,when the ,pustules are very few1 this second ,fever is so moderate1 that it requires some ,attention to discern it1 so that the ,danger is next to none4 ,sec4 #bjg4 ,besides those ,symptoms1 there are some others1 which require considerable ,attention and ,vigilance4 ,one of these is the ,soreness of the ,throat1 with which many ,persons in the ,small-,pocks are afflicted1 as soon as the ,fever grows pretty strong4 ,it continues for two or three ,days2 feels very strait and troublesome in the ,action of ,swallowing2 and whenever the ,disease is extremely acute1 it entirely prevents ,swallowing4 ,it is commonly ascribed to the ,eruption of ,pustules in the ,throat2 but this is a ,mistake1 such ,pustules being almost constantly #eb imaginary4 ,it begins1 most frequently1 before the ,eruption appears2 if this ,complaint is in a light ,degree1 it terminates upon the ,eruption2 and whenever it revives again in the ,course of the ,disease1 it is always in ,proportion to the ,degree of the ,fever4 ,hence we may infer it does not arise from the ,pustules1 but is owing to the ,inflammation2 and as often as it is of any considerable ,duration1 it is almost ever attended with another ,symptom1 the ,salivation1 or a ,discharge of a great ,quantity of ,spittle4 ,this ,salivation rarely exists1 where the ,disease is very gentle1 or the ,patient very young2 and is full as rarely absent1 where it is severe1 and the ,patient is past seven or eight ,years old3 but when the ,eruption is very confluent1 and the ,patient adult1 or grown up1 the ,discharge is surprizing4 ,under these ,circumstances it flows out incessantly1 allowing the afflicted ,patient no ,rest or ,respite2 and often incommodes him more than any other ,symptom of the ,distemper2 and so much the more1 as after its ,continuance for some ,days1 the ,lips1 the ,inside of the ,cheeks1 the ,tongue1 and the ,roof of the ,mouth are entirely peeled or flead1 as it were4 ,nevertheless1 however painful and embarrassing this ,discharge may prove1 it is very important and salutary4 ,meer ,infants are less subject to it1 some of them having a ,looseness1 in ,lieu of it3 and yet ,i have observed even this last ,discharge to be considerably less frequent in them1 than a ,salivation is in grown ,people4 #eb ,as ,pustules are1 and not very seldom1 visible on the ,tongue1 and sometimes on the ,roof1 even to its ,process called the ,palate1 which ,i have plainly seen2 it seems not very easy to assign any insuperable ,obstacle to the ,existence of a few within the ,throat2 though this scarcely ever occurs1 in the distinct ,small-,pocks4 ,doubtless however1 a considerable ,inflammation of that ,part will be as likely to produce the great ,difficulty of ,swallowing1 as the ,existence of ,pustules there2 which our learned ,author does not absolutely reject1 and consequently will forgive this ,supposition of them2 especially if he credits the ocular ,testimony of ,dr4 ,violante1 cited in the ,analysis1 ,ed4 #b;d4 p #ga4 ,k4 ,sec4 #bjh4 ,children1 to the ,age of five or six ,years1 are liable to ,convulsions1 before ,eruption3 these however are not dangerous1 if they are not accompanied with other grievous and violent ,symptoms4 ,but such ,convulsions as supervene1 either when ,eruption having already occurred1 suddenly retreats1 or strikes in1 according to the common ,phrase2 or during the ,course of the ,fever of ,suppuration1 are greatly more terrifying4 ,involuntary ,discharges of ,blood from the ,nose often occur1 in the first ,stage of this ,distemper1 which are extremely serviceable1 and commonly lessen1 or carry off1 the ,head-ach4 ,meer ,infants are less subject to this ,discharge2 though they have sometimes a little of it3 and ,i have known a considerable ,stupor or ,drowsiness1 vanish immediately after this ,bleeding4 ,sec4 #bji4 ,the ,small-,pocks is commonly distinguished into two ,kinds1 the confluent and the distinct1 such a ,distinction really existing in ,nature3 but as the ,treatment of each of them is the same2 and as the ,quantity or ,dose of the ,medicines is only to be varied1 in ,proportion to the ,danger of the ,patient 7not to enter here into very tedious ,details1 and such as might exceed the ,comprehension of many of our ,readers2 as well as whatever might relate particularly to the malignant ,small-,pocks7 ,i shall limit myself within the ,description ,i have premised1 which includes all the ,symptoms common to both these ,kinds of the ,small-,pocks4 ,i content myself with adding here1 that we may expect a very confluent and dangerous ,pock1 is1 at the very ,time of seizure1 the ,patient is immediately attacked with many violent ,symptoms2 more especially if his ,eyes are extremely quick1 lively1 and even glistening1 as it were2 if he vomits almost continually2 if the ,pain of his ,loins be violent2 and if he suffers at the same ,time great ,anguish and ,inquietude3 ,if in ,infants there is great ,stupor or ,heaviness2 if ,eruption appears on the third ,day1 and sometimes even on the second3 as the hastier ,eruptions in this ,disease signify the most dangerous ,kind and ,degree of it2 and on the contrary1 the slower ,eruption is1 it is the safer too2 supposing this ,slowness of the ,eruption not to have been the ,consequence of great ,weakness1 or of some violent inward ,pain4 ,sec4 #baj4 ,the ,disorder is sometimes so very mild and slight1 that ,eruption appears with scarcely any ,suspicion of the ,child's having the least ,ailment1 and the ,event is as favourable as the ,invasion4 ,the ,pustules appear1 grow large1 suppurate and attain their ,maturity1 without confining the ,patient to his ,bed1 or lessening either his ,sleep1 or ,appetite4 ,it is very common to see ,children in the ,country 7and they are seldom more than ,children who have it so very gently7 run about in the open ,air1 through the whole ,course of this ,disease1 and feeding just as they do in ,health4 ,even those who take it in a somewhat higher ,degree1 commonly go out when ,eruption is finished1 and give themselves up1 without ,reserve1 to the ,voracity of their ,hunger4 ,notwithstanding all this ,neglect1 many get perfectly cured2 though such a ,conduct should never be proposed for ,imitation1 since ,numbers have experienced its pernicious ,consequences1 and several of these ,children have been brought to me1 especially from ,jurat1 who after such ,neglect1 in the ,course of the mild and kindly ,sort of this ,distemper1 have contracted ,complaints and ,infirmities of different ,kinds1 which have been found very difficult to subdue4 ,sec4 #baa4 ,this still continues to be one of these ,distempers1 whose ,danger has long been increased by its improper ,treatment1 and especially by forcing the ,patients into ,sweats2 and it still continues to be increased1 particularly among ,country ,people4 ,they have seen ,eruption appear1 where the ,patient sweats1 and observed he found himself better after its ,appearance3 and hence they conclude that1 by quickening and forcing out this ,eruption1 they contribute to his ,relief2 and suppose1 that by increasing the ,quantity of his ,sweats1 and the ,number of his ,eruptions1 the ,blood is the better cleared and purified from the ,poison4 ,these are mortal ,errors1 which daily ,experience has demonstrated1 by their tragical ,consequences4 ,when the ,contagion or ,poison1 which generates this ,disease1 has been admitted into the ,blood1 it requires a certain ,term to produce its usual ,effects3 at which ,time the ,blood being tainted by the ,venom it has received1 and by that which such ,venom has formed or assimilated from it1 ,nature makes an ,effort to free herself of it1 and to expell it by the ,skin1 precisely at the ,time when every ,thing is predisposed for that ,purpose4 ,this ,effort pretty generally succeeds1 being very often rather too rapid and violent1 and very seldom too weak4 ,hence it is evident1 that whenever this ,effort is deficient1 it ought not to be heightened by hot ,medicines or ,means1 which make it too violent and dangerous3 for when it already exceeds in this ,respect1 a further ,increase of such ,violence must render it mortal4 ,there are but few ,cases in which the ,efforts of ,nature1 on this ,occasion1 are too languid and feeble1 especially in the ,country2 and whenever such rare ,cases do occur1 it is very difficult to form a just and proper ,estimation of them3 for which ,reason we should be very reserved and cautious in the ,use of heating ,medicines1 which are so mortally pernicious in this ,disease4 ,wine1 ,venice ,treacle1 cordial ,confections1 hot ,air1 and ,loads of ,bed-cloths1 annually sweep off ,thousands of ,children1 who might have recovered1 if they had taken nothing but warm ,water3 and every ,person who is interested in the ,recovery of ,patients in this ,distemper1 ought carefully to prevent the smallest ,use of such ,drugs2 which1 if they should not immediately aggravate it to a fatal ,degree1 yet will certainly increase the ,severity and ,torment of it1 and annex the most unhappy and tragical ,consequences to it4 ,the ,prejudice in this ,point is so strongly rooted1 that a total ,eradication of it must be very difficult3 but ,i only desire ,people would be convinced by their own ,eyes1 of the different ,success of the hot ,regimen1 and of that ,i shall propose4 ,and here indeed ,i must confess1 ,i found more ,attention and ,docility1 on this ,point1 among the ,inhabitants of the ,city1 and especially in the last epidemical spreading of the ,small-,pocks1 than ,i presumed to hope for4 ,not only as many as consulted me on the ,invasion of it1 complied exactly with the cooling ,regimen ,i advised them2 but their ,neighbours also had ,recourse to it1 when their ,children sickened3 and being often called in when it had been many ,days advanced1 ,i observed with great ,pleasure1 that in many ,houses1 not one heating ,medicine had been given2 and great ,care had been taken to keep the ,air of the ,patient's ,chamber refreshingly cool and temperate4 ,this encourages me to expect1 that this ,method hereafter will become general here4 ,what certainly ought most essentially to conduce to this is1 that notwithstanding the ,diffusion or spreading of this ,disease was as numerous and extensive as any of the former1 the ,mortality1 in ,consequence of it1 was evidently less4 ,sec4 #bab4 ,at the very ,beginning of the ,small-,pocks 7which may be reasonably suspected1 from the ,presence of the ,symptoms ,i have already described2 supposing the ,person complaining never to have had it1 and the ,disease to prevail near his ,residence7 the ,patient is immediately to be put on a strict ,regimen1 and to have his ,legs bathed ,night and ,morning in warm ,water4 ,this is the most proper and promising ,method to lessen the ,quantity of ,eruption in the ,face and ,head1 and to facilitate it every where else on the ,surface4 ,glysters also greatly contribute to abate the ,head-ach1 and to diminish the ,reachings to vomit1 and the actual ,vomitings1 which greatly distress the ,patient2 but which however it is highly absurd and pernicious to stop by any stomachic cordial ,confection1 or by ,venice ,treacle2 and still more dangerous to attempt removing the ,cause of them1 by a ,vomit or ,purge1 which are hurtful in the beginning of the ,small-,pocks4 ,if the ,fever be moderate1 the ,bathings of the ,legs on the first ,day of sickening1 and one ,glyster may suffice then4 ,the ,patient must be restrained to his ,regimen2 and instead of the ,ptisan ,no4 #a1 #b1 #d1 a very young ,child should drink nothing but ,milk diluted with two thirds of ,elder ,flower or ,lime-tree ,tea1 or with ,balm ,tea1 if there be no perceivable ,fever2 and in short1 if they have an ,aversion to the ,taste of them all1 with only the same ,quantity of good clear #ec ,water4 ,an ,apple coddled or baked may be added to it2 and if they complain of ,hunger1 a little ,bread may be allowed2 but they must be denied any ,meat1 or ,meat ,broth1 ,eggs and strong ,drink2 since it has appeared from ,observations frequently repeated1 that ,children who had been indulged with such ,diet proved the worse for it1 and recovered more slowly than others4 ,in this early ,stage too1 clear ,whey alone may serve them instead of every other ,drink1 the good ,effects of which ,i have frequently been a ,witness to2 or some ,buttermilk may be allowed4 ,when the ,distemper is of a mild ,species1 a perfect ,cure ensues1 without any other ,assistance or ,medicine3 but we should not neglect to purge the ,patient as soon as the ,pustules are perfectly scabbed on the greater ,part of his ,face1 with the ,prescription ,no4 #aa1 which must be repeated six ,days after4 ,he should not be allowed ,flesh 'till after this second ,purge2 though after the first he may he allowed some well-boiled ,pulse1 or ,garden-stuff and ,bread1 and in such a ,quantity1 as not to be pinched with ,hunger1 while he recovers from the ,disease4 #ec ,a ,negro ,girl1 about five or six ,years old1 under a coherent ,pock1 stole by ,night out of the ,garret where she lay1 into a ,kitchen out of ,doors1 where she drank plentifully of cold ,water4 ,how often she repeated these nightly cooling ,potions ,i never could certainly learn1 though they occurred in my own ,house in ,south-,carolina in ,summer4 ,but it is certain the ,child recovered as speedily as others1 whose ,eruption was more distinct1 and who drank ,barley-,water1 very thin ,rice or ,indian ,corn ,gruel1 ,balm ,tea1 or the like4 ,in fact1 throughout the ,course of this ,visitation from the ,small ,pocks in ,carolina in #agch1 we had but too many ,demonstrations of the fatal ,co-operation of violent ,heat with their ,contagion2 and not a very few surprizing ,instances of the salutary ,effects of being necessarily and involuntarily exposed to same very cooling ,accidents after ,infection1 and in some ,cases after ,eruption too3 which ,i then more particularly mentioned is a small controversial ,tract printed there4 ,k4 ,sec4 #bac4 ,but if the ,fever should be strong1 the ,pulse hard1 and the ,pain of the ,head and ,loins should be violent1 he must1 #a4 immediately lose ,blood from the ,arm2 receive a ,glyster two ,hours after2 and1 if the ,fever continues1 the ,bleeding must be repeated4 ,i have directed a ,repetition of it even to the fourth ,time1 within the two first ,days1 to young ,people under the ,age of eighteen2 and it is more especially necessary in such ,persons as1 with a hard and full ,pulse1 are also affected with a heavy ,drowsiness and a ,delirium1 or ,raving4 #b4 ,as long as the ,fever continues violently1 two1 three1 and even four ,glysters should be given in the #bd ,hours2 and the ,legs should be bathed twice4 #c4 ,the ,patient is to be taken out of ,bed1 and supported in a ,chair as long as he can tolerably bear it4 #d4 ,the ,air of his ,chamber should frequently be renewed1 and if it be too hot1 which it often is in ,summer1 in ,order to refresh it1 and the ,patient1 the ,means must be employed which are directed ,sec4 #cf4 #e4 ,he is to be restrained to the ,ptisans ,no4 #b or #d2 and if that does not sufficiently moderate the ,fever1 he should take every ,hour1 or every two ,hours1 according to the ,urgency of the ,case1 a ,spoonful of the ,mixture ,no4 #aj2 mixed with a ,cup of ,ptisan4 ,after the ,eruption1 the ,fever being then abated1 there is less ,occasion for ,medicine2 and should it even entirely disappear1 the ,patient may be regulated1 as directed1 ,sec4 #bab4 ,sec4 #bad4 ,when1 after a ,calm1 a ,remission or ,intermission of some ,days1 the ,process of ,suppuration revives the ,fever1 we ought first1 and especially1 to keep the #ed ,body very open4 ,for this ,purpose1 a an ,ounce of ,catholicon should be added to the ,glysters2 or they might be simply made of ,whey1 with ,honey1 ,oil and ,salt4 b ,give the ,patient three times every ,morning1 at the ,interval of two ,hours between each1 three ,glasses of the ,ptisan ,no4 #cb4 c ,purge him after two ,days1 with the ,potion ,no4 #bc1 but on that ,day he must not take the ,ptisan ,no4 #cb4 #ed ,we must remember that ,dr4 ,tissot is treating here of the higher or confluent ,degrees of this ,disease2 for in the distinct ,small-,pocks1 it is common to find ,persons for several ,days without a ,stool1 and without the least perceiveable ,disorder for ,want of one 7their whole ,nourishment being very light and liquid7 in which ,cases1 while ,matters proceeded well in all other ,respects1 there seems little ,occasion for a great ,solicitude about ,stools3 ,but if one should be judged necessary after four or five ,days ,costiveness1 accompanied with a ,tightness or ,hardness of the ,belly1 doubtless the ,glyster should be of the lenient ,kind 7as those directed by our ,author are7 and not calculated to produce more than a second ,stool at the very most4 ,indeed1 where there is ,reason to apprehend a strong secondary ,fever1 from the ,quantity of ,eruption1 and a previously high ,inflammation1 it is more prudent to provide for a ,mitigation of it1 by a moderately open ,belly1 than to suffer a long ,costiveness2 yet so as to incur very little ,hazard of abating the ,salivation1 or retarding the ,growth or ,suppuration of the ,pustules1 by a ,superpurgation1 which it may be too easy to excite in some ,habits4 ,if the ,discharge by spitting1 and the ,brightness and ,quantity of ,suppuration1 have been in ,proportion to the ,number of ,eruptions2 though the ,conflict from the secondary ,fever1 where these have been numerous1 is often acute and high2 and the ,patient1 who is in great ,anguish1 is far from being out of ,danger1 yet ,nature pretty generally proves stronger than the ,disease1 in such ,circumstances4 ,as the ,elect4 ,catholicon1 is little used1 or made here1 the lenitive ,electuary of our ,dispensatory may be substituted for it1 or that of the ,edinburgh ,dispensatory1 which was calculated particularly for ,glysters4 ,k4 #b4 ,he must1 if the ,distemper be very violent1 take a double ,dose of the ,mixture ,no4 #aj4 #c4 ,the ,patient should be taken out of ,bed1 and kept up in a ,room well aired ,day and ,night1 until the ,fever has abated4 ,many ,persons will probably be surprized at this ,advice2 nevertheless it is that which ,i have often experienced to be the most efficacious1 and without which the others are ineffectual4 ,they will say1 how shall the ,patient sleep at this ,rate8 ,to which it may be answered1 ,sleep is not necessary1 nay1 it is hurtful in this ,state and ,stage of the ,disease4 ,besides1 he is really unable to sleep3 the continual ,salivation prevents it1 and it is very necessary to keep up the ,salivation2 which is facilitated by often injecting warm ,water and ,honey into his ,throat4 ,it is also of considerable ,service to throw some up his ,nostrils1 and often thus to cleanse the ,scabs which form within them4 ,a due ,regard to these ,circumstances not only contributes to lessen the ,patient's ,uneasiness1 but very effectually also to his ,cure4 #d4 ,if the ,face and ,neck are greatly swelled1 emollient ,cataplasms are to be applied to the ,soles of the ,feet2 and if these should have very little ,effect1 ,sinapisms should be applied4 ,these are a kind of ,plaister or ,application composed of ,yeast1 ,mustard-flower1 and some ,vinegar4 ,they sometimes occasion sharp and almost burning ,pain1 but in ,proportion to the ,sharpness and ,increase of these ,pains1 the ,head and ,neck are remarkably relieved4 ,sec4 #bae4 ,the ,eyelids are puffed up and swelled when the ,disease runs high1 so as to conceal the ,eyes1 which are closed up fast for several ,days4 ,nothing further should be attempted1 with ,respect to this ,circumstance1 but the frequent moistening of them with a little warm ,milk and ,water4 ,the ,precautions which some take to stroke them with ,saffron1 a gold ,ducat1 or ,rose-water are equally childish and insignificant4 ,what chiefly conduces to prevent the ,redness or ,inflammation of the ,eyes after the ,disease1 and in general all its other bad ,consequences1 is to be content for a considerable ,time1 with a very moderate ,quantity of ,food1 and particularly to abstain from ,flesh and ,wine4 ,in the very bad ,small ,pocks1 and in little ,children1 the ,eyes are closed up from the ,beginning of the ,eruption4 ,sec4 #baf4 ,one extremely serviceable ,assistance1 and which has not been made use of for a long ,time past1 except as a ,means to preserve the ,smoothness and ,beauty of the ,face2 but yet which has the greatest ,tendency to preserve ,life itself1 is the ,opening of the ,pustules1 not only upon the ,face1 but all over the ,body4 ,in the first ,place1 by opening them1 the ,lodgment or ,retention of ,pus is prevented1 which may be supposed to prevent any ,erosion1 or eating down1 from it2 whence ,scars1 deep ,pitts and other ,deformities are obviated4 ,secondly1 in giving a ,vent to the ,poison1 the ,retreat of it into the ,blood is cut off1 which removes a principal ,cause of the ,danger of the ,small-,pocks4 ,thirdly1 the ,skin is relaxed2 the ,tumour of the ,face and ,neck diminish in ,proportion to that ,relaxation2 and thence the ,return of the ,blood from the ,brain is facilitated1 which must prove a great ,advantage4 ,the ,pustules should be opened every where1 successively as they ripen4 ,the precise ,time of doing it is when they are entirely white2 when they just begin to turn but a very little yellowish2 and when the red ,circle surrounding them is quite pale4 ,they should be opened with very fine sharp-pointed ,scissars2 this does not give the ,patient the least ,pain2 and when a certain ,number of them are opened1 a ,spunge dipt in a little warm ,water is to be repeatedly applied to suck up and remove that ,pus1 which would soon be dried up into ,scabs4 ,but as the ,pustules1 when emptied thus1 soon fill again1 a ,discharge of this fresh ,matter must be obtained in the same ,manner some ,hours after2 and this must sometimes be repeated five or even six ,times successively4 ,such extraordinary ,attention in this ,point may probably be considered as minute1 and even trivial1 by some2 and is very unlikely to become a #ee general ,practice3 but ,i do again affirm it to be of much more ,importance than many may imagine2 and that as often as the ,fever attending ,suppuration is violent and menacing1 a very general1 exact and repeated opening1 emptying1 and absorbing of the ripened ,pustules1 is a ,remedy of the utmost ,importance and ,efficacy2 as it removes two very considerable ,causes of the ,danger of this ,disease1 which are the ,matter itself1 and the great ,tension and ,stiffness of the ,skin4 #ee ,this ,practice which ,i had heard of1 and even suggested to myself1 but never seen actually enterprized1 seems so very rational as highly to deserve a fair ,trial in the confluent ,degrees of the ,small-,pocks for in the distinct it can scarcely be necessary wherein every probable ,assistance should be employed1 and in which the most potent ,medicines are very often unsuccessful4 ,we have but too many ,opportunities of trying it sufficiently2 and it certainly has a more promising ,aspect than a ,practice so highly recommended many ,years ago1 of covering all the ,pustules 7which is sometimes the whole ,surface of the ,patient7 in ,melilot1 or suppose any other suppurating1 ,plaister2 which will effectually prevent all ,perspiration1 and greatly increase the ,soreness1 ,pain and ,embarrassment of the ,patient1 at the ,height of the ,disease4 ,i can conceive but one bad ,consequence that might possibly sometimes result from the former2 but this 7besides the ,means that may be used to avert it7 is rather remote1 and so uncertain1 until the ,trial is repeatedly made1 that ,i think it ought not to be named1 in ,competition with the ,benefits that may arise from it in such ,cases1 as seem1 otherwise1 too generally irrecoverable4 ,k4 ,sec4 #bag4 ,in the ,treatment of this ,disease1 ,i have said nothing with ,respect to ,anodynes1 or such ,medicines as procure ,sleep1 which ,i am sensible are pretty generally employed in it1 but which ,i scarcely ever direct in this violent ,degree of the ,disease1 and the ,dangers of which ,medicine in it ,i have demonstrated in the ,letter to ,baron ,haller1 which ,i have already mentioned4 ,for which ,reason1 wherever the ,patient is not under the ,care and ,direction of a ,physician1 they should very carefully abstain from the ,use of ,venice ,treacle1 ,laudanum1 ,diacodium1 that is the ,syrup of white ,poppies1 or even of the wild red ,poppy2 ,syrup of ,amber1 ,pills of ,storax1 of ,cynoglossum or ,hounds-tongue1 and1 in one ,word1 of every ,medicine which produces ,sleep4 ,but still more especially should their ,use be entirely banished1 throughout the ,duration of the secondary ,fever1 when even natural ,sleep itself is dangerous4 ,one ,circumstance in which their ,use may sometimes be permitted1 is in the ,case of weakly ,children1 or such as are liable to ,convulsions1 where ,eruption is effected not without ,difficulty4 ,but ,i must again inculcate the greatest ,circumspection1 in the ,use of such ,medicines1 whose ,effects are fatal1 #ef when the ,blood-vessels are turgid or full2 whenever there is ,inflammation1 ,fever1 a great ,distension of the ,skin2 whenever the ,patient raves1 or complains of ,heaviness and ,oppression2 and when it is necessary that the ,belly should be open2 the ,urine plentifully discharged2 and the ,salivation be freely promoted4 #ef ,the ,use of ,opiates in this ,disease undoubtedly requires no ,small ,consideration1 the great ,sydenham himself not seeming always sufficiently guarded in the ,exhibition of them2 as far as ,experience since his ,day has enabled ,physicians to judge of this ,matter4 ,in general our ,author's ,limitations of them seem very just2 though we have seen a few clear ,instances1 in which a light ,raving1 which evidently arose from ,want of ,sleep 7joined to some ,dread of the ,event of the ,disease by ,inoculation7 was happily removed1 with every other considerable ,complaint1 by a moderate ,opiate4 ,in sore and fretful ,children too1 under a large or middling ,eruption1 as the ,time gained to ,rest is taken from ,pain1 and from wasting their ,spirits in ,crying and ,clamour1 ,i have seen ,suppuration very benignly promoted by ,diacodium4 ,but in the ,crisis of the secondary ,fever in the confluent or coherent ,pock1 when there is a morbid ,fulness1 and ,nature is struggling to unload herself by some other ,outlets than those of the ,skin1 which now are totally obstructed 7and which seems the only ,evacuation1 that is not restrained by ,opiates7 the giving and repeating them then1 as has too often been practised1 seems importantly erroneous2 for ,i think ,dr4 ,swan has taken a judicious ,liberty of dissenting from the great ,author he translates1 in forbidding an ,opiate1 if the ,spitting abates1 or grows so tough and ropy1 as to endanger ,suffocation4 ,as the ,difference of our ,oeconomy in the ,administration of ,physic from that in ,swisserland1 and ,dr4 ,tissot's just ,reputation may dispose many ,country ,practitioners to peruse this ,treatise1 ,i take the ,liberty of referring such ,readers1 for a ,recollection of some of my ,sentiments of ,opiates1 long before the ,appearance of this ,work in ,french1 to the second ,edition of the ,analysis from ,p4 #id to #ig1 c4 ,k4 ,sec4 #bah4 ,if ,eruption should suddenly retreat1 or strike in1 heating1 soporific1 spirituous and volatile ,remedies should carefully be avoided3 but the ,patient may drink plentifully of the ,infusion ,no4 #ab pretty hot1 and should be blistered on the fleshy ,part of the ,legs4 ,this is a very embarrassing and difficult ,case1 and the different ,circumstances attending it may require different ,means and ,applications1 the ,detail and ,discussion of which are beyond my ,plan here4 ,sometimes a single ,bleeding has effectually recalled ,eruption at once4 ,sec4 #bai4 ,the only certain ,method of surmounting all the ,danger of this ,malady1 is to inoculate4 ,but this most salutary ,method1 which ought to be regarded as a particular and gracious ,dispensation of ,providence1 can scarcely be attainable by1 or serviceable to1 the ,bulk of the ,people1 except in those ,countries1 where ,hospitals #eg are destined particularly for ,inoculation4 ,in these where as yet there are none1 the only ,resource that is left for ,children who cannot be inoculated at home1 is to dispose them happily for the ,distemper1 by a simple easy ,preparation4 #eg ,that ,i have long since had the ,honour of agreeing with our learned ,author1 in this ,consideration for the ,benefit of the ,body of the ,people1 which is the ,benefit of the ,state1 will appear from p4 #bhh of ,analys4 ,ed4 #ast4 and from p4 #cga1 #cgb of the ,second4 ,k4 ,sec4 #bbj4 ,this ,preparation consists1 upon the whole1 in removing all ,want of1 and all ,obstructions to1 the ,health of the ,person subject to this ,disease1 if he have any such2 and in bringing him into a mild and healthy1 but not into a very robust and vigorous1 ,state2 as this ,distemper is often exceedingly violent in this last4 ,it is evident1 that since the ,defects of ,health are very different in different ,bodies1 the ,preparations of them must as often vary2 and that a ,child subject to some habitual ,disorder1 cannot be prepared in the same ,method with another who has a very opposite one4 ,the ,detail and ,distinctions which are necessary on this important ,head1 would be improper here1 whether it might be owing to their unavoidable ,length2 or to the ,impossibility of giving ,persons1 who are not ,physicians1 sufficient ,knowlege and ,information to qualify them for determining on1 and preferring1 the most proper ,preparation in various ,cases4 ,nevertheless ,i will point out some such as may be very likely to agree1 pretty generally1 with ,respect to strong and healthy ,children4 #eh #eh ,the ,substance of this ,section flows from the ,combination of an excellent ,understanding with great ,experience1 mature ,reflection1 and real ,probity2 and fundamentally exposes both the ,absurdity of such as universally decry any ,preparation of any ,subject previous to ,inoculation1 7which is said to be the ,practice of a present very popular ,inoculator in ,paris7 and the opposite ,absurdity of giving one and the very same ,preparation to all ,subjects1 without ,distinction2 though this was avowed to have been successfully fully practised in ,pensylvania1 some ,years since2 which the ,reader may see ,analys4 ,ed4 #b;d1 from p4 #cbi to #cca and the ,note there4 ,k4 ,the first ,step then is an ,abatement of their usual ,quantity of ,food4 ,children commonly eat too much4 ,their ,limitation should be in ,proportion to their ,size and ,growth1 where we could exactly ascertain them3 but with ,regard to all1 or to much the greater ,number of them1 we may be allowed to make their ,supper very light1 and very small4 ,their second ,advantage will consist in the ,choice of their ,food4 ,this ,circumstance is less within the ,attainment of1 and indeed less necessary for1 the common ,people1 who are of ,course limited to a very few1 than to the ,rich1 who have ,room to make great ,retrenchments on this ,account4 ,the ,diet of ,country ,people being of the simplest ,kind1 and almost solely consisting of ,vegetables and of ,milk-meats1 is the most proper ,diet towards preparing for this ,disease4 ,for this ,reason1 such ,persons have little more to attend to in this ,respect1 but that such ,aliments be sound and good in their ,kind2 that their ,bread be well baked2 their ,pulse dressed without ,bacon1 or rancid strong ,fat of any sort2 that their ,fruits should be well ripened2 that their ,children should have no ,cakes or ,tarts1 ,but see ,note #aa1 ,p4 #dj1 #da4 and but little ,cheese4 ,these simple ,regulations may be sufficient1 with ,regard to this ,article of their ,preparation4 ,some ,judgment may be formed of the good ,consequences of their ,care on these two ,points1 concerning the ,quantity and ,quality of the ,childrens ,diet1 by the moderate ,shrinking of their ,bellies2 as they will be rendered more lively and active by this ,alteration in their living2 and yet1 notwithstanding a little less ,ruddiness in their ,complexion1 and some ,abatement of their common ,plight of ,body1 their ,countenances1 upon the whole1 will seem improved4 ,the third ,article ,i would recommend1 is to bathe their ,legs now and then in warm ,water1 before they go to ,bed4 ,this promotes ,perspiration1 cools1 dilutes the ,blood1 and allays the ,sharpness of it1 as often as it is properly timed4 ,the fourth ,precaution1 is the frequent ,use of very clear ,whey4 ,this agreeable ,remedy1 which consists of the ,juices of ,herbs filtred through1 and concocted1 or as it were1 sweetened by the ,organs of a healthy ,animal1 answers every visible ,indication 7,i am still speaking here of sound and hearty ,children74 ,it imparts a ,flexibility1 or ,soupleness to the ,vessels2 it abates the ,density1 the heavy ,consistence and ,thickness of the ,blood2 which being augmented by the ,action of the poisonous ,cause of the ,small-,pocks1 would degenerate into a most dangerous inflammatory #ei ,viscidity or ,thickness4 ,it removes all ,obstructions in the ,viscera1 or ,bowels of the lower ,cavity1 the ,belly4 ,it opens the ,passages which strain off the ,bile2 sheaths1 or blunts1 its ,sharpness1 gives it a proper ,fluidity1 prevents its ,putridity1 and sweetens whatever excessive ,acrimony may reside throughout the ,mass of ,humours4 ,it likewise promotes ,stools1 ,urine and ,perspiration2 and1 in a ,word1 it communicates the most favourable ,disposition to the ,body1 not to be too violently impressed and agitated by the ,operation of an inflammatory ,poison3 ,and with ,regard to such ,children as ,i have mentioned1 for those who are either sanguine or bilious1 it is beyond all ,contradiction1 the most effectual preparatory ,drink1 and the most proper to make them amends for the ,want of ,inoculation4 #ei ,there may certainly be an inflammatory ,acrimony or ,thinness1 as well as ,thickness of the ,blood2 and many medical ,readers may think a morbid ,fusion of the red ,globules to be a more frequent ,effect of this ,contagion1 than an increased ,viscidity of them4 ,see ,analys4 ,ed4 #b;d4 p4 #ge to #hc4 ,but this ,translation1 conforming to the ,spirit of its ,original1 admits very little ,theory1 and still less ,controversy1 into its ,plan4 ,k4 ,i have already observed1 that it may also be used to great ,advantage1 during the ,course of the ,disease3 but ,i must also observe1 that however salutary it is1 in the ,cases for which ,i have directed it1 there are many others in which it would be hurtful4 ,it would be extremely pernicious to order it to weak1 languishing1 scirrhous1 pale ,children1 subject to ,vomitings1 ,purgings1 ,acidities1 and to all ,diseases which prove their ,bowels to be weak1 their ,humours to be sharp3 so that ,people must be very cautious not to regard it as an universal and infallible ,remedy1 towards preparing for the ,small-,pocks4 ,those to whom it is advised1 may take a few ,glasses every ,morning1 and even drink it daily1 for their common ,drink2 they may also sup it with ,bread for ,breakfast1 for ,supper1 and indeed at any ,time4 ,if ,country ,people will pursue these ,directions1 which are very easy to observe and to comprehend1 whenever the ,small-,pocks rages1 ,i am persuaded it must lessen the ,mortality attending it4 ,some will certainly experience the ,benefit of them2 such ,i mean as are very sensible and discreet1 and strongly influenced by the truest ,love of their ,children4 ,others there are ,alas6 who are too stupid to discern the ,advantage of them1 and too unnatural to take any just ,care of their ,families4 ,chapter ,,xiv4 ,of the ,measles4 ,sect4 #bba4 ,the ,measles1 to which the human ,species are as generally liable1 as to the ,small-,pocks1 is a ,distemper considerably related to it2 though1 generally speaking1 it is less fatal2 notwithstanding which1 it is not a little destructive in some ,countries4 ,in ,swisserland we lose much fewer1 immediately in the ,disease1 than from the ,consequences of it4 ,it happens now and then that the ,small-,pocks and the ,measles rage at the same ,time1 and in the same ,place2 though ,i have more frequently observed1 that each of them was epidemical in different ,years4 ,sometimes it also happens that both these ,diseases are combined at once in the same ,person2 and that one supervenes before the other has finished its ,course1 which makes the ,case very perilous4 ,sec4 #bbb4 ,in some ,constitutions the ,measles gives ,notice of its ,approach many ,days before its evident ,invasion1 by a small1 frequent and dry ,cough1 without any other sensible ,complaint3 though more frequently by a general ,uneasiness2 by ,successions of ,shivering and of ,heat2 by a severe ,head-ach in grown ,persons2 a ,heaviness in ,children2 a considerable ,complaint of the ,throat2 and1 by what particularly characterizes this ,distemper1 an ,inflammation and a considerable ,heat in the ,eyes1 attended with a ,swelling of the ,eye-lids1 with a ,defluxion of sharp ,tears1 and so acute a ,sensation1 or ,feeling of the ,eyes1 that they cannot bear the ,light2 by very frequent ,sneezings1 and a ,dripping from the ,nose of the same ,humour with that1 which trickles from the ,eyes4 ,the ,heat and the ,fever increases with ,rapidity2 the ,patient is afflicted with a ,cough1 a ,stuffing1 with ,anguish1 and continual ,reachings to vomit2 with violent ,pains in the ,loins2 and sometimes with a ,looseness1 under which ,circumstance he is less persecuted with ,vomiting4 ,at other times1 and in other ,subjects1 ,sweating chiefly prevails1 though in less ,abundance than in the ,small-,pocks4 ,the ,tongue is foul and white2 the ,thirst is often very high2 and the ,symptoms are generally more violent than in the mild ,small-,pocks4 ,at length1 on the fourth or fifth ,day1 and sometimes about the ,end of the third1 a sudden ,eruption appears and in a very great ,quantity1 especially about the ,face2 which in a few ,hours is covered with ,spots1 each of which resembles a ,flea-bite2 many of them soon joining form red ,streaks or ,suffusions larger or smaller1 which inflame the ,skin1 and produce a very perceivable ,swelling of the ,face2 whence the very ,eyes are sometimes closed4 ,each small ,spot or ,suffusion is raised a little above the ,surface1 especially in the ,face1 where they are manifest both to the ,sight and the ,touch4 ,in the other ,parts of the ,body1 this ,elevation or ,rising is scarcely perceivable by any ,circumstance1 but the ,roughness of the ,skin4 ,the ,eruption1 having first appeared in the ,face1 is afterwards extended to the ,breast1 the ,back1 the ,arms1 the ,thighs and ,legs4 ,it generally spreads very plentifully over the ,breast and the ,back1 and sometimes red ,suffusions are found upon the ,breast1 before any ,eruption has appeared in the ,face4 ,the ,patient is often relieved1 as in the ,small-,pocks1 by plentiful ,discharges of ,blood from the ,nose1 which carry off the ,complaints of the ,head1 of the ,eyes1 and of the ,throat4 ,whenever this ,distemper appears in its mildest ,character1 almost every ,symptom abates after ,eruption1 as it happens in the ,small-,pocks2 though1 in general1 the ,change for the better is not as thoroughly perceivable1 as it is in the ,small-,pocks4 ,it is certain the ,reachings and ,vomitings cease almost entirely2 but the ,fever1 the ,cough1 the ,head-ach continue2 and ,i have sometimes observed that a bilious ,vomiting1 a ,day or two after the ,eruption1 proved a more considerable ,relief to the ,patient than the ,eruption had4 ,on the third or fourth ,day of the ,eruption1 the ,redness diminishes2 the ,spots1 or very small ,pustules1 dry up and fall off in very little branny ,scales2 the ,cuticle1 or superficial ,skin also shrivels off2 and is replaced by one succeeding beneath it4 ,on the ninth ,day1 when the ,progress of the ,malady has been speedy1 and on the eleventh1 when it has been very slow1 no ,trace of the ,redness is to be found2 and the ,surface immediately resumes its usual ,appearance4 ,sec4 #bbc4 ,notwithstanding all which the ,patient is not safe1 except1 during the ,course of the ,distemper1 or immediately after it1 he has had some considerable ,evacuation2 such as the ,vomiting ,i have just mentioned2 or a bilious ,looseness2 or considerable ,discharges by ,urine2 or very plentiful ,sweating4 ,for when any of these ,evacuations supervene1 the ,fever vanishes2 the ,patient resumes his ,strength1 and perfectly recovers4 ,it happens sometimes too1 and even without any of these perceivable ,discharges1 that insensible ,perspiration expels the ,relics of the poisonous ,cause of this ,disease1 and the ,patient recovers his ,health4 ,yet it occurs too often1 that this ,venom not having been entirely expelled 7or its internal ,effects not having been thoroughly effaced7 it is repelled upon the ,lungs1 where it produces a slight ,inflammation4 ,in ,consequence of this the ,oppression1 the ,cough1 the ,anguish1 and ,fever return1 and the ,patient's ,situation becomes very dangerous4 ,this ,outrage is frequently less vehement1 but it proves tedious and chronical1 leaving a very obstinate ,cough behind it1 with many ,resemblances of the ,whooping-,cough4 ,in #ageh there was an epidemic ,state of the ,measles here extremely numerous1 which affected great ,numbers3 ,almost all who had it1 and who were not very carefully and judiciously attended1 were seized in ,consequence of it with that ,cough1 which proved very violent and obstinate4 ,sec4 #bbd4 ,however1 notwithstanding this be the frequent ,progress and ,consequence of this ,disease1 when left entirely to itself1 or erroneously treated1 and more particularly when treated with a hot ,regimen2 yet when proper ,care was taken to moderate the ,fever at the ,beginning1 to dilute1 and to keep up the ,evacuations1 such unhappy ,consequences have been very rare4 ,sec4 #bbe4 ,the proper ,method of conducting this ,distemper is much the same with that of the ,small-,pocks4 #a1 ,if the ,fever be high1 the ,pulse hard1 the ,load and ,oppression heavy1 and all the ,symptoms violent1 the ,patient must be bled once or twice4 #b1 ,his ,legs must be bathed1 and he must take some ,glysters3 the ,vehemence of the ,symptoms must regulate the ,number of each4 #c1 ,the ,ptisans ,no4 #c or #d must be taken1 or a ,tea of ,elder and ,lime-tree ,flowers1 to which a fifth ,part ,milk may be added4 #d1 ,the ,vapour1 the ,steam of warm ,water should also be employed1 as very conducive to asswage the ,cough2 the ,soreness of the ,throat1 and the ,oppression the ,patient labours under4 #e1 ,as soon as the ,efflorescence1 the ,redness becomes pale1 the ,patient is to be purged with the ,draught ,no4 #bc4 #f1 ,he is still to be kept strictly to his ,regimen1 for two ,days after this ,purge2 after which he is to be put upon the ,diet of those who are in a ,state of ,recovery4 #g1 ,if during the ,eruption such ,symptoms supervene as occur at the same ,term in the ,small-,pocks1 they are to be treated in the ,manner already directed there4 ,sec4 #bbf4 ,whenever this ,method has not been observed1 and the ,accidents described ,sec4 #bbc supervene1 the ,distemper must be treated like an ,inflammation in its first ,state1 and all must be done as directed ,sec4 #bbe4 ,if the ,disease is not vehement1 #fj ,bleeding may be omitted4 ,if it is of some standing in gross ,children1 loaded with ,humours1 inactive1 and pale1 we must add to the ,medicines already prescribed the ,potion ,no4 #h1 and ,blisters to the ,legs4 #fj ,our ,author very prudently limits this ,discharge1 and the ,repetition of it1 in this ,disease 7,sec4 #bbe7 as an erroneous ,excess of it has sometimes prevailed4 ,i have seen a very epidemical ,season of the ,measles1 where ,bleeding was not indicated in one third of the infected4 ,and yet ,i have known such an ,abuse of ,bleeding in it1 that being repeated more than once in a ,case before ,eruption 7the ,measles probably not being suspected7 the ,eruption was retarded several ,days2 and the ,patient1 a young ,lady of ,condition1 remained exceeding low1 faint and sickish2 'till after recruiting a very little1 the ,measles appeared1 and she recovered4 ,in a ,youth of a lax ,fibre1 where the ,measles had appeared1 a seventh or eighth ,bleeding was ordered on a ,stitch in the ,side1 supervening from their too early ,disappearance1 and the ,case seemed very doubtful4 ,but ,nature continued very obstinately favourable in this ,youth1 who at length1 but very slowly1 recovered4 ,his ,circulation remained so languid1 his ,strength1 with his ,juices1 so exhausted1 that he was many ,weeks before he could sit upright in a ,chair1 being obliged to make ,use of a ,cord depending from the ,ceiling1 to raise himself erectly in his ,seat4 ,k4 ,sec4 #bbg4 ,it often happens from the ,distance of proper ,advice1 that the ,relics1 the ,dregs as it were1 of the ,disease have been too little regarded1 especially the ,cough2 in which ,circumstance it forms a real ,suppuration in the ,lungs1 attended with a slow ,fever4 ,i have seen many ,children in ,country ,villages destroyed by this ,neglect4 ,their ,case is then of the same ,nature with that described ,sec4 #fh and #hb1 and terminates in the same ,manner in a ,looseness1 7attended with very little ,pain7 and sometimes a very foetid one1 which carries off the ,patient4 ,in such ,cases we must recur to the ,remedies prescribed ,sec4 #gd1 ,article #c1 #d1 #e2 to the ,powder ,no4 #ad2 and to ,milk and ,exercise4 ,but it is so very difficult to make ,children take the ,powder1 that it may be sometimes necessary to trust to the ,milk without it1 which ,i have often seen in such ,situations accomplish a very difficult ,cure4 ,i must advise the ,reader at the same ,time1 that it has not so compleat an ,effect1 as when it is taken solely unjoined by any other ,aliment2 and that it is of the last ,importance not to join it with any1 which has the least ,acidity or ,sharpness4 ,persons in easy ,circumstances may successfully take1 at the same ,time1 ,pfeffer1 #fa ,seltzer1 ,peterstal1 or some other light ,waters1 which are but moderately loaded with mineral ,ingredients4 ,these are also successfully employed in all the ,cases1 in which the ,cure ,i have mentioned is necessary4 #fa ,bristol ,water will be no bad ,substitute for any of these1 in such ,cases4 ,k4 ,sec4 #bbh4 ,sometimes there remains1 after the ,course of the ,measles1 a strong dry ,cough1 with great ,heat in the ,breast1 and throughout the whole ,body1 with ,thirst1 an excessive ,dryness of the ,tongue1 and of the whole ,surface of the ,body4 ,i have cured ,persons thus indisposed after this ,distemper1 by making them breathe in the ,vapour of warm ,water2 by the repeated ,use of warm ,baths2 and by allowing them to take nothing for several ,days but ,water and ,milk4 ,before ,i take leave of this ,subject1 ,i assure the ,reader again1 that the contagious ,cause of the ,measles is of an extremely sharp and acrid ,nature4 ,it appears to have some ,resemblance to the bilious ,humour1 which produces the ,erisipelas1 or ,st4 ,anthony's ,fire2 and thence it demands our particular ,attention and ,vigilance2 without which very troublesome and dangerous ,consequences may be apprehended4 ,i have seen1 not very long since1 a young ,girl1 who was in a very languid ,state after the ,measles1 which she had ,undergone three ,years before3 ,it was at length attended with an ,ulceration in her ,neck1 which was cured1 and her ,health finally restored by ,sarsaparilla with ,milk and ,water4 ,sec4 #bbi4 ,the ,measles have been communicated by #fb ,inoculation in some ,countries1 where it is of a very malignant ,disposition2 and that ,method might also be very advantageous in this4 ,but what we have already observed1 with ,respect to the ,inoculation of the ,small-,pocks1 viz4 ,that it cannot be extended to the general ,benefit of the ,people1 without the ,foundation of ,hospitals for that very ,purpose1 is equally applicable to the ,inoculation of the ,measles4 #fb ,the only ,account ,i have read of this ,practice1 is in the learned ,dr4 ,home's ,medical ,facts and ,experiments1 published in #agei1 which admits1 that but nine out of fifteen of the ,subjects of this ,practice took4 ,cotton dipt in the ,blood of a ,patient in the ,measles was inserted into the ,arms of twelve2 and three received the ,cotton into their ,nostrils1 after the ,chinese ,manner of infusing the ,small-,pocks2 but of these last not one took1 and one of those who had taken1 had the ,measles again two ,months after4 ,we think the sharp hot ,lymph distilling from the inflamed ,eyes of ,persons in this ,disease1 a likelier ,vehicle to communicate it than the ,blood1 especially the dry ,blood1 which was sometimes tried2 since the human ,serum seems the ,fluid more particularly affected by it2 and this must have been evaporated when the ,blood grew dry4 ,a few practical ,strictures on this ,work1 and particularly on this ,practice described in it1 appeared in the ,monthly ,review ,vol4 ,,xxi4 ,p4 #fh to #ge4 ,k4 ,chapter ,,xv4 ,of the ardent or burning ,fever4 ,sect4 #bcj4 ,the much greater ,number of the ,diseases ,i have hitherto considered1 result from an ,inflammation of the ,blood1 combined with the particular ,inflammation of some ,part1 or occasioned by some ,contagion or ,poison1 which must be evacuated4 ,but when the ,blood is solely and strongly inflamed1 without an ,attack on any particular ,part1 this ,fever1 which we term hot or burning1 is the ,consequence4 ,sec4 #bca4 ,the ,signs which make it evident are1 a ,hardness and ,fulness of the ,pulse in a higher ,degree than happens in any other ,malady2 an excessive ,heat2 great ,thirst2 with an extraordinary ,dryness of the ,eyes1 ,nostrils1 ,lips1 of the ,tongue1 and of the ,throat2 a violent ,head-ach2 and sometimes a ,raving at the ,height of the ,paroxysm1 or ,increase of the ,fever1 which rises considerably every ,evening4 ,the ,respiration is also somewhat oppressed1 but especially at the ,return of this ,paroxysm1 with a ,cough now and then2 though without any ,pain in the ,breast1 and without any ,expectoration1 or coughing up4 ,the ,body is costive2 the ,urine very high coloured1 hot1 and in a small ,quantity4 ,the ,sick are also liable to start sometimes1 but especially when they seem to sleep2 for they have little sound refreshing ,sleep1 but rather a kind of ,drowsiness1 that makes them very little attentive to1 or sensible of1 whatever happens about them1 or even of their own ,condition4 ,they have sometimes a little ,sweat or ,moisture2 though commonly a very dry ,skin2 they are manifestly weak1 and have either little or no ,smell or ,taste4 ,sec4 #bcb4 ,this ,disease1 like all other inflammatory ones1 is produced by the ,causes which thicken the ,blood1 and increase its ,motion2 such as excessive ,labour1 violent ,heat1 ,want of ,sleep1 the ,abuse of ,wine or other strong ,liquors2 the long ,continuance of a dry ,constitution of the ,air1 ,excess of every kind1 and heating inflaming ,food4 ,sec4 #bcc4 ,the ,patient1 under these ,circumstances1 ought1 #a1 immediately to be put upon a ,regimen2 to have the ,food allowed him given only every eight ,hours1 and1 in some ,cases1 only twice a ,day3 and indeed1 when the ,attack is extremely violent1 ,nourishment may be wholly omitted4 #b1 ,bleeding should be performed and repeated1 'till the ,hardness of the ,pulse is sensibly abated4 ,the first ,discharge should be considerable1 the second should be made four ,hours after4 ,if the ,pulse is softened by the first1 the second may be suspended1 and not repeated before it becomes sufficiently hard again1 to make us apprehensive of ,danger3 but should it continue strong and hard1 the ,bleeding may be repeated on the same ,day to a third ,time1 which often happens to be all the ,repetitions that are necessary4 #c1 ,the ,glyster ,no4 #e should be given twice1 or even thrice1 daily4 #d1 ,his ,legs are to be bathed twice a ,day in warm ,water3 his ,hands may be bathed in the same ,water4 ,linen or ,flanel ,cloths dipt in warm ,water may be applied over the ,breast1 and upon the ,belly2 and he should regularly drink the ,almond ,milk ,no4 #d and the ,ptisan ,no4 #g4 ,the poorest ,patients may content themselves with the last1 but should drink very plentifully of it2 and after the ,bleeding properly repeated1 fresh ,air and the plentiful ,continuance of small diluting ,liquors generally establish the ,health of the ,patient4 #e1 ,if notwithstanding the repeated ,bleedings1 the ,fever still rages highly1 it may be lessened by giving a ,spoonful of the ,potion ,no4 #aj every ,hour1 till it abates2 and afterwards every three ,hours1 until it becomes very moderate4 ,sec4 #bcd4 ,haemorrhages1 or ,bleedings1 from the ,nose frequently occur in this ,fever1 greatly to the ,relief and ,security of the ,patient4 ,the first ,appearances of ,amendment are a softening of the ,pulse1 7which however does not wholly lose all its ,hardness1 before the ,disease entirely terminates7 a sensible ,abatement of the ,head-ach2 a greater ,quantity of ,urine1 and that less high coloured2 and a manifestly approaching ,moisture of the ,tongue4 ,these favourable ,signs keep increasing in their ,degree1 and there frequently ensue between the ninth and the fourteenth ,day1 and often after a ,flurry of some ,hours ,continuance1 very large ,evacuations by ,stool2 a great ,quantity of ,urine1 which lets fall a palely reddish ,sediment2 the ,urine above it being very clear1 and of a natural ,colour2 and these accompanied with ,sweats in a less or greater ,quantity4 ,at the same ,time the ,nostrils and the ,mouth grow moist3 the brown and dry ,crust which covered the ,tongue1 and which was hitherto inseparable from it1 peels off of itself2 the ,thirst is diminished2 the ,clearness of the ,faculties rises2 the ,drowsiness goes off1 it is succeeded by comfortable ,sleep1 and the natural ,strength is restored4 ,when ,things are evidently in this ,way1 the ,patient should take the ,potion ,no4 #bc1 and be put upon the ,regimen of those who are in a ,state of ,recovery4 ,it should be repeated at the ,end of eight or ten ,days4 ,some ,patients have perfectly recovered from this ,fever1 without the least ,sediment in their ,urine4 ,sec4 #bce4 ,the augmenting ,danger of this ,fever may be discerned1 from the continued ,hardness of the ,pulse1 though with an ,abatement of its ,strength2 if the ,brain becomes more confused2 the ,breathing more difficult2 if the ,eyes1 ,nose1 ,lips and ,tongue become still more dry1 and the ,voice more altered4 ,if to these ,symptoms there be also added a ,swelling of the ,belly2 a ,diminution of the ,quantity of ,urine2 a constant ,raving2 great ,anxiety1 and a certain ,wildness of the ,eyes1 the ,case is in a manner desperate2 and the ,patient cannot survive many ,hours4 ,the ,hands and ,fingers at this ,period are incessantly in ,motion1 as if feeling for something upon the ,bed-,cloths1 which is commonly termed1 their hunting for ,flies4 ,chapter ,,xvi4 ,of putrid ,fevers4 ,sect4 #bcf4 ,having treated of such feverish ,distempers1 as arise from an ,inflammation of the ,blood1 ,i shall here treat of those produced by corrupt ,humours1 which stagnate in the ,stomach1 the ,guts1 or other ,bowels of the lower ,cavity1 the ,belly2 or which have already passed from them into the ,blood4 ,these are called putrid ,fevers1 or sometimes bilious ,fevers1 when a certain ,degeneracy or ,corruption of the ,bile seems chiefly to prevail in the ,disease4 ,sec4 #bcg4 ,this ,distemper frequently gives ,notice of its ,approach1 several ,days before its manifest ,attack2 by a great ,dejection1 a ,heaviness of the ,head2 ,pains of the ,loins and ,knees2 a ,foulness of the ,mouth in the ,morning2 little ,appetite2 broken ,slumber2 and sometimes by an excessive ,head-ach for many ,days1 without any other ,symptom4 ,after this1 or these ,disorders1 a ,shivering comes on1 followed by a sharp and dry ,heat3 the ,pulse1 which was small and quick during the ,shivering1 is raised during the ,heat1 and is often very strong1 though it is not attended with the same ,hardness1 as in the preceding ,fever2 except the putrid ,fever be combined with an inflammatory one1 which it sometimes is4 ,during this ,time1 that is the ,duration of the ,heat1 the ,head-ach is commonly extremely violent2 the ,patient is almost constantly affected with ,loathings1 and sometimes even with ,vomiting2 with ,thirst1 disagreeable ,risings1 a ,bitterness in the ,mouth2 and very little ,urine4 ,this ,heat continues for many ,hours1 frequently the whole ,night2 it abates a little in the ,morning1 and the ,pulse1 though always feverish1 is then something less so1 while the ,patient suffers less1 though still greatly dejected4 ,the ,tongue is white and furred1 the ,teeth are foul1 and the ,breath smells very disagreeably4 ,the ,colour1 ,quantity and ,consistence of the ,urine1 are very various and changeable4 ,some ,patients are costive1 others frequently have small ,stools1 without the least ,relief accruing from them4 ,the ,skin is sometimes dry1 and at other ,times there is some sensible ,perspiration1 but without any ,benefit attending it4 ,the ,fever augments every ,day1 and frequently at unexpected irregular ,periods4 ,besides that great ,paroxysm or ,increase1 which is perceivable in all the ,subjects of this ,fever1 some have also other less intervening ones4 ,sec4 #bch4 ,when the ,disease is left to itself1 or injudiciously treated2 or when it proves more powerful than the ,remedies against it1 which is by no ,means seldom the ,case1 the ,aggravations of it become longer1 more frequent and irregular4 ,there is scarcely an ,interval of ,ease4 ,the ,patient's ,belly is swell'd out like a ,foot-ball2 a ,delirium or ,raving comes on2 he proves insensible of his own ,evacuations1 which come away involuntarily2 he rejects ,assistance1 and keeps muttering continually1 with a quick1 small1 irregular ,pulse4 ,sometimes little ,spots of a brown1 or of a livid ,colour appear on the ,surface1 but particularly about the ,neck1 ,back and ,breast4 ,all the ,discharges from his ,body have a most foetid ,smell3 convulsive ,motions also supervene1 especially in the ,face2 he lies down only on his ,back1 sinks down insensibly towards the ,foot of the ,bed1 and picks about1 as if catching ,flies2 his ,pulse becomes so quick and so small1 that it cannot be perceived without ,difficulty1 and cannot be counted4 ,his ,anguish seems inexpressible3 his ,sweats stream down from ,agony3 his ,breast swells out as if distended by ,fullness1 and he dies miserably4 ,sec4 #bci4 ,when this ,distemper is less violent1 or more judiciously treated1 and the ,medicines succeed well1 it continues for some ,days in the ,state described ,sec4 #bcg1 without growing worse1 though without abating4 ,none of these ,symptoms however appear1 described ,sec4 #bch2 but1 on the contrary1 all the ,symptoms become milder1 the ,paroxysms1 or ,aggravations1 are shorter and less violent1 the ,head-ach more supportable2 the ,discharges by ,stool are less frequent1 but more at once1 and attended with ,relief to the ,patient4 ,the ,quantity of ,urine is very considerable1 though it varies at different ,times in ,colour and ,consistence1 as before4 ,the ,patient soon begins to get a little ,sleep1 and grows more composed and easy4 ,the ,tongue disengages itself from its ,filth and ,furriness1 and ,health gradually1 yet daily1 advances4 ,sec4 #bdj4 ,this ,fever seems to have no critical ,time1 either for its ,termination in ,recovery1 or in ,death4 ,when it is very violent1 or very badly conducted1 it proves sometimes fatal on the ninth ,day4 ,persons often die of it from the eighteenth to the twentieth2 sometimes only about the fortieth2 after having been alternately better and worse4 ,when it happens but in a light ,degree1 it is sometimes cured within a few ,days1 after the earliest ,evacuations4 ,when it is of a very different ,character1 some ,patients are not out of ,danger before the ,end of six ,weeks1 and even still later4 ,nevertheless it is certain1 that these ,fevers1 extended to this ,length of ,duration1 often depend in a great ,measure on the ,manner of treating them2 and that in general their ,course must be determined1 some time from the fourteenth to the thirtieth ,day4 ,sec4 #bda4 ,the ,treatment of this ,species of ,fevers is comprized in the following ,method and ,medicines4 #a1 ,the ,patient must be put into a ,regimen2 and notwithstanding he is far from costive1 and sometimes has even a small ,purging1 he should receive one ,glyster daily4 ,his common ,drink should be ,lemonade1 7which is made of the ,juice of ,lemons1 ,sugar and ,water7 or the ,ptisan ,no4 #c4 ,instead of ,juice of ,lemons1 ,vinegar may be occasionally substituted1 which1 with ,sugar and ,water1 makes an agreeable and very wholesome ,drink in these ,fevers4 #b1 ,if there be an ,inflammation also1 which may be discovered by the ,strength and the ,hardness of the ,pulse1 and by the ,temperament and ,complexion of the ,patient2 if he is naturally robust1 and has heated himself by any of the ,causes described1 ,sec4 #bcb1 he should be bled once1 and even a second ,time1 if necessary1 some ,hours after4 ,i must observe however1 that very frequently there is no such ,inflammation1 and that in such a ,case1 ,bleeding would be hurtful4 #c1 ,when the ,patient has drank very plentifully for two ,days of these ,liquids1 if his ,mouth still continues in a very foul ,state1 and he has violent ,reachings to vomit1 he must take the ,powder ,no4 #cd1 dissolved in half a #fc ,pot of warm ,water1 a #fd ,glass of it being to be drank every half ,quarter of an ,hour4 ,but as this ,medicine vomits1 it must not be taken1 except we are certain the ,patient is not under any ,circumstance1 which forbids the ,use of a ,vomit3 all which ,circumstances shall be particularly mentioned in the ,chapter1 respecting the ,use of such ,medicines1 as are taken by way of ,precaution1 or ,prevention4 ,if the first ,glasses excite a plentiful ,vomiting1 we must forbear giving another1 and be content with obliging the ,patient to drink a considerable ,quantity of warm ,water4 ,but if the former ,glasses do not occasion ,vomiting1 they must be repeated1 as already directed until they do4 ,those who are afraid of taking this ,medicine1 which is usually called1 the ,emetic1 may take that of ,no4 #ce1 also drinking warm ,water plentifully during its ,operation2 but the former is preferable1 as more prevalent1 in dangerous ,cases4 ,we must caution our ,readers at the same ,time1 that wherever there is an ,inflammation of any ,part1 neither of these ,medicines must be given1 which might prove a real ,poison in such a ,circumstance2 and even if the ,fever is extremely violent1 though there should be no particular ,inflammation1 they should not be given4 #fc ,that is about two ,ounces more than a ,pint and a half of our ,measure4 #fd ,about three ,ounces4 ,the ,time of giving them is soon after the ,end of the ,paroxysm1 when the ,fever is at the lowest4 ,the ,medicine ,no4 #cd generally purges1 after it ceases to make the ,patient vomit3 ,but ,no4 #ce is seldom attended with the same ,effect4 ,when the ,operation of the ,vomit is entirely over1 the ,sick should return to the ,use of the ,ptisan2 and great ,care must be taken to prohibit them from the ,use of ,flesh ,broth1 under the ,pretext of working off a ,purging with it4 ,the same ,method is to be continued on the following ,days as on the first2 but as it is of ,importance to keep the ,body open1 he should take every ,morning some of the ,ptisan ,no4 #cb4 ,such1 as this would be too expensive for1 may substitute1 in the room of it1 a fourth ,part of the ,powder ,no4 #cd in five or six ,glasses of ,water1 of which they are to take a ,cup every two ,hours1 beginning early in the ,morning4 ,nevertheless1 if the ,fever be very high1 ,no4 #cb should be preferred to it4 #d1 ,after the ,operation of the ,vomit1 if the ,fever still continue1 if the ,stools are remarkably foetid1 and if the ,belly is tense and distended as it were1 and the ,quantity of ,urine is small1 a ,spoonful of the ,potion ,no4 #aj should be given every two ,hours1 which checks the ,putridity and abates the ,fever4 ,should the ,distemper become violent1 and very pressing1 it ought to be taken every ,hour4 #e1 ,whenever1 notwithstanding the giving all these ,medicines as directed1 the ,fever continues obstinate2 the ,brain is manifestly disordered2 there is a violent ,head-ach1 or very great ,restlessness1 two blistering ,plaisters ,no4 #cf must be applied to the inside and fleshy ,part of the ,legs1 and their ,suppuration and ,discharge should be continued as long as possible4 #f1 ,if the ,fever is extremely violent indeed1 there is a ,necessity absolutely to prohibit the ,patient from receiving the least ,nourishment4 #g1 ,when it is thought improper1 or unsafe1 to give the ,vomit1 the ,patient should take in the ,morning1 for two successive ,days1 three ,doses of the ,powder ,no4 #bd1 at the ,interval of one ,hour between each3 ,this ,medicine produces some bilious ,stools1 which greatly abate the ,fever1 and considerably lessen the ,violence of all the other ,symptoms of the ,disease4 ,this may be done with ,success1 when the excessive ,height of the ,fever prevents us from giving the ,vomit3 and we should limit ourselves to this ,medicine1 as often as we are uncertain1 what ever the ,circumstances of the ,disease and the ,patient will admit of the ,vomiting2 which may thus be dispensed with1 in many ,cases4 #h1 ,when the ,distemper has manifestly and considerably declined2 the ,paroxysms are more slight2 and the ,patient continues without any ,fever for several ,hours1 the daily use of the purging opening ,drinks should be discontinued4 ,the common ,ptisans however should be still made use of2 and it will be proper to give every other ,day two ,doses of the ,powder ,no4 #bd1 which sufficiently obviates every ill ,consequence from this ,disease4 #i1 ,if the ,fever has been clearly off for a long ,part of the ,day2 if the ,tongue appears in a good healthy ,state2 if the ,patient has been well purged2 and yet one moderate ,paroxysm of the ,fever returns every ,day1 he should take four ,doses of the ,powder ,no4 #ad between the ,end of one ,return and the ,beginning of the next1 and continue this ,repetition some ,days4 ,people who cannot easily procure this ,medicine1 may substitute1 instead of it1 the bitter ,decoction ,no4 #cg4 four ,glasses of which may be taken at equal ,intervals1 between the two ,paroxysms or ,returns of the ,fever4 #aj1 ,as the ,organs of ,digestion have been considerably weakened through the ,course of this ,fever1 there is a ,necessity for the ,patient's conducting himself very prudently and regularly long after it1 with ,regard both to the ,quantity and ,quality of his ,food4 ,he should also use due ,exercise as soon as his ,strength will permit1 without which he may be liable to fall into some chronical and languishing ,disorder1 productive of considerable ,languor and ,weakness4 99 99 ,as our ,jail1 ,hospital1 and ,camp ,fevers may often be ranged in this ,class1 as of the most putrid ,kind1 and not seldom occasioned by bad ,food1 bad ,air1 unclean1 unwholesome ,lodging1 c4 a judicious ,use may certainly be made of a small ,quantity of genuine1 and not ungenerous1 ,wine in such of them1 as are not blended with an inflammatory ,cause1 or inflammable ,constitution1 or which do not greatly result from a bilious ,cause2 though in these last1 where there is manifest ,lowness and ,dejection1 perhaps a little ,rhenish might be properly interposed between the ,lemonade and other ,drinks directed ,sec4 #bda4 ,doubtless ,dr4 ,tissot was perfectly apprized of this salutary ,use of it in some low ,fevers2 but the ,necessity of its being regulated by the ,presence of a ,physician has probably disposed him rather to omit mentioning it1 than to leave the ,allowance of it to the ,discretion of a simple ,country ,patient1 or his ignorant ,assistants4 ,k4 ,chapter ,,xvii4 ,of malignant ,fevers4 ,sect4 #bdb4 ,those ,fevers are termed malignant1 in which the ,danger is more than the ,symptoms would make us apprehensive of3 they have frequently a fatal ,event without appearing so very perilous2 on which ,account it has been well said of this ,fever1 that it is a ,dog which bites without barking4 ,sec4 #bdc4 ,the distinguishing ,criterion or ,mark of malignant ,fevers is a total ,loss of the ,patient's ,strength1 immediately on their first ,attack4 ,they arise from a ,corruption of the ,humours1 which is noxious to the very ,source and ,principle of ,strength1 the ,impairing or ,destruction of which is the ,cause of the ,feebleness of the ,symptoms2 by ,reason none of the ,organs are strong enough to exert an ,opposition sufficiently vigorous1 to subdue the ,cause of the ,distemper4 ,if1 for ,instance or ,illustration1 we were to suppose1 that when two ,armies were on the ,point of engaging1 one of them should be nearly deprived of all their ,weapons1 the ,contest would not appear very violent1 nor attended with great ,noise or ,tumult1 though with a horrible ,massacre4 ,the ,spectator1 who1 from being ignorant of one of the ,armies being disarmed1 would not be able to calculate the ,carnage of the ,battle1 but in ,proportion to its ,noise and ,tumult1 must be extremely deceived in his ,conception of it4 ,the ,number of the ,slain would be astonishing1 which might have been much less 7though the ,noise and ,clangor of it had been greater7 if each ,army had been equally provided for the ,combat4 ,sec4 #bdd4 ,the ,causes of this ,disease are a long ,use of animal ,food or ,flesh alone1 without ,pulse1 ,fruits or ,acids2 the continued ,use of other bad ,provisions1 such as ,bread made of damaged ,corn or ,grain1 or very stale ,meat4 ,eight ,persons1 who dined together on corrupt ,fish1 were all seized with a malignant ,fever1 which killed five of them1 notwithstanding the ,endeavours of the most able ,physicians4 ,these ,fevers are also frequently the ,consequence of a great ,dearth or ,famine2 of too hot and moist an ,air1 or an ,air1 which highly partakes of these two ,qualities2 so that they happen to spread most in hot ,years1 in ,places abounding with ,marshes and standing ,waters4 ,they are also the ,effect of a very close and stagnant ,air1 especially if many ,persons are crouded together in it1 this being a ,cause that particularly tends to corrupt the ,air4 ,tedious ,grief and ,vexation also contribute to generate these ,fevers4 ,sec4 #bde4 ,the ,symptoms of malignant ,fevers are1 as ,i have already observed1 a total and sudden ,loss of ,strength1 without any evident preceding ,cause1 sufficient to produce such a ,privation of ,strength3 at the same ,time there is also an utter ,dejection of the ,mind1 which becomes almost insensible and inattentive to every ,thing1 and even to the ,disease itself2 a sudden ,alteration in the ,countenance1 especially in the ,eyes3 some small ,shiverings1 which are varied throughout the ,space of twenty-four ,hours1 with little ,paroxysms or ,vicissitudes of ,heat2 sometimes there is a great ,head-ach and a ,pain in the ,loins2 at other ,times there is no perceivable ,pain in any ,part2 a kind of ,sinkings or ,faintings1 immediately from the ,invasion of the ,disease1 which is always very unpromising2 not the least refreshing ,sleep2 frequently a kind of half ,sleep1 or ,drowsiness2 a light and silent or inward ,raving1 which discovers itself in the unusual and astonished ,look of the ,patient1 who seems profoundly employed in meditating on something1 but really thinks of nothing1 or not at all3 ,some ,patients have1 however1 violent ,ravings2 most have a ,sensation of ,weight or ,oppression1 and at other ,times of a ,binding or ,tightness about1 or around1 the ,pit of the ,stomach4 ,the sick ,person seems to labour under great ,anguish3 he has sometimes slight convulsive ,motions and ,twitchings in his ,face and his ,hands1 as well as in his ,arms and ,legs4 ,his ,senses seem torpid1 or as it were benumbed4 ,i have seen many who had lost1 to all ,appearance1 the whole five1 and yet some of them recover4 ,it is not uncommon to meet with some1 who neither see1 understand1 nor speak4 ,their ,voices change1 become weak1 and are sometimes quite lost4 ,some of them have a fixed ,pain in some ,part of the ,belly3 this arises from a ,stuffing or ,obstruction1 and often ends in a ,gangrene1 whence this ,symptom is highly dangerous and perplexing4 ,the ,tongue is sometimes very little altered from its ,appearance in ,health2 at other ,times covered over with a yellowish brown ,humour2 but it is more rarely dry in this ,fever than in the others2 and yet it sometimes does resemble a ,tongue that has been long smoaked4 ,the ,belly is sometimes very soft1 and at other ,times tense and hard4 ,the ,pulse is weak1 sometimes pretty regular1 but always more quick than in a natural ,state1 and at some ,times even very quick2 and such ,i have always found it1 when the ,belly has been distended4 ,the ,skin is often neither hot1 dry1 nor moist3 it is frequently overspread with petechial or eruptive ,spots 7which are little ,spots of a reddish livid ,colour7 especially on the ,neck1 about the ,shoulders1 and upon the ,back4 ,at other ,times the ,spots are larger and brown1 like the ,colour of ,wheals from the ,strokes of a ,stick4 ,the ,urine of the ,sick is almost constantly crude1 that is of a lighter ,colour than ordinary4 ,i have seen some1 which could not be distinguished1 merely by the ,eye1 from ,milk4 ,a black and stinking ,purging sometimes attends this ,fever1 which is mortal1 except the ,sick be evidently relieved by the ,discharge4 ,some of the ,patients are infested with livid ,ulcers on the ,inside of the ,mouth1 and on the ,palate4 ,at other ,times ,abscesses are formed in the ,glands of the ,groin1 of the ,arm-pit1 in those between the ,ears and the ,jaw2 or a ,gangrene may appear in some ,part1 as on the ,feet1 the ,hands1 or the ,back4 ,the ,strength proves entirely spent1 the ,brain is wholly confused3 the miserable ,patient stretched out on his ,back1 frequently expires under ,convulsions1 an enormous ,sweat1 and an oppressed ,breast and ,respiration4 ,haemorrhages also happen sometimes and are mortal1 being almost unexceptionably such in this ,fever4 ,there is also in this1 as in all other ,fevers1 an ,aggravation of the ,fever in the ,evening4 ,sec4 #bdf4 ,the ,duration and ,crisis of these malignant1 as well as those of putrid ,fevers1 are very irregular4 ,sometimes the ,sick die on the seventh or eighth ,day1 more commonly between the twelfth and the fifteenth1 and not infrequently at the ,end of five or six ,weeks4 ,these different ,durations result from the different ,degree and ,strength of the ,disease4 ,some of these ,fevers at their first ,invasion are very slow2 and during a few of the first ,days1 the ,patient1 though very weak1 and with a very different ,look and ,manner1 scarcely thinks himself sick4 ,the ,term or ,period of the ,cure or the ,recovery1 is as uncertain as that of ,death in this ,distemper4 ,some are out of ,danger at the ,end of fifteen ,days1 and even sooner2 others not before the ,expiration of several ,weeks4 ,the ,signs which portend a ,recovery are1 a little more ,strength in the ,pulse2 a more concocted ,urine2 less ,dejection and ,discouragement2 a less confused ,brain2 an equal kindly ,heat2 a pretty warm or hot ,sweat in a moderate ,quantity1 without ,inquietude or ,anguish2 the ,revival of the different ,senses that were extinguished1 or greatly suspended in the ,progress of the ,disease2 though the ,deafness is not a very threatening ,symptom1 if the others amend while it endures4 ,this ,malady commonly leaves the ,patient in a very weak ,condition2 and a long ,interval will ensue between the ,end of it1 and their recovering their full ,strength4 ,sec4 #bdg4 ,it is1 in the first place1 of greater ,importance in this ,distemper than in any other1 both for the ,benefit of the ,patients1 and those who attend them1 that the ,air should be renewed and purified4 ,vinegar should often be evaporated from a hot ,tile or ,iron in the ,chamber1 and one ,window kept almost constantly open4 #b1 ,the ,diet should be light2 and the ,juice of ,sorrel may be mixed with their ,water2 the ,juice of ,lemons may be added to ,soups prepared from different ,grains and ,pulse2 the ,patient may eat sharp acid ,fruits1 such as tart juicy #fe ,cherries1 ,gooseberries1 small black ,cherries2 and those who can afford them1 may be allowed ,lemons1 ,oranges and ,pomgranates4 #fe ,the ,french ,word is ,griettes1 which ,beyer englishes1 the ,agriot1 the red or sour ,cherry2 and ,chambaud1 the sweeter large black ,cherry or ,mazzard--,but as ,dr4 ,tissot was recommending the ,use of ,acids1 it is more probably the first of these3 so that our ,morellas1 which make a pleasant ,preserve1 may be a good ,substitute to them1 supposing them not to be the same4 ,our ,berbery ,jam1 and ,jelly of ,red ,currants1 may be also employed to answer the same ,indication4 ,k4 #c1 ,the ,patient's ,linen should be changed every two ,days4 #d1 ,bleeding is very rarely necessary1 or even proper1 in this ,fever2 the ,exceptions to which are very few1 and cannot be thoroughly ascertained1 as fit and proper ,exceptions to the ,omission of ,bleeding1 without a ,physician1 or some other very skilful ,person's seeing the ,patient4 #e1 ,there is often very little ,occasion for ,glysters1 which are sometimes dangerous in this ,fever4 #f1 ,the ,patient's common ,drink should be ,barley ,water made acid with the ,spirit ,no4 #aj1 at the ,rate of one ,quarter of an ,ounce to at least full three ,pints of the ,water1 or acidulated agreeably to his ,taste4 ,he may also drink ,lemonade4 #g1 ,it is necessary to open and evacuate the ,bowels1 where a great ,quantity of corrupt ,humours is generally lodged4 ,the ,powder ,no4 #ce may be given for this ,purpose1 after the ,operation of which the ,patient generally finds himself better1 at least for some ,hours4 ,it is of ,importance not to omit this at the ,beginning of the ,disease2 though if it has been omitted at first1 it were best to give it even later1 provided no particular ,inflammation has supervened1 and the ,patient has still some ,strength4 ,i have given it1 and with remarkable ,success1 on the twentieth ,day4 #h1 ,having by this ,medicine expelled a considerable ,portion of the bad ,humours1 which contribute to feed and keep up the ,fever1 the ,patient should take every other ,day1 during the ,continuance of the ,disease1 and sometimes even every ,day1 one ,dose of the ,cream of ,tartar and ,rhubarb ,no4 #ch4 ,this ,remedy evacuates the corrupt ,humours1 prevents the ,corruption of the others2 expells the ,worms that are very common in these ,fevers1 which the ,patient sometimes discharges upwards and downwards2 and which frequently conduce to many of the odd and extraordinary ,symptoms1 that are observed in malignant ,fevers4 ,in short it strengthens the ,bowels1 and1 without checking the necessary ,evacuations1 it moderates the ,looseness1 when it is hurtful4 #i1 ,if the ,skin be dry1 with a ,looseness1 and that by checking it1 we design to increase ,perspiration1 instead of the ,rhubarb1 the ,cream of ,tartar may be blended with the ,ipecacuana1 ,no4 #ci1 which1 being given in small and frequent ,doses1 restrains the ,purging1 and promotes ,perspiration4 ,this ,medicine1 as the former1 is to be taken in the ,morning2 two ,hours after1 the ,sick must begin with the ,potion ,no4 #dj1 and repeat it regularly every three ,hours2 until it be interrupted by giving one of the ,medicines ,no4 #ch or #ci3 ,after which the ,potion is to be repeated again1 as already directed1 till the ,patient grows considerably better4 #aj1 ,if the ,strength of the ,sick be very considerably depressed1 and he is in great ,dejection and ,anguish1 he should take1 with every ,draught of the ,potion1 the ,bolus1 or ,morsel ,no4 #da4 ,if the ,diarrhoea1 the ,purging is violent1 there should be added1 once or twice a ,day to the ,bolus1 the ,weight of twenty ,grains1 or the ,size of a very small ,bean1 of ,diascordium2 or if that is not readily to be got1 as much ,venice ,treacle4 #aa1 ,whenever1 notwithstanding all this ,assistance1 the ,patient continues in a ,state of ,weakness and ,insensibility1 two large ,blisters should be applied to the fleshy ,insides of the ,legs1 or a large one to the ,nape of the ,neck3 and sometimes1 if there be a great ,drowsiness1 with a manifest ,embarrassment of the ,brain1 they may be applied with great ,success over the whole ,head4 ,their ,suppuration and ,discharge is to be promoted abundantly2 and1 if they dry up within a few ,days1 others are to be applied1 and their ,evacuation is to be kept up for a considerable ,time4 #ab1 ,as soon as the ,distemper is sufficiently abated1 for the ,patient to remain some ,hours with very little or no ,fever1 we must avail ourselves of this ,interval1 to give him six1 or at least five ,doses of the ,medicine ,no4 #ad1 and repeat the same the next ,day1 which may prevent the ,return of the ,fever3 #ff after which it may be sufficient to give daily only two ,doses for a few ,days4 #ff ,observation and ,experience have demonstrated the ,advantage of the ,bark1 to obviate a ,gangrene1 and prevent the ,putrefaction of animal ,substances4 ,we therefore conclude it may be usefully employed in malignant ,fevers1 as soon as the previous and necessary ,evacuations shall have taken ,place4 ,e4 ,l4--,provided there be very clear and regular ,remissions at least4 ,k4 #ac1 ,when the ,sick continue entirely clear of a ,fever1 or any ,return1 they are to be put into the ,regimen of ,persons in a ,state of ,recovery4 ,but if his ,strength returns very slowly1 or not at all2 in ,order to the speedier ,establishment and ,confirmation of it1 he may take three ,doses a ,day of the ,theriaca ,pauperum1 or poor ,man's ,treacle ,no4 #db1 the first of them fasting1 and the other twelve ,hours after4 ,it were to be wished indeed1 this ,medicine was introduced into all the ,apothecaries ,shops1 as an excellent ,stomachic1 in which ,respect it is much preferable to ,venice ,treacle1 which is an absurd ,composition1 dear and often dangerous4 ,it is true it does not dispose the ,patients to ,sleep2 but when we would procure them ,sleep1 there are better ,medicines than the ,treacle to answer that ,purpose4 ,such as may not think the ,expence of the ,medicine ,no4 #ad1 too much1 may take three ,doses of it daily for some ,weeks1 instead of the ,medicine ,no4 #db1 already directed4 ,sec4 #bdh4 ,it is necessary to eradicate a ,prejudice that prevails among ,country ,people1 with ,regard to the ,treatment of these ,fevers2 not only because it is false and ridiculous1 but even dangerous too4 ,they imagine that the ,application of ,animals can draw out the ,poison of the ,disease2 in ,consequence of which they apply ,poultry1 or ,pigeons1 ,cats or sucking ,pigs to the ,feet1 or upon the ,head of the ,patient1 having first split the living ,animals open4 ,some ,hours after they remove their strange ,applications1 corrupted1 and stinking very offensively2 and then ascribe such ,corruption and horrid ,stink to the ,poison they suppose their ,application to be charged with2 and which they suppose to be the ,cause of this ,fever4 ,but in this supposed ,extraction of ,poison1 they are grosly mistaken1 since the ,flesh does not stink in ,consequence of any such ,extraction1 but from its being corrupted through ,moisture and ,heat3 and they contract no other ,smell but what they would have got1 if they had been put in any other ,place1 as well as on the ,patient's ,body1 that was equally hot and moist4 ,very far from drawing out the ,poison1 they augment the ,corruption of the ,disease2 and it would be sufficient to communicate it to a sound ,person1 if he was to suffer many of these animal ,bodies1 thus absurdly and uselessly butchered1 to be applied to various ,parts of his ,body in ,bed2 and to lie still a long ,time with their putrified ,carcases fastened about him1 and corrupting whatever ,air he breathed there4 ,with the same ,intention they fasten a living ,sheep to the ,bed's-foot for several ,hours2 which1 though not equally dangerous1 is in some ,measure hurtful1 since the more ,animals there are in a ,chamber1 the ,air of it is proportionably corrupted1 or altered at least from its natural ,simplicity1 by their ,respiration and ,exhalations3 but admitting this to be less pernicious1 it is equally absurd4 ,it is certain indeed1 the ,animals who are kept very near the sick ,person breathe in the poisonous1 or noxious ,vapours which exhale from his ,body1 and may be incommoded with them1 as well as his ,attendants3 ,but it is ridiculous to suppose their being kept near the ,sick causes such ,poison to come out of their ,bodies4 ,on the very contrary1 in contributing still further to the ,corruption of the ,air1 they increase the ,disease4 ,they draw a false ,consequence1 and no ,wonder1 from a false ,principle2 saying1 if the ,sheep dies1 the ,sick will recover4 ,now1 most frequently the ,sheep does not die2 notwithstanding which the ,sick sometimes recover2 and sometimes they both die4 ,sec4 #bdi4 ,the ,cause of ,malignant ,fevers is1 not infrequently1 combined with other ,diseases1 whose ,danger it extremely increases4 ,it is blended for ,instance1 with the ,poison of the ,small-,pocks1 or of the ,measles4 ,this may be known by the ,union of those ,symptoms1 which carry the ,marks of ,malignity1 with the ,symptoms of the other ,diseases4 ,such combined ,cases are extremely dangerous2 they demand the utmost ,attention of the ,physician2 nor is it possible to prescribe their exact ,treatment here2 since it consists in general of a ,mixture of the ,treatment of each ,disease2 though the ,malignity commonly demands the greatest ,attention4 ,chapter ,,xviii4 ,of intermitting ,fevers4 ,sect4 #bej4 ,intermitting ,fevers1 commonly called here1 ,fevers and ,agues1 are those1 which after an ,invasion and ,continuance for some ,hours1 abate very perceivably1 as well as all the ,symptoms attending them1 and then entirely cease2 nevertheless1 not without some periodical or stated ,return of them4 ,they were very frequent with us some ,years since2 and indeed might even be called epidemical3 but for the five or six last ,years1 they have been much less frequent throughout the greater ,part of ,swisserland3 notwithstanding they still continue in no small ,number in all ,places1 where the ,inhabitants breathe the ,air that prevails in all the marshy ,borders of the ,rhone1 and in some other ,situations that are exposed to much the same humid ,air and ,exhalations4 ,sec4 #bea4 ,there are several ,kinds of intermitting ,fevers1 which take their different ,names from the ,interval or different ,space of ,time1 in which the ,fits return4 ,if the ,paroxysm or ,fit returns every ,day1 it is either a true ,quotidian1 or a double ,tertian ,fever3 ,the first of these may be distinguished from the last by this ,circumstance1 that in the ,quotidian1 or one ,day ,fever1 the ,fits are long2 and correspond pretty regularly to each other in ,degree and ,duration4 ,this however is less frequent in ,swisserland4 ,in the double ,tertian1 the ,fits are shorter1 and one is alternately light1 and the other more severe4 ,in the simple ,tertian1 or third ,day's ,fever1 the ,fits return every other ,day2 so that three ,days include one ,paroxysm1 and the ,return of another4 ,in a ,quartan1 the ,fit returns every fourth ,day1 including the ,day of the first and that of the second ,attack3 so that the ,patient enjoys two clear ,days between the two sick ones4 ,the other kinds of ,intermittents are much rarer4 ,i have seen however one true ,quintan1 or fifth ,day ,ague1 the ,patient having three clear ,days between two ,fits2 and one regularly weekly ,ague1 as it may be called1 the ,visitation of every ,return happening every ,sunday4 ,sec4 #beb4 ,the first ,attack of an intermittent ,fever often happens1 when the ,patient thought himself in perfect ,health4 ,sometimes however it is preceded by a ,sensation of ,cold and a kind of ,numbness1 which continue some ,days before the manifest ,invasion of the ,fit4 ,it begins with frequent ,yawnings1 a ,lassitude1 or ,sensation of ,weariness1 with a general ,weakness1 with ,coldness1 ,shivering and ,shaking3 ,there is also a ,paleness of the extreme ,parts of the ,body1 attended with ,loathings1 and sometimes an actual ,vomiting4 ,the ,pulse is quick1 weak1 and small1 and there is a considerable ,degree of ,thirst4 ,at the ,end of an ,hour or two1 and but seldom so long as three or four ,hours1 a ,heat succeeds1 which increases insensibly1 and becomes violent at its ,height4 ,at this ,period the whole ,body grows red1 the ,anxiety of the ,patient abates2 the ,pulse is very strong and large1 and his ,thirst proves excessive4 ,he complains of a violent ,head-ach1 and of a ,pain in all his ,limbs1 but of a different sort of ,pain from that he was sensible of1 while his ,coldness continued4 ,finally1 having endured this hot ,state1 four1 five or six ,hours1 he falls into a general ,sweat for a few more3 upon which all the ,symptoms already mentioned abate1 and sometimes ,sleep supervenes4 ,at the ,conclusion of this ,nap the ,patient often wakes without any sensible ,fever2 complaining only of ,lassitude and ,weakness4 ,sometimes his ,pulse returns entirely to its natural ,state between the two ,fits2 though it often continues a little quicker than in perfect ,health2 and does not recover its first ,distinctness and ,slowness1 till some ,days after the last ,fit4 ,one ,symptom1 which most particularly characterises these several ,species of intermitting ,fevers1 is the ,quality of the ,urines which the ,sick pass after the ,fit4 ,they are of a reddish ,colour1 and let fall a ,sediment1 or ,settling1 which exactly resembles ,brick-dust4 ,they are sometimes frothy too1 and a ,pellicle1 or thin filmy ,skin1 appears on the ,top1 and adheres to the ,sides of the ,glass that contains them4 ,sec4 #bec4 ,the ,duration of each ,fit is of no fixed ,time or ,extent1 being various according to the particular sort of ,intermittents1 and through many other ,circumstances4 ,sometimes they return precisely at the very same ,hour2 at other ,times they come one1 two1 or three ,hours sooner1 and in other ,instances as much later than the former4 ,it has been imagined that those ,fevers1 whose ,paroxysms returned sooner than usual1 were sooner finally terminated3 but there seems to be no general ,rule in this ,case4 ,sec4 #bed4 ,intermitting ,fevers are distinguished into those of ,spring and ,autumn4 ,the former generally prevail from ,february to ,june3 the latter are those which reign from ,july to ,january4 ,their essential ,nature and ,characters are the very same1 as they are not different ,distempers2 though the various ,circumstances attending them deserve our ,consideration4 ,these ,circumstances depend on the ,season itself1 and the ,constitution of the ,patients1 during such ,seasons4 ,the ,spring ,intermittents are sometimes blended with an inflammatory ,disposition1 as that is the ,disposition of ,bodies in that ,season2 but as the ,weather then advances daily into an improving ,state1 the ,spring ,fevers are commonly of a shorter ,duration4 ,the autumnal ,fevers are frequently combined and aggravated with a ,principle of ,putrefaction2 and as the ,air of that ,season rather degenerates1 they are more tedious and obstinate4 ,sec4 #bee4 ,the autumnal ,fevers seldom begin quite so early as ,july1 but much oftner in ,august3 and the ,duration to which they are often extended1 has increased the ,terror which the ,people entertain of ,fevers that begin in that ,month4 ,but that ,prejudice which ascribes their ,danger to the ,influence of ,august1 is a very absurd ,error2 since it is better they should set in then than in the following ,months2 because they are obstinate in ,proportion to the ,tardiness1 the ,slowness of their ,approach4 ,they sometimes appear at first considerably in the ,form of putrid ,fevers1 not assuming that of ,intermittents till some ,days after their ,appearance3 but very happily there is little or no ,danger in mistaking them for putrid ,fevers1 or in treating them like such4 ,the ,brick-coloured ,sediment1 and particularly the ,pellicle or ,film on the ,surface of the ,urine1 are very common in autumnal ,intermittents1 and are often wanting in the ,urine of putrid ,fevers4 ,in these latter1 it is generally less high coloured1 and leaning rather to a yellow1 a kind of ,cloudiness is suspended in the ,middle of it4 ,these also deposite a white ,sediment1 which affords no bad ,prognostic4 ,sec4 #bef4 ,generally speaking1 intermitting ,fevers are not mortal2 often terminating in ,health of their own ,accord 7without the ,use of any ,medicine7 after some ,fits4 ,in this last ,respect ,intermittents in the ,spring differ considerably from those in the ,fall1 which continue a long ,time1 and sometimes even until ,spring1 if they are not removed by ,art1 or if they have been improperly treated4 ,quartan ,fevers are always more obstinate and inveterate than ,tertians2 the former sometimes persevering in certain ,constitutions for whole ,years4 ,when these ,sorts of ,fevers occur in boggy marshy ,countries1 they are not only very chronical or tedious1 but ,persons infested with them are liable to frequent ,relapses4 ,sec4 #beg4 ,a few ,fits of an ,intermittent are not very injurious1 and it happens sometimes1 that they are attended with a favourable ,alteration of the ,habit in ,point of ,health2 by their exterminating the ,cause or ,principle of some languid and tedious ,disorder2 though it is erroneous to consider them as salutary4 ,if they prove tedious and obstinate1 and the ,fits are long and violent1 they weaken the whole ,body1 impairing all its ,functions1 and particularly the ,digestions3 ,they make the ,humours sharp and unbalmy1 and introduce several other ,maladies1 such as the ,jaundice1 ,dropsy1 ,asthma and slow wasting ,fevers4 ,nay sometimes old ,persons1 and those who are very weak1 expire in the ,fit2 though such an ,event never happens but in the cold ,fit4 ,sec4 #beh4 ,very happily ,nature has afforded us a ,medicine1 that infallibly cures these ,fevers3 this is the ,kinkina1 or ,jesuits ,bark2 and as we are possessed of this certain ,remedy1 the only remaining ,difficulty is to discover1 if there be not some other ,disease combined with these ,fevers1 which ,disease might be aggravated by the ,bark4 ,should any such exist1 it must be removed by ,medicines adapted to it1 before the ,bark is given4 #fg #fg ,this admirable ,medicine was unknown in ,europe1 till about one hundred and twenty ,years past2 we are obliged to the ,spaniards for it1 who found it in the ,province of ,quito in ,peru2 the ,countess of ,chinchon being the first ,european who used it in ,america1 whence it was brought to ,spain1 under the ,name of the ,countesses ,powder4 ,the ,jesuits having soon dispensed and distributed it abroad1 it became still more publick by the ,name of the ,jesuits ,powder3 and since it has been known by that of ,kinkina or the ,peruvian ,bark4 ,it met with great ,opposition at first2 some deeming it a ,poison1 while others considered it as a divine ,remedy3 so that the ,prejudices of many being heightened by their ,animosity1 it was nearly a full ,century1 before its true ,virtue and its ,use were agreed to3 and about twenty ,years since the most unfavourable ,prejudices against it pretty generally subsided4 ,the ,insufficience of other ,medicines in several ,cases2 its great ,efficaciousness2 and the many and surprizing ,cures which it did1 and daily does effect2 the ,number of ,distempers2 the different kinds of ,fevers1 in which it proves the sovereign ,remedy2 its ,effects in the most difficult chirurgical ,cases2 the ,comfort1 the ,strength and ,sprits it gives those who need and take it1 have at length opened every ,persons ,eyes2 so that it has almost unanimously obtained the first ,reputation1 among the most efficacious ,medicines4 ,the ,world is no longer amused with ,apprehensions of its injuring the ,stomach2 of its fixing1 or shutting up the ,fever 7as the ,phrase has been7 without curing it2 that it shuts up the ,wolf in the ,sheepfold2 that it throws those who take it into the ,scurvy1 the ,asthma1 the ,dropsy1 the ,jaundice4 ,on the contrary they are persuaded it prevents there very ,diseases2 and1 that if it is ever hurtful1 it is only when it is either adulterated1 as most great ,remedies have been2 or has been wrongly prescribed1 or improperly taken3 or lastly when it meets with some latent1 some unknown ,particularities in a ,constitution1 which ,physicians term an ,idiosyncrasy1 and which prevent or pervert its very general ,effects4 ,tissot4 ,sec4 #bei4 ,in the vernal1 or ,spring-,fevers1 if the ,fits are not very severe2 if the ,patient is evidently well in their ,intervals2 if his ,appetite1 his ,strength1 and his ,sleep continue as in ,health1 no ,medicine should be given1 nor any other ,method be taken1 but that of putting the ,person1 under such a gentle ,intermittent1 upon the ,regimen directed for ,persons in a ,state of ,recovery4 ,this is such a ,regimen as pretty generally agrees with all the ,subjects of these ,fevers3 for if they should be reduced to the ,regimen proper in acute ,diseases1 they would be weakened to no ,purpose1 and perhaps be the worse for it4 ,but at the same ,time if we were not to retrench from the ,quantity1 nor somewhat to vary the ,quality of their usual ,food in a ,state of ,health2 as there is not the least ,digestion made in the ,stomach1 during the whole ,term of the ,fit2 and as the ,stomach is always weakened a little by the ,disease1 crude and indigested ,humours would be produced1 which might afford a ,fuel to the ,disease4 ,not the least solid ,food should be allowed1 for at least two ,hours before the usual ,approach of the ,fit4 ,sec4 #bfj4 ,if the ,fever extends beyond the sixth1 or the seventh ,fit2 and the ,patient seems to have no ,occasion for a ,purge2 which may be learned by attending to the ,chapter1 which treats of ,remedies to be taken by ,way of ,precaution2 #fh he may take the ,bark1 that is the ,powder ,no4 #ad4 ,if it is a ,quotidian1 a daily ,fever1 or a double ,tertian1 six ,doses1 containing three ,quarters of an ,ounce1 should be taken between the two ,fits2 and as these ,intermissions commonly consist of but ten or twelve1 or at the most of fourteen or fifteen ,hours1 there should be an ,interval of only one ,hour and a half between each ,dose4 ,during this ,interval the ,sick may take two of his usual ,refreshments or ,suppings4 #fh ,it happens very seldom that intermitting ,fevers require #fi no ,purge towards their ,cure1 especially in ,places1 which are disposed to generate ,putridity4 ,there is always some material ,cause essential to these ,fevers1 of which ,nature disembarrasses herself more easily by ,stools1 than by any other ,discharge3 ,and as there is not the least ,danger to be apprehended from a gentle ,purge1 such at those of ,no4 #aa or #bc1 we think it would be prudent always to premise a ,dose or two of either to the ,bark4 ,e4 ,l4 #fi ,yet ,i have known many in whom no ,purge was necessary1 and have seen some rendered more obstinate and chronical by erroneous ,purging4 ,but a ,vomit is very generally necessary before the ,bark is given4 ,k4 ,when the ,fever is a ,tertian1 an ,ounce should be given between the two ,fits3 which makes eight ,doses1 one of which is to be taken every three ,hours4 ,in a ,quartan ,i direct one ,ounce and a half1 to be taken in the same ,manner4 ,it is meer trifling to attempt preventing the ,returns with smaller ,doses4 ,the frequent ,failures of the ,bark are owing to over small ,doses4 ,on such ,occasions the ,medicine is cried down1 and censured as useless1 when the ,disappointment is solely the ,fault of those who do not employ it properly4 ,the last ,dose is to be given two ,hours before the usual ,return of the ,fit4 ,the ,doses1 just mentioned1 frequently prevent the ,return of the ,fit2 but whether it returns or not1 after the ,time of its usual ,duration is past1 repeat the same ,quantity1 in the same ,number of ,doses1 and ,intervals1 which certainly keeps off another4 ,for six ,days following1 half the same ,quantity must be continued1 in the ,intervals that would have occurred between the ,fits1 if they had returned3 and during all this ,time the ,patient should inure himself to as much ,exercise1 as he can well bear4 ,sec4 #bfa4 ,should the ,fits be very strong1 the ,pain of the ,head violent1 the ,visage red1 the ,pulse full and hard2 if there is any ,cough2 if1 even after the ,fit is over1 the ,pulse still is perceivably hard2 if the ,urine is inflamed1 hot and high-coloured1 and the ,tongue very dry1 the ,patient must be bled1 and drink plentifully of ,barley ,water ,no4 #c4 ,these two ,remedies generally bring the ,patient into the ,state described ,sec4 #bei3 in which ,state he may take on a ,day1 when the ,fever is entirely off1 three or four ,doses of the ,powder ,no4 #bd1 and then leave the ,fever to pursue its own ,course for the ,space of a few ,fits4 ,but should it not then terminate of itself1 the ,bark must be recurred to4 ,if the ,patient1 even in the ,interval of the ,returns1 has a foetid1 furred ,mouth1 a ,loathing1 ,pains in the ,loins1 or in the ,knees1 much ,anxiety1 and bad ,nights1 he should be purged with the ,powder ,no4 #ba or the ,potion ,no4 #bc1 before he takes the ,bark4 ,sec4 #bfb4 ,if ,fevers in ,autumn appear to be of the continual kind1 and very like putrid ,fevers1 the ,patients should drink abundantly of ,barley ,water2 and if at the ,expiration of two or three ,days1 there still appears to be a ,load or ,oppression at the ,stomach1 the ,powder ,no4 #cd or that of #ce is to be given 7but see ,sec4 #bda73 and if1 after the ,operation of this1 the ,signs of ,putridity continue1 the ,body is to be opened with repeated ,doses of the ,powder ,no4 #bd2 or1 where the ,patients are very robust1 with ,no4 #ba2 and when the ,fever becomes quite regular1 with distinct ,remissions at least1 the ,bark is to be given as directed ,sec4 #bfj4 ,but as autumnal ,fevers are more obstinate2 after having discontinued the ,bark for eight ,days2 and notwithstanding there has been no ,return of the ,fever1 it is proper to resume the ,bark1 and to give three ,doses of it daily for the succeeding eight ,days1 more especially if it was a ,quartan2 in which ,species ,i have ordered it to be repeated1 every other eight ,days1 for six ,times4 ,many ,people may find it difficult to comply with this ,method of ,cure1 which is unavoidably expensive1 through the ,price of the ,bark4 ,i thought however this ought not to prevent me from averring it to be the only certain one2 since nothing can be an equivalent ,succedaneum or ,substitute to this ,remedy1 which is the only sure and safe one in all these ,cases4 ,the ,world had long been prepossessed with ,prejudices to the contrary3 it was supposed to be hurtful to the ,stomach2 to prevent which it has been usual to make the ,sick eat something an ,hour after it4 ,nevertheless1 very far from injuring the ,stomach1 it is the best ,medicine in the ,universe to strengthen it2 and it is a pernicious ,custom1 when a ,patient is obliged to take it often1 to eat an ,hour after it4 ,it had also been imagined to cause ,obstructions1 and that it subjected ,patients to a ,dropsy3 but at present we are convinced1 it is the obstinate and inveterate ,duration of the ,intermittent1 that causes ,obstructions1 and paves the ,way to a ,dropsy4 ,the ,bark1 in ,consequence of its speedily curing the ,fever1 does not only prevent the former ,disease2 but when it continues1 through an injudicious ,omission of the ,bark1 a proper ,use of it is serviceable in the ,dropsy4 ,in a ,word1 if there is any other ,malady combined with the ,fever1 sometimes that indeed prevents the ,success of the ,bark1 yet without rendering it hurtful4 ,but whenever the intermitting ,fever is simple and uncombined1 it ever has1 and ever will render the ,patient all possible ,service4 ,in another ,place ,i shall mention such ,means and ,methods as may in some ,degree1 though but imperfectly1 be substituted instead of it4 ,after the ,patient has begun with the ,bark1 he must take no purging ,medicine1 as that ,evacuation would1 with the greatest ,probability1 occasion a ,return of the ,fever4 ,sec4 #bfc4 ,bleeding is never1 or extremely seldom indeed necessary in a ,quartan ,ague1 which occurs in the ,fall oftner than in the ,spring2 and with the ,symptoms of ,putridity rather than of ,inflammation4 ,sec4 #bfd4 ,the ,patient ought1 two ,hours before the ,invasion of the ,fit1 to drink a small ,glass of warm ,elder ,flower ,tea1 sweetened with ,honey1 every ,quarter of an ,hour1 and to walk about moderately2 this disposes him to a very gentle ,sweat1 and thence renders the ensuing ,coldness and the whole ,fit milder4 ,he is to continue the same ,drink throughout the ,duration of the cold ,fit2 and when the hot one approaches1 he may either continue the same1 or substitute that of ,no4 #b1 which is more cooling4 ,it is not necessary however1 in this ,state1 to drink it warm1 it is sufficient that it be not over cold4 ,when the ,sweat1 at the ,termination of the hot ,fit1 is concluded1 the ,patient should be well wiped and dried1 and may get up4 ,if the ,fit was very long1 he may be allowed a little ,gruel1 or some other such ,nourishment during the ,sweat4 ,sec4 #bfe4 ,sometimes the first1 and a few successive ,doses of the ,bark purge the ,patient4 ,this is no otherwise an ill ,consequence1 than by its retarding the ,cure2 since1 when it purges1 it does not commonly prevent the ,return of the ,fever2 so that these ,doses may be considered as to no ,purpose1 and others should be repeated1 which1 ceasing to purge1 do prevent it4 ,should the ,looseness notwithstanding continue1 the ,bark must be discontinued for one entire ,day1 in order to give the ,patient half a ,quarter of an ,ounce of ,rhubarb3 after which the ,bark is to be resumed again1 and if the ,looseness still perseveres1 fifteen ,grains of ,venice ,treacle should be added to each ,dose1 but not otherwise4 ,all other ,medicines which are superadded1 very generally serve only to increase the ,bulk of the ,dose1 while they lessen its ,virtue4 ,sec4 #bff4 ,before our thorough ,experience of the ,bark1 other bitter ,medicines were used for the same ,purpose3 these indeed were not destitute of ,virtue in such ,cases1 though they were considerably less available than the ,bark4 ,under ,no4 #dc1 some valuable ,prescriptions of that kind may be seen1 whose ,efficacy ,i have often experienced3 though at other ,times ,i have been obliged to leave them off1 and recur to the ,bark more successfully4 ,filings of ,iron1 which enter into the third ,prescription1 are an excellent ,febrifuge in particular ,cases and ,circumstances4 ,in the ,middle of the ,winter #agec1 ,i cured a ,patient of a ,quartan ,ague with it1 who would not be prevailed on to take the ,bark4 ,it must be confessed he was perfectly regular in observing the ,regimen directed for him2 and that1 during the most rigid ,severity of the ,winter1 he got every ,day on ,horseback1 and took such a ,degree of other ,exercise in the open ,air1 as disposed him to perspire abundantly4 ,sec4 #bfg4 ,another very practicable easy ,method1 of which ,i have often availed my ,patients1 under tertian ,fevers 7but which succeeded with me only twice in ,quartans7 was to procure the ,sufferer a very plentiful ,sweat1 at the very ,time when the ,fit was to return1 in its usual ,course4 ,to effect this he is to drink1 three or four ,hours before it is expected1 an ,infusion of ,elder ,flowers sweetened with ,honey1 which ,i have already recommended ,sec4 #bfd2 and one ,hour before the usual ,invasion of the ,shivering1 he is to go into ,bed1 and take1 as hot as he can drink it1 the ,prescription ,no4 #dd4 ,i have also cured some ,tertians and even ,quartans1 in #agea and #ageb1 by giving them1 every four ,hours between the ,fits1 the ,powder ,no4 #de4 ,but ,i must acknowledge that1 besides its having often failed me1 and its never succeeding so speedily as the ,bark1 ,i have found it weaken some ,patients2 it disorders1 or disagrees with1 their ,stomachs3 and in two ,cases1 where it had removed the ,fever1 ,i was obliged to call in the ,bark for a thorough ,establishment of the ,patient's ,health4 ,nevertheless1 as these ,medicines are very cheap and attainable1 and often do succeed1 ,i thought ,i could not properly omit them4 ,sec4 #bfh4 ,a ,multitude of other ,remedies are cried up for the ,cure of ,fevers3 though none of them are equally efficacious with those ,i have directed3 and as many of them are even dangerous1 it is prudent to abstain from them4 ,some ,years since certain ,powders were sold here1 under the ,name of the ,berlin ,powders2 these are nothing but the ,bark masqued or disguised 7which has sometimes been publickly discovered7 and have always been sold very dear3 though the ,bark well chosen1 and freshly powdered when wanted1 is greatly preferable4 ,sec4 #bfi4 ,i have often known ,peasants1 who had laboured for several ,months under intermitting ,fevers2 having made ,use of many bad ,medicines and ,mixtures for them1 and observed no ,manner of ,regimen4 ,such ,i have happily treated by giving them the ,remedies ,no4 #cd1 or #ce2 and afterwards1 for some ,days1 that of ,no4 #ch2 at the ,end of which ,time1 ,i have ordered them the ,bark 7,see ,sec4 #bfj7 or other ,febrifuges1 as at ,sec4 #bff1 #bfg2 and then finally ordered them for some ,days1 to take ,morsels of the poor ,man's ,treacle 7,see ,sec4 #bdg1 ,art4 #ac7 to strengthen and confirm their ,digestions1 which ,i have found very weak and irregular4 ,sec4 #bgj4 ,some ,intermittents are distinguished as pernicious or malignant1 from every ,fit's being attended with the most violent ,symptoms4 ,the ,pulse is small and irregular1 the ,patient exceedingly dejected1 and frequently swooning2 afflicted with inexpressible ,anguish1 ,convulsions1 a deep ,drowsiness1 and continual ,efforts to go to ,stool1 or make ,urine1 but ineffectually4 ,this ,disease is highly pressing and dangerous2 the ,patient may die in the third ,fit1 and rarely survives the sixth1 if he is not very judiciously treated4 ,not a ,moment should be lost1 and there is no other ,step to be taken1 but that of giving the ,bark continually1 as directed ,sec4 #bfj1 to prevent the succeeding ,fits4 ,these worst ,kinds of ,intermittents are often combined with a great ,load of putrid ,humours in the first ,passages3 and as often as such an aggravating ,combination is very evident1 we should immediately after the ,end of one ,fit1 give a ,dose of ,ipecacuana ,no4 #ce1 and1 when its ,operation is finished1 give the ,bark4 ,but ,i chuse to enter into very few ,details on this ,species of ,intermittents1 both as they occur but seldom1 and as the ,treatment of them is too difficult and important1 to be submitted to the ,conduct of any one but a ,physician4 ,my ,intention has only been to represent them sufficiently1 that they may be so distinguished when they do occur1 as to apprize the ,people of their great ,danger4 ,sec4 #bga4 ,the same ,cause which produces these intermitting ,fevers1 frequently also occasions ,disorders1 which return periodically at the same ,hour1 without ,shivering1 without ,heat1 and often without any ,quickness of the ,pulse4 ,such ,disorders generally preserve the ,intermissons of quotidian or tertian ,fevers1 but much seldomer those of ,quartans4 ,i have seen violent ,vomittings1 and ,reachings to vomit1 with inexpressible ,anxiety2 the severest ,oppressions1 the most racking ,cholics2 dreadful ,palpitations and excessive ,tooth-achs3 ,pains in the ,head1 and very often an unaccountable ,pain over one ,eye1 the ,eyelid1 ,eyebrow and ,temple1 on the same ,side of the ,face2 with a ,redness of that ,eye1 and a continual1 involuntary trickling of ,tears4 ,i have also seen such a prodigious ,swelling of the affected ,part1 that the ,eye projected1 or stood out1 above an ,inch from the ,head1 covered by the ,eyelid1 which was also extremely inflated or puffed up4 ,all these ,maladies begin precisely at a certain ,hour2 last about the usual ,time of a ,fit2 and terminating without any sensible ,evacuation1 return exactly at the same ,hour1 the next ,day1 or the next but one4 ,there is but one known ,medicine that can effectually oppose this ,sort1 which is the ,bark1 given as directed ,sec4 #bfj4 ,nothing affords ,relief in the ,fit1 and no other ,medicine ever suspends or puts it off4 ,but ,i have cured some of these ,disorders with the ,bark1 and especially those affecting the ,eyes1 which happen oftner than the other ,symptoms1 after their ,duration for many ,weeks1 and after the ineffectual ,use of ,bleeding1 ,purging1 ,baths1 ,waters1 ,blisters1 and a great ,number of other ,medicines4 ,if a sufficient ,dose of it be given1 the next ,fit is very mild2 the second is prevented2 and ,i never saw a ,relapse in these ,cases1 which sometimes happens after the ,fits of common ,intermittents seemed cured4 ,sec4 #bgb4 ,in ,situations where the ,constitution of the ,air renders these ,fevers very common1 the ,inhabitants should frequently burn in their ,rooms1 at least in their lodging ,rooms1 some aromatic ,wood or ,herbs4 ,they should daily chew some ,juniper ,berries1 and drink a fermented ,infusion of them4 ,these two ,remedies are very effectual to fortify the weakest ,stomachs1 to prevent ,obstructions1 and to promote ,perspiration4 ,and as these are the ,causes which prolong these ,fevers the most obstinately2 nothing is a more certain ,preservation from them than these cheap and obvious ,assistances4 #gj #gj ,i have seen several ,cases in very marshy maritime ,countries1 with little good drinking ,water1 and far ,south of ,swisserland1 where intermitting ,fevers1 with ,agues at different ,intervals1 are annually endemic1 very popular1 and often so obstinate as to return repeatedly1 whenever the weekly precautionary ,doses of the ,bark have been omitted 7through the ,patient's nauseating the frequent ,swallowing of it7 so that the ,disease has sometimes been extended beyond the ,term of a full ,year1 and even far into a second1 including the temporary ,removals of it by the ,bark4 ,nevertheless1 in some such obstinate ,intermittents1 and particularly ,quartans there1 wherein the ,bark alone has had but a short and imperfect ,effect1 ,i have known the following ,composition1 after a good ,vomit1 attended with speedy and final ,success1 viz4 ,take of fresh ,sassafras ,bark1 of ,virginia ,snake-root1 of ,roch-,allom1 of ,nutmeg1 of diaphoretic ,antimony1 and of ,salt of ,wormwood of each one ,drachm4 ,to these well rubbed together into fine ,powder1 add the ,weight of the whole1 of the best and freshest ,bark2 then drop in three ,drops of the chemical ,oil of ,mint1 and with ,syrup of ,cloves make it into the ,consistence of an ,electuary or ,bolus1 for #ab ,doses for a grown ,person1 to be taken at the ,distance of three or four ,hours from each other1 while the ,patient is awake1 according to the longer or shorter ,intermission of the ,fever4 ,i have also known1 particularly in obstinate autumnal ,agues there1 an ,infusion of two ,ounces of the best ,bark in fine ,powder1 or two ,ounces and a half in gross ,powder1 in a ,quart of the best ,brandy1 for three or four ,days 7a small ,wine ,glass to be taken by grown ,persons at the ,distance of from four to six ,hours7 effectually and speedily terminate such intermittent ,agues1 as had given but little ,way to the ,bark in ,substance4 ,this was certainly more suitable for those who were not of a light delicate ,habit and ,temperament1 and who had not been remarkable for their ,abstinence from strong ,liquors3 the inebriating ,force of the ,brandy being remarkably lessened1 by the ,addition and long ,infusion of the ,bark4 ,these ,facts which ,i saw1 are the less to be wondered at1 as in such inveterate1 but perfectly clear and distinct ,intermittents1 both the ,state of the ,fluids and ,solids seem very opposite to their ,state in an acutely inflammatory ,disease4 ,k4 ,chapter ,,xix4 ,of the ,erisipelas1 and the ,bites of ,animals4 ,sect4 #bgc4 ,the ,erisipelas1 commonly called in ,english1 ,st4 ,anthony's ,fire1 and in ,swisserland the ,violet1 is sometimes but a very slight ,indisposition which appears on the ,skin1 without the ,person's being sensible of any other ,disorder2 and it most commonly breaks out either in the ,face1 or on the ,legs4 ,the ,skin becomes tense1 or stiff1 rough and red2 but this ,redness disappears on pressing the ,spot with a ,finger1 and returns on removing it4 ,the ,patient feels in the ,part affected a burning ,heat1 which makes him uneasy1 and sometimes hinders him from sleeping4 ,the ,disorder increases for the ,space of two or three ,days2 continues at its ,height one or two1 and then abates4 ,soon after this1 that ,part of the ,skin that was affected1 falls off in pretty large ,scales1 and the ,disorder entirely terminates4 ,sec4 #bgd4 ,but sometimes this ,malady is considerably more severe1 beginning with a violent ,shivering1 which is succeeded by a burning ,heat1 a vehement ,head-ach1 a ,sickness at ,heart1 as it is commonly termed1 or ,reachings to vomit1 which continue till the ,erisipelas appears1 which sometimes does not happen before the second1 or even the third ,day4 ,the ,fever then abates1 and the ,sickness goes off1 though frequently a less ,degree of ,fever1 and of ,sickness or ,loathing remain1 during the whole ,time1 in which the ,disease is in its increasing ,state4 ,when the ,eruption and ,inflammation happen in the ,face1 the ,head-ach continues1 until the ,decline1 or going off1 of the ,disease4 ,the ,eyelid swells1 the ,eye is closed1 and the ,patient has not the least ,ease or ,tranquillity4 ,it often passes from one ,cheek to the other1 and extends successively over the ,forehead1 the ,neck1 and the ,nape of the ,neck2 under which ,circumstance the ,disease is of a more than ordinary ,duration4 ,sometimes also when it exists in a very high ,degree1 the ,fever continues1 the ,brain is obstructed and oppressed2 the ,patient raves2 his ,case becomes extremely dangerous2 whence sometimes1 if he is not very judiciously assisted1 he dies1 especially if of an advanced ,age4 ,a violent ,erisipelas on the ,neck brings on a ,quinsey1 which may prove very grievous1 or even fatal4 ,when it attacks the ,leg1 the whole ,leg swells up2 and the ,heat and ,irritation from it is extended up to the ,thigh4 ,whenever this ,tumour is considerable1 the ,part it seizes is covered with small ,pustules filled with a clear watery ,humour1 resembling those which appear after a ,burn1 and drying afterwards and scaling off4 ,i have sometimes observed1 especially when this ,distemper affected the ,face1 that the ,humour1 which issued from these little ,pustules1 was extremely thick or glewy1 and formed a thick ,scurf1 or ,scabs nearly resembling those of sucking ,children3 they have continued fast on the ,face many ,days before they fell off4 ,when the ,disease may be termed violent1 it sometimes continues eight1 ten1 twelve ,days at the same ,height2 and is at last terminated by a very plentiful ,sweat1 that may sometimes be predicted by a ,restlessness attended with ,shiverings1 and a little ,anxiety of some ,hours ,duration4 ,throughout the ,progress of the ,disease1 the whole ,skin is very dry1 and even the ,inside of the ,mouth4 ,sec4 #bge4 ,an ,erisipelas rarely comes to ,suppuration1 and when it does1 the ,suppuration is always unkindly1 and much disposed to degenerate into an ,ulcer4 ,sometimes a malignant kind of ,erisipelas is epidemical1 seizing a great ,number of ,persons1 and frequently terminating in ,gangrenes4 ,sec4 #bgf4 ,this ,distemper often shifts its ,situation2 it sometimes retires suddenly2 but the ,patient is uneasy and disordered2 he has a ,propensity to vomit1 with a sensible ,anxiety and ,heat3 the ,erisipelas appears again in a different ,part1 and he feels himself quite relieved from the preceding ,symptoms4 ,but if instead of re-appearing on some other ,part of the ,surface1 the ,humour is thrown upon the ,brain1 or the ,breast1 he dies within a few ,hours2 and these fatal ,changes and ,translations sometimes occur1 without the least ,reason or ,colour for ascribing them either to any ,error of the ,patient1 or of his ,physician4 ,if the ,humour has been transferred to the ,brain1 the ,patient immediately becomes delirious1 with a highly flushed ,visage1 and very quick sparkling ,eyes3 very soon after he proves downright frantic1 and goes off in a ,lethargy4 ,if the ,lungs are attacked1 the ,oppression1 ,anxiety1 and ,heat are inexpressible4 ,sec4 #bgg4 ,there are some ,constitutions subject to a very frequent1 and1 as it were1 to an habitual ,erisipelas4 ,if it often affects the ,face1 it is generally repeated on the same ,side of it1 and that ,eye is1 at length1 considerably weakened by it4 ,sec4 #bgh4 ,this ,distemper results from two ,causes2 the one1 an acrid sharp ,humour1 which is commonly bilious1 diffused through the ,mass of ,blood2 the other consists in that ,humour's not being sufficiently discharged by ,perspiration4 ,sec4 #bgi4 ,when this ,disease is of a gentle ,nature1 such as it is described ,sec4 #bgc1 it will be sufficient to keep up a very free ,perspiration1 but without heating the ,patient2 and the best ,method to answer this ,purpose is putting him upon the ,regimen so often already referred to1 with a plentiful ,use of ,nitre in ,elder ,tea4 ,flesh1 ,eggs and ,wine are prohibited of ,course1 allowing the ,patient a little ,pulse and ripe ,fruits4 ,he should drink ,elder ,flower ,tea abundantly1 and take half a ,drachm of ,nitre every three ,hours2 or1 which amounts to the same ,thing1 let three ,drachms of ,nitre be dissolved in as much ,infusion of ,elder ,flowers1 as he can drink in twenty-four ,hours4 ,nitre may be given too in a ,bolus with ,conserve of ,elder-berries4 ,these ,medicines keep the ,body open1 and increase ,urine and ,perspiration4 ,sec4 #bhj4 ,when the ,distemper prevails in a severer ,degree1 if the ,fever is very high1 and the ,pulse1 at the same ,time1 strong or hard1 it may be necessary to bleed once3 but this should never be permitted in a large ,quantity at a ,time in this ,disease2 it being more adviseable1 if a sufficient ,quantity has not been taken at once1 to bleed a second ,time1 and even a third1 if the ,fever should prove very high1 as it often does1 and that sometimes in so violent a ,degree1 as to render it extremely dangerous3 and in some such ,cases ,nature has sometimes saved the ,patients by effecting a large ,hemorrhage1 or ,bleeding1 to the ,quantity of four or five ,pounds4 ,this ,conduct a very intelligent and prudent ,physician may presume to imitate2 but ,i dare not advise the same ,conduct to that ,class of ,physicians1 for which only ,i write3 it being safer for them to use repeated ,bleedings in such ,cases1 than one in an excessive ,quantity4 ,these erisipelatous ,fevers are often excited by a ,person's being too long over-heated4 ,after ,bleeding the ,patient is to be restrained to his ,regimen2 ,glysters are to be given until there is a sensible ,abatement of the ,fever2 and he should drink the ,barley ,water freely1 ,no4 #c4 ,when the ,fever is somewhat diminished1 either the ,purge ,no4 #bc should be given1 or a few ,doses every ,morning of ,cream of ,tartar ,no4 #bd4 ,purging is absolutely necessary to carry off the stagnant ,bile1 which is generally the first ,cause of the violent ,degrees of this ,distemper4 ,it may sometimes be really necessary too1 if the ,disease is very tedious2 if the ,loathing and ,sickness at ,stomach is obstinate2 the ,mouth ill-favoured1 and the ,tongue foul1 7provided there be only a slight ,fever1 and no ,fear of an ,inflammation7 to give the ,medicines ,no4 #cd or #ce1 which1 in ,consequence of the ,agitation1 the ,shaking they occasion1 remove these ,impediments still better than ,purges4 ,it commonly happens that this ,disease is more favourable after these ,evacuations2 nevertheless it is sometimes necessary to repeat them the next ,day1 or the next but one2 especially if the ,malady affects the ,head4 ,purging is the true ,evacuation for curing it1 whenever it attacks this ,part4 ,by carrying off the ,cause of the ,disease1 they diminish it1 and prevent its worst ,effects4 ,whenever1 even after these ,evacuations1 the ,fever still continues to be very severe1 the ,patient should take every two ,hours1 or occasionally1 oftner1 two ,spoonfuls of the ,prescription ,no4 #aj1 added to a ,glass of ,ptisan4 ,it will be very useful1 when this ,disease is seated in the ,head or ,face1 to bathe the ,legs frequently in warm ,water2 and where it is violent there1 also to apply ,sinapisms to the ,soles of the ,feet4 ,i have seen this ,application1 in about four ,hours attract1 or draw down an ,erisipelas to the ,legs1 which had spread over the ,nose1 and both the ,eyes4 ,when the ,distemper once begins to go off by ,sweating1 this should be promoted by ,elder-flower ,tea and ,nitre 7,see ,sec4 #bgi7 and the ,sweating may be encouraged to ,advantage for some ,hours4 ,sec4 #bha4 ,the best ,applications that can be made to the affected ,part are #ast1 ,the ,herb ,robert1 a ,kind of ,geranium1 or ,crane's-,bill2 or ,chervil1 or ,parsley1 or ,elder ,flowers3 and if the ,complaint be of a very mild ,disposition1 it may be sufficient to apply a very soft smooth ,linen over it1 which some ,people dust over with a little dry ,meal4 #b1 ,if there is a very considerable ,inflammation1 and the ,patient is so circumstanced as to be very tractable and regularly attended1 ,flanels wrung out of a strong ,decoction of ,elder-flowers and applied warm1 afford him the speediest ,ease and ,relief4 ,by this simple ,application ,i have appeased the most violent ,pains of a ,st4 ,anthony's ,fire1 which is the most cruel ,species of an ,erisipelas1 and has some peculiar ,marks or ,symptoms extraordinary4 #c1 ,the ,plaister of ,smalt1 and ,smalt itself ,no4 #df1 are also very successfully employed in this ,disease4 ,this ,powder1 the farinaceous1 or mealy ones1 or others cried up for it1 agree best when a thin watery ,humour distills or weeps from the little ,vesications attending it1 which it is convenient to absorb by such ,applications2 without which ,precaution it might gall1 or even ulcerate the ,part4 ,all other ,plaisters1 which are partly compounded of greasy1 or of resinous ,substances1 are very dangerous3 they often repel1 or strike in the ,erisipelas1 occasioning it to ulcerate1 or even to gangrene4 ,if ,people who are naturally subject to this ,disease should apply any such ,plaister to their ,skin1 even in its soundest ,state1 an ,erisipelas is the speedy ,consequence4 ,sec4 #bhb4 ,whenever the ,humour occasioning the ,distemper is repelled1 and thrown upon the ,brain1 the ,throat1 the ,lungs1 or any internal ,part1 the ,patient should be bled2 ,blisters must be applied to the ,legs2 and ,elder ,tea1 with ,nitre dissolved in it1 should be plentifully drank4 ,sec4 #bhc4 ,people who are liable to frequent ,returns of an ,erisipelas1 should very carefully avoid using ,milk1 ,cream1 and all fat and viscid1 or clammy ,food1 ,pies1 brown ,meat1 ,spices1 thick and heady ,liquors1 a sedentary ,life1 the more active ,passions1 especially ,rage1 and1 if possible1 all ,chagrin too4 ,their ,food should chiefly consist of ,herbage1 ,fruits1 of ,substances inclining to ,acidity1 and which tend to keep the ,body open2 they should drink ,water1 and some of the light white ,wines2 by no ,means omitting the frequent ,use of ,cream of ,tartar4 ,a careful ,conformity to these ,regulations is of real ,importance1 as1 besides the ,danger of the frequent ,visitations of this ,disease1 they denote some slight ,indispositions of the ,liver and the ,gall-bladder2 which1 if too little attended to1 might in ,time prove very troublesome and pernicious4 ,such mineral ,waters as are gently opening are very proper for these ,constitutions1 as well as the ,juice of ,succory1 and clarified ,whey1 of which they should take about three ,pints every ,morning1 during the five or six ,summer ,months4 ,this becomes still more efficacious1 if a little ,cream of ,tartar and ,honey be added to it4 ,of the ,stings1 or little ,wounds1 by ,animals4 ,sec4 #bhd4 ,the ,stings or little ,bites of ,animals1 frequently producing a kind of ,erisipelas1 ,i shall add a very few ,words concerning them in this ,place4 ,of the ,serpents in this ,country none but the ,vipers are poisonous2 and none of these are found except at ,baume1 where there is a ,viperary1 if we may be allowed that ,word4 ,we have no ,scorpions1 which are somewhat poisonous2 our ,toads are not in the least so3 whence the only ,stings we are exposed to1 are those of ,bees1 ,wasps1 ,hornets1 ,muskitos or ,gnats1 and ,dragon #ga ,flies3 all of which are sometimes attended with severe ,pain1 a ,swelling1 and a very considerable erisipelatous ,redness2 which1 if it happens in the ,face1 sometimes entirely closes the ,eyes up2 occasioning also a ,fever1 ,pains of the ,head1 ,restlessness1 and ,sickness at ,heart2 and1 when the ,pains are in a violent ,degree1 ,faintings and ,convulsions1 though always without any mortal ,consequence4 ,these ,symptoms go off naturally within a few ,days1 without any ,assistance3 ,nevertheless they may either be prevented1 diminished in ,degree1 or shortned in ,duration4 #ga ,these1 in some ,parts of ,america1 are called ,muskito ,hawks2 but we do not recollect their biting there4 ,k4 #a1 ,by extracting the ,sting of the ,animal1 if it is left behind4 #b1 ,by a continual ,application of one of the ,remedies directed ,sec4 #bha1 ,article #a and #b1 particularly the ,infusion of ,elder-flowers1 to which a little ,venice ,treacle is added2 or by covering the ,part affected with a ,pultice1 made of ,crum of ,bread1 ,milk1 ,honey1 and a little ,venice ,treacle4 #gb #gb ,pounded ,parsley is one of the most availing ,applications in such ,accidents4 ,e4,l4 #c1 ,by bathing the ,legs of the ,person stung repeatedly in warm ,water4 #d1 ,by retrenching a little of their customary ,food1 especially at ,night1 and by making them drink an ,infusion of ,elder-flowers1 with the ,addition of a little ,nitre4 ,oil1 if applied very quickly after the ,sting1 sometimes prevents the ,appearance of any ,swelling1 and from thence the ,pains that attend it4 ,chapter ,,xx4 ,of spurious1 or false ,inflammations of the ,breast1 and of spurious1 bilious1 ,pleurisies4 ,sect4 #bhe4 ,the ,inflammation of the ,breast and that ,pleurisy1 which is called bilious1 are the same ,disease4 ,it is properly a putrid ,fever1 attended with an ,infarction or ,stuffing of the ,lungs1 though without ,pain2 in which ,circumstance it is called a putrid or bilious ,peripneumony3 but when attended with a ,pain of the ,side1 a ,stitch1 it is called a spurious or bastard ,pleurisy4 ,sec4 #bhf4 ,the ,signs which distinguish these ,diseases from the inflammatory ones of the same ,name1 described ,chap4 ,,iv and ,v1 are a less hard and less strong1 but a quicker ,pulse1 though unaccompanied with the same ,symptoms which constitute the inflammatory ones 7,see ,sec4 #dg and #ij74 ,the ,mouth is foul1 and has a ,sensation of ,bitterness2 the ,patient is infested with a sharp and dry ,heat2 he has a ,feeling of ,heaviness and ,anxiety all about his ,stomach1 with ,loathings3 he is less flushed and red in these1 than in the inflammatory ,diseases1 but rather a little yellow4 ,he has a dejected wan ,look2 his ,urine resembles that in putrid ,fevers1 and not that of inflammatory ones2 and he has very often a small bilious ,looseness1 which is extremely offensive4 ,the ,skin is commonly very dry in this ,disease2 the ,humour spit up is less thick1 less reddish1 and rather more yellow than in the inflammatory ,diseases of the same ,names4 ,sec4 #bhg4 ,they must be treated after the manner of putrid ,fevers1 as in ,sec4 #bda4 ,supposing some little ,degree of ,inflammation to be combined with the ,disease1 it may be removed by a single ,bleeding4 ,after this the ,patient is to drink ,barley ,water ,no4 #c1 to make ,use of ,glysters2 and as soon as all ,symptoms of any ,inflammation wholly disappear1 he is to take the vomiting and purging ,draught ,no4 #cd4 ,but the utmost ,caution must be taken not to give it1 before every ,appearance of any ,inflammation is totally removed2 as giving it sooner would be certain ,death to the ,sick3 and it is dreadful but to think of agitating1 by a ,vomit1 ,lungs that are inflamed1 and overloaded with ,blood1 whose ,vessels burst and discharge themselves1 only from the ,force of ,expectoration4 ,after an ,interval of some ,days1 he may be purged again with the ,medicine ,no4 #bc4 ,the ,prescription ,no4 #be succeeds also very well as a ,vomit4 ,if the ,fever is violent1 he must drink plentifully of the ,potion ,no4 #aj4 ,blisters to the ,legs are very serviceable1 when the ,load and ,oppression are not considerably abated after general ,evacuations4 ,sec4 #bhh4 ,the false ,inflammation of the ,breast is an ,overfulness or ,obstruction in the ,lungs1 accompanied with a ,fever2 and it is caused by extremely thick and tenacious ,humours2 and not by a really inflammatory ,blood1 or by any putrid or bilious ,humour4 ,sec4 #bhi4 ,this ,distemper happens more frequently in the ,spring1 than in any other ,season4 ,old ,men1 puny1 ill-constitutioned ,children1 languid ,women1 feeble young ,men1 and particularly such as have worn their ,constitutions out by drinking1 are the ,subjects most frequently attacked by it2 especially if they have used but little ,exercise throughout the ,winter3 if they have fed on viscid1 mealy and fat ,aliments1 as ,pastry1 ,chesnuts1 thick ,milk or ,pap1 and ,cheese4 ,all their ,humours have contracted a thick glutinous ,quality2 they are circulated with ,difficulty1 and when ,heat or ,exercise in the ,spring increases their ,motion at once1 the ,humours1 already stuffing up the ,lungs1 still more augment that ,plenitude1 whence these vital ,organs are fatally extended1 and the ,patient dies4 ,sec4 #bij4 ,this ,distemper is known to exist1 #a1 ,by the previous ,existence of the ,causes already mentioned4 #b1 ,by the ,symptoms which precede and usher it in4 ,for ,example1 the ,patient many ,days before-hand has a slight ,cough2 a small ,oppression when he moves about2 a little ,restlessness1 and is sometimes a little choleric or fretful4 ,his ,countenance is higher coloured than in ,health2 he has a ,propensity to sleep1 but attended with ,confusion and without ,refreshment1 and has sometimes an extraordinary ,appetite4 #c1 ,when this ,state has continued for some ,days1 there comes on a cold ,shivering1 though more considerable for its ,duration than its ,violence2 it is succeeded by a moderate ,degree of ,heat1 but that attended with much ,inquietude and ,oppression4 ,the sick ,person cannot confine himself to the ,bed2 but walks to and fro in his ,chamber1 and is greatly dejected4 ,the ,pulse is weak and pretty quick2 the ,urine is sometimes but little changed from that in ,health2 at other ,times it is discharged but in a small ,quantity1 and is higher coloured3 he coughs but moderately1 and does not expectorate1 or cough up1 but with ,difficulty4 ,the ,visage becomes very red1 and even almost livid2 he can neither keep awake1 nor sleep well2 he raves for some ,moments1 and then his ,head grows clear again4 ,sometimes it happens1 especially to ,persons of advanced ,age1 that this ,state suddenly terminates in a mortal ,swoon or ,fainting3 at other ,times and in other ,cases1 the ,oppression and ,anguish increase2 the ,patient cannot breathe but when sitting up1 and that with great ,difficulty and ,agony3 the ,brain is utterly disturbed and embarrassed2 this ,state lasts for some ,hours1 and then terminates of a sudden4 ,sec4 #bia4 ,this is a very dangerous ,distemper2 because1 in the first ,place1 it chiefly attacks those ,persons whose ,temperament and ,constitution are deprived of the ordinary ,resources for ,health and ,recovery3 in the second ,place1 because it is of a precipitate ,nature1 the ,patient sometimes dying on the third ,day1 and but seldom surviving the seventh2 while the ,cause of it requires a more considerable ,term for its ,removal or ,mitigation4 ,besides which1 if some ,indications present for the ,employment of a ,remedy1 there are frequently others which forbid it2 and all that seems to be done is1 as follows2 #a1 ,if the ,patient has still a pretty good ,share of ,health2 if he is not of too advanced an ,age2 if the ,pulse has a perceivable ,hardness1 and yet at the same ,time some ,strength2 if the ,weather is dry1 and the ,wind blows from the ,north1 he should be bled once1 to a moderate ,quantity4 ,but if the greater ,part of these ,circumstances are wanting1 ,bleeding would be very prejudicial4 ,were we obliged to establish some general and positive ,rule in this ,case1 it were better to exclude ,bleeding1 than to admit it4 #b1 ,the ,stomach and the ,bowels should be unloaded from their viscid glutinous ,contents2 and the ,medicines which succeed the best in this ,respect are ,no4 #ce1 when the ,symptoms shew there is a great ,necessity for vomiting1 and there is no ,inflammation2 or the ,prescription ,no4 #be1 which after vomiting1 purges by ,stool1 promotes ,urine1 breaks down and divides the viscid ,humours that occasion the ,disease1 and increase ,perspiration4 ,when we are afraid of hazarding the ,agitation of a ,vomit and its ,consequences1 the ,potion1 ,no4 #aa may be given2 but we must be very cautious1 in ,regard to old ,men1 even with this2 as such may expire during the ,operation of it4 #c1 ,they should1 from the ,beginning of the ,disease1 drink plentifully of the ,ptisan ,no4 #bf1 which is the best ,drink in this ,disease2 or that of ,no4 #ab1 adding half a ,dram of ,nitre to every ,pint of it4 #d1 ,a ,cup of the ,mixture ,no4 #h must be taken every two ,hours4 #e4 ,blisters are to be applied to the ,insides of the ,legs4 ,when the ,case is very doubtful and perplexing1 it were best to confine ourselves to the three last-mentioned ,remedies1 which have often been successful in severe ,degrees of this ,disease2 and which can occasion no ill ,consequence4 ,sec4 #bib4 ,when this ,malady invades old ,people1 though they partly recover1 they never recover perfectly1 entirely1 from it3 and if due ,precaution is not taken1 they are very liable to fall into a ,dropsy of the ,breast after it4 ,sec4 #bic4 ,the spurious or false ,pleurisy is a ,distemper that does not affect the ,lungs1 but only the ,teguments1 the ,skin1 and the ,muscles which cover the ,ribs4 ,it is the ,effect of a rheumatic ,humour thrown upon these ,parts1 in which1 as it produces very sharp ,pains resembling that which is called a ,stitch1 it has from this ,circumstance1 been termed a ,pleurisy4 ,it is generally supposed by the meer ,multitude1 and even by some of a different ,rank1 that a false ,pleurisy is more dangerous than a genuine1 a true one2 but this is a ,mistake4 ,it is often ushered in by a ,shivering1 and almost ever attended with a little ,fever1 a small ,cough1 and a slight ,difficulty of breathing2 which1 as well as the ,cough1 is occasioned from the ,circumstance of a ,patient's 7who feels ,pain in ,respiration1 or ,breathing7 checking ,breathing as much as he can2 this accumulates a little too much ,blood in the ,lungs2 but yet he has no ,anguish1 nor the other ,symptoms of acute true ,pleurisies4 ,in some ,patients this ,pain is extended1 almost over the whole ,breast1 and to the ,nape of the ,neck4 ,the sick ,person cannot repose himself on the ,side affected4 ,this ,disorder is not more dangerous than a ,rheumatism1 except in two ,cases2 #a1 ,when the ,pain is so very severe1 that the ,patient strongly endeavours not to breathe at all1 which brings on a great ,infarction or ,stoppage in the ,lungs4 #b1 ,when this ,humour1 like any other rheumatic one1 is transferred to some internal ,part4 ,sec4 #bid4 ,it must be treated exactly like a ,rheumatism4 ,see ,sec4 #afh and #afi4 ,after bleeding once or more1 a ,blister applied to the affected ,part is often attended with a very good ,effect3 ,this being indeed the ,kind of #gc ,pleurisy1 in which it particularly agrees4 #gc ,the ,seneka ,rattle-,snake root1 already recommended in true ,pleurisies1 will1 with the greatest ,probability1 be found not less effectual in these false ones1 in which the ,inflammation of the ,blood is less4 ,the ,method of giving it may be seen ,p4 #aah1 ,n4 7#bf47 ,by ,dr4 ,tissot's having never mentioned this valuable ,simple throughout his ,work1 it may be presumed1 that when he wrote it1 this ,remedy had not been admitted into the ,apothecaries ,shops in ,swisserland4 ,k4 ,sec4 #bie4 ,this ,malady sometimes gives ,way to the first ,bleeding2 often terminating on the third1 fourth or fifth ,day1 by a very plentiful ,sweat1 and rarely lasting beyond the seventh4 ,sometimes it attacks a ,person very suddenly1 after a ,stoppage of ,perspiration2 and then1 if at once before the ,fever commences1 and has had ,time to inflame the ,blood1 the ,patient takes some ,faltrank1 it effects a speedy ,cure by restoring ,perspiration4 ,they are such ,cases as these1 or that mentioned ,sec4 #if1 which have given this ,composition the ,reputation it has obtained in this ,disease3 a ,reputation nevertheless1 which has every ,year proved tragical in its ,consequences to many ,peasants1 who being deceived by some misleading ,resemblances in this ,distemper1 have rashly and ignorantly made ,use of it in true inflammatory ,pleurisies4 ,chapter ,,xxi4 ,of the ,cholic and its different ,kinds4 ,sect4 #bif4 ,the ,appellation of a ,cholic is commonly given to all ,pains of the ,belly indiscriminately2 but ,i apply it in this ,place only to such as attack the ,stomach1 or the ,intestines1 the ,guts4 ,cholics may and do result from very many ,causes2 and the greater ,number of ,cholics are chronical or tedious ,complaints1 being more common among the inactive ,inhabitants of ,cities1 and ,workmen in sedentary ,trades1 than among ,country ,people4 ,hence ,i shall treat here only of the small ,variety of ,cholics1 which happen the most usually in ,villages4 ,i have already proved that the fatal ,events of some ,distempers were occasioned by endeavouring to force the ,patients into ,sweats2 and the same unhappy ,consequences have attended ,cholics1 from accustoming the ,subjects of this ,disease to ,drams1 and hot inflaming spirituous ,liquors1 with an ,intention to expel the ,wind4 ,of the inflammatory ,cholic4 ,sec4 #big4 ,the most violent and dangerous kind of ,cholic is that1 which arises from an ,inflammation of the ,stomach1 or of the ,intestines4 ,it begins most commonly without any ,shivering1 by a vehement ,pain in the ,belly1 which gradually becomes still more so4 ,the ,pulse grows quick and hard2 a burning ,pain is felt through the whole ,region of the ,belly2 sometimes there is a watery ,diarrhoea1 or ,purging2 at other ,times the ,belly is rather costive1 which is attended with ,vomiting1 a very embarrassing and dangerous ,symptom3 the ,countenance becomes highly flushed2 the ,belly tense and hard2 neither can it be touched scarcely without a cruel ,augmentation of the ,patient's ,pain1 who is also afflicted with extreme ,restlessness2 his ,thirst is very great1 being unquenchable by ,drink2 the ,pain often extends to the ,loins1 where it proves very sharp1 and severe2 little ,urine is made1 and that very red1 and with a kind of burning ,heat4 ,the tormented ,patient has not a ,moment's ,rest1 and now and then raves a little4 ,if the ,disease is not removed or moderated1 before the ,pains rise to their utmost ,height and ,violence1 the ,patient begins at length to complain less2 the ,pulse becomes less strong and less hard than before1 but quicker3 his ,face first abates of its ,flush and ,redness1 and soon after looks pale2 the ,parts under the ,eyes become livid2 the ,patient sinks into a low stupid ,kind of ,delirium1 or ,raving2 his ,strength entirely deserts him2 the ,face1 ,hands1 ,feet1 and the whole ,body1 the ,belly only excepted1 become cold3 the ,surface of the ,belly appears bluish2 extreme ,weakness follows1 and the ,patient dies4 ,there frequently occurs1 just a ,moment before he expires1 an abundant ,discharge of excessively foetid ,matter by ,stool2 and during this ,evacuation he dies with his ,intestines quite gangrened1 or mortified4 ,when the ,distemper assaults the ,stomach1 the ,symptoms are the very same1 but the ,pain is felt higher up1 at the ,pit of the ,stomach4 ,almost every thing that is swallowed is cast up again2 the ,anguish of the tortured ,patient is terrible1 and the ,raving comes on very speedily4 ,this ,disease proves mortal in a few ,hours4 ,sec4 #bih4 ,the only ,method of succeeding in the ,cure of it is as follows3 #a1 ,take a very large ,quantity of ,blood from the ,arm2 this almost immediately diminishes the ,violence of the ,pains1 and allays the ,vomiting3 besides its contributing to the greater ,success of the other ,remedies4 ,it is often necessary to repeat this ,bleeding within the ,space of two ,hours4 #b1 ,whether the ,patient has a ,looseness1 or has not1 a ,glyster of a ,decoction of ,mallows1 or of ,barley ,water and ,oil1 should be given every two ,hours4 #c1 ,the ,patient should drink very plentifully of ,almond ,milk ,no4 #d2 or a ,ptisan of ,mallow ,flowers1 or of ,barley1 all which should be warm4 #d1 ,flanels dipt in hot1 or very warm ,water should be continually applied over the ,belly1 shifting them every ,hour1 or rather oftner2 for in this ,case they very quickly grow dry4 #e1 ,if the ,disease1 notwithstanding all this1 continues very obstinate and violent1 the ,patient should be put into a warm ,water ,bath1 the extraordinary ,success of which ,i have observed4 ,when the ,distemper is over1 that is to say1 when the ,pains have terminated1 and the ,fever has ceased1 so that the ,patient recovers a little ,strength1 and gets a little ,sleep1 it will be proper to give him a ,purge1 but a very gentle one4 ,two ,ounces of ,manna1 and a ,quarter of an ,ounce of ,sedlitz #gd ,salt dissolved in a ,glass of clear ,whey is generally sufficient1 at this ,period1 to purge the most robust and hardy ,bodies4 ,manna alone may suffice for more delicate ,constitutions3 as all acrid sharp ,purges would be highly dangerous1 with ,regard to the great ,sensibility and tender ,condition of the ,stomach1 and of the ,intestines after this ,disease4 #gd ,glauber or ,epsom ,salt may be substituted1 where the other is not to be readily procured4 ,k4 ,sec4 #bii4 ,it is sometimes the ,effect of a general ,inflammation of the ,blood2 and is produced1 like other inflammatory ,diseases1 by extraordinary ,labour1 very great ,heat1 heating ,meats or ,drinks1 c4 ,it is often the ,consequence of other ,cholics which have been injudiciously treated1 and which otherwise would not have degenerated into inflammatory ones2 as ,i have many ,times seen these ,cholics introduced after the ,use of heating ,medicines2 one ,instance of which may be seen ,sec4 #afd4 ,sec4 #cjj4 ,ten ,days after ,i had recovered a ,woman out of a severe ,cholic1 the ,pains returned violently in the ,night4 ,she1 supposing them to arise only from ,wind1 hoped to appease them by drinking a deal of distilled ,walnut ,water2 which1 far from producing any such ,effect1 rendered them more outrageous4 ,they soon were heightened to a surprising ,degree1 which might reasonably be expected4 ,being sent for very early in the ,morning1 ,i found her ,pulse hard1 quick1 short2 her ,belly was tense and hard2 she complained greatly of her ,loins3 her ,urine was almost entirely stopt4 ,she past but a few ,drops1 which felt as it were scalding hot1 and these with excessive ,pain4 ,she went very frequently to the ,close-stool1 with scarcely any ,effect2 her ,anguish1 ,heat1 ,thirst1 and the ,dryness of her ,tongue were even terrifying3 and her wretched ,state1 the ,effect of the strong hot ,liquor she had taken1 made me very apprehensive for her4 ,one ,bleeding1 to the ,quantity of fourteen ,ounces1 somewhat abated all the ,pains2 she took several ,glysters1 and drank off a few ,pots of ,orgeat in a few ,hours4 ,by these ,means the ,disease was a little mitigated2 by continuing the same ,drink and the ,glysters the ,looseness abated2 the ,pain of the ,loins went off1 and she passed a considerable ,quantity of ,urine1 which proved turbid1 and then let fall a ,sediment1 and the ,patient recovered4 ,nevertheless ,i verily believe1 if the ,bleeding had been delayed two ,hours longer1 this spirituous ,walnut ,water would have been the ,death of her4 ,during the ,progress of this violent ,disease1 no ,food is to be allowed2 and we should never be too inattentive to such ,degrees of ,pain1 as sometimes remain after their ,severity is over2 lest a ,scirrhus1 an inward hard ,tumour1 should be generated1 which may occasion the most inveterate and tedious ,maladies4 ,sec4 #cja4 ,an ,inflammation of the ,intestines1 and one of the ,stomach1 may also terminate in an ,abscess1 like an ,inflammation of any other ,part2 and it may be apprehended that one is forming1 when1 though the ,violence of the ,pains abates1 there still remains a slow1 obtuse1 heavy ,pain1 with general ,inquietude1 little ,appetite1 frequent ,shiverings2 the ,patient at the same ,time not recovering any ,strength4 ,in such ,cases the ,patient should be allowed no other ,drinks1 but what are already directed in this ,chapter1 and some ,soops made of ,pulse1 or other farinaceous ,food4 ,the ,breaking of the ,abscess may sometimes be discovered by a slight ,swoon or fainting ,fit2 attended with a perceivable ,cessation of a ,weight or ,heaviness in the ,part1 where it was lately felt3 and when the ,pus1 or ripe ,matter1 is effused into the ,gut1 the ,patient sometimes has ,reachings to vomit1 a ,vertigo1 or ,swimming in the ,head1 and the ,matter appears in the next ,stools4 ,in this ,case there remains an ,ulcer within the ,gut1 which1 if either neglected1 or improperly treated1 may pave the ,way to a slow wasting ,fever1 and even to ,death4 ,yet this ,i have cured by making the ,patient live solely upon skimmed ,milk1 diluted with one third ,part ,water1 and by giving every other ,day a ,glyster1 consisting of equal ,parts of ,milk and ,water1 with the ,addition of a little ,honey4 ,when the ,abscess breaks on the ,outside of the ,gut1 and discharges its ,contents into the ,cavity of the ,belly1 it becomes a very miserable ,case1 and demands such further ,assistance as cannot be particularized here4 ,of the bilious ,cholic4 ,sec4 #cjb4 ,the bilious ,cholic discovers itself by very acute ,pains1 but is seldom accompanied with a ,fever2 at least not until it has lasted a ,day or two4 ,and even if there should be some ,degree of a ,fever1 yet the ,pulse1 though quick1 is neither strong nor hard3 the ,belly is neither tense or stretched as it were1 nor burning hot1 as in the former ,cholic3 the ,urine comes away with more ,ease1 and is less high-coloured3 ,nevertheless the inward ,heat and ,thirst are considerable2 the ,mouth is bitter2 the ,vomiting or ,purging1 when either of them attend it1 discharge a yellowish ,humour or ,excrement2 and the ,patient's ,head is often vertiginous or dizzy4 ,sec4 #cjc4 ,the ,method of curing this is1 #a1 ,by injecting ,glysters of ,whey and ,honey2 or1 if ,whey is not readily procurable1 by repeating the ,glyster1 ,no4 #e4 #b1 ,by making the ,sick drink considerably of the same ,whey1 or of a ,ptisan made of the ,root of ,dog's-,grass 7the common ,grass7 and a little ,juice of ,lemon1 for want of which1 a little ,vinegar and ,honey may be substituted instead of it4 #ge #ge ,pullet1 or rather ,chicken ,water1 but very weak1 may often do instead of ,ptisan1 or serve for a little ,variety of ,drink to some ,patients4 ,e4 ,l4--,k4 #c1 ,by giving every ,hour one ,cup of the ,medicine ,no4 #cb2 or where this is not to be had1 half a ,drachm of ,cream of ,tartar at the same short ,intervals4 #d1 ,fomentations of warm ,water and ,half-baths are also very proper4 #e1 ,if the ,pains are sharp and violent1 in a robust strong ,person1 and the ,pulse is strong and tense1 ,bleeding should be used to prevent an ,inflammation4 #f1 ,no other ,nourishment should be given1 except some maigre ,soops1 made from ,vegetables1 and particularly of ,sorrel4 #g1 ,after plentiful ,dilution with the proper ,drink1 if no ,fever supervenes2 if the ,pains still continue1 and the ,patient discharges but little by ,stool1 he should take a moderate ,purge4 ,that directed ,no4 #dg is a very proper one4 ,sec4 #cjd4 ,this bilious ,cholic is habitual to many ,persons2 and may be prevented or greatly mitigated by an habitual ,use of the ,powder ,no4 #bd2 by submitting to a moderate ,retrenchment in the ,article of ,flesh-meat2 and by avoiding heating and greasy ,food1 and the ,use of ,milk4 ,of ,cholics from ,indigestions1 and of ,indigestion4 ,sec4 #cje4 ,under this ,appellation ,i comprehend all those ,cholics1 which are either owing to any overloading ,quantity of ,food taken at once2 or to a ,mass or ,accumulation of ,aliments formed by ,degrees in such ,stomachs1 as digest but very imperfectly2 or which result from noxious ,mixtures of ,aliment in the ,stomach1 such as that of ,milk and ,acids2 or from ,food either not wholesome in its self1 or degenerated into an unwholesome ,condition4 ,this kind of ,cholic may be known from any of these ,causes having preceded it2 by its ,pains1 which are accompanied with great ,restlessness1 and come on by ,degrees1 being less fixed than in the ,cholics before treated of4 ,these ,cholics are also without any ,fever1 ,heat or ,thirst1 but accompanied with a ,giddiness of the ,head1 and ,efforts to vomit1 and rather with a pale1 than a high-coloured ,visage4 ,sec4 #cjf4 ,these ,disorders1 from these last ,causes1 are scarcely ever dangerous in themselves2 but may be made such by injudicious ,management1 and doing more than is necessary or proper3 as the only ,thing to be done is to promote the ,discharges by warm ,drinks4 ,there are a considerable ,variety of them1 which seem equally good1 such as warm ,water1 or even cold ,water with a ,toast1 with the ,addition either of a little ,sugar1 or a little ,salt3 a light ,infusion of ,chamomile1 or of ,elder-flowers1 common ,tea1 or ,baum1 it imports little which1 provided the ,patient drink plentifully of them3 in ,consequence of which the offending ,matter is discharged1 either by vomiting1 or a considerable purging2 and the speedier and more in ,quantity these ,discharges are1 the sooner the ,patient is relieved4 ,if the ,belly is remarkably full and costive1 ,glysters of warm ,water and ,salt should be injected4 ,the ,expulsion of the obstructing ,matter is also facilitated1 by rubbing the ,belly heartily with hot ,cloths4 ,sometimes the ,humours1 or other retained ,contents of the ,belly1 are more pernicious from their ,quality1 than their ,quantity2 and then the ,malady may be dissipated without the former ,discharges1 by the irritating sharp ,humour being diluted1 or even drowned1 as it were1 in the ,abundance of small watery ,drinks4 ,when the ,pains invade first in the ,stomach1 they become less sharp1 and the ,patient feels less ,inquietude1 as soon as the ,cause of the ,pain has descended out of the ,stomach into the ,intestines1 whose ,sensations are something less acute than1 or somewhat different from1 those of the ,stomach4 ,it is often found that after these plentiful ,discharges1 and when the ,pains are over1 there remains a very disagreeable ,taste in the ,mouth1 resembling the ,savour of rotten ,eggs4 ,this may be removed by giving some ,doses of the ,powder ,no4 #bd1 and drinking largely of good ,water3 ,it is an essential ,point in these ,cases1 to take no ,food before a perfect ,recovery4 ,sec4 #cjg4 ,some have been absurd enough in them1 to fly at once to some heating ,cordial ,confection1 to ,venice ,treacle1 ,aniseed ,water1 ,geneva1 or red ,wine to stop these ,evacuations2 but there cannot be a more fatal ,practice3 since these ,evacuations are the only ,thing which can cure the ,complaint1 and to stop them is to deprive the ,person1 who was in ,danger of drowning1 of the ,plank which might save him4 ,nay should this ,endeavour of stopping them unhappily succeed1 the ,patient is either thrown into a putrid ,fever1 or some chronical tedious ,malady2 unless ,nature1 much wiser than such a miserable ,assistant1 should prevail over the ,obstacles opposed to her ,recovery1 and restore the obstructed ,evacuations by her own ,oeconomy1 in the ,space of a few ,days4 ,sec4 #cjh4 ,sometimes an ,indigestion happens1 with very little ,pain or ,cholic1 but with violent ,reachings to vomit1 inexpressible ,anguish1 ,faintings1 and cold ,sweats3 and not seldom also the ,malady begins1 only with a very sudden and unexpected ,fainting3 the ,patient immediately loses all his ,senses1 his ,face is pale and wan3 he has some ,hickups rather than ,reachings to vomit1 which joined to the ,smallness of his ,pulse1 to the ,easiness of his respiring1 or breathing1 and to the ,circumstance of his being attacked immediately1 or very soon1 after a ,meal1 makes this ,disorder distinguishable from a real ,apoplexy4 ,nevertheless1 when it rises to this ,height1 with these terrible ,symptoms1 it sometimes kills in a few ,hours4 ,the first thing to be done is to throw up a sharp ,glyster1 in which ,salt and ,soap are to be dissolved2 next to get down as much ,salt and ,water as he can swallow2 and if that is ineffectual1 the ,powder ,no4 #cd is to be dissolved in three ,cups of ,water2 one half of which is to be given directly2 and1 if it does not operate in a ,quarter of an ,hour1 the other half4 ,generally speaking the ,patient's ,sense begins to return1 as soon as he begins to vomit4 ,of the flatulent or windy ,cholic4 ,sec4 #cji4 ,every ,particular which constitutes our ,food1 whether solid or liquid1 contains much ,air1 but some of them more than others4 ,if they do not digest soon enough1 or but badly1 which occasions a sensible ,escape of such ,air2 if they are such as contain an extraordinary ,quantity of ,air2 or if the ,guts being straitened or compressed any where in the ,course of their ,extent1 prevent that ,air from being equally diffused 7which must occasion a greater ,proportion of it in some ,places7 then the ,stomach and the ,guts are distended by this ,wind2 and this ,distention occasions these ,pains1 which are called flatulent1 or windy4 ,this ,sort of ,cholic rarely appears alone and simple2 but is often complicated with1 or added1 as it were1 to the other ,sorts1 of which it is a ,consequence2 and is more especially joined with the ,cholic from ,indigestions1 whose ,symptoms it multiplies and heightens4 ,it may be known1 like that1 by the ,causes which have preceded it1 by its not being accompanied either with ,fever1 ,heat1 or ,thirst2 the ,belly's being large and full1 though without ,hardness1 being unequal in its ,largeness1 which prevails more in one ,part of it than in another1 forming something like ,pockets of ,wind1 sometimes in one ,part1 sometimes in another2 and by the ,patient's feeling some ,ease merely from the rubbing of his ,belly1 as it moves the ,wind about2 which escaping either upwards or downwards affords him still a greater ,relief4 ,sec4 #caj4 ,when it is combined with any different ,species of the ,cholic1 it requires no distinct ,treatment from that ,species2 and it is removed or dissipated by the ,medicines which cure the principal ,disease4 ,sometimes however it does happen to exist alone1 and then it depends on the ,windiness of the solid and liquid ,food of the ,person affected with it1 such as the ,must or new ,wine1 ,beer1 especially very new ,beer1 certain ,fruits and ,garden-stuff4 ,it may be cured by a ,glyster2 by chaffing the ,belly with hot ,cloths2 by the ,use of ,drink moderately spiced2 and especially by ,camomile ,tea1 to which a little cordial ,confection1 or even ,venice ,treacle1 may be added4 ,when the ,pains are almost entirely vanished1 and there is no ,fever1 nor any unhealthy ,degree of ,heat2 and if the ,patient is sensible of a ,weakness at ,stomach1 he may take a little aromatic1 or spiced ,wine1 or even a small cordial stomachic ,dram4 ,it should be observed1 that these are not to be allowed in any other ,kind of ,cholic4 ,sec4 #caa4 ,when any ,person is frequently subject to cholic-like ,pains1 it is a ,proof that the digestive ,faculty is impaired2 the restoring of which should be carefully attended to2 without which the ,health of the ,patient must suffer considerably1 and he must be very likely to contract many tedious and troublesome ,disorders4 ,of ,cholics from ,cold4 ,sec4 #cab4 ,when any ,person has been very cold1 and especially in his ,feet1 it is not uncommon for him to be attacked1 within a few ,hours after it1 with violent ,cholic ,pains1 in which heating and spirituous ,medicines are very pernicious3 but which are easily cured by rubbing the ,legs well with hot ,cloths2 and keeping them afterwards for a considerable ,time in warm ,water2 advising them at the same ,time to drink freely of a light ,infusion of ,chamomile or ,elder-flowers4 ,the ,cure will be effected the sooner1 if the ,patient is put to ,bed and sweats a little1 especially in the ,legs and ,feet4 ,a ,woman who had put her ,legs into a pretty cool ,spring1 after travelling in the ,height of ,summer1 was very quickly after attacked with a most violent ,cholic4 ,she took different hot ,medicines2 she became still worse2 she was purged1 but the ,distemper was still further aggravated4 ,i was called in on the third ,day1 a few ,hours before her ,decease4 ,in such ,cases1 if the ,pain be excessive1 it may be necessary to bleed2 #gf to give a ,glyster of warm ,water2 to keep the ,legs several ,hours over the ,steam of hot ,water1 and afterwards in the ,water2 to drink plentifully of an ,infusion of the ,flowers of the ,lime-tree1 with a little ,milk2 and if the ,distemper is not subdued by these ,means1 ,blisters should be applied to the ,legs1 which ,i have known to be highly efficacious4 #gf ,bleeding should not be determined on too hastily in this ,sort of ,cholic1 but rather be omitted1 or deferred at least1 till there be an evident ,tendency to an ,inflammation4 ,e4 ,l4 ,the ,propriety or ,impropriety of ,bleeding in a ,cholic from this ,cause should be determined1 ,i think1 from the ,state of the ,person it happens to3 ,so that ,bleeding a strong ,person with a firm ,fibre1 and a hard ,pulse1 may be very prudent and precautionary3 ,but if it be a weakly lax ,subject with a soft and low ,pulse1 there may be ,room either for omitting1 or for suspending it4 ,k4 ,sec4 #cac4 ,it appears1 through the ,course of this ,chapter1 that it is necessary to be extremely on our ,guard1 against permitting the ,use of heating and spirituous ,medicines in ,cholics1 as they may not only aggravate1 but even render them mortal4 ,in short they should never be given1 and when it is difficult to discover the real ,cause of the ,cholic1 ,i advise ,country ,people to confine themselves to the three following ,remedies1 which cannot be hurtful in any ,sort of ,cholic1 and may remove as many as are not of a violent ,nature4 ,first then1 let ,glysters be frequently repeated4 #b1 ,let the ,patient drink warm ,water plentifully1 or ,elder ,tea4 #c1 ,let the ,belly be often fomented in pretty warm ,water1 which is the most preferable ,fomentation of any4 ,sec4 #cad ,i have said nothing here of the ,use of any ,oils in this ,disease1 as they agree but in very few ,species of ,cholics1 and not at all in those of which ,i have been treating4 ,for this ,reason ,i advise a total ,disuse of them1 since they may be of bad ,consequence in many ,respects4 ,sec4 #cae4 ,chronical ,diseases not coming within the ,plan of this ,work1 ,i purposely forbear treating of any ,kind of those tedious ,cholics1 which afflict some ,people for many ,years3 but ,i think it my ,duty to admonish such1 that their ,torments being very generally occasioned by ,obstructions in the ,viscera1 or different ,bowels of the ,belly1 or by some other ,fault1 and more particularly in those ,organs1 which are intended to prepare the ,bile1 they should1 #a1 avoid with the greatest ,care1 the ,use of sharp1 hot1 violent ,medicines1 ,vomits1 strong ,purges1 ,elixirs1 c4 #b1 ,they should be thoroughly on their ,guard against all those1 who promise them a very speedy ,cure1 by the ,assistance of some specific ,remedy2 and ought to look upon them as ,mountebanks1 into whose ,hands it is highly dangerous to trust themselves4 #c1 ,they should be persuaded1 or rather convinced1 that they can entertain no reasonable ,hope of being cured1 without an exact ,conformity to a proper and judicious ,regimen1 and a long ,perseverance in a ,course of mild and safe ,remedies4 #d1 ,they should continually reflect with themselves1 that there is little ,difficulty in doing them great ,mischief2 and that their ,complaints are of that ,sort1 which require the greatest ,knowledge and ,prudence in those ,persons1 to whom the ,treatment and ,cure of them are confided4 ,chapter ,,xxii4 ,of the ,iliac ,passion1 and of the ,cholera-morbus4 ,sect4 #caf4 ,these violent ,diseases are fatal to many ,country ,people1 while their ,neighbours are frequently so ignorant of the ,cause of their ,death1 that ,superstition has ascribed it to ,poison1 or to ,witchcraft4 ,sec4 #cag4 ,the first of these1 the ,miserere1 or ,iliac ,passion1 is one of the most excruciating ,distempers4 ,if any ,part of the ,intestines1 the ,cavity of the ,guts is closed up1 whatever may have occasioned it1 the ,course or ,descent of the ,food they contain is necessarily stopped2 in which ,case it frequently happens1 that that continual ,motion observed in the ,guts of a living ,animal dissected1 and which was intended to detrude1 or force their ,contents downwards1 is propagated in a directly contrary ,manner1 from the ,guts towards the ,mouth4 ,this ,disease sometimes begins after a ,constipation1 or ,costiveness1 of some ,days2 at other ,times without that ,costiveness having been preceded by ,pains in any ,part of the ,belly1 especially around the ,navel2 but which ,pains1 gradually increasing after their ,commencement1 at length become extremely violent1 and throw the ,patient into excessive ,anguish4 ,in some of these ,cases a hard ,tumour may be felt1 which surrounds the ,belly like a ,cord4 ,the ,flatulences within become very audible1 some of them are discharged upwards2 in a little ,time after1 ,vomitings come on1 which increase till the ,patient has thrown up all he had taken in1 with a still further ,augmentation of the excessive ,pain4 ,with the first of his ,vomitings he only brings up the last ,food he had taken1 with his ,drink and some yellowish ,humour3 but what comes up afterwards proves stinking2 and when the ,disease is greatly heightened1 they have what is called the ,smell of ,excrement or ,dung2 but which rather resembles that of a putrid dead ,body4 ,it happens too sometimes1 that if the ,sick have taken ,glysters composed of ,materials of a strong ,smell1 the same ,smell is discernible in the ,matter they vomit up4 ,i confess however ,i never saw either real ,excrements1 or the ,substance of their ,glysters1 brought up1 much less the ,suppositories that were introduced into the ,fundament3 and were it credible that ,instances of this ,kind had occurred1 they must be allowed very difficult to account for4 ,throughout this whole ,term of the ,disease1 the ,patient has not a single ,discharge by ,stool2 the ,belly is greatly distended2 the ,urine not seldom suppressed1 and at other ,times thick and foetid4 ,the ,pulse1 which at first was pretty hard1 becomes quick and small2 the ,strength entirely vanishes2 a ,raving comes on2 a ,hiccup almost constantly supervenes1 and sometimes general ,convulsions2 the ,extremities grow cold1 the ,pulse scarcely perceivable2 the ,pain and the ,vomiting cease1 and the ,patient dies very quickly after4 ,sec4 #cah4 ,as this ,disease is highly dangerous1 the ,moment it is strongly apprehended1 it is necessary to oppose it by proper ,means and ,remedies3 the smallest ,error may be of fatal ,consequence1 and hot inflaming ,liquids have been known to kill the ,patient in a few ,hours4 ,i was called in the second ,day of the ,disease to a young ,person1 who had taken a good deal of ,venice ,treacle3 ,nothing could afford her any ,relief1 and she died early on the third ,day4 ,this ,disease should be treated precisely in the same ,manner as an inflammatory ,cholic2 the principal ,difference being1 that in the former there are no ,stools1 but continual ,vomitings4 #a1 ,first of all then the ,patient should be plentifully bled1 if the ,physician has been called in early enough1 and before the ,sick has lost his ,strength4 #b1 ,he should receive opening ,glysters made of a ,decoction of ,barley ,water1 with five or six ,ounces of ,oil in each4 #c1 ,we should endeavour to allay the violent ,efforts to vomit1 by giving every two ,hours a ,spoonful of the ,mixture ,no4 #dh4 #d1 ,the ,sick should drink plentifully1 in very small ,quantities1 very often repeated1 of an appeasing1 diluting1 refreshing ,drink1 which tends at the same ,time to promote both ,stools and ,urine4 ,nothing is preferable to the ,whey ,no4 #di1 if it can be had immediately3 if not1 give simple clear ,whey sweetened with ,honey1 and the ,drinks prescribed ,sec4 #bih1 ,art4 #c4 #e1 ,the ,patient is to be put into a warm ,bath1 and kept as long as he can bear it1 repeating it as often daily too1 as his ,strength will permit4 #f1 ,after ,bleeding1 warm ,bathing1 repeated ,glysters and ,fomentations1 if each and all of these have availed nothing2 the ,fume or ,smoak of ,tobacco may be introduced in the ,manner of a ,glyster1 of which ,i shall speak further1 in the ,chapter on ,persons drowned4 ,i cured a ,person of this ,disease1 by conveying him into a ,bath1 immediately after bleeding him1 and giving him a ,purge on his going into the ,bath4 ,sec4 #cai4 ,if the ,pain abates before the ,patient has quite lost his ,strength2 if the ,pulse improves at the same ,time2 if the ,vomitings are less in ,number1 and in the ,quantity of the ,matter brought up2 if that ,matter seems in a less putrid offensive ,state2 if he feels some ,commotion and ,rumbling in his ,bowels2 if he has some little ,discharge by ,stool2 and if at the same ,time he feels himself a little stronger than before1 his ,cure may reasonably be expected2 but if he is otherwise circumstanced he will soon depart4 ,it frequently happens1 a single ,hour before ,death1 that the ,pain seems to vanish1 and a surprising ,quantity of extremely foetid ,matter is discharged by ,stool3 the ,patient is suddenly seized with a great ,weakness and ,sinking1 falls into a cold ,sweat1 and immediately expires4 ,sec4 #cbj4 ,this is the ,disease which the common ,people attribute to1 and term1 the ,twisting of the ,guts2 and in which they make the ,patients swallow ,bullets1 or large ,quantities of ,quick-silver4 ,this twisting1 tangling1 or ,knoting of the ,guts is an utter1 an impossible ,chimera2 for how can they admit of such a ,circumstance1 as one of their ,extremities1 their ,ends1 is connected to the ,stomach1 and the other irremoveably fastened to the ,skin of the ,fork or ,cleft of the ,buttocks8 ,in ,fact this ,disease results from a ,variety of ,causes1 which have been discovered on a ,dissection of those who have died of it4 ,it were to be wished indeed this prudent ,custom1 so extremely conducive to enrich1 and to perfect1 the ,art of ,physick1 were to prevail more generally2 and which we ought rather to consider as a ,duty to comply with1 than a ,difficulty to submit to2 as it is our ,duty to contribute to the ,perfection of a ,science1 on which the ,happiness of ,mankind so considerably depends4 ,i shall not enter into a ,detail of these ,causes2 but whatever they are1 the ,practice of swallowing ,bullets in the ,disease is always pernicious1 and the like ,use of ,mercury must be often so4 ,each of these pretended ,remedies may aggravate the ,disease1 and contribute an insurmountable ,obstacle to the ,cure--,of that ,iliac ,passion1 which is sometimes a ,consequence of ,ruptures1 ,i shall treat in another ,place4 ,of the ,cholera-morbus4 ,sec4 #cba4 ,this ,disease is a sudden1 abundant1 and painful ,evacuation by vomiting and by ,stool4 ,it begins with much ,flatulence1 or ,wind1 with ,swelling and slight ,pains in the ,belly1 accompanied with great ,dejection2 and followed with large ,evacuations either by ,stool or by ,vomit at first1 but whenever either of them has begun1 the other quickly follows4 ,the ,matter evacuated is either yellowish1 green1 brown1 whitish1 or black2 the ,pains in the ,belly violent2 the ,pulse1 almost constantly feverish1 is sometimes strong at first1 but soon sinks into ,weakness1 in ,consequence of the prodigious ,discharge4 ,some ,patients purge a hundred ,times in the ,compass of a few ,hours3 they may even be seen to fall away2 and if the ,disease exists in a violent ,degree1 they are scarcely to be known within three or four ,hours from the ,commencement of these ,discharges4 ,after a great ,number of them they are afflicted with ,spasms1 or ,cramps1 in their ,legs1 ,thighs1 and ,arms1 which torment them as much as the ,pains in the ,belly4 ,when the ,disease rages too highly to be asswaged1 ,hiccups1 ,convulsions and a ,coldness of the ,extremities approach2 there is a scarcely intermitting ,succession of fainting1 or swooning ,fits1 the ,patient dying either in one of them1 or in ,convulsions4 ,sec4 #cbb4 ,this ,disease1 which constantly depends on a ,bile raised to the highest ,acrimony1 commonly prevails towards the ,end of ,july and in ,august3 especially if the ,heats have been very violent1 and there have been little or no ,summer ,fruits1 which greatly conduce to attempt3 and allay the putrescent ,acrimony of the ,bile4 ,sec4 #cbc4 ,nevertheless1 however violent this ,distemper may be1 it is less dangerous1 and also less tormenting than the former1 many ,persons recovering from it4 #a1 ,our first ,endeavour should be to dilute1 or even to drown this acrid ,bile1 by ,draughts1 by ,deluges1 of the most mitigating ,drinks2 the irritation being so very great1 that every ,thing having the least ,sharpness is injurious4 ,wherefore the patient should continually take in1 by ,drink1 and by ,way of ,glyster1 either ,barley-,water1 ,almond-,milk1 or pure ,water1 with one eighth ,part ,milk1 which has succeeded very well in my ,practice4 ,or he may use a very light ,decoction1 or ,ptisan1 as it were1 of ,bread1 which is made by gently boiling a ,pound of toasted ,bread1 in three or four ,pots of ,water for half an ,hour4 ,in ,swisserland we prefer ,oat bread4 ,we also successfully use pounded ,rye1 making a light ,ptisan of it4 ,a very light thin ,soup made of a ,pullet1 a ,chicken1 or of one ,pound of lean ,veal1 in three ,pots of ,water1 is very proper too in this ,disease4 ,whey is also employed to good ,purpose2 and in those ,places1 where it can easily be had1 ,butter-milk is the best ,drink of any4 ,but1 whichever of these ,drinks shall be thought preferable1 it is a necessary ,point to drink very plentifully of it2 and the ,glysters should be given every two ,hours4 #b1 ,if the ,patient is of a robust ,constitution1 and sanguine ,complexion1 with a strong ,pulse at the ,time of the ,attack1 and the ,pains are very severe1 a first1 and in some ,cases1 a second ,bleeding1 very early in the ,invasion1 asswages the ,violence of the ,malady1 and allows more ,leisure for the ,assistance of other ,remedies4 ,i have seen the ,vomiting cease almost entirely1 after the first ,bleeding4 ,the ,rage of this ,disease abates a little after a ,duration of five or six ,hours3 we must not however1 during this ,remission or ,abatement1 forbear to throw in proper ,remedies2 since it returns soon after with great ,force1 which ,return however indicates no ,alteration of the ,method already entered upon4 #c1 ,in general the warm ,bath refreshes the ,patient while he continues in it2 but the ,pains frequently return soon after he is taken out1 which1 however1 is no ,reason for omitting it1 since it has frequently been found to give a more durable ,relief4 ,the ,patient should continue in it a considerable ,time1 and1 during that ,time1 he should take six or seven ,glasses of the ,potion ,no4 #cb1 which has been very efficacious in this ,disease4 ,by these ,means the ,vomiting has been stopt2 and the ,patient1 upon going out of the ,bath1 has had several large ,stools1 which very considerably diminished the ,violence of the ,disease4 #d1 ,if the ,patient's ,attendants are terrified by these great ,evacuations1 and determine to check them 7however prematurely7 by ,venice ,treacle1 ,mint ,water1 ,syrup of white ,poppies1 called ,diacodium1 by ,opium or ,mithridate1 it either happens1 that the ,disease and all its ,symptoms are heightened1 to which ,i have been a ,witness2 or1 if the ,evacuations should actually be stopt1 the ,patient1 in ,consequence of it1 is thrown into a more dangerous ,condition4 ,i have been obliged to give a ,purge1 in order to renew the ,discharges1 to a ,man1 who had been thrown into a violent ,fever1 attended with a raging ,delirium1 by a ,medicine composed of ,venice ,treacle1 ,mithridate and ,oil4 ,such ,medicines ought not to be employed1 until the ,smallness of the ,pulse1 great ,weakness1 violent and almost continual ,cramps1 and even the ,insufficience of the ,patient's ,efforts to vomit1 make us apprehensive of his sinking irrecoverably4 ,in such ,circumstances indeed he should take1 every ,quarter or half ,quarter of an ,hour1 a ,spoonful of the ,mixture ,no4 #ej1 still continuing the diluting ,drinks4 ,after the first ,hour1 they should only be given every ,hour1 and that only to the ,extent of eight ,doses4 ,but ,i desire to insist upon it here1 that this ,medicine should not be given too early in this ,distemper4 ,sec4 #cbd4 ,if the ,patient is likely to recover1 the ,pains and the ,evacuations gradually abate2 the ,thirst is less2 the ,pulse continues very quick1 but it becomes regular4 ,there have been ,instances of their ,propensity to a heavy kind of ,drowsiness at this ,time2 for perfect refreshing ,sleep advances but slowly after this ,disease4 ,it will still be proper to persevere in the ,medicines already directed1 though somewhat less frequently4 ,and now we may begin to allow the ,patient a few ,soups from farinaceous mealy ,substances2 and as soon as the ,evacuations accompanying this ,disease are evidently ceased1 and the ,pains are vanished2 though an acute ,sensibility and great ,weakness continues1 beside such ,soups1 he may be allowed some new-laid ,eggs1 very lightly boiled1 or even raw1 for some ,days4 ,after this he must be referred to the ,regimen so frequently recommended to ,persons in a ,state of ,recovery3 when the concurring ,use of the ,powder ,no4 #bd1 taken twice a ,day1 will greatly assist to hasten and to establish his ,health4 ,chapter ,,xxiii4 ,of a ,diarrhoea1 or ,looseness4 ,sect4 #cbe4 ,every one knows what is meant by a ,looseness or ,purging1 which the ,populace frequently call a ,flux1 and sometimes a ,cholic4 ,there are certain very chronical1 or tedious and obstinate ones1 which arise from some essential ,fault in the ,constitution4 ,of such1 as foreign to my ,plan1 ,i shall say nothing4 ,those which come on suddenly1 without any preceding ,disorder1 except sometimes a slight ,qualm or short ,loathing1 and a ,pain in the ,loins and ,knees2 which are not attended with smart ,pains nor a ,fever 7and frequently without any ,pain1 or any other ,complaint7 are oftener of ,service than prejudicial4 ,they carry off a ,heap of ,matter that may have been long amassed and corrupted in the ,body2 which1 if not discharged1 might have produced some ,distemper2 and1 far from weakening the ,body1 such ,purgings as these render it more strong1 light and active4 ,sec4 #cbf4 ,such therefore ought by no ,means to be stopped1 nor even speedily checked3 they generally cease of themselves1 as soon as all the noxious ,matter is discharged2 and as they require no ,medicine1 it is only necessary to retrench considerably from the ordinary ,quantity of ,nourishment2 to abstain from ,flesh1 ,eggs and ,wine or other strong ,drink2 to live only on some ,soups1 on ,pulse1 or on a little ,fruit1 whether raw or baked1 and to drink rather less than usual4 ,a simple ,ptisan with a little ,syrup of ,capillaire1 or ,maiden-hair1 is sufficient in these ,purgings1 which require no ,venice ,treacle1 ,confection1 nor any ,drug whatever4 ,sec4 #cbg4 ,but should it continue more than five or six ,days1 and manifestly weaken the ,patient2 if the ,pain attending it grows a little severe2 and especially if the ,irritation1 the urging to ,stool1 proves more frequent1 it becomes seasonable to check1 or to stop1 it4 ,for this ,purpose the ,patient is to be put into a ,regimen2 and if the ,looseness has been accompanied with a great ,loathing1 with ,risings or ,wamblings at ,stomach1 with a foul furred ,tongue1 and a bad ,taste in the ,mouth1 he must take the ,powder ,no4 #ce4 ,but if these ,symptoms do not appear1 give him that of ,no4 #ea3 and during the three following ,hours1 let him take1 every half ,hour1 a ,cup of weak light ,broth1 without any ,fat on it4 ,if the ,purging1 after being restrained by this ,medicine1 should return within a few ,days1 it would strongly infer1 there was still some tough viscid ,matter within1 that required ,evacuation4 ,to effect this he should take the ,medicines ,no4 #ba1 #be or #bg2 and afterwards take fasting1 for two successive ,mornings1 half the ,powder1 ,no4 #ea4 ,on the ,evening of that ,day when the ,patient took ,no4 #ce1 or ,no4 #ea1 or any other ,purge1 he may take a small ,dose of ,venice ,treacle4 ,sec4 #cbh4 ,a ,purging is often neglected for a long ,time1 without observing the least ,regimen1 from which ,neglect they degenerate into tedious and as it were habitual1 perpetual ones1 and entirely weaken the ,patient4 ,in such ,cases1 the ,medicine ,no4 #ce should be given first2 then1 every other ,day for four ,times successively1 he should take ,no4 #ea3 during all which ,time he should live on nothing but ,panada 7,see ,sec4 #eg7 or on ,rice boiled in weak ,chicken-broth4 ,a strengthing stomachic ,plaister has sometimes been successfully applied1 which may be often moistened in a ,decoction of ,herbs boiled in ,wine4 ,cold and ,moisture should be carefully avoided in these ,cases1 which frequently occasion immediate ,relapses1 even after the ,looseness had ceased for many ,days4 ,chapter ,,xxiv4 ,of the ,dysentery1 or ,bloody-flux4 ,sect4 #cbi4 ,the ,dysentery is a ,flux or ,looseness of the ,belly1 attended with great ,restlessness and ,anguish1 with severe ,gripings1 and frequent ,propensities to go to ,stool4 ,there is generally a little ,blood in the ,stools1 though this is not a constant ,symptom1 and is not essential to the ,existence of a ,dysentery2 notwithstanding it may not be much less dangerous1 for the ,absence of this ,symptom4 ,sec4 #ccj4 ,the ,dysentery is often epidemical2 beginning sometimes at the ,end of ,july1 though oftner in ,august1 and going off when the ,frosts set in4 ,the great preceding ,heats render the ,blood and the ,bile acrid or sharp2 and though1 during the ,continuance of the ,heat1 ,perspiration is kept up 7,see ,introduct4 ,p4 #bh7 yet as soon as the ,heat abates1 especially in the ,mornings and ,evenings1 that ,discharge is diminished2 and by how much the more ,viscidity or ,thickness the ,humours have acquired1 in ,consequence of the violent ,heats1 the ,discharge of the sharp ,humour by ,perspiration being now checked1 it is thrown upon the ,bowels which it irritates1 producing ,pains in1 and ,evacuations from them4 ,this ,kind of ,dysentery may happen at all ,times1 and in all ,countries2 but if other ,causes1 capable of producing a ,putridity of the ,humours1 be complicated with it2 such as the crouding up a great ,number of ,people into very little ,room1 and very close ,quarters1 as in ,hospitals1 ,camps1 or ,prisons1 this introduces a malignant ,principle into the ,humours1 which1 co-operating with the simpler ,cause of the ,dysentery1 renders it the more difficult and dangerous4 ,sec4 #cca4 ,this ,disease begins with a general ,coldness rather than a ,shivering1 which lasts some ,hours2 the ,patient's ,strength soon abates1 and he feels sharp ,pains in his ,belly1 which sometimes continue for several ,hours1 before the ,flux begins4 ,he is affected with ,vertigos1 or ,swimmings in the ,head1 with ,reachings to vomit1 and grows pale2 his ,pulse at the same ,time being very little1 if at all1 feverish1 but commonly small1 and at length the ,purging begins4 ,the first ,stools are often thin1 and yellowish2 but in a little ,time they are mixt with a viscid ropy ,matter1 which is often tinged with ,blood4 ,their ,colour and ,consistence are various too1 being either brown1 greenish or black1 thinner or thicker1 and foetid3 ,the ,pains increase before each of the ,discharges1 which grow very frequent1 to the ,number of eight1 ten1 twelve or fifteen in an ,hour3 then the ,fundament becomes considerably irritated1 and the ,tenesmus 7which is a great ,urgency to go to ,stool1 though without any ,effect7 is joined to the ,dysentery or ,flux1 and often brings on a ,protrusion or falling down of the ,fundament1 the ,patient being now most severely afflicted4 ,worms are sometimes voided1 and glairy hairy ,humours1 resembling ,pieces or ,peelings of ,guts1 and sometimes ,clots of ,blood4 ,if the ,distemper rises to a violent ,height1 the ,guts become inflamed1 which terminates either in ,suppuration or in ,mortification2 the miserable ,patient discharges ,pus1 or black and foetid watery ,stools3 the ,hiccup supervenes2 he grows delirious2 his ,pulse sinks2 and he falls into cold ,sweats and ,faintings which terminate in ,death4 ,a kind of ,phrenzy1 or raging ,delirium1 sometimes comes on before the ,minute of ,expiration4 ,i have seen a very unusual ,symptom accompany this ,disease in two ,persons1 which was an ,impossibility of swallowing1 for three ,days before ,death4 ,but in general this ,distemper is not so extremely violent2 the ,discharges are less frequent1 being from twenty-five to forty within a ,day and ,night4 ,their ,contents are less various and uncommon1 and mixed with very little ,blood2 the ,patient retains more ,strength2 the ,number of ,stools gradually decrease2 the ,blood disappears2 the ,consistence of the ,discharges improves2 ,sleep and ,appetite return1 and the ,sick recovers4 ,many of the ,sick have not the least ,degree of ,fever1 nor of ,thirst1 which perhaps is less common in this ,disease1 than in a simple ,purging or ,looseness4 ,their ,urine sometimes is but in a small ,quantity2 and many ,patients have ineffectual ,endeavours to pass it1 to their no small ,affliction and ,restlessness4 ,sec4 #ccb4 ,the most efficacious ,remedy for this ,disease is a ,vomit4 ,that of ,no4 #cd1 7when there is no present ,circumstance that forbids the giving a ,vomit7 if taken immediately on the first ,invasion of it1 often removes it at once2 and always shortens its ,duration4 ,that of ,no4 #ce is not less effectual2 it has been considered for a long ,time1 even as a certain ,specific1 which it is not1 though a very useful ,medicine4 ,if the ,stools prove less frequent after the ,operation of either of them1 it is a good ,sign2 if they are no ,ways diminished1 we may apprehend the ,disease is like to be tedious and obstinate4 ,the ,patient is to be ordered to a ,regimen1 abstaining from all ,flesh-meat with the strictest ,attention1 until the perfect ,cure of the ,disease4 ,the ,ptisan ,no4 #c is the best ,drink for him4 ,the ,day after the ,vomit1 he must take the ,powder ,no4 #ea divided into two ,doses3 the next ,day he should take no other ,medicine but his ,ptisan2 on the fourth the ,rhubarb must be repeated2 after which the ,violence of the ,disease commonly abates3 ,his ,diet during the ,disease is nevertheless to be continued exactly for some ,days2 after which he may be allowed to enter upon that of ,persons in a ,state of ,recovery4 ,sec4 #ccc4 ,the ,dysentery sometimes commences with an inflammatory ,fever2 a feverish1 hard1 full ,pulse1 with a violent ,pain in the ,head and ,loins1 and a stiff distended ,belly4 ,in such a ,case the ,patient must be bled once2 and daily receive three or even four of the ,glysters ,no4 #f1 drinking plentifully of the ,drink ,no4 #c4 ,when all ,dread of an ,inflammation is entirely over1 the ,patient is to be treated in the ,manner just related2 though often there is no ,necessity for the ,vomit3 and if the inflammatory ,symptoms have run high1 his first ,purge should be that of ,no4 #aa1 and the ,use of the ,rhubarb may be postponed1 till about the manifest ,conclusion of the ,disease4 ,i have cured many ,dysenteries1 by ordering the ,sick no other ,remedy1 but a ,cup of warm ,water every ,quarter of an ,hour2 and it were better to rely only on this simple ,remedy1 which must be of some ,utility1 than to employ those1 of whose ,effects ,country ,people are ignorant1 and which are often productive of very dangerous ones4 ,sec4 #ccd4 ,it sometimes happens that the ,dysentery is combined with a putrid ,fever1 which makes it necessary1 after the ,vomit1 to give the ,purges ,no4 #bc or #dg1 and several ,doses of ,no4 #bd1 before the ,rhubarb is given4 ,no4 #cb is excellent in this combined ,case4 ,there was in ,swisserland in the ,autumn of #agee1 after a very numerous ,prevalence of epidemical putrid ,fevers had ceased1 a ,multitude of ,dysenteries1 which had no small ,affinity with1 or ,relation to1 such ,fevers4 ,i treated them first1 with the ,prescription ,no4 #cd1 giving afterwards ,no4 #cb2 and ,i directed the ,rhubarb only to very few1 and that towards the ,conclusion of the ,disease4 ,by much the greater ,number of them were cured at the ,end of four or five ,days4 ,a small ,proportion of them1 to whom ,i could not give the ,vomit1 or whose ,cases were more complicated1 remained languid a considerable ,time1 though without ,fatality or ,danger4 ,sec4 #cce4 ,when the ,dysentery is blended with ,symptoms of ,malignity 7,see ,sec4 #bde7 after premising the ,prescription ,no4 #ce1 those of ,no4 #ch and #ci may be called in successfully4 ,sec4 #ccf4 ,when the ,disease has already been of many ,days standing1 without the ,patient's having taken any ,medicines1 or only such as were injurious to him1 he must be treated as if the ,distemper had but just commenced2 unless some ,symptoms1 foreign to the ,nature of the ,dysentery1 had supervened upon it4 ,sec4 #ccg4 ,relapses sometimes occur in ,dysenteries1 some few ,days after the ,patients appeared well2 much the greater ,number of which are occasioned either by some ,error in ,diet1 by cold ,air1 or by being considerably over-heated4 ,they are to be prevented by avoiding these ,causes of them2 and may be removed by putting the ,patient on his ,regimen1 and giving him one ,dose of the ,prescription ,no4 #ea4 ,should it return even without any such discoverable ,causes1 and if it manifests itself to be the same ,distemper renewed1 it must be treated as such4 ,sec4 #cch4 ,this ,disease is sometimes combined too with an intermitting ,fever2 in which ,case the ,dysentery must be removed first1 and the intermittent afterwards4 ,nevertheless if the ,access1 the ,fits of the ,fever have been very strong1 the ,bark must be given as directed ,sec4 #bei4 ,sec4 #cci4 ,one pernicious ,prejudice1 which still generally prevails is1 that ,fruits are noxious in a ,dysentery1 that they even give it1 and aggravate it2 and this perhaps is an extremely ill-grounded one4 ,in truth bad ,fruits1 and such as have not ripened well1 in unseasonable ,years1 may really occasion ,cholics1 a ,looseness 7though oftner a ,costiveness7 and ,disorders of the ,nerves1 and of the ,skin2 but never can occasion an epidemical ,dysentery or ,flux4 ,ripe ,fruits1 of whatever ,species1 and especially ,summer ,fruits1 are the real ,preservatives from this ,disease4 ,the greatest ,mischief they can effect1 must result from their thinning and washing down the ,humours1 especially the thick glutinous ,bile1 if they are in such a ,state2 good ripe ,fruits being the true ,dissolvents of such2 by which indeed they may bring on a ,purging1 but such a one1 as is rather a ,guard against a ,dysentery4 ,we had a great1 an extraordinary ,abundance of ,fruit in #agei and #agfj1 but scarcely any ,dysenteries4 ,it has been even observed to be more rare1 and less dangerous than formerly2 and if the ,fact is certain1 it cannot be attributed to any thing more probably1 than to the very numerous ,plantations of ,trees1 which have rendered ,fruit very plenty1 cheap and common4 ,whenever ,i have observed ,dysenteries to prevail1 ,i made it a ,rule to eat less ,flesh1 and ,plenty of ,fruit2 ,i have never had the slightest ,attack of one2 and several ,physicians use the same ,caution with the same ,success4 ,i have seen eleven ,patients in a ,dysentery in one ,house1 of whom nine were very tractable2 they eat ,fruit and recovered4 ,the ,grandmother and one ,child1 whom she loved more than the rest1 were carried off4 ,she managed the ,child after her own ,fashion1 with burnt ,wine1 ,oil1 and some ,spices1 but no ,fruit4 ,she conducted herself in the very same ,manner1 and both died4 ,in a ,country ,seat near ,berne1 in the ,year #agea1 when these ,fluxes made great ,havock1 and ,people were severely warned against the ,use of ,fruits1 out of eleven ,persons in the ,family1 ten eat plentifully of ,prunes1 and not one of them was seized with it3 ,the poor ,coachman alone rigidly observed that ,abstinence from ,fruit injoined by this ,prejudice1 and took a terrible ,dysentery4 ,this same ,distemper had nearly destroyed a ,swiss ,regiment in ,garrison in the ,south of ,france2 the ,captains purchased the whole ,crop of several ,acres of ,vineyard2 there they carried the sick ,soldiers1 and gathered the ,grapes for such as could not bear being carried into the ,vineyard2 those who were well eating nothing else3 after this not one more died1 nor were any more even attacked with the ,dysentery4 ,a ,clergyman was seized with a ,dysentery1 which was not in the least mitigated by any ,medicines he had taken4 ,by meer ,chance he saw some red ,currans2 he longed for them1 and eat three ,pounds of them between seven and nine o',clock in the ,morning2 that very ,day he became better1 and was entirely well on the next4 ,i could greatly enlarge the ,number of such ,instances2 but these may suffice to convince the most incredulous1 whom ,i thought it might be of some ,importance to convince4 ,far from forbidding good ,fruit1 when ,dysenteries rage1 the ,patients should be encouraged to eat them freely2 and the ,directors of the ,police1 instead of prohibiting them1 ought to see the ,markets well provided with them4 ,it is a ,fact of which ,persons1 who have carefully informed themselves1 do not in the least doubt4 ,experience demonstrates it1 and it is founded in ,reason1 as good ,fruit counter-operates all the ,causes of ,dysenteries4 #gg #gg ,the ,experience of all ,countries and ,times so strongly confirms these important ,truths1 that they cannot be too often repeated1 too generally published1 whenever and wherever this ,disease rages4 ,the ,succession of cold ,showers to violent ,heats2 too moist a ,constitution of the ,air2 an ,excess of animal ,food2 ,uncleanliness and ,contagion1 are the frequent ,causes of epidemical ,fluxes4 ,e4 ,l4 ,i have retained the preceding ,note1 abridged from this ,gentleman1 as it contains the ,suffrage of another experienced ,physician1 against that ,prejudice of ripe ,fruits occasioning ,fluxes1 which is too popular among ourselves1 and probably more so in the ,country than in ,london4 ,i have been also very credibly assured1 that the ,son of a learned ,physician was perfectly cured of a very obstinate ,purging1 of a ,year's ,continuance 7in ,spite of all the usual officinal ,remedies7 by his devouring large ,quantities of ripe ,mulberries1 for which he ardently longed1 and drinking very freely of their expressed ,juice4 ,the ,fact occurred after his ,father's ,decease1 and was affirmed to me by a ,gentleman intimately acquainted with them both4 ,k4 ,sec4 #cdj4 ,it is important and even necessary1 that each ,subject of this ,disease should have a ,close-stool or ,convenience apart to himself1 as the ,matter discharged is extremely infectious3 and if they make ,use of ,bed-pans1 they should be carried immediately out of the ,chamber1 the ,air of which should be continually renewed1 burning ,vinegar frequently in it4 ,it is also very necessary to change the ,patient's ,linen frequently2 without all which ,precautions the ,distemper becomes more violent1 and attacks others who live in the same ,house4 ,hence it is greatly to be wished the ,people in general were convinced of these ,truths4 ,it was ,boerhaave's ,opinion1 that all the ,water which was drank1 while ,dysenteries were epidemical1 should be stummed1 as we term it1 or sulphurized4 #gh #gh ,our learned ,author1 or his medical ,editor at ,lyons1 observes here1 'that in the ,edition of this ,treatise at ,paris1 there was an essential ,mistake1 by making ,boerhaave recommend the ,addition of ,brandy1 ,eau de vie1 instead of stumming or sulphurizing it1' for which this ,note1 and the ,text too use the ,verb branter1 which ,word we do not find in any ,dictionary4 ,we are told however1 it means to impregnate the ,casks in which the ,water is reserved1 with the ,vapour of ,sulphur1 and then stopping them2 in the same ,manner that ,vessels are in some ,countries1 for the keeping of ,wine4 ,he observes the ,purpose of this is to oppose ,corruption by the acid ,steams of the ,sulphur4 ,k4 ,sec4 #cda4 ,it has happened1 by some unaccountable ,fatality1 that there is no ,disease1 for which a greater ,number of ,remedies are advised1 than for the ,dysentery4 ,there is scarcely any ,person but what boasts of his own ,prescription1 in ,preference to all the rest1 and who does not boldly engage to cure1 and that within a few ,hours1 a tedious severe ,disease1 of which he has formed no just ,notion1 with some ,medicine or ,composition1 of whose ,operation he is totally ignorant3 while the poor ,sufferer1 restless and impatient1 swallows every ,body's ,recommendation1 and gets poisoned either through ,fear1 downright ,disgust or ,weariness1 or through entire ,complaisance4 ,of these many boasted ,compositions1 some are only indifferent1 but others pernicious4 ,i shall not pretend to detail all ,i know myself1 but after repeatedly affirming1 that the only true ,method of ,cure is that ,i have advised here1 the ,purpose of which is evacuating the offending ,matter2 ,i also affirm that all those ,methods1 which have a different ,scope or ,drift1 are pernicious2 but shall particularly observe1 that the ,method most generally followed1 which is that of stopping the ,stools by ,astringents1 or by ,opiates1 is the worst of all1 and even so mortal a one1 as to destroy a ,multitude of ,people annually1 and which throws others into incurable ,diseases4 ,by preventing the ,discharge of these ,stools1 and inclosing the ,wolf in the ,fold1 it either follows1 #a1 that this #gi retained ,matter irritates and inflames the ,bowels from which ,inflammation excruciating ,pains arise1 an acute inflammatory ,cholic1 and finally a ,mortification and ,death2 or a ,schirrhus1 which degenerates into a ,cancer1 7of which ,i have seen a dreadful ,instance7 or else an ,abscess1 ,suppuration and ,ulcer4 ,or #b1 this arrested ,humour is repelled elsewhere1 producing a ,scirrhus in the ,liver1 or ,asthmas1 ,apoplexy1 ,epilepsy1 or ,falling ,sickness2 horrible rheumatic ,pains1 or incurable ,disorders of the ,eyes1 or of the ,teguments1 the ,skin and ,surface4 #gi ,a first or second ,dose of ,glauber ,salt has been known to succeed in the epidemical ,summer ,fluxes of the hotter ,climates1 when repeated ,doses of ,rhubarb and ,opiates had failed4 ,such ,instances seems a collateral ,confirmation of ,dr4 ,tissot's rational and successful ,use of cooling opening ,fruits in them4 ,k4 ,such are the ,consequences of all the astringent ,medicines1 and of those which are given to procure ,sleep in this ,disease1 as ,venice ,treacle1 ,mithridate and ,diascordium1 when given too early in ,dysenteries4 ,i have been consulted on ,account of a terrible ,rheumatism1 which ensued immediately after taking a ,mixture of ,venice ,treacle and ,plantain1 on the second ,day of a ,dysentery4 ,as those who advise such ,medicines1 are certainly unaware of their ,consequences1 ,i hope this ,account of them will be sufficient1 to prevent their ,repetition4 ,sec4 #cdb4 ,neither are ,purges without their ,abuse and ,danger2 they determine the ,course of all the ,humours more violently to the tender afflicted ,parts2 the ,body becomes exhausted2 the ,digestions fail2 the ,bowels are weakened1 and sometimes even lightly ulcerated1 whence incurable ,diarrhoeas or ,purgings ensue1 and prove fatal after many ,years ,affliction4 ,sec4 #cdc4 ,if the ,evacuations prove excessive1 and the ,distemper tedious1 the ,patient is likely to fall into a ,dropsy2 but if this is immediately opposed1 it may be removed by a regular and drying ,diet1 by ,strengthners1 by ,friction and proper ,exercise4 ,chapter ,,xxv4 ,of the ,itch4 ,sect4 #cdd4 ,the ,itch is an infectious ,disorder contracted by touching infected ,persons or ,cloaths1 but not imbibed from the ,air3 ,so that by carefully avoiding the ,medium1 or ,means of ,contagion1 the ,disorder may be certainly escaped4 ,though any ,part of the ,body may be infested with the ,itch1 it commonly shews itself on the ,hands1 and chiefly between the ,fingers4 ,at first one or two little ,pimples or ,pustules appear1 filled with a kind of clear ,water1 and excite a very disagreeable ,itching4 ,if these ,pustules are broke by scratching them1 the ,water oozing from them infects the neighbouring ,parts4 ,at the ,beginning of this ,infection it can scarcely be distinguished1 if a ,person is not well apprized of its ,nature2 but in the ,progress of it1 the little ,pustules increase both in ,number and ,size2 and when they are opened by scratching1 a loathsome kind of ,scab is formed1 and the ,malady extends over the whole ,surface4 ,where they continue long1 they produce small ,ulcers1 and are at that ,time highly contagious4 ,sec4 #cde4 ,bad ,diet1 particularly the ,use of ,salt ,meat1 bad unripe ,fruit1 and ,uncleanliness occasion this ,disease2 though it is oftnest taken by ,contagion4 ,some very good ,physicians suppose it is never contracted otherwise2 but ,i must take ,leave to dissent1 as ,i have certainly seen it exist without ,contagion4 ,when it happens to a ,person1 who cannot suspect he has received it by ,contact1 his ,cure should commence with a total ,abstinence from all ,salt1 sour1 fat and spicy ,food4 ,he should drink a ,ptisan of wild and bitter ,succory1 or that of ,no4 #bf1 five or six ,glasses of which may be daily taken2 at the ,end of four or five ,days1 he may be purged with ,no4 #ba1 or with an ,ounce of ,sedlitz or ,epsom ,salt4 ,his ,abstinence1 his ,regimen is to be continued2 the ,purge to be repeated after six or seven ,days2 and then all the ,parts affected1 and those very near them1 are to be rubbed in the ,morning fasting1 with a fourth ,part of the ,ointment ,no4 #eb4 ,the three following ,days the same ,friction is to be repeated1 after which the same ,quantity of ,ointment is to be procured1 and used in the same ,proportion2 but only every other ,day4 ,it happens but seldom that this ,method fails to remove this disagreeable ,malady2 sometimes however it will return1 in which ,case1 the ,patient must be purged again1 and then recur to the ,ointment1 whose good ,effects ,i have experienced1 and continually do4 ,if the ,disease has been very lately contracted1 and most certainly by ,contact1 the ,ointment may be fearlessly employed1 as soon as it is discovered1 without taking any ,purge before it4 ,but if1 on the contrary1 the ,disease has been long neglected1 and has rose to a high ,degree1 it will be necessary to restrain the ,patient a long ,time to the ,regimen ,i have directed2 he must be repeatedly purged1 and then drink plentifully of the ,ptisan ,no4 #bf1 before the ,ointment is rubbed in4 ,when the ,malady is thus circumstanced1 ,i have always begun with the ,ointment ,no4 #bh1 half a ,quarter of which is to be used every ,morning4 ,i have also frequently omitted the ,use of that ,no4 #eb1 having always found the former as certain1 but a little slower in its ,effects4 ,sec4 #cdf4 ,while these ,medicines are employed1 the ,patient must avoid all ,cold and ,wet1 especially if he makes ,use of ,no4 #bh1 #hj in which there is ,quick-silver2 which1 if such ,precautions were neglected1 might bring on a ,swelling of the ,throat and ,gums1 and even rise to a ,salivation4 ,yet this ,ointment has one ,advantage in its having no ,smell1 and being susceptible of an agreeable one2 while it is very difficult to disguise the disagreeable ,odour of the other4 ,the ,linen of a ,person in this ,disease ought to be often changed2 but his upper ,cloaths must not be changed3 because these having been infected1 might1 when worn again1 communicate the ,itch to the ,wearer again1 after he had been cured4 ,shirts1 ,breeches and ,stockings may be fumigated with ,sulphur1 before they are put on2 and this ,fumigation should be made in the open ,air4 #hj ,i have seen a pretty singular ,consequence from the ,abuse of mercurial ,unction for the ,itch2 whether it happened from the ,strength or ,quantity of the ,ointment1 or from taking ,cold after applying it1 as this ,subject1 a healthy ,youth of about sixteen1 probably did1 by riding three or four ,miles through the ,rain4 ,but without any other previous ,complaint1 he awoke quite blind one ,morning1 wondering1 as he said1 when it would be ,day4 ,his ,eyes were very clear1 and free from ,inflammation1 but the ,pupil was wholly immoveable1 as in a ,gutta serena4 ,i effected the ,cure by some moderate ,purges repeated a few ,times2 by disposing him to sweat by lying pretty much in ,bed 7it being towards ,winter7 and by promoting his ,perspiration1 chiefly with ,sulphur3 after which the shaved ,scalp was embrocated with a warm nervous ,mixture1 in which ,balsam of ,peru was a considerable ,ingredient4 ,in something less than three ,weeks he could discern a glowing ,fire1 or the bright ,flame of a ,candle4 ,as his ,sight increased1 he discerned other ,objects1 which appeared for some ,days inverted to him1 with their ,colours confused2 but ,red was most distinguishable4 ,he discovered the ,aces sooner than other ,cards2 and in about six or seven ,weeks recovered his full ,sight in all its natural ,strength1 which he now enjoys4 ,k4 ,sec4 #cdg4 ,if this ,disorder becomes very inveterate and tedious1 it exhausts the ,patient1 in ,consequence of its not suffering him to sleep at ,nights1 as well as by his restless ,irritation2 and sometimes even brings on a ,fever1 so that he falls away in ,flesh1 and his ,strength abates4 ,in such a ,case he must take1 #a1 a gentle ,purge4 #b1 ,make ,use frequently of warm ,baths4 #c1 ,he must be put on the ,regimen of ,persons in a ,state of ,recovery4 #d1 ,he must take ,morning and ,evening1 fifteen ,days successively1 the ,powder ,no4 #ec1 with the ,ptisan ,no4 #bf4 ,this ,malady is often very obstinate1 and then the ,medicines must be varied according to the ,circumstances1 the ,detail of which ,i avoid here4 ,sec4 #cdh4 ,after giving repeated ,purges in such obstinate ,cases1 mineral ,waters abounding with ,sulphur1 such as #ha those of ,yverdun1 c4 often effect a ,cure2 and simple cold ,bathings in ,rivers or ,lakes have sometimes succeeded in very inveterate ,cases of this ,disorder4 #ha ,sea water1 and those of ,dulwich1 ,harrigate1 ,shadwell1 c4 will be full as effectual4 ,k4 ,nothing conduces more to the long ,continuance of this ,malady1 than the ,abuse of hot ,waters1 such as infusions of ,tea1 c4 ,sec4 #cdi4 ,i shall conclude this ,chapter1 with a repeated ,injunction not to be too free or rash in the ,use of the ,ointment ,no4 #eb1 and other outward ,remedies for extinguishing the ,itch4 ,there is hardly any ,complaint1 but what has been found to be the ,consequence of too sudden a ,removal of this ,disorder by outward ,applications1 before due ,evacuations have been made1 and a moderate ,abatement of the ,sharpness of the ,humours has been effected4 ,chapter ,,xxvi4 ,the ,treatment of ,diseases peculiar to ,women4 ,sect4 #cej4 ,besides all the preceding ,diseases1 to which ,women are liable in common with ,men1 their ,sex also exposes them to others peculiar to it1 and which depend upon four principal ,sources2 which are their monthly ,discharges1 their ,pregnancy1 their ,labours in ,child-birth1 and the ,consequences of their ,labours4 ,it is not my present ,design to treat professedly on each of the ,diseases arising from these ,causes1 which would require a larger ,volume than ,i have proposed2 but ,i shall confine myself to certain general ,directions on these four ,heads4 ,sec4 #cea4 ,nature1 who intended ,women for the ,increase1 and the ,nourishment of the human ,race at the ,breast1 has subjected them to a periodical ,efflux1 or ,discharge1 of ,blood3 which ,circumstance constitutes the ,source1 from whence the ,infant is afterwards to receive his ,nutrition and ,growth4 ,this ,discharge generally commences1 with us1 between the ,age of sixteen and eighteen4 ,young ,maidens1 before the ,appearance of this ,discharge1 are frequently1 and many for a long ,time1 in a ,state of ,weakness1 attended with various ,complaints1 which is termed the ,chlorosis1 or ,green ,sickness1 and ,obstructions3 and when their ,appearance is extremely slow and backward1 it occasions very grievous1 and sometimes even mortal ,diseases4 ,nevertheless it is too usual1 though very improper1 to ascribe all the ,evils1 to which they are subject at this ,term of ,life1 solely to this ,cause2 while they really often result from a different ,cause1 of which the ,obstructions themselves are sometimes only the ,effect2 and this is the natural1 and1 in some ,degree1 even necessary ,feebleness of the ,sex4 ,the ,fibres of ,women which are intended to be relaxed1 and to give ,way1 when they are unavoidably extended by the ,growth of the ,child1 and its inclosing ,membranes 7which frequently arise to a very considerable ,size7 should necessarily be less stiff and rigid1 less strong1 and more lax and yielding than the ,fibres of ,men4 ,hence the ,circulation of their ,blood is more slow and languid than in ,males2 their ,blood is less compact and dense1 and more watery2 their ,fluids are more liable to stagnate in their different ,bowels1 and to form ,infarctions and ,obstructions4 ,sec4 #ceb4 ,the ,disorders to which such a ,constitution subjects them might1 in some ,measure1 be prevented1 by assisting that ,languor or ,feebleness of their natural ,movements1 by such an ,increase of their ,force1 as ,exercise might contribute to3 ,but this ,assistance1 which in some ,manner is more necessary for ,females than ,males1 they are partly deprived of1 by the general ,education and ,habitude of the ,sex2 as they are usually employed in managing ,household ,business1 and such light sedentary ,work1 as afford them less ,exercise and ,motion1 than the more active ,occupations of ,men4 ,they stir about but little1 whence their natural ,tendency to ,weakness increases from ,habit1 and thence becomes morbid and sickly4 ,their ,blood circulates imperfectly2 its ,qualities become impaired2 the ,humours tend to a pretty general ,stagnation2 and none of the vital ,functions are completely discharged4 ,from such ,causes and ,circumstances they begin to sink into a ,state of ,weakness1 sometimes while they are very young1 and many ,years before this periodical ,discharge could be expected4 ,this ,state of ,languor disposes them to be inactive2 a little ,exercise soon fatigues them1 whence they take none at all4 ,it might prove a ,remedy1 and even effect a ,cure1 at the ,beginning of their ,complaint2 but as it is a ,remedy1 that is painful and disagreeable to them1 they reject it1 and thus increase their ,disorders4 ,their ,appetite declines with the other vital ,functions1 and gradually becomes still less2 the usual salutary ,kinds of ,food never exciting it2 instead of which they indulge themselves in whimsical ,cravings1 and often of the oddest and most improper ,substances for ,nutrition1 which entirely impair the ,stomach with its digestive ,functions1 and consequently ,health itself4 ,but sometimes after the ,duration of this ,state for a few ,years1 the ordinary ,time of their monthly ,evacuations approaches1 which however make not the least ,appearance1 for two ,reasons4 ,the first is1 that their ,health is too much impaired to accomplish this new ,function1 at a ,time when all the others are so languid3 and the second is1 that under such ,circumstances1 the ,evacuations themselves are unnecessary2 since their final ,purpose is to discharge 7when the ,sex are not pregnant7 that superfluous ,blood1 which they were intended to produce1 and whose ,retention would be unhealthy1 when not applied to the ,growth of the ,foetus1 or ,nourishment of the ,child3 and this ,superfluity of ,blood does not exist in ,women1 who have been long in a very low and languishing ,state4 ,sec4 #cec4 ,their ,disorder however continues to increase1 as every one daily must1 which does not terminate4 ,this ,increase of it is attributed to the ,suppression or ,non-appearance of their monthly ,efflux1 which is often erroneous2 since the ,disorder is not always owing to that ,suppression1 which is often the ,effect of their ,distemperature4 ,this is so true1 that even when the ,efflux happens1 if their ,weakness still continues1 the ,patients are far from being the better for it1 but the reverse4 ,neither is it unusual to see young ,lads1 who have received from ,nature1 and from their ,parents1 a sort of feminine ,constitution1 ,education and ,habitude1 infested with much the same ,symptoms1 as obstructed young ,women4 ,country ,girls1 who are generally more accustomed to such hardy ,work and ,exercise as ,country ,men1 are less subject to these ,complaints1 than ,women who live in ,cities4 ,sec4 #ced4 ,let ,people then be careful not to deceive themselves on this important ,account2 since all the ,complaints of young ,maidens are not owing to the ,want of their ,customs4 ,nevertheless it is certain there are some of them1 who are really afflicted from this ,cause4 ,for ,instance1 when a strong young ,virgin in full ,health1 who is nearly arrived to her full ,growth1 and who manifestly abounds with ,blood1 does not obtain this ,discharge at the usual ,time of ,life1 then indeed this superfluous ,blood is the ,fountain of very many ,disorders1 and greatly more violent ones than those1 which result from the contrary ,causes already mentioned4 ,if the lazy inactive ,city ,girls are more subject to the ,obstructions1 which either arise from the ,weakness and ,languor ,i have formerly taken ,notice of1 or which accompany it2 ,country ,girls are more subject to ,complaints from this latter ,cause 7too great a ,retention of superfluous ,blood7 than ,women who live in ,cities3 and it is this last ,cause that excites those singular ,disorders1 which appear so supernatural to the common ,people1 that they ascribe them to ,sorcery4 ,sec4 #cee4 ,and even after these periodical ,discharges have appeared1 it is known that they have often been suppressed1 without the least unhealthy ,consequence resulting from that ,suppression4 ,they are often suppressed1 in the ,circumstances mentioned ,sec4 #cea1 by a ,continuance of the ,disease1 which was first an ,obstacle or ,retardment to their ,appearance2 and in other ,cases1 they have been suppressed by other ,causes1 such as ,cold1 ,moisture1 violent ,fear1 any very strong ,passion2 by too chilly a ,course of ,diet1 with ,indigestion2 or too hot and irritating ,diet2 by ,drinks cooled with ,ice1 by ,exercise too long continued1 and by unusual ,watching4 ,the ,symptoms1 occasioned by such ,suppressions1 are sometimes more violent than those1 which preceded the first ,appearance of the ,discharge4 ,sec4 #cef4 ,the great ,facility with which this ,evacuation may be suppressed1 diminished1 or disordered1 by the ,causes already assigned2 the terrible ,evils which are the ,consequences of such ,interruptions and ,irregularities of them1 seem to me very cogent ,reasons to engage the ,sex to use all possible ,care1 in every ,respect1 to preserve the ,regularity of them2 by avoiding1 during their ,approach and ,continuance1 every ,cause that may prevent or lessen them4 ,would they be thoroughly persuaded1 not solely by my ,advice1 but by that of their ,mothers1 their ,relations1 their ,friends1 and by their own ,experience1 of what great ,importance it is to be very attentive to themselves1 at those critical ,times1 ,i think there is not one ,woman1 who from the first1 to the very last ,appearance of them1 would not conduct herself with the most scrupulous ,regularity4 ,their ,demeanour1 in these ,circumstances1 very fundamentally interests their own ,health1 as well as that of their ,children2 and consequently their own ,happiness1 as well as that of their ,husbands and ,families4 ,the younger and more delicate they are1 ,caution becomes the more necessary for them4 ,i am very sensible a strong ,country ,girl is too negligent in regulating herself at those critical ,seasons1 and sometimes without any ill ,consequence2 but at another ,time she may suffer severely for it3 and ,i could produce a long ,list of many1 who1 by their ,imprudence on such ,occasions1 have thrown themselves into the most terrible ,condition4 ,besides the ,caution with which ,females should avoid these general ,causes1 just mentioned in the preceding ,section1 every ,person ought to remember what has most particularly disagreed with her during that ,term1 and for ever constantly to reject it4 ,sec4 #ceg4 ,there are many ,women whose ,customs visit them without the slightest ,impeachment of their ,health3 others are sensibly disordered on every ,return of them2 and to others again they are very tormenting1 by the violent ,cholics1 of a longer or a shorter ,duration1 which precede or accompany them4 ,i have known some of these violent ,attacks last but some ,minutes1 and others which continued a few ,hours4 ,nay some indeed have persisted for many ,days1 attended with ,vomiting1 ,fainting1 with ,convulsions from excessive ,pain1 with ,vomiting of ,blood1 ,bleedings from the ,nose1 c4 which1 in short1 have brought them to the very ,jaws of ,death4 ,so very dangerous a ,situation requires the closest ,attention2 though1 as it results from several and frequently very opposite ,causes1 it is impossible within the present ,plan1 to direct the ,treatment that may be proper for each ,individual4 ,some ,women have the ,unhappiness to be subject to these ,symptoms every ,month1 from the first ,appearance1 to the final ,termination1 of these ,discharges2 except proper ,remedies and ,regimen1 and sometimes a happy ,child-birth1 remove them4 ,others complain but now and then1 every second1 third1 or fourth ,month2 and there are some again1 who having suffered very severely during the first ,months1 or ,years1 after their first ,eruptions1 suffer no more afterwards4 ,a fourth ,number1 after having had their ,customs for a long ,time1 without the least ,complaint1 find themselves afflicted with cruel ,pains1 at every ,return of them2 if by ,imprudence1 or some inevitable ,fatality1 they have incurred any ,cause1 that has suppressed1 diminished1 or delayed them4 ,this ,consideration ought to suggest a proper ,caution even to such1 as generally undergo these ,discharges1 without ,pain or ,complaint3 since all may be assured1 that though they suffer no sensible ,disorder at that ,time1 they are nevertheless more delicate1 more impressible by extraneous ,substances1 more easily affected by the ,passions of the ,mind1 and have also weaker ,stomachs at these particular ,periods4 ,sec4 #ceh4 ,these ,discharges may also be sometimes too profuse in ,quantity1 in which ,case the ,patients become obnoxious to very grievous ,maladies2 into the ,discussion of which however ,i shall not enter here1 as they are much less frequent than those1 arising from a ,suppression of them4 ,besides which1 in such ,cases1 ,recourse may be had to the ,directions ,i shall give hereafter1 when ,i treat of that ,loss of ,blood1 which may be expedient1 during the ,course of ,gravidation or ,pregnancy4 ,see ,sec4 #cfe4 ,sec4 #cei4 ,finally1 even when they are the most regular1 after their ,continuance for a pretty certain ,number of ,years 7rarely exceeding thirty-five7 they go off of their own ,accord1 and necessarily1 between the ,age of forty-five and fifty2 sometimes even sooner1 but seldom continuing longer3 and this ,crisis of their ceasing is generally a very troublesome1 and often a very dangerous1 one for the ,sex4 ,sec4 #cfj4 ,the ,evils mentioned ,sec4 #ceb may be prevented1 by avoiding the ,causes producing them2 and1 #a1 by obliging young ,maidens to use considerable ,exercise2 especially as soon as there is the least ,reason to suspect the ,approach of this ,disorder1 the ,chlorosis1 or ,green ,sickness4 #b1 ,by watching them carefully1 that they eat nothing unwholesome or improper2 as there are scarcely any natural ,substances1 even among such as are most improper for them1 and the most distasteful1 which have not sometimes been the ,objects of their sickly1 their unaccountable ,cravings4 ,fat ,aliments1 ,pastry1 farinaceous or mealy1 and sour and watery ,foods are pernicious to them4 ,herb-,teas1 which are frequently directed as a ,medicine for them1 are sufficient to throw them into the ,disorder1 by increasing that ,relaxation of their ,fibres1 which is a principal ,cause of it4 ,if they must drink any such ,infusions1 as medicated ,drinks1 let them be taken cold3 but the best ,drink for them is ,water1 in which red hot ,iron has been extinguished4 #c1 ,they must avoid hot sharp ,medicines1 and such as are solely intended to force down their ,terms1 which are frequently attended with very pernicious ,consequences1 and never do any good3 and they are still the more hurtful1 as the ,patient is the younger4 #d1 ,if the ,malady increases1 it will be necessary to give them some ,remedies2 but these should not be ,purges1 nor consist of ,diluters1 and ,decoctions of ,herbs1 of ,salts1 and a ,heap of other useless and noxious ,ingredients2 but they should take ,filings of ,iron1 which is the most certain ,remedy in such ,cases4 ,these ,filings ,should be of true simple ,iron1 and not from ,steel2 and ,care should be taken that it be not rusty1 in which ,state it has very little ,effect4 ,at the ,beginning of this ,distemper1 and to young ,girls1 it is sufficient to give twenty ,grains daily1 enjoining due ,exercise and a suitable ,diet4 ,when it prevails in a severer ,degree1 and the ,patient is not so young1 a ,quarter of an ,ounce may be safely ventured on3 ,certain ,bitters or ,aromatics may be advantageously joined to the ,filings1 which are numbered in the ,appendix1 #ed1 #ee1 #ef1 and constitute the most effectual ,remedies in this ,distemper1 to be taken in the ,form of ,powder1 of vinous ,infusion1 or of ,electary4 #hb ,when there is a just ,indication to bring down the ,discharge1 the vinous ,infusion ,no4 #ee must be given1 and generally succeeds3 but ,i must again repeat it 7as it should carefully be considered7 that the ,stoppage or ,obstruction of this ,discharge is frequently the ,effect1 not the ,cause1 of this ,disease2 and that there should be no ,attempt to force it down1 which in such a ,case1 may sometimes prove more hurtful than beneficial2 since it would naturally return of its own ,accord1 on the ,recovery1 and with the ,strength1 of the ,patient3 as their ,return should follow that of perfect ,health1 and neither can precede ,health1 nor introduce it4 ,there are some ,cases particularly1 in which it would be highly dangerous to use hot and active ,medicines1 such ,cases for ,instance1 as are attended with some ,degree of ,fever1 a frequent ,coughing1 a ,haemorrhage1 or ,bleeding1 with great ,leanness and considerable ,thirst3 all which ,complaints should be removed1 before any hot ,medicines are given to force this ,evacuation1 which many very ignorantly imagine cures all other female ,disorders2 an ,error1 that has prematurely occasioned the ,loss of many ,womens' ,lives4 #hb ,the ,french ,word here1 ,opiat1 is sometimes used by them for a compound ,medicine of the ,consistence of an ,electary2 and cannot be supposed1 in this ,place1 to mean any ,preparation1 into which ,opium enters4 ,k4 ,sec4 #cfa4 ,while the ,patient is under a ,course of these ,medicines1 she should not take any of those ,i have forbidden in the preceding ,sections2 and the ,efficacy of these should also be furthered with proper ,exercise4 ,that in a ,carriage is very healthy2 ,dancing is so too1 provided it be not extended to an ,excess4 ,in ,case of a ,relapse in these ,disorders1 the ,patient is to be treated1 as if it were an original ,attack4 ,sec4 #cfb4 ,the other ,sort of ,obstructions described ,sec4 #ced requires a very different ,treatment4 ,bleeding1 which is hurtful in the former ,sort1 and the ,use1 or rather ,abuse1 of which has thrown several young ,women into irrecoverable ,weaknesses1 has often removed this latter ,species1 as it were1 in a ,moment4 ,bathing of the ,feet1 the ,powders ,no4 #bj1 and ,whey have frequently succeeded3 but at other ,times it is necessary to accommodate the ,remedies and the ,method to each particular ,case1 and to judge of it from its own peculiar ,circumstances and ,appearances4 ,sec4 #cfc4 ,when these ,evacuations naturally cease through ,age 7,see ,sec4 #cei7 if they stop suddenly and all at once1 and had formerly flowed very largely1 ,bleeding must1 #a1 necessarily be directed1 and repeated every six1 every four1 or even every three ,months4 #b1 ,the usual ,quantity of ,food should be somewhat diminished1 especially of ,flesh1 of ,eggs and of strong ,drink4 #c1 ,exercise should be increased4 #d1 ,the ,patient should frequently take1 in a ,morning fasting1 the ,powder ,no4 #bd1 which is very beneficial in such ,cases2 as it moderately increases the natural ,excretions by ,stool1 ,urine and ,perspiration2 and thence lessens that ,quantity of ,blood1 which would otherwise superabound4 ,nevertheless1 should this total ,cessation of the monthly ,discharge be preceded by1 or attended with1 any extraordinary ,loss of ,blood1 which is frequently the ,case1 ,bleeding is not so necessary2 but the ,regimen and ,powder just directed are very much so2 to which the ,purge ,no4 #bc should now and then be joined1 at moderate ,intervals4 ,the ,use of astringent ,medicines at this critical ,time might dispose the ,patient to a ,cancer of the ,womb4 ,many ,women die about this ,age1 as it is but too easy a ,matter to injure them then2 a ,circumstance that should make them very cautious and prudent in the ,medicines they recur to4 ,on the other ,hand it also frequently happens1 that their ,constitutions alter for the better1 after this critical ,time of ,life2 their ,fibres grow stronger2 they find themselves sensibly more hearty and hardy2 many former slight ,infirmities disappear1 and they enjoy a healthy and happy old ,age4 ,i have known several who threw away their ,spectacles at the ,age of fifty-two1 or fifty-three1 which they had used five or six ,years before4 ,the ,regimen ,i have just directed1 the ,powder ,no4 #bd1 and the ,potion ,no4 #cb1 agree very well in almost all inveterate ,discharges 7,i speak of the female ,peasantry7 at whatever ,time of ,life4 ,of ,disorders attending ,gravidation1 or the ,term of going with ,child4 ,sec4 #cfd4 ,gravidation is generally a less ailing or unhealthy ,state in the ,country1 than in very populous ,towns4 ,nevertheless ,country ,women are subject1 as well as ,citizens1 to ,pains of the ,stomach1 to vomiting in a ,morning1 to ,head-ach and ,tooth-ach2 but these ,complaints very commonly yield to ,bleeding1 which is almost the only ,remedy necessary #hc for pregnant ,women4 #hc ,too great a ,fulness of ,blood is undoubtedly the ,cause of all these ,complaints2 but as there are different ,methods of opposing this ,cause1 the gentlest should always be preferred2 nor should the ,constitution become habituated to such ,remedies1 as might either impair the ,strength of the ,mother1 or of her ,fruit4 ,some ,expedients therefore should be thought of1 that may compensate for the ,want of ,bleeding1 by enjoining proper ,exercise in a clear ,air1 with a less nourishing1 and a less juicy ,diet4 ,e4 ,l4 ,this ,note might have its ,use sometimes1 in the ,cases of such delicate and hysterical1 yet pregnant ,women1 as are apt to suffer from ,bleeding1 or any other ,evacuation1 though no ways immoderate4 ,but it should have been considered1 that ,dr4 ,tissot was professedly writing here to hearty active ,country ,wives1 who are very rarely thus constituted2 and whom he might be unwilling to confuse with such multiplied ,distinctions and ,directions1 as would very seldom be necessary1 and might sometimes prevent them from doing what was so4 ,besides which1 this ,editor might have seen1 our ,author has hinted at such ,cases very soon after4 ,k4 ,sec4 #cfe4 ,sometimes after carrying too heavy ,burthens2 after too much or too violent ,work2 after receiving excessive ,jolts1 or having had a ,fall1 they are subject to violent ,pains of the ,loins1 which extend down to their ,thighs1 and terminate quite at the ,bottom of the ,belly2 and which commonly import1 that they are in ,danger of an ,abortion1 or ,miscarrying4 ,to prevent this ,consequence1 which is always dangerous1 they should1 #a1 immediately go to ,bed2 and if they have not a ,mattrass1 they should lie upon a ,bed stuffed with ,straw1 a ,feather-bed being very improper in such ,cases4 ,they should repose1 or keep themselves quite still in this ,situation for several ,days1 not stirring1 and speaking as little as possible4 #b1 ,they should directly lose eight or nine ,ounces of ,blood from the ,arm4 #c1 ,they should not eat ,flesh1 ,flesh-broth1 nor ,eggs2 but live solely on ,soups made of farinaceous or mealy ,substances4 #d1 ,they should take every two ,hours half a ,paper of the ,powder ,no4 #bj2 and should drink nothing but the ,ptisan ,no4 #b4 ,some sanguine robust ,women are very liable to miscarry at a certain ,time1 or ,stage1 of their ,pregnancy4 ,this may be obviated by their bleeding some ,days before that ,time approaches1 and by their observing the ,regimen ,i have advised4 ,but this ,method would avail very little for delicate ,citizens1 who miscarry from a very different ,cause2 and whose ,abortions are to be prevented by a very different ,treatment4 ,of ,delivery1 or ,child-birth4 ,sec4 #cff4 ,it has been observed that a greater ,proportion of ,women die in the ,country in1 or very speedily after1 their ,delivery1 and that from the ,scarcity of good ,assistance1 and the great ,plenty of what is bad2 and that a greater ,proportion of those in ,cities die after their ,labours are effected1 by a ,continuance of their former bad ,health4 ,the ,necessity there is for better instructed1 better qualified ,midwives1 through a great ,part of ,swisserland1 is but too manifest an ,unhappiness1 which is attended with the most fatal ,consequences1 and which merits the utmost ,attention of the ,government4 ,the ,errors which are incurred1 during actual ,labour1 are numberless1 and too often indeed are also irremediable4 ,it would require a whole ,book1 expressly for that ,purpose 7and in some ,countries there are such7 to give all the ,directions that are necessary1 to prevent so many ,fatalities3 and it would be as necessary to form a sufficient ,number of well-qualified ,midwives to comprehend1 and to observe them2 which exceeds the ,plan of the ,work ,i have proposed4 ,i shall only mark out one of the ,causes1 and the most injurious one on this ,occasion3 ,this is the ,custom of giving hot irritating ,things1 whenever the ,labour is very painful1 or is slow2 such as ,castor1 or its ,tincture1 ,saffron1 ,sage1 ,rue1 ,savin1 ,oil of ,amber1 ,wine1 ,venice ,treacle1 ,wine burnt with ,spices1 ,coffee1 ,brandy1 ,aniseed-,water1 ,walnut-,water1 ,fennel-,water1 and other ,drams or strong ,liquors4 ,all these ,things are so many ,poisons in this ,respect1 which1 very far from promoting the ,woman's ,delivery1 render it more difficult by inflaming the ,womb 7which cannot then so well contract itself7 and the ,parts1 through which the ,birth is to pass1 in ,consequence of which they swell1 become more straitened1 and cannot yield or be dilated4 ,sometimes these stimulating hot ,medicines also bring on ,haemorrhages1 which prove mortal in a few ,hours4 ,sec4 #cfg4 ,a considerable ,number1 both of ,mothers and ,infants1 might be preserved by the directly opposite ,method4 ,as soon as a ,woman who was in very good ,health1 just before the ,approach of her ,labour1 being robust and well made1 finds her ,travail come on1 and that it is painful and difficult2 far from encouraging those premature ,efforts1 which are always destructive2 and from furthering them by the pernicious ,medicines ,i have just enumerated1 the ,patient should be bled in the ,arm1 which will prevent the ,swelling and ,inflammation2 asswage the ,pains2 relax the ,parts1 and dispose every thing to a favourable ,issue4 ,during actual ,labour no other ,nourishment should be allowed1 except a little ,panada every three ,hours1 and as much ,toast and ,water1 as the ,woman chuses4 ,every fourth ,hour a ,glyster should be given1 consisting of a ,decoction of ,mallows and a little ,oil4 ,in the ,intervals between these ,glysters she should be set over a kind of ,stove1 or in a pierced easy ,chair1 containing a ,vessel in which there is some hot ,water3 the ,passage should be gently rubbed with a little ,butter2 and ,stapes wrung out of a ,fomentation of simple hot ,water1 which is the most efficacious of any1 should be applied over the ,belly4 ,the ,midwives1 by taking this ,method1 are not only certain of doing no ,mischief1 but they also allow ,nature an ,opportunity of doing ,good3 as a great many ,labours1 which seem difficult at time1 terminate happily2 and this safe and unprecipitate ,manner of proceeding at least affords ,time to call in further ,assistance4 ,besides1 the ,consequences of such ,deliveries are healthy and happy2 when by pursuing the heating oppressing ,practice1 even though the ,delivery be effected1 both ,mother and ,infant have been so cruelly1 though undesignedly1 tormented1 that both of them frequently perish4 ,sec4 #cfh4 ,i acknowledge these ,means are insufficient1 when the ,child is unhappily situated in the ,womb2 or when there is an embarrassing ,conformation in the ,mother3 though at least they prevent the ,case from proving worse1 and leave ,time for calling in ,men-,midwives1 or other female ones1 who may be better qualified4 ,i beg leave again to remind the ,midwives1 that they should be very cautious of urging their ,women to make any forced ,efforts to forward the ,birth1 which are extremely injurious to them1 and which may render a ,delivery very dangerous and embarrassing1 that might otherwise have been happily effected3 and ,i insist the more freely on the ,danger attending these unreasonable ,efforts1 and on the very great ,importance of ,patience1 as the other very pernicious ,practice is become next to universal amongst us4 ,the ,weakness1 in which the labouring ,woman appears1 makes the ,by-standers fearful that she will not have ,strength enough to be delivered2 which they think abundantly justifies them in giving her ,cordials2 but this ,way of ,reasoning is very weak and chimerical4 ,their ,strength1 on such ,occasions1 is not so very speedily dissipated3 the small light ,pains sink them1 but in ,proportion as the ,pains become stronger1 their ,strength arises2 being never deficient1 when there is no extraordinary and uncommon ,symptom2 and we may reasonably be assured1 that in a healthy1 well formed ,woman1 meer ,weakness never prevents a ,delivery4 ,of the ,consequences of ,labour1 or ,childbirth4 ,sec4 #cfi4 ,the most usual ,consequences of ,childbirth in the ,country are1 #a1 ,an excessive ,haemorrhage4 #b1 ,an ,inflammation of the ,womb4 #c1 ,a sudden ,suppression of the ,lochia1 or usual ,discharges after ,delivery4 ,and1 #d1 the ,fever and other ,accidents1 resulting from the ,milk4 ,excessive ,bleedings or ,floodings1 should be treated according to the ,manner directed ,sec4 #cfe3 and if they are very excessive1 ,folds of ,linen1 which have been wrung out of a ,mixture of equal ,parts of ,water and ,vinegar1 should be applied to the ,belly1 the ,loins1 and the ,thighs3 these should be changed for fresh moist ones1 as they dry2 and should be omitted1 as soon as the ,bleeding abates4 ,sec4 #cgj4 ,the ,inflammation of the ,womb is discoverable by ,pains in all the lower ,parts of the ,belly2 by a ,tension or ,tightness of the whole2 by a sensible ,increase of ,pain upon touching it2 a kind of red ,stain or ,spot1 that mounts to the ,middle of the ,belly1 as high as the ,navel2 which ,spot1 as the ,disease increases1 turns black1 and then is always a mortal ,symptom2 by a very extraordinary ,degree of ,weakness2 an astonishing ,change of ,countenance2 a light ,delirium or ,raving2 a continual ,fever with a weak and hard ,pulse2 sometimes incessant ,vomitings2 a frequent ,hiccup2 a moderate ,discharge of a reddish1 stinking1 sharp ,water2 frequent ,urgings to go to ,stool2 a burning kind of ,heat of ,urine2 and sometimes an entire ,suppression of it4 ,sec4 #cga4 ,this most dangerous and frequently mortal ,disease should be treated like inflammatory ones4 ,after ,bleeding1 frequent ,glysters of warm ,water must by no ,means be omitted2 some should also be injected into the ,womb1 and applied continually over the ,belly4 ,the ,patient may also drink continually1 either of simple ,barley-,water1 with a ,quarter of an ,ounce of ,nitre in every ,pot of it1 or of ,almond ,milk ,no4 #d4 ,sec4 #cgb4 ,the total ,suppression of the ,lochia1 the ,discharges after ,labour1 which proves a ,cause of the most violent ,disorders1 should be treated exactly in the same ,manner3 but if unhappily hot ,medicines have been given1 in order to force them down1 the ,case will very generally prove a most hopeless one4 ,sec4 #cgc4 ,if the ,milk-fever run very high1 the ,barley ,ptisan directed ,sec4 #cga1 and ,glysters1 with a very light ,diet1 consisting only of ,panada1 or made of some other farinaceous ,substances1 and very thin1 very generally remove it4 ,sec4 #cgd4 ,delicate infirm ,women1 who have not all the requisite and necessary ,attendance they want2 and such as from ,indigence are obliged to work too soon1 are exposed to many ,accidents1 which frequently arise from a ,want of due ,perspiration1 and an insufficient ,discharge of the ,lochia2 and hence1 the ,separation of the ,milk in their ,breasts being disturbed1 there are milky ,congestions1 or ,knots as it were1 which are always very painful and troublesome1 and especially when they are formed more inwardly4 ,they often happen on the ,thighs1 in which ,case the ,ptisan ,no4 #eh is to be drank1 and the ,pultices ,no4 #ei must be applied4 ,these two ,remedies gradually dissipate and remove the ,tumour1 if that may be effected without ,suppuration4 ,but if that proves impossible1 and ,pus1 or ,matter1 is actually formed1 a ,surgeon must open the ,abscess1 and treat it like any other4 ,sec4 #cge4 ,should the ,milk coagulate1 or curdle as it were1 in the ,breast1 it is of the utmost ,importance immediately to attenuate or dissolve that ,thickness1 which would otherwise degenerate into a ,hardness and prove a ,scirrhus2 and from a ,scirrhus in ,process of ,time a ,cancer1 that most tormenting and cruel ,distemper4 ,this horrible ,evil however may be prevented by an ,application to these small ,tumours1 as soon as ever they appear1 ,for this ,purpose nothing is more effectual than the ,prescriptions ,no4 #eg and #fj2 but under such menacing ,circumstances1 it is always prudent to take the best ,advice1 as early as possible4 ,from the ,moment these hard ,tumours become excessively and obstinately so1 and yet without any ,pain1 we should abstain from every ,application1 all are injurious2 and greasy1 sharp1 resinous and spirituous ones speedily change the ,scirrhus into a ,cancer4 ,whenever it becomes manifestly such1 all ,applications are also equally pernicious1 except that of ,no4 #fj4 ,cancers have long been thought and found incurable2 but within a few ,years past some have been cured by the ,remedy ,no4 #eg2 which nevertheless is not infallible1 though it should always be tried4 #hd #hd ,the ,use of ,hemlock1 which has been tried at ,lyons1 by all who have had cancerous ,patients1 having been given in very large ,doses1 has been attended with no ,effect there1 that merited the serious ,attention of ,practitioners4 ,many were careful to obtain the ,extract from ,vienna1 and even to procure it from ,dr4 ,storck himself4 ,but now it appears to have had so little ,success1 as to become entirely neglected4 ,e4 ,l4 ,having exactly translated in this ,place1 and in the ,table of ,remedies1 our learned ,author's considerable ,recommendation of the ,extract of ,hemlock in ,cancers1 we think it but fair1 on the other ,hand1 to publish this ,note of his ,editor's against it2 that the real ,efficacy or ,inefficacy of this ,medicine may at length be ascertained1 on the most extensive ,evidence and ,experience4 ,as far as my own ,opportunities and ,reflections1 and the ,experience of many others1 have instructed me on this ,subject1 it appears clear to myself1 that though the ,consequences of it have not been constantly unsuccessful with us1 yet its ,successes have come very short of its ,failures4 ,nevertheless1 as in all such ,cancers1 every other internal ,medicine almost universally fails1 we think with ,dr4 ,tissot it should always be tried 7from the meer ,possibility of its succeeding in some particular ,habit and ,circumstances7 at least till longer ,experience shall finally determine against it4 ,k4 ,sec4 #cgf4 ,the ,nipples of ,women1 who give ,milk1 are often fretted or excoriated1 which proves very severely painful to them4 ,one of the best ,applications is the most simple ,ointment1 being a ,mixture of ,oil and ,wax melted together2 or the ,ointment ,no4 #ff4 ,should the ,complaint prove very obstinate1 the ,nurse ought to be purged1 which generally removes it4 ,chapter ,,xxvii4 ,medical ,directions concerning ,children4 ,sect4 #cgg4 ,the ,diseases of ,children1 and every ,thing relating to their ,health1 are ,objects which generally seem to have been too much neglected by ,physicians2 and have been too long confided to the ,conduct of the most improper ,persons for such a ,charge4 ,at the same ,time it must be admitted their ,health is of no little ,importance2 their ,preservation is as necessary as the ,continuance of the human ,race2 and the ,application of the ,practice of ,physick to their ,disorders is susceptible of nearer ,approaches to ,perfection1 than is generally conceived4 ,it seems to have even some ,advantage over that ,practice which regards grown ,persons2 and it consists in this1 that the ,diseases of ,children are more simple1 and less frequently complicated than those of ,adults4 ,it may be said indeed1 they cannot make themselves so well understood1 and meer ,infants certainly not at all4 ,this is true in ,fact to a certain ,degree1 but not rigidly true2 for though they do not speak our ,language1 they have one which we should contrive to understand4 ,nay every ,distemper may be said1 in some ,sense1 to have a ,language of its own1 which an attentive ,physician will learn4 ,he should therefore use his utmost ,care to understand that of ,infants1 and avail himself of it1 to increase the ,means of rendering them healthy and vigorous1 and to cure them of the different ,distempers to which they are liable4 ,i do not propose actually to compleat this ,task myself1 in all that ,extent it may justly demand2 but ,i shall set forth the principal ,causes of their ,distempers1 and the general ,method of treating them4 ,by this ,means ,i shall at least preserve them from some of the ,mischiefs which are too frequently done them2 and the lessening such ,evils as ,ignorance1 or erroneous ,practice1 occasions1 is one of the most important ,purposes of the present ,work4 ,sec4 #cgh4 ,nearly all the ,children who die before they are one ,year1 and even two ,years1 old1 die with ,convulsions3 ,people say they died of them1 which is partly true1 as it is in ,effect1 the ,convulsions that have destroyed them4 ,but then these very ,convulsions are the ,consequences1 the ,effects1 of other ,diseases1 which require the utmost ,attention of those1 who are entrusted with the ,care and ,health of the little ,innocents3 as an effectual ,opposition to these ,diseases1 these morbid ,causes1 is the only ,means of removing the ,convulsions4 ,the four principal known ,causes are1 the ,meconium2 the ,excrements contained in the ,body of the ,infant1 at the ,birth2 ,acidities1 or sharp and sour ,humours2 the ,cutting of the ,teeth1 and ,worms4 ,i shall treat briefly of each4 ,of the ,meconium4 ,sec4#cgi4 ,the ,stomach and ,guts of the ,infant1 at its ,entrance into the ,world1 are filled with a black ,sort of ,matter1 of a middling ,consistence1 and very viscid or glutinous1 which is called the ,meconium4 ,it is necessary this ,matter should be discharged before the ,infant sucks1 since it would otherwise corrupt the ,milk1 and1 becoming extremely sharp itself1 there would result from their ,mixture a double ,source of ,evils1 to the ,destruction of the ,infant4 ,the ,evacuation of this ,excrement is procured1 #a1 ,by giving them no ,milk at all for the first twenty-four ,hours of their ,lives4 #b1 ,by making them drink during that ,time some ,water1 to which a little ,sugar or ,honey must be added1 which will dilute this ,meconium1 and promote the ,discharge of it by ,stool1 and sometimes by vomiting4 ,to be the more certain of expelling all this ,matter1 they should take one ,ounce of ,compound ,syrup #he of ,succory1 which should be diluted with a little ,water1 drinking up this ,quantity within the ,space of four or five ,hours4 ,this ,practice is a very beneficial one1 and it is to be wished it were to become general4 ,this ,syrup is greatly preferable to all others1 given in such ,cases1 and especially to ,oil of ,almonds4 #he ,this ,method 7says the ,editor and ,annotator of ,lyons7 is useful1 whenever the ,mother does not suckle her ,child4 ,art is then obliged to prove a ,kind of ,substitute to ,nature1 though always a very imperfect one4 ,but when a ,mother1 attentive to her own true ,interest1 as well as her ,infant's1 and1 listening to the ,voice of ,nature and her ,duty1 suckles it herself1 these ,remedies he adds seem hurtful1 or at least1 useless4 ,the ,mother should give her ,child the ,breast as soon as she can4 ,the first ,milk1 the ,colostrum1 or ,strippings1 as it is called in ,quadrupeds1 which is very serous or watery1 will be serviceable as a ,purgative2 it will forward the ,expulsion of the ,meconium1 prove gradually nourishing1 and is better than ,biscuits1 or ,panada1 which 7he thinks7 are dangerous in the first ,days after the ,birth4 ,e4 ,l4 ,this ,syrup of ,succory being scarcely ever prepared with us1 though sufficiently proper for the ,use assigned it here1 ,i have retained the preceding ,note1 as the ,author of it directs these ,strippings1 for the same ,purpose1 with an ,air of certain ,experience2 and as this ,effect of them seems no ,ways repugnant to the physical ,wisdom and ,oeconomy of ,nature1 on such important ,points4 ,should it in fact be their very general ,operation1 it cannot be unknown to any ,male or ,female ,practitioner in ,midwifery1 and may save poor ,people a little ,expence1 which was one ,object of our humane ,author's ,plan4 ,the ,oil ,of ,ricinus1 corruptly called ,castor ,oil 7being expressed from the ,berries of the ,palma ,christi7 is particularly recommended by some late medical ,writers from ,jamaica1 c4 for this ,purpose of expelling the ,meconium1 to the ,quantity of a small ,spoonful4 ,these ,gentlemen also consider it as the most proper1 and almost specific ,opener1 in the dry ,belly-ach of that torrid ,climate1 which tormenting ,disease has the closest ,affinity to the ,miserere1 or ,iliac ,passion1 of any ,i have seen4 ,the ,annotator's ,objection to our ,author's very thin light ,panada1 seems to be of little ,weight4 ,k4 ,should the great ,weakness of the ,child seem to call for some ,nourishment1 there would be no ,inconvenience in allowing a little ,biscuit well boiled in ,water1 which is pretty commonly done1 or a little very thin light ,panada4 ,of ,acidities1 or sharp ,humours4 ,sec4 #chj4 ,notwithstanding the ,bodies of ,children have been properly emptied speedily after their ,birth1 yet the ,milk very often turns sour in their ,stomachs1 producing ,vomitings1 violent ,cholics1 ,convulsions1 a ,looseness1 and even terminating in ,death4 ,there are but two ,purposes to be pursued in such ,cases1 which are to carry off the sour or sharp ,humours1 and to prevent the ,generation of more4 ,the first of these ,intentions is best effected by the ,syrup of ,succory #hf just mentioned4 #hf ,or1 for ,want of it1 the solutive ,syrup of ,roses4 ,k4 ,the ,generation of further ,acidities is prevented1 by giving three ,doses daily1 if the ,symptoms are violent1 and but two1 or even one only1 if they are very moderate1 of the ,powder ,no4 #fa1 drinking after it ,bawm ,tea1 or a ,tea of ,lime-tree ,leaves4 ,sec4 #cha4 ,it has been a ,custom to load ,children with ,oil of ,almonds1 #hg as soon as ever they are infested with ,gripes3 but it is a pernicious ,custom1 and attended with very dangerous ,consequences4 ,it it very true that this ,oil sometimes immediately allays the ,gripes1 by involving1 or sheathing up1 as it were1 the acid ,humours1 and somewhat blunting the ,sensibility of the ,nerves4 ,but it proves only a palliative ,remedy1 or asswaging for a ,time1 which1 far from removing1 increases the ,cause1 since it becomes sharp and rancid itself2 whence the ,disorder speedily returns1 and the more ,oil the ,infant takes1 it is griped the more4 ,i have cured some ,children of such ,disorders1 without any other ,remedy1 except abstaining from ,oil1 which weakens their ,stomachs1 whence their ,milk is less perfectly1 and more slowly digested1 and becomes more easily soured4 ,besides this ,weakness of the ,stomach1 which thus commences at that very early ,age1 has sometimes an unhealthy ,influence on the ,constitution of the ,child1 throughout the ,remainder of his ,life4 #hg ,the ,magnesia is an excellent ,substitute in ,children1 for these ,oils ,dr4 ,tissot so justly condemns here4 ,k4 ,a free and open ,belly is beneficial to ,children2 now it is certain that the ,oil very often binds them1 in ,consequence of its diminishing the ,force and ,action of the ,bowels4 ,there is scarcely any ,person1 who cannot observe this ,inconvenience attending it2 notwithstanding they all continue to advise and to give it1 to obtain a very different ,purpose3 ,but such is the ,power of ,prejudice in this ,case1 and in so many others2 ,people are so strongly pre-possessed with a ,notion1 that such a ,medicine must produce such an ,effect2 that its never having produced it avails nothing with them1 their ,prejudice still prevails2 they ascribe its ,want of ,efficacy to the ,smallness of the ,doses2 these are doubled then1 and notwithstanding its bad ,effects are augmented1 their obstinate ,blindness continues4 ,this ,abuse of the ,oil also disposes their ,child to knotty hard ,tumours1 and at length often proves the first ,cause of some ,diseases of the ,skin1 whose ,cure is extremely difficult4 ,hence it is evident1 this ,oil should be used on such ,occasions but very seldom2 and that it is always very injudicious to give it in ,cholics1 which arise from sharp and sour ,humours in the ,stomach1 or in the ,bowels4 ,sec4 #chb4 ,infants are commonly most subject to such ,cholics during their earliest ,months2 after which they abate1 in ,proportion as their ,stomachs grow stronger4 ,they may be relieved in the ,fit by ,glysters of a ,decoction of ,chamomile ,flowers1 in which a ,bit of ,soap of the ,size of a ,hazel ,nut is dissolved4 ,a ,piece of ,flanel wrung out of a ,decoction of ,chamomile ,flowers1 with the ,addition of some ,venice ,treacle1 and applied hot over the ,stomach and on the ,belly1 is also very beneficial1 and relieving4 ,children cannot always take ,glysters1 the ,continuance of which ,circumstance might be dangerous to them2 and every one is acquainted with the common ,method of substituting ,suppositories to them1 whether they are formed of the smooth and supple ,stalks of ,vines1 c4 of ,soap1 or of ,honey boiled up to a proper ,consistence4 ,but one of the most certain ,means to prevent these ,cholics1 which are owing to ,children's not digesting their ,milk1 is to move and exercise them as much as possible2 having a due ,regard however to their tender ,time of ,life4 ,sec4 #chc4 ,before ,i proceed to the third ,cause of the ,diseases of ,children1 which is1 the ,cutting of their ,teeth1 ,i must take ,notice of the first ,cares their ,birth immediately requires1 that is the ,washing of them the first ,time1 meerly to cleanse1 and afterwards1 to strengthen them4 ,of washing ,children4 ,sec4 #chd4 ,the whole ,body of an ,infant just born is covered with a gross ,humour1 which is occasioned by the ,fluids1 in which it was suspended in the ,womb4 ,there is a ,necessity to cleanse it directly from this1 for which nothing is so proper as a ,mixture of one third ,wine1 and two thirds ,water2 ,wine alone would be dangerous4 ,this ,washing may be repeated some ,days successively2 but it is a bad ,custom to continue to wash them thus warm1 the ,danger of which is augmented by adding some ,butter to the ,wine and ,water1 which is done too often4 ,if this gross ,humour1 that covers the ,child1 seems more thick and glutinous than ordinary1 a ,decoction of ,chamomile ,flowers1 with a little ,bit of ,soap1 may be used to remove it4 ,the ,regularity of ,perspiration is the great ,foundation of ,health2 to procure this ,regularity the ,teguments1 the ,skin1 must be strengthened2 but warm ,washing tends to weaken it4 ,when it is of a proper ,strength it always performs its ,functions2 nor is ,perspiration disordered sensibly by the ,alteration of the ,weather4 ,for this ,reason nothing should be omitted1 that may fix it in this ,state2 and to attain so important an ,advantage1 ,children should be washed1 some few ,days after their ,birth1 with cold ,water1 in the ,state it is brought from the ,spring4 ,for this ,purpose a ,spunge is employed1 with which they begin1 by washing first the ,face1 the ,ears1 the back ,part of the ,head 7carefully avoiding the #hh ,fontanelle1 or ,mould of the ,head7 the ,neck1 the ,loins1 the ,trunck of the ,body1 the ,thighs1 ,legs and ,arms1 and in short every ,spot4 ,this ,method which has obtained for so many ,ages1 and which is practised at present by many ,people1 who prove very healthy1 will appear shocking to several ,mothers2 they would be afraid of killing their ,children by it2 and would particularly fail of ,courage enough to endure the ,cries1 which ,children often make1 the first ,time they are washed4 ,yet if their ,mothers truly love them1 they cannot give a more substantial ,mark of their ,tenderness to them1 than by subduing their ,fears and their ,repugnance1 on this important ,head4 #hh ,that ,part of the ,head where a ,pulsation may be very plainly felt1 where the ,bones are less hard1 and not as yet firmly joined with those about them4 ,weakly ,infants #hi are those who have the greatest ,need of being washed3 such as are remarkably strong may be excused from it2 and it seems scarcely credible 7before a ,person has frequently seen the ,consequences of it7 how greatly this ,method conduces to give1 and to hasten on1 their ,strength4 ,i have had the ,pleasure to observe1 since ,i first endeavoured to introduce the ,custom among us1 that several of the most affectionate and most sensible ,mothers1 have used it with the greatest ,success4 ,the ,midwives1 who have been ,witnesses of it2 the ,nurses and the ,servants of the ,children1 whom they have washed1 publish it abroad2 and should the ,custom become as general1 as every thing seems to promise it will1 ,i am fully persuaded1 that by preserving the ,lives of a great ,number of ,children1 it will certainly contribute to check the ,progress of ,depopulation4 #hi ,there is however a certain ,degree of ,weakness1 which may very reasonably deter us from this ,washing2 as when the ,infant manifestly wants ,heat1 and needs some ,cordial and frequent ,frictions1 to prevent its expiring from downright ,feebleness2 in which ,circumstances ,washing must be hurtful to it4 ,tissot4 ,they should be washed very regularly every ,day1 in every ,season1 and every ,sort of ,weather2 and in the fine warm ,season they should be plunged into a large ,pail of ,water1 into the ,basins around ,fountains1 in a ,brook1 a ,river1 or a ,lake4 ,after a few ,days crying1 they grow so well accustomed to this ,exercise1 that it becomes one of their ,pleasures2 so that they laugh all the ,time of their going through it4 ,the first ,benefit of this ,practice is1 as ,i have already said1 the keeping up their ,perspiration1 and rendering them less obnoxious to the ,impressions of the ,air and ,weather3 and it is also in ,consequence of this first ,benefit1 that they are preserved from a great ,number of ,maladies1 especially from knotty ,tumours1 often called ,kernels2 from ,obstructions2 from ,diseases of the ,skin1 and from ,convulsions1 its general ,consequence being to insure them firm1 and even robust ,health4 ,sec4 #che4 ,but ,care should be taken not to prevent1 or1 as it were to undo1 the ,benefit this ,washing procures them1 by the bad ,custom of keeping them too hot4 ,there is not a more pernicious one than this1 nor one that destroys more ,children4 ,they should be accustomed to light ,cloathing by ,day1 and light ,covering by ,night1 to go with their ,heads very thinly covered1 and not at all in the ,day-time1 after their attaining the ,age of two ,years4 ,they should avoid sleeping in ,chambers that are too hot1 and should live in the open ,air1 both in ,summer and ,winter1 as much as possible4 ,children who have been kept too hot in such ,respects1 are very often liable to ,colds2 they are weakly1 pale1 languishing1 bloated and melancholy4 ,they are subject to hard knotty ,swellings1 a ,consumption1 all ,sorts of languid ,disorders1 and either die in their ,infancy1 or only grow up into a miserable valetudinary ,life2 while those who are washed or plunged into cold ,water1 and habitually exposed to the open ,air1 are just in the opposite ,circumstances4 ,sec4 #chf4 ,i must further add here1 that ,infancy is not the only ,stage of ,life1 in which cold ,bathing is advantagious4 ,i have advised it with remarkable ,success to ,persons of every ,age1 even to that of seventy3 and there are two ,kinds of ,diseases1 more frequent indeed in ,cities than in the ,country1 in which cold ,baths succeed very greatly2 that is1 in ,debility1 or ,weakness of the ,nerves2 and when ,perspiration is disordered1 when ,persons are fearful of every ,breath of ,air1 liable to ,defluxions or ,colds1 feeble and languishing1 the cold ,bath re-establishes ,perspiration2 restores ,strength to the ,nerves2 and by that ,means dispels all the ,disorders1 which arise from these two ,causes1 in the animal ,oeconomy4 ,they should be used before ,dinner4 ,but in the same ,proportion that cold ,bathing is beneficial1 the habitual ,use1 or rather ,abuse1 of warm ,bathing is pernicious2 they dispose the ,persons addicted to them to the ,apoplexy2 to the ,dropsy2 to ,vapours1 and to the hypochondriacal ,disease3 and ,cities1 in which they are too frequently used1 become1 in some ,measure1 desolate from such ,distempers4 ,of the ,cutting of the ,teeth4 ,sec4 #chg4 ,cutting of the ,teeth is often very tormenting to ,children1 some dying under the severe ,symptoms attending it4 ,if it proves very painful1 we should during that ,period1 #a1 ,keep their ,bellies open by ,glysters consisting only of a simple ,decoction of ,mallows3 but ,glysters are not necessary1 if the ,child1 as it sometimes happens then1 has a ,purging4 #b1 ,their ordinary ,quantity of ,food should be lessened for two ,reasons2 first1 because the ,stomach is then weaker than usual2 and next1 because a small ,fever sometimes accompanies the ,cutting4 #c1 ,their usual ,quantity of ,drink should be increased a little2 the best for them certainly is an ,infusion of the ,leaves or ,flowers1 of the ,lime or ,linden-tree1 to which a little ,milk may be added4 #d1 ,their ,gums should frequently be rubbed with a ,mixture of equal ,parts of ,honey1 and ,mucilage of ,quince-seeds2 and a ,root of ,march-,mallows1 or of ,liquorice1 may be given them to chew4 ,it frequently happens1 that during ,dentition1 or the ,time of their toothing1 ,children prove subject to ,knots or ,kernels4 ,of ,worms4 ,sec4 #chh4 ,the ,meconium1 the ,acidity of the ,milk1 and ,cutting of the ,teeth are the three great ,causes of the ,diseases of ,children4 ,there is also a fourth1 ,worms1 which is likewise very often pernicious to them2 but which1 nevertheless1 is not1 at least not near so much1 a general ,cause of their ,disorders1 as it is generally supposed1 when a ,child exceeding two ,years of ,age proves sick4 ,there are a great ,variety of ,symptoms1 which dispose ,people to think a ,child has ,worms2 though there is but one that demonstrates it1 which is discharging them upwards or downwards4 ,there is great ,difference among ,children too in this ,respect1 some remaining healthy1 though having several ,worms1 and others being really sick with a few4 ,they prove hurtful1 #a1 by obstructing the ,guts1 and compressing the neighbouring ,bowels by their ,size4 #b1 ,by sucking up the ,chyle intended to nourish the ,patient1 and thus depriving him of his very ,substance as well as ,subsistence3 and1 #c1 by irritating the ,guts and even #ij gnawing them4 #ij ,i have seen a ,child about three ,years old1 whose ,navel1 after swelling and inflaming1 suppurated1 and through a small ,orifice 7which must have communicated with the ,cavity of the ,gut or the ,belly7 discharged one of these ,worms we call teretes1 about three ,inches long4 ,he had voided several by ,stool1 after taking some vermifuge ,medicines4 ,the ,fact ,i perfectly remember2 and to the best of my ,recollection1 the ,ulcer healed some ,time after1 and the ,orifice closed3 but the ,child died the following ,year of a putrid ,fever1 which might be caused1 or was aggravated1 by ,worms4 ,k4 ,sec4 #chi4 ,the ,symptoms which make it probable they are infested with ,worms1 are slight1 frequent and irregular ,cholics2 a great ,quantity of ,spittle running off while they are fasting2 a disagreeable ,smell of their ,breath1 of a particular ,kind1 especially in the ,morning2 a frequent ,itchiness of their ,noses which makes them scratch or rub them often2 a very irregular ,appetite1 being sometimes voracious1 and at other ,times having none at all3 ,pains at ,stomach and ,vomitings3 sometimes a costive ,belly2 but more frequently loose ,stools of indigested ,matter2 the ,belly rather larger than ordinary1 the rest of the ,body meagre2 a ,thirst which no ,drink allays2 often great ,weakness1 and some ,degree of ,melancholy4 ,the ,countenance has generally an odd unhealthy ,look1 and varies every ,quarter of an ,hour2 the ,eyes often look dull1 and are surrounded with a ,kind of livid ,circle3 the ,white of the ,eye is sometimes visible while they sleep1 their ,sleep being often attended with terrifying ,dreams or ,deliriums1 and with continual ,startings1 and ,grindings of their ,teeth4 ,some ,children find it impossible to be at ,rest for a single ,moment4 ,their ,urine is often whitish1 ,i have seen it from some as white as ,milk4 ,they are afflicted with ,palpitations1 ,swoonings1 ,convulsions1 long and profound ,drowsiness2 cold ,sweats which come on suddenly2 ,fevers which have the ,appearances of ,malignity2 ,obscurities and even ,loss of ,sight and of ,speech1 which continue for a considerable ,time2 ,palsies either of their ,hands1 their ,arms1 or their ,legs1 and ,numbnesses4 ,their ,gums are in a bad ,state1 and as though they had been gnawed or corroded3 they have often the ,hickup1 a small and irregular ,pulse1 ,ravings1 and1 what is one of the least doubtful ,symptoms1 frequently a small dry ,cough2 and not seldom a ,mucosity or ,sliminess in their ,stools3 sometimes very long and violent ,cholics1 which terminate in an ,abscess on the ,outside of the ,belly1 from whence ,worms issue4 7,see ,note #ij p4 #chh47 ,sec4 #cij4 ,there are a great ,multitude of ,medicines against ,worms4 ,the #ia ,grenette or ,worm-seed1 which is one of the commonest1 is a very good one4 ,the ,prescription ,no4 #fb1 is also a very successful one2 and the ,powder ,no4 #ad is one of the best4 ,flower of ,brimstone1 the ,juice of ,nasturtium1 or ,cresses1 ,acids and ,honey ,water have often been very serviceable2 but the first three ,i have mentioned1 succeeded by a ,purge1 are the best4 ,no4 #fc is a purging ,medicine1 that the most averse and difficult ,children may easily take4 ,but when1 notwithstanding these ,medicines1 the ,worms are not expelled1 it is necessary to take ,advice of some ,person qualified to prescribe more efficacious ones4 ,this is of considerable ,importance1 because1 notwithstanding a great ,proportion of ,children may probably have ,worms1 and yet many of them continue in good ,health1 there are1 nevertheless1 some who are really killed by ,worms1 after having been cruelly tormented by them for several ,years4 #ia ,this ,word occurs in none of the common ,dictionaries2 but suspecting it for the ,semen ,santonici of the ,shops1 ,i find the learned ,dr4 ,bikker has rendered it so1 in his very well received ,translation of this valuable ,work into ,low ,dutch4 ,k4 ,a ,disposition to breed ,worms always shews the ,digestions are weak and imperfect2 for which ,reason ,children liable to ,worms should not be nourished with ,food difficult to digest4 ,we should be particularly careful not to stuff them with ,oils1 which1 admitting such ,oils should immediately kill some of their ,worms1 do yet increase that ,cause1 which disposes them to generate others4 ,a long continued ,use of ,filings of ,iron is the ,remedy1 that most effectually destroys this ,disposition to generate ,worms4 ,of ,convulsions4 ,sec4 #cia4 ,i have already said1 ,sec4 #cgh1 that the ,convulsions of ,children are almost constantly the ,effect of some other ,disease1 and especially of some of the four ,i have mentioned4 ,some other1 though less frequent ,causes1 sometimes occasion them1 and these may be reduced to the following4 ,the first of them is the corrupted ,humours1 that often abound in their ,stomachs and ,intestines2 and which1 by their ,irritation1 produce irregular ,motions throughout the whole ,system of the ,nerves1 or at least through some ,parts of them2 whence those ,convulsions arise1 which are merely involuntary ,motions of the ,muscles4 ,these putrid ,humours are the ,consequence of too great a ,load of ,aliments1 of unsound ones1 or of such1 as the ,stomachs of ,children are incapable of digesting4 ,these ,humours are also sometimes the ,effect of a ,mixture and ,confusion of different ,aliments1 and of a bad ,distribution of their ,nourishment4 ,it may be known that the ,convulsions of a ,child are owing to this ,cause1 by the ,circumstances that have preceded them1 by a disgusted loathing ,stomach2 by a certain ,heaviness and ,load at it2 by a foul ,tongue2 a great ,belly2 by its bad ,complexion1 and its disturbed unrefreshing ,sleep4 ,the ,child's proper ,diet1 that is1 a certain ,diminution of the ,quantity of its ,food2 some ,glysters of warm ,water1 and one ,purge of ,no4 #fc1 very generally remove such ,convulsions4 ,sec4 #cib4 ,the second ,cause is the bad ,quality of their ,milk4 ,whether it be that the ,nurse has fallen into a violent ,passion1 some considerable ,disgust1 great ,fright or frequent ,fear3 whether she has eat unwholesome ,food1 drank too much ,wine1 spirituous ,liquors1 or any strong ,drink3 whether she is seized with a ,descent of her monthly ,discharges1 and that has greatly disordered her ,health2 or finally whether she prove really sick3 ,in all these ,cases the ,milk is vitiated1 and exposes the ,infant to violent ,symptoms1 which sometimes speedily destroy it4 ,the ,remedies for ,convulsions1 from this ,cause1 consist1 #a1 ,in letting the ,child abstain from this corrupted ,milk1 until the ,nurse shall have recovered her ,state of ,health and ,tranquillity1 the speedy ,attainment of which may be forwarded by a few ,glysters2 by gentle pacific ,medicines2 by an entire ,absence of whatever caused or conduced to her bad ,health2 and by drawing off all the ,milk that had been so vitiated4 #b1 ,in giving the ,child itself some ,glysters3 in making it drink plentifully of a light ,infusion of the ,lime-tree ,flowers1 in giving it no other ,nourishment for a ,day or two1 except ,panada and other light ,spoon-meat1 without ,milk4 #c1 ,in purging the ,child 7supposing what has been just directed to have been unavailable7 with an ,ounce1 or an ,ounce and a ,half1 of compound ,syrup of ,succory1 or as much ,manna4 ,these lenient gentle ,purges carry off the ,remainder of the corrupted ,milk1 and remove the ,disorders occasioned by it4 ,sec4 #cic4 ,a third ,cause which also produces ,convulsions1 is the feverish ,distempers which attack ,children1 especially the ,small-pocks and the ,measles2 but in general such ,convulsions require no other ,treatment1 but that proper for the ,disease1 which has introduced them4 ,sec4 #cid4 ,it is evident from what has been said in the ,course of this ,chapter1 and it deserves to be attended to1 that ,convulsions are commonly a ,symptom attending some other ,disease1 rather than an original ,disease themselves3 that they depend on many different ,causes2 that from this ,consideration there can be no general ,remedy for removing or checking them2 and that the only ,means and ,medicines which are suitable in each ,case1 are those1 which are proper to oppose the particular ,cause producing them1 and which ,i have already pointed out in treating of each ,cause4 ,the greater ,part of the pretended ,specifics1 which are indiscriminately and ignorantly employed in all ,sorts of ,convulsions1 are often useless1 and still oftner prejudicial4 ,of this last ,sort and ,character are1 #a1 ,all sharp and hot ,medicines1 spirituous ,liquors1 ,oil of ,amber1--other hot ,oils and ,essences1 volatile ,salts1 and such other ,medicines1 as1 by the ,violence of their ,action on the irritable ,organs of ,children1 are likelier to produce ,convulsions1 than to allay them4 #b1 ,astringent ,medicines1 which are highly pernicious1 whenever the ,convulsions are caused by any sharp ,humour1 that ought to be discharged from the ,body by ,stool2 or when such ,convulsions are the ,consequences of an #ib ,effort of ,nature1 in ,order to effect a ,crisis3 ,and as they almost ever depend on one or the other of these ,causes1 it follows that ,astringents can very rarely1 if ever1 be beneficial4 ,besides that there is always some ,danger in giving them to ,children without a mature1 a thorough ,consideration of their particular ,case and ,situation1 as they often dispose them to ,obstructions4 #ib ,this very important ,consideration1 on which ,i have treated pretty largely1 in the ,analysis1 seems not to be attended to in ,practice1 as frequently as it ought4 ,k4 #c1 ,the over early1 and too considerable ,use of ,opiates1 either not properly indicated1 or continued too long1 such as ,venice ,treacle1 ,mithridate1 ,syrup of ,poppies 7and it is very easy to run upon some of these ,sholes7 are also attended with the most embarrassing ,events1 in ,regard to ,convulsions2 and it may be affirmed they are improper1 for nine ,tenths of those they are advised to4 ,it is true they often produce an apparent ,ease and ,tranquillity for some ,minutes1 and sometimes for some ,hours too2 but the ,disorder returns even with greater ,violence for this ,suspension1 by ,reason they have augmented all the ,causes producing it2 they impair the ,stomach2 they bind up the ,belly2 they lessen the usual ,quantity of ,urine2 and besides1 by their abating the ,sensibility of the ,nerves1 which ought to be considered as one of the chief ,centinels appointed by ,nature1 for the ,discovery of any approaching ,danger1 they dispose the ,patient insensibly to such ,infarctions and ,obstructions1 as tend speedily to produce some violent and mortal ,event1 or which generate a ,disposition to languid and tedious ,diseases3 and ,i do again repeat it1 that notwithstanding there are some ,cases1 in which they are absolutely necessary1 they ought in general to be employed with great ,precaution and and ,prudence4 ,to mention the principal ,indications for them in convulsive ,cases1 they are proper1 #a1 ,when the ,convulsions still continue1 after the original ,cause of them is removed4 #b1 ,when they are so extremely violent1 as to threaten a great and very speedy ,danger of ,life2 and when they prove an ,obstacle to the taking ,remedies calculated to extinguish their ,cause2 and1 #c1 ,when the ,cause producing them is of such a ,nature1 as is apt to yield to the ,force of ,anodynes2 as when1 for ,instance1 they have been the immediate ,consequence of a ,fright4 ,sec4 #cie4 ,there is a very great ,difference in different ,children1 in ,respect to their being more or less liable to ,convulsions4 ,there are some1 in whom very strong and irritating ,causes cannot excite them2 not even excruciating ,gripes and ,cholics2 the most painful ,cutting of their ,teeth2 violent ,fevers2 the ,small ,pocks2 ,measles2 and though they are1 as it were1 continually corroded by ,worms1 they have not the slightest ,tendency to be convulsed4 ,on the other ,hand1 some are so very obnoxious to ,convulsions1 or so easily convulsible1 if that ,expression may be allowed1 that they are very often seized with them from such very slight ,causes1 that the most attentive ,consideration cannot investigate them4 ,this ,sort of ,constitution1 which is extremely dangerous1 and exposes the unhappy ,subject of it1 either to a very speedy ,death1 or to a very low and languid ,state of ,life1 requires some peculiar ,considerations2 the ,detail of which would be the more foreign to the ,design of this ,treatise1 as they are pretty common in ,cities1 but much less so in ,country ,places4 ,in general cold ,bathing and the ,powder ,no4 #ad are serviceable in such ,circumstances4 ,general ,directions1 with ,respect to ,children4 ,sec4 #cif4 ,i shall conclude this ,chapter by such farther ,advice1 as may contribute to give ,children a more vigorous ,constitution and ,temperament1 and to preserve them from many ,disorders4 ,first then1 we should be careful not to cram them too much1 and to regulate both the ,quantity and the set ,time of their ,meals1 which is a very practicable ,thing1 even in the very earliest ,days of their ,life2 when the ,woman who nurses them1 will be careful to do it regularly4 ,perhaps indeed this is the very ,age1 when such a ,regulation may be the most easily attempted and effected2 because it is that ,stage1 when the constant ,uniformity of their ,way of living should incline us to suppose1 that what they have ,occasion for is most constantly very much the same4 ,a ,child who has already attained to a few ,years1 and who is surrendered up more to his own ,exercise and ,vivacity1 feels other ,calls2 his ,way of ,life is become a little more various and irregular1 whence his ,appetite must prove so too4 ,hence it would be inconvenient to subject him over exactly to one certain ,rule1 in the ,quantity of his ,nourishment1 or the ,distance of his ,meals4 ,the ,dissipation or passing off of his ,nutrition being unequal1 the ,occasions he has for repairing it cannot be precisely dated and regular4 ,but with ,respect to very little ,children in ,arms1 or on the ,lap1 a ,uniformity in the first of these ,respects1 the ,quantity of their ,food1 very consistently conduces to a useful ,regularity with ,respect to the second1 the ,times of feeding them4 ,sickness is probably the only ,circumstance1 that can warrant any ,alteration in the ,order and ,intervals of their ,meals2 and then this ,change should consist in a ,diminution of their usual ,quantity1 notwithstanding a general and fatal ,conduct seems to establish the very ,reverse2 and this pernicious ,fashion authorizes the ,nurses to cram these poor little ,creatures the more1 in ,proportion as they have real ,need of less feeding4 ,they conclude of ,course1 that all their ,cries are the ,effects of ,hunger1 and the ,moment an ,infant begins1 then they immediately stop his ,mouth with his ,food2 without once suspecting1 that these ,wailings may be occasioned by the ,uneasiness an over-loaded ,stomach may have introduced2 or by ,pains whose ,cause is neither removed nor mitigated1 by making the ,children eat2 though the meer ,action of eating may render them insensible to slight ,pains1 for a very few ,minutes2 in the first ,place1 by calling off their ,attention2 and secondly1 by hushing them to sleep1 a common ,effect of feeding in ,children1 being in fact1 a very general and constant one1 and depending on the same ,causes1 which dispose so many grown ,persons to sleep after ,meals4 ,a ,detail of the many ,evils ,children are exposed to1 by thus forcing too much ,food upon them1 at the very ,time when their ,complaints are owing to ,causes1 very different from ,hunger1 might appear incredible4 ,they are however so numerous and certain1 that ,i seriously wish sensible ,mothers would open their ,eyes to the ,consideration of this ,abuse1 and agree to put an ,end to it4 ,those who overload them with ,victuals1 in ,hopes of strengthening them1 are extremely deceived2 there being no one ,prejudice equally fatal to such a ,number of them4 ,whatever unnecessary ,aliment a ,child receives1 weakens1 instead of strengthening him4 ,the ,stomach1 when over-distended1 suffers in its ,force and ,functions1 and becomes less able to digest thoroughly4 ,the ,excess of the ,food last received impairs the ,concoction of the ,quantity1 that was really necessary3 which1 being badly digested1 is so far from yielding any ,nourishment to the ,infant1 that it weakens it1 and proves a ,source of ,diseases1 and concurs to produce ,obstructions1 ,rickets1 the ,evil1 slow ,fevers1 a ,consumption and ,death4 ,another unhappy ,custom prevails1 with ,regard to the ,diet of ,children1 when they begin to receive any other ,food besides their ,nurse's ,milk1 and that is1 to give them such as exceeds the digestive ,power of their ,stomachs2 and to indulge them in a ,mixture of such ,things in their ,meals1 as are hurtful in themselves1 and more particularly so1 with ,regard to their feeble and delicate ,organs4 ,to justify this pernicious ,indulgence1 they affirm it is necessary to accustom their ,stomachs to every ,kind of ,food2 but this ,notion is highly absurd1 since their ,stomachs should first be strengthened1 in ,order to make them capable of digesting every ,food2 and crouding indigestible1 or very difficultly digestible ,materials into it1 is not the ,way to strengthen it4 ,to make a ,foal sufficiently strong for future ,labour1 he is exempted from any1 till he is four ,years old2 which enables him to submit to considerable ,work1 without being the worse for it4 ,but if1 to inure him to ,fatigue1 he should be accustomed1 immediately from his ,birth1 to submit to ,burthens above his ,strength1 he could never prove any ,thing but an utter ,jade1 incapable of real ,service4 ,the ,application of this to the ,stomach of a ,child is very obvious4 ,i shall add another very important ,remark1 and it is this1 that the too early ,work to which the ,children of ,peasants are forced1 becomes of real ,prejudice to the ,publick4 ,hence ,families themselves are less numerous1 and the more ,children that are removed from their ,parents1 while they are very young1 those who are left are the more obliged to ,work1 and very often even at hard ,labour1 at an ,age when they should exercise themselves in the usual ,diversions and ,sports of ,children4 ,hence they wear out in a ,manner1 before they attain the ordinary ,term of ,manhood2 they never arrive at their utmost ,strength1 nor reach their full ,stature2 and it is too common to see a ,countenance with the ,look of twenty ,years1 joined to a ,stature of twelve or thirteen4 ,in fact1 they often sink under the ,weight of such hard involuntary ,labour1 and fall into a mortal ,degree of ,wasting and ,exhaustion4 ,sec4 #cig4 ,secondly1 which indeed is but a ,repetition of the ,advice ,i have already given1 and upon which ,i cannot insist too much1 they must be frequently washed or bathed in cold ,water4 ,sec4 #cih4 ,thirdly1 they should be moved about and exercised as much as they can bear1 after they are some ,weeks old3 the earlier ,days of their tender ,life seeming consecrated1 by ,nature herself1 to a nearly total ,repose1 and to sleeping1 which seems not to determine1 until they have ,need of ,nourishment3 so that1 during this very tender ,term of ,life1 too much ,agitation or ,exercise might be attended with mortal ,consequences4 ,but as soon as their ,organs have attained a little more ,solidity and ,firmness1 the more they are danced about 7provided it is not done about their usual ,time of ,repose1 which ought still to be very considerable7 they are so much the better for it2 and by increasing it gradually1 they may be accustomed to a very quick ,movement1 and at length very safely to such1 as may be called hard and hearty ,exercise4 ,that ,sort of ,motion they receive in ,go-,carts1 or other ,vehicles1 particularly contrived for their ,use1 is more beneficial to them1 than what they have from their ,nurses ,arms1 because they are in a better ,attitude in the former2 and it heats them less in ,summer1 which is a ,circumstance of no small ,importance to them2 considerable ,heat and ,sweat disposing them to be ricketty4 ,sec4 #cii4 ,fourthly1 they should be accustomed to breathe in the free open ,air as much as possible4 ,if ,children have unhappily been less attended to than they ought1 whence they are evidently feeble1 thin1 languid1 obstructed1 and liable to ,scirrhosities 7which constitute what is termed a ricketty or consumptive ,state7 these four ,directions duly observed retrieve them from that unhappy ,state2 provided the ,execution of them has not been too long delayed4 ,sec4 #djj4 ,fifthly1 ,if they have any natural ,discharge of a ,humour by the ,skin1 which is very common with them1 or any ,eruption1 such as ,tetters1 white ,scurf1 a ,rashe1 or the like1 ,care must be taken not to check or repel them1 by any greasy or restringent ,applications4 ,not a ,year passes without ,numbers of ,children having been destroyed by ,imprudence in this ,respect2 while others have been reduced to a deplorable and weakly ,habit4 ,i have been a ,witness to the most unhappy ,consequences of external ,medicines applied for the ,rashe and white ,scurf2 which1 however frightful they may appear1 are never dangerous2 provided nothing at all is applied to them1 without the ,advice and ,consideration of a truly skilful ,person4 ,when such external ,disorders prove very obstinate1 it is reasonable to suspect some ,fault or ,disagreement in the ,milk the ,child sucks2 in which ,case it should immediately be discontinued1 corrected1 or changed4 ,but ,i cannot enter here into a particular ,detail of all the ,treatment necessary in such ,cases4 ,chapter ,,xxviii4 ,directions with ,respect to drowned ,persons4 #ic #ic ,the ,misfortune of a young ,man drowned in bathing himself1 at the ,beginning of the ,season1 occasioned the ,publication of this ,chapter by itself in ,june1 #agfa4 ,a few ,days after1 the like ,misfortune happened to a labouring ,man2 but he was happily taken out of the water sooner than the first 7who had remained about half an ,hour under it7 and he was recovered by observing ,part of the ,advice this ,chapter contains2 of which ,chapter several ,bystanders had ,copies4--,this ,note seems to be from the ,author himself4 ,sect4 #dja4 ,whenever a ,person who has been drowned1 has remained a ,quarter of an ,hour under ,water1 there can be no considerable ,hopes of his ,recovery3 the ,space of two or three ,minutes in such a ,situation being often sufficient to kill a ,man irrecoverably4 ,nevertheless1 as several ,circumstances may happen to have continued ,life1 in such an unfortunate ,situation1 beyond the ordinary ,term1 we should always endeavour to afford them the most effectual ,relief1 and not give them up as irrecoverable too soon3 since it has often been known1 that until the ,expiration of two1 and sometimes even of three ,hours1 such ,bodies have exhibited some apparent ,tokens of ,life4 ,water has sometimes been found in the ,stomach of drowned ,persons2 at other times none at all4 ,besides1 the greatest ,quantity which has ever been found in it has not exceeded that1 which may be drank without any ,inconvenience2 whence we may conclude1 the meer ,quantity was not mortal2 neither is it very easy to conceive how drowned ,persons can swallow ,water4 ,what really kills them is meer ,suffocation1 or the ,interception of ,air1 of the ,action of breathing2 and the ,water which descends into the ,lungs1 and which is determined there1 by the ,efforts they necessarily1 though involuntarily make1 to draw ,breath1 after they are under ,water3 for there absolutely does not any ,water descend1 either into the ,stomach or the ,lungs of ,bodies plunged into ,water1 after they are dead2 a ,circumstance1 which serves to establish a legal ,sentence and ,judgment in some criminal ,cases1 and ,trials3 ,this ,water intimately blending itself with the ,air in the ,lungs1 forms a viscid inactive ,kind of ,froth1 which entirely destroys the ,functions of the ,lungs2 whence the miserable ,sufferer is not only suffocated1 but the ,return of the ,blood from the ,head being also intercepted1 the ,blood ,vessels of the ,brain are overcharged1 and an ,apoplexy is combined with the ,suffocation4 ,this second ,cause1 that is1 the ,descent of the ,water into the ,lungs1 is far from being general1 it having been evident from the ,dissection of several drowned ,bodies1 that it really never had existed in them4 ,sec4 #djb4 ,the ,intention that should be pursued1 is that of unloading the ,lungs and the ,brain1 and of reviving the extinguished ,circulation4 ,for which ,purpose we should1 #a1 immediately strip the ,sufferer of all his wet ,cloaths2 rub him strongly with dry coarse ,linnen2 put him1 as soon as possible1 into a well heated ,bed1 and continue to rub him well a very considerable ,time together4 #b1 ,a strong and healthy ,person should force his own warm ,breath into the ,patient's ,lungs2 and the ,smoke of ,tobacco1 if some was at ,hand1 by ,means of some ,pipe1 ,chanel1 ,funnel or the like1 that may be introduced into the ,mouth4 ,this ,air or ,fume1 being forcibly blown in1 by stopping the ,sufferer's ,nostrils close at the same ,time1 penetrates into the ,lungs1 and there rarifies by its ,heat that ,air1 which blended with the ,water1 composed the viscid ,spume or ,froth4 ,hence that ,air becomes disengaged from the ,water1 recovers its ,spring1 dilates the ,lungs2 and1 if there still remains within any ,principle of ,life1 the ,circulation is renewed again that ,instant4 #c1 ,if a moderately expert ,surgeon is at ,hand1 he must open the jugular ,vein1 or any large ,vein in the ,neck1 and let out ten or twelve ,ounces of ,blood4 ,such a ,bleeding is serviceable on many ,accounts4 ,first1 merely as ,bleeding1 it renews the ,circulation1 which is the constant ,effect of ,bleeding in such ,swoonings1 as arise from an intercepted or suffocated ,circulation4 ,secondly1 it is that particular ,bleeding1 which most suddenly removes1 in such ,cases1 the ,infarction or ,obstruction of the ,head and ,lungs2 and1 thirdly1 it is sometimes the only ,vessel1 whence ,blood will issue under such ,circumstances4 ,the ,veins of the ,feet then afford none2 and those of the ,arms seldom2 but the ,jugulars almost constantly furnish it4 ,fourthly1 the ,fume of ,tobacco should be thrown up1 as speedily and plentifully as possible1 into the ,intestines by the ,fundament4 ,there are very commodious ,contrivances devised for this ,purpose2 but as they are not common1 it may be effected by many speedy ,means4 ,one1 by which a ,woman's ,life was preserved1 consisted only in introducing the small ,tube of a ,tobacco ,pipe well lighted up3 the ,head or ,bowl of it was wrapped up in a ,paper1 in which several ,holes were pricked1 and through these the ,breath was strongly forced4 ,at the fifth ,blast a considerable ,rumbling was heard in the ,woman's ,belly2 she threw up a little ,water1 and a ,moment afterwards came to her ,senses4 ,two ,pipes may be thus lighted and applied1 with their ,bowls covered over2 the ,extremity of one is to be introduced into the ,fundament2 and the other may be blown through into the ,lungs4 ,any other ,vapour may also be conveyed up1 by introducing a ,canula1 or any other ,pipe1 with a ,bladder firmly fixed to it4 ,this ,bladder is fastened at its other ,end to a large ,tin ,funnel1 under which ,tobacco is to be lighted4 ,this ,contrivance has succeeded with me upon other ,occasions1 in which ,necessity compelled me to invent and apply it4 ,fifthly1 the strongest ,volatiles should be applied to the ,patient's ,nostrils4 ,the ,powder of some strong dry ,herb should be blown up his ,nose1 such as ,sage1 ,rosemary1 ,rue1 ,mint1 and especially ,marjoram1 or very well dried ,tobacco2 or even the ,fume1 the ,smoke of these ,herbs4 ,but all these ,means are most properly employed after ,bleeding1 when they are most efficacious and certain4 ,sixthly1 as long as the ,patient shews no ,signs of ,life1 he will be unable to swallow1 and it is then useless1 and even dangerous1 to pour much ,liquid of any kind into his ,mouth1 which could do nothing but keep up1 or increase ,suffocation4 ,it is sufficient1 in such ,circumstances1 to instil a few ,drops of some irritating ,liquor1 which might also be cordial and reviving4 ,but as soon as ever he discovers any ,motion1 he should take1 within the ,space of one ,hour1 five or six common ,spoonfuls of ,oxymel of ,squills diluted with warm ,water3 or if that ,medicine was not to be had very speedily1 a strong ,infusion of the blessed ,thistle1 or ,carduus benedictus1 of ,sage1 or of ,chamomile ,flowers sweetened with ,honey1 might do instead of it3 and supposing nothing else to be had1 some warm ,water1 with the ,addition of a little common ,salt1 should be given4 ,some ,persons are bold enough to recommend ,vomits in such ,cases2 but they are not without their ,inconvenience2 and it is not as a ,vomit that ,i recommend the ,oxymel of ,squills in them4 ,seventhly1 ,notwithstanding the ,sick discover some ,tokens of ,life1 we should not cease to continue our ,assistance2 since they sometimes irrecoverably expire1 after these first ,appearances of recovering4 ,and lastly1 though they should be manifestly re-animated1 there sometimes remains an ,oppression1 a ,coughing and ,feverishness1 which effectually constitute a ,disease3 and then it becomes necessary sometimes to bleed them in the ,arms2 to give them ,barley ,water plentifully1 or ,elder-flower ,tea4 ,sec4 #djc4 ,having thus pointed out such ,means as are necessary1 and truly effectual1 in such unfortunate ,accidents1 ,i shall very briefly mention some others1 which it is the general ,custom to use and apply in the first ,hurry4 #a1 ,these unhappy ,people are sometimes wrapped up in a ,sheep's1 or a ,calf's1 or a ,dog's ,skin1 immediately flead from the ,animal3 these ,applications have sometimes indeed revived the ,heat of the ,drowned2 but their ,operations are more slow1 and less efficacious1 than the ,heat of a well-warmed ,bed2 with the additional ,vapour of burnt ,sugar1 and long continued ,frictions with hot ,flanels4 #b1 ,the ,method of rolling them in an empty ,hogshead is dangerous1 and mispends a deal of important ,time4 #c1 ,that also of hanging them up by the ,feet is attended with ,danger1 and ought to be wholly discontinued4 ,the ,froth or ,foam1 which is one of the ,causes of their ,death1 is too thick and tough to discharge itself1 in ,consequence of its own ,weight4 ,nevertheless1 this is the only ,effect that can be expected1 from this ,custom of suspending them by the ,feet2 which must also be hurtful1 by its tending to increase the ,overfulness of the ,head and of the ,lungs4 ,sec4 #djd4 ,it is some ,years since a ,girl of eighteen ,years old was recovered though it is unknown whether she remained under ,water only a little ,time or some ,hours who was motionless1 frozen as it were1 insensible1 with her ,eyes closed1 her ,mouth wide open1 a livid ,colour1 a swoln ,visage1 a ,tumour or bloating of the whole ,body1 which was overladen as it were1 or ,water-soaked4 ,this miserable ,object was extended on a ,kind of ,bed1 of hot or very warm ,ashes1 quickly heated in great ,kettles2 and by laying her quite naked on these ,ashes2 by covering her with others equally hot2 by putting a ,bonnet round her ,head1 with a ,stocking round her ,neck stuffed with the same1 and heaping ,coverings over all this1 at the ,end of half an ,hour her ,pulse returned1 she recovered her ,speech1 and cried out1 ,i freeze1 ,i freeze3 ,a little ,cherry-,brandy was given her1 and then she remained buried1 as it were1 eight ,hours under the ,ashes2 being taken out of them afterwards without any other ,complaint1 except that of great ,lassitude or ,weariness1 which went entirely off the third ,day4 ,this ,method was undoubtedly so effectual1 that it well deserves ,imitation2 but it should not make us inattentive to the others4 ,heated ,gravel or ,sand mixed with ,salt1 or hot ,salt alone1 would have been equally efficacious1 and they have been found so4 ,at the very ,time of writing this1 two young ,ducks1 who were drowned1 have been revived by a dry ,bath of hot ,ashes4 ,the ,heat of a ,dung-heap may also be beneficial2 and ,i have just been informed1 by a very creditable and sensible ,spectator of it1 that it effectually contributed to restore ,life to a ,man1 who had certainly remained six ,hours under ,water4 ,sec4 #dje4 ,i shall conclude these ,directions with an ,article printed in a little ,work at ,paris1 about twenty ,years since1 by ,order of the ,king1 to which there is not the least ,doubt1 but that any other ,sovereign will readily accede4 ,notwithstanding the common ,people are very generally disposed to be compassionate1 and may wish to give all ,assistance to drowned ,persons1 it frequently happens they do not1 only because they dare not2 imagining they expose themselves by it to ,prosecutions4 ,it is therefore necessary1 that they should know1 and it cannot be too often repeated1 in order to eradicate such a pernicious ,prejudice1 that the ,magistrates have never interposed to prevent ,people from trying every possible ,means to recover such unfortunate ,persons1 as shall be drowned and taken out of the ,water4 ,it is only in those ,cases1 when the ,persons are known to be absolutely and irrecoverably dead1 that ,justice renders it necessary to seize their ,bodies4 ,chapter ,,xxix4 ,of ,substances stopt between the ,mouth and the ,stomach4 ,sect4 #djf4 ,the ,food we take in descends from the ,mouth through a very strait ,passage or ,chanel1 called the ,oesophagus1 the ,gullet1 which1 going parallel with the ,spine or ,backbone1 joins to1 or terminates at1 the ,stomach4 ,it happens sometimes that different ,bodies are stopt in this ,chanel1 without being able either to descend or to return up again2 whether this ,difficulty arises from their being too large2 or whether it be owing to their having such ,angles or ,points1 as by penetrating into1 and adhering to the ,sides of this membranous ,canal1 absolutely prevent the usual ,action and ,motion of it4 ,sec4 #djg4 ,very dangerous ,symptoms arise from this ,stoppage1 which are frequently attended with a most acute ,pain in the ,part2 and at other ,times1 with a very incommodious1 rather than painful1 ,sensation2 sometimes a very ineffectual ,commotion at1 or rising of1 the ,stomach1 attended with great ,anguish2 and if the ,stoppage be so circumstanced1 that the ,glottis is closed1 or the ,wind-pipe compressed1 a dreadful ,suffocation is the ,consequence3 the ,patient cannot breathe1 the ,lungs are quite distended2 and the ,blood being unable to return from the ,head1 the ,countenance becomes red1 then livid2 the ,neck swells2 the ,oppression increases1 and the poor ,sufferer speedily dies4 ,when the ,patient's ,breathing is not stopt1 nor greatly oppressed2 if the ,passage is not entirely blocked up1 and he can swallow something1 he lives very easily for a few ,days1 and then his ,case becomes a particular ,disorder of the ,oesophagus1 or ,gullet4 ,but if the ,passage is absolutely closed1 and the ,obstruction cannot be removed for many ,days1 a terrible ,death is the ,consequence4 ,sec4 #djh4 ,the ,danger of such ,cases does not depend so much on the ,nature of the obstructing ,substance1 as on its ,size1 with ,regard to that of the ,passage of the ,part where it stops1 and of the ,manner in which it forms the ,obstruction2 and frequently the very ,food may occasion ,death2 while ,substances less adapted to be swallowed are not attended with any violent ,consequences1 though swallowed4 ,a ,child of six ,days old swallowed a ,comfit or ,sugar ,plumb1 which stuck in the ,passage1 and instantly killed it4 ,a grown ,person perceived that a ,bit of ,mutton had stopt in the ,passage2 not to alarm any ,body he arose from ,table2 a ,moment afterwards1 on looking where he might be gone1 he was found dead4 ,another was choaked by a ,bit of ,cake2 a third by a ,piece of the ,skin of a ,ham2 and a fourth by an ,egg1 which he swallowed whole in a ,bravo4 ,a ,child was killed by a ,chesnut swallowed whole4 ,another died suddenly1 choaked 7which is always the ,circumstance1 when they die instantly after such ,accidents7 by a ,pear which he had tossed up1 and catched in his ,mouth4 ,a ,woman was choaked with another ,pear4 ,a ,piece of a ,sinew continued eight ,days in the ,passage1 so that it prevented the ,patient from getting down any ,thing else2 at the ,expiration of that ,time it fell into the ,stomach1 being loosened by its ,putridity3 ,the ,patient notwithstanding died soon after1 being killed by the ,inflammation1 ,gangrene and ,weakness it had occasioned4 ,unhappily there occur but too many ,instances of this ,sort1 of which it is unnecessary to cite more4 ,sec4 #dji4 ,whenever any ,substance is thus detained in the ,gullet1 there are two ,ways of removing it2 that is either by extracting it1 or pushing it down4 ,the safest and most certain ,way is always to extract or draw it out1 but this is not always the easiest3 and as the ,efforts made for this ,purpose greatly fatigue the ,patient1 and are sometimes attended with grievous ,consequences2 and yet if the ,occasion is extremely urging1 it may be eligible to thrust it down1 if that is easier2 and if there is no ,danger from the obstructing ,bodies ,reception into the ,stomach4 ,the ,substances which may be pushed down without ,danger1 are all common nourishing ones1 as ,bread1 ,meat1 ,cakes1 ,fruits1 ,pulse1 ,morsels of ,tripe1 and even ,skin of ,bacon4 ,it is only very large ,morsels of particular ,aliments1 that prove very difficult to digest2 yet even such are rarely attended with any ,fatality4 ,sec4 #daj4 ,the ,substances we should endeavour to extract or draw out1 though it be more painful and less easy than to push them down1 are all those1 whose ,consequences might be highly dangerous1 or even mortal1 if swallowed4 ,such are all totally indigestible ,bodies1 as ,cork1 ,linen-,rags1 large ,fruit ,stones1 ,bones1 ,wood1 ,glass1 ,stones1 ,metals2 and more especially if any further ,danger may be superadded to that of its ,indigestibility1 from the ,shape1 whether rough1 sharp1 pointed1 or angular1 of the ,substance swallowed4 ,wherefore we should chiefly endeavour to extract ,pins1 ,needles1 ,fish-bones1 other pointed ,fragments of ,bones1 ,bits of ,glass1 ,scissars1 ,rings1 or ,buckles4 ,nevertheless it has happened1 that every one of these ,substances have at one ,time or another been swallowed1 and the most usual ,consequences of them are violent ,pains of the ,stomach1 and in the ,guts2 ,inflammations1 ,suppurations1 ,abscesses1 a slow ,fever1 ,gangrene1 the ,miserere or ,iliac ,passion2 external ,abscesses1 through which the ,bodies swallowed down have been discharged2 and frequently1 after a long ,train of ,maladies1 a dreadful ,death4 ,sec4 #daa4 ,when such ,substances have not passed in too deep1 we should endeavour to extract them with our ,fingers1 which often succeeds4 ,if they are lower1 we should make use of ,nippers or a small ,forceps2 of which ,surgeons are provided with different ,sorts4 ,those which some ,smoakers carry about them might be very convenient for such ,purposes2 and in ,case of ,necessity they might be made very readily out of two ,bits of ,wood4 ,but this ,attempt to extract rarely succeeds1 if the ,substance has descended far into the ,oesophagus1 and if the ,substance be of a flexible ,nature1 which exactly applies itself to1 and fills up the ,cavity or ,chanel of it4 ,sec4 #dab4 ,if the ,fingers and the ,nippers fail1 or cannot be duly applied1 ,crotchets1 a ,kind of ,hooks1 must be employed4 ,these may be made at once with a pretty strong iron ,wire1 crooked at the ,end4 ,it must be introduced in the flat ,way1 and for the better conducting of it1 there should be another ,curve or ,hook at the ,end it is held by1 to serve as a ,kind of ,handle to it1 which has this further ,use1 that it may be secured by a ,string tied to it2 a ,circumstance not to be omitted in any ,instrument employed on such ,occasions1 to avoid such ill ,accidents as have sometimes ensued1 from these ,instruments slipping out of the ,operators ,hold4 ,after the ,crotchet has passed beyond and below the ,substance1 that obstructs the ,passage1 it is drawn up again1 and hooks up with it and extracts that ,impediment to swallowing4 ,this ,crotchet is also very convenient1 whenever a ,substance somewhat flexible1 as a ,pin or a ,fishbone stick1 as it were1 across the ,gullet3 the ,crotchet in such ,cases seizing them about their middle ,part1 crooks and thus disengages them4 ,if they are very brittle ,substances1 it serves to break them2 and if any ,fragments still stick within1 some other ,means must be used to extract them4 ,sec4 #dac4 ,when the obstructing ,bodies are small1 and only stop up ,part of the ,passage2 and which may either easily elude the ,hook1 or straiten it by their ,resistance1 a ,kind of ,rings may be used1 and made either solid or flexible4 ,the solid ones are made of iron ,wire1 or of a ,string of very fine brass ,wire4 ,for this ,purpose the ,wire is bent into a ,circle about the middle ,part of its ,length1 the ,sides of which ,circle do not touch each other1 but leave a ,ring1 or hollow ,cavity1 of about an ,inch ,diameter4 ,then the long unbent ,sides of the ,wire are brought near each other2 the circular ,part or ,ring is introduced into the ,gullet1 in order to be conducted about the obstructing ,body1 and so to extract it4 ,very flexible ,rings may be made of ,wool1 ,thread1 ,silk1 or small ,packthread1 which may be waxed1 for their greater ,strength and ,consistence4 ,then they are to be tied fast to a ,handle of ,iron-,wire1 of ,whale-bone1 or of any flexible ,wood2 after which the ,ring is to be introduced to surround the obstructing ,substance1 and to draw it out4 ,several of these ,rings passed through one another are often made use of1 the more certainly to lay hold of the obstructing ,body1 which may be involved by one1 if another should miss it4 ,this ,sort of ,rings has one ,advantage1 which is1 that when the ,substance to be extracted is once laid hold of1 it may then1 by turning the ,handle1 be retained so strongly in the ,ring thus twisted1 as to be moved every ,way2 which must be a considerable ,advantage in many such ,cases4 ,sec4 #dad4 ,a fourth ,material employed on these unhappy ,occasions is the ,sponge4 ,its ,property of swelling considerably1 on being wet1 is the ,foundation of its ,usefulness here4 ,if any ,substance is stopt in the ,gullet1 but without filling up the whole ,passage1 a ,bit of ,sponge is introduced1 into that ,part that is unstopt1 and beyond the ,substance4 ,the ,sponge soon dilates1 and grows larger in this moist ,situation1 and indeed the ,enlargement of it may be forwarded1 by making the ,patient swallow a few ,drops of ,water2 and then drawing back the ,sponge by the ,handle it is fastened to1 as it is now too large to return through the small ,cavity1 by which it was conveyed in1 it draws out the obstructing ,body with it1 and thus unplugs1 as it were1 and opens the ,gullet4 ,as dry ,sponge may shrink or be contracted1 this ,circumstance has proved the ,means of squeezing a pretty large ,piece of it into a very small ,space4 ,it becomes greatly compressed by winding a ,string or ,tape very closely about it1 which ,tape may be easily unwound and withdrawn1 after the ,sponge has been introduced4 ,it may also be inclosed in a ,piece of ,whalebone1 split into four ,sticks at one ,end1 and which1 being endued with a considerable ,spring1 contracts upon the ,sponge4 ,the ,whalebone is so smoothed and accommodated1 as not to wound2 and the ,sponge is also to be safely tied to a strong ,thread2 that after having disengaged the ,whalebone from it1 the ,surgeon may also draw out the ,sponge at ,pleasure4 ,sponge is also applied on these ,occasions in another ,manner4 ,when there is no ,room to convey it into the ,gullet1 because the obstructing ,substance ingrosses its whole ,cavity2 and supposing it not hooked into the ,part1 but solely detained by the ,straitness of the ,passage1 a pretty large ,bit of ,sponge is to be introduced towards the ,gullet1 and close to the obstructing ,subtance3 ,thus applied1 the ,sponge swells1 and thence dilates that ,part of the ,passage that is above this ,substance4 ,the ,sponge is then withdrawn a little1 and but a very little1 and this ,substance being less pressed upon above than below1 it sometimes happens1 that the greater ,staitness and ,contraction of the lower ,part of the ,passage1 than of its upper ,part1 causes that ,substance to ascend2 and as soon as this first ,loosening or ,disengagement of it has happened1 the total ,disengagement of it easily follows4 ,sec4 #dae4 ,finally1 when all these ,methods prove unavailable1 there remains one more1 which is to make the ,patient vomit2 but this can scarcely be of any ,service1 but when such obstructing ,bodies are simply engaged in1 and not hooked or stuck into the ,sides of the ,oesophagus2 since under this latter ,circumstance vomiting might occasion further ,mischief4 ,if the ,patient can swallow1 a ,vomiting may be excited with the ,prescription ,no4 #h1 or with ,no4 #cd1 or #ce4 ,by this ,operation a ,bone was thrown out1 which had stopt in the ,passage four and twenty ,hours4 ,when the ,patient cannot swallow1 an ,attempt should be made to excite him to vomit by introducing into1 and twirling about the feathery ,end of a ,quill in1 the ,bottom of the ,throat1 which the ,feather however will not effect1 if the obstructing ,body strongly compresses the whole ,circumference of the ,gullet2 and then no other ,resource is left1 but giving a ,glyster of ,tobacco4 ,a certain ,person swallowed a large ,morsel of ,calf's ,lights1 which stopt in the ,middle of the ,gullet1 and exactly filled up the ,passage4 ,a ,surgeon unsuccessfully attempted various ,methods to extract it2 but another seeing how unavailable all of them were2 and the ,patient's ,visage becoming black and swelled2 his ,eyes ready to start1 as it were1 out of his ,head2 and falling into frequent ,swoonings1 attended with ,convulsions too1 he caused a ,glyster of an ,ounce of ,tobacco boiled to be thrown up2 the ,consequence of which was a violent ,vomiting1 which threw up the ,substance that was so very near killing him4 ,sec4 #daf4 ,a sixth ,method1 which ,i believe has never hitherto been attempted1 but which may prove very useful in many ,cases1 when the ,substances in the ,passage are not too hard1 and are very large1 would be to fix a ,worm 7used for withdrawing the ,charge of ,guns that have been loaded7 fast to a flexible ,handle1 with a waxed ,thread fastened to the ,handle1 in ,order to withdraw it1 if the ,handle slipt from the ,worm2 and by this ,contrivance it might be very practicable1 if the obstructing ,substance was not too deep in the ,passage of the ,gullet1 to extract it--,it has been known that a ,thorn fastened in the ,throat1 has been thrown out by laughing4 ,sec4 #dag4 ,in the ,circumstances mentioned ,sec4 #dji1 when it is more easy and convenient to push the obstructing ,body downwards1 it has been usual to make ,use of ,leeks1 which may generally be had any where 7but which indeed are very subject to break7 or of a ,wax-candle oiled1 and but a very little heated1 so as to make it flexible2 or of a ,piece of ,whale-bone2 or of ,iron-,wire2 one ,extremity of which may be thickened and blunted in a ,minute with a little melted ,lead4 ,small ,sticks of some flexible ,wood may be as convenient for the same ,use1 such as the ,birch-tree1 the ,hazel1 the ,ash1 the ,willow1 a flexible ,plummet1 or a leaden ,ring4 ,all these ,substances should be very smooth1 that they may not give the least ,irritation2 for which ,reason they are sometimes covered over with a thin ,bit of ,sheep's ,gut4 ,sometimes a ,sponge is fastened to one ,end of them1 which1 completely filling up the whole ,passage1 pushes down whatever ,obstacle it meets with4 ,in such ,cases too1 the ,patient may be prompted to attempt swallowing down large ,morsels of some unhurtful ,substance1 such as a ,crust of ,bread1 a small ,turnep1 a ,lettuce ,stalk1 or a ,bullet1 in ,hopes of their carrying down the obstructing ,cause with them4 ,it must be acknowledged1 however1 that these afford but a feeble ,assistance2 and if they are swallowed without being well secured to a ,thread1 it may be apprehended they may even increase the ,obstruction1 by their own ,stoppage4 ,it has sometimes very happily1 though rarely1 occurred1 that those ,substances attempted to be detruded or thrust downwards1 have stuck in the ,wax-,candle1 or the ,leek1 and sprung up and out with them3 but this can never happen except in the ,case of pointed ,substances4 ,sec4 #dah4 ,should it be impossible to extract the ,bodies mentioned ,sec4 #daj1 and all such as it must be dangerous to admit into the ,stomach1 we must then prefer the least of two ,evils1 and rather run the ,hazard of pushing them down1 than suffer the ,patient to perish dreadfully in a few ,moments4 ,and we ought to scruple this ,resolution the less1 as a great many ,instances have demonstrated1 that notwithstanding several bad ,consequences1 and even a tormenting ,death1 have often followed the swallowing of such hurtful or indigestible ,substances2 yet at other times they have been attended with little or no ,disorder4 ,sec4 #dai4 ,one of these four ,events is always the ,case1 after swallowing such ,things4 ,they either1 #a1 go off by ,stool2 or1 #b1 they are not discharged and kill the ,patient4 ,or else1 #c1 they are discharged by ,urine2 or1 #d1 are visibly extruded to the ,skin4 ,i shall give some ,instances of each of these ,events4 ,sec4 #dbj4 ,when they are voided by ,stool1 they are either voided soon after they have been swallowed1 and that without having occasional scarce any troublesome ,symptom2 or the voiding of them has not happened till a long ,time after swallowing1 and is preceded with very considerable ,pain4 ,it has been seen that a ,bone of the ,leg of a ,fowl1 a ,peach-stone1 the ,cover of a small ,box of ,venice ,treacle1 ,pins1 ,needles1 and ,coins of different ,sorts1 have been voided within a few ,days after they had slipt down into the ,stomach2 and that with little or no ,complaint4 ,a small ,flute1 or ,pipe also1 four ,inches long1 which occasioned acute ,pains for three ,days1 has been voided happily afterwards1 besides1 ,knives1 ,razors1 and one ,shoe-buckle4 ,i have seen but a few ,days since a ,child between two and three ,years old1 who swallowed a ,nail above an ,inch long1 the ,head of which was more than three ,tenths of an ,inch broad3 it stopt a few ,moments about the ,neck1 but descended while its ,friends were looking for me2 and was voided with a ,stool that ,night1 without any bad ,consequence4 ,and still more lately ,i have known the entire ,bone of a ,chicken's ,wing thus swallowed1 which only occasioned a slight ,pain in the ,stomach for three or four ,days4 ,sometimes such ,substances are retained within for a long ,time1 not being voided till after several ,months1 and even ,years1 without the least ill ,effect3 and some of them have never either appeared1 nor been complained of4 ,sec4 #dba4 ,but the ,event is not always so happy2 and sometimes though they are discharged through the natural ,passages1 the ,discharges have been preceded by very acute ,pains in the ,stomach1 and in the ,bowels4 ,a ,girl swallowed down some ,pins1 which afflicted her with violent ,pains for the ,space of six ,years2 at the ,expiration of which ,term she voided them and recovered4 ,three ,needles being swallowed brought on ,cholics1 ,swoonings and ,convulsions for a ,year after3 and then being voided by ,stool1 the ,patient recovered4 ,another ,person who swallowed two1 was much happier in suffering but six ,hours from them2 when they were voided by ,stool1 and he did well4 ,it sometimes happens that such indigestible ,substances1 after having past all the ,meanders1 the whole ,course of the ,intestines1 have been stopt in the ,fundament1 and brought on very troublesome ,symptoms2 but such however1 as an expert ,surgeon may very generally remove4 ,if it is practicable to cut them1 as it is when they happen to be thin ,bones1 the ,jaw-bones of ,fish1 or ,pins1 they are then very easily extracted4 ,sec4 #dbb4 ,the second ,event is1 when these fatal ,substances are never voided1 but cause very embarrassing ,symptoms which finally kill the ,patient2 and of these ,cases there have been but too many ,examples4 ,a young ,girl having swallowed some ,pins1 which she held in her ,mouth1 some of them were voided by ,stool2 but others of them pricked and pierced into her ,guts1 and even into the ,muscles of her ,belly1 with the severest ,pain2 and killed her at the ,end of three ,weeks4 ,a ,man swallowed a ,needle1 which pierced through his ,stomach1 and into his ,liver1 #id and ended in a mortal ,consumption4 #id ,i saw a very similar ,instance and ,event in a ,lady's little favourite ,bitch1 whole ,body she desired to be opened1 from suspecting her to have been poisoned4 ,but it appeared that a small ,needle with fine ,thread1 which she had swallowed1 had passed out of the ,stomach into the ,duodenum 7one of the ,guts7 through which the ,point had pierced and pricked and corroded the concave ,part of the ,liver1 which was all rough and putrid4 ,the whole ,carcase was greatly bloated and extremely offensive1 very soon after the poor ,animal's ,death1 which happened two or three ,months after the ,accident1 and was preceded by a great ,wheezing1 ,restlessness and ,loss of ,appetite4 ,the ,needle was rusty1 but the ,thread entire1 and very little altered4 ,k4 ,a ,plummet which slipt down1 while the ,throat of a ,patient was searching1 killed him at the ,end of two ,years4 ,it is very common for different ,coins1 and of different ,metals1 to be swallowed without any fatal or troublesome ,effects4 ,even a hundred ,luidores #ie have been swallowed1 and all voided4 ,nevertheless these fortunate ,escapes ought not to make ,people too secure and incautious on such ,occasions1 since such melancholy ,consequences have happened1 as may very justly alarm them4 ,one single ,piece of ,money that was swallowed1 entirely obstructed the ,communication between the ,stomach and the ,intestines1 and killed the ,patient4 ,whole ,nuts have often been inadvertently swallowed2 but there have been some ,instances of ,persons in whom a ,heap #if of them has been formed1 which proved the ,cause of ,death1 after producing much ,pain and ,inquietude4 #ie ,i knew a ,man of the ,name of ,poole1 who being taken in the same ,ship with me1 #agag or #ah1 by ,pirates1 had swallowed four ,ginueas1 and a gold ,ring1 all which he voided some ,days after without any ,injury or ,complaint1 and saved them4 ,i forget the exact ,number of ,days he retained them1 but the ,pirates staid with us from ,saturday ,night to ,thursday ,noon4 ,k4 #if ,many fatal ,examples of this ,kind may be seen in the ,philosophical ,transactions2 and they should caution ,people against swallowing ,cherry-stones1 and still more against those of ,prunes1 or such as are pointed1 though not very acutely4 ,k4 ,sec4 #dbc4 ,the third ,issue or ,event is1 when these ,substances1 thus swallowed down1 have been discharged by ,urine3 but these ,cases are very rare4 ,a ,pin of a middling ,size has been discharged by ,urine1 three ,days after it slipt down2 and a little ,bone has been expelled the same ,way1 besides ,cherry-stones1 ,plumb-stones1 and even one ,peach-stone4 ,sec4 #dbd4 ,finally1 the fourth ,consequence or ,event is1 when the indigestible ,substances thus swallowed1 have pierced through the ,stomach or ,intestines1 and even to the ,skin itself2 and occasioning an ,abscess1 have made an ,outlet for themselves1 or have been taken out of the ,abscess4 ,a long ,time is often required to effect this extraordinary ,trajection and ,appearance of them2 sometimes the ,pains they occasion are continual2 in other ,cases the ,patient complains for a ,time1 after which the ,pain ceases1 and then returns again4 ,the ,imposthume1 or ,gathering1 is formed in the ,stomach1 or in some other ,part of the ,belly3 and sometimes these very ,substances1 after having pierced through the ,guts1 make very singular ,routs1 and are discharged very remotely from the ,belly4 ,one ,needle that had been swallowed found its ,way out1 at the ,end of four ,years1 through the ,leg2 another at the ,shoulder4 ,sec4 #dbe4 ,all these ,examples1 and many others of cruel ,deaths1 from swallowing noxious ,substances1 demonstrate the great ,necessity of an habitual ,caution in this ,respect2 and give in their ,testimony against the horrid1 ,i had almost said1 the criminal ,imprudence1 of ,people's amusing themselves with such ,tricks as may lead to such terrible ,accidents2 or even holding any such ,substance in their ,mouths1 as by slipping down through ,imprudence or ,accident1 may prove the ,occasion of their ,death4 ,is it possible that any one1 without shuddering1 can hold ,pins or ,needles in their ,mouths1 after reflecting on the dreadful ,accidents1 and cruel ,deaths1 that have thus been caused by them4 ,sec4 #dbf4 ,it has been shewn already1 that ,substances obstructing the ,passage of the ,gullet sometimes suffocate the ,patient2 that at other ,times they can neither be extracted nor thrust down2 but that they stop in the ,passage1 without killing the ,patient1 at least not immediately and at once4 ,this is the ,case when they are so circumstanced1 as not to compress the ,trachaea1 the ,wind-pipe1 and not totally to prevent the swallowing of ,food2 which last ,circumstance can scarcely happen1 except the ,obstruction has been formed by angular or pointed ,bodies4 ,the ,stoppage of such ,bodies is sometimes attended1 and that without much ,violence1 with a small ,suppuration1 which loosens them2 and then they are either returned upwards through the ,mouth1 or descend into the ,stomach4 ,but at other ,times an extraordinary ,inflammation is produced1 which kills the ,patient4 ,or if the ,contents of the ,abscess attending the ,inflammation tend outwardly1 a ,tumour is formed on the external ,part of the ,neck1 which is to be opened1 and through whose ,orifice the obstructing ,body is discharged4 ,in other ,instances again they take a different ,course1 attended with little or no ,pain1 and are at length discharged by a ,gathering behind the ,neck1 on the ,breast1 the ,shoulder1 or various other ,parts4 ,sec4 #dbg4 ,some ,persons1 astonished at the extraordinary ,course and ,progression of such ,substances1 which1 from their ,size1 and especially from their ,shape1 seem to them incapable of being introduced into1 and in some ,sort1 circulating through the human ,body1 without destroying it1 are very desirous of having the ,rout and ,progression of such intruding ,substances explained to them4 ,to gratify such ,inquirers1 ,i may be indulged in a short ,digression1 which perhaps is the less foreign to my ,plan2 as in dissipating what seems marvelous1 and has been thought supernatural in such ,cases1 ,i may demolish that superstitious ,prejudice1 which has often ascribed ,effects of this ,sort to ,witchcraft2 but which admit of an easy ,explanation4 ,this very ,reason is the ,motive that has determined me to give a further ,extent to this ,chapter4 ,wherever an ,incision is made through the ,skin1 a certain ,membrane appears1 which consists of two ,coats or ,laminae1 separated from each other by small ,cells or ,cavities1 which all communicate together2 and which are furnished1 more or less1 with ,fat4 ,there is not any ,fat throughout the human ,body1 which is not inclosed in1 or enveloped with1 this ,coat1 which is called the adipose1 fatty1 or cellular ,membrane4 ,this ,membrane is not only found under the ,skin1 but further plying and insinuating itself in various ,manners1 it is extended throughout the whole ,body4 ,it distinguishes and separates all the ,muscles2 it constitutes a ,part of the ,stomach1 of the ,guts1 of the ,bladder1 and of all the ,viscera or ,bowels4 ,it is this which forms what is called the ,cawl1 and which also furnishes a ,sheath or ,envelopement to the ,veins1 ,arteries1 and ,nerves4 ,in some ,parts it is very thick1 and is abundantly replenished with ,fat2 in others it is very thin and unprovided with any2 but wherever it extends1 it is wholly insensible1 or void of all ,sensation1 all ,feeling4 ,it may be compared to a quilted ,coverlet1 the ,cotton1 or other ,stuffing of which1 is unequally distributed2 greatly abounding in some ,places1 with none at all in others1 so that in these the ,stuff above and below touch each other4 ,within this ,membrane1 or ,coverlet1 as it were1 such extraneous or foreign ,substances are moved about2 and as there is a general ,communication throughout the whole ,extent of the ,membrane1 it is no ways surprizing1 that they are moved from one ,part to another very distant1 in a long ,course and ,duration of ,movement4 ,officers and ,soldiers very often experience1 that ,bullets which do not pass through the ,parts where they have entered1 are transferred to very different and remote ones4 ,the general ,communication throughout this ,membrane is daily demonstrated by ,facts1 which the ,law prohibits2 this is the ,butchers inflating1 or blowing up1 the cellular ,membrane throughout the whole ,carcase of a ,calf1 by a small ,incision in the ,skin1 into which they introduce a ,pipe or the ,nozzle of a small ,bellows2 and then1 blowing forcibly1 the ,air evidently puffs up the whole ,body of the ,calf into this artificial ,tumour or ,swelling4 ,some very criminal ,impostors have availed themselves of this wicked ,contrivance1 thus to bloat up ,children into a ,kind of ,monsters1 which they afterwards expose to ,view for ,money4 ,in this cellular ,membrane the extravasated ,waters of hydropic ,patients are commonly diffused2 and here they give ,way to that ,motion1 to which their own ,weight disposes them4 ,but here ,i may be asked--,as this ,membrane is crossed and intersected in different ,parts of it1 by ,nerves1 ,veins1 ,arteries1 c4 the wounding of which unavoidably occasions grievous ,symptoms1 how comes it1 that such do not ensue upon the ,intrusion of such noxious ,substances8 ,to this ,i answer1 #a1 that such ,symptoms do sometimes really ensue2 and #b1 that nevertheless they must happen but seldom1 by ,reason that all the aforesaid ,parts1 which traverse and intersect this ,membrane1 being harder than the ,fat it contains2 such foreign ,substances must almost necessarily1 whenever they rencounter those ,parts1 be turned aside towards the ,fat which surrounds them1 whose ,resistance is very considerably less2 and this the more certainly so1 as these ,nerves1 c4 are always of a cylindrical ,form4----,but to return from this necessary ,digression4 ,sec4 #dbh4 ,to all these ,methods and ,expedients ,i have already recommended on the important ,subject of this ,chapter1 ,i shall further add some general ,directions4 #a4 ,it is often useful1 and even necessary1 to take a considerable ,quantity of ,blood from the ,arm2 but especially if the ,patient's ,respiration1 or ,breathing1 is extremely oppressed2 or when we cannot speedily succeed in our ,efforts to remove the obstructing ,substance2 as the ,bleeding is adapted to prevent the ,inflammation1 which the frequent ,irritations from such ,substances occasion2 and as by its disposing the whole ,body into a ,state of ,relaxation1 it might possibly procure an immediate ,discharge of the offending ,substance4 #b4 ,whenever it is manifest that all ,endeavours1 either to extract1 or to push down the ,substance stopt in the ,passage1 are ineffectual1 they should be discontinued2 because the ,inflammation occasioned by persisting in them1 would be as dangerous as the ,obstruction itself2 as there have been ,instances of ,people's dying in ,consequence of the ,inflammation2 notwithstanding the ,body1 which caused the ,obstruction1 had been entirely removed4 #c4 ,while the ,means already advised are making ,use of1 the ,patient should often swallow1 or if he cannot1 he should frequently receive by ,injection through a crooked ,tube or ,pipe1 that may reach lower down than the ,glottis1 some very emollient ,liquor1 as warm ,water1 either alone or mixed with ,milk1 or a ,decoction of ,barley1 of ,mallows1 or of ,bran4 ,a two-fold ,advantage may arise from this2 the first is1 that these softening ,liquors smooth and sooth the irritated ,parts2 and secondly1 an ,injection1 strongly thrown in1 has often been more successful in loosening the obstructing ,body1 than all ,attempts with ,instruments4 #d4 ,when after all we are obliged to leave this in the ,part1 the ,patient must be treated as if he had an inflammatory ,disease2 he must be bled1 ordered to a ,regimen1 and have his whole ,neck surrounded with emollient ,pultices4 ,the like ,treatment must also be used1 though the obstructing ,substance be removed2 if there is ,room to suppose any ,inflammation left in the ,passage4 #e4 ,a proper ,degree of ,agitation has sometimes loosened the inhering ,body1 more effectually than ,instruments4 ,it has been experienced that a ,blow with the ,fist on the ,spine1 the ,middle of the ,back1 has often disengaged such obstructed and obstructing ,bodies2 and ,i have known two ,instances of ,patients who had ,pins stopt in the ,passage2 and who getting on ,horseback to ride out in ,search of ,relief at a neighbouring ,village1 found each of them the ,pin disengaged after an ,hour's riding3 ,one spat it out1 and the other swallowed it1 without any ill ,consequence4 #f4 ,when there is an immediate ,apprehension of the ,patient's being suffocated2 when bleeding him has been of no ,service2 when all ,hope of freeing the ,passage in time is vanished1 and ,death seems at ,hand1 if ,respiration be not restored2 the ,operation of ,bronchotomy1 or opening of the ,wind-pipe1 must be directly performed2 an ,operation neither difficult to a tolerably knowing and expert ,surgeon1 nor very painful to the ,patient4 #g4 ,when the ,substance that was stopt passes into the ,stomach1 the ,patient must immediately be put into a very mild and smooth ,regimen4 ,he should avoid all sharp1 irritating1 inflaming ,food2 ,wine1 spirituous ,liquors1 all strong ,drink1 and ,coffee2 taking but little ,nourishment at once1 and no ,solids1 without their having been thoroughly well chewed4 ,the best ,diet would be that of farinaceous mealy ,soups1 made of various leguminous ,grains1 and of ,milk and ,water1 which is much better than the usual ,custom of swallowing different ,oils4 ,sec4 #dbi4 ,the ,author of ,nature has provided1 that in eating1 nothing should pass by the ,glottis into the ,wind-pipe4 ,this ,misfortune nevertheless does sometimes happen2 at which very ,instant there ensues an incessant and violent ,cough1 an acute ,pain1 with ,suffocation2 all the ,blood being forced up into the ,head1 the ,patient is in extreme ,anguish1 being agitated with violent and involuntary ,motions1 and sometimes dying on the ,spot4 ,a ,hungarian ,grenadier1 by ,trade a ,shoemaker1 was eating and working at the same time4 ,he tumbled at once from his ,seat1 without uttering a single ,word4 ,his ,comrades called out for ,assistance2 some ,surgeons speedily arrived1 but after all their ,endeavours he discovered no ,token of ,life4 ,on opening the ,body1 they found a ,lump1 or large ,morsel1 of ,beef1 weighing two ,ounces1 forced into the ,windpipe1 which it plugged up so exactly1 that not the least ,air could pass through it into the ,lungs4 ,sec4 #dcj4 ,in a ,case so circumstanced1 the ,patient should be struck often on the ,middle of the ,back2 some ,efforts to vomit should be excited2 he should be prompted to sneeze with ,powder of ,lilly of the ,valley1 ,sage1 or any cephalic ,snuffs1 which should be blown strongly up his ,nose4 ,a ,pea1 pitched into the ,mouth in playing1 entered into the ,wind-pipe1 and sprung out again by vomiting the ,patient with ,oil4 ,a little ,bone was brought up by making another sneeze1 with powdered ,lilly of the ,valley4 ,in short1 if all these ,means of assisting1 or saving the ,patient are evidently ineffectual1 ,bronchotomy must be speedily performed 7,see ,no4 #f1 of the preceding ,section47 ,by this ,operation1 some ,bones1 a ,bean1 and a ,fish-bone have been extracted1 and the ,patient has been delivered from approaching ,death4 ,sec4 #dca4 ,nothing should be left untried1 when the ,preservation of human ,life is the ,object4 ,in those ,cases1 when an obstructing ,body can neither be disengaged from the ,throat1 the ,passage to the ,stomach1 nor be suffered to remain there without speedily killing the ,patient1 it has been proposed to make an ,incision into this ,passage1 the ,oesophagus1 through which such a ,body is to be extracted2 and to employ the like ,means1 when a ,substance which had slipt even into the ,stomach itself1 was of a ,nature to excite such ,symptoms1 as must speedily destroy the ,patient4 ,when the ,oesophagus is so fully and strongly closed1 that the ,patient can receive no ,food by the ,mouth1 he is to be nourished by ,glysters of ,soup1 ,gelly1 and the like4 ,chapter ,,xxx4 ,of external ,disorders1 and such as require chirurgical ,application4 ,of ,burns1 ,wounds1 ,contusions or ,bruises3 ,of ,sprains1 ,ulcers1 frostbitten ,limbs1 ,chilblains1 ,ruptures1 ,boils4 ,of ,fellons1 ,thorns or ,splinters in the ,fingers or ,flesh2 of ,warts1 and of ,corns4 ,sect4 #dcb4 ,labouring ,countrymen are exposed in the ,course of their daily ,work1 to many outward ,accidents1 such as ,cuts1 ,contusions1 c4 which1 however considerable in themselves1 very generally end happily2 and that chiefly in ,consequence of the pure and simple ,nature of their ,blood1 which is generally much less acrimonious1 or sharp1 in the ,country1 than in great ,towns or ,cities4 ,nevertheless1 the very improper ,treatment of such ,accidents1 in the ,country1 frequently renders them1 however light in themselves1 very troublesome2 and indeed1 ,i have seen so many ,instances of this1 that ,i have thought it necessary to mark out here the proper ,treatment of such ,accidents1 as may not necessarily require the ,hand or ,attendance of a ,surgeon4 ,i shall also add something very briefly1 concerning some external ,disorders1 which at the same ,time result from an inward ,cause4 ,of ,burns4 ,sec4 #dcc4 ,when a ,burn is very trifling and superficial1 and occasions no ,vesication or ,blister1 it is sufficient to clap a ,compress of several ,folds of soft ,linen upon it1 dipt in cold ,water1 and to renew it every ,quarter of an ,hour1 till the ,pain is entirely removed4 ,but when the ,burn has blistered1 a ,compress of very fine ,linen1 spread over with the ,pomatum1 ,no4 #fd1 should be applied over it1 and changed twice a ,day4 ,if the true ,skin is burnt1 and even the ,muscles1 the ,flesh under it1 be injured1 the same ,pomatum may be applied2 but instead of a ,compress1 it should be spread upon a ,pledget of soft ,lint1 to be applied very exactly over it1 and over the ,pledget again1 a ,slip of the simple ,plaister ,no4 #fe1 which every ,body may easily prepare2 or1 if they should prefer it1 the ,plaister ,no4 #ff4 ,but1 independently of these external ,applications1 which are the most effectual ones1 when they are directly to be had2 whenever the ,burn has been very violent1 is highly inflamed1 and we are apprehensive of the ,progress and the ,consequences of the ,inflammation1 the same ,means and ,remedies must be recurred to1 which are used in violent ,inflammations3 the ,patient should be bled1 and1 if it is necessary1 it should be repeated more than once1 and he should be put into a ,regimen2 drink nothing but the ,ptisans ,no4 #b and #d1 and receive daily two simple ,glysters4 ,if the ,ingredients for the ,ointment1 called ,nutritum1 are not at ,hand to make the ,pomatum ,no4 #fd2 one ,part of ,wax should be melted in eight such ,parts of ,oil1 to two ,ounces of which ,mixture the ,yolk of an ,egg should be added4 ,a still more simple and sooner prepared ,application1 is that of one ,egg1 both the ,yolk and the ,white1 beat up with two common ,spoonfuls of the sweetest ,oil1 without any ,rankness4 ,when the ,pain of the ,burn1 and all its other ,symptoms have very nearly disappeared1 it is sufficient to apply the ,sparadrap1 or ,oil-cloth ,no4 #ff4 ,of ,wounds4 ,sec4 #dcd4 ,if a ,wound has penetrated into any of the ,cavities1 and has wounded any ,part contained in the ,breast1 or in the ,belly3 ,or if1 without having entered into one of the ,cavities1 it has opened some great ,blood-vessel2 or if it has wounded a considerable ,nerve1 which occasions ,symptoms much more violent1 than would otherwise have happened2 if it has penetrated even to and injured the ,bone3 in short1 if any great and severe ,symptom supervenes1 there is an absolute ,necessity for calling in a ,surgeon4 ,but whenever the ,wound is not attended with any of these ,circumstances2 when it affects only the ,skin1 the fat ,membrane beneath it1 the fleshy ,parts and the small ,vessels1 it may be easily and simply dressed without such ,assistance2 since1 in general1 all that is truly necessary in such ,cases is1 to defend the ,wound from the ,impressions of the ,air2 and yet not so1 as to give any material ,obstruction to the ,discharge of the ,matter1 that is to issue from the ,wound4 ,sec4 #dce4 ,if the ,blood does not particularly flow out of any considerable ,vessel1 but trickles almost equally from every ,spot of the ,wound1 it may very safely be permitted to bleed1 while some ,lint is speedily preparing4 ,as soon as the ,lint is ready1 so much of it may be introduced into the ,wound as will nearly fill it1 without being forced in2 which is highly improper1 and would be attended with the same ,inconveniences as ,tents and ,dossils4 ,it should be covered over with a ,compress dipt in sweet ,oil1 or with the ,cerecloth ,no4 #fe2 though ,i prefer the ,compress for the earliest ,dressings3 and the whole ,dressing should be kept on1 with a ,bandage of two ,fingers ,breadth1 and of a ,length proportioned to the ,size of the ,part it is to surround3 ,this should be rolled on tight enough to secure the ,dressings1 and yet so moderately1 as to bring on no ,inflammation4 ,this ,bandage with these ,dressings are to remain on twenty-four or forty-eight ,hours2 ,wounds being healed the sooner1 for being less frequently drest4 ,at the second ,dressing all the ,lint must be removed1 which can be done with ,ease1 and with reasonable ,speed1 to the ,wounded2 and if any of it should stick close1 in ,consequence of the clogged and dried ,blood1 it should be left behind1 adding a little fresh ,lint to it2 this ,dressing in other ,respects exactly resembling the first4 ,when1 from the ,continuance of this simple ,dressing1 the ,wound is become very superficial1 it is sufficient to apply the ,cerecloth1 or ,plaister1 without any ,lint4 ,such as have conceived an extraordinary ,opinion of any medical ,oils1 impregnated with the ,virtues of particular ,plants1 may1 if that will increase their ,satisfaction1 make use of the common ,oil of ,yarrow1 of ,trefoil1 of ,lilies1 of ,chamomile1 of ,balsamines1 or of red ,roses2 only being very careful1 that such ,oils are not become stale and rank4 ,sec4 #dcf4 ,when the ,wound is considerable1 it must be expected to inflame before ,suppuration 7which1 in such a ,case1 advances more slowly7 can ensue2 which ,inflammation will necessarily be attended with ,pain1 with a ,fever1 and sometimes with a ,raving1 or ,wandering1 too4 ,in such a ,situation1 a ,pultice of ,bread and ,milk1 with the ,addition of a little ,oil1 that it may not stick too close1 must be applied instead of the ,compress or the ,plaister3 which ,pultice is to be changed1 but without uncovering the ,wound1 thrice and even four times every ,day4 ,sec4 #dcg4 ,should some pretty considerable ,blood-vessel be opened by the ,wound1 there must be applied over it1 a ,piece of ,agaric of the ,oak1 ,no4 #fg1 with which no ,country place ought to be unprovided4 ,it is to be kept on1 by applying a good deal of ,lint over it2 covering the whole with a thick ,compress1 and then with a ,bandage a little tighter than usual4 ,if this should not be sufficient to prevent the ,bleeding from the large ,vessel1 and the ,wound be in the ,leg or ,arm1 a strong ,ligature must be made above the ,wound with a ,turniquet1 which is made in a ,moment with a ,skain of ,thread1 or of ,hemp1 that is passed round the ,arm circularly1 into the ,middle of which is inserted a ,piece of ,wood or ,stick of an ,inch ,thickness1 and four or five ,inches long2 so that by turning round this ,piece of ,wood1 any ,tightness or ,compression may be effected at ,pleasure2 exactly as a ,country-man secures a ,hogshead1 or a ,piece of ,timber on his ,cart1 with a ,chain and ,ring4 ,but ,care must be taken1 #a1 to dispose the ,skain in such a ,manner1 that it must always be two ,inches wider than the ,part it surrounds3 and1 #b1 not to strain it so tight as to bring on an ,inflammation1 which might terminate in a ,gangrene4 ,sec4 #dch4 ,all the boasted ,virtues of a ,multitude of ,ointments are downright ,nonsense or ,quackery4 ,art1 strictly considered1 does not in the least contribute to the healing of ,wounds2 the utmost we can do amounting only to our removing those ,accidents1 which are so many ,obstacles to their ,re-union4 ,on this ,account1 if there is any extraneous ,body in the ,wound1 such as ,iron1 ,lead1 ,wood1 ,glass1 ,bits of ,cloth or ,linen1 they must be extracted1 if that can be very easily done2 but if not1 ,application must be made to a good ,surgeon1 who considers what ,measures are to be taken1 and then dresses the ,wound1 as ,i have already advised4 ,very far from being useful1 there are many ,ointments that are pernicious on these ,occasions2 and the only ,cases in which they should be used1 are those in which the ,wounds are distinguished with some particular ,appearances1 which ought to be removed by particular ,applications3 ,but a simple recent ,wound1 in a healthy ,man1 requires no other ,treatment but what ,i have already directed1 besides that of the general ,regimen4 ,spirituous ,applications are commonly hurtful1 and can be suitable and proper but in a few ,cases1 which ,physicians and ,surgeons only can distinguish4 ,when ,wounds occur in the ,head1 instead of the ,compress dipt in ,oil1 or of the ,cerecloth1 the ,wound should be covered with a ,betony ,plaister2 or1 when none is to be had in time1 with a ,compress squeezed out of hot ,wine4 ,sec4 #dci4 ,as the following ,symptoms1 of which we should be most apprehensive1 are such as attend on ,inflammations1 the ,means we ought to have ,recourse to are those which are most likely to prevent them2 such as ,bleeding1 the usual ,regimen1 moderate ,coolers and ,glysters4 ,should the ,wound be very inconsiderable in its ,degree1 and in its ,situation1 it may be sufficient to avoid taking any ,thing heating2 and above all ,things to retrench the ,use of any strong ,drink1 and of ,flesh-meat4 ,but when it is considerable1 and an ,inflammation must be expected1 there is a ,necessity for ,bleeding2 the ,patient should be kept in the most quiet and easy ,situation2 he should be ordered immediately to a ,regimen2 and sometimes the ,bleeding also must be repeated4 ,now all these ,means are the more indispensably necessary1 when the ,wound has penetrated to some internal ,part2 in which ,situation1 no ,remedy is more certain than that of an extremely light ,diet4 ,such wounded ,persons as have been supposed incapable of living many ,hours1 after ,wounds in the ,breast1 in the ,belly1 or in the ,kidnies1 have been completely recovered1 by living for the ,course of several ,weeks1 on nothing but a ,barley1 or other farinaceous mealy1 ,ptisans1 without ,salt1 without ,soup1 without any ,medicine2 and especially without the ,use of any ,ointments4 ,sec4 #ddj4 ,in the same ,proportion that ,bleeding1 moderately and judiciously employed1 is serviceable1 in that very same an ,excess of it becomes pernicious4 ,great ,wounds are generally attended with a considerable ,loss of ,blood1 which has already exhausted the wounded ,person2 and the ,fever is often a ,consequence of this copious ,loss of ,blood4 ,now if under such a ,circumstance1 ,bleeding should be ordered and performed1 the ,patient's ,strength is totally sunk2 the ,humours stagnate and corrupt2 a ,gangrene supervenes1 and he dies miserably1 at the ,end of two or three ,days1 of a ,series of repeated ,bleedings1 but not of the ,wound4 ,notwithstanding the ,certainty of this1 the ,surgeon frequently boasts of his ten1 twelve1 or even his fifteen ,bleedings2 assuring his ,hearers of the insuperable ,mortality of the ,wound1 since the letting out such a ,quantity of ,blood could not recover the ,patient2 when it really was that excessive artificial ,profusion of it1 that downright dispatched him4------,the ,pleasures of ,love are very mortal ones to the ,wounded4 ,sec4 #dda4 ,the ,balsams and vulnerary ,plants1 which have often been so highly celebrated for the ,cure of ,wounds1 are very noxious1 when taken inwardly2 because the ,introduction of them gives or heightens the ,fever1 which ought to have been abated4 ,of ,contusions1 or ,bruises4 ,sec4 #ddb4 ,a ,contusion1 which is commonly called a ,bruise1 is the ,effect of the forcible ,impression or ,stroke of a ,substance not sharp or cutting1 on the ,body of a ,man1 or any ,animal2 whether such an ,impression be violently made on the ,man1 as when he is struck by a ,stick1 or by a ,stone thrown at him2 or whether the ,man be involuntarily forced against a ,post1 a ,stone1 or any hard ,substance by a ,fall2 or whether1 in short1 he is squeezed and oppressed betwixt two hard ,bodies1 as when his ,finger is squeezed betwixt the ,door and the ,door-,post1 or the whole ,body jammed in betwixt any ,carriage and the ,wall4 ,these ,bruises1 however1 are still more frequent in the ,country than ,wounds1 and commonly more dangerous too2 and indeed the more so1 as we cannot judge so exactly1 and so soon1 of the whole ,injury that has been incurred2 and because all that is immediately visible of it is often but a small ,part of the real ,damage attending it3 since it frequently happens that no ,hurt appears for a few successive ,days2 nor does it become manifest1 until it is too late to admit of an effectual ,cure4 ,sec4 #ddc4 ,it is but a few ,weeks since a ,cooper came to ask my ,advice4 ,his ,manner of breathing1 his ,aspect1 the ,quickness1 ,smallness1 and ,irregularity of his ,pulse1 made me apprehensive at once1 that some ,matter was formed within his ,breast4 ,nevertheless he still kept up1 and went about1 working also at some ,part of his ,trade4 ,he had fallen in removing some ,casks or ,hogsheads2 and the whole ,weight of his ,body had been violently impressed upon the right ,side of his ,breast4 ,notwithstanding this1 he was sensible of no ,hurt at first2 but some ,days afterwards he began to feel a dull heavy ,pain in that ,part1 which continued and brought on a ,difficulty of ,breathing1 ,weakness1 broken ,sleep and ,loss of ,appetite4 ,i ordered him immediately to ,stillness and ,repose1 and ,i advised him to drink a ,ptisan of ,barley sweetened with ,honey1 in a plentiful ,quantity4 ,he regularly obeyed only the latter ,part of my ,directions3 yet on meeting him a few ,days after1 he told me he was better4 ,the very same ,week1 however1 ,i was informed he had been found dead in his ,bed4 ,the ,imposthume had undoubtedly broke1 and suffocated him4 ,sec4 #ddd4 ,a young ,man1 run away with by his ,horse1 was forced with ,violence against a ,stable-,door1 without being sensible of any ,damage at the ,time4 ,but at the ,expiration of twelve ,days1 he found himself attacked by some such ,complaints1 as generally occur at the ,beginning of a ,fever4 ,this ,fever was mistaken for a putrid one1 and he was very improperly treated1 for the ,fever it really was1 above a ,month4 ,in short1 it was agreed at a ,consultation1 that ,matter was collected in the ,breast4 ,in ,consequence of this1 he was more properly attended1 and at length happily cured by the ,operation for an ,empyema1 after languishing a whole ,year4 ,i have published these two ,instances1 to demonstrate the great ,danger of neglecting violent ,strokes or ,bruises2 since the first of these ,patients might have escaped ,death2 and the second a tedious and afflicting ,disorder1 if they had taken1 immediately after each ,accident1 the necessary ,precautions against its ,consequences4 ,sec4 #dde4 ,whenever any ,part is bruised1 one of two ,things always ensues1 and commonly both happen together2 especially if the ,contusion is pretty considerable3 ,either the small ,blood-vessels of the contused ,part are broken1 and the ,blood they contained is spread about in the adjoining ,parts2 or else1 without such an ,effusion of it1 these ,vessels have lost their ,tone1 their active ,force1 and no longer contributing to the ,circulation1 their ,contents stagnate4 ,in each of these ,cases1 if ,nature1 either without or with the ,assistance of ,art1 does not remove the ,impediment1 an ,inflammation comes on1 attended with an imperfect1 unkindly ,suppuration1 with ,putrefaction and a ,gangrene2 without mentioning the ,symptoms that arise from the ,contusion of some particular ,substance1 as a ,nerve1 a large ,vessel1 a ,bone1 c4 ,hence we may also conceive the ,danger of a ,contusion1 happening to any inward ,part1 from which the ,blood is either internally effused1 or the ,circulation wholly obstructed in some vital ,organ4 ,this is the ,cause of the sudden ,death of ,persons after a violent ,fall2 or of those who have received the violent ,force of heavy descending ,bodies on their ,heads2 or of some violent ,strokes1 without any evident external ,hurt or ,mark4 ,there have been many ,instances of sudden ,deaths after one ,blow on the ,pit of the ,stomach1 which has occasioned a ,rupture of the ,spleen4 ,it is in ,consequence of ,falls occasioning a general slight ,contusion1 as well internal as external1 that they are sometimes attended with such grievous ,consequences1 especially in old ,men1 where ,nature1 already enfeebled1 is less able to redress such ,disorders4 ,and thus in ,fact has it been1 that many such1 who had before enjoyed a firm ,state of ,health1 have immediately lost it after a ,fall 7which seemed at first to have affected them little or not at all7 and languished soon after to the ,moment of their ,death1 which such ,accidents very generally accelerate4 ,sec4 #ddf4 ,different external and internal ,remedies are applicable in ,contusions4 ,when the ,accident has occurred in a slight ,degree1 and there has been no great nor general ,shock1 which might produce an internal ,soreness or ,contusion1 external ,applications may be sufficient4 ,they should consist of such ,things as are adapted1 first1 to attenuate and resolve the effused and stagnant ,blood1 which shews itself so apparently2 and which1 from its manifest ,blackness very soon after the ,contusion1 becomes successively brown1 yellow1 and greyish1 in ,proportions as the ,magnitude of the ,suffusion or ,sealing decreases1 till at last it disappears entirely1 and the ,skin recovers its ,colour1 without the ,blood's having been discharged through the external ,surface1 as it has been insensibly and gradually dissolved1 and been taken in again by the ,vessels3 ,and secondly1 the ,medicines should be such as are qualified to restore the ,tone1 and to recover the ,strength of the affected ,vessels4 ,the best ,application is ,vinegar1 diluted1 if very sharp1 with twice as much warm ,water2 in which ,mixture ,folds of ,linnen are to be dipt1 within which the contused ,parts are to be involved2 and these ,folds are to be remoistened and re-applied every two ,hours on the first ,day4 ,parsley1 ,chervil1 and ,houseleek ,leaves1 lightly pounded1 have also been successfully employed2 and these ,applications are preferable to ,vinegar1 when a ,wound is joined to the ,bruise4 ,the ,pultices1 ,no4 #fh1 may also be used with ,advantage4 ,sec4 #ddg4 ,it has been a common ,practice immediately to apply spirituous ,liquors1 such as ,brandy1 ,arquebussade and #ig ,alibour ,water1 and the like2 but a long ,abuse ought not to be established by ,prescription4 ,these ,liquids which coagulate the ,blood1 instead of resolving it1 are truly pernicious2 notwithstanding they are sometimes employed without any visible ,disadvantage on very slight ,occasions4 ,frequently by determining the settled ,blood towards the ,insterstices of the ,muscles1 the fleshy ,parts2 or sometimes even by preventing the ,effusion1 or visible ,settling of the ,blood1 and fixing it1 as it were1 within the bruised ,vessels1 they seem to be well2 though this only arises from their concentring and concealing the ,evil1 which1 at the ,end of a few ,months1 breaks forth again in a very troublesome ,shape4 ,of this ,i have seen some miserable ,examples1 whence it has been abundantly evinced1 that ,applications of this ,sort should never be admitted2 and that ,vinegar should be used instead of them4 ,at the utmost it should only be allowed1 7after there is ,reason to suppose all the stagnant ,blood resolved and resorbed into the ,circulation7 to add a third ,part of ,arquebusade ,water to the ,vinegar2 with an ,intention to restore some ,strength to the relaxed and weakened ,parts4 #ig ,this1 ,dr4 ,tissot informs me1 is a ,solution of white ,vitriol and some other ,drugs in ,spirit of ,wine1 and is never used in regular ,practice now4 ,it has its ,name from the ,author of the ,solution4 ,k4 ,sec4 #ddh4 ,it is still a more pernicious ,practice to apply1 in ,bruises1 ,plaisters composed of greasy ,substances1 ,rosins1 ,gums1 ,earths1 c4 ,the most boasted of these is always hurtful1 and there have been many ,instances of very slight ,contusions being aggravated into ,gangrenes by such ,plaisters ignorantly applied2 which ,bruises would have been entirely subdued by the ,oeconomy of ,nature1 if left to herself1 in the ,space of four ,days4 ,those ,sacs or ,suffusions of coagulated ,blood1 which are visible under the ,skin1 should never be opened1 except for some urgent ,reason2 since however large they may be1 they insensibly disappear and dissipate2 instead of which ,termination1 by opening them1 they sometimes terminate in a dangerous ,ulceration4 ,sec4 #ddi4 ,the internal ,treatment of ,contusions is exactly the same with that of ,wounds2 only that in these ,cases the best ,drink is the ,prescription1 ,no4 #a1 to each ,pot of which a ,drachm of ,nitre must be added4 ,when any ,person has got a violent ,fall2 has lost his ,senses1 or is become very stupid2 when the ,blood starts out of his ,nostrils1 or his ,ears2 when he is greatly oppressed1 or his ,belly feels very tight and tense1 which import an ,effusion of ,blood either into the ,head1 the ,breast or the ,belly1 he must1 first of all1 be bled upon the ,spot1 and all the ,means must be recurred to1 which have been mentioned ,sec4 #dci1 giving the wretched ,patient the least possible ,disturbance or ,motion2 and by all means avoiding to jog or shake him1 with a ,design to bring him to his ,senses2 which would be directly and effectually killing him1 by causing a further ,effusion of ,blood4 ,instead of this the whole ,body should be fomented1 with some one of the ,decoctions already mentioned3 and when the ,violence has been chiefly impressed on the ,head1 ,wine and ,water should be prefered to ,vinegar4 ,falls attended with ,wounds1 and even a ,fracture of the ,skull1 and with the most alarming ,symptoms1 have been cured by these internal ,remedies1 and without any other external ,assistance1 except the ,use of the aromatic ,fomentation1 ,no4 #fh4 ,a ,man from ,pully-petit came to consult me some ,months ago1 concerning his ,father1 who had a high ,fall out of a ,tree4 ,he had been twenty-four ,hours without ,feeling or ,sense1 and without any other ,motion than frequent ,efforts to vomit2 and ,blood had issued both from his ,nose and ,ears4 ,he had no visible outward ,hurt neither on his ,head1 nor any other ,part2 and1 very fortunately for him1 they had not as yet exerted the least ,effort to relieve him4 ,i immediately directed a plentiful ,bleeding in the ,arm2 and a large ,quantity of ,whey sweetened with ,honey to be drank1 and to be also injected by ,way of ,glyster4 ,this ,advice was very punctually observed2 and fifteen ,days after the ,father came to ,lausanne1 which is four ,leagues from ,pully-petit1 and told me he was very well4 ,it is proper1 in all considerable ,bruises1 to open the ,patient's ,belly with a mild cooling ,purge1 such as ,no4 #aa1 #bc1 #cb1 #di4 ,the ,prescription ,no4 #bd1 and the honyed ,whey are excellent ,remedies1 from the same ,reason4 ,sec4 #dej4 ,in these ,circumstances1 ,wine1 distiled ,spirits1 and whatever has been supposed to revive and to rouse1 is mortal4 ,for this ,reason ,people should not be too impatient1 because the ,patients remain some ,time without ,sense or ,feeling4 ,the giving of ,turpentine is more likely to do ,mischief than ,good2 and if it has been sometimes serviceable1 it must have been in ,consequence of its purging the ,patient1 who probably then needed to be purged4 ,the ,fat of a ,whale1 7,sperma caeti7 ,dragons ,blood1 ,crabs-,eyes1 and ,ointments of whatsoever ,sort are at least useless and dangerous ,medicine1 if the ,case be very hazardous2 either by the ,mischief they do1 or the ,good they prevent from being done4 ,the proper ,indication is to dilute the ,blood1 to render it more fluid and disposed to circulate2 and the ,medicines just mentioned produce a very contrary ,effect4 ,sec4 #dea4 ,when an aged ,person gets a ,fall1 which is the more dangerous in ,proportion to his ,age and ,grossness2 notwithstanding he should not seem in the least incommoded by it1 if he is sanguine and still somewhat vigorous1 he should part with three or four ,ounces of ,blood4 ,he should take immediately a few successive ,cups of a lightly aromatic ,drink1 which should be given him hot2 such1 for ,instance1 as an ,infusion of ,tea sweetened with ,honey1 and he should be advised to move gently about4 ,he must retrench a little from the usual ,quantity of his ,food1 and accustom himself to very gentle1 but very frequent1 ,exercise4 ,sec4 #deb4 ,sprains or ,wrenches1 which very often happen1 produce a ,kind of ,contusion1 in the ,parts adjoining to the sprained ,joint4 ,this ,contusion is caused by the violent ,friction of the ,bone against the neighbouring ,parts2 and as soon as the ,bones are immediately returned into their proper ,situation1 the ,disorder should be treated as a ,contusion4 ,indeed if the ,bones should not of themselves return into their proper natural ,position1 ,recourse must be had to the ,hand of a ,surgeon4 ,the best ,remedy in this ,case is absolute ,rest and ,repose1 after applying a ,compress moistened in ,vinegar and ,water1 which is to be renewed and continued1 till the ,marks of the ,contusion entirely disappear2 and there remains not the smallest ,apprehension of an ,inflammation4 ,then indeed1 and not before1 a little ,brandy or ,arquebusade ,water may be added to the ,vinegar2 and the ,part 7which is almost constantly the ,foot7 should be strengthened and secured for a considerable ,time with a ,bandage2 as it might otherwise be liable to fresh ,sprains1 which would daily more and more enfeeble it3 and if this ,evil is overlooked too much in its ,infancy1 the ,part never recovers its full ,strength2 and a small ,swelling often remains to the ,end of the ,patient's ,life4 ,if the ,sprain is very slight and moderate1 a ,plunging of the ,part into cold ,water is excellent2 but if this is not done at once immediately after the ,sprain1 or if the ,contusion is violent1 it is even hurtful4 ,the ,custom of rolling the naked ,foot upon some round ,body is insufficient1 when the ,bones are not perfectly replaced2 and hurtful1 when the ,sprain is accompanied with a ,contusion4 ,it happens continually almost that ,country ,people1 who encounter such ,accidents1 apply themselves either to ignorant or knavish ,imposters1 who find1 or are determined to find1 a ,disorder or ,dislocation of the ,bones1 where there is none2 and who1 by their violent ,manner of handling the ,parts1 or by the ,plaisters they surround them with1 bring on a dangerous ,inflammation1 and change the ,patient's ,dread of a small ,disorder1 into a very grievous ,malady4 ,these are the very ,persons who have created1 or indeed rather imagined1 some impossible ,diseases1 such as the ,opening1 the ,splitting of the ,stomach1 and of the ,kidnies4 ,but these big ,words terrify the poor ,country ,people1 and dispose them to be more easily and effectually duped4 ,of ,ulcers4 ,sec4 #dec4 ,whenever ,ulcers arise from a general ,fault of the ,blood1 it is impossible to cure them1 without destroying the ,cause and ,fuel of them4 ,it is in ,fact imprudent to attempt to heal them up by outward ,remedies2 and a real ,misfortune to the ,patient1 if his ,assistant effectually heals and closes them4 ,but1 for the greater ,part1 ,ulcers in the ,country are the ,consequence of some ,wound1 ,bruise1 or ,tumour improperly treated2 and especially of such as have been dressed with too sharp1 or too spirituous ,applications4 ,rancid ,oils are also one of the ,causes1 which change the most simple ,wounds into obstinate ,ulcers1 for which ,reason they should be avoided2 and ,apothecaries should be careful1 when they compound greasy ,ointments1 to make but little at a ,time1 and the oftner1 as a very considerable ,quantity of any of them becomes rank before it is all sold2 notwithstanding sweet fresh ,oil may have been employed in preparing them4 ,sec4 #ded4 ,what serves to distinguish ,ulcers from ,wounds1 is the ,dryness and ,hardness of the ,sides or ,borders of ,ulcers1 and the ,quality of the ,humour discharged from them2 which1 instead of being ripe consistent ,matter1 is a ,liquid more thin1 less white1 sometimes yielding a disagreable ,scent1 and so very sharp1 that if it touch the adjoining ,skin1 it produces ,redness1 ,inflammation1 or ,pustules there2 sometimes a serpiginous1 or ,ring-worm like ,eruption1 and even a further ,ulceration4 ,sec4 #dee4 ,such ,ulcers as are of a long ,duration1 which spread wide1 and discharge much1 prey upon the ,patient1 and throw him into a slow ,fever1 which melts and consumes him4 ,besides1 when an ,ulcer is of a long ,standing1 it is dangerous to dry it up2 and indeed this never should be done1 but by substituting in the ,place of one ,discharge that is become almost natural1 some other ,evacuation1 such as ,purging from ,time to ,time4 ,we may daily see sudden ,deaths1 or very tormenting ,diseases1 ensue the sudden drying up such ,humours and ,drains as have been of a long ,continuance3 and whenever any ,quack 7and as many as promise the speedy ,cure of such1 deserve that ,title7 assures the ,patient of his curing an inveterate ,ulcer in a few ,days1 he demonstrates himself to be a very dangerous and ignorant ,intermeddler1 who must kill the ,patient1 if he keeps his ,word4 ,some of these impudent ,impostors make use of the most corrosive ,applications1 and even arsenical ones2 notwithstanding the most violent ,death is generally the ,consequence of them4 ,sec4 #def4 ,the utmost that ,art can effect1 with ,regard to ,ulcers1 which do not arise from any ,fault in the ,humours1 is to change them into ,wounds4 ,to this ,end1 the ,hardness and ,dryness of the ,edges of the ,ulcer1 and indeed of the whole ,ulcer1 must be diminished1 and its ,inflammation removed4 ,but sometimes the ,hardness is so obstinate1 that this cannot be mollified any other ,way1 than by scarifying the ,edges with a ,lancet4 ,but when it may be effected by other ,means1 let a ,pledget spread with the ,ointment1 ,no4 #fi1 be applied all over the ,ulcer2 and this ,pledget be covered again with a ,compress of several ,folds1 moistened in the ,liquid1 ,no4 #gj1 which should be renewed three times daily2 though it is sufficient to apply a fresh ,pledget only twice4 ,as ,i have already affirmed that ,ulcers were often the ,consequence of sharp and spirituous ,dressings1 it is evident such should be abstained from1 without which ,abstinence they will prove incurable4 ,to forward the ,cure1 salted ,food1 ,spices1 and strong ,drink should be avoided2 the ,quantity of ,flesh-meat should be lessened2 and the ,body be kept open by a ,regimen of ,pulse1 of ,vegetables1 and by the habitual ,use of ,whey sweetened with ,honey4 ,if the ,ulcers are in the ,legs1 a very common ,situation of them1 it is of great ,importance1 as well as in ,wounds of the same ,parts1 that the ,patient should walk about but little2 and yet never stand up without walking4 ,this indeed is one of these ,cases1 in which those1 who have some ,credit and ,influence in the ,estimation of the ,people1 should omit nothing to make them thoroughly comprehend the ,necessity of confining themselves1 some ,days1 to undisturbed ,tranquillity and ,rest2 and they should also convince them1 that this ,term of ,rest is so far from being lost ,time1 that it is likely to prove their most profitable ,time of ,life4 ,negligence1 in this material ,point1 changes the slightest ,wounds into ,ulcers1 and the most trifling ,ulcers into obstinate and incurable ones3 insomuch that there is scarcely any ,man1 who may not observe some ,family in his ,neighbourhood1 reduced to the ,hospital1 #ih from their having been too inattentive to the due ,care of some ,complaint of this ,sort4 #ih ,this seems just the same as coming on the ,parish1 or being received into an ,alms house here2 in ,consequence of such an incurable ,disability happening to the poor working ,father of a ,family4 ,k4 ,i conclude this ,article on ,ulcers with repeating1 that those which are owing to some internal ,cause2 or even such as happen from an external one1 in ,persons of a bad ,habit of ,body1 frequently require a more particular ,treatment4 ,of ,frozen ,limbs4 ,sec4 #deg4 ,it is but too common1 in very rigorous ,winters1 for some ,persons to be pierced with so violent a ,degree of ,cold1 that their ,hands or ,feet1 or sometimes both together are frozen at once1 just like a ,piece of ,flesh-meat exposed to the ,air4 ,if a ,person thus pierced with the ,cold1 dispose himself to walk about1 which seems so natural and obvious a ,means to get warm2 and especially1 if he attempts to #ii warm the ,parts that have been frozen1 his ,case proves irrecoverable4 ,intolerable ,pains are the ,consequence1 which ,pains are speedily attended with an incurable ,gangrene2 and there is no ,means left to save the ,patient's ,life1 but by cutting off the gangrened ,limbs4 #ii ,the ,reason of the ,fatality of ,heat1 in these ,cases1 and of the ,success of an opposite ,application1 7,see ,sec4 #dei7 seems strictly and even beautifully analogous to what ,hippocrates has observed of the ,danger1 and even ,fatality1 of all great and sudden ,changes in the human ,body1 whether from the ,weather or otherwise4 ,whence this truly great ,founder of ,physick1 when he observes elsewhere1 that ,diseases are to be cured by something contrary to their ,causes1 very consistently advises1 not a direct and violent ,contrariety1 but a gradual and regulated one1 a ,sub-contrariety4 ,k4 ,there was a very late and terrible ,example of this1 in the ,case of an ,inhabitant at ,cossonay1 who had both his ,hands frozen4 ,some greasy ,ointments were applied hot to them1 the ,consequence of which was1 the ,necessity of cutting off six of his ,fingers4 ,sec4 #deh4 ,in short1 there is but one certain ,remedy in such ,cases1 and this is to convey the ,person affected into some ,place where it does not freeze1 but where1 however1 it is but very moderately hot1 and there continually to apply1 to the frozen ,parts1 ,snow1 if it be at hand2 and if not1 to keep washing them incessantly1 but very gently 7since all ,friction would at this ,juncture prove dangerous7 in ,ice-water1 as the ,ice thaws in the ,chamber4 ,by this ,application the ,patients will be sensible of their ,feeling's returning very gradually to the ,part1 and that they begin to recover their ,motion4 ,in this ,state they may ,safely be moved into a ,place a little warmer1 and drink some ,cups of the ,potion ,no4 #ac1 or of another of the like ,quality4 ,sec4 #dei4 ,every ,person may be a competent judge of the manifest ,danger of attempting to relieve such ,parts by heating them1 and of the ,use of ,ice-water1 by a common1 a daily ,experience4 ,frozen ,pears1 ,apples1 and ,radishes1 being put into ,water just about to freeze1 recover their former ,state1 and prove quickly eatable4 ,but if they are put into warm ,water1 or into a hot ,place1 ,rottenness1 which is one ,sort of ,gangrene1 is the immediate ,effect4 ,the following ,case will make this right ,method of treating them still more intelligible1 and demonstrate its ,efficacy4 ,a ,man was travelling to the ,distance of six ,leagues in very cold ,weather2 the ,road being covered with ,snow and ,ice4 ,his ,shoes1 not being very good1 failed him on his ,march1 so that he walked the three last ,leagues bare-footed2 and felt1 immediately after the first ,half ,league1 sharp ,pains in his ,legs and ,feet1 which increased as he proceeded4 ,he arrived at his ,journey's ,end in a ,manner nearly deprived of his lower ,extremities4 ,they set him before a great ,fire1 heated a ,bed well1 and put him into it4 ,his ,pains immediately became intolerable3 he was incessantly in the most violent ,agitations1 and cried out in the most piercing and affecting ,manner4 ,a ,physician1 being sent for in the ,night1 found his ,toes of a blackish ,colour1 and beginning to lose their ,feeling4 ,his ,legs and the upper ,part of his ,feet1 which were excessively swelled1 of a purplish ,red1 and varied with ,spots of a violet ,colour1 were still sensible of the most excruciating ,pains4 ,the ,physician ordered in a ,pail of ,water from the adjoining ,river1 adding more to it1 and some ,ice withal4 ,in this he obliged the ,patient to plunge his ,legs2 they were kept in near an ,hour1 and within that ,time1 the ,pains became less violent4 ,after another ,hour he ordered a second cold ,bath1 from which the ,patient perceiving still further ,relief1 prolonged it to the ,extent of two ,hours4 ,during that ,time1 some ,water was taken out of the ,pail1 and some ,ice and ,snow were put into it4 ,now his ,toes1 which had been black1 grew red2 the violet ,spots in his ,legs disappeared2 the ,swelling abated2 the ,pains became moderate1 and intermitted4 ,the ,bath was nevertheless repeated six times2 after which there remained no other ,complaint1 but that of a great ,tenderness or extraordinary ,sensibility in the ,soles of his ,feet1 which hindered him from walking4 ,the ,parts were afterwards bathed with some aromatic ,fomentations2 and he drank a ,ptisan of ,sarsaparilla one of ,elder ,flowers would have answered the same ,purpose1 and have been less expensive4 ,on the eighth ,day from his ,seizure he was perfectly recovered1 and returned home on ,foot on the fifteenth4 ,sec4 #dfj4 ,when cold ,weather is extremely severe1 and a ,person is exposed to it for a long ,time at once1 it proves mortal1 in ,consequence of its congealing the ,blood1 and because it forces too great a ,proportion of ,blood up to the ,brain2 so that the ,patient dies of a ,kind of ,apoplexy1 which is preceded by a ,sleepiness4 ,in this ,circumstance the ,traveller1 who finds himself drowsy1 should redouble his ,efforts to extricate himself from the eminent ,danger he is exposed to4 ,this ,sleep1 which he might consider as some ,alleviation of his ,sufferings1 if indulged1 would prove his last4 ,sec4 #dfa4 ,the ,remedies in such ,cases are the same with those directed in frozen ,limbs4 ,the ,patient must be conducted to an ,apartment rather cold than hot1 and be rubbed with ,snow or with ,ice-water4 ,there have been many well attested ,instances of this ,method2 and as such ,cases are still more frequent in more northern ,climates1 a ,bath of the very coldest ,water has been found the surest ,remedy4 ,since it is known that many ,people have been revived1 who had remained in the ,snow1 or had been exposed to the freezing ,air during five1 or even six successive ,days1 and who had discovered no one ,mark of ,life for several ,hours1 the utmost ,endeavours should be used for the ,recovery of ,persons in the like ,circumstances and ,situation4 ,of ,kibes1 or ,chilblains4 ,sec4 #dfb4 ,these troublesome and smarting ,complaints attack the ,hands1 ,feet1 ,heels1 ,ears1 ,nose and ,lips1 those of ,children especially1 and mostly in ,winter2 when these ,extremities are exposed to the sudden ,changes from hot to cold1 and from cold to hot ,weather4 ,they begin with an ,inflation or kind of ,swelling1 which1 at first1 occasions but little ,heat1 ,pain or ,itching4 ,sometimes they do not exceed this first ,state1 and go off spontaneously without any ,application3 ,but at other ,times 7which may be termed the second ,degree of the ,disorder1 whether it happens from their being neglected1 or improperly treated7 their ,heat1 ,redness1 ,itching and ,pain increase considerably2 so that the ,patient is often deprived of the free ,use of his ,fingers by the ,pain1 ,swelling and ,numbness3 in which ,case the ,malady is still aggravated1 if effectual ,means are not used4 ,whenever the ,inflammation mounts to a still higher ,degree1 small ,vesications or ,blisters are formed1 which are not long without bursting2 when they leave a slight ,excoriation1 or ,rawness1 as it were1 which speedily ulcerates1 and frequently proves a very deep and obstinate ,ulcer1 discharging a sharp and ill-conditioned ,matter4 ,the last and most virulent ,degree of ,chilblains1 which is not infrequent in the very coldest ,countries1 though very rare in the temperate ones1 is1 when the ,inflammation degenerates into a ,gangrene4 ,sec4 #dfc4 ,these ,tumours are owing to a ,fulness and ,obstruction of the ,vessels of the ,skin1 which occurs from this ,circumstance1 that the ,veins1 which are more superficial than the ,arteries1 being proportionably more affected and straitened by the ,cold1 do not carry off all the ,blood communicated to them by the ,arteries2 and perhaps also the ,particles or ,atoms of ,cold1 which are admitted through the ,pores of the ,skin1 may act upon our ,fluids1 as it does upon ,water1 and occasion a ,congelation of them1 or a considerable ,approach towards it4 ,if these ,complaints are chiefly felt1 which in ,fact is the ,case1 rather on the extreme ,parts than on others1 it arises from two ,causes1 the principal one being1 that the ,circulation's being weaker at the ,extremities than elsewhere1 the ,effect of those ,causes1 that may impair it1 must be more considerably felt there4 ,the second ,reason is1 because these ,parts are more exposed to the ,impressions from without than the others4 ,they occur most frequently to ,children1 from their ,weakness and the greater ,tenderness and ,sensibility of their ,organs1 which necessarily increases the ,effect of external ,impressions4 ,it is the frequent and strong ,alteration from ,heat to ,cold1 that seems to contribute the most powerfully to the ,production of ,chilblains2 and this ,effect of it is most considerable1 when the ,heat of the ,air is at the same ,time blended with ,moisture2 whence the extreme and superficial ,parts pass suddenly as it were1 out of a hot1 into a cold1 ,bath4 ,a ,man sixty ,years of ,age1 who never before was troubled with ,kibes1 having worn1 for some ,hours on a ,journey1 a ,pair of furred ,gloves1 in which his ,hands sweated1 felt them very tender1 and found them swelled up with ,blood3 as the common ,effect of the warm ,bath is to soften and relax1 and to draw ,blood abundantly to the bathed ,parts1 whence it renders them more sensible4 ,this ,man1 ,i say1 thus circumstanced1 was at that ,age first attacked with ,chilblains1 which proved extremely troublesome2 and he was every succeeding ,winter as certainly infested with them1 within ,half an ,hour after he left off his ,gloves1 and was exposed to a very cold ,air4 ,it is for this ,reason1 that several ,persons are never infested with ,chilblains1 but when they use themselves to ,muffs1 which are scarcely known in hot ,countries2 nor are they very common among the more northern ones1 in which the extraordinary ,changes from ,cold to ,heat are very rare and unusual4 ,some ,people are subject to this troublesome ,complaint in the ,fall2 while others have it only in the ,spring4 ,the ,child of a labouring ,peasant1 who has a hard ,skin1 and one inured to all the ,impressions of the ,seasons and of the ,elements1 is1 and indeed necessarily must be1 less liable to ,kibes1 than the ,child of a rich ,citizen1 whose ,skin is often cherished1 at the ,expence of his ,constitution4 ,but even among ,children of the same ,rank in ,life and ,circumstances1 who seem pretty much of the same ,complexion1 and live much in the same ,manner2 whence they might of ,course be supposed equally liable to the same ,impressions1 and to the like ,effects of them1 there is1 nevertheless1 a very great ,difference with ,respect to their constitutional ,propensity to contract ,chilblains4 ,some are very cruelly tormented with them1 from the setting in of ,autumn1 to the very ,end of the ,spring3 others have either none at all1 or have them but very slightly1 and for a very short ,time4 ,this ,difference undoubtedly arises from the different ,quality of their ,humours1 and the ,texture of their whole ,surface1 but particularly from that of the ,skin of their ,hands2 though we readily confess it is by no ,means easy to determine1 with ,certainty and ,precision1 in what this ,difference essentially consists4 ,children of a sanguine ,complexion and delicate ,skin are pretty generally subject to this ,disorder1 which is often regarded much too slightly1 though it is really severe enough to engage our ,attention more2 since1 even abstracted from the sharp ,pains which smart these unhappy ,children for several ,months2 it sometimes gives them a ,fever1 hinders them from sleeping1 and yet confines them to their ,bed1 which is very prejudicial to their ,constitutions4 ,it also breaks in upon the ,order of their different ,duties and ,employments2 it interrupts their innocent salutary ,pleasures2 and sometimes1 when they are obliged to earn their daily ,bread by doing some ,work or other1 it sinks them down to ,misery4 ,i knew a young ,man1 who from being rendered incapable by ,chilblains1 of serving out his ,apprenticeship to a ,watch-maker1 is become a lazy ,beggar4 ,chilblains which attack the ,nose1 often leave a ,mark that alters the ,physiognomy1 the ,aspect of the ,patient1 for the ,remainder of his ,life3 and the ,hands of such as have suffered from very obstinate ones1 are commonly ever sensible of their ,consequences4 ,sec4 #dfd4 ,with ,respect1 therefore1 to these afflicting ,tumours and ,ulcerations1 we should1 in the first ,place1 do our utmost to prevent them2 and next exert our best ,endeavours to cure such as we could not prevent4 ,sec4 #dfe4 ,since they manifestly depend on the ,sensibility of the ,skin1 the ,nature of the ,humours1 and the ,changes of the ,weather from ,heat to ,cold1 in ,order to prevent them1 in the first ,place1 the ,skin must be rendered firmer or less tender4 #b1 ,that vicious ,quality of the ,temperament1 which contributes to their ,existence1 must be corrected2 and1 #c1 the ,persons so liable must guard themselves as well as possible1 against these ,changes of the ,weather4 ,now the ,skin of the ,hands1 as well as that of the whole ,body1 may be strengthened by that ,habit of washing or bathing in cold ,water1 which ,i have described at large1 ,sec4 #chd2 and in ,fact ,i have never seen ,children1 who had been early accustomed and inured to this ,habit1 as much afflicted with ,chilblains as others4 ,but still a more particular ,regard should be had to fortify the ,skin of the ,hands1 which are more obnoxious to this ,disorder than the ,feet1 by making ,children dip them in cold ,water1 and keep them for some ,moments together in it every ,morning1 and every ,evening too before ,supper1 from the very ,beginning of the ,fall4 ,it will give the ,children no ,sort of ,pain1 during that ,season1 to contract this ,habit2 and when it is once contracted1 it will give them no ,trouble to continue it throughout the ,winter1 even when the ,water is ready to freeze every where4 ,they may also be habituated to plunge their ,feet into cold ,water twice or thrice a ,week3 and this ,method1 which might be less adapted for grown ,persons1 who had not been accustomed to it1 must be without ,objection with ,respect to such ,children1 as have been accustomed to it2 to whom all its ,consequences must be useful and salutary4 ,at the same ,time ,care must be taken not to defeat or lessen the ,effect of the cold bathing1 by suffering the ,bather or ,washer1 to grow too warm between two ,baths or ,dippings2 which is also avoiding the too speedy ,successions of ,heat and ,cold4 ,for this ,purpose1 #a1 the ,children must be taught never to warm their ,hands before the ,fire at such ,times1 and still less before the ,stoves1 which very probably are one of the principal ,causes of ,chilblains1 that are less usual in ,countries which use no such ,stoves1 and among those ,individuals who make the least ,use of them1 where they are4 ,above all1 the ,use of ,cavettes 7that is1 of ,seats or little ,stairs1 as it were1 contrived between the ,stove and the ,wall7 is prejudicial to ,children1 and even to grown ,people1 upon several ,accounts4 #b1 ,they should never accustom themselves to wear ,muffs4 #c1 ,it would be also proper they should never use ,gloves1 unless some particular ,circumstances require it2 and ,i recommend this ,abstinence from ,gloves1 especially to young ,boys3 but if any should be allowed them1 let the ,gloves be thin and smooth4 ,sec4 #dff4 ,when ,chilblains seem to be nourished by some ,fault in the ,temperament or ,humours1 the ,consideration of a ,physician becomes necessary1 to direct a proper ,method of removing or altering it4 ,i have seen ,children from the ,age of three1 to that of twelve or thirteen ,years1 in whom their ,chilblains1 raw and flead1 as it were1 for eight ,months of the ,year1 seemed to be a particular ,kind of ,issue1 by which ,nature freed herself of an inconvenient ,superfluity of ,humours1 when the ,perspiration was diminished by the ,abatement of the violent ,heats4 ,in such ,cases ,i have been obliged to carry them through a pretty long ,course of ,regimen and ,remedies2 which1 however1 being necessarily various from a ,variety of ,circumstances1 cannot be detailed here4 ,the milder ,preparations of ,antimony are often necessary in such ,cases2 and some ,purges conduce in particular ones to allay and to abridge the ,disorder4 ,sec4 #dfg4 ,the first ,degree of this ,complaint goes off1 as ,i have already said1 without the ,aid of ,medicine2 or should it prove somewhat more obstinate1 it may easily be dissipated by some of the following ,remedies4 ,but when they rise to the second ,degree1 they must be treated like other ,complaints from ,congelation1 or ,frost-biting 7of which they are the first ,degree7 with cold ,water1 ,ice-water and ,snow4 ,no other ,method or ,medicine is nearly as efficacious as very cold ,water1 so as to be ready to freeze1 in which the ,hands are to be dipt and retained for some ,minutes together1 and several ,times daily4 ,in short it is the only ,remedy which ought to be applied1 when the ,hands are the ,parts affected2 when the ,patient has the ,courage to bear this ,degree of ,cold2 and when he is under no ,circumstance which may render it prejudicial4 ,it is the only ,application ,i have used for myself1 after having been attacked with ,chilblains for some ,years past1 from having accustomed myself to too warm a ,muff4 ,there ensues a slight ,degree of ,pain for some ,moments after plunging the ,hand into ,water1 but it diminishes gradually4 ,on taking the ,hand out1 the ,fingers are numbed with the ,cold1 but they presently grow warm again2 and within a ,quarter of an ,hour1 it is entirely over4 ,the ,hands1 on being taken out of the ,water1 are to be well dried1 and put into ,skin ,gloves2 after bathing three or four ,times1 their ,swelling subsides1 so that the ,skin wrinkles3 but by continuing the cold ,bathing1 it grows tight and smooth again2 the ,cure is compleated after using it three or four ,days2 and1 in general1 the ,disorder never returns again the same ,winter4 ,the most troublesome raging ,itching is certainly assuaged by plunging the ,hands into cold ,water4 ,the ,effect of ,snow is1 perhaps1 still more speedy3 the ,hands are to be gently and often rubbed with it for a considerable ,time2 they grow hot1 and are of a very high ,red for some ,moments1 but entire ,ease very quickly succeeds4 ,nevertheless1 a very small ,number of ,persons1 who must have extremely delicate and sensible ,skins1 do not experience the ,efficacy of this ,application4 ,it seems too active for them2 it affects the ,skin much like a common blistering ,plaister2 and by bringing on a large flow of ,humours there1 it increases1 instead of lessening the ,complaint4 ,sec4 #dfh4 ,when this last ,reason indeed1 or some other ,circumstance exists2 such as the ,child's ,want of ,courage1 or its ,affliction2 the monthly ,discharges in a ,woman2 a violent ,cough2 habitual ,colics2 and some other ,maladies1 which have been observed to be renewed or aggravated by the ,influence of ,cold at the ,extremities1 do really forbid this very cold ,application1 some others must be substituted4 ,one of the best is to wear ,day and ,night1 without ever putting it off1 a ,glove made of some smooth ,skin1 such as that of a ,dog2 which seldom fails to extinguish the ,disorder in some ,days time4 ,when the ,feet are affected with ,chilblains1 ,socks of the same ,skin should be worn2 and the ,patient keep close to his ,bed for some ,days4 ,sec4 #dfi4 ,when the ,disorder is violent1 the ,use of cold ,water prohibited1 and the ,gloves just recommended have but a slow ,effect1 the diseased ,parts should be gently fomented or moistened several times a ,day1 with some ,decoction1 rather more than warm2 which at the same time should be dissolving and emollient4 ,such is that celebrated ,decoction of the ,scrapings1 the ,peel of ,radishes1 whose ,efficacy is still further increased1 by adding one sixth ,part of ,vinegar to the ,decoction4 ,another ,decoction1 of whose great ,efficacy ,i have been a ,witness1 but which dies the ,hands yellow for a few ,days1 is the ,prescription ,no4 #ga4 ,many others may be made1 of nearly the same ,virtues1 with all the vulnerary ,herbs1 and even with the ,faltranc4 ,urine1 which some boast of in these ,cases1 from their having used it with ,success2 and the ,mixture of ,urine and ,lime-water have the like ,virtues with the former ,decoctions4 #ajj #ajj ,chilblains may also be advantageously washed with ,water and ,flower of ,mustard1 which will concur1 in a certain and easy ,manner1 both to cleanse and to cure them4 ,e4 ,l4 ,as soon as the ,hands affected are taken out of these ,decoctions1 they must be defended from the ,air by ,gloves4 ,sec4 #dgj4 ,vapours or ,steams are often more efficacious than ,decoctions2 whence instead of dipping the ,hands into these already mentioned1 we may expose them to their ,vapours1 with still more ,success4 ,that of hot ,vinegar is one of the most powerful ,remedies2 those of #aja ,asphalt1 or of ,turpentine have frequently succeeded too4 ,it may be needless to add that the affected ,parts must be defended from the ,air1 as well after the ,steams as the ,decoctions2 since it is from this ,cause of keeping off the ,air1 that the ,cerecloths are of ,service2 and hence also the ,application of ,suet has sometimes answered4 #aja ,this is or should be1 the same with the ,bitumen ,judaicum1 formerly kept in the ,shops2 but which is never directed1 except in that strange ,medley the ,venice ,treacle1 according to the old ,prescription4 ,the best is found in ,egypt1 and on the ,red ,sea3 but a different ,sort1 from ,germany1 ,france1 and ,swisserland1 is now generally substituted here4 ,k4 ,when the ,distemper is subdued by the ,use of ,bathings or ,steams1 which make the ,skin supple and soft1 then it should be strengthened by washing the ,parts with a little camphorated ,brandy1 diluted with an equal ,quantity of ,water4 ,sec4 #dga4 ,when the ,nose is affected with a ,chilblain1 the ,steam of ,vinegar1 and an artificial ,nose1 or ,covering for it1 made of ,dog-skin1 are the most effectual ,applications4 ,the same ,treatment is equally proper for the ,ears and the ,chin1 when infested with them4 ,frequently washing these ,parts in cold ,water is a good ,preservative from their being attacked4 ,sec4 #dgb4 ,whenever the ,inflammation rises very high1 and brings on some ,degree of a ,fever1 the ,patient's usual ,quantity of strong ,drink and of ,flesh-meat must be lessened2 his ,body should be kept open by a few ,glysters2 he should take every ,evening a ,dose of ,nitre as prescribed1 ,no4 #bj2 and if the ,fever proved strong1 he should lose some ,blood too4 ,as many as are troubled with obstinate ,chilblains1 should always be denied the ,use of strong ,liquor and ,flesh4 ,sec4 #dgc4 ,when this ,distemper prevails in its third ,degree1 and the ,parts are ulcerated2 besides keeping the ,patients strictly to the ,regimen of ,persons in a ,way of ,recovery1 and giving them a ,purge of ,manna1 the swelled ,parts should be exposed to the ,steams of ,vinegar2 the ,ulcerations should be covered with a ,diapalma ,plaister2 and the whole ,part should be enveloped in a smooth soft ,skin1 or in thin ,cerecloths4 ,sec4 #dgd4 ,the fourth ,degree of this ,disease1 in which the ,parts become gangrenous1 must be prevented by the ,method and ,medicines which remove an ,inflammation2 but if unhappily a ,gangrene has already appeared1 the ,assistance of a ,surgeon proves indispensably necessary4 ,of ,ruptures4 ,sec4 #dge4 ,hernias or ,ruptures1 which ,country-,people term being bursten1 are a ,disorder which sometimes occurs at the very ,birth2 though more frequently they are the ,effects of violent crying1 of a strong forcing ,cough1 or of repeated ,efforts to vomit1 in the first ,months of ,infancy4 ,they may happen afterwards indiscriminately at every ,age1 either as ,consequences of particular ,maladies1 or ,accidents1 or from ,peoples' violent ,exertions of their ,strength4 ,they happen much oftner to ,men than ,women2 and the most common ,sort1 indeed the only one of which ,i propose to treat1 and that but briefly1 is that which consists in the ,descent of a ,part of the ,guts1 or of the ,cawl1 into the ,bag or ,cod-piece4 ,it is not difficult to distinguish this ,rupture4 ,when it occurs in little ,children1 it is almost ever cured by making them constantly wear a ,bandage which should be made only of ,fustian1 with a little ,pillow or ,pincushion1 stuffed with ,linen ,rags1 ,hair or ,bran4 ,there should be at least two of these ,bandages1 to change them alternately2 nor should it ever be applied1 but when the ,child is laid down on its ,back1 and after being well assured that the ,gut or ,cawl1 which had fallen down1 has been safely returned into the ,cavity of the ,belly2 since without this ,precaution it might occasion the worst ,consequences4 ,the good ,effect of the ,bandage may be still further promoted1 by applying upon the ,skin1 and within the ,plait or ,fold of the ,groin 7under which ,place the ,rings1 or ,passage out of the ,belly into the ,bag lie7 some pretty astringent or strengthening ,plaister1 such as that commonly used for ,fractures1 or that ,i have already mentioned1 ,sec4 #add4 ,here we may observe by the ,way1 that ruptured ,children should never be set on a ,horse1 nor be carried by any ,person on ,horseback1 before the ,rupture is perfectly cured4 ,sec4 #dgf4 ,in a more advanced ,age1 a ,bandage only of ,fustian is not sufficient2 one must be procured with a ,plate of ,steel1 even so as to constrain and incommode the ,wearer a little at first3 nevertheless it soon becomes habitual1 and is then no longer inconvenient to them4 ,sec4 #dgg4 ,ruptures sometimes attain a monstrous ,size2 and a great ,part of the ,guts fall down in to the ,scrotum or ,bag1 without any ,symptom of an actual ,disease4 ,this ,circumstance1 nevertheless1 is accompanied with very great ,inconvenience1 which disables ,persons affected with it to work2 and whenever the ,malady is so considerable1 and of a long ,standing too1 there are commonly some ,obstacles that prevent a compleat ,return of the ,guts into the ,belly4 ,in this ,state indeed1 the ,application of the ,bandage or ,truss is impracticable1 and the miserable ,patients are condemned to carry their grievous ,burthen for the ,remainder of their ,lives2 which may however1 be palliated a little by the ,use of a ,suspensory and ,bag1 adapted to the ,size of the ,rupture4 ,this ,dread of its increasing ,magnitude is a strong ,motive for checking the ,progress of it1 when it first appears4 ,but there is another still stronger1 which is1 that ,ruptures expose the ,patient to a ,symptom frequently mortal4 ,this occurs when that ,part of the ,intestines fallen into the ,scrotum inflames2 when still increasing in its ,bulk1 and being extremely compressed1 acute ,pains come on3 for now from the ,increase of the ,rupture's ,extent1 the ,passage which gave ,way to its ,descent1 cannot admit of its ,return or ,ascent2 the ,blood-vessels themselves being oppressed1 the ,inflammation increases every ,moment2 the ,communication between the ,stomach and the ,fundament is often entirely cut off2 so that nothing passes through1 but incessant ,vomitings come on this being the ,kind of ,miserere1 or ,iliac ,passion ,i have mentioned1 ,sec4 #cbj which are succeeded by the ,hickup1 ,raving1 ,swooning1 cold ,sweats1 and ,death4 ,sec4 #dgh4 ,this ,symptom supervenes in ,ruptures1 when the ,excrements become hard in that ,part of the ,guts fallen into the ,scrotum2 when the ,patient is overheated with ,wine1 ,drams1 an inflammatory ,diet1 c4 or when he has received a ,stroke on the ailing ,part1 or had a ,fall4 ,sec4 #dgi4 ,the best ,means and ,remedies are1 #a1 as soon as ever this ,symptom or ,accident is manifest1 to bleed the ,patient very plentifully1 as he lies down in his ,bed and upon his ,back1 with his ,head a little raised1 and his ,legs somewhat bent1 so that his ,knees may be erect4 ,this is the ,attitude or ,posture they should always preserve as much as possible4 ,when the ,malady is not too far advanced1 the first ,bleeding often makes a compleat ,cure2 and the ,guts return up as soon as it is over4 ,at other ,times this ,bleeding is less successful1 and leaves a ,necessity for its ,repetition4 #b1 ,a ,glyster must be thrown up consisting of a strong ,decoction of the large white ,beet ,leaves1 with a small ,spoonful or ,pinch of common ,salt1 and a ,bit of fresh ,butter of the ,size of an ,egg4 #c1 ,folds of ,linen dipt in ,ice-water must be applied all over the ,tumour1 and constantly renewed every ,quarter of an ,hour4 ,this ,remedy1 when immediately applied1 has produced the most happy ,effects2 but if the ,symptom has endured violently more than ten or twelve ,hours1 it is often too late to apply it2 and then it is better to make ,use of ,flanels dipt in a warm ,decoction of ,mallow and ,elder ,flowers1 shifting them frequently4 ,it has been known however1 that ,ice-water1 or ,ice itself has succeeded as late as the third ,day4 #ajb #ajb ,pieces of ,ice applied between two ,pieces of ,linen1 directly upon the ,rupture1 as soon as possible after its first ,appearance1 is one of those extraordinary ,remedies1 which we should never hesitate to make immediate ,use of4 ,we may be certain by this ,application1 if the ,rupture is simple1 and not complicated from some aggravating ,cause1 to remove speedily1 and with very little ,pain1 a ,disorder1 that might be attended with the most dreadful ,consequences4 ,but the ,continuance of this ,application must be proportioned to the ,strength of the ,person ruptured1 which may be sufficiently estimated by the ,pulse4 ,e4 ,l4 #d1 ,when these ,endeavours are insufficient1 ,glysters of ,tobacco ,smoke must be tried1 which has often redressed and returned ,ruptures1 when every ,thing else had failed4 #e1 ,and lastly1 if all these ,attempts are fruitless1 the ,operation must be resolved on1 without losing a ,moment's ,time2 as this local ,disease proves sometimes mortal in the ,space of two ,days2 but for this ,operation an excellent ,surgeon is indispensably necessary4 ,the happy ,consequence with which ,i have ordered it1 in a most desperate ,case since the first ,edition of this ,work1 on the sixth ,day after a ,labour1 has convinced me1 still more than any former ,observation ,i had made1 that the ,trial of it ought never to be omitted1 when other ,attempts have been unavailing4 ,it cannot even hasten the ,patient's ,death1 which must be inevitable without it1 but it rather renders that more gentle1 where it might fail to prevent it4 ,when it is performed as ,mr4 ,levade effected it1 in the ,case ,i have just referred to1 the ,pain attending it is very tolerable and soon over4 ,i shall not attempt to describe the ,operation1 as ,i could not explain myself sufficiently to instruct an ignorant ,surgeon in it2 and an excellent and experienced one must be sufficiently apprized of all ,i could say concerning it4 ,a certain ,woman in this ,place1 but now dead1 had the great and impudent ,temerity to attempt this ,operation1 and killed her ,patients after the most excruciating ,torments1 and an ,extirpation1 or cutting away of the ,testicle2 which ,quacks and ignorant ,surgeons always do1 but which a good ,surgeon never does in this ,operation4 ,this is often the ,custom too 7in ,country ,places7 of those ,caitiffs1 who perform this ,operation without the least ,necessity2 and mercilessly emasculate a ,multitude of ,infants2 whom ,nature1 if left to her own ,conduct1 or assisted only by a simple ,bandage1 would have perfectly cured2 instead of which1 they absolutely kill a great many1 and deprive those of their ,virility1 who survive their ,robbery and ,violence4 ,it were religiously to be wished such ,caitiffs were to be duly1 that is1 severely punished2 and it cannot be too much inculcated into the ,people1 that this ,operation 7termed the ,bubonocele7 in the ,manner it is performed by the best ,surgeons1 is not necessary2 except in the ,symptoms and ,circumstances ,i have mentioned1 and that the cutting off the ,testicle never is so4 ,of ,phlegmons or ,boils4 ,sec4 #dhj4 ,every ,person knows what ,boils are at ,sight1 which are considerably painful when large1 highly inflamed1 or so situated as to incommode the ,motions1 or different ,positions of the ,body4 ,whenever their ,inflammation is very considerable2 when there are a great many of them at once1 and they prevent the ,patients from sleeping1 it becomes necessary to enter them into a cooling ,regimen2 to throw up some opening ,glysters2 and to make them drink plentifully of the ,ptisan1 ,no4 #b4 ,sometimes it is also necessary to bleed the ,patient4 ,should the ,inflammation be very high indeed1 a ,pultice of ,bread and ,milk1 or of ,sorrel a little boiled and bruised1 must be applied to it4 ,but if the ,inflammation is only moderate1 a ,mucilage ,plaister1 or one of the simple ,diachylon1 may be sufficient4 ,diachylon with the ,gums is more active and efficacious2 but it so greatly augments the ,pain of some ,persons afflicted with ,boils1 that they cannot bear it4 ,boils1 which often return1 signify some ,fault in the ,temperament1 and frequently one so considerable1 that might dispose a ,physician to be so far apprehensive of its ,consequences1 as to enquire into the ,cause1 and to attempt the ,extinction of it4 ,but the ,detail of this is no ,part nor ,purpose of the present ,work4 ,sec4 #dha4 ,the ,phlegmon1 or ,boil1 commonly terminates in ,suppuration1 but a ,suppuration of a singular ,kind4 ,it breaks open at first on its ,top1 or the most pointed ,part1 when some ,drops of a ,pus like that of an ,abscess comes out1 after which the ,germ1 or what is called the ,core of it may be discerned4 ,this is a purulent ,matter or ,substance1 but so thick and tenacious1 that it appears like a solid ,body2 which may be drawn out entirely in the ,shape of a small ,cylinder1 like the ,pith of ,elder1 to the ,length of some ,lines of an ,inch2 sometimes to the ,length of a full ,inch1 and even more4 ,the ,emission of this ,core is commonly followed by the ,discharge of a certain ,quantity1 according to the ,size of the ,tumour1 of liquid ,matter1 spread throughout the ,bottom of it4 ,as soon as ever this ,discharge is made1 the ,pain goes entirely off2 and the ,swelling disappears at the ,end of a few ,days1 by continuing to apply the simple ,diachylon1 or the ,ointment ,no4 #ff4 ,of ,fellons or ,whitlows4 ,sec4 #dhb4 ,the ,danger of these small ,tumours is much greater than is generally supposed4 ,it is an ,inflammation at the ,extremity or ,end of a ,finger1 which is often the ,effect of a small ,quantity of ,humour extravasated1 or stagnant1 in that ,part2 whether this has happened in ,consequence of a ,bruise1 a ,sting1 or a ,bite4 ,at other times it is evident that it has resulted from no external ,cause1 but is the ,effect of some inward one4 ,it is distinguished into many ,kinds1 according to the ,place in which the ,inflammation begins2 but the essential ,nature of the ,malady is always the same1 and requires the same ,sort of ,remedies4 ,hence such as are neither ,physicians nor ,surgeons1 may spare themselves the ,trouble of enquiring into the ,divisions of this ,distemper2 which1 though they vary the ,danger of it1 and diversify the ,manner of the ,surgeons ,operation1 yet have no ,relation to the general ,treatment of it2 the ,power and ,activity of which must be regulated by the ,violence of the ,symptoms4 ,sec4 #dhc4 ,this ,disorder begins with a slow heavy ,pain1 attended by a slight ,pulsation1 without ,swelling1 without ,redness1 and without ,heat2 but in a little ,time the ,pain1 ,heat1 and ,pulsation or ,throbbing becomes intolerable4 ,the ,part grows very large and red2 the adjoining ,fingers and the whole ,hand swelling up4 ,in some ,cases a ,kind of red and inflated ,fuse or ,streak may be observed1 which1 beginning at the affected ,part1 is continued almost to the ,elbow2 neither is it unusual for the ,patients to complain of a very sharp ,pain under the ,shoulder2 and sometimes the whole ,arm is excessively inflamed and swelled4 ,the ,sick have not a ,wink of ,sleep1 the ,fever and other ,symptoms quickly increasing4 ,if the ,distemper rises to a violent ,degree indeed1 a ,delirium and ,convulsions supervene4 ,this ,inflammation of the ,finger determines1 either in ,suppuration1 or in a ,gangrene4 ,when the last of these occurs1 the ,patient is in very great ,danger1 if he is not very speedily relieved2 and it has proved necessary more than once to cut off the ,arm1 for the ,preservation of his ,life4 ,when ,suppuration is effected1 if the ,matter lies very deep and sharp1 or if the ,assistance of a ,surgeon has arrived too late1 the ,bone of the last ,phalanx1 or ,row of ,bones of the ,finger1 is generally carious and lost4 ,but how gentle soever the ,complaint has been1 the ,nail is very generally separated and falls off4 ,sec4 #dhd4 ,the internal ,treatment in ,whitlows1 is the same with that in other inflammatory ,distempers4 ,the ,patient must enter upon a ,regimen more or less strict1 in ,proportion to the ,degree of the ,fever2 and if this runs very high1 and the ,inflammation be very considerable1 there may be a ,necessity for several ,bleedings4 ,the external ,treatment consists in allaying the ,inflammation2 in softening the ,skin2 and in procuring a ,discharge of the ,matter1 as soon as it is formed4 ,for this ,purpose1 #a1 ,the ,finger affected is to be plunged1 as soon as the ,disorder is manifest1 in ,water a little more than warm3 the ,steam of boiling ,water may also by admitted into it2 and by doing these ,things almost constantly for the first ,day1 a total ,dissipation of the ,malady has often been obtained4 ,but unhappily it has been generally supposed1 that such slight ,attacks could have but very slight ,consequences1 whence they have been neglected until the ,disorder has greatly advanced2 in which ,state ,suppuration becomes absolutely necessary4 #b1 ,this ,suppuration therefore may be forwarded1 by continually involving the ,finger1 as it were1 in a ,decoction of ,mallow ,flowers boiled in ,milk1 or with a ,cataplasm of ,bread and ,milk4 ,this may be rendered still more active and ripening1 by adding a few white ,lilly ,roots1 or a little ,honey4 ,but this last must not be applied before the ,inflammation is somewhat abated1 and ,suppuration begins2 before which ,term1 all sharp ,applications are very dangerous4 ,at this ,time1 ,yeast or ,leaven may be advantagiously used1 which powerfully promotes ,suppuration4 ,the ,sorrel ,pultice1 mentioned ,sec4 #dhj1 is also a very efficacious one4 ,sec4 #dhe4 ,a speedy ,discharge of the ripe ,matter is of considerable ,importance1 but this particularly requires the ,attention of the ,surgeon2 as it is not proper to wait till the ,tumour breaks and discharges of itself2 and this the rather1 as from the ,skin's proving sometimes extremely hard1 the ,matter might be inwardly effused between the ,muscles1 and upon their ,membranes1 before it could penetrate through the ,skin4 ,for this ,reason1 as soon as ,matter is suspected to be formed1 a ,surgeon should be called in1 to determine exactly on the ,time1 when an ,opening should be made2 which had better be performed a little too soon than too late2 and a little too deep1 than not deep enough4 ,when the ,orifice has been made1 and the ,discharge is effected1 it is to be dressed up with the ,plaister ,no4 #ff1 spread upon ,linen1 or with the ,cerecloth2 and these ,dressings are to be repeated daily4 ,sec4 #dhf4 ,when the ,whitlow is caused by a ,humour extravasated very near the ,nail1 an expert ,surgeon speedily checks its ,progress1 and cures it effectually by an ,incision which lets out the ,humour4 ,yet1 notwithstanding this ,operation is in no wise difficult1 all ,surgeons are not qualified to perform it1 and but too many have no ,idea at all of it4 ,sec4 #dhg4 ,fungous1 or1 as it is commonly called1 proud ,flesh sometimes appears during the incarning or healing of the ,incision4 ,such may be kept down with sprinkling a little ,minium 7red ,lead7 or burnt ,alum over it4 ,sec4 #dhh4 ,if a ,caries1 a ,rottenness of the ,bone1 should be a ,consequence1 there is a ,necessity for a ,surgeon's ,attendance1 as much as if there was a ,gangrene2 for which ,reason1 ,i shall add nothing with ,respect to either of these ,symptoms2 only observing1 there are three very essential ,remedies against the last2 viz4 the ,bark1 ,no4 #ad1 a ,drachm of which must be taken every two ,hours2 ,scarifications throughout the whole gangrened ,part2 and ,fomentations with a ,decoction of the ,bark1 and the ,addition of ,spirit of ,sulphur4 ,this ,medicine is certainly no cheap one2 but a ,decoction of other bitter ,plants1 with the ,addition of ,spirit of ,salt1 may sometimes do instead of it4 ,and here ,i take leave to insist again upon it1 that in most ,cases of gangrened ,limbs1 it is judicious not to proceed to an ,amputation of the mortified ,part1 till the ,gangrene stops1 which may be known by a very perceivable ,circle1 7and easily distinguished by the most ignorant ,persons7 that marks the ,bounds of the ,gangrene1 and separates the living from the mortified ,parts4 ,of ,thorns1 ,splinters1 or other pointed ,substances piercing into the ,skin1 or ,flesh4 ,sec4 #dhi4 ,it is very common for the ,hands1 ,feet or ,legs1 to be pierced by the forcible ,intrusion of small pointed ,substances1 such as ,thorns or ,prickles1 whether of ,roses1 ,thistles or ,chestnuts1 or little ,splinters of ,wood1 ,bone1 c4 ,if such ,substances are immediately and entirely extracted1 the ,accident is generally attended with no bad ,consequences2 though more certainly to obviate any such1 ,compresses of ,linen dipt in warm ,water may be applied to the ,part1 or it may be kept a little while in a warm ,bath4 ,but if any such pointed penetrating ,body cannot be directly extracted1 or if a ,part of it be left within1 it causes an ,inflammation1 which1 in its ,progress1 soon produces the same ,symptoms as a ,whitlow3 or if it happens in the ,leg1 it inflames and forms a considerable ,abscess there4 ,sec4 #dij4 ,to prevent such ,consequences1 if the penetrating ,substance is still near the ,surface1 and an expert ,surgeon is at ,hand1 he must immediately make a small ,incision1 and thence extract it4 ,but if the ,inflammation were already formed1 this would be useless1 and even dangerous4 ,when the ,incision1 therefore1 is improper2 there should be applied to the affected ,part1 7after conveying the ,steam of some hot ,water into it7 either some very emollient ,pultices of the ,crumb of ,bread1 ,milk and ,oil1 or some very emollient unctuous ,matter alone1 the ,fat of a #ajc ,hare being generally employed in such ,cases1 and being indeed very effectual to relax and supple the ,skin2 and1 by thus diminishing its ,resistance1 to afford the offensive penetrating ,body an ,opportunity of springing forth4 ,nothing however1 but the grossest ,prejudice1 could make any one imagine1 that this ,fat attracted the ,splinter1 ,thorn1 or any other intruded ,substance by any sympathetic ,virtue2 no other ,sympathy in ,nature being clearly demonstrated1 except that very common one between wrong ,heads1 and absurd extravagant ,opinions4 #ajc ,these ,creatures perhaps are fatter in ,swisserland1 than we often see them here4 ,k4 ,it is absolutely necessary that the injured ,part should be kept in the easiest ,posture1 and as immoveable as possible4 ,if ,suppuration has not been prevented by an immediate ,extraction of the offending ,substance1 the ,abscess should be opened as soon as ever ,matter is formed4 ,i have known very troublesome ,events from its being too long delayed4 ,sec4 #dia4 ,sometimes the ,thorn1 after having very painfully penetrated through the ,teguments1 the ,skin1 enters directly into the ,fat2 upon which the ,pain ceases1 and the ,patient begins to conclude no sharp prickling ,substance had ever been introduced into the ,part2 and of ,course supposes none can remain there4 ,nevertheless some ,days after1 or1 in other ,instances1 some ,weeks1 fresh ,pains are excited1 to which an ,inflammation and ,abscess succeed1 which are to be treated as usual1 with ,emollients1 and seasonably opened4 ,a ,patient has been reduced to lose his ,hand1 in ,consequence of a sharp ,thorn's piercing into his ,finger2 from its having been neglected at first1 and improperly treated afterwards4 ,of ,warts4 ,sec4 #dib4 ,warts are sometimes the ,effects of a particular ,fault in the ,blood1 which feeds and extrudes a surprizing ,quantity of them4 ,this happens to some ,children1 from four to ten ,years old1 and especially to those who feed most plentifully on ,milk or ,milk-meats4 ,they may be removed by a moderate ,change of their ,diet1 and the ,pills prescribed ,no4 #ah4 ,but they are more frequently an accidental ,disorder of the ,skin1 arising from some external ,cause4 ,in this last ,case1 if they are very troublesome in ,consequence of their great ,size1 their ,situation or their long ,standing1 they may be destroyed1 #a1 by tying them closely with a ,silk ,thread1 or with a strong flaxen one waxed4 #b1 ,by cutting them off with a sharp ,scissars or a ,bistory1 and applying a ,plaister of ,diachylon1 with the ,gums1 over the cut ,wart1 which brings on a small ,suppuration that may destroy or dissolve the ,root of the ,wart3 and1 #c1 ,by drying1 or1 as it were1 withering them up by some moderately corroding ,application1 such as that of the milky ,juice of #ajd ,purslain1 of ,fig-leaves1 of ,chelidonium 7,swallow-wort7 or of ,spurge4 ,but besides these corroding vegetable ,milks being procurable only in ,summer1 ,people who have very delicate thin ,skins should not make ,use of them1 as they may occasion a considerable and painful ,swelling4 ,strong ,vinegar1 charged with as much common ,salt as it will dissolve1 is a very proper ,application to them4 ,a ,plaister may also be composed from ,sal ,ammoniac and some ,galbanum1 which being kneaded up well together and applied1 seldom fails of destroying them4 #ajd ,our ,garden ,purslain1 though a very juicy ,herb1 cannot strictly be termed milky4 ,in the hotter ,climates where it is wild1 and grows very rankly1 they sometimes boil the ,leaves and ,stalks 7besides eating them as a cooling ,salad7 and find the whole an insipid mucilaginous ,pot-herb4 ,but ,dr4 ,tissot observes to me1 that its ,juice will inflame the ,skin2 and that some ,writers on ,diet1 who disapprove it internally1 affirm they have known it productive of bad ,effects4 ,yet none such have ever happened to myself1 nor to many others1 who have frequently eaten of it4 ,its ,seeds have sometimes been directed in cooling ,emulsions4 ,the ,wart ,spurge is a very milky and common ,herb1 which flowers in ,summer here4 ,k4 ,the most powerful ,corrosives should never be used1 without the ,direction of a ,surgeon2 and even then it is full as prudent not to meddle with them1 any more than with actual ,cauteries4 ,i have lately seen some very tedious and troublesome ,disorders and ,ulcerations of the ,kidnies1 ensue the ,application of a corrosive ,water1 by the ,advice of a ,quack4 ,cutting them away is a more certain1 a less painful1 and a less dangerous ,way of removing them4 ,wens1 if of a pretty considerable ,size1 and ,duration1 are incurable by any other ,remedy1 except ,amputation4 ,of ,corns4 ,sec4 #dic4 ,the very general or only ,causes of ,corns1 are ,shoes either too hard and stiff1 or too small4 ,the whole ,cure consists in softening the ,corns by repeated ,washings and ,soakings of the ,feet in pretty hot ,water2 then in cutting them1 when softened1 with a ,penknife or ,scissars1 without wounding the sound ,parts 7which are the more sensible1 in ,proportion as they are more extended than usual7 and next in applying a ,leaf of ,house-leek1 of ,ground-ivy1 or of ,purslain dipt in ,vinegar1 upon the ,part4 ,instead of these ,leaves1 if any ,person will give himself the little ,trouble of dressing them every ,day1 he may apply a ,plaister of simple ,diachylon1 or of ,gum ,ammoniacum softened in ,vinegar4 ,the ,increase or ,return of ,corns can only be prevented1 by avoiding the ,causes that produce them4 ,chapter ,,xxxi4 ,of some ,cases which require immediate ,assistance2 such as ,swoonings2 ,haemorrhages1 or involuntary ,loss of ,blood2 ,convulsion ,fitts1 and ,suffocations2 the sudden ,effects of great ,fear2 of ,disorders caused by noxious ,vapours2 of ,poisons1 and of acute ,pains4 ,of ,swoonings4 ,sect4 #did4 ,there are many ,degrees of ,swooning1 or fainting away3 the slightest is that in which the ,patient constantly perceives and understands1 yet without the ,power of speaking4 ,this is called a ,fainting1 which happens very often to vapourish ,persons1 and without any remarkable ,alteration of the ,pulse4 ,if the ,patient entirely loses ,sensation1 or ,feeling1 and ,understanding1 with a very considerable ,sinking of the ,pulse1 this is called a ,syncope1 and is the second ,degree of ,swooning4 ,but if this ,syncope is so violent1 that the ,pulse seems totally extinguished2 without any discernible ,breathing2 with a manifest ,coldness of the whole ,body2 and a wanly livid ,countenance1 it constitutes a third and last ,degree1 which is the true ,image of ,death1 that in ,effect sometimes attends it1 and it is called an ,asphixy1 which may signify a total ,resolution4 ,swoonings result from many different ,causes1 of which ,i shall only enumerate the principal2 and these are1 #a1 ,too large a ,quantity of ,blood4 #b1 ,a ,defect or insufficient ,proportion of it1 and a general ,weakness4 #c1 ,a ,load at and violent ,disorders of the ,stomach4 #d1 ,nervous ,maladies4 #e1 ,the ,passions2 and1 #f1 some ,kinds of ,diseases4 ,of ,swoonings occasioned by ,excess of ,blood4 ,sec4 #die4 ,an excessive ,quantity of ,blood is frequently a ,cause of ,swooning2 and it may be inferred that it is owing to this ,cause1 when it attacks sanguine1 hearty and robust ,persons2 and more especially when it attacks them1 after being combined with any additional or supervening ,cause1 that suddenly increased the ,motion of the ,blood2 such as heating ,meats or ,drinks1 ,wine1 spirituous ,liquors3 smaller ,drinks1 if taken very hot and plentifully1 such as ,coffee1 ,indian ,tea1 ,bawm ,tea and the like2 a long ,exposure to the hot ,sun1 or being detained in a very hot ,place2 much and violent ,exercise2 an over intense and assiduous ,study or ,application1 or some excessive ,passion4 ,in such ,cases1 first of all the ,patient should be made to smell to1 or even to snuff up1 some ,vinegar2 and his ,forehead1 his ,temples and his ,wrists should be bathed with it2 adding an equal ,quantity of warm ,water1 if at ,hand4 ,bathing them with distilled or spirituous ,liquids would be prejudicial in this ,kind of ,swooning4 #b1 ,the ,patient should be made1 if possible1 to swallow two or three ,spoonfuls of ,vinegar1 with four or five ,times as much ,water4 #c1 ,the ,patient's ,garters should be tied very tightly above his ,knees2 as by this ,means a greater ,quantity of ,blood is retained in the ,legs1 whence the ,heart may be less overladen with it4 #d1 ,if the ,fainting proves obstinate1 that is1 if it continues longer than a ,quarter of an ,hour1 or degenerates into a ,syncope1 an ,abolition of ,feeling and ,understanding1 he must be bled in the ,arm1 which quickly revives him4 #e1 ,after the ,bleeding1 the ,injection of a ,glyster will be highly proper2 and then the ,patient should be kept still and calm1 only letting him drink1 every half ,hour1 some ,cups of ,elder ,flower ,tea1 with the ,addition of a little ,sugar and ,vinegar4 ,when ,swoonings which result from this ,cause occur frequently in the same ,person1 he should1 in ,order to escape them1 pursue the ,directions ,i shall hereafter mention1 ,sec4 #edd1 when treating of ,persons who superabound with ,blood4 ,the very same ,cause1 or ,causes1 which occasion these ,swoonings1 also frequently produce violent ,palpitations1 under the same ,circumstances2 the ,palpitation often preceding or following the ,deliquium1 or ,swooning4 ,of ,swoonings occasioned by ,weakness4 ,sec4 #dif4 ,if too great a ,quantity of ,blood1 which may be considered as some ,excess of ,health1 is sometimes the ,cause of ,swooning1 this last is oftener the ,effect of a very contrary ,cause1 that is1 of a ,want of ,blood1 or an ,exhaustion of too much4 ,this ,sort of ,swooning happens after great ,haemorrhages1 or ,discharges of ,blood2 after sudden or excessive ,evacuations1 such as one of some ,hours ,continuance in a ,cholera ,morbus 7,sec4 #cba7 or such as are more slow1 but of longer ,duration1 as for ,instance1 after an inveterate ,diarrhoea1 or ,purging2 excessive ,sweats2 a ,flood of ,urine2 such ,excesses as tend to exhaust ,nature2 obstinate ,wakefulness2 a long ,inappetency1 which1 by depriving the ,body of its necessary ,sustenance1 is attended with the same ,consequence as profuse ,evacuations4 ,these different ,causes of ,swooning should be opposed by the ,means and ,remedies adapted to each of them4 ,a ,detail of all these would be improper here2 but the ,assistances that are necessary at the ,time of ,swooning1 are nearly the same for all ,cases of this ,class2 excepting for that attending a great ,loss of ,blood1 of which ,i shall treat hereafter3 first of all1 the ,patients should be laid down on a ,bed1 and being covered1 should have their ,legs and ,thighs1 their ,arms1 and their whole ,bodies rubbed pretty strongly with hot ,flanels2 and no ,ligature should remain on any ,part of them4 #b1 ,they should have very spirituous ,things to smell or snuff up1 such as the ,carmelite ,water1 ,hungary ,water1 the #aje ,english ,salt1 ,spirit of ,sal ,ammoniac1 strong smelling ,herbs1 such as ,rue1 ,sage1 ,rosemary1 ,mint1 ,wormwood1 and the like4 #aje ,dr4 ,tissot informs me1 that in ,swisserland1 they call a volatile ,salt of ,vipers1 or the volatile ,salt of raw ,silk1 ,sel4 d',angleterre1 of which one ,goddard made a ,secret1 and which he brought into ,vogue the latter ,end of the last ,century4 ,but he justly observes at the same ,time1 that on the present ,occasion every other volatile ,alkali will equally answer the ,purpose2 and indeed the ,smell of some of them1 as the ,spirit of ,sal ,ammoniac with ,quicklime1 ,eau de ,luce1 c4 seem more penetrating4 ,k4 #c1 ,these should be conveyed into their ,mouths2 and they should be forced1 if possible1 to swallow some ,drops of ,carmelite ,water1 or of ,brandy1 or of some other potable ,liquor1 mixed with a little ,water2 while some hot ,wine mixed with ,sugar and ,cinnamon1 which makes one of the best ,cordials1 is getting ready4 #d1 ,a ,compress of ,flanel1 or of some other woollen ,stuff1 dipt in hot ,wine1 in which some aromatic ,herb has been steeped1 must be applied to the ,pit of the ,stomach4 #e1 ,if the ,swooning seems likely to continue1 the ,patient must be put into a well heated ,bed1 which has before been perfumed with burning ,sugar and ,cinnamon2 the ,frictions of the whole ,body with hot ,flanels being still continued4 #f1 ,as soon as the ,patient can swallow1 he should take some ,soup or ,broth1 with the ,yolk of an ,egg2 or a little ,bread or ,biscuit2 soaked in the hot spiced ,wine4 #g1 ,lastly1 during the whole ,time that all other ,precautions are taken to oppose the ,cause of the ,swooning1 ,care must be had for some ,days to prevent any ,deliquium or ,fainting1 by giving them often1 and but little at a time1 some light yet strengthening ,nourishment1 such as ,panada made with ,soup instead of ,water1 new laid ,eggs very lightly poached1 light roast ,meats with sweet ,sauce1 ,chocolate1 ,soups of the most nourishing ,meats1 ,jellies1 ,milk1 c4 ,sec4 #dig4 ,those ,swoonings1 which are the ,effect of ,bleeding1 or of the violent ,operation of some ,purge1 are to be ranged in this ,class4 ,such as happen after artificial ,bleeding1 are generally very moderate1 commonly terminating as soon as the ,patient is laid upon the ,bed3 and ,persons subject to this ,kind1 should be bled lying down1 in ,order to prevent it4 ,but should the ,fainting continue longer than usual1 some ,vinegar smelt to1 and a little swallowed with some ,water1 is a very good ,remedy4 ,the ,treatment of such ,faintings or ,swoonings1 as are the ,consequences of too violent ,vomits or ,purges1 may be seen hereafter ,sec4 #eeb4 ,of ,faintings occasioned by a ,load1 or ,uneasiness1 at ,stomach4 ,sec4 #dih4 ,it has been already observed1 ,sec4 #cjh1 that ,indigestions were sometimes attended with ,swoonings1 and indeed such vehement ones1 as required speedy and very active ,succour too1 such as that of a ,vomit4 ,the ,indigestion is sometimes less the ,effect of the ,quantity1 than of the ,quality1 or the ,corruption of the ,food1 contained in the ,stomach4 ,thus we see there are some ,persons1 who are disordered by eating ,eggs1 ,fish1 ,craw ,fish1 or any fat ,meat2 being thrown by them into inexpressible ,anguish attended with ,swooning too4 ,it may be supposed to depend on this ,cause1 when these very ,aliments have been lately eaten2 and when it evidently neither depends on the other ,causes ,i have mentioned2 nor on such as ,i shall soon proceed to enumerate4 ,we should in ,cases of this ,sort1 excite and revive the ,patients as in the former1 by making them receive some very strong ,smell1 of whatever ,kind is at hand2 but the most essential ,point is to make them swallow down a large ,quantity of light warm ,fluid2 which may serve to drown1 as it were1 the indigested ,matter2 which may soften its ,acrimony2 and either effect the ,discharge of it by vomiting1 or force it down into the ,chanel of the ,intestines4 ,a light ,infusion of ,chamomile ,flowers1 of ,tea1 of ,sage1 of ,elder ,flowers1 or of ,carduus ,benedictus1 operate with much the same ,efficacy2 though the ,chamomile and ,carduus promote the ,operation of vomiting rather more powerfully2 which warm ,water alone will sometimes sufficiently do4 ,the ,swooning ceases1 or at least1 considerably abates in these ,cases1 as soon as ever the ,vomiting commences4 ,it frequently happens too1 that1 during the ,swooning1 ,nature herself brings on certain ,nausea1 a ,wambling and sickish ,commotion of the ,stomach1 that revives or rouses the ,patient for a ,moment2 but yet not being sufficient to excite an actual ,vomiting1 lets him soon sink down again into this temporary ,dissolution1 which often continues a pretty considerable ,time2 leaving behind it a ,sickness at ,stomach1 ,vertigos1 and a ,depression and ,anxiety1 which do not occur in the former ,species of this ,malady4 ,whenever these ,swoonings from this ,cause are entirely terminated1 the ,patient must be kept for some ,days to a very light ,diet1 and take1 at the same ,time1 every ,morning fasting1 a ,dose of the ,powder1 ,no4 #ch1 which relieves and exonerates the ,stomach of whatever noxious ,contents might remain in it2 and then restores its natural ,strength and ,functions4 ,sec4 #dii4 ,there is another ,kind of ,swooning1 which also results from a ,cause in the ,stomach2 but which is1 nevertheless1 very different from this we have just been treating of2 and which requires a very different ,kind of ,assistance4 ,it arises from an extraordinary ,sensibility of this important ,organ1 and from a general ,weakness of the ,patient4 ,those subject to this ,malady are valetudinary weakly ,persons1 who are disordered from many slight ,causes1 and whose ,stomachs are at once very feeble and extremely sensible4 ,they have almost continually a little ,uneasiness after a ,meal1 though they should indulge but a little more than usual2 or if they eat of any ,food not quite so easy of ,digestion1 they have some ,qualm or ,commotion after it3 ,nay1 should the ,weather only be unfavourable1 and sometimes without any perceivable assignable ,cause1 their ,uneasiness terminates in a ,swoon4 ,patients swooning1 from these ,causes1 have a greater ,necessity for great ,tranquillity and ,repose1 than for any other ,remedy2 and it might be sufficient to lay them down on the ,bed3 ,but as the ,bystanders in such ,cases find it difficult to remain inactive ,spectators of ,persons in a ,swoon1 some spirituous ,liquid may be held to their ,nose1 while their ,temples and ,wrists are rubbed with it2 and at the same ,time a little ,wine should be given them4 ,frictions are also useful in these ,cases4 ,this ,species of ,swooning is oftener attended with a little ,feverishness than the others4 ,of those ,swoonings1 which arise from nervous ,disorders4 ,sec4 #ejj4 ,this ,species of ,swooning is almost wholely unknown to those ,persons1 for whom this ,treatise is chiefly intended4 ,yet as there are some ,citizens who pass a ,part of their ,lives in the ,country2 and some ,country ,people who are unhappily afflicted with the ,ailments of the ,inhabitants of large ,towns and ,cities1 it seemed necessary to treat briefly of them4 ,by ,disorders of the ,nerves1 ,i understand in this ,place1 only that ,fault or ,defect in them1 which is the ,cause of their exciting in the ,body1 either irregular ,motions1 that is1 ,motions without any external ,cause1 at least any perceivable one2 and without our ,will's consenting to the ,production of them3 or such ,motions1 as are greatly more considerable than they should be1 if they had been proportioned to the ,force of the ,impression from without4 ,this is very exactly that ,state1 or ,affection termed the ,vapours2 and by the common ,people1 the ,mother3 ,and as there is no ,organ unprovided with ,nerves2 and none1 or hardly any ,function1 in which the ,nerves have not their ,influence2 it may be easily comprehended1 that the ,vapours being a ,state or ,condition1 which arises from the ,nerves exerting irregular involuntary ,motions1 without any evident ,cause1 and all the ,functions of the ,body depending partly on the ,nerves2 there is no one ,symptom of other ,diseases which the ,vapours may not produce or imitate2 and that these ,symptoms1 for the same ,reason1 must vary infinitely1 according to those ,branches of the ,nerves which are disordered4 ,it may also hence be conceived1 why the ,vapours of one ,person have frequently no ,resemblance to those of another3 and why the ,vapours of the very same ,person1 in one ,day1 are so very different from those in the next4 ,it is also very conceivable that the ,vapours are a certain1 a real ,malady2 and that ,oddity of the ,symptoms1 which cannot be accounted for1 by ,people unacquainted with the animal ,oeconomy1 has been the ,cause of their being considered rather as the ,effect of a depraved ,imagination1 than as a real ,disease4 ,it is very conceiveable1 ,i say1 that this surprizing ,oddity of the ,symptoms is a necessary ,effect of the ,cause of the ,vapours2 and that no ,person can any more prevent his being invaded by the ,vapours1 than he can prevent the ,attack of a ,fever1 or of the ,tooth-ach4 ,sec4 #eja4 ,a few plain ,instances will furnish out a more compleat ,notion of the ,mechanism1 or ,nature1 of ,vapours4 ,an ,emetic1 a vomiting ,medicine1 excites the ,act1 or rather the ,passion1 the ,convulsion of ,vomiting1 chiefly by the ,irritation it gives to the ,nerves of the ,stomach2 which ,irritation produces a ,spasm1 a ,contraction of this ,organ4 ,now if in ,consequence of this morbid or defective ,texture of the ,nerves1 which constitutes the ,vapours1 those of the ,stomach are excited to act with the same ,violence1 as in ,consequence of taking a ,vomit1 the ,patient will be agitated and worked by violent ,efforts to vomit1 as much as if he had really taken one4 ,if an involuntary unusual ,motion in the ,nerves1 that are distributed through the ,lungs1 should constrain and straiten the very little ,vesicles1 or ,bladders1 as it were1 which admit the fresh ,air at every ,respiration1 the ,patient will feel a ,degree of ,suffocation2 just as if that ,straitening or ,contraction of the ,vesicles were occasioned by some noxious ,steam or ,vapour4 ,should the ,nerves which are distributed throughout the whole ,skin1 by a ,succession of these irregular morbid ,motions1 contract themselves1 as they may from external ,cold1 or by some stimulating ,application1 ,perspiration by the ,pores will be prevented or checked2 whence the ,humours1 which should be evacuated through the ,pores of the ,skin1 will be thrown upon the ,kidnies1 and the ,patient will make a great ,quantity of thin clear ,urine1 a ,symptom very common to vapourish ,people2 or it may be diverted to the ,glands of the ,intestines1 the ,guts1 and terminate in a watery ,diarrhoea1 or ,looseness1 which frequently proves a very obstinate one4 ,sec4 #ejb4 ,neither are ,swoonings the least usual ,symptoms attending the ,vapours3 and we may be certain they spring from this ,source1 when they happen to a ,person subject to the ,vapours2 and none of the other ,causes producing them are evident1 or have lately preceded them4 ,such ,swoonings1 however1 are indeed very rarely dangerous1 and scarcely require any medical ,assistance4 ,the ,patient should be laid upon a ,bed2 the fresh ,air should be very freely admitted to him2 and he should be made to smell rather to some disagreeable and fetid1 than to any fragrant1 ,substance4 ,it is in such ,faintings as these that the ,smell of burnt ,leather1 of ,feathers1 or of ,paper1 have often proved of great ,service4 ,sec4 #ejc4 ,patients also frequently faint away1 in ,consequence of fasting too long2 or from having eat a little too much2 from being confined in too hot a ,chamber2 from having seen too much ,company2 from smelling too over-powering a ,scent2 from being too costive2 from being too forcibly affected with some ,discourse or ,sentiments2 and1 in a ,word1 from a great ,variety of ,causes1 which might not make the least ,impression on ,persons in perfect ,health2 but which violently operate upon those vapourish ,people1 because1 as ,i have said1 the ,fault of their ,nerves consists in their being too vividly1 too acutely affected2 the ,force of their ,sensation being nowise proportioned to the external ,cause of it4 ,as soon as that particular ,cause is distinguished from all the rest1 which has occasioned the present ,swooning2 it is manifest that this ,swooning is to be remedied by removing that particular ,cause of it4 ,of ,swoonings occasioned by the ,passions4 ,sec4 #ejd4 ,there have been some ,instances of ,persons dying within a ,moment1 through excessive ,joy4 ,but such ,instances are so very rare and sudden1 that ,assistance has seldom been sought for on this ,occasion4 ,the ,case is otherwise with ,respect to those produced from ,rage1 ,vexation1 and ,dread or ,horror4 ,i shall treat in a separate ,article of those resulting from great ,fear2 and shall briefly consider here such as ensue from ,rage1 and vehement ,grief or ,disappointment4 ,sec4 #eje4 ,excessive ,rage and violent ,affliction are sometimes fatal in the ,twinkling of an ,eye2 though they oftener terminate in fainting only4 ,excessive ,grief or ,chagrine is especially accompanied with this ,consequence2 and it is very common to see ,persons thus affected1 sink into successive ,faintings for several ,hours4 ,it is plainly obvious that very little ,assistance can be given in such ,cases3 it is proper1 however1 they should smell to strong ,vinegar2 and frequently take a few ,cups of some hot and temperately cordial ,drink1 such as ,bawm ,tea1 or ,lemonade with a little ,orange or ,lemon-peel4 ,the calming asswaging ,cordial1 that has seemed the most efficacious to me1 is one small ,coffee ,spoonful of a ,mixture of three ,parts of the ,mineral ,anodyne ,liquor of ,hoffman1 #ajf and one ,part of the spirituous ,tincture of ,amber1 which should be swallowed in a ,spoonful of ,water2 taking after it a few ,cups of such ,drinks as ,i shall presently direct4 #ajf ,our sweet ,spirit of ,vitriol is a similar1 and as effectual a ,medicine4 ,k4 ,it is not to be supposed that ,swoonings or ,faintings1 from excessive ,passions1 can be cured by ,nourishment4 ,the physical ,state or ,condition1 into which vehement ,grief throws the ,body1 is that1 of all others1 in which ,nourishment would be most injurious to it3 and as long as the ,vehemence of the ,affliction endures1 the ,sufferer should take nothing but some ,spoonfuls of ,soup or ,broth1 or a few ,morsels of some light ,meat roasted4 ,sec4 #ejf4 ,when ,wrath or ,rage has risen to so high a ,pitch1 that the human ,machine1 the ,body1 entirely exhausted1 as it were1 by that violent ,effort1 sinks down at once into excessive ,relaxation1 a ,fainting sometimes succeeds1 and even the most perilous ,degree of it1 a ,syncope4 ,it is sufficient1 or rather the most that can be done here1 to let the ,patient be perfectly still a while in this ,state2 only making him smell to some ,vinegar4 ,but when he is come to himself1 he should drink plentifully of hot ,lemonade1 and take one or more of the ,glysters ,no4 #e4 ,sometimes there remain in these ,cases ,sicknesses at ,stomach1 ,reachings to vomit1 a ,bitterness in the ,mouth1 and some vertiginous ,symptoms which seem to require a ,vomit4 ,but such a ,medicine must be very carefully avoided1 since it may be attended with the most fatal ,consequence2 and ,lemonade with ,glysters generally and gradually remove these ,swoonings4 ,if the ,nausea and ,sickness at ,stomach continue1 the utmost ,medicine we should allow besides1 would be that of ,no4 #bc1 or a few ,doses of ,no4 #bd4 ,of symptomatical ,swoonings1 or such1 as happen in the ,progress of other ,diseases4 ,sec4 #ejg4 ,swoonings1 which supervene in the ,course of other ,diseases1 never afford a favourable ,prognostic2 as they denote ,weakness1 and ,weakness is an ,obstacle to ,recovery4 ,in the ,beginning of putrid ,diseases1 they also denote an ,oppression at ,stomach1 or a ,mass of corrupt ,humours2 and they cease as soon as an ,evacuation supervenes1 whether by ,vomit or ,stool4 ,when they occur at the ,beginning of malignant ,fevers1 they declare the high ,degree of their ,malignancy1 and the great ,diminution of the ,patient's natural ,strength4 ,in each of these ,cases ,vinegar1 used externally and internally1 is the best ,remedy during the ,exacerbation or ,height of the ,paroxysm2 and ,plenty of ,lemon ,juice and ,water after it4 ,sec4 #ejh4 ,swoonings which supervene in ,diseases1 accompanied with great ,evacuations1 are cured like those which are owing to ,weakness2 and ,endeavours should be used to restrain or moderate the ,evacuations4 ,sec4 #eji4 ,those who have any inward ,abscess or ,imposthume are apt to swoon frequently4 ,they may sometimes be revived a little by ,vinegar1 but they prove too frequently mortal4 ,sec4 #eaj4 ,many ,persons have a slighter or a deeper ,swooning1 at the ,end of a violent ,fit of an intermitting ,fever1 or at that of each ,exacerbation of a continual ,fever2 this constantly shews the ,fever has run very high1 the ,swooning having been the ,consequence of that great ,relaxation1 which has succeeded to a very high ,tension4 ,a ,spoonful or two of light white ,wine1 with an equal ,quantity of ,water1 affords all the ,succour proper in such a ,case4 ,sec4 #eaa4 ,persons subject to frequent ,swoonings1 should neglect nothing that may enable them to remove them when known2 since the ,consequences of them are always detrimental1 except in some ,fevers1 in which they seem to mark the ,crisis4 ,every swooning ,fit leaves the ,patient in ,dejection and ,weakness2 the ,secretions from the ,blood are suspended2 the ,humours disposed to ,stagnation2 ,grumosities1 or ,coagulations1 and ,obstructions are formed2 and if the ,motion of the ,blood is totally intercepted1 or considerably checked1 ,polypus's1 and these often incurable1 are formed in the ,heart1 or in the larger ,vessels2 the ,consequences of which are dreadful1 and sometimes give ,rise to internal ,aneurisms1 which always prove mortal1 after long ,anxiety and ,oppression4 ,swoonings which attack old ,people1 without any manifest ,cause1 always afford an unfavourable ,prognostic4 ,of ,haemorrhages1 or an involuntary ,loss of ,blood4 ,sec4 #eab4 ,haemorrhages of the ,nose1 supervening in inflammatory ,fevers1 commonly prove a favourable ,crisis2 which ,bleeding we should carefully avoid stopping2 except it becomes excessive1 and seems to threaten the ,patient's ,life4 ,as they scarcely ever happen in very healthy ,subjects1 but from a superfluous ,abundance of ,blood1 it is very improper to check them too soon2 lest some internal ,stuffings and ,obstructions should prove the ,consequence4 ,a ,swooning sometimes ensues after the ,loss of only a moderate ,quantity of ,blood4 ,this ,swooning stops the ,haemorrhage1 and goes off without any further ,assistance1 except the smelling to ,vinegar4 ,but in other ,cases there is a ,succession of fainting ,fits1 without the ,blood's stopping2 while at the same time slight convulsive ,motions and ,twitchings ensue1 attended with a ,raving1 when it becomes really necessary to stop the ,bleeding3 and indeed1 without waiting till these violent ,symptoms appear1 the following ,signs will sufficiently direct us1 when it is right to stop the ,flux of ,blood1 or to permit its ,continuance--,as long as the ,pulse is still pretty full2 while the ,heat of the ,body is equally extended to the very ,extremities2 and the ,countenance and ,lips preserve their natural ,redness1 no ill ,consequence is to be apprehended from the ,haemorrhage1 though it has been very copious1 and even somewhat profuse4 ,but whenever the ,pulse begins to faulter and tremble2 when the ,countenance and the ,lips grow pale1 and the ,patient complains of a ,sickness at ,stomach1 it is absolutely necessary to stop the ,discharge of ,blood4 ,and considering that the ,operation of ,remedies does not immediately follow the ,exhibition or ,application of them1 it is safer to begin a little too early with them1 than to delay them1 though ever so little too long4 ,sec4 #eac4 ,first of all then1 tight ,bandages1 or ,ligatures1 should be applied round both ,arms1 on the ,part they are applied over in order to ,bleeding2 and round the lower ,part of both ,thighs1 on the gartering ,place2 and all these are to be drawn very tight1 with an ,intention to detain and accumulate the ,blood in the ,extremities4 #b1 ,in ,order to increase this ,effect1 the ,legs are to be plunged in warm ,water up to the ,knees2 for by relaxing the ,blood-vessels of the ,legs and ,feet1 they are dilated at the same time1 and thence receive1 and1 in ,consequence of the ,ligatures above the ,knees1 retain the more ,blood4 ,if the ,water were cold1 it would repel the ,blood to the ,head2 if hot1 it would increase the ,motion of it2 and1 by giving a greater ,quickness to the ,pulse1 would even contribute to increase the ,haemorrhage4 ,as soon however1 as the ,haemorrhage is stopt1 these ,ligatures on the ,thighs may be relaxed a little1 or one of them be entirely removed2 allowing the others to continue on an ,hour or two longer without touching them3 but great ,precaution should be taken not to slacken them entirely1 nor all at once4 #c1 ,seven or eight ,grains of ,nitre1 and a ,spoonful of ,vinegar1 in half a ,glass of cool ,water1 should be given the ,patient every half ,hour4 #d1 ,one ,drachm of white ,vitriol must be dissolved in two common ,spoonfuls of ,spring ,water2 and a ,tent of ,lint1 or ,bits of soft fine ,linen dipt in this ,solution1 are to be introduced into the ,nostrils1 horizontally at first1 but afterwards to be intruded upwards1 and as high as may be1 by the ,assistance of a flexible ,bit of ,wood or ,whale-bone4 ,but should this ,application be ineffectual1 the ,mineral ,anodyne ,liquor of ,hoffman is certain to succeed3 and in the ,country1 where it often happens that neither of these ,applications are to be had speedily1 ,brandy1 and even ,spirit of ,wine1 mixt with a third ,part ,vinegar1 have answered entirely well1 of which ,i have been a ,witness4 ,the ,prescription ,no4 #fg1 which ,i have already referred to1 on the ,article of ,wounds1 may also be serviceable on this ,occasion4 ,it must be reduced to ,powder1 and conveyed up the ,nostrils as high as may be1 on the ,point or ,extremity of a ,tent of ,lint1 which may easily be covered with it4 ,or a ,quill1 well charged with the ,powder1 may be introduced high into the ,nostrils1 and its ,countents be strongly blown up from its other ,extremity3 though after all the former ,method is preferable4 #e1 ,when the ,flux of ,blood is totally stopt1 the ,patient is to be kept as still and quiet as possible2 taking great ,care not to extract the ,tent which remains in the ,nose2 nor to remove the ,clots of coagulated ,blood which fill up the ,passage4 ,the loosening and removing of these should be effected very gradually and cautiously2 and frequently the ,tent does not spring out spontaneously1 till after many ,days4 ,sec4 #ead4 ,i have not1 hitherto1 said any thing of artificial ,bleeding in these ,cases1 as ,i think it at best unserviceable2 since1 though it may sometimes have stopt the morbid ,loss of ,blood1 it has at other times increased it4 ,neither have ,i mentioned ,anodynes here1 whose constant ,effect is to determine a larger ,quantity of ,blood to the ,head4 ,applications of cold ,water to the ,nape of the ,neck ought to be wholly disused1 having sometimes been attended with the most embarrassing ,consequences4 ,in all ,haemorrhages1 all ,fluxes of ,blood1 great ,tranquillity1 ,ligatures1 and the ,use of the ,drinks ,no4 #b or #d1 are very useful4 ,sec4 #eae4 ,people who are very liable to frequent ,haemorrhages1 ought to manage themselves conformably to the ,directions contained in the next ,chapter1 ,sec4 #edd4 ,they should take very little ,supper2 avoid all sharp and spirituous ,liquors2 ,apartments that are over hot1 and cover their ,heads but very lightly4 ,when a ,patient has for a long time been subject to ,haemorrhages1 if they cease1 he should retrench from his usual ,quantity of ,food2 accustom himself to artificial ,bleedings at proper ,intervals2 and take some gentle opening ,purges1 especially that of ,no4 #bd1 and frequently a little ,nitre in an ,evening4 ,of ,convulsion ,fits4 ,sec4 #eaf4 ,convulsions are1 in general1 more terrifying than dangerous2 they result from many and various ,causes2 and on the ,removal or ,extirpation of these1 their ,cure depends4 ,in the very ,fit itself very little is to be done or attempted4 ,as nothing does shorten the ,duration1 nor even lessen the ,violence1 of an epileptic ,fit1 so nothing at all should be attempted in it2 and the rather1 because ,means and ,medicines often aggravate the ,disease4 ,we should confine our ,endeavours solely to the ,security of the ,patient1 by preventing him from giving himself any violent ,strokes2 by getting something1 if possible1 between his ,teeth1 such as a small ,roller of ,linen to prevent his ,tongue from being hurt1 or very dangerously squeezed and bruised1 in a strong ,convulsion4 ,the only ,case which requires immediate ,assistance in the ,fit1 is1 when it is so extremely violent1 the ,neck so swelled1 and the ,face so very red1 that there is ,room to be apprehensive of an ,apoplexy1 which we should endeavour to obviate1 by drawing eight or ten ,ounces of ,blood from the ,arm4 ,as this terrible ,disease is common in the ,country1 it is doing a real ,service to the unfortunate ,victims of it1 to inform them how very dangerous it is to give themselves blindly up to take all the ,medicines1 which are cried up to them in such ,cases4 ,if there be any one ,disease1 which requires a more attentive1 delicate1 and exquisite ,kind of ,treatment1 it is this very ,disease4 ,some ,species of it are wholly incurable3 and such as may be susceptible of a ,cure1 require the utmost ,care and ,consideration of the most enlightned and most experienced ,physicians3 while those who pretend to cure all epileptic ,patients1 with one invariable ,medicine1 are either ,ignorants1 or ,impostors1 and sometimes both in one4 ,sec4 #eag4 ,simple ,convulsion ,fits1 which are not epileptic1 are frequently of a long ,continuance1 persevering1 with very few and short ,intervals1 for ,days and even for ,weeks4 ,the true genuine ,cause should be investigated as strictly as possible1 though nothing should be attempted in the ,fit4 ,the ,nerves are1 during that ,term1 in so high a ,degree of ,tension and ,sensibility1 that the very ,medicines1 supposed to be strongly indicated1 often redouble the ,storm they were intended to appease4 ,thin watery ,liquors1 moderately imbued with ,aromatics1 are the least hurtful1 the most innocent ,things that can be given2 such as ,bawm1 ,lime-tree1 and ,elder ,flower ,tea4 ,a ,ptisan of ,liquorice ,root only has sometimes answered better than any other4 ,of suffocating1 or strangling ,fits4 ,sec4 #eah4 ,these ,fits 7by whatever other ,name they may be called7 whenever they very suddenly attack a ,person1 whose ,breathing was easy and natural just before1 depend almost constantly on a ,spasm or ,contraction of the ,nerves1 in the ,vesicles of the ,lungs2 or upon an ,infarction1 a ,stuffing of the same ,parts1 produced by viscid clammy ,humours4 ,that ,suffocation which arises from a ,spasm is not dangerous1 it goes off of itself1 or it may be treated like ,swoonings owing to the same ,cause4 ,see ,sec4 #ejb4 ,sec4 #eai4 ,that ,suffocation1 which is the ,effect of a sanguineous ,fulness and ,obstruction1 may be distinguished by its attacking strong1 vigorous1 sanguine ,persons1 who are great ,eaters1 using much juicy nutritious ,food1 and strong ,wine and ,liquors1 and who frequently eat and inflame themselves2 and when the ,fit has come on after any inflaming ,cause2 when the ,pulse is full and strong1 and the ,countenance red4 ,such are cured1 #a1 by a very plentiful ,discharge of ,blood from the ,arm1 which is to be repeated1 if necessary4 #b1 ,by the ,use of ,glysters4 #c1 ,by drinking plentifully of the ,ptisan ,no4 #a2 to each ,pot of which1 a ,drachm of ,nitre is to be added2 and1 #d1 ,by the ,vapour of hot ,vinegar1 continually received by ,respiration or ,breathing4 ,see ,sec4 #ee4 ,sec4 #ebj4 ,there is ,reason to think that one of these ,fits is owing to a ,quantity of tough viscid ,humours in the ,lungs1 when it attacks ,persons1 whose ,temperament1 and whose ,manner of living are opposite to those ,i have just described2 such as valetudinary1 weakly1 phlegmatic1 pituitous1 inactive1 and squeamish ,persons1 who feed badly1 or on fat1 viscid1 and insipid ,diet1 and who drink much hot ,water1 either alone1 or in ,tea-like ,infusions4 ,and these ,signs of ,suffocation1 resulting from such ,causes1 are still more probable1 if the ,fit came on in rainy ,weather1 and during a southerly ,wind2 and when the ,pulse is soft and small1 the ,visage pale and hollow4 ,the most efficacious ,treatment we can advise1 is1 #a1 ,to give every half ,hour half a ,cup of the ,potion1 ,no4 #h1 if it can be readily had4 #b1 ,to make the ,patient drink very plentifully of the ,drink ,no4 #ab2 and1 #c1 to apply two strong ,blisters to the fleshy ,parts of his ,legs4 ,if he was strong and hearty before the ,fit1 and the ,pulse still continues vigorous1 and feels somewhat full withall1 the ,loss of seven or eight ,ounces of ,blood is sometimes indispensably necessary4 ,a ,glyster has also frequently been attended with extraordinary good ,effects4 ,those afflicted with this oppressing ,malady are commonly relieved1 as soon as they expectorate1 and sometimes even by vomiting a little4 ,the ,medicine ,no4 #be1 a ,dose of which may be taken every two ,hours1 with a ,cup of the ,ptisan ,no4 #ab1 often succeeds very well4 ,but if neither this ,medicine1 nor the ,prescription of ,no4 #h are at ,hand1 which may be the ,case in ,country ,places2 an ,onion of a moderate ,size should be pounded in an ,iron or ,marble ,mortar2 upon this1 a ,glass of ,vinegar is to be poured1 and then strongly squeezed out again through a ,piece of ,linen4 ,an equal ,quantity of ,honey is then to be added to it4 ,a ,spoonful of this ,mixture1 whose remarkable ,efficacy ,i have been a ,witness of1 is to be given every half ,hour4 ,of the violent ,effects of ,fear4 ,sec4 #eba4 ,here ,i shall insert some ,directions to prevent the ill ,consequences of great ,fear or ,terror1 which are very prejudicial at every ,term of ,life1 but chiefly during ,infancy4 ,the general ,effects of ,terror1 are a great ,straitening or ,contraction of all the small ,vessels1 and a ,repulsion of the ,blood into the large and internal ones4 ,hence follows the ,suppression of ,perspiration1 the general ,seizure or ,oppression1 the ,trembling1 the ,palpitations and ,anguish1 from the ,heart and the ,lungs being overcharged with ,blood2 and sometimes attended with ,swoonings1 irremediable ,disorders of the ,heart1 and ,death itself4 ,a heavy ,drowsiness1 ,raving1 and a ,kind of furious or raging ,delirium happen in other ,cases1 which ,i have frequently observed in ,children1 when the ,blood-vessels of the ,neck were swelled and stuffed up2 and ,convulsions1 and even the ,epilepsy have come on1 all which have proved the horrible ,consequence of a most senseless and wicked ,foolery or ,sporting4 ,one half of those ,epilepsies which do not depend on such ,causes1 as might exist before the ,child's ,birth1 are owing to this detestable ,custom2 and it cannot be too much inculcated into ,children1 never to frighten one another2 a ,point which ,persons intrusted with their ,education1 ought to have the strictest ,regard to4 ,when the ,humours that should have passed off by ,perspiration1 are repelled to the ,intestines1 a tedious and very obstinate ,looseness is the frequent ,consequence4 ,sec4 #ebb4 ,our ,endeavours should be directed1 to re-establish the disordered ,circulation2 to restore the obstructed ,perspiration2 and to allay the ,agitation of the ,nerves4 ,the popular ,custom in these ,cases has been to give the terrified ,patient some cold ,water directly2 but when the ,fright has been considerable1 this is a very pernicious custom1 and ,i have seen some terrible ,consequences from it4 ,they should1 on the contrary1 be conveyed into some very quiet ,situation1 leaving there but very few ,persons1 and such only as they are thoroughly familiar with4 ,they should take a few ,cups of pretty warm ,drink1 particularly of an ,infusion of ,lime-tree ,flowers and ,bawm4 ,their ,legs should be put into warm ,water1 and remain there an ,hour1 if they will patiently permit it1 rubbing them gently now and then1 and giving them every half-quarter of an ,hour1 a small ,cup of the said ,drink4 ,when their ,composure and ,tranquillity are returned a little1 and their ,skin seems to have recovered its wonted and general ,warmth1 ,care should be taken to dispose them to sleep1 and to perspire plentifully4 ,for this ,purpose they may be allowed a few ,spoonfuls of ,wine1 on putting them into ,bed1 with one ,cup of the former ,infusion2 or1 which is more certain and effectual1 a few ,drops of ,sydenham's ,liquid ,laudanum1 ,no4 #dd2 but should that not be near at ,hand1 a small ,dose of ,venice ,treacle4 ,sec4 #ebc4 ,it sometimes happens that ,children do not seem at first extremely terrified2 but the ,fright is renewed while they sleep1 and with no small ,violence4 ,the ,directions ,i have just given must then be observed1 for some successive ,evenings1 before they are put to ,bed4 ,their ,fright frequently returns about the latter ,end of the ,night1 and agitates them violently every ,day4 ,the same ,treatment should be continued in such ,cases2 and we should endeavour to dispose them to be a-sleep at the usual ,hour of its ,return4 ,by this very ,method1 ,i have dissipated the dismal ,consequences of ,fear of ,women in ,child-bed1 which is so commonly1 and often speedily1 mortal4 ,if a ,suffocation from this ,cause is violent1 there is sometimes a ,necessity for opening a ,vein in the ,arm4 ,these ,patients should gradually be inured to an almost continual1 but gentle1 ,kind of ,exercise4 ,all violent ,medicines render those ,diseases1 which are the ,consequences of great ,fear1 incurable4 ,a pretty common one is that of an ,obstruction of the ,liver1 which has been productive of a ,jaundice4 #ajg #ajg ,i have seen this actually verified by great and disagreeable ,surprize1 attended indeed with much ,concern1 in a ,person of exquisite ,sensations4 ,k4 ,of ,accidents or ,symptoms produced by the ,vapours of ,coal1 and of ,wine4 ,sec4 #ebd4 ,not a single ,year passes over here1 without the ,destruction of many ,people by the ,vapour of ,charcoal1 or of small ,coal1 and by the ,steam or ,vapour of ,wine4 ,the ,symptoms by ,coal occur1 when #ajh small ,coal1 and especially when #aji ,charcoal is burnt in a ,chamber close shut1 which is direct ,poison to a ,person shut up in it4 ,the sulphureous ,oil1 which is set at ,liberty and diffused by the ,action of ,fire1 expands itself through the ,chamber2 while those who are in it perceive a ,disorder and ,confusion in their ,heads2 contract ,vertigos1 ,sickness at ,stomach1 a ,weakness1 and very unusual ,kind of ,numbness2 become raving1 convulsed and trembling2 and if they fail of ,presence of ,mind1 or of ,strength1 to get out of the ,chamber1 they die within a short ,time4 #ajh ,la ,braise4 #aji ,charbon4 ,dr4 ,tissot informs me1 their ,difference consists in this1 that the ,charcoal is prepared from ,wood burnt in a close or stifled ,fire2 and that the small ,coal is made of ,wood 7and of smaller ,wood7 burnt in an open ,fire1 and extinguished before it is reduced to the ,state of a ,cinder4 ,he says the latter is smaller1 softer1 less durable in the ,fire1 and the ,vapour of it less dangerous than that of ,charcoal4 ,i have seen a ,woman who had vertiginous ,commotions in her ,head for two ,days1 and almost continual ,vomitings1 from her having been confined less than six ,minutes in a ,chamber 7and that notwithstanding1 both one ,window and one ,door were open7 in which there was a ,chafing-dish with some burning ,coals4 ,had the ,room been quite close1 she must have perished by it4 ,this ,vapour is narcotic or stupefying1 and proves mortal in ,consequence of its producing a sleepy or apoplectic ,disorder1 though blended1 at the same time1 with something convulsive2 which sufficiently appears from the ,closure of the ,mouth1 and the strict ,contraction or ,locking of the ,jaws4 ,the ,condition of the ,brain1 in the dissected ,bodies of ,persons thus destroyed1 proves that they die of an ,apoplexy3 notwithstanding it is very probable that ,suffocation is also partly the ,cause of their ,deaths2 as the ,lungs have been found stuffed up with ,blood and livid4 ,it has also been observed in some other such ,bodies1 that ,patients killed by the ,vapour of burning ,coals1 have commonly their whole ,body swelled out to one third more than their ,magnitude1 when living4 ,the ,face1 ,neck1 and ,arms are swelled out1 as if they had been blown up2 and the whole human ,machine appears in such a ,state1 as the dead ,body of a ,person would1 who had been violently strangled2 and who had made all possible ,resistance for a long time1 before he was overpowered4 ,sec4 #ebe4 ,such as are sensible of the great ,danger they are in1 and retreat seasonably from it1 are generally relieved as soon as they get into the open ,air2 or if they have any remaining ,uneasiness1 a little ,water and ,vinegar1 or ,lemonade1 drank hot1 affords them speedy ,relief4 ,but when they are so far poisoned1 as to have lost their ,feeling and ,understanding1 if there be any ,means of reviving them1 such ,means consist1 #a1 ,in exposing them to a very pure1 fresh and open ,air4 #b1 ,in making them smell to some very penetrating ,odour1 which is somewhat stimulating and reviving1 such as the volatile ,spirit of ,sal ,ammoniac1 the #aaj ,english ,salt2 and afterwards to surround them1 as it were1 with the ,steam of ,vinegar4 #aaj ,see ,note #aje ,page #die4 #c1 ,in taking some ,blood from their ,arm4 #d1 ,in putting their ,legs into warm or hot ,water1 and chafing them well4 #e1 ,in making them swallow1 if practicable1 much ,lemonade1 or ,water and ,vinegar1 with the ,addition of ,nitre3 and1 #f1 ,in throwing up some sharp ,glysters4 ,as it is manifest there is something spasmodic in these ,cases1 it were proper to be provided with some antispasmodic ,remedies1 such as the ,mineral ,anodyne ,liquid of ,hoffman4 ,even ,opium has sometimes been successfully given here1 but it should be allowed to ,physicians only to direct it in such ,cases4 ,a ,vomit would be hurtful2 and the ,reachings to vomit arise only from the ,oppression on the ,brain4 ,it is a common but erroneous ,opinion1 that if the ,coal be suffered to burn for a ,minute or so in the open ,air1 or in a ,chimney1 it is sufficient to prevent any ,danger from the ,vapour of it4 ,hence it amounts even to a criminal ,degree of ,imprudence1 to sleep in a ,chamber while ,charcoal or small ,coal is burning in it2 and the ,number of such imprudent ,persons1 as have never awaked after it1 is so considerable1 and so generally known too1 that the ,continuance of this unhappy ,custom is astonishing4 ,sec4 #ebf4 ,the ,bakers1 who make ,use of much small ,coal1 often keep great ,quantities of it in their ,cellars1 which frequently abound so much with the ,vapour of it1 that it seizes them violently the ,moment they enter into the ,cellar4 ,they sink down at once deprived of all ,sensation1 and die if they are not drawn out of it soon enough to be assisted1 according to the ,directions ,i have just given4 ,one certain ,means of preventing such fatal ,accidents is1 upon going into the ,cellar to throw some flaming ,paper or ,straw into it1 and if these continue to flame out and consume1 there is no ,reason for dreading the ,vapour3 but if they should be extinguished1 no ,person should venture in4 ,but after opening the ,vent-hole1 a ,bundle of flaming ,straw must be set at the ,door1 which serves to attract the external ,air strongly4 ,soon after the ,experiment of the flaming ,paper must be repeated1 and if it goes out1 more ,straw is to be set on ,fire before the ,cellar ,door4 ,sec4 #ebg4 ,small ,coal1 burnt in an open ,fire1 is not near so dangerous as ,charcoal1 properly so called1 the ,danger of which arises from this1 that in extinguishing it by the usual ,methods1 all those sulphureous ,particles of it1 in which its ,danger consists1 are concentred4 ,nevertheless1 small ,coal is not entirely deprived of all its noxious ,quality1 without some of which it could not strictly be ,coal4 ,the common ,method of throwing some ,salt on live ,coals1 before they are conveyed into a ,chamber2 or of casting a ,piece of ,iron among them to imbibe some ,part of their deadly narcotic ,sulphur1 is not without its ,utility2 though by no means sufficient to prevent all ,danger from them4 ,sec4 #ebh4 ,when the most dangerous ,symptoms from this ,cause disappear1 and there remains only some ,degree of ,weakness1 of ,numbness1 and a little ,inappetency1 or ,loathing at ,stomach1 nothing is better than ,lemonade with one fourth ,part ,wine1 half a ,cup of which should frequently be taken1 with a small ,crust of ,bread4 ,sec4 #ebi4 ,the ,vapour which exhales from ,wine1 and in general from all fermenting ,liquors1 such as ,beer1 ,cyder1 c4 contains something poisonous1 which kills in the like ,manner with the ,vapour of ,coal2 and there is always some ,danger in going into a ,cellar1 where there is much ,wine in the ,state of ,fermentation2 if it has been shut up close for several ,hours4 ,there have been many ,examples of ,persons struck dead on entering one1 and of others who have escaped out of it with ,difficulty4 ,when such unhappy ,accidents occur1 ,men should not be successively exposed1 one after another1 to perish1 by endeavouring to fetch out the first who sunk down upon his ,entrance2 but the ,air should immediately be purified by the ,method already directed1 or by discharging some ,guns into the ,cellar2 after which ,people may venture in with ,precaution4 ,and when the ,persons unfortunately affected are brought out1 they are to be treated like those1 who were affected with the ,coal-,vapour4 ,i saw a ,man1 about eight ,years since1 who was not sensible of the ,application of ,spirit of ,sal ,ammoniac1 till about an ,hour after he was struck down1 and who was entirely freed at last by a plentiful ,bleeding2 though he had been so insensible1 that it was several ,hours before he discovered a very great ,wound he had1 which extended from the ,middle of his ,arm to his ,armpit1 and which was made by a ,hook intended to be used1 in ,case of a ,house catching ,fire1 to assist ,persons in escaping from the ,flames4 ,sec4 #ecj4 ,when subterraneous ,caves that have been very long shut are opened2 or when deep ,wells are cleaned1 that have not been emptied for several ,years1 the ,vapours arising from them produce the same ,symptoms ,i have mentioned1 and require the same ,assistance4 ,they are to be cleansed and purified by burning ,sulphur and ,salt ,petre in them1 or ,gunpowder1 as compounded of both4 ,sec4 #eca4 ,the offensive ,stink of ,lamps and of ,candles1 especially when their ,flames are extinguished1 operate like other ,vapours1 though with less ,violence1 and less suddenly4 ,nevertheless there have been ,instances of ,people killed by the ,fumes of ,lamps fed with ,nut ,oil1 which had been extinguished in a close ,room4 ,these last ,smells or ,fumes prove noxious also1 in ,consequence of their ,greasiness1 which being conveyed1 together with the ,air1 into the ,lungs1 prevent their ,respiration3 ,and hence we may observe1 that ,persons of weak delicate ,breasts find themselves quickly oppressed in ,chambers or ,apartments1 illuminated with many ,candles4 ,the proper ,remedies have been already directed1 ,sec4 #ebe4 ,the ,steam of ,vinegar is very serviceable in such ,cases4 ,of ,poisons4 ,sec4 #ecb4 ,there are a great ,number of ,poisons1 whose ,manner of acting is not alike2 and whose ill ,effects are to be opposed by different ,remedies3 ,but ,arsenic1 or ,ratsbane1 and some particular ,plants are the ,poisons which are the most frequently productive of ,mischief1 in ,country ,places4 ,sec4 #ecc4 ,it is in ,consequence of its excessive ,acrimony1 or violent ,heat and ,sharpness1 which corrodes or gnaws1 that ,arsenic destroys by an excessive ,inflammation1 with a burning ,fire as it were1 most torturing ,pains in the ,mouth1 ,throat1 ,stomach1 ,guts2 with rending and often bloody ,vomitings1 and ,stools1 ,convulsions1 ,faintings1 c4 ,the best ,remedy of all is pouring down whole ,torrents of ,milk1 or1 where there is not ,milk1 of warm ,water4 ,nothing but a prodigious ,quantity of such weak ,liquids can avail such a miserable ,patient4 ,if the ,cause of the ,disorder is immediately known1 after having very speedily taken down a large ,quantity of warm ,water1 ,vomiting may be excited with ,oil1 or with melted ,butter1 and by tickling the ,inside of the ,throat with a ,feather4 ,but when the ,poison has already inflamed the ,stomach and the ,guts1 we must not expect to discharge it by vomiting4 ,whatever is healing or emollient1 ,decoctions of mealy ,pulse1 of ,barley1 of ,oatmeal1 of ,marsh-mallows1 and ,butter and ,oil are the most suitable4 ,as soon as ever the tormenting ,pains are felt in the ,belly1 and the ,intestines seem attacked1 ,glysters of ,milk must be very frequently thrown up4 ,if at the very ,beginning of the ,attack1 the ,patient has a strong ,pulse1 a very large ,bleeding may be considerably serviceable by its delaying the ,progress1 and diminishing the ,degree of ,inflammation4 ,and even though it should happen that a ,patient overcomes the first ,violence of this dreadful ,accident1 it is too common for him to continue in a languid ,state for a long ,time1 and sometimes for all the ,remainder of his ,life4 ,the most certain ,method of preventing this ,misery1 is to live for some ,months solely upon ,milk1 and some very new laid ,eggs1 just received from the ,hen1 and dissolved or blended in the ,milk1 without boiling them4 ,sec4 #ecd4 ,the ,plants which chiefly produce these unhappy ,accidents are some ,kinds of ,hemlock1 whether it be the ,leaf or the ,root1 the ,berries of the ,bella ,donna1 or deadly ,nightshade1 which ,children eat by mistake for ,cherries2 some ,kind of ,mushrooms1 the ,seed of the ,datura1 or the stinking ,thorn-,apple4 ,all the ,poisons of this ,class prove mortal rather from a narcotic1 or stupefying1 than from an acrid1 or very sharp ,quality4 ,vertigos1 ,faintings1 ,reachings to vomit1 and actual ,vomitings are the first ,symptoms produced by them4 ,the ,patient should immediately swallow down a large ,quantity of ,water1 moderately seasoned with ,salt or with ,sugar2 and then a ,vomiting should be excited as soon as possible by the ,prescription ,no4 #cd or #ce3 or1 if neither of these is very readily procurable1 with ,radish-seed pounded1 to the ,quantity of a ,coffee ,spoonful1 swallowed in warm ,water1 soon after forcing a ,feather or a ,finger into the ,patient's ,throat1 to expedite the ,vomiting4 ,after the ,operation of the ,vomit1 he must continue to take a large ,quantity of ,water1 sweetened with ,honey or ,sugar1 together with a considerable ,quantity of ,vinegar1 which is the true ,specific1 or ,antidote1 as it were1 against those ,poisons3 the ,intestines must also be emptied by a few ,glysters4 ,thirty-seven ,soldiers having unhappily eaten1 instead of ,carrots1 of the ,roots of the ,oenanthe2 or ,water-hemlock1 became all extremely sick2 when the ,emetic1 ,no4 #cd1 with the ,assistance of ,glysters1 and very plentiful drinking of warm ,water1 saved all but one of them1 who died before he could be assisted4 ,sec4 #ece4 ,if a ,person has taken too much ,opium2 or any ,medicine into which it enters1 as ,venice ,treacle1 ,mithridate1 ,diascordium1 c4 whether by ,imprudence1 ,mistake1 ,ignorance1 or through any bad ,design1 he must be bled upon the ,spot1 and treated as if he had a sanguine ,apoplexy1 7,see ,sec4 #adg7 by ,reason that ,opium in ,effect produces such a one4 ,he should snuff up and inhale the ,vapour of ,vinegar plentifully1 adding it also liberally to the ,water he is to drink4 ,of acute ,pains4 ,sec4 #ecf4 ,it is not my ,intention to treat here of those ,pains1 that accompany any evident known ,disease1 and which should be conducted as relating to such ,diseases2 nor of such ,pains as infirm valetudinary ,persons are habitually subject to2 since ,experience has informed such of the most effectual ,relief for them3 ,but when a ,person sound and hale1 finds himself suddenly attacked with some excessive ,pain1 in whatever ,part it occurs1 without knowing either the ,nature1 or the ,cause of it1 they may1 till proper ,advice can be procured1 #a1 ,part with some ,blood1 which1 by abating the ,fulness and ,tension1 almost constantly asswages the ,pains1 at least for some ,time3 and it may even be repeated1 if1 without weakening the ,patient much1 it has lessened the ,violence of the ,pain4 #b1 ,the ,patient should drink abundantly of some very mild temperate ,drink1 such as the ,ptisan ,no4 #b1 the ,almond ,emulsion ,no4 #d1 or warm ,water with a fourth or fifth ,part ,milk4 #c1 ,several emollient ,glysters should be given4 #d1 ,the whole ,part that is affected1 and the adjoining ,parts should be covered with ,cataplasms1 or soothed with the emollient ,fomentation1 ,no4 #i4 #e1 ,the warm ,bath may also be advantagiously used4 #f1 ,if notwithstanding all these ,assistances1 the ,pain should still continue violent1 and the ,pulse is neither full nor hard1 the grown ,patient may take an ,ounce of ,syrup of ,diacodium1 or sixteen ,drops of liquid ,laudanum2 and when neither of these are to be had1 #aaa an ,english ,pint of boiling ,water must be poured upon three or four ,poppy-heads with their ,seeds1 but without the ,leaves1 and this ,decoction is to be drank like ,tea4 #aaa ,une ,quartette4 ,sec4 #ecg4 ,persons very subject to frequent ,pains1 and especially to violent ,head-achs1 should abstain from all strong ,drink2 such ,abstinence being often the only ,means of curing them3 ,and ,people are very often mistaken in supposing ,wine necessary for as many as seem to have a weak ,stomach4 ,chapter ,,xxxii4 ,of ,medicines taken by ,way of ,precaution1 or ,prevention4 ,sect4 #ech4 ,i ,have pointed out1 in some ,parts of this ,work1 the ,means of preventing the bad ,effects of several ,causes of ,diseases2 and of prohibiting the ,return of some habitual ,disorders4 ,in the present ,chapter ,i shall adjoin some ,observations1 on the ,use of the principal ,remedies1 which are employed as general ,preservatives2 pretty regularly too at certain stated ,times1 and almost always from meer ,custom only1 without knowing1 and often with very little ,consideration1 whether they are right or wrong4 ,nevertheless1 the ,use1 the ,habit of taking ,medicines1 is certainly no indifferent ,matter3 it is ridiculous1 dangerous1 and even criminal to omit them1 when they are necessary1 but not less so to take them when they are not wanted4 ,a good ,medicine taken seasonably1 when there is some ,disorder1 some ,disarrangement in the ,body1 which would in a short time occasion a ,distemper1 has often prevented it4 ,but yet the very same ,medicine1 if given to a ,person in perfect ,health1 if it does not directly make him sick1 leaves him at the best in a greater ,propensity to the ,impressions of ,diseases3 and there are but too many ,examples of ,people1 who having very unhappily contracted a ,habit1 a ,disposition to take ,physick1 have really injured their ,health1 and impaired their ,constitution1 however naturally strong1 by an ,abuse of those ,materials which ,providence has given for the ,recovery and ,re-establishment of it2 an ,abuse which1 though it should not injure the ,health of the ,person1 would occasion those ,remedies1 when he should be really sick1 to be less efficacious and serviceable to him1 from their having been familiar to his ,constitution2 and thus he becomes deprived of the ,assistance he would have received from them1 if taken only in those ,times and ,circumstances1 in which they were necessary for him4 ,of ,bleeding4 ,sec4 #eci4 ,bleeding is necessary only in these four ,cases4 #a1 ,when there is too great a ,quantity of ,blood in the ,body4 #b1 ,when there is any ,inflammation1 or an inflammatory ,disease4 #c1 ,when some ,cause supervenes1 or is about to supervene1 in the ,constitution1 which would speedily produce an ,inflammation1 or some other dangerous ,symptom1 if the ,vessels were not relaxed by ,bleeding4 ,it is upon this ,principle that ,patients are bled after ,wounds1 and after ,bruises2 that ,bleeding is directed for a pregnant ,woman1 if she has a violent ,cough2 and that ,bleeding is performed1 by ,way of ,precaution1 in several other ,cases4 #d1 ,we also advise ,bleeding sometimes to asswage an excessive ,pain1 though such ,pain is not owing to ,excess of ,blood1 nor arises from an inflamed ,blood2 but in ,order to appease and moderate the ,pain by ,bleeding2 and thereby to obtain ,time for destroying the ,cause of it by other ,remedies4 ,but as these two last ,reasons are in ,effect involved or implied in the two first2 it may be very generally concluded1 that an ,excess of ,blood1 and an inflamed ,state of it1 are the only two necessary ,motives for ,bleeding4 ,sec4 #edj4 ,an ,inflammation of the ,blood is known by the ,symptoms accompanying those ,diseases1 which that ,cause produces4 ,of these ,i have already spoken1 and ,i have at the same time regulated the ,practice of ,bleeding in such ,cases4 ,here ,i shall point out those ,symptoms and ,circumstances1 which manifest an ,excess of ,blood4 ,the first1 then1 is the general ,course and ,manner of the ,patient's living1 while in ,health4 ,if he is a great ,eater1 and indulges in juicy nutritious ,food1 and especially on much ,flesh-meat2 if he drinks rich and nourishing ,wine1 or other strong ,drink1 and at the same time enjoys a good ,digestion2 if he takes but little ,exercise1 sleeps much1 and has not been subject to any very considerable ,evacuation1 he may well be supposed to abound in ,blood4 ,it is very obvious that all these ,causes rarely occur in ,country ,people2 if we except only the ,abatement of their ,exercise1 during some ,weeks in ,winter1 which indeed may contribute to their generating more ,blood than they commonly do4 ,the labouring ,country-man1 for much the greater part of his ,time1 lives only on ,bread1 ,water and ,vegetables2 ,materials but very moderately nourishing1 as one ,pound of ,bread probably does not make1 in the same ,body1 more ,blood than one ,ounce of ,flesh2 though a general ,prejudice seems to have established a contrary ,opinion4 #b1 ,the total ,stopping or long ,interruption of some involuntary ,bleeding or ,haemorrhage1 to which he had been accustomed4 #c1 ,a full and strong ,pulse1 and ,veins visibly filled with ,blood1 in a ,body that is not lean and thin1 and when he is not heated4 #d1 ,a florid lively ,ruddiness4 #e1 ,a considerable and unusual ,numbness2 ,sleep more profound1 of more ,duration1 and yet less tranquil and calm1 than at other times2 a greater ,propensity than ordinary to be fatigued after moderate ,exercise or ,work2 and a little ,oppression and ,heaviness from walking4 #f1 ,palpitations1 accompanied sometimes with very great ,dejection1 and even with a slight fainting ,fit2 especially on being in any hot ,place1 or after moving about considerably4 #g1 ,vertigos1 or ,swimmings of the ,head1 especially on bowing down and raising it up at once1 and after sleeping4 #h1 ,frequent ,pains of the ,head1 to which the ,person was not formerly subject2 and which seem not to arise from any ,defect in the ,digestions4 #i1 ,an evident ,sensation of ,heat1 pretty generally diffused over the whole ,body4 #aj1 ,a smarting ,sort of ,itching all over1 from a very little more ,heat than usual4 ,and lastly1 frequent ,haemorrhages1 and these attended with manifest ,relief1 and more ,vivacity4 ,people should1 notwithstanding1 be cautious of supposing an unhealthy ,excess of ,blood1 from any one of these ,symptoms only4 ,many of them must concur2 and they should endeavour to be certain that even such a ,concurrence of them does not result from a very different ,cause1 and wholly opposite in ,effect to that of an ,excess of ,blood4 ,but when it is certain1 from the whole ,appearance1 that such an ,excess doth really exist1 then a single1 or even a second ,bleeding is attended with very good ,effects4 ,nor is it material1 in such ,cases1 from what ,part the ,blood is taken4 ,sec4 #eda4 ,on the other ,hand1 when these ,circumstances do not exist1 ,bleeding is in no wise necessary3 nor should it ever be practised in these following ,conditions and ,circumstances2 except for some particular and very strong ,reasons2 of the due ,force of which none but ,physicians can judge4 ,first1 when the ,person is in a very advanced ,age1 or in very early ,infancy4 #b1 ,when he is either naturally of a weakly ,constitution1 or it has been rendered such by ,sickness1 or by some other ,accident4 #c1 ,when the ,pulse is small1 soft1 feeble1 and intermits1 and the ,skin is manifestly pale4 #d1 ,when the ,limbs1 the ,extremities of the ,body1 are often cold1 puffed up and soft4 #e1 ,when their ,appetite has been very small for a long time2 their ,food but little nourishing1 and their ,perspiration too plentiful1 from great ,exercise4 #f1 ,when the ,stomach has long been disordered1 and the ,digestion bad1 whence very little ,blood could be generated4 #g1 ,when the ,patient has been considerably emptied1 whether by ,haemorrhages1 a ,looseness1 profuse ,urine or ,sweat3 or when the ,crisis of some ,distemper has been effected by any one of these ,evacuations4 #h1 ,when the ,patient has long been afflicted with some depressing ,disease2 and troubled with many such ,obstructions as prevent the ,formation of ,blood4 #i1 ,whenever a ,person is exhausted1 from whatever ,cause4 #aj1 ,when the ,blood is in a thin1 pale1 and dissolved ,state4 ,sec4 #edb1 ,in all these ,cases1 and in some others less frequent1 a single ,bleeding often precipitates the ,patient into an absolutely incurable ,state1 an irreparable ,train of ,evils4 ,many dismal ,examples of it are but too obvious4 ,whatever1 therefore1 be the ,situation of the ,patient1 and however naturally robust1 that ,bleeding1 which is unnecessary1 is noxious4 ,repeated1 re-iterated ,bleedings1 weaken and enervate1 hasten old ,age1 diminish the ,force of the ,circulation1 thence fatten and puff up the ,body2 and next by weakening1 and lastly by destroying1 the ,digestions1 they lead to a fatal ,dropsy4 ,they disorder the ,perspiration by the ,skin1 and leave the ,patient liable to ,colds and ,defluxions3 ,they weaken the nervous ,system1 and render them subject to ,vapours1 to the hypochondriac ,disorders1 and to all nervous ,maladies4 ,the ill ,consequence of a single1 though erroneous ,bleeding is not immediately discernible3 on the contrary1 when it was not performed in such a ,quantity1 as to weaken the ,patient perceivably1 it appears to have been rather beneficial4 ,yet ,i still here insist upon it1 that it is not the less true that1 when unnecessary1 it is prejudicial2 and that ,people should never bleed1 as sometimes has been done1 for meer ,whim1 or1 as it were1 for ,diversion4 ,it avails nothing to affirm1 that within a few ,days after it1 they have got more ,blood than they had before it1 that is1 that they weigh more than at first1 whence they infer the ,loss of ,blood very speedily repaired4 ,the ,fact of their augmented ,weight is admitted2 but this very ,fact testifies against the real ,benefit of that ,bleeding2 hence it is a ,proof1 that the natural ,evacuations of the ,body are less compleatly made2 and that ,humours1 which ought to be expelled1 are retained in it4 ,there remains the same ,quantity of ,blood1 and perhaps a little more2 but it is not a ,blood so well made1 so perfectly elaborated2 and this is so very true1 that if the thing were otherwise2 if some ,days after the ,bleeding they had a greater ,quantity of the same ,kind of ,blood1 it would amount to a ,demonstration1 that more re-iterated ,bleedings must necessarily have brought on an inflammatory ,disease1 in a ,man of a robust ,habit of ,body4 ,sec4 #edc4 ,the ,quantity of ,blood1 which a grown ,man may ,part with1 by ,way of ,precaution1 is about ten ,ounces4 ,sec4 #edd4 ,persons so constituted as to breed much ,blood1 should carefully avoid all those ,causes which tend to augment it1 7,see ,sec4 #edj1 ,no4 #a7 and when they are sensible of the ,quantity augmented1 they should confine themselves to a light frugal ,diet1 on ,pulse1 ,fruits1 ,bread and ,water2 they should often bathe their ,feet in warm ,water1 taking ,night and ,morning the ,powder ,no4 #bj2 drink of the ,ptisan ,no4 #a2 sleep but very moderately1 and take much ,exercise4 ,by using these ,precautions they may either prevent any ,occasion for ,bleeding1 or should they really be obliged to admit of it1 they would increase and prolong its good ,effects4 ,these are also the very ,means1 which may remove all the ,danger that might ensue from a ,person's omitting to bleed1 at the usual ,season or ,interval1 when the ,habit1 the ,fashion of ,bleeding had been inveterately established in him4 ,sec4 #ede4 ,we learn with ,horror and ,astonishment1 that some have been bled eighteen1 twenty and even twenty-four times in two ,days2 and some others1 some #aab hundred times1 in the ,course of some ,months4 ,such ,instances irrefragably demonstrate the continual ,ignorance of their ,physician or ,surgeon2 and should the ,patient escape1 we ought to admire the inexhaustible ,resources of ,nature1 that survived so many murderous ,incisions4 #aab ,how shocking is this6 and yet how true in some ,countries6 ,i have been most certainly assured1 that ,bleeding has been inflicted and repeated in the last sinking and totally relaxing ,stage of a ,sea-,scurvy1 whose fatal ,termination it doubtless accelerated4 ,this did not happen in our own ,fleet2 yet we are not as yet ,wholly exempt on ,shore1 from some ,abuse of ,bleeding1 which a few raw unthinking ,operators are apt to consider as a meer ,matter of ,course4 ,i have in some other ,place stigmatized the ,madness of ,bleeding in ,convulsions1 from manifest ,exhaustion and ,emptiness1 with the ,abhorrence it deserves4 ,k4 ,sec4 #edf4 ,the ,people entertain a common ,notion1 which is1 that the first ,time of bleeding certainly saves the ,life of the ,patient2 but to convince them of the ,falsity of this silly ,notion1 they need only open their ,eyes1 and see the very contrary ,fact to this occur but too unhappily every ,day2 many ,people dying soon after their first ,bleeding4 ,were their ,opinion right1 it would be impossible that any ,person should die of the first ,disease that seized him1 which yet daily happens4 ,now the ,extirpation of this absurd ,opinion is really become important1 as the ,continuance of it is attended with some unhappy ,consequences3 their ,faith in1 their great ,dependance on1 the extraordinary ,virtue of this first ,bleeding makes them willing to omit it1 that is1 to treasure it up against a ,distemper1 from which they shall be in the greatest ,danger2 and thus it is deferred as long as the ,patient is not extremely bad1 in ,hopes that if they can do without it then1 they shall keep it for another and more pressing ,occasion4 ,their present ,disease in the mean time rises to a violent ,height2 and then they bleed1 but when it is too late1 and ,i have seen ,instances of many ,patients1 who were permitted to die1 that the first ,bleeding might be reserved for a more important ,occasion4 ,the only ,difference between the first ,bleeding1 and any subsequent one is1 that the first commonly gives the ,patient an ,emotion1 that is rather hurtful than salutary4 ,of ,purges4 ,sec4 #edg4 ,the ,stomach and ,bowels are emptied either by ,vomiting1 or by ,stools1 the latter ,discharge being much more natural than the first1 which is not effected without a violent ,motion1 and one indeed to which ,nature is repugnant4 ,nevertheless1 there are some ,cases1 which really require this artificial ,vomiting2 but these excepted 7some of which ,i have already pointed out7 we should rather prefer those ,remedies1 which empty the ,belly by ,stool4 ,sec4 #edh4 ,the ,signs1 which indicate a ,necessity for ,purging1 are1 #a1 a disagreeable ,tast or ,savour of the ,mouth in a ,morning1 and especially a bitter ,tast2 a foul1 furred ,tongue and ,teeth1 disagreable ,eructations or ,belchings1 ,windiness and ,distension4 #b1 ,a ,want of ,appetite which increases very gradually1 without any ,fever1 which degenerates into a ,disgust or total ,aversion to ,food2 and sometimes communicates a bad ,tast to the very little such ,persons do eat4 #c1 ,reachings to vomit in a ,morning fasting1 and sometimes throughout the ,day2 supposing such not to depend on a ,woman's ,pregnancy1 or some other ,disorder1 in which ,purges would be either useless or hurtful4 #d1 ,a vomiting up of bitter1 or corrupted1 ,humours4 #e1 ,a manifest ,sensation of a ,weight1 or ,heaviness in the ,stomach1 the ,loins1 or the ,knees4 #f1 ,a ,want of ,strength sometimes attended with ,restlessness1 ill ,humour1 or ,peevishness1 and ,melancholy4 #g1 ,pains of the ,stomach1 frequent ,pains of the ,head1 or ,vertigos2 sometimes a ,drowsiness1 which increases after ,meals4 #h1 ,some ,species of ,cholics2 irregular ,stools which are sometimes very great in ,quantity1 and too liquid for many ,days together2 after which an obstinate ,costiveness ensues4 #i1 ,a ,pulse less regular1 and less strong1 than what is natural to the ,patient1 and which sometimes intermits4 ,sec4 #edi4 ,when these ,symptoms1 or some of them1 ascertain the ,necessity of purging a ,person1 not then attacked by any manifest ,disease 7for ,i am not speaking here of ,purges in such ,cases7 a proper purging ,medicine may be given him4 ,the bad ,tast in his ,mouth2 the continual ,belchings2 the frequent ,reachings to vomit2 the actual ,vomitings and ,melancholy discover1 that the ,cause of his ,disorder resides in the ,stomach1 and shew that a ,vomit will be of ,service to him4 ,but when such ,signs or ,symptoms are not evident1 the ,patient should take such purging or opening ,remedies1 as are particularly indicated by the ,pains1 whether of the ,loins2 from the ,cholic2 or by a ,sensation of ,weight or ,heaviness in the ,knees4 ,sec4 #eej4 ,but we should abstain from either vomiting or purging1 #a1 ,whenever the ,complaints of the ,patients are founded in their ,weakness1 and their being already exhausted1 #b1 ,when there is a general ,dryness of the ,habit1 a very considerable ,degree of ,heat1 some ,inflammation1 or a strong ,fever4 #c1 ,whenever ,nature is exerting herself in some other salutary ,evacuation2 whence purging must never be attempted in critical ,sweats1 during the monthly ,discharges1 nor during a ,fit of the ,gout4 #d1 ,nor in such inveterate ,obstructions as ,purges cannot remove1 and really do augment4 #e1 ,neither when the nervous ,system is considerably weakened4 ,sec4 #eea4 ,there are other ,cases again1 in which it may be proper to purge1 but not to give a ,vomit4 ,these ,cases are1 #a1 ,when the ,patient abounds too much with ,blood1 7,see ,sec4 #edj7 since the ,efforts which attend vomiting1 greatly augment the ,force of the ,circulation2 whence the ,blood-vessels of the ,head and of the ,breast1 being extremely distended with ,blood1 might burst1 which must prove fatal on the ,spot1 and has repeatedly proved so4 #b1 ,for the same ,reason they should not be given to ,persons1 who are subject to frequent ,bleeding from the ,nose1 or to coughing up or vomiting of ,blood2 to ,women who are subject to excessive or unseasonable ,discharges of ,blood1 c4 from the ,vagina1 the ,neck of the ,womb2 nor to those who are with ,child4 #c1 ,vomits are improper for ruptured ,persons4 ,sec4 #eeb4 ,when any ,person has taken too acrid1 too sharp1 a ,vomit1 or a ,purge1 which operates with excessive ,violence2 whether this consists in the most vehement ,efforts and ,agitations1 the ,pains1 ,convulsions1 or ,swoonings1 which are their frequent ,consequences2 or whether that prodigious ,evacuation and ,emptiness their ,operation causes1 7which is commonly termed a ,super-purgation7 and which may hurry the ,patient off2 ,instances of which are but too common among the lower ,class of the ,people1 who much too frequently confide themselves to the ,conduct of ignorant ,men-slayers3 ,in all such unhappy ,accidents1 ,i say1 we should treat these unfortunate ,persons1 as if they had been actually poisoned1 by violent corroding ,poisons1 7,see ,sec4 #ecc7 that is1 we should fill them1 as it were1 with ,draughts of warm ,water1 ,milk1 ,oil1 ,barley-water1 ,almond ,milk1 emollient ,glysters with ,milk1 and the ,yolks of ,eggs2 and also bleed them plentifully1 if their ,pains are excessive1 and their ,pulses strong and feverish4 ,the ,super-purgation1 the excessive ,discharge1 is to be stopt1 after having plied the ,patient plentifully with diluting ,drinks1 by giving the calming ,anodyne ,medicines directed in the ,removal of acute ,pains1 ,sec4 #ecf1 ,no4 #f4 ,flanels dipt in hot ,water1 in which some ,venice ,treacle is dissolved1 are very serviceable3 and should the ,evacuations by ,stool be excessive1 and the ,patient has not a high ,fever1 and a parching ,kind of ,heat1 a ,morsel of the same ,treacle1 as large as a ,nutmeg1 may be dissolved in his ,glyster4 ,but should the ,vomiting solely be excessive1 without any ,purging1 the ,number of the emollient ,glysters with ,oil and the ,yolk of an ,egg must be increased2 and the ,patient should be placed in a warm ,bath4 ,sec4 #eec4 ,purges frequently repeated1 without just and necessary ,indications1 are attended with much the same ill ,effects as frequent ,bleedings4 ,they destroy the ,digestions2 the ,stomach no longer1 or very languidly1 exerts its ,functions2 the ,intestines prove inactive2 the ,patient becomes liable to very severe ,cholics2 the ,plight of the ,body1 deprived of its salutary ,nutrition1 falls off2 ,perspiration is disordered2 ,defluxions ensue2 nervous ,maladies come on1 with a general ,languor2 and the ,patient proves old1 long before the ,number of his ,years have made him so4 ,much irreparable ,mischief has been done to the ,health of ,children1 by ,purges injudiciously given and repeated4 ,they prevent them from attaining their utmost natural ,strength1 and frequently contract their due ,growth4 ,they ruin their ,teeth2 dispose young ,girls to future ,obstructions2 and when they have been already affected by them1 they render them still more obstinate4 ,it is a ,prejudice too generally received1 that ,persons who have little or no ,appetite need purging2 since this is often very false1 and most of those ,causes1 which lessen or destroy the ,appetite1 cannot be removed by purging2 though many of them may be increased by it4 ,persons whose ,stomachs contain much glairy viscid ,matter suppose1 they may be cured by ,purges1 which seem indeed at first to relieve them3 but this proves a very slight and deceitful ,relief4 ,these ,humours are owing to that ,weakness and ,laxity of the ,stomach1 which ,purges augment2 since notwithstanding they carry off ,part of these viscid ,humours generated in it1 at the ,expiration of a few ,days there is a greater ,accumulation of them than before2 and thus1 by a ,re-iteration of purging ,medicines1 the ,malady soon becomes incurable1 and ,health irrecoverably lost4 ,the real ,cure of such ,cases is effected by directly opposite ,medicines4 ,those referred to1 or mentioned1 ,sec4 #bgb1 are highly conducive to it4 ,sec4 #eed4 ,the ,custom of taking stomachic ,medicines infused in ,brandy1 ,spirit of ,wine1 ,cherry ,water1 c4 is always dangerous2 for notwithstanding the present immediate ,relief such ,infusions afford in some ,disorders of the ,stomach1 they really by slow ,degrees impair and ruin that ,organ2 and it may be observed1 that as many as accustom themselves to ,drams1 go off1 just like excessive ,drinkers1 in ,consequence of their having no ,digestion2 whence they sink into a ,state of ,depression and ,languor1 and die dropsical4 ,sec4 #eee4 ,either ,vomits or ,purges may be often beneficially omitted1 even when they have some ,appearance of seeming necessary1 by abating one ,meal a ,day for some time2 by abstaining from the most nourishing ,sorts of ,food2 and especially from those which are fat2 by drinking freely of cool ,water1 and taking extraordinary ,exercise4 ,the same ,regimen also serves to subdue1 without the ,use of ,purges1 the various ,complaints which often invade those1 who omit taking purging ,medicines1 at those ,seasons and ,intervals1 in which they have made it a ,custom to take them4 ,sec4 #eef4 ,the ,medicines1 ,no4 #cd and #ce1 are the most certain ,vomits4 ,the ,powder1 ,no4 #ba1 is a good ,purge1 when the ,patient is in no wise feverish4 ,the ,doses recommended in the ,table of ,remedies are those1 which are proper for a grown ,man1 of a vigorous ,constitution4 ,nevertheless there are some few1 for whom they may be too weak3 in such ,circumstances they may be increased by the ,addition of a third or fourth ,part of the ,dose prescribed4 ,but should they not operate in that ,quantity1 we must be careful not to double the ,dose1 much less to give a three-fold ,quantity1 which has sometimes been done1 and that even without its ,operation1 and at the ,risque of killing the ,patient1 which has not seldom been the ,consequence4 ,in ,case of such purging not ensuing1 we should rather give large ,draughts of ,whey sweetened with ,honey1 or of warm ,water1 in a ,pot of which an ,ounce1 or an ,ounce and a half of common ,salt must be dissolved2 and this ,quantity is to be taken from time to time in small ,cups1 moving about with it4 ,the ,fibres of ,country ,people who inhabit the ,mountains1 and live almost solely on ,milk1 are so little susceptible of ,sensation1 that they must take such large ,doses to purge them1 as would kill all the ,peasantry in the ,vallies4 ,in the ,mountains of ,valais there are ,men who take twenty1 and even twenty-four ,grains of ,glass of ,antimony for a single ,dose2 a ,grain or two of which were sufficient to poison ordinary ,men4 ,sec4 #eeg4 ,notwithstanding our ,cautions on this important ,head1 whenever an urgent ,necessity commands it1 ,purging must be recurred to at all ,times and ,seasons3 but when the ,season may be safely selected1 it were right to decline ,purging in the ,extremities of either ,heat or ,cold2 and to take the ,purge early in the ,morning1 that the ,medicines may find less ,obstruction or ,embarrassment from the ,contents of the ,stomach4 ,every other ,consideration1 with ,relation to the ,stars and the ,moon1 is ridiculous1 and void of any ,foundation4 ,the ,people are particularly averse to purging in the ,dog-days2 and if this were only on ,account of the great ,heat1 it would be very pardonable3 but it is from an astrological ,prejudice1 which is so much the more absurd1 as the real ,dog-days are at thirty-six ,days ,distance from those commonly reckoned such2 and it is a melancholy ,reflection1 that the ,ignorance of the ,people should be so gross1 in this ,respect1 in our enlightened ,age2 and that they should still imagine the ,virtue and ,efficacy of ,medicines to depend on what ,sign of the ,zodiac the ,sun is in1 or in any particular ,quarter of the ,moon4 ,yet it is certain in this ,point1 they are so inveterately attached to this ,prejudice1 that it is but too common to see ,country-,people die1 in waiting for the ,sign or ,quarter most favourable to the ,operation and ,effect of a ,medicine1 which was truly necessary five or six ,days before either of them4 ,sometimes too that particular ,medicine is given1 to which a certain ,day is supposed to be auspicious and favourable1 in ,preference to that which is most prevalent against the ,disease4 ,and thus it is1 than an ignorant ,almanack ,maker determines on the ,lives of the human ,race2 and contracts the ,duration of them with ,impunity4 ,sec4 #eeh4 ,when a ,vomit or a ,purge is to be taken1 the ,patient's ,body should be prepared for the ,reception of it twenty-four ,hours beforehand2 by taking very little ,food1 and drinking some ,glasses of warm ,water1 or of a light ,tea of some ,herbs4 ,he should not drink after a ,vomit1 until it begins to work2 but then he should drink very plentifully of warm ,water1 or a light ,infusion of ,chamomile ,flowers1 which is preferable4 ,it is usual1 after ,purges1 to take some thin ,broth or ,soup during their ,operation2 but warm ,water sweetened with ,sugar or ,honey1 or an ,infusion of ,succory ,flowers1 would sometimes be more suitable4 ,sec4 #eei4 ,as the ,stomach suffers1 in some ,degree1 as often as either a ,vomit1 or a ,purge1 is taken1 the ,patient should be careful how he lives and orders himself for some ,days after taking them1 as well in ,regard to the ,quantity as ,quality of his ,food4 ,sec4 #efj4 ,i shall say nothing of other ,articles taken by ,way of ,precaution1 such as ,soups1 ,whey1 ,waters1 c4 which are but little used among the ,people2 but confine myself to this general ,remark1 that when they take any of these precautionary ,things1 they should enter on a ,regimen or ,way of living1 that may co-operate with them1 and contribute to the same ,purpose4 ,whey is commonly taken to refresh and cool the ,body2 and while they drink it1 they deny themselves ,pulse1 ,fruits1 and ,sallads4 ,they eat nothing then1 but the best and heartiest ,flesh-meats they can come at2 such ,vegetables as are used in good ,soups1 ,eggs1 and good ,wine2 notwithstanding this is to destroy1 by high and heating ,aliments1 all the attemperating cooling ,effects expected from the ,whey4 ,some ,persons propose to cool and attemperate their ,blood by ,soups and a thin ,diet1 into which they cram ,craw-fish1 that heat considerably1 or ,nasturtium1 ,cresses which also heat1 and thus defeat their own ,purpose4 ,happily1 in such a ,case1 the ,error in one ,respect often cures that in the other2 and these ,kinds of ,soup1 which are in no wise cooling1 prove very serviceable1 in ,consequence of the ,cause of the ,symptoms1 which they were intended to remove1 not requiring any ,coolers at all4 ,the general physical ,practice of the ,community1 which unhappily is but too much in ,fashion1 abounds with similar ,errors4 ,i will just cite one1 because ,i have seen its dismal ,effects4 ,many ,people suppose ,pepper cooling1 though their ,smell1 ,taste1 and common ,sense concur to inform them of the contrary4 ,it is the very hottest of ,spices4 ,sec4 #efa4 ,the most certain ,preservative1 and the most attainable too by every ,man1 is to avoid all ,excess1 and especially ,excess in eating and in drinking4 ,people generally eat more than thoroughly consists with ,health1 or permits them to attain the utmost ,vigour1 of which their natural ,constitutions are capable4 ,the ,custom is established1 and it is difficult to eradicate it3 notwithstanding we should at least resolve not to eat1 but through ,hunger1 and always under a ,subjection to ,reason2 because1 except in a very few ,cases1 ,reason constantly suggests to us not to eat1 when the ,stomach has an ,aversion to ,food4 ,a sober moderate ,person is capable of ,labour1 ,i may say1 even of excessive ,labour of some ,kinds2 of which greater ,eaters are absolutely incapable4 ,sobriety of itself cures such ,maladies as are otherwise incurable1 and may recover the most shattered and unhealthy ,persons4 ,chapter ,,xxxiii4 ,of ,mountebanks1 ,quacks1 and ,conjurers4 ,sect4 #efb4 ,one dreadful ,scourge still remains to be treated of1 which occasions a greater ,mortality1 than all the ,distempers ,i have hitherto described2 and which1 as long as it continues1 will defeat our utmost ,precautions to preserve the ,healths and ,lives of the common ,people4 ,this1 or rather1 these ,scourges1 for they are very numerous1 are ,quacks2 of which there are two ,species3 ,the ,mountebanks or travelling ,quacks1 and those pretended ,physicians in ,villages and ,country-,places1 both male and female1 known in ,swisserland by the ,name of ,conjurers1 and who very effectually unpeople it4 ,the first of these1 the ,mountebanks1 without visiting the ,sick1 or thinking of their ,distempers1 sell different ,medicines1 some of which are for external ,use1 and these often do little or no ,mischief2 but their internal ones are much oftener pernicious4 ,i have been a ,witness of their dreadful ,effects1 and we are not visited by one of these wandering ,caitiffs1 whose ,admission into our ,country is not mortally fatal to some of its ,inhabitants4 ,they are injurious also in another ,respect1 as they carry off great ,sums of ,money with them1 and levy annually some thousands of ,livres1 amongst that ,order of the ,people1 who have the least to spare4 ,i have seen1 and with a very painful ,concern1 the poor ,labourer and the ,artisan1 who have scarcely possessed the common ,necessaries of ,life1 borrow wherewithal to purchase1 and at a dear ,price1 the ,poison that was to compleat their ,misery1 by increasing their ,maladies2 and which1 where they escaped with their ,lives1 has left them in such a languid and inactive ,state1 as has reduced their whole ,family to ,beggary4 ,sec4 #efc4 ,an ignorant1 knavish1 lying and impudent ,fellow will always seduce the gross and credulous ,mass of ,people1 incapable to judge of and estimate any thing rightly2 and adapted to be the eternal ,dupes of such1 as are base enough to endeavour to dazzle their weak ,understandings2 by which ,method these vile ,quacks will certainly defraud them1 as long as they are tolerated4 ,but ought not the ,magistrates1 the ,guardians1 the ,protectors1 the political ,fathers of the ,people interpose1 and defend them from this ,danger1 by severely prohibiting the ,entrance of such pernicious ,fellows into a ,country1 where ,mens' ,lives are very estimable1 and where ,money is scarce2 since they extinguish the first1 and carry off the last1 without the least ,possibility of their being in anywise useful to it4 ,can such forcible ,motives as these suffer our ,magistrates to delay their ,expulsion any longer1 whom there never was the least ,reason for admitting8 ,sec4 #efd4 ,it is acknowledged the ,conjurers1 the residing ,conjurers1 do not carry out the current ,money of the ,country1 like the itinerant ,quacks2 but the ,havock they make among their ,fellow ,subjects is without ,intermission1 whence it must be very great1 as every ,day in the ,year is marked with many of their ,victims4 ,without the least ,knowledge or ,experience1 and offensively armed with three or four ,medicines1 whose ,nature they are as thoroughly ignorant of1 as of their unhappy ,patients ,diseases2 and which ,medicines1 being almost all violent ones1 are very certainly so many ,swords in the ,hands of raging ,madmen4 ,thus armed and qualified1 ,i say1 they aggravate the slightest ,disorders1 and make those that are a little more considerable1 mortal2 but from which the ,patients would have recovered1 if left solely to the ,conduct of ,nature2 and1 for a still stronger ,reason1 if they had confided to the ,guidance of her experienced ,observers and ,assistants4 ,sec4 #efe4 ,the ,robber who assassinates on the ,high-way1 leaves the ,traveller the ,resource of defending himself1 and the ,chance of being aided by the ,arrival of other ,travellers3 ,but the ,poisoner1 who forces himself into the ,confidence of a sick ,person1 is a hundred times more dangerous1 and as just an ,object of ,punishment4 ,the ,bands of ,highwaymen1 and their ,individuals1 that enter into any ,country or ,district1 are described as particularly as possible to the ,publick4 ,it were equally to be wished1 we had also a ,list of these physical ,impostors and ,ignorants male and female2 and that a most exact ,description of them1 with the ,number1 and a brief ,summary of their murderous ,exploits1 were faithfully published4 ,by this ,means the ,populace might probably be inspired with such a wholesome ,dread of them1 that they would no longer expose their ,lives to the ,mercy of such ,executioners4 ,sec4 #eff4 ,but their ,blindness1 with ,respect to these two ,sorts of maleficent ,beings1 is inconceivable4 ,that indeed in ,favour of the ,mountebank is somewhat less gross1 because as they are not personally acquainted with him1 they may the more easily credit him with some ,part of the ,talents and the ,knowledge he arrogates4 ,i shall therefore inform them1 and it cannot be repeated too often1 that whatever ostentatious ,dress and ,figure some of these ,impostors make1 they are constantly vile ,wretches1 who1 incapable of earning a ,livelyhood in any honest ,way1 have laid the ,foundation of their ,subsistence on their own amazing ,stock of ,impudence1 and that of the weak ,credulity of the ,people2 that they have no scientific ,knowledge2 that their ,titles and ,patents are so many ,impositions1 and inauthentic2 since by a shameful ,abuse1 such ,patents and ,titles are become ,articles of ,commerce1 which are to be obtained at very low ,prices2 just like the second-hand laced ,cloaks which they purchase at the ,brokers4 ,that their ,certificates of ,cures are so many ,chimeras or ,forgeries2 and that in short1 if among the prodigious ,multitudes of ,people who take their ,medicines1 some of them should recover1 which it is almost physically impossible must not sometimes be the ,case1 yet it would not be the less certain1 that they are a pernicious destructive ,set of ,men4 ,a ,thrust of a ,rapier into the ,breast has saved a ,man's ,life by seasonably opening an ,imposthume in it1 which might otherwise have killed him3 and yet internal penetrating ,wounds1 with a small ,sword1 are not the less mortal for one such extraordinary ,consequence4 ,nor is it even surprizing that these ,mountebanks1 which is equally applicable to ,conjurers1 who kill thousands of ,people1 whom ,nature alone1 or assisted by a ,physician1 would have saved1 should now and then cure a ,patient1 who had been treated before by the ablest ,physicians4 ,frequently ,patients of that ,class1 who apply to these ,mountebanks and ,conjurers 7whether it has been1 that they would not submit to the ,treatment proper for their ,distempers2 or whether the real ,physician tired of the intractable ,creatures has discontinued his ,advice and ,attendance7 look out for such ,doctors1 as assure them of a speedy ,cure1 and venture to give them such ,medicines as kill many1 and cure one 7who has had ,constitution enough to overcome them7 a little sooner than a justly reputable ,physician would have done4 ,it is but too easy to procure1 in every ,parish1 such ,lists of their ,patients1 and of their ,feats1 as would clearly evince the ,truth of whatever has been said here relating to them4 ,sec4 #efg4 ,the ,credit of this ,market1 this ,fair-hunting ,doctor1 surrounded by five or six hundred ,peasants1 staring and gaping at him1 and counting themselves happy in his condescending to cheat them of their very scarce and necessary ,cash1 by selling them1 for twenty times more than its real ,worth1 a ,medicine whose best ,quality were to be only a useless one2 the ,credit1 ,i say1 of this vile yet tolerated ,cheat1 would quickly vanish1 could each of his ,auditors be persuaded1 of what is strictly true1 that except a little more ,tenderness and ,agility of ,hand1 he knows full as much as his ,doctor2 and that if he could assume as much ,impudence1 he would immediately have as much ,ability1 would equally deserve the same ,reputation1 and to have the same ,confidence reposed in him4 ,sec4 #efh4 ,were the ,populace capable of reasoning1 it were easy to disabuse them in these ,respects2 but as it is1 their ,guardians and ,conductors should reason for them4 ,i have already proved the ,absurdity of reposing any ,confidence in ,mountebanks1 properly so called2 and that ,reliance some have on the ,conjurers is still more stupid and ridiculous4 ,the very meanest ,trade requires some ,instruction3 ,a ,man does not commence even a ,cobler1 a ,botcher of old ,leather1 without serving an ,apprenticeship to it2 and yet no ,time has been served1 no ,instruction has been attended to1 by these ,pretenders to the most necessary1 useful and elegant ,profession4 ,we do not confide the mending1 the cleaning of a ,watch to any1 who have not spent several ,years in considering how a ,watch is made2 what are the ,requisites and ,causes of its going right2 and the ,defects or ,impediments that make it go wrong3 and yet the preserving and rectifying the ,movements of the most complex1 the most delicate and exquisite1 and the most estimable ,machine upon ,earth1 is entrusted to ,people who have not the least ,notion of its ,structure2 of the ,causes of its ,motions2 nor of the ,instruments proper to rectify their ,deviations4 ,let a ,soldier discarded from his ,regiment for his roguish ,tricks1 or who is a ,deserter from it1 a ,bankrupt1 a disreputable ,ecclesiastic1 a drunken ,barber1 or a ,multitude of such other worthless ,people1 advertize that they mount1 set and fit up all ,kinds of ,jewels and ,trinkets in ,perfection2 if any of these are not known2 if no ,person in the ,place has ever seen any of their ,work2 or if they cannot produce authentic ,testimonials of their ,honesty1 and their ,ability in their ,business1 not a single ,individual will trust them with two ,pennyworth of false ,stones to work upon2 in short they must be famished4 ,but if instead of professing themselves ,jewellers1 they post themselves up as ,physicians1 the ,croud purchase1 at a high ,rate1 the ,pleasure of trusting them with the ,care of their ,lives1 the remaining ,part of which they rarely fail to empoison4 ,sec4 #efi4 ,the most genuine and excellent ,physicians1 these extraordinary ,men1 who1 born with the happiest ,talents1 have began to inform their ,understandings from their earliest ,youth2 who have afterwards carefully qualified themselves by cultivating every ,branch of ,physic2 who have sacrificed the best and most pleasurable ,days of their ,lives1 to a regular and assiduous ,investigation of the human ,body2 of its various ,functions2 of the ,causes that may impair or embarrass them1 and informed themselves of the ,qualities and ,virtues of every simple and compound ,medicine2 who have surmounted the ,difficulty and ,loathsomness of living in ,hospitals among thousands of ,patients2 and who have added the medical ,observations of all ,ages and ,places to their own2 these few and extraordinary ,men1 ,i say1 still consider themselves as short of that perfect ,ability and consummate ,knowledge1 which they contemplate and wish for1 as necessary to guarding the precious ,depositum of human ,life and ,health1 confided to their ,charge4 ,nevertheless we see the same inestimable ,treasures1 intrusted to gross and stupid ,men1 born without ,talents2 brought up without ,education or ,culture2 who frequently can scarcely read2 who are as profoundly ignorant of every ,subject that has any ,relation to ,physic1 as the ,savages of ,asia2 who awake only to drink away2 who often exercise their horrid ,trade merely to find themselves in strong ,liquor1 and execute it chiefly when they are drunk3 who1 in short1 became ,physicians1 only from their ,incapacity to arrive at any ,trade or ,attainment6 ,certainly such a ,conduct in ,creatures of the human ,species must appear very astonishing1 and even melancholy1 to every sensible thinking ,man2 and constitute the highest ,degree of ,absurdity and ,extravagance4 ,should any ,person duly qualified enter into an ,examination of the ,medicines they use1 and compare them with the ,situation and ,symptoms of the ,patients to whom they give them1 he must be struck with ,horror2 and heartily deplore the ,fate of that unfortunate ,part of the human ,race1 whose ,lives1 so important to the ,community1 are committed to the ,charge of the most murderous ,set of ,beings4 ,sec4 #egj4 ,some of these ,caitiffs however1 apprehending the ,force and ,danger of that ,objection1 founded on their ,want of ,study and ,education1 have endeavoured to elude it1 by infusing and spreading a false1 and indeed1 an impudent impious ,prejudice among the ,people1 which prevails too much at present2 and this is1 that their ,talents for ,physic are a supernatural ,gift1 and1 of ,course1 greatly superior to all human ,knowledge4 ,it were going out of my ,province to expatiate on the ,indecency1 the ,sin1 and the ,irreligion of such ,knavery1 and incroaching upon the ,rights and perhaps the ,duty of the ,clergy2 but ,i intreat the ,liberty of observing to this respectable ,order of ,men1 that this ,superstition1 which is attended with dreadful ,consequences1 seems to call for their utmost ,attention3 and in general the ,expulsion of ,superstition is the more to be wished1 as a ,mind1 imbued with false ,prejudices1 is less adapted to imbibe a true and valuable ,doctrine4 ,there are some very callous hardened ,villains among this murdering ,band1 who1 with a ,view to establish their ,influence and ,revenue as well upon ,fear as upon ,hope1 have horridly ventured so far as to incline the ,populace to doubt1 whether they received their boasted ,gift and ,power from ,heaven or from ,hell6 ,and yet these are the ,men who are trusted with the ,health and the ,lives of many others4 ,sec4 #ega4 ,one ,fact which ,i have already mentioned1 and which it seems impossible to account for is1 that great ,earnestness of the ,peasant to procure the best ,assistance he can for his sick ,cattle4 ,at whatever ,distance the ,farrier lives1 or some ,person who is supposed qualified to be one 7for unfortunately there is not one in ,swisserland7 if he has considerable ,reputation in this ,way1 the ,country-man goes to consult him1 or purchases his ,visit at any ,price4 ,however expensive the ,medicines are1 which the ,horse-doctor directs1 if they are accounted the best1 he procures them for his poor ,beast4 ,but if himself1 his ,wife or ,children fall sick1 he either calls in no ,assistance nor ,medicines2 or contents himself with such as are next at ,hand1 however pernicious they may be1 though nothing the cheaper on that account3 for certainly the ,money1 extorted by some of these physical ,conjurers from their ,patients1 but oftner from their ,heirs1 is a very shameful ,injustice1 and calls loudly for ,reformation4 ,sec4 #egb4 ,in an excellent ,memoir or ,tract1 which will shortly be published1 on the ,population of ,swisserland1 we shall find an important and very affecting ,remark1 which strictly demonstrates the ,havock made by these immedical ,magicians or ,conjurers2 and which is this3 ,that in the common ,course of ,years1 the ,proportion between the ,numbers and ,deaths of the ,inhabitants of any one ,place1 is not extremely different in ,city and ,country3 but when the very same epidemical ,disease attacks the ,city and the ,villages1 the ,difference is enormous2 and the ,number of ,deaths of the former compared with that of the ,inhabitants of the ,villages1 where the ,conjurer exercises his bloody ,dominion1 is infinitely more than the ,deaths in the ,city4 ,i find in the second ,volume of the ,memoirs of the oeconomical ,society of ,berne1 for the ,year #agfb1 another ,fact equally interesting1 which is related by one of the most intelligent and sagacious ,observers1 concerned in that ,work4 ,pleurisies and ,peripneumonies 7he says7 prevailed at ,cottens a la ,cote2 and some ,peasants died under them1 who had consulted the ,conjurers and taken their heating ,medicines2 while of those1 who pursued a directly opposite ,method1 almost every one recovered4 ,sec4 #egc4 ,but ,i shall employ myself no longer on this ,topic1 on which the ,love of my ,species alone has prompted me to say thus much2 though it deserves to be considered more in ,detail1 and is1 in ,reality1 of the greatest ,consequence4 ,none methinks could make themselves easy with ,respect to it so much as ,physicians1 if they were conducted only by lucrative ,views2 since these ,conjurers diminish the ,number of those poor ,people1 who sometimes consult the real ,physicians1 and with some ,care and ,trouble1 but without the least ,profit1 to those ,gentlemen4 ,but what good ,physician is mean and vile enough to purchase a few ,hours of ,ease and ,tranquillity at so high1 so very odious a ,price8 ,sec4 #egd4 ,having thus clearly shewn the ,evils attending this crying ,nusance1 ,i wish ,i were able to prescribe an effectual ,remedy against it1 which ,i acknowledge is far from being easy to do4 ,the first necessary ,point probably was to have demonstrated the great and public ,danger1 and to dispose the ,state to employ their ,attention on this fatal1 this mortal ,abuse2 which1 joined to the other ,causes of ,depopulation1 has a manifest ,tendency to render ,swisserland a ,desert4 ,sec4 #ege4 ,the second1 and doubtless the most effectual ,means1 which ,i had already mentioned is1 not to admit any travelling ,mountebank to enter this ,country2 and to set a ,mark on all the ,conjurers3 ,it may probably also be found convenient1 to inflict corporal ,punishment on them2 as it has been already adjudged in different ,countries by sovereign ,edicts4 ,at the very least they should be marked with public ,infamy1 according to the following ,custom practised in a great ,city in ,france4 ,when any ,mountebanks appeared in ,montpellier1 the ,magistrates had a ,power to mount each of them upon a meagre miserable ,ass1 with his ,head to the ,ass's ,tail4 ,in this ,condition they were led throughout the whole ,city1 attended with the ,shouts and ,hooting of the ,children and the ,mob1 beating them1 throwing ,filth and ,ordure at them1 reviling them1 and dragging them all about4 ,sec4 #egf4 ,a third conducive ,means would be the ,instructions and ,admonition of the ,clergy on this ,subject1 to the ,peasants in their several ,parishes4 ,for this ,conduct of the common ,people amounting1 in ,effect1 to ,suicide1 to ,self-murder1 it must be important to convince them of it4 ,but the little ,efficacy of the strongest and repeated ,exhortations on so many other ,articles1 may cause us to entertain a very reasonable ,doubt of their ,success on this4 ,custom seems to have determined1 that there is nothing in our ,day1 which excludes a ,person from the ,title and ,appellation of an honest or honourable ,man1 except it be meer and convicted ,theft2 and that for this simple and obvious ,reason1 that we attach ourselves more strongly to our ,property1 than to any ,thing else4 ,even ,homicide is esteemed and reputed honourable in many ,cases4 ,can we reasonably then expect to convince the ,multitude1 that it is criminal to confide the ,care of their ,health to these ,poisoners1 in ,hopes of a ,cure of their ,disorders8 ,a much likelier ,method of succeding on this ,point would certainly be1 to convince the deluded ,people1 that it will cost them less to be honestly and judiciously treated1 than to suffer under the ,hands of these ,executioners4 ,the ,expectation of a good and cheap ,health-market will be apt to influence them more1 than their ,dread of a ,crime would4 ,sec4 #egg4 ,a fourth ,means of removing or restraining this ,nusance would be to expunge1 from the ,almanacs1 all the astrological ,rules relating to ,physick2 as they continually conduce to preserve and increase some dangerous ,prejudices and ,notions in a ,science1 the smallest ,errors in which are sometimes fatal4 ,i had already reflected on the ,multitude of ,peasants that have been lost1 from postponing1 or mistiming a ,bleeding1 only because the sovereign ,decision of an ,almanac had directed it at some other ,time4 ,may it not also be dreaded1 to mention it by the ,way1 that the same ,cause1 the ,almanacs1 may prove injurious to their rural ,oeconomy and ,management2 and that by advising with the ,moon1 who has no ,influence1 and is of no ,consequence in ,vegetation or other ,country ,business1 they may be wanting in a due ,attention to such other ,circumstances and ,regulations1 as are of real ,importance in them8 ,sec4 #egh4 ,a fifth concurring ,remedy against this popular ,evil would be the ,establishment of ,hospitals1 for the ,reception of poor ,patients1 in the different ,cities and ,towns of ,swisserland4 ,there may be a great many easy and concurring ,means of erecting and endowing such1 with very little new ,expence2 and immense ,advantages might result from them3 besides1 however considerable the ,expenses might prove1 is not the ,object of them of the most interesting1 the most important ,nature8 ,it is incontestably our serious ,duty2 and it would soon be manifest1 that the ,performance of it would be attended with more essential intrinsic ,benefit to the ,community1 than any other ,application of ,money could produce4 ,we must either admit1 that the ,multitude1 the ,body of the ,people is useless to the ,state1 or agree1 that ,care should be taken to preserve and continue them4 ,a very respectable ,english ,man1 who1 after a previous and thorough ,consideration of this ,subject1 had applied himself very assiduously and usefully on the ,means of increasing the ,riches and the ,happiness of his ,country-men1 complains that in ,england1 the very ,country in which there are the most ,hospitals1 the ,poor who are sick are not sufficiently assisted4 ,what a deplorable ,deficience of the necessary ,assistance for such must then be in a ,country1 that is not provided with a single ,hospital8 ,that ,aid from ,surgery and ,physic1 which abounds in ,cities1 is not sufficiently diffused into ,country-places3 and the ,peasants are liable to some simple and moderate ,diseases1 which1 for ,want of proper ,care1 degenerate into a ,state of ,infirmity1 that sinks them into premature ,death4 ,sec4 #egi4 ,in fine1 if it be found impossible to extinguish these ,abuses 7for those arising from ,quacks are not the only ones1 nor is that ,title applied to as many as really deserve it7 beyond all ,doubt it would be for the ,benefit and ,safety of the ,public1 upon the whole1 entirely to prohibit the ,art1 the ,practice of ,physic itself4 ,when real and good ,physicians cannot effect as much ,good1 as ignorant ones and ,impostors can do ,mischief1 some real ,advantage must accrue to the ,state1 and to the whole ,species1 from employing none of either4 ,i affirm it1 after much ,reflection1 and from thorough ,conviction1 that ,anarchy in ,medicine is the most dangerous ,anarchy4 ,for this ,profession1 when loosed from every ,restraint1 and subjected to no ,regulations1 no ,laws1 is the more cruel ,scourge and ,affliction1 from the incessant ,exercise of it2 and should its ,anarchy1 its ,disorders prove irremediable1 the ,practice of an ,art1 become so very noxious1 should be prohibited under the severest ,penalties3 ,or1 if the ,constitution of any ,government was inconsistent with the ,application of so violent a ,remedy1 they should order public ,prayers against the ,mortality of it1 to be offered up in all the ,churches2 as the ,custom has been in other great and general ,calamities4 ,sec4 #ehj4 ,another ,abuse1 less fatal indeed than those already mentioned 7but which1 however1 has real ill ,consequences1 and at the best1 carries out a great deal of ,money from us1 though less at the ,expense of the common ,people1 than of those of easy ,circumstances7 is that ,blindness and ,facility1 with which many suffer themselves to be imposed upon1 by the pompous ,advertisements of some ,catholicon1 some universal ,remedy1 which they purchase at a high ,rate1 from some foreign ,pretender to a mighty ,secret or ,nostrum4 ,persons of a ,class or two above the ,populace do not care to run after a ,mountebank1 from supposing they should depretiate themselves by mixing with the ,herd4 ,yet if that very ,quack1 instead of coming among us1 were to reside in some foreign ,city2 if1 instead of posting up his lying ,puffs and ,pretentions at the ,corners of the ,streets1 he would get them inserted in the ,gazettes1 and ,news-papers2 if1 instead of selling his boasted ,remedies in ,person1 he should establish ,shops or ,offices for that ,purpose in every ,city2 and finally1 if instead of selling them twenty times above their real ,value1 he would still double that ,price2 instead of having the common ,people for his ,customers1 he would take in the wealthy ,citizen1 ,persons of all ,ranks1 and from almost every ,country4 ,for strange as it seems1 it is certain1 that a ,person of such a ,condition1 who is sensible in every other ,respect2 and who will scruple to confide his ,health to the ,conduct of such ,physicians as would be the justest ,subjects of his ,confidence1 will venture to take1 through a very unaccountable ,infatuation1 the most dangerous ,medicine1 upon the ,credit of an imposing ,advertisement1 published by as worthless and ignorant a ,fellow as the ,mountebank whom he despises1 because the latter blows a ,horn under his ,window2 and yet who differs from the former in no other ,respects except those ,i have just pointed out4 ,sec4 #eha4 ,scarcely a ,year passes1 without one or another such advertized and vaunted ,medicine's getting into high ,credit2 the ,ravages of which are more or less1 in ,proportion to its being more or less in ,vogue4 ,fortunately1 for the human ,species1 but few of these ,nostrums have attained an equal ,reputation with ,ailbaud's ,powders1 an ,inhabitant of ,aix in ,provence1 and unworthy the ,name of a ,physician2 who has over-run ,europe for some ,years1 with a violent ,purge1 the ,remembrance of which will not be effaced before the ,extinction of all its ,victims4 ,i attend now1 and for a long time past1 several ,patients1 whose ,disorders ,i palliate without ,hopes of ever curing them2 and who owe their present melancholy ,state of ,body to nothing but the manifest ,consequences of these ,powders2 and ,i have actually seen1 very lately1 two ,persons who have been cruelly poisoned by this boasted ,remedy of his4 ,a ,french ,physician1 as eminent for his ,talents and his ,science1 as estimable from his personal ,character in other ,respects1 has published some of the unhappy and tragical ,consequences which the ,use of them has occasioned2 and were a ,collection published of the same ,events from them1 in every ,place where they have been introduced1 the ,size and the ,contents of the ,volume would make a very terrible one4 ,sec4 #ehb4 ,it is some ,comfort however1 that all the other ,medicines thus puffed and vended have not been altogether so fashionable1 nor yet quite so dangerous3 but all posted and advertized ,medicines should be judged of upon this ,principle 7and ,i do not know a more infallible one in ,physics1 nor in the ,practice of ,physic71 that whoever advertises any ,medicine1 as a universal ,remedy for all ,diseases1 is an absolute ,impostor1 such a ,remedy being impossible and contradictory4 ,i shall not here offer to detail such ,proofs as may be given of the ,verity of this ,proposition3 but ,i freely appeal for it to every sensible ,man1 who will reflect a little on the different ,causes of ,diseases2 on the ,opposition of these ,causes2 and on the ,absurdity of attempting to oppose such various ,diseases1 and their ,causes1 by one and the same ,remedy4 ,as many as shall settle their ,judgments properly on this ,principle1 will never be imposed upon by the superficial ,gloss of these ,sophisms contrived to prove1 that all ,diseases proceed from one ,cause2 and that this ,cause is so very tractable1 as to yield to one boasted ,remedy4 ,they will perceive at once1 that such an ,assertion must be founded in the utmost ,knavery or ,ignorance2 and they will readily discover where the ,fallacy lies4 ,can any one expect to cure a ,dropsy1 which arises from too great a ,laxity of the ,fibres1 and too great an ,attenuation or ,thinness of the ,blood1 by the same ,medicines that are used to cure an inflammatory ,disease1 in which the ,fibres are too stiff and tense1 and the ,blood too thick and dense8 ,yet consult the ,news-papers and the ,posts1 and you will see published in and on all of them1 ,virtues just as contradictory2 and certainly the ,authors of such poisonous ,contradictions ought to be legally punished for them4 ,sec4 #ehc4 ,i heartily wish the ,publick would attend here to a very natural and obvious ,reflection4 ,i have treated in this ,book1 but of a small ,number of ,diseases1 most of them acute ones2 and ,i am positive that no competent well qualified ,physician has ever employed fewer ,medicines1 in the ,treatment of the ,diseases themselves4 ,nevertheless ,i have prescribed seventy-one1 and ,i do not see which of them ,i could retrench1 or dispense with the ,want of1 if ,i were obliged to use one less4 ,can it be supposed then1 that any one single ,medicine1 compound or simple1 shall cure thirty times as many ,diseases as those ,i have treated of8 ,sec4 #ehd4 ,i shall add another very important ,observation1 which doubtless may have occurred to many of my ,readers2 and it is this1 that the different ,causes of ,diseases1 their different ,characters2 the ,differences which arise from the necessary ,alterations that happen throughout their ,progress and ,duration2 the ,complications of which they are susceptible2 the ,varieties which result from the ,state of different ,epidemics1 of ,seasons1 of ,sexes1 and of many other ,circumstances2 that these ,diversities1 ,i say1 oblige us very often to vary and change the ,medicines2 which proves how very ticklish and dangerous it is to have them directed by ,persons1 who have such an imperfect ,knowledge of them1 as those who are not ,physicians must be supposed to have4 ,and the ,circumspection to be used in such ,cases ought to be proportioned to the ,interest the ,assistant takes in the ,preservation of the ,patient2 and that ,love of his ,neighbour with which he is animated4 ,sec4 #ehe4 ,must not the same ,arguments and ,reflections unavoidably suggest the ,necessity of an entire ,tractability on the ,part of the ,patient1 and his ,friends and ,assistants8 ,the ,history of ,diseases which have their stated ,times of ,beginning1 of manifesting and displaying themselves2 of arriving at1 and continuing in their ,height1 and of decreasing2 do not all these demonstrate the ,necessity of continuing the same ,medicines1 as long as the ,character of the ,distemper is the same2 and the ,danger of changing them often1 only because what has been given has not afforded immediate ,relief8 ,nothing can injure the ,patient more than this ,instability and ,caprice4 ,after the ,indication which his ,distemper suggests1 appears to be well deduced1 the ,medicine must be chosen that is likeliest to resist the ,cause of it2 and it must be continued as long as no new ,symptom or ,circumstance supervenes1 which requires an ,alteration of it2 except it should be evident1 that an ,error had been incurred in giving it4 ,but to conclude that a ,medicine is useless or insignificant1 because it does not remove or abate the ,distemper as speedily1 as the ,impatience of the ,sick would naturally desire it2 and to change it for another1 is as unreasonable1 as it would be for a ,man to break his ,watch1 because the ,hand takes twelve ,hours1 to make a ,revolution round the ,dial-plate4 ,sec4 #ehf4 ,physicians have some ,regard to the ,state of the ,urine of sick ,persons1 especially in inflammatory ,fevers2 as the ,alterations occurring in it help them to judge of the ,changes that may have been made in the ,character and ,consistence of the ,humours in the ,mass of ,blood2 and thence may conduce to determine the ,time1 in which it will be proper to dispose them to some ,evacuation4 ,but it is gross ,ignorance to imagine1 and utter ,knavery and ,imposture to persuade the ,sick1 that the meer ,inspection of their ,urine solely1 sufficiently enables others to judge of the ,symptoms and ,cause of the ,disease1 and to direct the best ,remedies for it4 ,this ,inspection of the ,urine can only be of ,use when it is duly inspected2 when we consider at the same time the exact ,state and the very ,looks of the ,patient2 when these are compared with the ,degree of the ,symptoms of the ,malady2 with the other ,evacuations2 and when the ,physician is strictly informed of all external ,circumstances1 which may be considered as foreign to the ,malady2 which may alter or affect the ,evacuations1 such as particular ,articles of ,food1 particular ,drinks1 different ,medicines1 or the very ,quantity of ,drink4 ,where a ,person is not furnished with an exact ,account of these ,circumstances1 the meer ,inspection of the ,urine is of no ,service1 it suggests no ,indication1 nor any ,expedient2 and meer common ,sense sufficiently proves1 and it may be boldly affirmed1 that whoever orders any ,medicine1 without any other ,knowledge of the ,disease1 than what an ,inspection of the ,urine affords1 is a rank ,knave1 and the ,patient who takes them is a ,dupe4 ,sec4 #ehg4 ,and here now any ,reader may very naturally ask1 whence can such a ridiculous ,credulity proceed1 upon a ,subject so essentially interesting to us as our own ,health8 ,in ,answer to this it should be observed1 that some ,sources1 some ,causes of it seem appropriated merely to the ,people1 the ,multitude4 ,the first of these is1 the mechanical ,impression of ,parade and ,shew upon the ,senses4 #b1 ,the ,prejudice they have conceived1 as ,i said before1 of the ,conjurers curing by a supernatural ,gift4 #c1 ,the ,notion the ,country ,people entertain1 that their ,distemper and ,disorders are of a ,character and ,species peculiar to themselves1 and that the ,physicians1 attending the ,rich1 know nothing concerning them4 #d1 ,the general ,mistake that their employing the ,conjurer is much cheaper4 #e1 ,perhaps a sheepish shame-faced ,timidity may be one ,motive1 at least with some of them4 #f1 ,a ,kind of ,fear too1 that ,physicians will consider their ,cases with less ,care and ,concern1 and be likely to treat them more cavalierly2 a ,fear which increases that ,confidence which the ,peasant1 and which indeed every ,man has in his ,equal1 being sounded in ,equality itself4 ,and #g1 the ,discourse and ,conversation of such illiterate ,empirics being more to their ,tast1 and more adapted to their ,apprehension4 ,but it is less easy to account for this blind ,confidence1 which ,persons of a superior ,class 7whole ,education being considered as much better are regarded as better ,reasoners7 repose in these boasted ,remedies2 and even for some ,conjurer in ,vogue4 ,nevertheless even some of their ,motives may be probably assigned4 ,the first is that great ,principle of ,seity1 or ,selfness1 as it may be called1 innate to ,man1 which attaching him to the ,prolongation of his own ,existence more than to any other thing in the ,universe1 keeps his ,eyes1 his utmost ,attention1 continually fixed upon this ,object2 and compels him to make it the very ,point1 the ,purpose of all his ,advances and ,proceedings2 notwithstanding it does not permit him to distinguish the safest ,paths to it from the dangerous ones4 ,this is the surest and shortest ,way says some ,collector at the ,turnpike1 he pays1 passes1 and perishes from the ,precipices that occur in his ,route4 ,this very ,principle is the ,source of another ,error1 which consists in reposing1 involuntarily1 a greater ,degree of ,confidence in those1 who flatter and fall in the most with us in our favourite ,opinions4 ,the well apprised ,physician1 who foresees the ,length and the ,danger of a ,disease2 and who is a ,man of too much ,integrity to affirm what he does not think1 must1 from a necessary ,construction of the human ,frame and ,mind1 be listened to less favourably1 than he who flatters us by saying what we wish4 ,we endeavour to elongate1 to absent ourselves1 from the ,sentiments1 the ,judgment of the first2 we smile1 from ,self-complacency1 at those of the last1 which in a very little time are sure of obtaining our ,preference4 ,a third ,cause1 which results from the same ,principle is1 that we give ourselves up the most readily to his ,conduct1 whose ,method seems the least disagreeable1 and flatters our ,inclinations the most4 ,the ,physician who enjoins a strict ,regimen2 who insists upon some ,restraints and ,self-denials2 who intimates the ,necessity of ,time and ,patience for the ,accomplishment of the ,cure1 and who expects a thorough ,regularity through the ,course of it1 disgusts a ,patient who has been accustomed to indulge his own ,tast and ,humour2 the ,quack1 who never hesitates at complying with it1 charms him4 ,the ,idea of a long and somewhat distant ,cure1 to be obtained at the ,end of an unpleasant and unrelaxing ,regimen1 supposes a very perilous ,disease2 this ,idea disposes the ,patient to ,disgust and ,melancholy1 he cannot submit to it without ,pain2 and he embraces1 almost unconsciously1 merely to avoid this1 an opposite ,system which presents him only with the ,idea of such a ,distemper1 as will give ,way to a few ,doses of ,simples4 ,that ,propensity to the ,new and ,marvellous1 which tyrannizes over so large a ,proportion of our ,species1 and which has advanced so many absurd ,persons and ,things into ,reputation1 is a fourth and a very powerful ,motive4 ,an irksome ,satiety1 and a ,tiresomeness1 as it were1 from the same ,objects1 is what our ,nature is apt to be very apprehensive of2 though we are incessantly conducted towards it1 by a ,perception of some ,void1 some ,emptiness in ourselves1 and even in ,society too3 ,but new and extraordinary ,sensations rousing us from this disagreeable ,state1 more effectually than any ,thing else1 we unthinkingly abandon ourselves to them1 without foreseeing their ,consequences4 ,a fifth ,cause arises from seven ,eighths of ,mankind being managed by1 or following1 the other ,eighth2 and1 generally speaking1 the ,eighth that is so very forward to manage them1 are the least fit and worthy to do it2 whence all must go amiss1 and absurd and embarrassing ,consequences ensue from the ,condition of ,society4 ,a ,man of excellent ,sense frequently sees only through the ,eyes of a ,fool1 of an intriguing ,fellow1 or of a ,cheat2 in this he judges wrong1 and his ,conduct must be so too4 ,a man of real ,merit cannot connect himself with those who are addicted to caballing2 and yet such are the ,persons1 who frequently conduct others4 ,some other ,causes might be annexed to these1 but ,i shall mention only one of them1 which ,i have already hinted1 and the ,truth of which ,i am confirmed in from several ,years ,experience2 which is1 that we generally love those who reason more absurdly than ourselves1 better than those who convince us of our own weak ,reasoning4 ,i hope the ,reflexions every ,reader will make on these ,causes of our ill ,conduct on this important ,head1 may contribute to correct or diminish it2 and to destroy those ,prejudices whose fatal ,effects we may continually observe4 ,n4 ,b4 ,the ,multitude of all the ,objects of this excellent ,chapter in this ,metropolis1 and doubtless throughout ,england1 were strong ,inducements to have taken a little wholesome ,notice of the ,impostures of a few of the most pernicious4 ,but on a second ,perusal of this ,part of the ,original and its ,translation1 ,i thought it impossible 7without descending to personal1 nominal ,anecdotes about the ,vermin7 to add any ,thing material upon a ,subject1 which the ,author has with such ,energy exhausted4 ,he even seems1 by some of his ,descriptions1 to have taken ,cognizance of a few of our most self-dignified itinerant ,empirics2 as these ,genius's find it necessary sometimes to treat themselves with a little ,transportation4 ,in reality ,dr4 ,tissot has1 in a very masterly ,way1 thoroughly dissected and displayed the whole ,genus1 every ,species of ,quacks4 ,and when he comes to account for that ,facility1 with which ,persons of very different ,principles from them1 and of better ,intellects1 first listen to1 and finally countenance such ,caitiffs1 he penetrates into some of the most latent ,weaknesses of the human ,mind2 even such as are often ,secrets to their ,owners4 ,it is difficult1 throughout this ,disquisition1 not to admire the ,writer2 but impossible not to love the ,man1 the ardent ,philanthropist4 ,his ,sentiment that--,a ,man of real ,merit cannot connect himself with those who are addicted to caballing1--is exquisitely just1 and so liberal1 that it never entered into the ,mind of any disingenuous ,man1 however dignified1 in any ,profession4 ,persons of the simplest ,hearts and purest ,reflections must shrink at every ,consciousness of ,artifice2 and secretly reproach themselves for each ,success1 that has redounded to them at the ,expence of ,truth4 ,k4 ,chapter ,,xxxiv4 ,containing ,questions absolutely necessary to be answered exactly by the ,patient1 who consults a ,physician4 ,sect4 #ehh4 ,great ,consideration and ,experience are necessary to form a right ,judgment of the ,state of a ,patient1 whom the ,physician has not personally seen2 even though he should receive the best ,information it is possible to give him1 at a ,distance from the ,patient4 ,but this ,difficulty is greatly augmented1 or rather changed into an ,impossibility1 when his ,information is not exact and sufficient4 ,it has frequently happened to myself1 that after having examined ,peasants who came to get ,advice for others1 ,i did not venture to prescribe1 because they were not able to give me a sufficient ,information1 in order to my being certain of the ,distemper4 ,to prevent this great ,inconvenience1 ,i subjoin a ,list of such ,questions1 as indispensably require clear and direct ,answers4 ,general ,questions4 ,what is the ,patient's ,age8 ,is he generally a healthy ,person8 ,what is his general ,course of ,life8 ,how long has he been sick8 ,in what ,manner did his present ,sickness begin1 or appear8 ,has he any ,fever8 ,is his ,pulse hard or soft8 ,has he still tolerable ,strength1 or is he weak8 ,does he keep his ,bed in the ,day ,time1 or quit it8 ,is he in the same ,condition throughout the whole ,day8 ,is he still1 or restless8 ,is he hot1 or cold8 ,has he ,pains in the ,head1 the ,throat1 the ,breast1 the ,stomach1 the ,belly1 the ,loins1 or in the ,limbs1 the ,extremities of the ,body8 ,is his ,tongue dry8 does he complain of ,thirst8 of an ill ,tast in his ,mouth8 of ,reachings to vomit1 or of an ,aversion to ,food8 ,does he go to stool often or seldom8 ,what ,appearance have his ,stools1 and what is their usual quantity8 ,does he make much ,urine8 ,what ,appearance has his ,urine1 as to ,colour and ,contents8 ,are they generally much alike1 or do they change often8 ,does he sweat8 ,does he expectorate1 or cough up8 ,does he get ,sleep8 ,does he draw his ,breath easily8 ,what ,regimen does he observe in his ,sickness8 ,what ,medicines has he taken8 ,what ,effects have they produced8 ,has he never had the same ,distemper before8 ,sec4 #ehi4 ,the ,diseases of ,women and ,children are attended with peculiar ,circumstances2 so that when ,advice is asked for them1 ,answers must be given1 not only to the preceding ,questions1 which relate to sick ,persons in general2 but also to the following1 which regard these particularly4 ,questions with ,respect to ,women4 ,have they arrived at their monthly ,discharges1 and are these regular8 ,are they pregnant8 ,is so1 how long since8 ,are they in ,child-bed8 ,has their ,delivery been happily accomplished8 ,has the ,mother cleansed sufficiently8 ,has her ,milk come in due ,time and ,quantity8 ,does she suckle the ,infant herself8 ,is she subject to the ,whites8 ,questions relating to ,children4 ,what is the ,child's exact ,age8 ,how many ,teeth has he cut8 ,does he cut them painfully8 ,is he any-wise ricketty1 or subject to ,knots or ,kernels8 ,has he had the ,small ,pocks8 ,does the ,child void ,worms1 upwards or downwards8 ,is his ,belly large1 swelled1 or hard8 ,is his ,sleep quiet1 or otherwise8 ,sec4 #eij4 ,besides these general ,questions1 common in all the ,diseases of the different ,sexes and ,ages1 the ,person consulting must also answer to those1 which have a close and direct ,relation to the ,disease1 at that very ,time affecting the ,sick4 ,for ,example1 in the ,quinsey1 the ,condition of the ,throat must be exactly inquired into4 ,in ,diseases of the ,breast1 an ,account must be given of the ,patient's ,pains2 of his ,cough2 of the ,oppression1 and of his ,breathing1 and ,expectoration4 ,i shall not enter upon a more particular ,detail2 common ,sense will sufficiently extend this ,plan or ,specimen to other ,diseases2 and though these ,questions may seem numerous1 it will always be easy to write down their ,answers in as little ,room1 as the ,questions take up here4 ,it were even to be wished that ,persons of every ,rank1 who occasionally write for medical ,advice and ,directions1 would observe such a ,plan or ,succession1 in the ,body of their ,letters4 ,by this ,means they would frequently procure the most satisfactory ,answers2 and save themselves the ,trouble of writing second ,letters1 to give a necessary ,explanation of the first4 ,the ,success of ,remedies depends1 in a very great ,measure1 on a very exact ,knowledge of the ,disease2 and that ,knowledge on the precise ,information of it1 which is laid before the ,physician4 ,,finis4 ,,table ,of the ,prescriptions and ,medicines1 referred to in the foregoing ,treatise3 ,which1 with the ,notes beneath them1 are to be read before the taking1 or ,application1 of any of the said ,medicines4 ,as in ,order to ascertain the ,doses of ,medicines1 ,i have generally done it by ,pounds1 ,ounces1 ,half-,ounces1 c4 c4 and as this ,method1 especially to the common ,people1 might prove a little too obscure and embarrassing1 ,i have specified here the exact ,weight of ,water1 contained in such ,vessels or liquid ,measures1 as are most commonly used in the ,country4 ,the ,pound which ,i mean1 throughout all these ,prescriptions1 is that consisting of sixteen ,ounces4 ,these ,ounces contain eight ,drachms1 each ,drachm consisting of three ,scruples1 and each ,scruple of twenty ,grains2 the medical ,scruple of ,paris solely containing twenty-four ,grains4 ,the liquid ,measure1 the ,pot used at ,berne1 being that ,i always speak of1 may be estimated1 without any material ,error1 to contain three ,pounds and a ,quarter1 which is equal to three ,pints1 and eight common ,spoonfuls ,english ,measure4 ,but the exact ,weight of the ,water1 contained in the ,pot of ,berne1 being fifty-one ,ounces and a ,quarter only1 it is strictly equal but to three ,pints and six common ,spoonfuls ,english4 ,this however is a ,difference of no ,importance1 in the usual ,drinks or ,aliments of the ,sick4 ,the small drinking ,glass we talk of1 filled so as not to run over1 contains three ,ounces and three ,quarters4 ,but filled1 as we propose it should for the ,sick1 it is to be estimated only at three ,ounces4 ,the common middle sized ,cup1 though rather large than little1 contains three ,ounces and a ,quarter4 ,but as dealt out to the ,sick1 it should not be estimated1 at the utmost1 above three ,ounces4 ,the small ,glass contains seven common ,spoonfuls2 so that a ,spoonful is supposed to contain half an ,ounce4 ,the small ,spoon1 or ,coffee ,spoon1 when of its usual ,size and ,cavity1 may contain thirty ,drops1 or a few more2 but1 in the ,exhibition of ,medicines1 it may be reckoned at thirty ,drops4 ,five or six of these are deemed equal in ,measure1 to a common ,soup-,spoon4 ,the ,bason or ,porrenger1 mentioned in the present ,treatise1 holds1 without running over1 the ,quantity of five ,glasses1 which is equivalent to eighteen ,ounces and three ,quarters4 ,it may be estimated however1 without a ,fraction1 at eighteen ,ounces3 and a sick ,person should never be allowed to take more than a third ,part of this ,quantity of ,nourishment1 at any one ,time4 ,the ,doses in all the following ,prescriptions are adjusted to the ,age of an ,adult or grown ,man1 from the ,age of eighteen to that of sixty ,years4 ,from the ,age of twelve to eighteen1 two thirds of that ,dose will generally be sufficient3 and from twelve down to seven ,years one half1 diminishing this still lower1 in ,proportion to the greater ,youth of the ,patient3 so that not more than one eighth of the ,dose prescribed should be given to an infant of some ,months old1 or under one ,year4 ,but it must also be considered1 that their different ,constitutions will make a considerable ,difference in adjusting their different ,doses4 ,it were to be wished1 on this ,account1 that every ,person would carefully observe whether a strong ,dose is necessary to purge him1 or if a small one is sufficient2 as ,exactness is most important in adjusting the ,doses of such ,medicines1 as are intended to purge1 or to evacuate in any other ,manner4 ,no4 #a4 ,take a ,pugil or large ,pinch between the ,thumb and ,fingers of ,elder ,flowers2 put them into an earthen-ware ,mug or ,porrenger1 with two ,ounces of ,honey1 and an ,ounce and a half of good ,vinegar4 ,pour upon them three ,pints and one ,quarter of boiling ,water4 ,stir it about a little with a ,spoon to mix and dissolve the ,honey2 then cover up the ,mug2 and1 when the ,liquor is cold1 strain it through a ,linen ,cloth4 ,no4 #b4 ,take two ,ounces of whole ,barley1 cleanse and wash it well in hot ,water1 throwing away this ,water afterwards4 ,then boil it in five ,chopins or ,english ,pints of ,water1 till the ,barley bursts and opens4 ,towards the ,end of the boiling1 throw in one ,drachm and a half of ,nitre ,salt ,petre strain it through a ,linen ,cloth1 and then add to it one ,ounce and a half of ,honey1 and one ,ounce of ,vinegar4 #aac #aac ,this makes an agreeable ,drink2 and the ,notion of its being windy is idle2 since it is so only to those1 with whom ,barley does not agree4 ,it may1 where ,barley is not procurable1 be made from ,oats4 ,no4 #c4 ,take the same ,quantity of ,barley as before1 and instead of ,nitre1 boil in it1 as soon as the ,barley is put in to boil1 a ,quarter of an ,ounce of ,cream of ,tartar4 ,strain it1 and add nothing else #aad to it4 #aad ,in those ,cases mentioned ,sec4 #bda1 #bfb1 #bhj1 instead of the ,barley1 four ,ounces of ,grass ,roots may be boiled in the same ,quantity of ,water for half an ,hour1 with the ,cream of ,tartar4 ,no4 #d4 ,take three ,ounces of the freshest sweet ,almonds1 and one ,ounce of ,gourd or ,melon ,seed2 bruise them in a ,mortar1 adding to them by a little at a time1 one ,pint of ,water1 then strain it through ,linen4 ,bruise what remains again1 adding gradually to it another ,pint of ,water1 then straining2 and adding ,water to the ,residue1 till full three ,pints at least of ,water are thus used3 after which it may again be poured upon the bruised ,mass1 stirred well about1 and then be finally strained off4 ,half an ,ounce of ,sugar may safely be bruised with the ,almonds and ,seeds at first1 though some weakly imagine it too heating2 and delicate ,persons may be allowed a little ,orange ,flower ,water with it4 ,no4 #e4 ,take two ,pugils of ,mallow ,leaves and ,flowers1 cut them small1 and pour a ,pint of boiling ,water upon them4 ,after standing some time strain it1 adding one ,ounce of ,honey to it4 ,for ,want of ,mallows1 which is preferable1 a similar ,glyster may be made of the ,leaves of ,mercury1 ,pellitory of the ,wall1 the ,marsh-,mallows1 the greater ,mallows1 from ,lettuce1 or from ,spinage4 ,a few very particular ,consititutions are not to be purged by any ,glyster but warm ,water alone2 such should receive no other1 and the ,water should not be very hot4 ,no4 #f4 ,boil a ,pugil of ,mallow ,flowers1 in a ,pint of ,barley ,water for a ,glyster4 ,no4 #g4 ,take three ,pints of simple ,barley ,water1 add to it three ,ounces of the ,juice of ,sow-thistle1 or of ,groundsel1 or of the greater ,houseleek1 or of ,borage4 #aae #aae ,these ,juices are to be procured from the ,herbs when fresh and very young1 if possible1 by beating them in a ,marble ,mortar1 or for ,want of such or a wooden ,mortar in an ,iron one1 and then squeezing out the ,juice through a ,linen ,bag4 ,it must be left to settle a little in an earthen ,vessel1 after which the clear ,juice must be decanted gently off1 and the ,sediment be left behind4 ,no4 #h4 ,to one ,ounce of ,oxymel of ,squills1 add five ,ounces of a strong ,infusion of ,elder ,flowers4 ,no4 #i4 ,there are many different emollient ,applications1 which have very nearly the same ,virtues4 ,the following are the most efficacious4 #a1 ,flanels wrung out of a hot ,decoction of ,mallow ,flowers4 #b1 ,small ,bags filled with ,mallow ,flowers1 or with those of ,mullein1 of ,elder1 of ,camomile1 of wild ,corn ,poppy1 and boiled either in ,milk or ,water4 #c1 ,pultices of the same ,flowers boiled in ,milk and ,water4 #d1 ,bladders half filled with hot ,milk and ,water1 or with some emollient ,decoction4 #e1 ,a ,pultice of boiled ,bread and ,milk1 or of ,barley or ,rice boiled till thoroughly soft and tender4 #f1 ,in the ,pleurisy 7,see ,sec4 #hi7 the affected ,part may be rubbed sometimes with ,ointment of ,marsh-mallows4 ,no4 #aj4 ,to one ,ounce of ,spirit of ,sulphur1 add six ,ounces of ,syrup of ,violets1 or for want of the latter1 as much ,barley ,water1 of a thicker ,consistence than ordinary4 #aaf #aaf ,some ,friends1 says ,dr4 ,tissot1 whose judgment ,i greatly respect1 have thought the ,doses of acid ,spirit which ,i direct extremely strong2 and doubtless they are so1 if compared with the ,doses generally prescribed1 and to which ,i should have limited myself1 if ,i had not frequently seen their ,insufficience4 ,experience has taught me to increase them considerably2 and1 augmenting the ,dose gradually1 ,i now venture to give larger ,doses of them than have ever been done before1 and always with much ,success2 the same ,doses which ,i have advised in this ,work not being so large as those ,i frequently prescribe4 ,for this ,reason ,i intreat those ,physicians1 who have thought them excessive1 to try the acid ,spirits in larger ,doses than those commonly ordered2 and ,i am persuaded they will see ,reason to congratulate themselves upon the ,effect4 #aag #aag ,our ,author's ,french ,annotator has a ,note against this ,acid1 which ,i have omitted2 for though ,i have given his ,note ,page #hd with the ,substance of the immediately preceding one to which ,i have also added some ,doubts of my own1 from ,facts1 concerning the ,benefit of ,acids in inflammatory ,disorders of the ,breast2 yet with ,regard to the ardent1 the putrid1 the malignant ,fever1 and ,erisipelas1 in which ,dr4 ,tissot directs this1 ,i have no ,doubt of its ,propriety 7supposing no insuperable ,disagreement to ,acids in the ,constitution7 and with ,respect to their ,doses1 ,i think we may safely rely on our honest ,author's ,veracity4 ,dr4 ,fuller assures us1 a ,gentleman's ,coachman was recovered from the ,bleeding ,small ,pocks1 by large and repeated ,doses of the ,oil of ,vitriol1 in considerable ,draughts of cold ,water4 ,k4 ,no4 #aa4 ,take two ,ounces of ,manna1 and half an ,ounce of ,sedlitz ,salt1 or for want of it1 as much ,epsom ,salt2 dissolving them in four ,ounces of hot ,water1 and straining them4 ,no4 #ab4 ,take of ,elder ,flowers one ,pugil1 of ,hyssop ,leaves half as much4 ,pour three ,pints of boiling ,water upon them4 ,after infusing some time1 strain1 and dissolve three ,ounces of ,honey in the ,infusion4 ,no4 #ac4 ,is only the same ,kind of ,drink made by omitting the ,hyssop1 and adding instead of it as much more ,elder ,flowers4 ,no4 #ad4 ,let one ,ounce of the best ,jesuits ,bark in fine ,powder be divided into sixteen equal ,portions4 ,no4 #ae4 ,take of the ,flowers of ,st4 ,john's ,wort1 of ,elder1 and of ,melilot1 of each a few ,pinches2 put them into the ,bottom of an ,ewer or ,vessel containing five or six ,english ,pints1 with half an ,ounce of ,oil of ,turpentine1 and fill it up with boiling ,water4 ,no4 #af4 ,is only the ,syrup of the ,flowers of the wild red ,corn ,poppy4 ,no4 #ag4 ,is only very clear sweet ,whey1 in every ,pint of which one ,ounce of ,honey is to be dissolved4 ,no4 #ah4 ,take of ,castile or hard white ,soap six ,drachms2 of ,extract of ,dandelion one ,drachm and a half2 of ,gum ,ammoniacum half a ,drachm1 and with ,syrup of ,maidenhair make a ,mass of ,pills1 to be formed into ,pills1 weighing three ,grains each4 ,no4 #ai4 ,gargarisms may be prepared from a ,decoction1 or rather an ,infusion1 of the ,leaves of ,periwinkle1 or of ,red ,rose-,leaves1 or of ,mallows4 ,two ,ounces of ,vinegar and as much ,honey must be added to every ,pint of it1 and the ,patient should gargle with it pretty hot4 ,the deterging1 cleansing ,gargarisin referred to ,sec4 #aab1 is a light ,infusion of the ,tops of ,sage1 adding two ,ounces of ,honey to each ,pint of it4 ,no4 #bj4 ,is only one ,ounce of powdered ,nitre1 divided into sixteen equal ,doses4 ,no4 #ba4 ,take of ,jalap1 of ,senna1 and of ,cream of ,tartar of each thirty ,grains finely powdered2 and let them be very well mixed4 #aah #aah ,this1 our ,author observes1 will work a strong ,country-man very well3 by which however he does not seem to mean an ,inhabitant of the ,mountains in ,valais4 ,see ,p4 #edg4 ,no4 #bb4 ,take of ,china ,root1 and of ,sarsaparilla of each one ,ounce and a half1 of ,sassafras ,root1 and of the ,shavings of ,guiacum1 otherwise called ,lignum vitae1 of each one ,ounce4 ,let the whole be cut very fine4 ,then put them into a glazed earthen ,vessel2 pouring upon them about five pints of boiling ,water4 ,let them boil gently for an ,hour2 then take it from the ,fire1 and strain it off through ,linen4 ,this is called the ,decoction of the ,woods1 and is often of different ,proportions of these ,ingredients1 or with the ,addition of a few others4 ,more ,water may1 after the first boiling1 be poured on the same ,ingredients1 and be boiled up into a small ,decoction for common ,drink4 ,no4 #bc4 ,take one ,ounce of the ,pulp of ,tamarinds1 half a ,drachm of ,nitre1 and four ,ounces of ,water2 let them boil not more than one ,minute1 then add two ,ounces of ,manna1 and when dissolved strain the ,mixture off4 ,no4 #bd4 ,is only an ,ounce of ,cream of ,tartar1 divided into eight equal ,parts4 ,no4 #be4 ,this ,prescription is only the ,preparation of ,kermes mineral1 otherwise called the ,chartreusian ,powder4 ,dr4 ,tissot orders but one ,grain for a ,dose4 ,it has been directed from one to three4 ,no4 #bf4 ,take three ,ounces of the common ,burdock ,root2 boil it for half an ,hour1 with half a ,drachm of ,nitre1 in three full ,pints of ,water4 ,no4 #bg4 ,take half a ,pinch of the ,herbs prescribed ,no4 #i1 ,article #b1 and half an ,ounce of hard white ,soap shaved thin4 ,pour on these one ,pint and a half of boiling ,water1 and one ,glass of ,wine4 ,strain the ,liquor and squeeze it strongly out4 ,no4 #bh4 ,take of the purest ,quicksilver one ,ounce2 of ,venice ,turpentine half a ,drachm1 of the freshest ,hog's ,lard two ,ounces1 and let the whole be very well rubbed together into an ,ointment4 #aai #aai ,this ,ointment should be prepared at the ,apothecaries2 the ,receipt of it being given here1 only because the ,proportions of the ,quicksilver and the ,lard are not always the same in different ,places4 ,no4 #bi4 ,this ,prescription is nothing but the yellow ,basilicon4 ,no4 #cj4 ,take of natural and factitious1 or artificial ,cinnabar1 twenty-four ,grains each2 of ,musk sixteen ,grains1 and let the whole be reduced into fine ,powder1 and very well mixed4 #abj #abj ,this ,medicine is known by the ,name of ,cob's ,powder2 and as its ,reputation is very considerable1 ,i did not chuse to omit it2 though ,i must repeat here what ,i have said ,sec4 #aie--,that the ,cinnabar is probably of little or no ,efficacy2 and there are other ,medicines that have also much more than the ,musk2 which besides is extremely dear for poor ,people1 as the requisite ,doses of it1 in very dangerous ,cases1 would cost ten or twelve ,shillings daily4 ,the ,prescription1 ,no4 #ca1 is more effectual than the ,musk2 and instead of the useless ,cinnabar1 the powerful ,quicksilver may be given to the ,quantity of forty-five ,grains4 ,i have said nothing hitherto in this ,work of the red blossomed ,mulberry ,tree1 which passes for a real ,specific1 among some ,persons1 in this dreadful ,malady4 ,an ,account of it may be seen in the first ,volume of the ,oeconomical ,journal of ,berne4 ,it is my ,opinion however1 that none of the ,instances related there are satisfactory and decisive2 its ,efficacy still appearing to me very doubtful4 ,no4 #ca4 ,take one ,drachm of ,virginia ,snake ,root in ,powder2 of ,camphor and of ,assa-foetida ten ,grains each2 of ,opium one ,grain1 and with a sufficient ,quantity of ,conserve1 or ,rob of ,elder1 make a ,bolus4 #aba #aba ,when this is preferred to ,no4 #cj1 of which ,musk is an ,ingredient1 the ,grain of ,opium should be omitted1 except once or at most twice in the twenty-four ,hours4 ,two ,doses of ,quicksilver1 of fifteen ,grains each1 should be given daily in the ,morning1 in the ,interval between the other ,bolus's4 ,no4 #cb4 ,take three ,ounces of ,tamarinds4 ,pour on them one ,pint of boiling ,water1 and after letting them boil a ,minute or two1 strain the ,liquor through a ,linen ,cloth4 ,no4 #cc4 ,take seven ,grains of ,turbith ,mineral2 and make it into a ,pill or ,bolus with a little ,crumb of ,bread4 #abb #abb ,this ,medicine makes the ,dogs vomit and slaver abundantly4 ,it has effected many ,cures after the ,hydrophobia1 the ,dread of ,water1 was manifest4 ,it must be given three ,days successively1 and afterwards twice a ,week1 for fifteen ,days4 ,no4 #cd4 ,this is nothing but a ,prescription of six ,grains of ,tartar #abc emetic4 #abc ,when ,people are ignorant of the ,strength of the ,tartar emetic 7which is often various7 or of the ,patient's being easy or hard to vomit1 a ,dose and a half may be dissolved in a ,quart of warm ,water1 of which he may take a ,glass every ,quarter of an ,hour1 whence the ,operation may be forwarded1 or otherwise regulated1 according to the ,number of ,vomits or ,stools4 ,this ,method1 much used in ,paris1 seems a safe and eligible one4 ,no4 #ce4 ,take thirty-five ,grains of ,ipecacuanna1 which1 in the very strongest ,constitutions1 may be augmented to forty-five1 or even to fifty ,grains4 ,no4 #cf4 ,prescribes only the common blistering ,plaister2 and the ,note observes that very young ,infants who have delicate ,skins may have ,sinapisms applied instead of ,blisters2 and made of a little old ,leaven1 kneaded up with a few ,drops of sharp ,vinegar4 ,no4 #cg4 ,take of the ,tops of ,chamaedrys or ,ground ,oak1 of the lesser ,centaury1 of ,wormwood and of ,camomile1 of each one ,pugil4 ,pour on them three ,pints of boiling ,water2 and suffering them to infuse until it is cold1 strain the ,liquor through a ,linen ,cloth1 pressing it out strongly4 ,no4 #ch4 ,take forty ,grains of ,rhubarb1 and as much ,cream of ,tartar in ,powder1 mixing them well together4 ,no4 #ci4 ,take three ,drachms of ,cream of ,tartar1 and one ,drachm of ,ipecacuanna finely powdered4 ,rub them well together1 and divide them into six equal ,parts4 ,no4 #dj4 ,take of the simple ,mixture one ,ounce1 of ,spirit of ,vitriol half an ,ounce1 and mix them4 ,the ,dose is one or two ,tea ,spoonfuls in a ,cup of the ,patient's common ,drink4 ,the simple ,mixture is composed of five ,ounces of ,treacle ,water camphorated1 of three ,ounces of ,spirit of ,tartar rectified1 and one ,ounce of ,spirit of ,vitriol4 ,if the ,patient has an insuperable ,aversion to the ,camphor1 it must be omitted1 though the ,medicine is less efficacious without it4 ,and if his ,thirst is not very considerable1 the simple ,mixture may be given alone1 without any further ,addition of ,spirit of ,vitriol4 ,no4 #da4 ,take half a ,drachm of ,virginia ,snake-root1 ten ,grains of ,camphor1 and make them into a ,bolus with ,rob of ,elder-,berries4 ,if the ,patient's ,stomach cannot bear so large a ,dose of ,camphor1 he may take it in smaller ,doses and oftner1 viz4 three ,grains1 every two ,hours4 ,if there is a violent ,looseness1 ,diascordium must be substituted instead of the ,rob of ,elder-berries4 ,no4 #db4 ,prescribes only the ,theriaca pauperum1 or poor ,man's ,treacle1 in the ,dose of a ,quarter of an ,ounce4 ,the following ,composition of it is that chiefly preferred by our ,author4 ,take equal ,parts of round ,birthwort ,roots1 of ,elecampane1 of ,myrrh1 and of ,rob or ,conserve of ,juniper-berries1 and make them into an ,electuary of a rather thin1 than very stiff ,consistence1 with ,syrup of ,orange-peel4 ,no4 #dc4 ,the first of the three ,medicines referred to in this ,number1 is that already directed1 ,no4 #cg4 ,the second is as follows4 ,take equal ,parts of the lesser ,centaury1 of ,wormwood1 of ,myrrh1 all powdered1 and of ,conserve of ,juniper-berries1 making them up into a pretty thick ,consistence with ,syrup of ,wormwood4 ,the ,dose is a ,quarter of an ,ounce2 to be taken at the same ,intervals as the ,bark4 ,for the third ,composition--,take of the ,roots of ,calamus ,aromaticus and ,elecampane well bruised1 two ,ounces2 of the ,tops of the lesser ,centaury cut small1 a ,pugil2 of ,filings of unrusted ,iron two ,ounces1 of old white ,wine1 three ,pints4 ,put them all into a wide necked ,bottle1 and set it upon ,embers1 or on a ,stove1 or by the ,chimney1 that it may be always kept hot4 ,let them infuse twenty-four ,hours1 shaking them well five or six ,times2 then let the ,infusion settle1 and strain it4 ,the ,dose is a common ,cup every four ,hours1 four ,times daily1 and timing it one ,hour before ,dinner4 ,no4 #dd4 ,take a ,quarter of an ,ounce of ,cream of ,tartar1 a ,pugil of common ,camomile2 boil them in twelve ,ounces of ,water for half an ,hour1 and strain it off4 ,no4 #de4 ,directs only the common ,sal ,ammoniac1 from two ,scruples to one ,drachm for a ,dose4 ,the ,note to it adds1 that it may be made into a ,bolus with ,rob of ,elder2 and observes1 that those feverish ,patients1 who have a weak delicate ,stomach1 do not well admit of this ,salt2 no more than of several others1 which affect them with great ,disorder and ,anxiety4 ,no4 #df4 ,the ,powder4 ,take one ,pugil of ,camomile ,flowers1 and as much ,elder ,flowers1 bruising them well2 of fine ,flour or ,starch three ,ounces2 of ,ceruss and of blue ,smalt each half an ,ounce4 ,rub the whole1 and mix them well4 ,this ,powder may be applied immediately to the ,part4 ,the ,plaister4 ,take of the ,ointment called ,nutritum1 made with the newest sweet ,oil1 two ,ounces2 of white ,wax three ,quarters of an ,ounce1 and one ,quarter of an ,ounce of blue ,smalt4 ,melt the ,wax1 then add the ,nutritum to it1 after the ,smalt finely powdered has been exactly incorporated with it2 stirring it about with an ,iron ,spatula or ,rod1 till the whole is well mixed and cold4 ,this is to be smoothly spread on ,linen ,cloth4 ,a ,quarter of an ,ounce of ,smalt may also be mixed exactly with two ,ounces of ,butter or ,ointment of ,lead1 to be used occasionally instead of the ,plaister4 ,no4 #dg4 ,take one ,ounce of ,sedlitz1 or for want of that1 as much ,epsom ,salt1 and two ,ounces of ,tamarinds3 pour upon them eight ,ounces of boiling ,water1 stirring them about to dissolve the ,tamarinds4 ,strain it off2 and divide it into two equal ,draughts1 to be given at the ,interval of ,half an ,hour between the first and last4 ,no4 #dh4 ,take of ,sydenham's ,liquid ,laudanum eighty ,drops2 of ,bawm ,water two ,ounces and a half4 ,if the first1 or the second1 ,dose stops or considerably lessens the ,vomiting1 this #abd ,medicine should not be further repeated4 #abd ,the medical ,editor at ,lyons justly notes here1 that these eighty ,drops are a very strong ,dose of liquid ,laudanum2 adding that it is scarcely ever given at ,lyons in a greater ,dose than thirty ,drops2 and recommending a ,spoonful of ,syrup of ,lemon-peel to be given with it--,but we must observe here in answer to this ,note1 that when ,dr4 ,tissot directs this ,mixture in the ,iliac ,passion ,sec4 #cah1 to appease the ,vomitings1 ,art4 #c1 he orders but one spoonful of this ,mixture to be taken at once1 and an ,interval of two ,hours to be observed between the first and second ,repetition1 which reduces each ,dose to sixteen ,drops1 and which is not to be repeated without ,necessity4 ,no4 #di4 ,dissolve three ,ounces of ,manna and twenty ,grains of ,nitre in twenty ,ounces1 or six ,glasses1 of sweet ,whey4 ,no4 #ej4 ,to two ,ounces of ,syrup of ,diacodium1 or white ,poppy ,heads1 add an equal ,weight of ,elder ,flower ,water1 or1 for want of it1 of ,spring ,water4 ,no4 #ea4 ,directs nothing but a ,drachm of ,rhubarb in ,powder4 ,no4 #eb4 ,take of ,sulphur vivum1 or of ,flower of ,brimstone1 one ,ounce2 of ,sal ,ammoniac1 one ,drachm2 of fresh ,hogs ,lard1 two ,ounces2 and mix the whole very well in a ,mortar4 ,no4 #ec4 ,take two ,drachms of crude ,antimony and as much ,nitre1 both finely powdered and very well mixed2 dividing the whole into eight equal ,doses4 #abe #abe ,this ,medicine1 which often occasions ,cholics in some ,persons of a weakly ,stomach1 is attended with no such ,inconvenience in strong ,country ,people2 and has been effectual in some ,disorders of the ,skin1 which have baffled other ,medicines--,the ,remainder of this ,note observes the great ,efficacy of ,antimony in promoting ,perspiration1 and the extraordinary ,benefit it is of to ,horses in different ,cases4 ,no4 #ed4 ,take of ,filings of ,iron1 not the least rusty1 and of ,sugar1 each one ,ounce2 of ,aniseeds ,powdered1 half an ,ounce4 ,after rubbing then very well together1 divide the ,powder into twenty-four equal ,portions2 one of which is to be taken three times a ,day an ,hour before eating4 #abf #abf ,the ,prescriptions ,no4 #ed1 #ee1 #ef1 are calculated against ,distempers which arise from ,obstructions1 and a ,stoppage of the monthly ,discharges2 which ,no4 #ee is more particularly intended to remove2 those of #ed and #ef are most convenient1 either when the ,suppression does not exist1 or is not to be much regarded1 if it does4 ,this ,medicine may be rendered less unpalatable for ,persons in easy ,circumstances1 by adding as much ,cinamon instead of ,aniseeds2 and though the ,quantity of ,iron be small1 it may be sufficient1 if given early in the ,complaint2 one1 or at the most1 two of these ,doses daily1 being sufficient for a very young ,maiden4 ,no4 #ee4 ,take of ,filings of sound ,iron two ,ounces2 of ,leaves of ,rue1 and of white ,hoar-hound one ,pugil each2 of black ,hellebore ,root1 one ,quarter of an ,ounce1 and infuse the whole in three ,pints of ,wine in the ,manner already directed1 ,no4 #dc4 ,the ,dose of this is one small ,cup three times a ,day1 an ,hour before eating4 #abg #abg ,i chuse to repeat here1 the more strongly to inculcate so important a ,point1 that in ,women who have long been ill and languid1 our ,endeavours must be directed towards the restoring of the ,patient's ,health and ,strength1 and not to forcing down the monthly ,discharges1 which is a very pernicious ,practice4 ,these will return of ,course1 if the ,patient is of a proper ,age1 as she grows better4 ,their ,return succeeds the ,return of her ,health1 and should not1 very often cannot1 precede it4 ,no4 #ef4 ,take two ,ounces of ,filings of ,iron2 of ,rue ,leaves and ,aniseed powdered1 each half an ,ounce4 ,add to them a sufficient ,quantity of ,honey to make an ,electuary of a good ,consistence4 ,the ,dose is a ,quarter of an ,ounce three times daily4 ,no4 #eg4 ,take of the ,extract of the stinking ,hemlock1 with the purple spotted ,stalk1 one ,ounce4 ,form it into ,pills weighing two ,grains each2 adding as much of the ,powder of dry ,hemlock ,leaves1 as the ,pills will easily take up4 ,begin the ,use of this ,medicine by giving one ,pill ,night and ,morning4 ,some ,patients have been so familiarized to it1 as to take at length ,half an ,ounce daily4 #abh #abh ,our learned and candid ,author has a very long ,note in this ,place1 strongly in ,favour of ,storck's ,extract of ,hemlock1 in which it is evident he credits the greater ,part of the ,cures affirmed by ,dr4 ,storck to have been effected by it4 ,he says he made some himself1 but not of the right ,hemlock1 which we think it very difficult to mistake1 from its peculiar rank fetid ,smell1 and its purple spotted ,stalk4 ,after first taking this himself1 he found it mitigated the ,pain of ,cancers1 but did not cure them4 ,but then addressing himself to ,dr4 ,storck1 and exactly following his ,directions in making it1 he took of ,dr4 ,storck's ,extract1 and of his own1 which exactly resembled each other1 to the ,quantity of a ,drachm and a half daily2 and finding his ,health not in the least impaired by it1 he then gave it to several ,patients1 curing many scrophulous and cancerous ,cases1 and mitigating others1 which he supposes were incurable4 ,so that he seems fully persuaded ,dr4 ,storck's ,extract is always innocent which in ,fact1 except in a very few ,instances1 none of which were fatal1 it has been and he thinks it a ,specific in many ,cases1 to which nothing can be substituted as an equivalent ,remedy2 that it should be taken with entire ,confidence1 and that it would be absurd to neglect its ,continuance4 ,the ,translator of this ,work of ,dr4 ,tissot's has thought it but fair to give all the ,force of this ,note here1 which must be his own1 as his ,editor at ,lyons seems to entertain a very different ,opinion of the ,efficacy of this ,medicine2 for which ,opinion we refer back to his ,note1 ,sec4 #cge1 of this ,treatise1 which the ,reader may compare with this of our ,author's4 ,k4 ,no4 #eh4 ,take of the ,roots of ,grass and of ,succory well washed1 each one ,ounce4 ,boil them a ,quarter of an ,hour in a ,pint of ,water4 ,then dissolve in it ,half an ,ounce of ,sedlitz1 or of ,epsom ,salt1 and two ,ounces of ,manna2 and strain it off to drink one ,glass of it from ,half ,hour1 to ,half ,hour1 till its ,effects are sufficient4 ,it is to be repeated at the ,interval of two or three ,days4 ,no4 #ei4 ,is a ,cataplasm or ,pultice made of ,crumb of ,bread1 with ,camomile ,flowers boiled in ,milk1 with the ,addition of some ,soap1 so that each ,pultice may contain half a ,quarter of an ,ounce of this last ,ingredient4 ,and when the ,circumstances of female ,patients have not afforded them that regular ,attendance1 which the ,repetition of the ,pultice requires1 as it should be renewed every three ,hours1 ,i have successfully directed the ,hemlock ,plaister of the ,shops4 ,no4 #fj4 ,take a sufficient ,quantity of dry ,hemlock ,leaves4 ,secure them properly between two ,pieces of thin ,linen ,cloth1 so as to make a very flexible ,sort of small ,matrass1 letting it boil a few ,moments in ,water1 then squeeze it out and apply it to the affected ,part4 ,it must thus be moistened and heated afresh1 and re-applied every two ,hours4 ,no4 #fa4 ,take of the ,eyes of the ,craw-fish1 or of the true white ,magnesia1 two ,drachms2 of ,cinnamon powdered four ,grains4 ,rub them very well together1 and divide the whole into eight ,doses4 ,one of these is to be given in a ,spoonful of ,milk1 or of ,water1 before the ,infant sucks4 ,no4 #fb4 ,take of an ,extract of ,walnuts1 made in ,water1 two ,drachms2 and dissolve it in half an ,ounce of ,cinnamon ,water4 ,fifty ,drops a ,day of this ,solution is to be given to a ,child of two ,years old2 and after the whole has been taken1 the ,child should be purged4 ,this ,extract is to be made of the unripe ,nuts1 when they are of a proper ,growth and ,consistence for pickling4 ,no4 #fc4 ,take of ,rezin of ,jalap two ,grains4 ,rub it a considerable time with twelve or fifteen ,grains of ,sugar1 and afterwards with three or four sweet ,almonds2 adding1 very gradually1 two common ,spoonfuls of ,water4 ,then strain it through clear thin ,linen1 as the ,emulsion of ,almonds was ordered to be4 ,lastly1 add a ,tea ,spoonful of ,syrup of ,capillaire to it4 ,this is no disagreable ,draught1 and may be given to a ,child of two ,years old3 and if they are older1 a ,grain or two more of the ,rezin may be allowed4 ,but under two ,years old1 it is prudent to purge ,children rather with ,syrup of ,succory1 or with ,manna4 ,no4 #fd4 ,take of the ,ointment called ,nutritum one ,ounce2 the entire ,yolk of one small ,egg1 or the ,half of a large one1 and mix them well together4 ,this ,nutritum may be readily made by rubbing very well together1 and for some time1 two ,drachms of ,ceruss white ,lead half an ,ounce of ,vinegar1 and three ,ounces of common ,oil4 ,no4 #fe4 ,melt four ,ounces of white ,wax2 add to it1 if made in ,winter two ,spoonfuls of ,oil2 if in ,summer none at all1 or at most1 not above a ,spoonful4 ,dip in this ,slips of ,linen ,cloth not worn too thin1 and let them dry3 or spread it thin and evenly over them4 ,no4 #ff4 ,take of ,oil of ,roses one ,pound2 of red ,lead half a ,pound2 of ,vinegar four ,ounces4 ,boil them together nearly to the ,consistence of a ,plaister2 then dissolve in the liquid ,mass an ,ounce and a ,half of yellow ,wax1 and two ,drachms of ,camphor1 stirring the whole about well4 ,remove it then from the ,fire1 and spread it on ,sheets or ,slips of ,paper1 of what ,size you think most convenient4 ,the ,ointment of ,chambauderie1 so famous in many ,families on the ,continent1 is made of a ,quarter of a ,pound of yellow ,wax1 of the ,plaister of three ,ingredients 7very nearly the same with ,no4 #ff7 of compound ,diachylon and of common ,oil1 of each the same ,quantity1 all melted together1 and then stirred about well1 after it is removed from the ,fire1 till it grows cold4 ,to make a ,sparadrap1 or ,oil ,cloth1 which is ,linen1 covered with1 or dipt in an emplastic ,substance or ,ointment1 it must be melted over again with the ,addition of a little ,oil1 and applied to the ,linen as directed at ,no4 #fe4 ,no4 #fg4 ,gather in ,autumn1 while the fine ,weather lasts1 the ,agaric of the ,oak1 which is a ,kind of ,fungus or ,excrescence1 issuing from the ,wood of that ,tree4 ,it consists at first of four ,parts1 which present themselves successively1 #a1 ,the outward ,rind or ,skin1 which may be thrown away4 #b1 ,that ,part immediately under this ,rind1 which is the best of all4 ,this is to be beat well with a ,hammer1 till it becomes soft and very pliable4 ,this is the only ,preparation it requires1 and a ,slice of it of a proper ,size is to be applied directly over the bursting1 open ,blood-vessels4 ,it constringes and brings them close together2 stops the ,bleedings2 and generally falls off at the ,end of two ,days4 #c1 ,the third ,part1 adhering to the second may serve to stop the ,bleeding from the smaller ,vessels2 and the fourth and last ,part may be reduced to ,powder1 as conducing to the same ,purpose4 #abi #abi ,our ,author attests his seeing the happiest ,consequences from this ,application1 which ,m4 ,brossard1 a very eminent ,french ,surgeon1 first published2 and declared his ,preference of that ,agaric which sprung from those ,parts of the ,tree1 from whence large ,boughs had been lopped4 ,no4 #fh4 ,take four ,ounces of ,crumbs of ,bread1 a ,pugil of ,elder ,flowers1 and the same ,quantity of those of ,camomile1 and of ,st4 ,john's ,wort4 ,boil them into a ,pultice in equal ,quantities of ,vinegar and ,water4 ,if ,fomentations should be thought preferable1 take the same ,herbs1 or some ,pugils of the ,ingredients for ,faltrank3 throw them into a ,pint and a ,half of boiling ,water3 and let them infuse some ,minutes4 ,then a ,pint of ,vinegar is to be added1 and ,flanels or other woollen ,cloths dipt in the ,fomentation1 and wrung out1 are to be applied to the ,part affected4 ,for the aromatic ,fomentations recommended ,sec4 #ddi1 take ,leaves of ,betony and of ,rue1 ,flowers of ,rosemary or ,lavender1 and red ,roses1 of each a ,pugil and a ,half4 ,boil them for a ,quarter of an ,hour in a ,pot with a ,cover1 with three ,pints of old white ,wine4 ,then strain off1 squeezing the ,liquor strongly from the ,herbs1 and apply it as already directed4 ,no4 #fi4 ,directs only the ,plaister of ,diapalma4 #acj #acj ,to spread this upon ,lint as directed1 ,sec4 #def1 it must be melted down again with a little ,oil4 ,no4 #gj4 ,directs only a ,mixture of two ,parts ,water1 and one ,part of ,vinegar of ,litharge4 ,no4 #ga4 ,take of the ,leaves of ,sow-bread1 and of ,camomile ,tops1 of each one ,pugil4 ,put them into an earthen ,vessel with half an ,ounce of ,soap1 and as much ,sal ,ammoniac1 and pour upon them three ,pints of boiling ,water4 ,n4 ,b4 ,i conceive all the ,notes to this ,table1 in which ,i have not mentioned the ,editor at ,lyons1 nor subscribed with my initial ,letter ,k1 to come from the ,author1 having omitted nothing of them1 but the ,prices4 ,,errata4 ,page #d1 ,line #f1 for os read of4 p4 #af1 l4 #af1 for be read me4 p4 #bi1 l4 #ab1 after it add 4 p4 #di1 l4 #ab1 dele and at the ,end of it4 p4 #ea1 in the running ,title1 for ,causss read ,causes4 ib4 l4 #b1 dele and4 ib4 l4 #g1 dele and4 p4 #eg1 last line1 for hurtsul read hurtful4 p4 #fg1 l4 #ag1 after ,water1 add1 may be placed within the ,room4 p4 #gd1 line last but two1 after never1 dele 1 p4 #if1 l4 #aa1 for ,aiiment read ,ailment4 p4 #ajf1 l4 #bc1 for the second is read has4 p4 #abf1 l4 #ba1 for breath read breathe4 p4 #acg1 l4 #ac1 for ,efflorescene read ,efflorescence1 p4 #ade1 l4 #a1 for ,water read ,tea4 p4 #adh1 l4 #ai1 for beomes read becomes4 p4 #afc1 l4 #cj4 in the ,note1 for occured read occurred2 p4 #aga1 l4 #bj1 dele and4 p4 #ahi1 l4 #bh1 dele of4 p4 #aii1 l4 #f1 for ,paulmier read ,palmarius1 being the ,latinized ,name of that ,physician2 as we say for ,fernel ,fernelius1 ,holler ,hollerius1 c4 ,n4 ,b4 ,his ,powder for the ,bite of a mad ,dog consisted of equal ,parts of ,rue1 ,vervain1 ,plantain1 ,polypody1 common ,wormwood1 ,mugwort1 ,bastard ,baum1 ,betony1 ,st4 ,john's ,wort1 and lesser ,centaury ,tops1 to which ,default adds ,coraline4----p4 #bcg1 l4 #b1 for ,streakes read ,streaks4 p4 #bef1 first line of the ,note 99 dele the first often4 p4 #bfa1 l4 #ae1 for happens read happen4 p4 #bgj1 l4 #ab1 dele t in ,switsserland4 p4 #bhb1 l4 #bc1 for enters read enter4 p4 #bhc1 l4 #bc1 for ,stomach read ,stomachs4 p4 #bhd1 l4 #ab1 for it read them4 p4 #bhg1 ,note 99 l4 #be1 for here read there4 p4 #cjc1 l4 #ad1 for doubtsul read doubtful4 p4 #caa1 l4 #ah1 for abate read abates4 p4 #ccg1 l4 #g1 for glary read glairy4 ,n4 ,b4 ,in the first ,page that is folio'd #dde read #cde4 p4 #cdf1 l4 #ai1 for two read too4 p4 #cea1 l4 #be1 after ,waters add1 such as ,infusions of ,tea1 c4 p4 #cge1 l4 #g1 for two read too4 p4 #cib1 last line1 for ,leaves read ,flowers4 p4 #cic1 l4 #bf1 after them1 insert and4 p4 #cig1 l4 #a and #b1 for ,temparrament read ,temperament4 p4 #dbb1 l4 #f1 between several and ,consequences insert bad4 p4 #ded1 l4 #e1 for ,diflocation read ,dislocation4 p4 #dei1 l4 #ag1 in ,ice-thaws dele - p4 #dff1 l4 #af1 to ,constitution add s4 p4 #dhf1 l4 #bi1 after or add if4 p4 #dhg1 l4 #ab1 for ,parts read ,part4 p4 #eaa1 l4 #ab1 for not read nor4 p4 #ecc1 l4 #ab1 for arrives read arises4 p4 #edb1 l4 #bb1 for ,patient read ,patients4 p4 #efb1 l4 #ad1 for fays read says4 p4 #egc1 l4 #aj1 after ,cause1 dele ,comma4 ,table of the several ,chapters1 and their principal ,contents4 ,introduction ---- ,page #a ,the first ,cause of ,depopulation1 ,emigrations ---- ib4 ,the second ,cause1 ,luxury ---- #f ,third ,cause1 ,decay of ,agriculture ---- #aj ,fourth ,cause1 the pernicious ,treatment of ,diseases ---- #ab ,means for rendering this ,treatise useful ---- #ae ,explanation of certain physical ,terms1 and ,phrases ---- #bf ,chapter ,i4 ,the most common ,causes of popular ,sickness ---- #ca ,first ,cause1 excessive ,labour ---- ib4 ,second ,cause1 the ,effect of cold ,air1 when a ,person is hot ---- #cc ,third ,cause1 taking cold ,drink1 when in a ,heat ---- ib4 #cd ,fourth ,cause1 the ,inconstancy and sudden ,change of the ,weather ---- #ce ,fifth ,cause1 the ,situation of ,dunghills1 and ,marshes1 near inhabited ,houses1 and the bad confined ,air in the ,houses ---- #cg ,sixth ,cause1 ,drunkenness ---- #ch ,seventh ,cause1 the ,food of ,country ,people ---- #ci ,eighth ,cause1 the ,situation1 or ,exposure of ,houses ---- #db ,concerning the ,drink of ,country ,people ---- #dc ,chap4 ,,ii4 ,of ,causes which increase the ,diseases of the ,people1 with general ,considerations ---- #dg ,first ,cause1 the great ,care employed to force the ,sick to sweat1 and the ,methods taken for that ,purpose ---- ib4 #dh ,the ,danger of hot ,chambers ---- #di ,the ,danger of hot ,drinks and heating ,medicines ---- #ej ,second ,cause1 the ,quantity and ,quality of the ,food given sick ,persons ---- #ec ,third ,cause1 the giving ,vomits and ,purges at the ,beginning of the ,disease ---- #eg ,chap4 ,,iii4 ,concerning what should be done in the ,beginning of ,diseases1 and the ,diet in acute ,diseases ---- #fa ,signs which indicate approaching ,diseases2 with ,means to prevent them ---- #fb ,the common ,regimen1 or ,regulations1 for the ,sick ---- #fd ,the ,benefits of ripe sound ,fruits ---- #fh ,cautions and ,means to be used1 on ,recovery ---- #gc1 #gd ,chap4 ,,iv4 ,of the ,inflammation of the ,breast ---- #gg ,the ,signs of this ,disease ---- ib4 #gh ,the ,advantage of ,bleeding ---- #ha ,signs of ,recovery ---- #he ,of ,crises1 and the ,symptoms that precede them ---- #hf ,the ,danger of ,vomits1 of ,purges1 and of ,anodynes ---- #hh ,of the ,suppression of ,expectoration1 and the ,means to restore it4 ---- #hi ,of the ,formation of ,vomicas1 or ,imposthumes in the ,lungs1 and the ,treatment of them ---- #ij ,of the ,danger of ,remedies1 termed ,balsamics ---- #ajc ,the ,inefficacy of the ,antihectic of ,poterius ---- #ajd ,of an ,empyema ---- #aje ,of a ,gangrene of the ,lungs ---- #ajf ,of a ,scirrhus of the ,lungs ---- ib4 ,chap4 ,v4 ,of the ,pleurisy ---- #ajh ,the ,danger of heating ,remedies ---- #aab to #aae ,of frequent1 or habitual1 ,pleurisies ---- #aaf ,of ,goats ,blood2 the ,soot of a stale ,egg1 and of the ,wormwood of the ,alps1 in ,pleurisies ---- #aag1 #aah ,chap4 ,,vi4 ,of ,diseases of the ,throat ---- #aai ,of their proper ,treatment ---- #abd ,of the ,formation of an ,abscess there ---- #abg ,of swelled ,ears1 from the ,obstruction of the parotid and maxillary ,glands ---- #aca ,of the epidemic and putrid ,diseases of the ,throat1 which prevailed in #agfa at ,lausanne ---- #acb ,chap4 ,,vii4 ,of ,colds ---- #aci ,different ,prejudices concerning ,colds ---- ib4 #adj ,the ,danger of drinking much hot ,water1 and of strong spirituous ,liquors1 c4 ---- #adf ,means for strengthening and curing ,persons very subject to ,colds ---- #adh ,chap4 ,,viii4 ,of ,diseases of the ,teeth ---- #aej ,chap4 ,,ix4 ,of the ,apoplexy ---- #aeh ,of sanguine ,apoplexy ---- ib4 #aei ,of a serous1 or watery1 ,apoplexy ---- #afb ,means to prevent relapsing into them ---- #afd seq4 ,chap4 ,x4 ,of morbid ,strokes of the ,sun ---- #afg ,chap4 ,,xi4 ,of the ,rheumatism ---- #agg ,of the acute ,rheumatism1 attended with a ,fever ---- ib4 ,of the flow1 or chronical1 without a ,fever ---- #ahf ,the ,danger of spirituous and greasy ,remedies ---- #aia1 #aib ,chap4 ,,xii4 ,of the ,bite of a mad ,dog ---- #aid ,chap4 ,,xiii4 ,of the ,small ,pocks4 ---- #bjg ,of the preceding ,symptoms of this ,disease ---- #bji --,the ,danger of sweating ,medicines ---- #bag --,the ,treatment of the benign distinct ,small ,pocks ---- #bbj --,the ,use of ,bleeding ---- #bbb --,the ,fever of ,suppuration ---- #bbc --,the ,necessity of opening the ripe ,pustules ---- #bbf --,the ,danger of ,anodynes ---- #bbh ,of the striking in of the ,eruptions ---- #bbi ,preparations for receiving it favorably ---- #bcj ,chap4 ,,xiv4 ,of the ,measles ---- #bce ,of their ,treatment and the ,means to prevent any of their bad ,consequences1 to ---- #bdc ,chap4 ,,xv4 ,of the hot1 or burning1 ,fever ---- #bdd ,chap4 ,,xvi4 ,of putrid ,fevers ---- #bdh ,chap4 ,,xvii4 ,of malignant ,fevers ---- #beg ,the ,danger of applying living ,animals in them ---- #bfg ,chap4 ,,xviii4 ,of intermitting ,fevers ---- #bfi --,spring and ,autumn ,intermittents ---- #bgb ,method of ,cure by the ,bark ---- #bge ,method of treating the ,patient in the ,fit ---- #bgg ,of other ,febrifuges1 besides the ,bark ---- #bgh ,the ,treatment of long and obstinate ,intermittents ---- #bgi ,of some very dangerous ,intermittents ---- #bhd ,of some periodical ,disorders1 which may be termed1 ,fevers disguised ---- #bhe ,of ,preservatives from unwholesome ,air ---- #bhf ,chap4 ,,xix4 ,of an ,erisipelas1 or ,st4 ,anthony's ,fire4 ---- #bhh ,of a frequent or habitual ,erisipelas ---- #bie ,of the ,stings or ,bites of ,animals ---- #bif ,chap4 ,,xx4 ,of ,inflammations of the ,breast1 and of ,bastard and bilious ,pleurisies ---- #bih --,of the false ,inflammation of the ,breast ---- #cjj --,the false ,pleurisy ---- #cjc ,chap4 ,,xxi4 ,of ,cholics ---- #cjf ,of the inflammatory ,cholic ---- #cjg --the bilious ,cholic ---- #cab --the ,cholic from ,indigestion1 and of ,indigestions ---- #cad --the flatulent1 or windy1 ,cholic ---- #cag --the ,cholic1 from taking ,cold ---- #cai ,chap4 ,,xxii4 ,of the ,miserere1 or ,iliac ,passion1 and of the ,cholera ,morbus ---- #cbb ,the ,miserere ---- ib4 #cbc ,the ,cholera ,morbus ---- #cbg ,chap4 ,,xxiii4 ,of a ,diarrhoea1 or ,looseness ---- #ccb ,chap4 ,,xxiv4 ,of a ,dysentery1 or ,bloody-,flux ---- #cce ,the ,symptoms of the ,disease ---- #ccf ,the ,remedies against it ---- #cch ,of the beneficial ,use of ripe ,fruits ---- #cda ,of the ,danger of taking a great ,number of popular ,remedies in it ---- #cde ,chap4 ,,xxv4 ,of the ,itch ---- #cdg ,chap4 ,,xxvi4 ,directions peculiar to the ,sex ---- #ceb ,of the monthly ,customs ---- #cec ,of ,gravidation1 or going with ,child ---- #cfe ,of ,labours or ,deliveries1 ---- #cfg ,of their ,consequences ---- #cga ,of a ,cancer ---- #cgc ,chap4 ,,xxvii4 ,directions with ,regard to ,children ---- #cge ,of the first ,cause of their ,disorders1 the ,meconium ---- #cgg --the second1 the souring of their ,milk ---- #cgi --the ,danger of giving them ,oil ---- ib4 --,disorders from their ,want of ,perspiration1 the ,means of keeping it up1 and of washing them in cold ,water ---- #cha #chb --the third ,cause1 the cutting of their ,teeth ---- #chf --the fourth ,cause1 ,worms ---- #chg ,of ,convulsions ---- #cia ,methods necessary to make them strong and hardy1 with general ,directions about them ---- #cif seq4 ,chap4 ,,xxviii4 ,of ,assistances for drowned ,persons ---- #djc ,chap4 ,,xxix4 ,of ,substances stopt between the ,mouth and the ,stomach ---- #daa ,chap4 ,,xxx4 ,of ,disorders requiring the ,assistance of a ,surgeon ---- #dce ,of ,burns ---- #dcf ,of ,wounds ---- #dcg ,of ,bruises1 and of ,falls ---- #ddd ,of ,ulcers ---- #ded ,of frozen ,limbs1 or ,joints ---- #deh ,of ,chilblains ---- #dfb ,of ,ruptures ---- #dgd ,of ,phlegmons1 or ,boils ---- #dhj ,of ,fellons1 or ,whitlows ---- #dha ,of ,thorns1 ,splinters1 c4 in the ,skin or ,flesh ---- #dhf ,of ,warts ---- #dhh ,of ,corns ---- #dij ,chap4 ,,xxxi4 ,of some ,cases which require immediate ,assistance ---- #dia ,of ,swoonings1 from ,excess of ,blood ---- #dib ,of ,swoonings1 from great ,weakness ---- #did ,of ,swoonings1 occasioned by a ,load on the ,stomach ---- #dig ,of ,swoonings1 resulting from ,disorders of the ,nerves #ejj ,of ,swoonings1 occasioned by the ,passions ---- #ejd ,of the ,swoonings1 which occur in ,diseases ---- #ejf ,of ,haemorrhages1 or ,fluxes of ,blood ---- #ejh ,of ,convulsion ,fits ---- #eab ,of suffocating1 or strangling ,fits ---- #ead ,of the violent ,effects of great ,fear ---- #eaf ,of ,accidents produced by the ,vapours of ,charcoal1 and of ,wine ---- #eai ,of ,poisons ---- #ebf ,of acute and violent ,pains ---- #ebi ,chap4 ,,xxxii4 ,of giving ,remedies by ,way of ,precaution ---- #eca ,of ,bleeding ---- #ecb ,of ,purges ---- #edj ,remedies to be used after excessive ,purging ---- #edd ,reflections on some other ,remedies ---- #edf1 c4 ,chap4 ,,xxxiii4 ,of ,quacks1 ,mountebanks1 and ,conjurers ---- #eea ,chap4 ,,xxxiv4 ,questions necessary to be answered by any ,person1 who goes to consult a ,physician ---- #egi ,the ,table of ,remedies ---- #ehd ,transcription note ,old and variant spellings1 like surprising _/ surprizing1 ,buttermilk _/ ,butter-milk1 ,blood-vessels _/ ,blood-,vessels1 ,faltranc _/ ,faltrank1 wholesome _/ wholsome1 fetid _/ foetid1 public _/ publick1 ,physic _/ ,physick1 etc4 have been preserved in the present transcription4 ,in some cases of doubt1 the present edition has been compared with scans of the #agff edition printed by ,donaldson1 which differs slightly in setting1 for instance having all names not capitalized1 and corrects many typographic mistakes4 ,corrections listed in the ,errata at the end of the book have been carried into this transcription 7excepting those which are not relevant for the transcription1 like those in running titles74 ,typographic errors1 occurring at the following pages and lines in the original1 have been corrected 7negative numbers indicate lines from the bottom of the page73 - 99p4 #bc1 note 991 l4 -#f99 their ,druggs -- their ,drugs - 99p4 #bi1 l4 #ab99 thorough ,attentention -- thorough ,attention - 99p4 #ci1 l4 #b99 btutal ,souls -- brutal ,souls - 99p4 #dh1 l4 #ab-ac99 thick1 and and that -- thick1 and that - 99p4 #ee1 l4 -#e99 increases our ,horrour -- increases our ,horror - 99p4 #fa1 l4 #c-d99 deserves a ,patients ,confidence -- deserves a ,patient's ,confidence - 99p4 #fb1 l4 #af99 ,drink and ,glisters -- ,drink and ,glysters - 99p4 #hg1 l4 -#h99 the loosening ,glyster ,no4 #e -- the loosening ,glyster ,no4 #e - 99p4 #ajf1 l4 #a99 ,inflammamations -- ,inflammations - 99p4 #adh1 l4 #ba-bb99 ,perspiraration -- ,perspiration - 99p4 #ahb1 l4 #ai99 ,applications ,n4 #i -- ,applications ,no4 #i - 99p4 #ahi1 l4 #a99 the ,powder ,no4 #bi -- the ,powder ,no4 #bi - 99p4 #bbc1 note 991 l4 #d99 without the least peceiveable -- without the least perceiveable - 99p4 #bbf1 l4 #ag-ah99 ,relax-tion -- ,relaxation - 99p4 #bdd1 l4 #d-e99 ,dis-seases -- ,diseases - 99p4 #bfa1 l4 #ae99 ,haemmorrhages -- ,haemorrhages - 99p4 #bhc1 l4 #ad-ae99 ,pre-,precription -- ,prescription - 99p4 #cdd1 note 1 l4 -#b99 missing closing quote conjecturally inserted after instead of stumming or sulphurizing it1' - 99p4 #cec1 l4 #a99 stance constitutes -- ,circumstance constitutes - 99p4 #cee1 l4 #ah99 not pregant -- not pregnant - 99p4 #chc1 l4 #f99 the back ,bart of the ,head -- the back ,part of the ,head - 99p4 #dhe1 l4 #ac99 checks it ,progress -- checks its ,progress - 99p4 #die1 l4 #ai99 strong swelling ,herbs -- strong smelling ,herbs - 99p4 #ejf1 l4 #ae99 ,weakness is an ,obstable -- ,weakness is an ,obstacle - 99p4 #ejf1 l4 #ai99 an ,evacution supervenes -- an ,evacuation supervenes - 99p4 #ebe1 l4 -#b1-a99 ,never-vertheless -- ,nevertheless - 99p4 #efj1 l4 -#g99 ,villians -- ,villains - 99p4 #egc1 l4 #f99 some ,evacution -- some ,evacuation - 99p4 #fjh4 l4 -#g99 ,temparrament -- ,temperrament - 99p4 #faa1 col4 #b1 l4 #d99 ,of a ,diarrhaea -- ,of a ,diarrhoea ,so has been corrected the punctuation3 - 99p4 xxii1 last line1 note99 published at ,lyons4 missing period - 99p4 xxix1 l4 #aj99 ,infusion ,no4 #a2 missing dot - 99p4 xxix1 l4 #ac-ad99 ,numbers #a4 #b1 and #d -- ,numbers #a1 #b1 and #d - 99p4 #fc1 l4 #ae99 of the ,ptisans ,no4 #a missing dot - 99p4 #hd1 l4 -#g1 note99 the ,mixture1 ,no4 #aj missing dot - 99p4 #hh1 l4 #ba99 the purging ,potion ,no4 #aa missing dot - 99p4 #hi1 l4 #ab99 and drink plentifully of the ,ptisan ,no4 #b missing dot - 99p4 #hi1 l4 -#g99 should drink plentifully of the ,ptisan ,no4 #ab missing dot - 99p4 #aag1 l4 #ab-ac99 or some of those ,diet-,drinks ,no4 #a1 #b1 #d2 dots instead of commas - 99p4 #aah1 note 991 l4 #c99 it in his late ,materia ,medica4 ,k4 missing period - 99p4 #agc1 l4 -#h99 in ,hunting in #afeh4 additional comma - 99p4 #aih1 l4 #af99 #c4 ,the ,bites -- #c1 ,the ,bites - 99p4 #bjc1 note1 l4 #e99 in many other ,places4 missing period - 99p4 #bca1 note1 l- #a99 and the ,note there4 comma instead of period - 99p4 #bcc1 l4 #aj99 sound and hearty ,children74 missing period - 99p4 #bfe1 l4 -#f99 #ab1 ,as soon as the ,distemper period instead of comma - 99p4 #cbj1 last line of the note99 or for suspending it4 ,k4 missing dot - 99p4 #cga1 l4 #g99 #b1 ,an ,inflammation period instead of comma - 99p4 #eca1 l4 -#f99 or wrong4 missing period - 99p4 #ech1 l4 -#i99 ,powder ,no4 #bj missing dot - 99p4 #fja1 first line of the note99 ,the ,prescriptions ,no4 #ed1 #ee1 #ef missing dot after ,no and periods instead of commas ,the footnotes1 marked in the text mostly by asterisks1 symbols and alphabetic letters on a page by page basis1 have been renumbered progressively throughout the book4 ,the footnote 99 on page #bef does not appear to be referenced at any specific point on the printed page1 and has been treated as footnote to the last word of the paragraph4 ,italics markup of abbreviations like c41 ,k41 which was not always consistent in the original1 has been retained as printed4 ,the ,greek letters alpha1 beta1 gamma enumerating the prescriptions of ,sec4 #bad have been replaced by the ,latin letters a1 b1 c for better character set portability4