,,the ,,seaman',s ,medical ,instructor1 ,,in ,a ,,course ,,of ,,lectures ,,on ,,accidents ,,and ,,diseases ,,incident ,,to ,,seamen1 ,,in ,,the ,,various ,,climates ,,of ,,the ,,world4 ,,calculated ,,for ,,ships ,,that ,,carry ,,no ,,surgeon4 ,the ,whole delivered in a plain ,language1 and founded on a long and successful ,experience4 ---------------------------------------- ----------------- ,by ,n4 ,d4 ,,falck1 ,m4 ,d4 ---------------------------------------- ----------------- ,,london3 ,,printed ,,for ,,edward ,,and ,,charles ,,dilly4 ,m1,,dcc1,,lxxiv4 ---------------------------------------- -------------------------------- ,,the ,,preface4 ,if we consider the many benefits that navigation contributes to commerce in general1 and how much the prosperity of nations are indebted to its source1 we must without hesitation declare seamen1 a most respectable part of mankind2 and if we reflect a moment1 on the many hazards and perils they are exposed to on that precarious element1 and the advantages we reap from their toil1 the common feelings of human society1 must awake and remind us1 not only how much we are obliged as social members1 even from a motive of self interest1 to study their preservation1 but as fellow creatures1 how forcibly our duty calls us to give them every aid in our power1 and to lighten the burthen of their many toils4 ,a ship at sea may be considered as a floating kingdom2 and the subjects1 however few in number1 are not only liable to the same accidents as those on shore1 but to many more1 peculiar to that precarious and fluctuating element that surrounds them4 ,for this reason there are many things requisite to be known by the mariners besides the art of conducting a ship from port to port4 ,of all the various knowledges that distinguish the human species from the brute creation1 what is of more value than that which tends to the preservation of life and health8 ,i believe that every man who is actuated by motives of philanthropy will with me wish1 that mankind in general would advert more to it in the principles of education1 than what they at present do4 ,indeed it is astonishing that so valuable an acquisition1 as to have some knowledge of the body we possess1 and its preservation1 should be so totally neglected1 as to be entirely excluded from education2 an acquisition that not only enlivens the mind1 but in itself is so very essential to our existence2 yet what is more to be wondered at1 is1 that a seaman who launches into the main ocean1 is cut off from every assistance1 in case of an accident or sickness1 and rendered wholly unable to give the least aid to himself1 or those who are entrusted to his care4 ,large ships ,i own are exempt from this observation3 but are not the lives of men on board of small ships equally as valuable1 and worth preserving1 as those of greater burthen8 ,i am not the first who has had the welfare of seamen at heart2 various writers1 and men of abilities too1 have presented the world with observations1 that undoubtedly have proved beneficial to that class of men2 but then these books were neither intended1 nor fit to be put into the hands of such seamen1 as actually stand most in need of those very observations they have made1 and only intended for the perusal of men of physical talents2 nevertheless they merit for their labour public thanks1 as useful members of society4 ,but if we take an impartial view of the number of seamen1 ,i believe the greatest part are employed in small ships1 that either carry no surgeon1 or 7,i am sorry to say it7 sometimes one they had better be without2 especially in war time1 when they stand most in need of a good one4 ,to benefit these men1 and at the same time to make that benefit universal1 is the plan ,i have aimed at2 and ,i believe this is the first attempt of the kind2 at least ,i know of none whose steps ,i have followed in this design4 ,should ,i ask physical writers why they have neglected so valuable a part of society as seamen1 in giving them their friendly instructions respecting their health1 ,i doubt not1 but the majority would reply1 that the education of masters of ships and seamen in general1 has not enabled them to understand a subject so much above their comprehension1 or sphere4 ,but if seamen have not the advantage of an extensive education1 are they divested therefore of common sense and understanding8 and is it not possible to deliver them instructions1 dressed in so plain a language as to adapt it to their capacity8 ,nevertheless1 though men of abilities have not thought seamen worth their pen1 others have2 but such whose pursuit in life has been stimulated by motives of a different cast4 ,those have furnished seamen not only with directions to cure all diseases1 but even given them medicines to do it with1 into the bargain2 or to speak more seriously1 given them directions how to use such medicines as would yield the most profit to the apothecary1 who with pretended wisdom equipt them out3 and ,i am apt to think1 that kind of quackery has stolen away the lives of many valuable seamen4 ,it is universally asserted that seamen are not fond of reading2 this in a great measure is true1 but far from being a general rule2 and though blind prejudice has given them an aversion to every thing physical1 yet ,i will venture to say so much in their behalf1 that hitherto nothing has been offered to them that could alter their opinion in this respect1 or open their eyes1 in shewing them the beauties of that useful study1 and in how small a compass its true principles might be contained4 ,physic like religion is rendered intricate and abstruse1 the more it abounds in errors and absurdities2 but truth like the brilliant sun1 drives away all the phantoms of perplext mysteries1 and proves that both alike are simple and beautiful1 founded on reason1 and that its most useful part is comprehensive to common understanding4 ,this pleads in favour of my attempt1 and with every man of sense1 must overpower prejudice4 ,that ,i might the better succeed in my intention1 ,i have begun the whole at the first principles1 namely the mechanism of the human body2 for ,i cannot see how any man can pretend to know the nature of diseases1 or presume to administer any thing with certainty1 without he has some knowledge of the parts that suffer3 this then is the subject of my first lecture2 and to make it the more pleasing1 and to entice the reader to pursue1 ,i have stript it of every thing pedantic1 or the unnecessary perplexing particulars1 and confined myself to such things only1 as gives a concise and true idea of the whole animal system2 and if ,i may be allowed to judge from the opinion of some of my learned friends1 ,i flatter myself1 that my readers1 physical or not1 will give me their sanction1 as well with respect to plainness of language1 as conciseness of the subject1 and the utility of such a short dissertation1 founded on experience1 and stript of prejudice and errors4 ,the second lecture contains equally as copious a subject as the first2 contracted in a very small compass1 and which ,i hope will give as much satisfaction as the forementioned4 ,out of the whole ,materia ,medica1 ,i have chosen but very few medicines1 and these ,i have confined myself to throughout the whole book4 ,many surgeons at sea will not1 ,i know1 be contented with so small an assortment2 and ,i remember the time that such an observation might have been applicable to myself2 but as ,i have by long experience learned to shake off prejudices1 and been taught by the help of philosophy to pry into the nature of things in general1 ,i solemnly declare1 that now1 ,i would venture to go to any part of the globe1 not only with that little assortment of medicines ,i have mentioned1 but even with many less4 ,the emetick tartar1 sublimate mercury and the bark are powerful medicines2 but they should be in very skillful hands1 otherwise they are rank poisons1 and therefore ,i have omitted them here2 but strictly speaking1 every good medicine is the same4 ,i have two maxims in physic1 which ,i strictly attend to2 one is1 that to my friends ,i give the least medicines2 the other is1 that the principal virtue of a medicine depends on its application4 ,the form of the medicine box1 ,i have constructed so as it appears to me most convenient and handy2 and every kind of medicine1 ,i would advise to have labeled with their proper names1 as well as with another mark that may take the eye at first sight2 and the more to prevent mistake1 one label should be fixt on the pot that contains the medicine1 and the other on the box3 for in medicines too much caution cannot be used4 ,one thing with respect to the medicines1 ,i have omitted1 and that is their quantity requisite for the box1 and their prices3 ,i intended to have taken notice of this1 but found that that could not with exactness be ascertained1 unless entering into another subject1 and that would take off from the conciseness of my plan4 ,as ,i have however many other things respecting the benefit of seamen to offer1 peculiarly respecting distant climates1 ,i shall take notice of this1 where it may come in1 more pertinently to the subject3 till then1 that must be left to the management of the apothecary who is applied to for fitting out the box4 ,if he is a man of candour and judgment he cannot be much out of his calculation1 when he knows the number of hands1 and the voyage intended4 ,with respect to the other lectures1 ,i have1 as near as it was practicable1 divided them into their different classes and sections2 at the same time the whole is so linked together1 that one lecture must support the other4 ,and as ,i have throughout the whole course of the book differed more or less from the general mode of practice1 ,i must hereby declare1 that ,i have in this consulted my own experience more than any other authority1 without fear of censure1 or hope of applause1 any farther than of truth1 and my own conscience4 ,though ,i have principally written with an intent to be understood by masters of ships who carry no surgeon2 yet ,i am well persuaded that every practitioner1 whether on sea or shore1 will find many things to his improvement4 ,with respect to my receipts1 they are simple and powerful2 yet ,i do not enjoin so strict a conformity to them1 by the practitioner1 who has an extensive knowledge of the materia medica1 and is prepossessed in favour of some particular medicines2 but as he will discover my indications1 it may serve greatly to compare that of mine with his own1 and then he may judge for himself4 ,i have touched very slightly on the requisite diet for patients on board a ship2 though this is an essential article regarding health in general3 ,but ,i found that subject also of so very extensive a kind1 that it would swell the book2 but as ,i have many valuable things to offer of the same nature1 ,i must beg1 that in the mean time1 the reader will be satisfied with the universal observations in general2 namely1 that temperance is the principal object and that patients who are deprived of exercise ought to have the most easy digesting food4 ,copper and lead are pernicious2 but iron and earthen ware are safest either on sea or shore4 ,in order to render the book as useful as my zeal has intended1 ,i recommend it a fair perusal1 from the first page to the last2 a book of this nature is apt to be looked into1 only when advice is wanted3 that method is wrong2 and in such a case1 the best book in the world is apt to mislead4 ,it is not enough that we know what we are to do with such and such disorders1 but we should previously know what the disorder is2 and how shall we know that1 without having some idea of the evil before it comes on8 ,a book of this size is soon perused2 taking a lecture or a section at a leisure time on board1 will soon send the reader through the whole2 and ,i flatter myself1 that one perusal will lead to the second1 when then it may be referred to for advice with safety2 and ,i hope a study so essential to self-preservation1 will be viewed in a more agreeable light1 than it has hitherto been4 ,to compleat the whole1 a copper-plate is annexed1 wherein the most material utensils are exhibited1 which was scarce capable to be explained by bare description1 to men unacquainted with surgery4 ,to conclude1 ,i must beg leave to observe1 that the respect and esteem1 with which ,i have been constantly honoured by every worthy seaman1 whose life and health were committed to my care1 have ,i confess1 stimulated my endeavours1 to offer them this book as a grateful return4 ,and ,i am happy to reflect1 that my experience in life enables me to make it worth their acceptance4 ,may they reap that benefit from it1 which my heart has intended them2 and this is all the reward ,i wish to obtain4 ,n4 ,d4 ,,falck4 ---------------------------------------- -------------------------------- ,,errata4#a ,page #e4 line #bb4 for cataplexy1 read apoplexy4 ,page #f4 line #af4 read1 that a pressure on that part1 not only occasions an apoplexy1 but even stops life itself4 ,page #bf4 line #ag4 for theirs1 read thus4 ,page #ce4 for ,sect4 vii4 read viii4 and following ix4 x4 ,page #fa4 line #d4 for five or six1 read about four or five4 ,line #ba4 for iniform1 read inform4 ,page #ia4 line #ah4 read1 in order to get into4 ,page #aca4 line #bi4 for purify1 read putrefy4 ,page #ace4 line #ab4 delete them4 ,page #adb4 line #b4 from the bottom1 read1 and is a sufficient4 ,page #aeh4 line #f4 for malignitus1 read malignities4 ,page #bci4 line #g4 read1 the patient when not able to crawl to the tub1 so revived c4 ,footnote #a3 ,these errors have been corrected for this ebook 7,may1 #bjai74 ------------------------------------ ,to the ,,binder4 ,the ,copper-,plate and its ,explanation are to be placed at the ,end of the ,book4 ---------------------------------------- -------------------------------- ,,the ,,contents4 ------------------------------------ ,,lecture ,i4 ,an anatomical and physiological description of the human body ,,sect4 ,i4 ,of the composition #b and close connection of parts in the human body ,,sect4 ,,ii4 ,of the brains and #e nerves ,,sect4 ,,iii4 ,of the heart and #i lungs ,,sect4 ,,iv4 ,of the circulation #ab of the blood ,,sect4 ,v4 ,of the joint #ae connection of the brains1 heart1 lungs1 c4 ,,sect4 ,,vi4 ,of chylifaction1 #ai and nutrition ,,sect4 ,,vii4 ,of the bones1 #bh muscles1 ligaments1 tendons and their connection4 ,a skeleton of the #ca human body ,,sect4 ,of the urinary #ce ,,viii4 organs and genital parts ,,sect4 ,,ix4 ,of the skin #dj ,,sect4 ,x4 ,of the external #dc senses ------------------------------------ ,,lecture ,,ii4 ,on the requisite means and medicines towards restoring health4 ,,sect4 ,i4 ,of the pulse #ej ,,sect4 ,,ii4 ,of the effects of #ee bleeding ,,sect4 ,,iii4 ,of the operation of #eh bleeding ,,sect4 ,,iv4 ,of the requisite #fc medicines useful at sea ,a plan of a #hd medicine box--#fd4 ,of utensils1 and medicines--#fe4 ,lancets1 ibid4 scissars1 probe1 spatula--#ff4 ,bistouries1 and incision lancets1 teeth instruments1 syringes--#fg4 ,clyster pipes and bladders1 clyster syringe1 scales and weights--#fh4 ,splints--#fi4 ,bandages1 rags1 tow1 lint1 tape1 needles1 thread and pins--#gj4 ,camomile flowers1 balm1 sage1 sassafrass--#ga4 ,oatmeal1 cinamon1 allum1 chalk--#gb4 ,salts1 diachylon plaister--#gc4 ,mercurial plaister1 blistering plaister--#gd4 ,spirits of wine and camphire--#ge4 ,liniment of soap1 sweet oil1 sweet spirit of nitre--#gf4 ,honey1 yellow basilicon2 elixir of vitriol--#gg4 ,elixir proprietatis1 lenitive electuary--#gh4 ,turner's ,cerate1 fever powders1 stomachic powder--#gi4 ,calomel--#hj4 ,precipitate--#ha4 ,mercurial ointment--#hb4 ,rhubarb1 jalap1 ipecacuanha1 liquid laudanum--#hc4 ,essential oil of peppermint1 ,turlington's balsam ------------------------------------ ,,lecture ,,iii4 ,on accidents1 and their proper method of treatment ,,sect4 ,i4 ,of falls #hi ,,sect4 ,,ii4 ,of wounds--#ia4 ,cut #ib wounds bruised wounds--#id4 #if ,gun-shot wounds ,,sect4 ,,iii4 ,of bruises #ih ,,sect4 ,,iv4 ,of dislocations #ii ,dislocation of the #aja arm with the shoulder ,dislocation of the #ajc elbow or the knee ,of spraining the #ajc wrist1 or ancle ,dislocation of the #ajd thigh bone ,,sect4 ,v4 ,of fractures #ajg ,a fracture of the #ajh skull ,fracture of the #aji arm ,a fracture of the #aaj thigh bone ,a fractured leg #aaa ,compound fractures #aad ,conclusive #aae observations on fractures ,,sect4 ,,vi4 ,of scalding #aah ,,sect4 ,,vii4 ,of burning #aai ,,sect4 ,of drowning #abj ,,viii4 ,the method to #abc recover a drowned person ------------------------------------ ,,lecture ,,iv4 ,on external diseases1 and their cure ,,sect4 ,i4 ,of inflammation #acj ,of resolution #acb ,of suppuration #acc ,of tumours #acd ,of mortification ibid4 ,,sect4 ,,ii4 ,of ulcerations #acg ,,sect4 ,,iii4 ,of the diseases of #adb the skin ,of the itch ibid4 ,of boils #add ,of ring-worms1 #ade daw-worms1 c4 c4 ,of the lousy ibid4 disease ,,sect4 ,,iv4 ,of promiscuous #adh disorders ,of the tooth-ach #adi ,to draw a tooth ibid4 ,of sore eyes #aeb ,of the ear-ach #aec ,of hoarseness and #aed sore throat ,,sect4 ,v4 ,of the venereal #aef disease ,of the gonorrha #aeg ,of the phimosis and #aeh paraphimosis ,of the chordee1 and #aei priapism ,of the dysuria ibid4 ,of shankers #afj ,of the bubo #afa ,of swelled #afb testicles ,of venereal #afc excrescences ,of the second #afd infection ,,sect4 ,,vi4 ,of the bite of #aff venomous animals ,to cure the bite of #afg a rattle snake ,,sect4 ,,vii4 ,of the bite of a #agj mad dog ,the signs of a mad #aga dog ,the effect of a #agb bite of a mad dog ,of the cure of the #agc bite of a mad dog ------------------------------------ ,,lecture ,v4 ,of fevers and inflammatory diseases1 and their proper method of treatment ,,sect4 ,i4 ,of fevers in #ahb general ,,sect4 ,,ii4 ,of accidental #ahd fevers ,,sect4 ,,iii4 ,of a cold #aib ,,sect4 ,,iv4 ,of intermitting #aic fevers1 and agues ,,sect4 ,v4 ,of putrid and #bjc malignant fever ------------------------------------ ,,lecture ,,vi4 ,of the various internal diseases1 and their method of cure ,,sect4 ,i4 ,of diseases of the #bjh head1 of the apoplexy ,of the phrenzy and #baj delirium ,of a stupor and #baa lethargy ,of a violent #bac head-ach ,,sect4 ,,ii4 ,of diseases of the #bad neck ,of the malignant ibid4 sore throat ,,sect4 ,,iii4 ,of diseases in the #bai breast ,of the cough ibid4 ,of the pleurisy1 #bba and a peripneumony ,,sect4 ,,iv4 ,of diseases of the #bbd bowels1 and the alimentary canal4 ,of a ,depraved #bbe ,appetite ,of the ,colic #bbh ,of looseness1 and #bcj bloody flux ,,sect4 ,v4 ,of the ,scurvy #bcc ---------------------------------------- -------------------------------- ,,lecture ,i4 ,,an ,anatomical and ,physiological ,description ,,of ,,the ,,human ,,body4 ---------------------------------------- --- ,the mechanism of the human body is so wonderfully1 so curiously1 and so wisely contrived1 that the more we examine it1 the more we must with admiration acknowledge1 that nothing but an ,,almighty ,,being could be its author4 ,this incomprehensible ,,being let us ever remember to reverence and adore1 when we examine into the stupendous contrivance of our fabric2 ,,he is the fountain1 the benevolent upholder of nature1 and all the creation2 in whom we live1 breathe1 and have our being4 ---------------------------------------- --- ,,sect4 ,i4 ,of the ,composition and close ,connection of ,parts in the ,human ,body4 ,the human body is composed of solids and fluids2 these are so closely1 and so intimately combined with each other1 that we find upon a physical enquiry and examination1 they are scarce separable4 ,they aid and give action to each other1 and life depends not on each singly1 but on the united1 and on the separate spur1 and on the soul of activity each gives to the other3 ,their substances form the body1 and their action produces the operation of the mind4 ,whilst every thing moves free and agreeable to the talk prescribed by nature1 the automaton is in a state of health2 body and mind enjoy peace and tranquility4 ,so closely are body and mind in the most perfect bond of friendship1 that they share pleasure and pain sympathetically with each other2 and reciprocally contribute to each other's welfare4 ,with what satisfaction is the mind continually engaged to give pleasure to the body6 and with what alacrity are for ever the ,members ready to obey the will6 ,happy harmony1 by which we so wonderfully exist6 ,the solids are the canals and springs of life1 and the fluids1 which circulate in those canals1 nourish them1 and set the springs in action4 ,by the solids we understand1 #ast ,the bones2 the frame and support of our wonderful structure4 #b;dly4 ,gristles or cartilages2 which cover the ends of the bones1 in order to make them move with ease and agility4 #c;dly4 ,muscles2 the fleshy parts1 which by a nervous sensation1 are induced1 either voluntarily or involuntarily1 to contract or dilate themselves1 in order to give motion to the various parts of our body1 to which they are fastened or destined to move4 #dthly4 ,tendons2 the chords as it were1 by which the muscles are fastened to the bones1 so as to make them follow the contraction of the muscles4 #ethly4 ,ligaments2 the chords by which the bones are connected with each other1 and which give a firmness to their contact and articulation4 #fthly4 ,arteries2 the canals which transport the blood from the heart1 to all the parts of the body4 #gthly4 ,veins2 the canals which carry the blood from the remotest arteries 7in the most minute parts of the body7 back again to the heart1 for a new rotation of the blood4 #hthly4 ,lymphatic ,vessels2 which are small cellular canals1 that convey the lymph in different parts of the body4 #ithly4 ,glands2 which are kernels formed to secrete or separate various humours from the blood4 #ajthly4 ,nerves2 these are medullary branches springing from the brain1 and distributed in the most minute parts of the body2 ordained to give the act of sensation1 as the soul of animal activity4 #aathly4 ,hair and nails2 these are a horny substance1 and appropriated either for defence or warmth of the different parts where they are placed4 ,the fluids2 are1 #ast4 ,blood2 which is circulated in the arteries and veins1 and is the nutriment and source of life4 #b;dly4 ,the different humours separated by the glands from the blood2 of which there are many1 as the lymph1 serum1 spittle1 seed1 chyle1 urine1 gall1 c4 appropriated to different uses1 as hereafter will be described4 #c;dly4 ,fat1 and marrow in the bones2 which are designed not only as a store of nourishment1 but to lubricate and warm the parts where they are lodged4 ,these are the principal materials which compose our wonderful machine4 ,there are various other parts mentioned by ,anatomists1 both solids and fluids2 but as this is designed only to give a universal idea of the most material parts of the structure of this stupendous fabric1 we will let this definition suffice1 and now consider with what order the principal organs of life act1 either in consort1 or in opposition to each other4 ---------------------------------------- --- ,,sect4 ,,ii4 ,of the ,brains and ,nerves4 ,the brains are by all ,physiologists esteemed the most mysterious organs of life1 being the fountain of the nerves1 the organs of sensation1 and hence allowed by all to be the seat of the soul1 or the sanctum sanctorum of the human understanding4 ,they are distinguished into the common or great brain called cerebrum2 the small part called cerebellum2 and the spinal marrow1 which projects down the back-bone4 ,the great brain is divided into two great lobes1 seated in the upper and fore part of the skull1 of which it takes in the greatest cavity4 ,it is so exceedingly sensible1 that the least pressure puts an immediate stop to the sensation of the animal2 and which is generally termed a apoplexy4#b ,footnote #b3 ,hence in a fracture of the skull1 or any other heavy contusion1 where the brain is compressed either by the fractured bone1 or the extravasated blood1 the patient will remain in a state of stupefaction1 till either the fracture is reduced1 or the extravasated blood removed by trepannation2 after which he immediately comes to himself1 as if suddenly revived from a trance4 ,this part of the brain1 though it is so exquisitely sensible1 seems to be designed by nature as preparatory to the cerebellum1 the immediate root of the nerves4 ,the cerebellum is the lesser1 but the more material part of the brains4 ,it is seated in the hinder cavity of the skull1 7which for the sake of protecting this exquisite sensible organ1 is remarkably strong and firm7 and from thence as the fountain of life itself1 the nerves1 the instruments of sensation in the whole animal frame1 take their commencement3 ,for whereas the other is so sensible1 as that the least pressure will cause a stupor2 this is so far superior in point of exquisite sensibility1 that a pressure on that part1 not only occasions an apoplexy1 but even stops life itself4 ,from this cerebellum prolongates the marrow in the back-bone1 called medulla spinalis1 which is but a continuation of the same1 and is equally sensible1 and of the same substance with the former4 ,the whole brain1 that is1 the great brain1 the small brain1 spinal marrow1 together with all the nerves which spring from thence1 are covered with two coats1 called the external stronger coat1 dura mater2 and the thinner and inner coat1 pia mater2 which continue with each nerve1 even to its smallest ramification4 ,the whole in a living subject is in a continual motion peculiar to itself4#c ,footnote #c3 ,this motion in the brain is not unlike the peristaltic motion2 this is an observation too seldom taken notice of by anatomists1 though evidently plain in living animals1 and is of singular service in physiological enquiries4 ,from the cerebellum1 and medulla spinalis1 all the nerves take their commencement and origin4 ,ten pair spring forth from the part in the skull2 the principal are those which form the various senses1 tasting1 smelling1 hearing1 and seeing1 and that common to all1 feeling4 ,from the medulla spinalis1 or marrow in the back-bone1 proceed thirty pair of nerves1 which spread themselves variously over the whole system4 ,all nerves have this in common with each other1 namely1 exquisite sensibility2 but in other respects they differ however widely2 particularly the nerves destined for some of the external senses4 ,it is from that common quality feeling1 that they become the subtile springs of life2 and give an edge to all the animal functions4 ,there is nothing so plentifully1 and nothing more curiously interwoven with every other substance1 as the nerves2 and so amazingly quick is their sensation1 that the very instant a single nerve1 even the smallest and remotest in the system1 is affected1 the soul1 or the common sensorium1 is sensible of the identical part so affected4 ,it has been asserted1 that this amazing quick conveyance of the sensation of the nerves1 is owing to a subtile nervous fluid2 but on a rational reflection1 and a just enquiry into the animal conomy1 it must appear1 that such conveyance of a fluid is inconsistent with probability and experience3 ,for1 neither are the nerves tubulous1 nor has there ever been discovered any circulating humour in them4 ,and secondly1 is it consistent with reason1 that a conveyance of a fluid from the toe to the finger1 should be so momentarily quick1 as is sometimes experienced in the gout1 and other the like ailments8 ,that the quick transposition of sensation of the nerves1 is rather effected on a principle of vibration1 appears more probable1 and will admit of a more convincing experiment2 which may be exemplified in the following manner3 ,suppose 7in the language of a seaman7 a rope runs from the top-mast-head1 or any other part of the rigging1 to the deck1 and is kept tought and free from any interception2 then it will be evident1 that the least touch at one end will instantaneously be conveyed to the other end2 in like manner the nervous sensation may be communicated1 perhaps not unlike electricity2 which similarly will in an instant be conveyed to any part1 by a direct communication1 but equally subject to be intercepted4 ,hence1 a paralytic limb will lose1 together with its irritable sensibility1 its circulation of fluids1 and its nourishment2 and recover again when the pressure or interruption is ceased4 ,hence also1 spasmodic contractions will be affected at the irritation of some principal parts1 and from this instantaneous irritability1 the motion of every part is thought to obey the will4 ---------------------------------------- --- ,,sect4 ,,iii4 ,of the ,heart and ,lungs4 ,the heart is a muscular body1 situated in the breast or chest1 somewhat between the lobes of the lungs1 and formed by nature to be the principal organ for the circulation of the blood and other fluids4 ,its structure is wonderful1 and of a most curious piece of mechanism4 ,it has two principal cavities1 called ventricles1 which are separated length-ways by a wall1 and distinguished into the right and left4#d ,footnote #d3 ,they might with equal propriety1 be termed anterior1 or foremost1 and posterior or hindermost4 ,each of these cavities or ventricles1 have particular valves1 call'd ears1 or auricles2 which perform the function somewhat similar to the suckers of a pump3 ,by these contrivances the heart receives the blood from the veins1 and expels it again by the arteries1 to every part of the human body2 in a manner that ,i shall hereafter describe4 ,the lungs are organs immediately concerned in the circulation of the blood also2 their function is to receive the air1 to purify it1 to circulate1 and to distribute it in due proportion in the sanguineous mass1 and to extract and expel that part of air already made use of2 and thus act the part of ventilators in the animal conomy4 ,they are divided into two lobes4 ,these lobes are a continuation of little bladders1 that have an immediate continuation with the wind-pipe1 aspera arteria4 ,the wind-pipe from the larynx down to the very lungs1 is protected externally with semicircular gristles1 in order to keep it always open1 and so shelter it from external injury2 when it enters the lungs it spreads itself into numberless branches like a tree1 and sends ramifications into every little air-bladder in the lungs4 ,all along these ramifications and the air-bladders1 are arteries1 veins1 and lymphatic vessels1 which have an immediate communication with the heart1 by means of the pulmonary arteries and veins4 ,now at the instant of inspiration1 these little bladders in the lungs are filled with air1 which infuses itself by the small arteries into the whole mass of blood2 and at the expiration again1 the air which has been made use of1 and drawn from the neighbouring little veins1 is again expelled by the wind-pipe through the mouth3 ,and thus is respiration performed by alternate motions of the lungs2 receiving the fresh1 and alternately expelling the foul air again2 thence justly may they be deemed the ventilators of the human automaton1 and a principal organ of life1 in the animal creation in general4 ,the upper part of the wind-pipe1 which is in the fauces of the mouth1 is called the larynx4 ,this is the organ of voice4 ,in this animal mechanism is contained1 all the variety of formation requisite to every kind of sound that can be performed upon any instrument whatever4 ,its parts are chiefly of a gristly substance1 at the same time exquisitely delicate1 with nerves and glands2 from whence it is subject to diseases on the slightest indisposition4 ,in men it is larger than in women2 hence their voice is rougher2 which generally increases by exercise of the voice also4 ,its formation is very complex1 and too tedious here to enter upon2 we will therefore pass it over1 and hereafter say as much as relates to its preservation1 and giving it relief when disordered4 ---------------------------------------- --- ,,sect4 ,,iv4 ,of the ,circulation of the ,blood4 ,we shall now consider the circulation of the blood2 the grand source of our existence4 ,at the contemplation of which we must be lost in admiration1 at the wonderful wisdom of its contrivance2 and with uplifted eyes adore the cause of its motion6 ,the ,heart1 as ,i before observed1 has two chambers or ventricles1 distinguished by the right and left2 each of these chambers have also a valvular cavity call'd auricle1 or ear4 ,each ventricle opens itself into an artery and auricle2 and each auricle opens itself into a ventricle and vein4 ,these openings have valves1 which open and shut alternately1 and by this1 prevent any confusion or hindrance in the influx and efflux of the blood4 ,the right ventricle is the longest and greatest1 but weakest3 ,from this ventricle springs forth the pulmonary artery1 which spreads itself throughout the ,lungs4 ,the right auricle is also the largest2 in which opens itself the large vein1 called vena cava2 as the common trunk that receives the blood from all its branches spread over the whole human body4 ,the left ventricle is shorter1 but the walls are considerably stronger than that of the right ventricle4 ,here begins the aorta1 or the great artery1 by which the blood is sent to all the parts of the human body4 ,the left auricle is also somewhat smaller than the right2 and in that opens itself the pulmonary vein1 which returns the blood from the lungs1 after it has received its necessary assistance from the vesicles of air in the lungs4 ,this premised and understood1 the circulation is performed in the following manner3 ,the right ventricle being full of blood1 contracts itself4 ,this contraction is called the systole1 by which it forces the blood through the pulmonary artery into every part of the lungs1 even into every vesicle2 where it receives a portion of the air1 drawn in by the wind-pipe4 ,at the end of these arteries join the ramifications of the pulmonary vein1 which receives the blood from the ramifications of the arteries1 by anastomosation2 which1 by little quantities1 these veins gather gradually into little branches1 and at last become one common trunk1 which empties the blood into the left auricle of the heart4 ,from the left auricle it is let1 by means of a peculiar constructed valve1 into the left ventricle2 which1 by a dilation called the diastole1 receives it from its auricle4 ,immediately upon this reception1 the systole or contraction takes place1 and the blood is forced into the great universal artery1 aorta2 by which it is farther transported into every part of the human body4 ,this artery spreads as it goes1 and continually decreases in magnitude1 as it becomes numerous in branches2 until it terminates into the smallest ramification in the remotest part of the body4 ,the systolic contraction1 and the diastolic dilation1 which alternately take place in the heart1 continue throughout the arteries from the great trunk to the remotest capillary ramifications1#e by which means the blood is transported with more certainty and facility to the minutest part4 ,footnote #e3 ,concerning this great act of continued systole and diastole1 ,anatomists have greatly varied2 but from the structure of the arteries1 and the continued pulsation1 this way of transporting the blood is confirmed both by reason and experience4 ,at the extremity of these arteries the veins take their commencement1 in ramifications equally small with the former2 these take up the blood from the arteries1 by many infinite small quantities1 and carry it gradually back from those extremities to the heart again1 for a new rotation4 ,these veins commencing infinitely small1 but gradually gathering1 become branches1 and at length form one general trunk1 called the vena cava1 7or the great universal vein72 and this empties itself again into the right auricle2 from whence it is let again into the right ventricle1 whence it came2 then again forced into the lungs2 thence back again into the left ventricle2 from thence all over the whole body1 and continues the ,circulation4 ---------------------------------------- --- ,,sect4 ,v4 ,of the ,joint ,connection of the ,brain1 ,heart1 ,lungs1 c4 ,these are the principal actions in the grand movement of the human automaton4 ,the nerves are the subtile springs of the sensation1 by which the whole becomes sensible of irritation1 and agitated to its functions4 ,their ramifications are extended ad infinitum1 and so curiously distributed1 that though there is not a part in the whole system exempt from their spreading1 yet they are distributed with such regularity1 that they don't interfere with each other4 ,a regularity absolutely requisite to the order in the animal conomy3 ,for whereever the vibration of the nerves is obstructed1 life or motion must in consequence cease4 ,the lungs are the ventilators in the system3 they receive and let in the air2 they sift it from all its gross particles1 and extract the useful parts from this universal element of life2 thus they give from every little vesicle1 a due proportion of extracted air to the blood by the adjacent veins2 and by the neighbouring arteries1 again extract the foul air from the circulated blood1 which by the mouth and nostrils is expelled again2 at that instant a fresh quantity of air is drawn in again for a new supply4 ,thus by intervals1 the lungs1 like a perfect ventilatory machine1 repeatedly1 and without intermission1 keep time with systolic and diastolic motions of the heart1 in exchanging fresh and foul air for the support of this wonderful animal structure4 ,this is the function of breathing respiration1 namely inspiration1 or the drawing in the fresh air2 and expiration1 the expelling the foul air4 ,the heart may be considered as the grand perpetual pumping engine1 constructed on principles1 so as to have the least friction possible4 ,this curious pump1 the heart1 sends the fluid of life1 the blood1 to all the parts1 even the remotest in the whole machine4 ,the arteries are the canals of the conveyance2 they are strong elastic tubes1 whose fibres are of spiral direction1 and receive from the heart a power of contraction2 which is continued from the heart in the moment of the systole1 even to the remotest and most minute ramifications2 by which the blood is pushed along to the minutest extremities4 ,this is immediately succeeded with a diastolic reception of a fresh quantity of blood2 so that on succession1 the diastole and systole is perpetuated not only in the heart1 but throughout all the arteries1 in a friendly correspondence over the whole system3 ,and this constitutes the pulse4 ,the veins1 however1 are somewhat of a different texture from the arteries2 whilst the arteries transport the blood by an elastic and pulse-like contraction1 the veins on the contrary1 receive it from them at the extremities1 in an easy and imperceptible gradation2 for whereas the fibres in the arteries are in a spiral direction1 elastic and strong1 the coat of the veins are tender1 and the fibres more longitudinal4 ,hence1 the wounds in the arteries and veins differ greatly2 for whilst the arteries are for ever in a strong agitation1 the veins perform their functions with less exercise2 and therefore the wounds in arteries are always attended with danger1 whilst the veins heal easy4 ,from the same reason also1 the arterial blood differs from the venal2 for as the arterial blood is sent to all the ,parts1 as the grand nutriment1 from whence the glands secrete their peculiar humours2 the veins only transport it back again1 to prepare it for a new rotation4 ,whence the blood in the arteries is of a high colour1 and of a more alkalascent nature1 than that in the veins4 ,collateral with the minute ramifications of the veins and arteries1 over the whole system1 are the lymphatic vessels1 which separate from the blood as it passes along1 a transparent lymphatic humour1 adapted for the different parts1 which they are connected with4#f ,these vessels are materially different1 from either arteries and veins in their structure1 and justly to be compared to a continuation of little cells2 so constructed1 as to transport the humours1 without admitting a return4 ,footnote #f3 ,an opinion has lately been broached1 that the lymphatics are all absorbing vessels1 of the same nature with the lacteals1 and that they all join to empty themselves in the subclavian vein to the common mass of the blood2 but this to me1 seems too general1 and contradicts experience4 ,from hence we see plainly how these three organs1 the brains1 the lungs1 and the heart1 are concerned1 and mutually assist each other in the actions1 and circulation of the fluid of life2 nothing could move without the sensation of the nerves2 these could not exist without the blood1 from which they receive their support2 the blood could not circulate without the heart1 arteries1 and veins2 and in them it could not move with a necessary freedom1 except its being supplied with a sufficiency of air from the lungs3 ,so that evidently all three are so interested in this grand movement1 that the stopping of the one1 must needs be the stopping of the whole4 ---------------------------------------- --- ,,sect4 ,,vi4 ,of ,chylifaction and ,nutrition4 ,in the preceding we have briefly considered the state of the fluid of life1 and mechanical instruments of their motion in the human machine4 ,in this we will consider how the whole is supported1 and the vital lamp1 from time to time1 becomes supplied4 ,under this consideration we will examine the canal of food1 and the various changes the morsel undergoes from the time we take it in our mouths1 till the nutriment is reduced to blood1 and the remaining dross is expelled the body as useless4 ,the animal functions towards chylifaction and nutrition1 are mastication1 or chewing the food2 deglutition1 or swallowing2 digestion2 chylifaction2 nutrition2 and the excretion of the fces4 ,in order therefore to understand this clearly1 it becomes necessary to describe the organs which nature has formed for the requisite performances thereof4 ,in the first place then1 smelling is that sensation which nature has given to every animal1 that has a choice of food1 as the first safe-guard to inform it of any thing agreeable or disagreeable1 useful or pernicious to its body2 its seat is in the nose chiefly1 but we find by experience1 that it has a friendly connection with our palate and stomach2 for the effluvia of any thing will either create a desire1 or give us the greatest aversion to every substance that throws out a flavour4 ,it is performed by means of a subtile spreading of nerves1 peculiarly delicate2 which continues through the membrane of the nose1 the roof of the mouth1 gullet1 and the very stomach4 ,taste is the next sensation1 which nature has given us1 not only as a distinguisher of proper food1 but a sensation from which we receive many luxurious pleasures2 and to the indulgence of this sensation1 most evils and plagues to mankind1 take their origin4 ,the tongue is the principal instrument of that peculiar quality2 but if we examine somewhat closer into this affair1 we shall find that the soul of pleasure and pain of that sensation1 as well as that of smelling1 has its seat in the stomach2 for that which will taste pleasing and good at the first approach1 will soon lose its relish when the stomach is gratified3 and1 if any thing tastes disagreeable1 the stomach receives it with reluctance1 and will ever incline to discharge it again4 ,the tongue is an instrument 7if ,i may be allowed the term7 very curiously constructed2 it is moved by a variety of muscles1 and serves not only for tasting1 but also as a labourer1 to shovel and to turn our meat between our grinders2 so that nothing may escape being well masticated1 and intermixed with that fine digesting balsam1 the spittle1 in order that it may be easily swallowed4 ,besides this1 it makes the most requisite instrument for the noble and excellent faculty of speaking2 which forms one of the principal characteristics that distinguishes man from the brute creation4 ,the gullet or oesophagus1 is the canal which conveys drink and food from the mouth to the stomach2 this canal is a muscular1 tendinous1 and vascular tunic4 ,the commencement of it is in the mouth1 and is called the pharynx2 a curious structure1 that receives the food1 and by its contractive motion1 and the help of the tongue1 forces the aliment into the stomach4 ,the stomach is much like the bag of a ,scotch bag-pipe2 it lies immediately under the diaphragm or midriff1 covered partly on the right side with the liver1 and on the left side with the spleen4 ,the left and superior part1 is continued with the oesophagus2 and the right and inferior part1 or orifice1 commences the intestines4 ,the first orifice is called the mouth of the stomach2 and the second the pylorus1 or porter3 ,at the porter there is a curious valve which lets the aliment out by small parcels into the intestines1 where it undergoes its various other changes4 ,the stomach has three teguments1 a muscular1 a tendinous1 and nervous coat2 this nervous coat has another slimy one1 but this in reality1 is a delicate lining1 interwoven with nerves1 and the ramifications of fine blood vessels4 ,the intestines or guts1 are a continuation of the stomach1 they are a canal which is generally reckoned six times as long as the subject it is taken from2 it is distinguished in small tenuia1 and wide crassa4 ,each again is divided into three parts3 the tenuia1 or small narrow intestines1 are the duodenum1 or twelve finger-gut2 the jejunum2 the ileum3 ,the wide or crassa1 is divided into the ccum2 the colon2 and the rectum4 ,throughout the whole canal of intestines are numbers of little vessels1 called lacteals1 which lead the chyle1 extracted from the aliment1 into a receptacle1 which is lodged in the mesentery1 and from thence1 by another duct call'd the thoracic duct1 is carried along the back-bone upwards1 and joins to the left subclavian vein1 where the chyle gradually commences to be blood4 ,this short description we will let suffice1 and now enter upon the action itself4 ,the morsel now1 which is designed for food1 is taken into the mouth1 masticated with the teeth1 turned about with the tongue2 and as the mouth is at work1 the saliva or spittle is squeezed from the salival glands1 and thus intermixed with the aliment2 when enough chewed and moistened with this saliva1 it is conveyed to the pharynx1 or swallow1 which receives it1 and1 by its contraction1 forces it into the oesophagus2 and by a repeated contraction1 is carried down into the stomach4 ,there it is again moistened with saponaceous liquid1 or pancreatic juice2 by which and by a perpetual motion of the stomach1 it is brought into a state of digestion2 then by small degrees entered through the pylorus or porter1 into the first division of the gut1 the duodenum4 ,this gut is about twelve fingers long2 and whilst the aliment is there1 it is intermixed with the gall1 which is a liquor separated by the liver1 and contained in the gall bladder2 this liquor1 the gall1 is carried into the duodenum1 by a small duct1 called the ductus cysticus2 where also enters another kind of liquor called the pancreatic juice4 ,when the aliment is thus prepared1 and fit for a particular state of dissolution1 it is carried into1 and through the jejunum4 ,this gut is in length about twelve or thirteen hands breadth1 and its motion somewhat brisk2 through which the aliment passes pretty quick1 and hence1 generally is somewhat empty4 ,as it passes through this part1 the chyle is separated from it by the lacteals1 which are small vessels that separate the chyle from the aliment1 and abound there more than in any other part of the gut4 ,from thence it comes into the ileum2 that is the longest of all the divisions of the guts1 and is in length about twenty-one hands breadth2 it has a great many circumvolutions1 and next to the jejunum1 has many lacteals to separate the chyle4 ,now the aliment comes into the wide gut1 and gradually becomes fces2 and first1 the ccum3 ,this part is rather an appendix only1 and hangs from the main part like a finger to a glove4 ,the use of this gut has been much controverted by anatomists2 it seems however1 very probable1 that this appendix is designed to keep the aliment in for further digestion1 as it now begins to putrefy1 and becomes fces or excrement4 ,from thence it enters the colon1 which is a long1 and very winding intestine2 it runs up along and about the liver1 touches the gall bladder1 and the spleen2 from thence it descends again to the os sacrum4 ,it has but few lacteals1 and is1 as it were1 the last drainer of the fces3 ,it is this intestine which is the seat of the ,colic1 and of most other complaints of the belly4 ,next to this comes the last and straightest1 the rectum2 this gut is closely adherent to the sacrum1 and ends in the fundament2 which is provided with muscles to open and shut the anus1 in order to contain the fces1 and discharge it4 ,the mechanism of chylifaction in the human body differs from the brute creation in general1 except that most contemptible of the whole1 the hog2 to which it bears a very near resemblance1 insomuch that there is very little distinction4 ,both have that advantage over the generality of terrestrial animals1 that they are confined to no particular food2 which favours greatly the luxury of the one1 and the beastiality of the other4 ,the brute creation are generally distinguished into carnivorous and granivorous3 ,the first is that kind which feeds upon flesh2 and the latter upon grain and vegetables4 ,upon examination however1 we find1 that the stomach and guts are peculiarly adapted to their food2 and that grass agrees no more with the dog1 than mutton does with the horse4 ,but man is so happily made1 that any thing which is food1 is proper for him1 and he may become used to it2 and thus is either carnivorous or granivorous4 ,the whole canals1 from the stomach to the anus1 is in a continual vermicular motion1 which is called the peristaltic motion2 by this the aliments are dissolved1 and disunited2 and as they pass along1 are drained by the lacteals1 of their nutriment or chyle4 ,these lacteals are1 by means of a membrane 7with which they are surprisingly interwoven1 and connected to the whole canal7 called the mesentery1 lead regularly into one common cistern1 lodged almost in the middle of the intestines1 in that membrane1 called the receptacle of chyle2 and from thence the chyle is carried by a duct up along the back-bone1 called the ductus thoracicus1 into the left subclavian vein1 where it gradually commences to be blood4 ,by this mechanism we are nourished1 and the substance of our food converted into blood1 and transported through the whole animal machine1 for the support of every part of its wonderful composition4 ,as all animals which feed upon flesh1 are more subject to diseases1 nature has provided them with these advantages3 that when any thing is obnoxious to their nature1 and received into their stomach1 or their being over loaded1 it can discharge itself of so troublesome a burthen1 by vomiting1 which is effected thus3 when the inner coat of the stomach1 which is irritable and nervous1 is stimulated by whatever is obnoxious1 it will cause in the whole stomach1 a contraction2 and by that1 force its contents to the shortest direction of evacuation1 namely1 by the canal of the oesophagus1 through the mouth4 ,this expulsion is peculiar to carnivorous animals only4 ,purging or discharging by the fundament is common to all animals of whatever kind2 and is performed by an irritation in the intestines1 by which the peristaltic motion is increased2 to this ,i must add a reversion of the secretion of the lacteal vessels1 by which the humours are increased1 the motion accelerated1 and the fces discharged1 without giving any nourishment to the body1 and consequently the system diminished4 ,digestion is that act by which the aliment or food is prepared1 so as to produce a good chyle1 and consequently good blood1 for the nourishment of the body4 ,though no animal has a more delicate stomach than man1 yet it must be observed1 that none has a stomach better adapted for all kinds of food4 ,whence therefore in the common course of life1 temperance and gentle exercise is what nature requires to maintain health4 ,but nothing becomes more obnoxious to that blessing1 than gluttony1 voluptuousness1 and idleness4 ---------------------------------------- --- ,,sect4 ,,vii4 ,of the ,bones1 ,muscles1 ,ligaments1 ,tendons1 and their ,connections4 ,the bones may be considered as the timber-work of the human frame2 by which this wonderful fabric is supported1 and kept in its due form1 that the whole may be brought into its various movements1 without confusion or obstruction to each other4 ,the bones are the most solid parts of the human body1 composed of hard and indurated fibres1 striated over each other1 in a manner peculiar to that substance4 ,the bony fibres are in themselves insensible1 yet as the parts are variously distributed with arteries and veins1 and that the nerves must necessarily have a share in their formation1 they have a peculiar sensibility1 which is perceptible in some parts more than others2 they cannot strictly speaking1 be deemed quite insensible4 ,the whole bony frame is covered with a tendinous and nervous tegument1 called periosteum2 except such parts of the teeth as are designed for mastication1 which are provided with a peculiar enamel1 that is harder than the rest of the bony substance4 ,the periosteum is exquisitely sensible1 and is the safe-guard to the substance of the bone1 which is delicately tender notwithstanding it is not so sensible as the skin that covers it2 insomuch that it will become carious on the least exposure to the air1 or the attack of any foreign body of matter whatever2 whence in wounds and fractures in general1 great attention should be paid to the substance of the bone1 being very subject to become carious and to exfoliation1 which is of the greatest consequence2 but of this ,i shall say more in another place4 ,the marrow is principally designed for the nourishment of the bones2 which is evident from its being plentiest in young people1 when the bones are strongest2 and that when it is deficient1 they become brittle1 and lose their tenacity4 ,the marrow is contained in a cellular substance1 partly in vesicles of a nervous texture1 and partly bony cells4 ,at the ends of the long bones the texture is more spungy than in the middle1 where the cavity is less1 but the substance is most compact4 ,though anatomically there is no perceptible circulation in the bones1 yet1 that a circulation is actually existing1 is evident1 from a liquor oozing out from the ends of a fractured bone in the living animal2 by which a fractured bone again unites1 and this is called the callus2 and whilst in its liquid state1 resembles the white of an egg1 which gradually ossifies1 and becomes as hard as the main substance of the bone4 ,the number of bones differ somewhat in various subjects2 ordinarily they amount to two hundred and fifty-two3 ,in the head sixty-three2 in the trunk seventy2 in the arms and hands sixty2 and in the legs and feet sixty4 ,as the bones are the support of the animal fabric1 ,i have inserted in the next page1 a catalogue of the human skeleton1 which occasionally may be referred to3 ,a ,skeleton of the ,human ,body4 ,,bones in the ,,head4 ,the ,,skull4 ,the ,forehead4 ,os ,frontis #a ,the ,hindhead4 ,os ,occipitis #a ,the ,sides of the ,head4 ,ossa ,parietalia #b ,the ,temples4 ,ossa ,temporum #b ,the ,basis of the ,skull4 ,os ,ethmoides #a ,os ,sphenoides #a ,the ,bones of ,hearing4 ,ossicula #h ,auditus ,the ,,face4 ,the ,upper-,jaw4 ,ossa ,mal #b ----,maxillare #b ----,unguis #b ----,nasi #b ----,palati #b ,os ,vomer #a ,the ,under-,jaw4 ,maxilla #a ,inferior ,the ,teeth4 ,dentes ,incisivi #h ----,canini #d ----,molares #bj ,the ,tongue-,bone4 ,os ,hyoides1 is #c composed of -- #fc ,,bones in the ,,trunk4 ,the ,spine4 ,vertebr #g ,cervicis ----,dorsi #ab ----,lumborum #e ,the ,ribs4 ,cost ,vera #ad ----,spuria #aj ,the ,shoulders4 ,scapula #b ,clavicul #b ,the ,hip and ,bason4 ,os ,sacrum1 is #f composed of ,os ,coxygis1 is #c composed of ,ossa ,innomenata1 composed of ----,ischium #b ----,ilium #b ----,pubis #b ,the ,breast4 ,sternum1 is #c composed of -- #gj ,,upper ,,extremities4 ,the ,upper ,arm4 ,os ,humerus #a ,the ,under ,arm4 ,ulna #a ,radius #a ,the ,wrist4 ,ossa ,carpi #h ,the ,hand4 ,ossa ,metacarpi #d ,the ,fingers4 ,ossa ,digitorum #ae -- #cj ,,under ,,extremities4 ,the ,thigh4 ,os ,femoris #a ,the ,knee ,pan4 ,patella #a ,the ,leg4 ,tibia #a ,fibula #a ,ancle4 ,ossa ,tarsi #g ,foot4 ,ossa ,metatarsi #e ,toes4 ,digitorum #ad -- #cj ,the connection of the bones are in various ways2 those connections that are designed for rest1 are by close contact of parts1 and are called sutures or seams2 such are the bones of the skull with themselves and the face4 ,those connections which are designed for motion are called articulation4 ,some of the articulations have but an obscure motion1 as the ribs with the back-bone1 and the back with itself1 c4 ,others have an angular motion1 as the elbows and knees2 and others again have an universal motion1 as the arm-bone with the shoulder1 and the thigh bone with the hip4 ,the sutures1 and such connections as have no motion1 are merely dovetailed into one another in close connection2 but those articulations that are designed for motion are connected by cartilages1 either in close contact1 or so as to move slippery over one another4 ,the ligaments are those tough tendinous parts1 by which the articulations designed for motion are joined together2 at some parts they cover the joints only1 and at others1 they are immediately fastened to each other1 besides the external coverings2 those ligaments are very strong and elastic1 and have a close connection with the nerves that pass by them4 ,the surrounding ligaments of all moveable joints1 form a capsular-bag1 which contains a slippery liquor1 called synovia1 that lubricates the ends of the bones covered with cartilages1 that they may move with ease and agility over one another4 ,muscles are the fleshy parts on the human body1 appointed for motion4 ,they are a composition of arteries1 veins1 nerves1 and tendons4 ,muscles are generally divided into two kinds2 those for necessary or involuntary motion1 and those for voluntary4 ,some again are fastened at each end to some of the bones at their extremity1 and contract themselves in a straight direction2 others again are annular1 or in the form of a ring2 and by this manner open and shut4 ,the first kind are generally divided into three parts1 the head1 belly1 and tail4 ,the whole muscle begins and ends in a tendon1 by which it is fastened to the part it is designed to move2 which1 when the belly of the muscle contracts itself1 must consequently draw both bones nearer together1 fastened to the head and tail2 and thus performs the motion4 ,some of these muscles act in consort1 and others in opposition to each other4 ,the tendons are the principal parts of the muscle2 and that part thereof1 as before observed1 which is fastened in the bones1 namely1 at the head and tail of the muscle1 and is the chord1 as it were1 by which the limb is brought into motion4 ,a tendon is a hard1 substantial1 flexible1 and elastic body1 which1 at the head of the muscle1 is very compact2 but as it enters the muscle1 spreads its fibres over the whole body1 gathers again at the tail1 in as compact a manner as it began1 and continues in this chord-like texture till it fastens itself at its appropriated place4#g ,footnote #g3 ,it must be observed however1 that tendons take on many various forms1 as different as the muscles2 which would be too tedious here to particularize4 ,the tendons and ligaments are of equal substance1 and differ in nothing but their various uses2 namely1 the ligaments to connect the articulation2 and the tendons1 or the ends of the muscles1 to give motion4 ,the muscles are a composition of the tendinous fibres1 plentifully intermixed with small ramifications of blood vessels2 all which compose the fleshy part thereof4 ,hence1 the tendons being white and hard1 the muscles gradually grow softer and redder in the middle of them2 and they verge gradually to become tendinous at the tail1 the same as the head4 ,hence1 from the close texture of the tendons1 they are very painful when wounded1 or otherwise hurt2 but as the muscles are softer and more pliable1 their wounds and other accidents are of less consequence1 and not so dangerous as the former4 ,the number of muscles are undetermined1 for though the principal muscles are so distinct that they cannot be mistaken as to their form and use1 yet there is so great a number of small ones1 or so many of the great ones capable of being subdivided again1 that anatomists have not1 as yet1 agreed about their number4 ---------------------------------------- --- ,,sect4 ,,viii4 ,of the ,urinary ,organs and ,genital ,parts4 ,the kidnies1 the ureters1 the bladder1 and the urethra1 are the principal urinary organs4 ,the kidnies receive two arteries called the emulgent arteries1 from the great arterial trunk1 called aorta1 before described2 they each send also two veins back again1 accompanying the arteries to the vena cava4 ,whilst the blood is circulated in the kidnies1 the urine is secreted in many small quantities1 and carried from each kidney by a tendinous tube1 the bigness generally of a small goose quill1 called the ureter to the bladder4 ,the ureters enter the bladder between its lamillas1 so as not to admit of a return4 ,hence1 a bladder in its natural position is both wind and water tight1 and if reversed1 is neither4 ,the bladder of urine is of a tendinous and nervous texture1 and capable of great extension1 but at the same time exquisitely sensible4 ,the neck of the bladder is very muscular1 and by this forms a sphincter1 or annular muscle1 by which the urine is retained2 and as it is of a very sensible nature1 this part is subject to inflammatory constrictions2 great pain1 and many evils have there been occasioned1 either from venereal cases1 or gravelous complaints4 ,from the neck of the bladder to the end of the penis1 is the urethra2 which canal serves for the emission of the urine1 as well as that of the seed4 ,the whole is lined with a number of very little glans1 to lubricate and protect the sensitive lining from the sharpness of the urine4 ,these are the urinary organs4 ,we will in the next place1 proceed to the organs of generation4 ,the testicles are the principal instruments for forming the human seed2 they are generally two in number4 ,the testicles receive the blood1 of which they secrete the seed1 from the aorta1 about the same parts1 whence the emulgent arteries project4 ,these arteries run down from the aorta to the testicles1 in a very contorted and winding manner1 accompanied by the veins which return back again from the testicles1 and fix themselves in the ascending vena cava4 ,these contorted and interwoven vessels are called the spermatic vessels1 which carry the blood from the arteries in little quantities1 and slowly return it again into the great vein4 ,whilst the blood is circulated in the testicles1 the seed is secreted in them2 but as it is secreted1 it is transported back again from thence by tubes1 called vasa deferentia1 towards the neck of the bladder1 where there are two irregular bladder-like vessels1 wherein the seed is contained1 and kept for use1 called the vesicul seminales4 ,in these seed bladders the seed is kept for use1 till it is wanted4 ,they are remarkably delicate and nervous2 and when they are filled with seed1 they stimulate all the organs of generation with a desire for venery4 ,the penis1 or the manly member of generation1 is partly covered with the common skin2 the foremost part of which1 that covers the glans1 is called the prpuce4 ,this prpuce is tied underneath to the substance of the penis1 by what is called the frnum4 ,the inner part of the penis is composed of two kinds of bodies1 the cavernous bodies of the penis1 and the cavernous body of the urethra4 ,the first are bodies enveloped in their peculiar teguments1 and make the greatest part of the penis4 ,each of these bodies takes its origin from the erecting muscle of the penis1 which is near the pubis2 through each of them goes an artery and a nerve1 which spread themselves through these bodies4 ,these bodies are full of cavities1 which have all a communication with one another4 ,the cavernous body of the urethra continues from the bulb1 near the neck of the bladder all along to the end of the penis1 and includes the glans1 or the nut of the yard2 and is much of the same substance with the former4 ,at the back of the penis1 goes along the large vein1 called the vena penis1 which spreads itself all along into numberless branches that connect themselves with the ramifications of the arteries throughout all the cavernous bodies2 and from thence is caused the erection1 as ,i shall presently describe4 ,the glans1 or the nut of the yard1 is remarkably delicate and sensible1 as being the seat of pleasure in coition2 it is also of a cellular substance1 and in one continuation with the cavernous body of the urethra4 ,its sensation is greatly heightened by the frnum being tied underneath1 from the prpuce to that part which keeps it1 as it were1 in an agreeable constriction when erect4 ,the penis is allowed two pair1 and a single muscle4 ,the first pair is the erectores1 which take their origin from the fleshy protuberances of the ischium1 and lose themselves in the cavernous body of the penis4 ,the second pair of muscles is the transversales2 these take their rise near the forementioned1 and fasten themselves at the root of the penis4 ,the fifth is the accelerator1 or the odd muscle2 this muscle takes its commencement from the cavernous body of the urethra1 and grasps the whole penis1 and adheres to the sphincter of the anus2 the muscles aid and assist each other in the erection of the penis1 which happens in the following manner3 ,at the influx of the animal spirits1 the vena penis1 or the great vein in the penis is somewhat contracted1 whence the blood is forced into the cavernous bodies of the penis and that of the urethra1 as the reflux of the circulating blood from the arteries is hindered2 hence1 the cellul of the cavernous bodies are obliged to swell up and distend all the parts1 and thus make the penis turgid and erect2 when the penis is further titillated by the friction of coition1 the parts become generally irritated to an agreeable constriction1 whereby the seed rushes from the seed-bladders into the urethra1 and is thus forcibly ejected in the time of ejaculation2 then the whole fabric slackens1 the constriction of the great vein relaxes1 the blood regains its free circulation1 and the penis becomes slack again4 ,these are the faint out-lines of the genital parts2 but to have a full description and comprehension of the peculiar properties of the genitals of both sexes1 and also the sacred act of generation1 ,i recommend to a serious perusal of the anatomical and physiological description of the genital parts of both sexes1 in my ,treatise on the ,venereal ,disease1 where they will find a full and satisfactory account4 ---------------------------------------- --- ,,sect4 ,,viii4 ,of the ,skin4 ,the whole human automaton is covered with a skin1 the mechanism of which is not less curious than what we have already described4 ,it is a texture curiously interwoven with an infinite number of tendons1 arteries1 veins1 nerves1 and lymphatic vessels4 ,the tendons form the net-work of the whole1 and give it an elasticity1 from whence it requires a muscular motion2 and the rest add each their parts1 as ,i shall hereafter describe4 ,the skin1 universally over the whole body1 is divided into three parts2 but in most parts it is found to have four4 ,the external1 is the cuticula1 or scarf skin2 this is a horny and insensible substance1 formed by nature as a shelter for the next part of the skin1 which is exceedingly sensible2 on examination it appears to be a horny substance1 and as it were1 little scales continued from the immediate skin1 which on any external injury1 such as repeated friction1 fire1 scalding1 or blistering1 separates from the main skin4 ,the next is the real skin1 called cutis2 ,this is strongly interwoven with tendinous and nervous fibres1 interspersed with numberless ramifications of arteries1 veins1 and lymphatic vessels2 whence it is not only exquisitely sensible1 but elastic1 and on the least injury1 subject to bleed4 ,on the external surface is a very thin plexus1 called the reticulare2 which has the tinge of the natural hue of the skin1 and distinguishes the complexion of the negro1 the tawny1 and white1 from each other4 ,the structure of the cutis is peculiarly curious1 and may justly be considered as a continued secretory and excretory gland2 or more properly1 like the bark of a tree2 for whilst there is continual transpiration from the body1 it1 at the same time1 is capable to absorb the subtile particles of whatever surrounds it1 and exclude the grosser4 ,over the whole surface are innumerable little pores1 which are nothing but the little openings of the various lymphatics1 and of the blood vessels corresponding with their peculiar glandules1 called the milliary glans2 between those on the hairy parts1 the hair is planted as it were1 with their distinct roots1 corresponding with the hue of the subject they belong to4 ,these pores widen or contract according to the internal or external warmth of the body2 which when they contract1 cause a kind of roughness1 or continuation of little warts2 and on the contrary1 when dilated1 smooth the skin4 ,next to this follows the fat skin1 or membrana adiposa2 which is a continuation of cells1 wherein the fat is contained1 and has an immediate communication with the neighbouring blood and lymphatic vessels4 ,this part is not universal1 for some parts of the face1 the genitals1 c4 are without it4 ,the last of all is the membranosa1 a thin parchment-like texture1 which adheres spontaneously to whatever part it covers1 either periosteum1 the tendons1 ligaments1 or muscles4 ,these are the four principal divisions of the skin2 but that which is the principal1 is the second mentioned1 namely1 the cutis2 on which ,i shall have occasion to offer something hereafter1 that may prove of the greatest advantage to the sea-faring people1 for whose benefit ,i have particularly intended these ,lectures4 ---------------------------------------- --- ,,sect4 ,,ix4 ,of the ,external ,senses4 ,feeling is the universal sensation of the nerves1 on which all other senses depend1 as the subtile spring of life itself4 ,what it is1 and whence it proceeds1 has already in the foregoing been explained2 namely1 a sensation of the nerves1 by which we perceive an idea of hard or soft1 wet or dry1 hot or cold1 or in general terms1 pleasure or pain4 ,the peculiar seat thereof seems to be placed at the ends of our fingers2 whether this is the absolute seat ordained by nature1 or rendered so by custom1 is not my business here to enquire2 perhaps1 both conjoin to make it there most perfect1 as best suited for that purpose4 ,taste is the next sensation of the nerves1 regarding an immediate approach and action of substances themselves1 in order to distinguish betwixt the nature of foods1 by which we are enabled to form an idea of salt1 sweet1 sour1 bitter1 sharp1 or mild2 which according to their mixture and proportion1 render taste agreeable or disagreeable4 ,its seat is principally in the tongue2 but that it extends to the very stomach itself1 is evident1 from the immediate consent of parts2 namely1 that what is disagreeable to the palate1 will ever be nauseous to the stomach3 ,of which ,i shall say more hereafter4 ,smelling is that sensation given to the animal creation1 as a friendly messenger of taste1 in order to enable us the better to chuse our food4 ,it is actuated by means of the olfactory nerves spread in the pituitary membrane of the nose1 and has an immediate communication with the brain2 which nervous plexus is actuated by odorous particles1 exhaling from substances1 by which the olfactory nerves are stimulated agreeably1 or disagreeably1 as the first intelligence to the palate1 or to the whole consent of the nervous system4 ,hearing is that sensation of the nerves which is occasioned by the vibration of the air1 and forms the sound1 which enters the cavity of the ear1 and tremulates and puts in action1 the organs of hearing4 ,the ear is perhaps as curious a piece of mechanism to our conception1 as any part whatever we shall meet with in anatomy4 ,to the organs of hearing we must reckon the external and internal auditory1 divided by a thin membrane1 which is a thin spreading of nerves1 called the drum2 within this1 or in the internal cavity1 we observe1 #ast4 ,four little bones called1 from their forms1 the hammer1 malleus2 the anvil1 ancus2 the stirrup1 stapes2 and roundling1 orbicularis4 #b;dly4 ,their peculiar muscles4 ,and1 #c;dly4 ,two considerable cavities1 the labyrinth and aqueduct4 ,how hearing is actually brought about1 ,anatomists have not as yet agreed2 and which would be too tedious here to enquire into4 ,that the little hammer is perpetually moving on the tympanum1 according to the different sounds1 may be one part2 which1 however1 is greatly assisted by the other organs4 ,the labyrinth1 with many turnings and windings1 penetrates through the skull and forms part of the aqueduct1 by which the sound is modulated and magnified1 so as to cause the distinction between them1 and convey the idea of their sonorousness to the common receptacle of sensation4 ,seeing is that great faculty by which the form1 colour1 and motion of objects is represented to our ideas4 ,the principal conveyer of this wonderful sensation1 is the optic nerve2 the eye is a telescope finished to the greatest perfection2 or like a camera obscura1 where objects are pictured to the utmost nicety1 and a due proportion observed in their nature4 ,it is a globe enrolled with a strong tendinous coat1 and filled with three kinds of humours perfectly clear and transparent1 which differ in nothing but their various degrees of liquidity and form4 ,each of these humours is enclosed in a delicate thin transparent membrane4 ,the external coat of the eye is called the cornea1 from its resemblance to horn1 being a continuation of the dura mater and pia mater2 and is every where opaque1 except at the entrance of the light1 which is called pupilla1 and projects somewhat beyond the spherical form of the eye1 similar to the crystal of a watch4 ,inside the cornea it is lined with a spreading of the optic nerves1 called the retina1 where objects are reflected2 by which the ideas are immediately conveyed to the brain4 ,the humours are the following3 ,the aqueous humour1 the most external1 which is designed for collecting the rays of light2 the second is the crystaline humour1 which is in the form of a magnifying lens1 and invested with a subtile transparent tegument1 and so curiously fixed1 as to be contracted and dilated1 according as the objects are near1 or removed from the eye2 and accordingly the crystaline humour requires to be flattened or thickened2 the last is the vitrous humour1 which fills the remaining cavity of the eye2 this humour serves to spread the objects again on the retina1 and arrange them in their natural order1 so that the picture of the objects viewed1 may be preserved in its due proportion and regularity4 ,now the act of vision is performed thus3 ,the convex transparent part of the cornea faces at once every object which comes within the direct lines thereof1 and this is termed a full view4#h ,this view enters through the aqueous humour1 where the whole is contracted according to its convex and concave form1 so as to make it fit to enter the pupilla1 which is a muscular continuation of the sclerotis1 and called the uvea2 and from thence the whole view passes through the crystaline lens1 by which the view is again magnified1 and passed through the vitrous1 and the whole depicted on the retina1 in the same concave curve1 and at equal angles in which it was first received1 and apparently the same magnitude2 thence representing the objects in their natural perfection1 figure1 colour1 magnitude1 and motion4 ,footnote #h3 ,it is the general received opinion1 that objects are reversed in the representation on the retina of the eye4 ,this is however a mistake2 ,i hope on another subject to prove this in a full and satisfactory manner4 ,when1 however1 an object is singled out of the whole view for particular attention1 the uvea then contracts or dilates1 which1 together with the muscular action of the whole ball1 proportions all the humours suitable to the magnitude and distance of the object under examination1 and the quantity of light2 and to make the eye more capable1 the lids are frequently moving1 in order to moisten and varnish1 as it were1 with a liquid pressed from the innermost gland1 called canthus major1 to keep the surface smooth1 and assist its transparency4 ,if this intense looking is continued beyond the strength of this noble organ1 it relaxes from its proper destined expansion1 and the objects are rendered obscure4 ,darkness is ease and rest to the eye1 because it is then out of action2 whilst light always keeps it in exercise2 ,and in diseases of the eyes1 light should be kept away as much as possible4 ,here then ,i shall beg leave to conclude this short description of the wonderful structure of our frame2 which when we duly consider1 will never fail of filling our breasts with a sense of admiration2 and induce us to lift up our souls with reverence and gratitude1 to that incomprehensible ,,great ,,cause1 by whose wisdom we are formed2 and by whose goodness we exist4 ---------------------------------------- -------------------------------- ,,lecture ,,ii4 ,,on ,,the ,,necessary ,,means ,,and ,,medicines ,,requisite ,,towards ,,restoring ,,health4 ---------------------------------------- --- ,having1 in the preceding lecture1 given a general view of our wonderful structure1 ,i shall1 in this1 endeavour to lay a foundation of the healing art1 in order to assist nature when impaired by the attack of disease1 or any unforeseen accidents4 ,but that ,i may become useful1 and yet concise1 ,i will1 without loss of time1 lead the reader to the principal distinction between health and disease2 for without forming a proper judgment of an ailment1 there can be no reasonable intention of cure4 ,i shall therefore beg leave to solicit a serious attention to the following important observations1 particularly1 as they are founded upon the purest principles of physic1 authenticated by happy success in an extensive practice1 and communicated by the dictates of a candid and well disposed heart1 that wishes ,existence only as a useful member to society4 ---------------------------------------- --- ,,sect4 ,i4 ,of the ,pulse4 ,when we consider the admirably curious structure of the human mechanism1 it must clearly appear1 how easily the animal conomy may become disordered4 ,but so kind has the ,,allwise ,,author of our existence been to his creatures1 that on the slightest indisposition1 the whole system is sensible of the least disagreeable sensation2 and every part1 with a social and sympathetic friendship1 is ready to relieve the fabric from whatever is obnoxious1 and causes the disturbance4 ,as nothing has a greater share in life than the blood1 so nothing likewise on the least indisposition1 is sooner set in commotion1 and gives the alarm1 than this very liquor1 in which life itself is contained2 and the circulation of this fluid in the arteries1 furnishes us with the greatest prognostic1 namely1 the pulse1 by which we may1 with any degree of certainty1 judge of the state of the body1 and foretell good or bad events4 ,how beneficial it is then to be acquainted with this knowledge1 ,i shall leave to every rational being to determine4 ,every artery in the living body constitutes a pulse1 as has been explained in ,sect4 ,v4 in the foregoing lecture4 ,and it is demonstrative from simple reason1 that the pulsation of such arteries must be in proportion to their magnitude1 greatest in the heart1 whence they take their origin2 till the vibration must gradually be lost to the touch1 as they become insensibly small1 and lose themselves in their ramificatory capillary tubes4 ,the artery which is most convenient to our examination1 is that which lays immediately to the touch on our wrist1 below the thumb1 on the radius1 just below the knuckle of that bone2 and it is there we are best able to distinguish the pulsation of the arteries1 as being most exposed to the external touch2 because it is immediately between the skin and the flat of that bone4 ,thus much premised1 we will first consider the pulse in the sound state2 and next make a comparison with that in people labouring under diseases4 ,in a full grown man1 in the vigour of health1 the pulse ordinarily beats once to every second1 that is1 #fj times in a minute1 #cfjj in an hour1 and #ca1ecf1jjj times in a year4 ,it varies however in different subjects1 according to the stature1 temperament1 condition1 time1 and action of the same2 insomuch1 that two persons equally in a good state of health1 shall1 however1 differ widely in their pulses4 ,yet1 notwithstanding1 there are peculiar signs1 which will ever make a true distinction between health and sickness2 practice however is requisite to form a proper judgment of such distinction4 ,in order to lay a proper foundation to understand the nature of this great prognostic1 ,i shall divide the pulse into the following classes3 #ast4 ,a full1 slow1 and regular pulse1 denotes a perfect state of health2 for whilst the blood moves regularly in the arteries1 without pain to the nervous system1 or disturbance to the animal conomy1 the pulse will beat precisely regular1 without trembling1 fluttering1 hurry1 distinction1 or feebleness1 and discover to the touch1 a peculiar easiness2 and this1 every one1 who wishes to become master of that subject1 should carefully attend to4 #b;dly4 ,a full and quick pulse1 indicates a fever2 for by the irritation of the nerves1 the vibration of the arteries are accelerated4 ,if a gentle perspiration attends it1 it may be deemed salutary2 and with this pulse it appears1 that nature makes a vigorous effort to expel what is obnoxious3 therefore in such a pulse1 a gentle perspiration generally gives relief4 #c;dly4 ,a full1 quick1 and hard pulse1 denotes great irritability in the nerves1 and a redundancy of blood2 this is the pulse of a fever2 and here bleeding1 if timely applied1 is very requisite1 as also medicines which promote perspiration4 #dthly4 ,a small and quick pulse1 denotes an irritability in the nervous system1 and a contraction of the arteries2 this is generally the pulse which attends sudden shocks and frights1 as also in the cold fits of agues4 ,the causes should carefully be attended to3 if1 from a sudden shock1 bleeding is useful2 but in the latter case1 it is hurtful4 ,it seldom lasts long1 and a full feverish pulse generally follows1 and the state of the patient ought here to be the guide3 for1 the same pulse may proceed from too great a plenty of blood1 as well as from a deficiency2 consequently requires different treatment2 and this shall be pointed out more fully hereafter4 #ethly4 ,an irregular full pulse1 is at all times a bad one2 many may be the causes1 and generally denotes a great confusion in the nervous system1 and in the circulation of the blood4 ,this pulse is generally the attendant on violent inflammations1 phrenzy1 delirium1 c4 and if it continues any time1 forebodes great danger3 bleeding in time is greatly requisite1 and other remedies1 in order to assist the nerves1 and bring the circulation to its proper regulation again4 #fthly4 ,an irregular small pulse1 is frequently the attendant of an emaciated constitution1 putrid fevers1 and consumptions2 and this dangerous pulse too generally forebodes the approach of death4 ,the more irregular the pulse grows1 small1 weak1 trembling1 and leaves off by irregular intervals1 the sooner dissolution is at hand2 till at last1 the pulse entirely disappears1 and life ceases4 ,but dangerous as this pulse is1 yet it must be observed1 that it often appears in the strongest constitutions1 as in sudden emotions of the mind1 falls1 c4 or in a swooning4 ,this is also the last and the first pulse in suffocations2 or in other words1 the struggling pulse between life and death4 ,these few distinctions of the pulse we will let suffice1 as they1 when properly attended to1 will in all cases enable us to make a true distinction between health and the different stages of sickness1 and accordingly direct us to a true method of cure4 ---------------------------------------- --- ,,sect4 ,,ii4 ,of the ,effects of ,bleeding ,there is1 perhaps1 not a greater remedy in medicine than bleeding2 but good and effectual as it is1 yet ,i will venture to say1 there is none more pernicious than this1 if injudiciously applied4 ,as ,i value the life of my fellow creatures1 ,i would at all times caution them against the injudicious application of this operation1 being persuaded1 that more have lost their lives by the lancet1 than by the sword1 and pestilence itself4 ,not to be tedious on this important subject1 ,i shall give here some very few rules1 whereby a patient may be judged in a proper state for bleeding2 and likewise1 where that operation ought to be avoided3 for all the service we can possibly hope and receive from bleeding1 is to lessen the quantity of blood1 by which the whole body becomes relaxed1 consequently less liable to the inflammatory irritation1 that a too great quantity of blood might occasion2 but on the contrary1 if the solids are but weak1 and the blood poor1 we only augment the evil by bleeding1 which we would wish to remove1 as thereby the system becomes weakened1 and not able to disengage itself from the obnoxiousness it is incumbered with2 and thus proves the very destruction it was intended to remedy4 ,the notion of drawing off the bad blood by bleeding1 is very erroneous and absurd2 the whole is too intimately mixed1 and will ever generate the same again till the disease is removed4 ,bleeding is requisite #ast4 ,when a strong robust person1 of a full and sanguine complexion1 by accident receives a heavy contusion2 a broken limb2 or wound1 whereby the parts become inflamed2 a fever like to ensue2 and that the pulse becomes hard and full1 the veins distended1 c4 c4 #b;dly4 ,when such a person receives a great shock1 fall1 terror1 or any other strong emotion of the mind2 whereby the blood becomes rarefied1 or threatens a fever4 #c;dly4 ,in the beginning of pleurisy1 peripneumony1 sudden and violent fevers1 great colds1 c4 as also scalding1 burning1 apoplexies1 convulsions1 palpitations1 suffocations1 and all such dangerous violent disorders2 in these cases only bleeding is useful1 and then it ought to be performed immediately1 and with great moderation3 six or eight ounces is enough from the strongest man2 if requisite1 it may be easily repeated1 but if overdone1 it is not so easily replenished4 ,bleeding in general is hurtful #ast4 ,in agues1 notwithstanding the violent paroxysm of the hot fit1 because the solids are here too much relaxed4 #b;dly4 ,in all contagions distempers2 this is a circumstance worthy the greatest attention4 ,reason and experience prove that bleeding here is very improper2 for by bleeding1 the contagious miasmata is drawn only the more into the whole mass of blood1 and this is the fatal stumbling block1 by which thousands have lost their lives4 ,the manner of treating such distempers with success1 ,i shall shew in its proper place4 #c;dly4 ,in all old standing diseases1 where there is a low1 weak1 though quick pulse2 for in such cases bleeding is very improper1 as the system is already too much reduced4 #dthly4 ,in all dropsies1 scurvies1 lentors1 consumptions1 c4 for here instead of bleeding and lessening the power of the solids1 the patient wants strengthening1 and has no blood to spare4 #ethly4 ,in all rheumatic and gouty complaints2 for here nature must be assisted in order to throw off what is painful1 by such means as will strengthen the solids1 expell what is obnoxious1 and prevent it from returning to the blood1 or falling upon some more important part4 #fthly4 ,in all venereal cases1 particularly if recent2 as by bleeding1 the pox will unavoidably be the consequence2 as the venereal virus will be absorbed in the whole mass of blood4 #gthly4 ,in all paralytic cases1 and such weaknesses where the strength of the body is already impaired4 #hthly4 and lastly1 ,in the time of other evacuations of the body2 as purging1 fluxes1 bloody fluxes1 c4 and particularly when the body is in a sweat1 or perspiration4 ,from this1 ,i hope1 the good and bad effects of bleeding will be understood in many other cases1 which would be too tedious to mention here2 ,i shall therefore proceed to the operation of bleeding itself4 ---------------------------------------- --- ,,sect4 ,,iii4 ,of the ,operation of ,bleeding4 ,bleeding is thought in general to be a very simple performance2 but in fact1 there is not an operation in all surgery1 requires more care1 or is liable to more dangerous consequences1 if ill performed4 ,it is not only the opening a vein1 but it is to open it properly1 7taking care not to prick an artery or tendon7 to take away a sufficient quantity of blood1 and to heal up the orifice again4 ,in the bend of the arm are three distinct veins1 the head1 median1 and basilican4 ,the ancients1 before the discovery of the circulation of the blood1 fancied the head1 or upper vein1 carried the blood from the head2 the median1 or middle1 from the breast2 and the basilican1 from the liver1 c4 but this idle conjecture is laid aside1 as being highly absurd4 ,when it is remembered what was said in the first ,lecture1 in ,sect4 ,v4 of the circulation of the blood1 it will then plainly appear1 that all these veins become one before they enter the body2 so that there can be no difference as to their quality in being opened3 either therefore1 which lays most conspicuously easy1 is the vein that should be chosen2 for the arms of people differ in this respect1 as much as their features4 ,in order to chuse therefore properly1 examine with the finger how the veins lie2 if upon a flat hard substance1 it is a tendon2 if a pulsation is perceived1 there is an artery2 both which ought to be avoided if there is a vein that lays more free and conspicuous to the sight and touch4 ,if however it cannot be avoided1 the vein ought to be opened with the greatest caution1 for the pricking of a tendon would not only be exquisitely painful1 but endanger the arm by inflammation1 and even life itself2 and the pricking of the artery would endanger the patient's bleeding to death1 or else form an anauresma1 7which is a bag of blood protruding from the artery7 equally dangerous to the life of the patient4 ,in general the middle vein is the safest and most convenient1 provided it does not cross the tendon3 for the upper vein lies frequently very deep1 and is but small1 and the lower frequently crosses a tendon1 or lies immediately over an artery4 ,however1 one or the other will frequently suit1 and1 with caution1 the operation may be performed with ease4 ,as to the choice of the arm1 it can make no difference in regard to the effect1 whether it is the right or left1 for the veins of both arms end at last in the great trunk of the vena cava1 before they enter the heart4 ,to the operator1 however1 the right is the handiest1 and to the patient1 the left is most convenient4 ,in that arm however where the best vein offers1 that should be chosen4 ,when the arm is fixed on1 then tie it up4 ,the place should be on the upper arm1 about two inches from the bend1 and the vein fixed on to be bled1 first drawing up the skin a little1 and laving on the ligature twice round the arm1 drawn together with a draw knot2 the reason of laying on the ligature above the intended orifice of the vein1 is plain1 as it stops the reflux of the blood1 which is transfused from the heart by the arteries towards the fingers1 from thence taken up by the veins1 and by the ligature prevented from flowing back again1 and consequently distends the veins1 and swells them up4 ,when the ligature is laid on1 7which may be a garter1 or a piece of tape1 about four or five feet long7 and the veins are swelled up1 then open the vein4 ,bend the lancet so that the blade and handle may make an acute angle2 take the blade between the thumb and fore finger in the right hand1 if the right arm is bled1 but if the left arm1 the lancet ought to be held in the left hand1#i and open the vein obliquely1 so that the lancet cuts all the while1 stretching the vein a little downwards with the opposite thumb4 ,the lancet should cut a little slantingly1 for if perpendicular1 it would not only cause much pain1 but be apt to slip through the vein1 prick a tendon or artery1 and occasion dangerous mischief4 ,footnote #i3 ,this is the proper method of bleeding2 for a bleeder ought to be equally dexterous with the left hand as with the right1 which custom soon makes familiar2 but those who are awkward with the left hand1 must stand behind the left arm to bleed1 which method may be adapted rather than to risk danger4 ,the orifice should be somewhat obliquely in the vein1 neither directly length-ways1 as the veins would be apt to slip1 and the orifice not sufficiently opened to let the blood pass freely2 neither should the opening be right across1 as thereby the vein might be divided1 and the blood not be easily stopt1 or the orifice heal up4 ,when now the vein is well opened1 let the blood run1 7the arm a little bent7 till it changes to a higher colour1 the surest sign of being enough1 and this will be in about four1 six1 or eight ounces1 according to the constitution of the patient4 ,this simple rule ,i would advise to be attended to1 for whatever may be pretended about presaging the quantity of blood beforehand1 certain it is1 it cannot be ascertained but in the time of bleeding4 ,when it is time to leave off1 slacken the ligature1 and gradually untie it1 when generally the blood ceases to run2 draw close the orifice1 and wipe it clean all round4 ,let the patient bend the arm a little1 and close the orifice very close1 then lay a four-folded dry compress1 the bigness of a crown1 of clean tolerable fine linen rag1 and tie the arm up3 lay the ligature 7a garter or a piece of tape about four feet long7 at the middle of the compress1 the one half round the upper arm1 the other on the lower arm1 alternately1 so that they always cross each other in the bend of the arm on the compress1 till at last it is either tied or pinned2 care being taken that it neither be too tight or too slack1 so that the arm may be bent or extended with tolerable ease4 ,let the ligature remain on twenty-four hours1 when all will be closed up4 ,what is to be done if unfortunately a tendon or an artery should be pricked1 ,i shall mention hereafter4 ---------------------------------------- --- ,,sect4 ,,iv4 ,on the requisite ,medicines to be used at ,sea ,as my greatest ambition in this life tends only in becoming useful1 ,i shall studiously avoid that false pride of appearing learned4 ,there is perhaps not a medicine in the modern materia medica1 but what ,i have examined into1 and opportunely experienced the virtue of2 but so often have ,i been deceived in my expectations1 that out of the many hundreds1 with which ,i am acquainted1 there are not above a score1 or at farthest two1 which in any case whatever ,i should expect any benefit from4 ,yet ,i mean not to throw out prejudices1 for every physical man has his favourite medicine1 and we are all apt to praise the bridge that carries us well over4 ,the little assortment of medicines however1 which ,i here offer1 ,i know from experience to be good1 and as such ,i recommend them4 ,i have plowed the ocean myself1 visited most climates in the known world1 and in my practice on that precarious element1 drawn such observations1 as makes me happy to think1 that they may prove useful to a class of men1 who daily experience the uncertainty of human life4 ,in the first place ,i shall draw the plan of a sea medicine box1 as may suit a ship that carries no surgeon2 in which ,i shall endeavour to be so plain as ,i hope will prevent any mistake4 ,the ,,medicine ,,chest4 ---------------------------------------- ---------------------------------------- ---------------------------------------- -- ,lancets,a4,b4,c4,d4#aa ,camomile ,scissars,spt4 of ,wine,liniment of,sweet ,oil4,sweet ,spirit#ab ,balm #a ,probeand ,camphor4,soap4of ,nitre4#ac ,sage ,spatula ---------------------------------------- -------------------------- #ad ,sassafrass ,teeth ,instruments,e4,n4,o4,p4,g4#ae ,oatmeal #b ,syringes,honey4,calom4,fine ,prec4,me4 ,oi4,elixir of #c ,clyster ,pipes ,bladder ------------------------------ ,vitriol4 #d ,scales and ,weights,q4,r4,s4#af cinamon1 c4 ,rhub4,jalap4,ipecac4#ag ,allum ,f4 ------------------------------ ,h4#ah ,chalk #e ,splints,yellow ,basilicon4,t4,u4,w4,elixir ,proprietat4#ai ,salts #f ,bandages,liq4 ,l4,e4 ,o4 ,pep4,t's4 ,ba4 #g ,rags-------------------- #h ,tow #i ,lint,i4,k4,l4,m4#bj ,diachylon ,plaister #aj ,tapes1 ,thread1 ,needles,linitive,turner's,fever ,powder4,stomach#ba ,mercurial ,plaister and ,pins,electuary4,cerate4,powder4#bb ,blistering ,plaister ---------------------------------------- ---------------------------------------- ---------------------------------------- -- ,of the ,utensils4 ,first then1 ,i shall speak of the utensils and the instruments which must necessarily belong to a medicine box1 be it ever so small4 ,in the box1 ,no4 #a4 ,lancets3 ,there ought to be three or four1 and they should always be kept clean and bright in a case1 free1 as much as may best from the dampness of the sea air4 ,the best method for this is1 to wipe them often with a dry clean linen cloth1 warmed by the fire1 7taking care in the wiping of them1 that the blade of the lancet lays upon one of the handles1 by which the point is preserved7 and when properly cleaned1 wrap the whole case up in a large piece of dry paper4 ,let it be a constant rule1 to clean them well every time they are made use of4 ,and here ,i must remark once for all1 that all iron or steel instruments are ever best preserved clean and bright1 by rubbing them clean with a warm dry cloth1 and then wrapping them up in clean dry paper2 by which method ,i have preserved my capital instruments with the same brightness1 as they came out of the workman's hands throughout my voyages1 notwithstanding they have been made use of1 and frequently too4 ,the notion of oiling or greasing instruments is very erroneous1 and so far from preserving them1 that it will never fail of making them more rusty4 ,the wiping them quite clean and dry1 and wrapping them up in warm dry paper1 is certainly the best secret for keeping all iron or steel bright at sea1 and deserves strictly to be attended to4 ,scissars3 ,there ought at least to be two pair1 one for common use1 and the other for particular purposes2 and if the last mentioned are crooked1 they are certainly much the better1 being very handy on many occasions4 ,the best pair should be carefully preserved as already directed4 ,probe3 ,a probe is very requisite for searching of wounds1 c4 ,it should be of good silver1 and the smaller it is in thickness1 even like a small wire1 the better for use1 as it will bend and twist agreeable to the place it is to search4 ,at one end it should have a neat smooth button1 and at the other1 be triangularly pointed1 like a sail needle1 in order to wrap lint round it to clean sores with2 its length should be six or eight inches4 ,spatula3 ',tis not much matter what the spatula is made of1 whether silver or iron1 be it what it will1 7provided it is neither brass nor copper7 one end should be flexible1 so as to be handy in spreading salves upon lint1 or for other the like purposes2 whilst the other should be more stiff1 being very useful for pressing the tongue down1 in looking and examining the throat4 ,it should be about six or eight inches long1 and an inch broad4 ,bistouries and ,incision ,lancets3 ,a bistoury1 or neat sharp cutting knife1 is very useful indeed in many cases4 ,and a large incision lancet1 in the form of a common lancet1 except that the point inclines more one way1 is very necessary for opening aposthumes1 and where a collection of matter has been formed4 ,teeth ,instruments3 ,of the whole tribe there is certainly none more universal than the key2 this ought to have three different hooks1 and so that they may shift and unshift1 according as the operation requires4 ,the gum lancet ,i have no notion of1 ,i never saw any occasion for it1 and am apt to think it rather an hindrance to the operation4 ,the instrument should be kept clean in the same manner as ,i have said before4 #b4 ,syringe3 ,each box ought at least to have two4 ,ivory is the best substance they can be made of2 they ought to be pretty thick and stout1 as they are liable to warp4 ,a small one with a neat pipe1 slender1 and a button to it1 will be very useful for the clap1 or other cases1 where injections are requisite4 ,a larger one for the ulcerated sore throat1 or other the like cases1 where quantities are required to be injected4 #c4 ,clyster ,pipes and ,bladders3 ,there ought to be sundry4 ,i would have them previously mounted2 and to prevent the bladder from being decayed1 or eaten up by vermin1 or moths1 fill them up with wormwood2 a method ,i have found very effectual4 ,when they are to be made use of1 they are easily softened by a little lukewarm water4 ,the general method of mounting the bladder on the pipe1 is1 by the assistance of a cork in the pipe1 which is to be drawn by a string1 when the clyster is injected2 for my part1 ,i found it always a hindrance2 and therefore instead of the cork1 ,i always chose to secure the whole with a string1 tied with a slip knot1 which when the pipe is introduced1 is much more easily undrawn4 ,a clyster syringe of pewter1 that holds at least a pint1 or a pint and an half1 is far more preferable at sea1 and might easily be made with an additional pipe1 by which a man may be the operator himself4 #d4 ,scales and ,weights3 ,this is a requisite article1 in order to proportion the doses of medicines4 ,the scales need scarce any description1 as they require no more than their being of an equal length1 and the whole in equilibrio4 ,the ,apothecaries weights come in the following order1 and signified by these characters3 #a--;,a ,pound is #ab ,ounces4--xii4 i4--,an ,ounce is #h ,drachms4--viii4 i4--,a ,drachm is #c ,scruples4--iii4 i4--,a ,scruple is #bj ,grains4--gr4xx4 ,these marks are generally stampt upon the pieces4 ,as a pound and ounce are not generally used in the proportioning of doses1 they are omitted in the common little boxes prepared for that purpose4 ,the rest1 drachms1 scruples1 and grains1 are marked upon the requisite pieces2 and which at the first inspection may easily be understood4 ,i shall next proceed to another division of the chest or box4 #e4 ,splints3 ,of those there should be at least four pair2 two pair for broken legs1 and two pair for broken arms4 ,they are generally made of very thin deal boards1 pasted on leather1 and slit1 so as to bend to the parts applied1 sideways1 but remain stiff length-ways4 ,paste-boards may however be made use of with good success2 and if the paste-boards are kept in sheets1 they have the advantage1 that splints may be made of them occasionally2 but by fomentation they are apt to become soft and flabby1 which ought to be guarded against4 #f4 ,bandages3 ,there ought to be three or four long ones1 two or three yards each1 torn length-ways off an old sheet1 not too much worn1 stitched together so as not to make a seam1 three fingers broad1 and neatly rolled up1 so that they always may be ready for use4 #g4 ,rags3 are a most requisite article at sea1 and ,i can only say1 the more there are the better4 ,they should by all means be clean1 and neither too coarse nor too fine4 #h4 ,tow3 is also a very requisite article4 ,a good large bundle should be provided1 and it should be cleared from the shaggins1 as they render it stiff and unpliable3 the grey is generally the best for medicinal purposes4 #i4 ,lint3 should also be somewhat plenty2 but as this may be made at leisure1 the quantity of that is not so material4 ,lint in the common method is best made from rags torn length-ways1 about three fingers broad1 and the transverse thread drawn by the help of a knife4 #aj4 ,tape3 is very useful1 particularly that of two fingers breadth1 and ought to be pretty fine4 ,at least a dozen of yards should be provided4 ,needles1 threads1 and pins should by no means be omitted1 being highly useful on many occasions4 ,secondly4 ,i shall now proceed to the herbs1 which need but be few1 as they are very subject to decay4 #aa4 ,camomile flowers are much used by some1 and supposed to strengthen the stomach2 ,i could never think them of that effect4 ,when however a vomit is given1 camomile tea is very useful1 and promotes greatly the operation2 but it should not be made too strong3 as much as may be taken between three fingers1 pouring on it a quart of scalding water1 and thus made into a tea4 ,but that kind of tea should not be too often repeated1 unless it particularly agrees with the stomach4 #ab4 ,balm3 ,this is an excellent herb on many occasions2 it is cooling1 and there is not a tea ,i have more to recommend to sea-faring people1 let their ailment be what it will2 it is of a balsamic and healing nature1 and will not easily pall on the stomach1 except where there is an universal weakness in the system2 where then what is more warming to the body than balm1 may with propriety be added4 #ac4 ,sage3 ,this is an herb of a more hot nature2 and in fevers should be used with caution1 unless where a transpiration is required4 ,it promotes urine and perspiration1 in many cases it may be used with the balm1 and then makes a very good tea1 both for the sick as well as those in health4 #ad4 ,sassafras3 ,this is one of the warming and balsamic woods1 which1 if it is mixed with lignum vit chips1 makes an excellent decoction for all rheumatic complaints1 and where the blood wants to be diluted or purified4 #ae4 ,oatmeal3 ,this article cannot strictly be deemed a medicine1 yet1 as water gruel is frequently wanted1 that of oatmeal ,i think the best2 besides1 it is excellent for making poultices1 being of a softening and rich quality4 ,but if it should be wanting1 pounded biscuit will answer the purposes4 ,in regard to diet1 ,i shall say more in its proper place4 #af4 cinamon3 ,this is a necessary article at sea1 as it is of a gentle astringent nature1 together being very warming1 and is undoubtedly the best of all the spices1 where the bowels are weak4 ,its peculiar uses ,i shall speak more of hereafter1 when ,i come to treat on loosenesses and fluxes1 and such diseases where it is useful4 #ag4 ,allum3 ,this astringent medicine is very useful for gargles1 for scurvy gums1 and various other uses4 ,burned allum 7which may be done by exposing a piece on a fire shovel over the fire till it is bubbled up and become of a white cake7 is an excellent medicine1 for gently checking proud flesh in ulcers2 besides which1 it makes an excellent tooth powder4 #ah4 ,chalk1 is as necessary an article as any medicine1 and so useful is it in long voyages1 that a ship should be well stored with it2 for it is not only an excellent absorbent1 and will stop fluxes1 when made use of in decoctions for that purpose1 but1 makes also a great purifier of water1 and thereby contributes greatly to the preservation of health2 as ,i shall hereafter further take under a stricter consideration4 #ai4 ,salts3 ,glauber's purging salts1 is a medicine which has had many virtues ascribed to it2 as a cooling purge it is very well1 but further ,i cannot recommend it3 ,an ounce1 or an ounce and an half is the dose2 and it will be best to dissolve it in a tea cup of water over night1 so that it may be taken early in the morning1 and worked off with drinking gradually some tea after every motion4 #bj4 ,diachylon plaister3 ,take lytharge fine prepared one pound1 oil of olive one quart1 boil them over a gentle fire1 putting into the pan a little water1 stir it all the while1 and take care it does not burn2 continue boiling1 till it becomes of a consistency of a plaister1 and make it into rolls2 which1 according to art1 is best done before it is quite cold1 upon a wet marble slab1 and wet hands1 and then put up in paper1 previously rubbed over with some soap1 to prevent it from sticking4 ,there is not a medicine so generally useful for all hands on board1 as this very plaister1 in case of cuts1 bruises1 or sores of any kind2 it is not only the medicine box that should be well provided with it1 but every man on board1 ,i advise to have a roll1 and some spread on cloth in his chest2 for in every little accident1 a cut1 a broken nose1 or broken shin1 c4 to which a seaman is liable1 nothing is handier1 and nothing is more beneficial than this plaister1 as it will prevent inflammation and festering1 heal it up1 and prevent small sores from becoming great ones4 #ba4 ,mercurial plaister3 ,take of the diachylon one pound1 purified mercury half a pound1 triturate the mercury with a little hog's lard or turpentine1 then melt the diachylon1 and incorporate the triturated mercury into it4 ,this is principally fit for venereal cases1 for buboes1 and other hard tumours2 it may also be put to shankers and very bad ulcers2 but it should never be used unless necessity requires it4 #bb4 ,blistering plaister3 ,take ,spanish flies eight ounces finely powdered1 common drawing plaister one pound1 melt the plaister and sprinkle the powdered ,spanish flies till all is well incorporated1 then make it into rolls according to art4 ,this is intended for rising blisters4 ,in regard to the use of this1 ,i have only to observe1 that it should be made use of only1 when the greatest necessity requires it2 that is1 in bringing on a crisis of a fever1 which ,i shall point out in its proper place4 ,at present ,i shall only speak of its application4 ,whatever place is intended to be blistered1 either the neck1 between the shoulders1 or the calf of the leg1 let the place first be cleaned with a little vinegar1 and rubb'd till it becomes red1 then let the blistering plaister1 the bigness of the palm of the hand1 pretty thickly spread1 7best upon leather7 be laid on the part1 and remain there for about twelve hours1 and be tied on1 that it may not shift3 at that time the blister will rise2 let it be cut to let the water out1 7but care should be taken not to pull off the skin1 as is frequently practiced7 dress it with ,turner's ,cerate1 spread upon a thin rag1 7or what is still better1 dry lint7 and let that dressing be shifted once every twelve hours1 till all is healed up4 ,i shall now proceed to the inner part of the chest4 ,a4 ,spirit of wine camphorated4 ,take spirit of wine rectified one quart1 camphor two ounces1 mix it1 and let the camphor be dissolved in it4 ,this is an external application1 for bruises and other inflammations1 where discussion1 or dispersion of humours is necessary1 its chief benefit is in sprains1 dislocations1 and fractures4 ,i have this however to observe with the camphorated spirit1 that though it is exceedingly useful in the forementioned1 and in some rheumatic cases1 yet it should be used with caution1 and not too plentifully1 as it is liable to dry up the vessels1 and might incline the limb to wasting1 if too freely made use of4 ,b4 ,liniment of soap4 ,take spirit of wine rectified one quart1 distilled oil of rosemary one drachm1 camphor one ounce1 castile soap half a pound2 cut the soap small1 and let the whole be mixed and dissolved4 ,this is an excellent external medicine for sprains1 rheumatism1 bruises1 c4 ,this medicine is commonly called opideldock1 and in all such cases is far superior to the spirit of camphor singly2 unless where the constitution is sluggish1 and requires a greater stimulus2 in general1 however1 this excellent composition will supply the place of both4#aj ,footnote #aj3 ,since these compositions are so easily made1 they might occasionally be prepared on board2 ,instead thereof1 ,i would advise the seaman to furnish the box with camphor and soap2 and instead of rectified spirit1 good rum or brandy will answer equally as well4 ,c4 ,sweet oil3 ,this ought to be pure and good2 it is of many uses in medicine1 which ,i shall treat of as occasion requires4 ,d4 ,sweet spirit of nitre4 ,this is a spirit distilled from spirit of wine one quart1 and spirit of nitre half a pound1 according to the art of chymistry4 ,in regard to its virtue1 it is an excellent medicine in most acrimonious cases1 and acts principally as a gentle diuretic2 besides this1 it is of an antispasmodic and antiputrescent quality1 and therefore useful in all kinds of inflammatory disorders1 particularly of the putrid kind of fevers2 which ,i shall1 in the course of this work1 take notice of4 ,e4 ,honey3 ,this is a useful article1 which ought to be plenty1 and of the best kind2 it is particularly useful for making gargles1 clysters1 poultices1 c4 c4 as shall be farther specified4 ,f4 ,yellow basilicon3 ,take olive oil1 yellow bees wax1 yellow rosin1 ,burgundy pitch1 of each half a pound1 turpentine two ounces2 melt the whole1 and mix them properly4 ,this is an external digestive application to cleanse ulcers1 and to make them discharge good matter1 by which the inflammation will abate4 ,g4 ,elixir of ,vitriol3 ,take stomachic elixir one pint1 oil of vitriol four ounces2 mix them1 and filter it through paper4 ,this is an excellent elixir for weak stomachs1 that proceed from bile and other causes of indigestion2 it is also a great specific against the scurvy1 and the like habits2 as also in feverish complaints4 ,the dose is from #bj to #dj or #fj drops1 in a little water4 ,h4 ,elixir proprietatis3 ,take of myrrh in powder one ounce and an half1 succotrine aloes in powder an ounce1 saffron four ounces1 of dulcified spirit of vitriol six ounces1 of rectified spirit of wine twenty-four ounces2 digest them in a sand heat for four days1 and then pour off the elixir from the dregs4 ,this elixir is an excellent stomachic1 it will promote digestion1 strengthen the stomach1 and create an appetite2 it will also keep the body gently open1 and on that account be of great benefit against many ailments in the bowels4 ,the dose is about a drachm or two1 or a middling spoonful2 to be taken either by itself1 or in a glass of wine1 and makes a most agreeable bitter4 ,i4 ,lenitive ,electuary3 ,take dried figs one pound1 tamarinds1 cassia1 french prunes1 each half a pound1 sena leaves eight ounces1 coriander seed four ounces1 liquorice root three ounces1 double refined sugar two pounds and an half2 reduce the sena and coriander to a powder1 and sift it through a sieve1 boil the figs1 cassia1 prunes1 and liquorice into a pulp1 and strain these also1 then mix the powder gradually amongst it1 and make it1 with the help of the sugar1 into an electuary4 ,this electuary is a gentle cathartic1 keeping the body coolly open1 and therefore very useful in fevers1 and weak constitutions when openness of the body is required4 ,the bigness of a large nutmeg is a dose1 which may occasionally be repeated4 ,k4 ,turner's ,cerate3 ,take olive oil a pint1 yellow bees wax and prepared calamine stone1 of each half a pound2 melt the wax and oil1 and mix the calamine stone3 keep stirring till it is cool4 ,this is a healing cerate1 very useful in scalds and burns2 as also to dress blisters with2 likewise for the external dressing of sores1 when near healing1 or to keep other dressings on4 ,l4 ,fever powders3 ,take purified nitre powdered half a pound1 crabs eyes prepared four ounces1 cinnabar of antimony finely prepared two ounces1 calomel one drachm1 and mix them4 ,this is the celebrated antispasmodic powder of the great ,stahl1 with some considerable amendment by means of the calomel2 which1 in the course of a long practice1 ,i have found the most beneficial for fevers4 ,there is not a kind of fever to which mankind are subject1 either at shore or at sea1 but what this powder may with safety and with great benefit be applied4 ,a scruple1 or half a drachm is a dose1 and which may be repeated1 as the ardency of the fever shall require4 ,m4 ,stomach powder3 ,take purified nitre prepared and chalk1 of each eight ounces1 nutmeg two ounces2 reduce all to a fine powder1 and let them be properly mixed4 ,this is an excellent powder against the heart-burn1 or other crudities of the stomach and bowels2 for whilst it absorbs the crudities and accidities in the first passage1 it is at the same time a gentle digestive1 and withal a carminative3 ,hence in heart-burn1 belching1 and other disagreeable symptoms of depraved appetite it is highly useful4 ,n4 ,calomel3 ,this is a dulcified mercury1 made of sublimate mercury four ounces1 pure quicksilver three ounces2 intimately mixed1 and sublimed six times1 according to the art in chymistry4 ,this is the safest and gentlest of all mercurial preparations1 and if judiciously administered1 may be deemed one of the greatest of all medicines4 ,i shall therefore be somewhat particular on this head4 ,in the first place1 it should be faithfully prepared2 and secondly1 levigated as fine as is possible2 to do this therefore1 ,i have in my ,treatise on the ,venereal ,disease1 recommended it to be ground with a little water on a flat marble1 to the finest degree possible1 and then dried up for use4 ,the fineness of this excellent medicine is of the greatest importance1 and ought to be strictly attended to1 for not only much mischief has been done by its rough particles in the bowels1 but it must follow1 that the finer it is1 the farther it goes4 ,and with all mercurials1 it should be strictly observed1 the less quantity we can make do1 the more we may hope for success4 ,there is not an acrimony in the human body but what may be corrected by this universal antacrid medicine1 if properly administered4 ,in venereal cases1 it should be one of the first1 and the principal remedy throughout the cure2 but care should be taken that the quantity be small1 and adapted to the strength of the patient1 and to prevent it from falling on the salivary glands1 and thence to produce salivation4 ,the dose should never exceed one grain1 a quantity sufficient for twenty-four hours1 except where there is evacuation1 or other discharges of the body required2 in which case it may be occasionally increased1 especially in malignant fluxes1 or when purges are given1 or in other evacuations4 ,it may be made up in many forms2 the best1 however1 is in pills1 with a little flower and water1 c4 or it may occasionally be mixed up with other medicines1 as ,i shall frequently have occasion to speak of4 ,o4 ,precipitate3 ,this is made up of equal weight of ,quicksilver and compound ,aqua ,fortis1 well mixed1 evaporated to dryness1 in a broad bottomed vessel1 by a sand heat1 according to the art of chymistry2 in which operation it turns red4 ,this is an excellent medicine1 applied to all kinds of ulcers1 as it will correct the malignity of the matter1 take off fungous flesh1 bring on a kind suppuration4 ,it will also clear the skin from all kinds of breaking-out1 and perfectly destroy lice1 nits1 c4 ,it should1 however1 like the former1 be levigated very fine1 for thereby it loses greatly its sharpness1 and becomes more efficacious4 ,it should also be mixed with some cerate1 ointment1 or other dressing1 and never1 or very seldom1 be used by itself1 as ,i shall hereafter point out4 ,p4 ,mercurial ,ointment3 ,take hogs lard eight ounces1 purified quicksilver one ounce1 ,venice turpentine two drachms2 rub the mercury into the turpentine in a mortar1 till the quicksilver disappears1 then mix the whole together4 ,this is popularly called ,unction1 and peculiarly useful in venereal cases1 as also to destroy a particular vermin called ,crab-,lice1 and other foulnesses4 ,but ,i must here give a caution against the too free use of mercurial ointment1 as it is not only apt to bring on salivation1 but if the mercury is adulterated with lead1 7as sometimes is the case7 it is liable to occasion many incurable pains in the limbs2 and by this the remedy may prove worse than the disease4 ,q4 ,rhubarb4 ,this is a necessary article in all kind of fluxes1 and relaxations in the bowels2 for1 besides that it purges gently1 it has withal such an astringency as to brace up the weakened vessels1 and to restore their proper tone again4 ,the dose of rhubarb is one scruple2 which should be mixed with some fine chalk1 or ,stomachic ,powder4 7,m47 about equal quantity1 particularly in the beginning of fluxes4 ,r4 ,jalap4 ,this of all purging medicines is undoubtedly the best1 when purging is required4 ,the dose is from a scruple to half a drachm1 mixed up into a draught1 with a little syrup and water1 or any other form4 ,a grain or two of calomel is ever a proper addition1 let the case be what it will1 that requires purging4 ,s4 ,ipecacuanha4 ,this is the best of vomiting medicines2 to be given about a scruple1 either in form of a little draught1 or in a bolus4 ,vomits are often of more benefit than purges2 not so much on account of cleansing the stomach1 as by the agitation it gives to the whole body2 whence it is brought into perspiration1 and thereby promotes the circulation of the fluids that was obstructed4 ,t4 ,liquid ,laudanum3 ,take purified opium one ounce2 cinamon and cloves1 of each one drachm2 white wine one pint1 steep them for a week without heat1 and filter it for use4 ,this is a medicine of much use in painful and restless diseases1 but should never be had recourse to1 unless the greatest necessity require it4 ,for1 whilst it lulls the nerves from their irritation1 it is apt to weaken their tone1 and by that1 greatly lessen the strength of the whole body2 but where really requisite1 it is a happiness that ease can be given1 by which to relieve nature in pain that it may be restored again to tranquillity4 ,the dose of this tincture is from #aj drops upwards to #cj4 ,u4 ,essential ,oil of ,peppermint3 ,this is one of the most grateful nervins in the whole materia medica2 and at the same time the least stimulant4 ,in all cases where there is weakness and feebleness1 ,i would advise this in preference of spirit of hartshorn1 or any other stimulant whatever4 ,it warms the stomach1 comforts the bowels1 and infuses a liveliness over the whole nervous system4 ,the dose is from #c or #d to #f drops1 on a little lump of sugar1 and dissolved either in a glass of wine1 or water2 which may be repeated occasionally1 without the least hurt to the constitution4 ,w4 ,turlington's ,balsam3 ,take ,st4 ,johns worth a small handful1 rectified ,spirit of wine two quarts2 digest them for a few days1 then strain and filter the extracts2 then take ,angelica root1 ,olebanum1 ,myrrh1 and ,socotorine ,aloes1 of each one ounce2 ,styrax1 ,benzoin1 and ,peruvian balsam1 of each an ounce and a half2 digest the whole in a slow heat for some days1 and filter the balsam off for use4 ,this is the genuine receipt of the celebrated ,turlington's ,balsam1 and an excellent medicine it is1 for many purposes4 ,externally1 it is an efficacious remedy for all green wounds1 cuts1 bruises1 c4 if immediately applied4 ,but particularly for internal uses1 its virtues are great3 ,it warms the stomach1 promotes good digestion1 enriches the blood1 warms the whole system1 and1 above all1 is a sovereign remedy in all rheumatic complaints4 ,the dose is about a tea spoon full1 in a glass of wine1 or any other convenient vehicle2 and on all occasions1 where bitters are made use of1 this ought to have the preference1 being one of the best stomachics4 ,but at the same time it should be observed1 that where there is a fever in the system1 it ought to be avoided1 as it is remarkably heating in its nature1 and therefore agrees best with cold constitutions1 and where the habit is weak4 ,here then ,i shall end this lecture2 and only observe1 that though there are various other medicines of the greatest importance1 as well for external as for internal uses1 ,i have purposely avoided them1 as their application requires more care1 than what we may expect from men who have not made medicine their peculiar study4 ,at the same time ,i must also confess1 that the forementioned will be sufficient1 if managed as ,i have already intimated4 ,it is a maxim with me1 'tis not so much the medicines themselves whereon the success depends1 as the judgment requisite to know how and when properly to make use of them4 ,i must likewise take notice1 that ,i have purposely adhered as close to the recipes of the ,dispensatory as ,i could with propriety1 because it may the better suit the apothecarys' shops in all parts of the world2 and that when a medicine is wanted it may the easier be supplied4 ,it would have been an easy matter for me to alter every medicine in its composition2 but ,i conceive this would have tended but to raise difficulties in procuring them1 and taken away from the general utility of the book4 ---------------------------------------- -------------------------------- ,,lecture ,,iii4 ,,of ,,accidents1 ,,and ,,their ,proper ,method of ,treatment4 ---------------------------------------- --- ,i ,shall now proceed to the actual assistances that the human body stands in need of1 when the order of health is impaired4 ,this is the noblest office1 in which mankind can possibly give aid to each other4 ,health is certainly the greatest blessing this side of the grave2 and what service can we render to our fellow creature1 so valuable1 as to assist him in the hour of distress4 ,from this consideration it naturally follows1 what caution it also requires1 and how circumspect every one ought to be1 who takes upon him that noble office4 ,before therefore ,i begin this important lecture1 let me request of the reader the strictest attention1 and never to act before the ailment1 as well as the method of treatment is thoroughly understood2 since nothing less than health1 and even life itself1 is liable to be the forfeit of a fatal error4 ,mankind are ever liable to accidents1 how cautious soever their conduct in life may be3 ,but seamen1 particularly are more so2 not only from their occupation1 but from the precariousness of the element on which they are dependant1 and which so often exposes them to the most imminent danger4 ,i shall divide the accidents of bodily dangers1 into falls1 wounds1 bruises1 dislocations1 fractures1 scalding1 burning1 and drowning2 and treat on each part separately1 in as plain a manner as is in my power4 ---------------------------------------- --- ,,sect4 ,i4 ,of ,falls ,the man who falls1 is partly bereft of his senses1 or his presence of mind1 and particularly so the more timorous he is of his own preservation2 add to this1 because he is unaccustomed to it2 for custom makes us familiar in every thing3 ,thence we perceive the different effect in different persons in their falling2 for some will fall with a good deal of judgment1 prevent some unlucky blow or other2 whilst another shall fall as heavy as a dead log1 or like one drunk1 without having the least chance of saving himself in any shape4 ,i remember once ,i fell from the puttock shrowds of the fore-top1 but providentially escaped without the least injury1 my watch chain having catched some how1 which ,i endeavoured to save4 ,i confess this in a great measure was owing to good fortune2 at the same time ,i was naturally very active1 and having acquired a flight of jumping off the main-deck into the hold of a light ship1 ,i thereby had habituated myself to stop my breath1 and a presence of mind which principally saved me when ,i thus fell in good earnest4 ,i only mention this to shew1 that the greatest mischief in falling proceeds from timorousness and surprise4 ,i knew a wag1 who would play pranks that way to astonishment2 he could let himself fall from any part of the rigging1 catching as he came down like a cat1 make all hands come round to his assistance1 and then laugh at their credulous good nature4 ,a man who falls is apt to lose his breath1 particularly if he is not very careful1 and has not presence enough to stop it the moment he finds himself fall2 and the instant he loses his breath1 he loses also his mental faculties2 consequently comes motionless and exposed to every fatality4 ,thence we generally find a man1 who has fallen from a considerable height1 lays motionless like death on the spot1 even though he has not received the least injury otherwise4 ,the ,method4 ,when ,i have been called to such an accident1 and found my patient motionless2 ,i have untied his neckcloth taken him by the coller of his jacket1 and shaken him heartily2 which in the space of half a minute has brought him to1 with a heavy sigh4 ,next ,i have bled him without loss of time1 but not too copiously2 after which ,i have examined him1 and acted according to circumstances4 ,a person falling is liable to a number of dangerous consequences1 not mentioning immediate death4 ,the consternation1 the shock1 fright1 terror c4 are as alarming and dangerous as the external hurt itself4 ,the brain1 and the blood vessels in that part are very delicate1 and by the shock1 as well as the want of respiration1 they often burst2 thence an apoplexy is liable to hurry the patient from the stage4 ,a fever generally attends a fall1 which ought to be strictly attended to2 after1 therefore1 the patient is bled1 and seems to have recovered his reason1 he should have every six hours a dose of the ,fever ,powders1 7,l47 and drink some balm tea1 in order to get into a gentle perspiration1 which will in this respect soon recover his health again1 and enable him to do his duty4 ---------------------------------------- --- ,,sect4 ,,ii4 ,of ,wounds ,a ,wound is an unnatural separation of any part of our body1 whereby the order of circulation is hindered1 the solids divided1 and the fluids let out2 suddenly caused by some violent means or other4 ,but when such a separation becomes ulcerated1 it loses the apellation of wound1 and is called a sore1 or ulcer4--,this distinction is requisite to be taken notice of2 for wounds and sores are often confounded1 which shews not only ignorance1 but as their nature is materially different1 their method of treatment is not less so2 and ought therefore previously to be understood4 ,wounds are best distinguished into three different kinds2 cut wounds1 bruised wounds1 and gun-shot wounds4 ,i shall briefly shew how to treat each in particular4 ,cut ,wounds4 ,a ,cut wound is barely a separation of parts2 and the sharper the instrument with which the wound was made1 the easier will the wound be to heal up again4 ,it is however a natural thing to observe what parts of the body is wounded1 for tho' nature is kind in uniting the parts1 yet some parts are more easier healed than others4----,observe therefore ,the different ,methods4 ,if an artery is wounded 7which is known by the blood being of a florid colour and spinning out by starts7 care should be taken to have it stopt to prevent bleeding to death4 ,but in this you should not be too scrupulous4 ,two or three ounces from a wound makes a great shew2 and very often a little blood lost is of great benefit to the healing4 ,should1 however1 the blood gush from the wound violently1 especially from an artery1 make a compress of lint1 strewed with ,powder'd ,allum1 7#ag7 which secure well on the parts with a roller1 laying over it a compress1 with ,spirit of ,wine and ,camphor2 7,a7 if that should not be yet sufficient1 put a piece of money in a compress1 and secure it on the wound1 that is1 provided the part of the body will admit of it1 such as the arms or the legs1 c4 ,let the ligature1 or the first dressing1 lie on for two or three days1 and1 if no hindrance to the patient1 longer4 ,if all these things are not sufficient1 recourse must be had to the needle4 ,in every other kind of cut wounds1 care should be taken to have it first cleaned with some water2 7a small matter of vinegar1 and brandy may be mixed with it7 next1 let the lips of the wound be well closed1 dressed with dry lint1 and ,turlington's ,balsam 7,w71 and over which1 a compress with ,camphor ,spirits 7,a74 ,plaisters1 salves1 c4 in green cut wounds1 are altogether needless4 ,all that is required to healing1 is to keep the wound clean1 to give it rest1 and not to aggravate it with any thing acrimonious4 ,turlington's ,balsam 7,w7 is admirable1 but yet it suits small wounds better than large ones4 ,as a finger is very liable to be cut1 and sometimes gives a great deal of trouble1 ,i will here give a simple and expeditious remedy3--,if you have cut your finger1 wash it in a little salt or fresh water2 tie it round with a good long thread1 not too tight1--take care that your wooling may keep on without being removed2 and a day or two will heal it up1 without any farther plaistering4 ,if inflammation attends the wound1 methods should be taken accordingly1 by bleeding1 fever powders1 c4 ,of ,bruised ,wounds4 ,these kinds of wounds are of a worse nature1 and are not so kind to heal as the former2 for here the parts seem to be torn to pieces1 so that there is not only a separation of parts1 but a destruction of a great many tender fibres all round the wound4 ,hence we see in such cases a great deal of swelling1 inflammation1 and pain attend it2 for the blood being hindered1 the circulation naturally swells up the parts2 and the nerves being lacerated also1 must occasion great pain4 ,hence it must follow1 that nature must first get rid of the obnoxious and torn part before she will consent to unite the wound again2 and this must be performed by suppuration4 ,in small cases1 nothing is more beneficial than ,diachylon ,plaister1 7#bj7 which assuages the inflammation1 corrects the acrimony1 and brings the wound to a good state4 ,broken shins often occur on board a ship1 which is of that species of wounds4 ,and as from such a case1 7though in general slighted7 many evils have arisen1 ,i would caution the mariner to apply immediately ,diachylon ,plaister 7#bj7 to a broken shin2 by which he will prevent having an ulcerated leg2 a thing very troublesome4 ,if the bruised wound is on other parts1 and the parts all round are bruised1 care should be taken that it is cleaned as before directed1 and a pledget of lint1 with ,yellow ,basilicon1 7,f7 will be necessary2 over which a compress with ,spirits of ,wine and ,camphor1 7,a7 or rum1 may be applied2 and afterwards1 when it begins to heal1 it may be dressed with dry lint4 ,as these kind of wounds are liable of becoming ulcers1 great care should be taken in the beginning to treat them properly4--,wounds in general should not be dress'd or look'd to too often2 in general it aggravates the parts1 and retards healing4 ,a wound should not be opened the first three days after the first dressing3 nature is very kind1 and requires care only to replenish what is deficient4 ,when an ulcer has commenced1 see the treatment under that head4 ,gun-shot ,wounds4 ,these are the most terrible of all sorts of wounds2 for it is not only the contusion that attends them1 but frequently the ball forces strange things1 as cloaths1 c4 into the wound with it4 ,gun-shot wounds at best are tedious in their healing1 but very often1 from their nature1 liable to mortification1 and thence become dangerous4 ,besides1 it is seldom that the fleshy parts alone are wounded1 but they frequently penetrate into the very bones themselves4 ,the first care in gun-shot wounds1 is to extract the ball1 or whatever is forced into the wound2 in the next place1 the wound should be dressed with ,yellow ,basilicon1 7,f7 mixed with fine ,precipitate 7,o74 ,no4 ,i ,take ,basilicon one ounce1 fine ,precipitate one scruple1 and mix them4 ,the parts all round should be well fomented with warm claret1 intermixed with ,spirits of ,wine and ,camphor4 ,if the patient is full-bloody1 and no blood lost by the wound1 he should be blooded1 and immediately treated as a patient in a fever4 ,if the pain in the parts become violent1 eight or ten drops of liquid laudanum 7,t71 together with thirty or forty drops of sweet spirit of nitre 7,d71 should be given once1 twice1 or thrice a day4 ,if the wound begins to discharge plenty of matter1 it should be dressed with the same dressing often4 ,but if the parts become black1 very ftid1 the patient in great pain1 and grows faint1 a mortification is to be feared2 which ,i shall treat of in its proper place4 ,when the suppuration is unkind1 and the parts are much inflamed1 a poultice will be very proper4 ,no4 ,,ii ,take oatmeal 7#ae7 or 7if that is not on board7 biscuit pounded about three spoonfuls1 honey one spoonful1 water a sufficient quantity to boil it into soft poultice2 in which put of sweet oil about half a spoonful4 ,this poultice should be renewed twice a day at least1 and put on as warm as possible it can be borne4 ,as gun-shot wounds are apt to degenerate into malignant ulcers1 ,i shall refer the reader to the treatment of ulcers in general4 ---------------------------------------- --- ,,sect4 ,,iii4 ,of ,bruises4 ,bruises1 in whatever degree1 have more or less some blood and other vessels torn and injured1 and may properly be considered as wounds under whole skin4 ,it is from the tearing to pieces blood vessels1 whereby the blood extravasates from their natural channels1 that occasions the swelling4 ,if the bruise is but slight1 the vessels are soon enabled to circulate the humours2 but if the contusion is great1 the extravasated humours are apt to corrupt1 and make a collection of matter2 thence an aposthume and ulcer must naturally follow4 ,bruises on fleshy parts are not so bad by far1 as on the joints1 because the fibres in the muscles are more pliable1 and sooner unite2 the ligaments on the joints are very rigid1 and extremely sensible2 for which reason also1 they are generally more painful and tedious in their cure4 ,the first intention is to disperse the extravasated humour1 and to strengthen the tone of the injured fibres4 ,to this intention the parts should immediately be bathed with spirit of wine and camphor 7,a74 ,but if the bruise is immediately on the joints1 the linament of soap 7,b7 is still superior4 ,a bandage over the part1 so as to keep it in rest as much as possible1 is also of great service4 ,if1 however1 the part is so very much bruised1 that there appears a collection of crumous blood1 and that an aposthume is actually the consequence1 recourse may be had to the above poultice in order to ripen it the more1 and bring it the sooner to a head2 and then treat it as a common ulcer4 ,but that seldom is the case4 ,if the contusion is great1 and the patient is full of blood1 bleeding is necessary2 for in such a case a fever is apt to ensue1 which should be guarded against1 and the patient treated accordingly4 ---------------------------------------- --- ,,sect4 ,,iv4 ,of ,dislocations ,there are many accidents by which a limb may become dislocated2 the reduction of which is a material point in surgery4 ,but if a surgeon is not at hand1 a man ought nevertheless1 not to remain in that painful and deplorable state1 that endangers not only the limb of becoming useless1 but even the loss of life itself4 ,i shall proceed therefore in my directions as plain as possible1 avoiding every expression that may render this operation prolix4 ,it must first of all be remembered what was said of joints1 articulations1 and ligaments in the first lecture under that head4 ,we must thence observe1 that a dislocation of the upper arm with the shoulder is the most common that happens1 because of the great variety of motion1 and the flatness of the head of the arm-bone1 and the cavity of the shoulder blade4 ,next to this is the thigh bone1 with the hip4 ,but this is done by much greater force1 and therefore more troublesome in reducing4 ,all other joints that are angular are seldom really dislocated1 being stronger secured1 and cannot be separated from their articulation1 without first tearing the ligamentous capsula that surround them2 yet nevertheless1 some are subjected to be partly dislocated2 and this is what is commonly called sprains4 ,dislocations may be from two causes2 first from violence1 secondly from weakness of the ligament4 ,in the latter case the reduction is the easiest1 but the limb is apt to slip out again by the least accident4#aa ,footnote #aa3 ,i remember a man who frequently had his shoulder dislocated1 and was his own operator in reducing it again4 ,the first time the accident happened in the ship ,i was surgeon of1 ,i was naturally called to his assistance3 8,stop ,doctor10 7said ,tom7 8,i have got a tackle in my chest1 and ,i will soon bouse it in again20 and sure enough1 he had a pully1 with which he immediately reduced it4 ,i shall briefly consider each kind of dislocation1 that an accident makes a man liable to4 ,dislocation of the ,arm with the ,shoulder4 ,the dislocation of that1 may be two ways2 7viz7 downwards1 and forwards2 but it cannot be backwards nor upwards2 except some part of the shoulder-blade be broke4----,the best method to examine the patient what kind of dislocation it is1 7especially to one unacquainted with these branches of surgery7 is strictly to compare both shoulders1 and the difference will be very plain1 both to sight and touch4 ,if the dislocation is downwards that is1 the head of the arm-bone1 slipt in the arm-pit1 there will be a cavity on the top of the shoulder1 different from the sound arm1 and the elbow will be drawn upwards1 without being able to be moved either towards the body2 or so1 as the patient to put his hand out without the greatest pain4 ,when this is found to be the case1 then1 in order to reduce it1 set the patient low1 on a steady seat4 ,take a napkin or towel1 of which make a girt2 put one part over your neck1 and the other part under the arm-pit4 ,let an assistant hold the patient steady1 another take hold of the patient's arm1 with the elbow bent1 and extend it gradually2 then with both your hands take the arm1 and whilst you lift up the arm by help of the napkin resting on your neck1 you press gently down the arm with your hands like a lever2 in the mean time the assistant extends1 and thus you reduce it2 which you will hear by its snapping3 upon which the patient will be able to move his arm in all kind of direction1 without much pain4 ,if the head of the arm-bone is dislocated forwards1 there will be a cavity backwards on the shoulder1 and the elbow will stick backwards1 and remain motionless1 with great pain4 ,in this case1 as before1 let the patient sit low1 and with the help of the napkin1 and assistances1 first extend the arm forwards2 then like a lever bring the head of the bone in its cavity2 which1 like the former1 will be perceived by a snapping1 and the voluntary motion of the patient's arm4 ,when the shoulder is reduced1 secure the whole with a long double-headed bandage1 cross-wide over the shoulders1 and round the body4 ,foment it night and morning with spirits of wine and camphor 7,a74 ,keep the arm close to the body1 with the elbow bent1 and wear it in a sling1 that it may be free from motion till it is well4 ,dislocation of the ,elbow1 or the ,knee4 ,the elbow1 as ,i said before1 is very seldom dislocated1 unless fractured1 and the ligament tore at the same time2 and when so1 the case is terrible4 ,but very often those joints receive a wrench1 which1 though nothing out of its place1 is often very painful1 on account of the many tendons that surround the parts4 ,the only thing in such wrenching1 is to foment it with spirit of wine and camphor 7,a71 or else the saponaceous linament 7,b74 ,the same method should be observed with the knee1 securing it well with a bandage1 in order to give it rest to recover3 ,for rest is a principal remedy4 ,of spraining the ,wrist1 or ,ancle4 ,the wrist and ancle are complicated joints1 and thence capable of a great number of motions1 and subject to a variety of sprainings1 but not a perfect dislocation2 nevertheless1 they are very painful1 and sometimes tedious in getting well4 ,whatever be the matter1 the sick part should be compared with the sound1 and the difference is soon seen4 ,if it so happens1 that there appears a perceivable difference1 the parts should be gently extended1 and reduced2 and all that is to be done1 is the securing it well with a bandage1 and fomenting it with ,spirits of ,wine and ,camphor1 7,a7 or1 what is yet better1 ,linament of ,soap4 7,b7 ,the thumb1 however1 is liable to be dislocated1 which is easily perceived2 which should be immediately reduced1 and secured with a bandage1 and treated as already directed4 ,dislocation of the ,thigh ,bone4 ,the articulation of the thigh bone with the hip is similar to the shoulder1 with regard to the head of the bone1 and the pan in which it moves1 except that it is much deeper4 ,it must be a great force that drives it out of its articulation1 and consequently very difficult to be reduced4 ,it may either be dislocated inwards1 or backwards4 ,if the dislocation is inwards1 which is the most common1 the toes will be turned outwards1 and the whole leg and thigh will be somewhat shorter than the other2 so likewise1 if it is dislocated backwards1 the leg and thigh will appear shorter1 but the toes will be bent inwards4 ,the best way of determining1 as ,i have said before1 is to make a just comparison of the sick and sound leg4 ,the reduction is somewhat difficult1 and will sometimes baffle the most experienced surgeon1 because the acting muscles are very strong2 and when they have first begun to contract the parts1 they will not easily suffer themselves to be relaxed4 ,nevertheless1 lay the patient upon his back or on the sick side1 upon a steady table2 let an assistant hold him fast1 another extend the thigh1 so as to have the knee bent2 the operator having a napkin resting on his neck1 and under the thigh of the patient1 similar to the method directed before by the shoulder2 and then with both hands bend the thigh1 as with a lever1 into its socket again2 when it will give a loud snap1 coming into its proper place4 ,it very frequently happens in this heavy dislocation1 that either the articulation is not reduced1 or that it immediately slips out again when reduced2 so that the patient will never recover the former use of that limb more4 ,in this case nature is very kind1 and the part where the bone slips into will become callous1 and form as it were a new acetabulum2 by which the patient in time comes to walk1 though 7as it may be supposed7 but lamely4 ,in the course of my practice ,i have met with but two perfect dislocations of the thigh1 both of them perfectly recovered2 but it must be remembered1 they had youth on their side1 and the greatest care joined to favourable circumstances4 ,at best however1 it is an ugly accident1 for it is not only that the ligaments that surround the joint are generally torn1 but very often the thigh bone is fractured at the same time4 ,it requires more skill than one would suppose1 to determine which is the case1 whether a fracture1 dislocation1 or both2 and am apt to believe they are often confounded with each other4 ,when the dislocation is reduced it should be well secured with a long double-headed bandage2 the patient kept still1 the part well fomented1 and if requisite1 some blood taken away3 a fever generally attends1 which should be duely taken care of4 ,on the whole1 dislocations when they proceed from violence1 are sometimes attended with severe symptoms1 the parts being very sensible1 and it will require sometime for the patient to recover his strength again4--,care therefore should be taken to keep the parts warm1 and give them as much rest as possible4 ,a strengthening plaister spread upon leather1 and put for a constancy round the parts after the inflammation is gone of1 will also prove of singular service4 ---------------------------------------- --- ,,sect4 ,v4 ,of ,fractures ,we come now to fractures4 ,there is something terrible in the sound of broken bones2 and yet in common they are by far more easier managed and healed than a dislocated joint3 nature is very kind2 from the fractured parts of a broken bone1 there exsudes a gelatenous matter called ,callus1 that very soon glews them together again1 and makes them stronger than ever4 ,as easy as a fracture is ruined1 as easily it may be well treated4 ,i shall therefore lay down some few rules1 which if properly observed1 will ever be attended with success1 as they are founded upon happy experience1 in my own practice4 ,in the first place1 a fracture should be reduced as soon as possible4 ,secondly1 the part should have as much rest as possible till the callus is formed1 or the bone knitted together again4 ,thirdly1 bandages should not be laid on too tight4 ,fourthly1 camphorated fomentations should not be too plentifully made use of4 ,fifthly1 the habit of body should be kept in a slate of health2 and ,sixthly1 the diet during the time should be wholesome and sparing4 ,with regard to the reduction1 it was formerly a great error for a limb to be stretched out in an extensive posture2 for the extension of the muscles contracted the limb1 and made the reduction both painful and troublesome4 ,i shall here recommend a better method2 namely to have the muscles in a flexible position1 during the operation and the cure4 ,but to proceed to particulars4 ,a ,fracture of the ,skull4 ,this accident is frequently attended with many bad symptoms1 and often requires the operation of the trepan2 which ,i shall here pass over1 being too prolix for this place4 ,i have only to observe1 that we have frequent instances of the patient doing well without any other help than bleeding2 and where there is no surgeon on board1 this is the only remedy first to fly to1 and gives the greatest chance for the patient's life3 next to this1 shave the head1 and treat him as circumstances shall direct1 without meddling with the fracture1 any farther than applying gentle fomentations1 with flowers of chamomile 7#aa7 boil'd in claret1 and some linament of soap 7,b7 added to it2 and if there is any wound1 have it properly dressed as directed in the article of wounds4 ,fracture of the ,arm4 ,if the upper arm is fractured1 proceed in the following manner3 ,first of all be sure it is a fracture2 to know this1 put one hand on the middle of the arm1 and the other on the elbow1 move it gently to and fro1 and if there is a fracture1 you will find it crackle by the touch1 which sometimes is so distinct as to be heard4 ,the arm at the same time is somewhat swelled1 and either the patient cannot move it1 or else it is attended with very great pain4 ,when the fracture is certain1 then proceed in the following manner2 ,let the patient sit upon a low chair1 or chest1 let an assistant hold him steady1 and let another lift up the arm1 and extend it gradually1 horizontal to the shoulder1 keeping the elbow bent somewhat all the while4 ,then with both your hands gently press the fractured bone1 so that it may feel perfectly joined again4 ,sometimes it happens that the ends of the bones are somewhat slipt over each other2 in which case1 extension is the more requisite4 ,when this is done1 then take a bandage of about two yards long1 first rolled up1 and wrung out of spirit of wine and camphor 7,a472 begin near the elbow1 and lay it smoothly on1 laping over a little2 and proceed gradually till it comes to the shoulder1 and then return with it back again till it is done4 ,this bandage should not be too tight1 nor too slack1 but so as immediately to suit the arm exactly4 ,over this bandage again1 lay a double folded rag1 called a compress1 so as to cover the bandage2 and over this again two splints1 one above1 and another below2 which tie gently together with some tape in three places4 ,then put the arm into a sling2 cover up the whole arm and hand1 and let the patient go to rest4 ,if the fracture is upon the under arm1 the reduction is a little more difficult2 but only in the care it requires of reduction4 ,as there are two bones in the under arm1 it should well be examined which it is1 or if both4 ,in reducing of it1 let the arm be bent as before2 one assistant to hold the patient1 one to hold the elbow1 and another the wrist2 gently extending1 till the fracture is reduced1 as before directed1 and the bandage1 compress1 and splints1 put on according to the same ,method4 ,in this fracture the wrist and hand should be kept from moving2 as the motion of their muscles will be apt in a great measure to hinder the bones from uniting again4 ,a fractured ,thigh bone4 ,this is of very great importance2 which1 from its situation1 and the strength of the muscles1 in general1 even by the best method is very difficult to reduce4 ,let the patient lay on the opposite side1 and with the knee bent2 let the limb be extended by assistances1 and carefully set it according to the situation1 similar to the beforementioned method4 ,this limb requires a very long bandage1 and very large splints4 ,the method of treatment must be as before1 and the patient must be well secured in bed4 ,he should not lie constantly upon his back in a straight posture1 as formerly was practised2 but most part upon either side1 with his knee bent1 which should be kept bent as much as possible2 if he can lay chiefly upon his sick side1 so much the better2 he may also move a little his joints1 in order to prevent them from growing stiff4 ,a fractured ,leg4 ,this accident is more common1 and therefore ought to be paid the greatest attention to4 ,to know for certain whether the leg is fractured1 let the patient lay on his back or on either side1 with his leg and thigh bent1 so that the muscles are entirely at ease1 and out of action4 ,let an assistant hold up the leg by the knee2 then take with one hand the ancle1 with the other the middle of the leg1 and move the ancle to and fro1 holding the other hand steady1 and if you feel a crackling1 and the patient feels great pain in those parts1 the leg is certainly fractured2 particularly if the patient could not stand upon it before4 ,this being fully discovered1 we must next examine which bone is fractured1 the ,tibia or ,fibula2 and then proceed in the following manner4 ,let the patient lie as before directed2 one assistant holding the knee in a bent position1 another holding the leg near the foot1 both gradually extending4 ,then with both your hands reduce the fracture1 by gently pressing it with the palm of your hand while it is extending4 ,then lay on a long roller2 or1 what is still better1 a many-tailed bandage1 which is made thus3 ,take nine or ten slips of linen1 about two inches broad1 increasing from twelve to twenty inches in length1 laying over each other about half an inch4 ,the whole bandage must be secured with a slip of linen behind1 so as to make the breadth of the bandage the length of the leg2 either of these must be previously wrung out in camphor spirits4 ,if you make use of the roller1 begin laying it on from the ancle1 going gradually upwards1 folding each round over half an inch at a time2 and under the calf of the leg1 give the bandage a single twist1 by which it will always suit4 ,continue this till the whole is finished4 ,over this again put a compress1 and then put on the splints1 7previously bolstered with some tow7 which secure with tape1 as before observed with the fracture of the arm4 ,the many-tailed bandage is however superior to the roller1 in the fracture of the ,leg4 ,the method of laying it on is this3 the patient laying upon his back1 with his thigh lifted upwards by the assistant1 put the bandage under the calf of the leg2 then begin from the ancle upwards1 folding over alternately the tails of the bandage1 so that they secure each other4 ,when this is compleated1 put over the whole a ,compress1 as before directed1 as also the ,splints2 or in the room of common splints1 put on the new invented splints of ,mr4 ,sharp2 of which a ship should have three or four pair of different sizes1 both for the right and left leg4 ,when this is performed1 the patient should be put to rest as soon as possible2 and he will lay easiest upon the side where the fracture is1 with his thigh and leg bent forwards4 ,this position suits not only best on board a ship where the motion is continually apt to disturb the sick part1 but is also most natural both for ease1 and for healing2 as the muscles are all at rest1 and adds firmness and ease to the body4 ,compound ,fractures4 ,when a fracture is attended with a wound1 it is needless to observe1 that the case is of a more dangerous nature4 ,if the contusion has been so great1 as to splinter the bones1 such splints as are loose1 and seem to prick through the flesh1 should by all means be removed4 ,violence must however be avoided2 for by a little patience1 nature will of her own accord separate and discharge them4 ,gentleness should ever be observed in surgery1 though not a timid weakness1 by being defective in dressing properly4 ,the reduction of the fracture should be conducted the same as before1 with this difference1 that always a many-tailed bandage should be chosen1 so that it may be opened when requisite4 ,the dressing of the wound should be the simplest possible2 for the nature of bone is so delicate1 that it will neither bear to be much exposed to the air1 nor suffer any greasy salve or ointment to come near it2 both are liable to corrode it1 and bring on a carious1 which is of a most dangerous tendency4 ,dry lint therefore is the best1 particularly near the fractured bone4 ,in short1 it is to be treated cautiously1 like an ulcer1 and the greatest care to be taken1 that the arm1 leg1 or whatever fractured part it is1 be kept steady1 and no oftener dressed than what is absolutely necessary4 ,conclusive ,observations on ,fractures4 ,in the obscure times of surgery1 various medicines were applied to broken bones1 with a notion to unite them the sooner4 ,this1 however1 is entirely exploded from modern practice4 ,the inflammation that generally attends fractures requires however a fomentation of ,camphor ,spirits 7,a71 in order to disperse the obstructed humour2 but if there is no inflammation1 the part undoubtedly is the better without such applications2 as then there will be nothing to hinder a free circulation2 for which reason1 fomentation should be used as sparingly as possible4 ,it is well known too1 with what difficulty the fractured bones were set formerly1 owing principally to the limb being stretched out in a position that excited all the muscles to contraction4 ,this is also here obviated4 ,in reducing therefore a dislocation or fracture1 the muscles should be as much at rest as possible1 both in the operation1 as well as during the whole time of the cure4 ,it is for that very reason my direction in this respect differs from what has been delivered to us by authors on that subject1 particularly such1 as might be expected to fall into the hands of a seaman4 ,another error has been practised1 namely1 the laying on the bandage very tight4 ,it was supposed1 that that would strengthen the limb1 and make the bone smooth2 but it has sometimes prevented the bones from growing together at any rate4 ,the bandage to be sure should not be too slack1 for then we might as well lay it aside entirely4 ,a bandage certainly is necessary1 but merely as a support1 and it should never be tighter than what the patient can well bear4 ,in simple fractures1 the first dressing should be so permanent1 as to have no need for being removed1 at least for six1 seven1 eight1 nine days1 or more2 if the patient don't feel uneasy4 ,for my own part1 having ever been successful in fractures1 ,i have not opened the first dressing for a fortnight1 and sometimes three weeks4 ,the laying stretched upon the back when a leg is fractured1 is altogether needless1 troublesome1 and even a hindrance to the healing4 ,the patient should have a good wide cot1 and so that it may swing pretty easy2 or else entirely confined1 when the ship has much motion2 and having the leg well secured with splints1 he may safely lay on what side he pleases1 provided he does not sit up in the bed 7though he may out of it7 for the first three weeks2 for that strains the muscles very much4 ,the diet should be sparing1 the body kept open1 and a temperate warmth should be preserved1 in order to promote perspiration4 ,drinking of strong liquors should by all means be avoided1 and the diet should be as fresh as the circumstances will permit4 ,six weeks is generally the time allowed for the cure2 that however is no certain rule4 ,if the fracture is simple1 and the constitution good1 then at a month's time a small trial may be made by the help of crutches1 or a trusty mess-mate1 in a calm day2 but if it occasions the least pain1 it should be postponed4 ,this is then all ,i have of consequence to observe in simple fractures2 which holds good also with compound ones1 except that the wound requires to be dressed oftener2 but the greatest care should be taken1 that it is done in a manner1 so as not to disturb the knitting of the bone4 ---------------------------------------- --- ,,sect4 ,,vi4 ,of ,scalding ,scalding is another accident of much consequence1 which ought to be remedied by times1 in order to prevent the many evil consequences of inflammation it is liable to produce4 ,i must first of all refer the reader to what ,i have said on the skin1 ,lect4 ,i4 ,sect4 ,,vii4 for farther than this we will not suppose a scalding proceeds1 unless it is very dreadful indeed4 ,the nature of scalding then1 is this3 the hot water coming upon the body1 separates immediately the scarf skin from the real skin1 thereby opens the lymphatic vessels1 so that they discharge their lymph under the cuticula1 and thence arise blisters4 ,but withal1 the heat of the water irritating the nerves1 they are excited to contract and constrict the delicate vessels1 and hinder the circulation2 thence ensues the fiery colour and inflammation1 and create acrimonious tendencies4 ,thence we learn1 that a relaxation of the solids is to be relaxed1 and the humours to be rectified4 ,the moment a man has scalded himself1 immediately apply ,turner's ,cerate 7,k71 spread upon a rag1 to the part4 ,what is equally as efficacious1 and sometimes better1 is the ,linament of ,soap 7,b74 ,if notwithstanding this1 blisters arise1 open them not1 but let them remain with the application on them1 whereby a cure will soon be facilitated2 but if they break open on their own accord1 or that the scarf skin was scalded off1 then apply on the sore1 ,turner's ,cerate 7,k71 intermixed with a little ,calomel 7,n71 and levigated ,precipitate 7,o71 which will prove very beneficial4 ,no4 ,,iii ,take ,turner's ,cerate 7,k7 one ,ounce1 ,calomel1 and fine ,precipitate 7,o7 of each ten grains1 and mix it4 ,this spread upon a little lint will prove a fine healer4 ,if the ,diachylon ,plaister 7#bj7 can be applied1 it will also prove so powerful an antiphlogistic1 that any other will be unnecessary4 ---------------------------------------- --- ,,sect4 ,,vii4 ,of ,burning ,this is of the same nature with scalding1 but is liable to become more pernicious1 in proportion to the bulk and heat of the body that does the mischief4 ,if it is slight1 the treatment is equal with the former2 but if it has penetrated deeper1 it follows1 that the inflammation is greater1 and consequently the treatment requires more care4 ,if the sore so burned is deep1 and thence an eschar in the parts1 digestive medicines should be applied4 ,it will not be amiss to put a little ,mercurial ointment 7,p7 in the poultice4 ,if the inflammation is very great1 ,bleeding1 and other methods requisite to prevent a fever1 should be observed4 ,in general1 the ointment ,no4 ,,iii4 will ever be found ,efficacious4 ---------------------------------------- --- ,,sect4 ,,viii4 ,of ,drowning ,a ,man who unfortunately falls over board1 and is taken up for drowned 7immediately7 should not be given up for lost4 ,as this is a circumstance of the utmost consequence to a sea-faring man1 ,i shall think my time well rewarded in explaining the method of recovery contributing to the preserving the life of my fellow creature4 ,there are different ways of drowning2 and according to the nature of the accident1 the probability of recovery is founded4 ,a man1 before he comes into the water1 may receive an unlucky blow1 that will not only stun him1 but make him expire his breath 7which is generally the case in high falls7 as before observed4 ,in this case his senses are benumm'd1 and by the inspiration apt to draw in a quantity of water into his lungs instead of air2 thence1 both from the blow1 and from the total stoppage of respiration1 he may have some blood vessels burst1 both in the lungs and in the brains1 whereby he is instantly irrecoverably dead1 beyond all hopes4 ,in this case it may happen1 that either way1 separately1 is enough to kill him4 ,a man may also1 in the very act of drowning1 swallow a prodigious quantity of water2 not only filling his stomach and intestines2 but thence forcibly infuse the water into the lacteals1 thereby overload them1 and force it into the blood vessels that they burst4 ,the great quantity of cold water will also be apt to chill the stomach and intestines2 thereby destroy the sensibility1 and prevent them from performing the peristaltic motion2 and by the universal consent1 destroy the whole nervous system1 which is the spring of life1 that promotes the blood to circulation1 and consequently stops the animal motion1 and life itself4 ,but the most common way of drowning is by suffocation2 namely1 a sudden constriction of the respirative organs2 whereby the supply of the air is cut off1 and consequently the circulation of the blood must stop4 ,this is verified by the frequent instances we have of people drowned1 who have scarce any water1 either in their bellies or in their lungs4 ,to understand this properly1 we must first observe1 that a continual supply of fresh air is requisite for the circulation of the blood2 partly and principally for its motion1 and partly from the nourishment the blood actually receives from the air4 ,in the next place1 we must also consider1 that the lungs1 appropriated barely for respiration1 are so very delicate in the irritability throughout the larynx1 aspera1 bronchea1 and vesicles themselves1 that the least heterogeneous particle stimulates them to a convulsive expulsion1 of what seems obnoxious to them1 and thence excites a cough4 ,but1 when the parts are too irritating1 the lungs are excited to a universal constriction1 and occasions strangling4 ,this we find is the case when in drinking or swallowing our aliment1 that the least morsel happens by mischance coming the wrong way 7as it is called7 that is1 into the larynx1 occasions a heavy cough1 or even a suffocation2 to obviate which1 nature has formed the epiglottis in the larynx1 like a flap1 that opens in respiration1 but is always shut in the act of deglutition1 except by some mischance or other1 that it becomes lame1 and unable to do its office4 ,these circumstances considered1 we shall not only be able to account for the act of drowning1 but discover the principles that furnishes us with probabilities of restoring life again4 ,i have mentioned three kinds of drowning that at present occurs to my memory2 and unless that some blood vessels1 either in the lungs or in the brains1 or in some other principal viscera are burst2 or1 that the lungs are so much filled with water1 as to be unable to recover their respirative functions again1 7which is seldom the case7 or1 that the whole nervous system has received a universal paralytic shock by the chill of the ,water in the stomach1 so as to be robbed of its irritability1 either way of drowning is recoverable4 ,for the whole mystery consists1 in setting the animal automaton or clock-work in motion1 again2 to stimulate the nerves to their sensation2 to set the heart a pumping2 and the lungs1 in order to push forward the fluids1 in respiration4 ,i could say much on the subject2 but philosophy aside1 let us endeavour to recover the man to life again4 ,the ,method to recover a drowned ,person4 ,three things are to be the intention to restore life in a person taken up for drowned4 #a4 ,to liquify the fluids4 ,for the moment the circulation of the fluids is stopt1 the blood and lymph congeals2 and after this1 putrefaction gradually commences4 #b4 ,to stimulate the nerves4 ,for on the irritability of the nerves life itself depends2 and which sets every thing in the animal fabric in motion4 #c4 ,to restore respiration4 ,for without this1 neither can the blood circulate nor the nerves have sensibility4 ,the moment therefore you receive the person drowned1 strip him of his wet cloaths1 and wrap him up in three or four dry blankets2 if his belly is swelled with water lay him across a chair or barrel upon his belly1 in order to make him void the water2 but in this spend not much time1 but be as quick as possible4 ,take a good quantity of salt1 the more the better1 with which employ three or four handy men to rub him all over2--his temples1 his wrist1 his arms1 his breast1 his back1 his groins1 his knees1 his ancles1 c4 let this friction either be by the hands or rough woollen cloaths pretty briskly2 and1 whilst this is doing1 let one apply his mouth to that of the patient1 stop his nostrils1 and with all effort blow gradually into his lungs1 and try to make him breathe4 ,if the lungs are open to this1 there is a good prospect of recovery1 and let the breathing into the lungs be briskly repeated4 ,in the mean time1 try to open a vein in the arm2 if the head is bloated1 as it frequently is1 open the jugular vein1 or whatever vein that appears distended in and about the head4 ,on signs of life1 continue the friction briskly1 rub some essential oil of peppermint 7,u7 in and about his nostrils4 ,if he recovers1 at first he will open his eyes1 heave his breast1 his heart will beat1 and gradually he will move some of his limbs4 ,if he opens his mouth put a little salt in it at first1 next give him the following draught4 ,no4 ,,iv ,take essential oil of peppermint 7,u7 six drops1 upon a lump of sugar1 which dissolve in a table spoonful of elixir proprietatis 7,h74 ,if he inclines to vomiting1 promote it with decoction of camomile 7#aa7 or a vomit of ipecacuanha 7,s72 besides all this1 blankets should continually be warming1 so as to preserve a warmth of the body4 ,if he is fortunately brought to life1 put him directly into a warm bed1 and give him a dose of the fever powder1 and let him drink freely of good sage punch1 in order to promote a perspiration1 which is here very requisite4 ,no4 ,v ,take sage about a pugil 7that is as much as you can well take betwixt three fingers7 on this pour boiling water1 one quart2 to which add sugar and good old ,jamaica rum1 sufficient to make it agreeable1 but not too strong4 ,or instead of this give him some mulled wine4 ,a fever always attends a patient after the recovery of ,drowning2 therefore care should be taken when he is brought to himself1 that he is not over heated by liquor2 as this is liable to throw him into a disease as dangerous as the narrow chance he has just escaped4 ,should however the above methods not succeed1 you must not despair4 ,if the lungs1 or the larynx seem so contracted that it appears impossible to blow breath into him by the mouth1 recourse must be had to bronchotomy1 that is1 opening the wind-pipe betwixt the third and fourth cartilage2 to which a man should put his mouth and inflate the lungs2 the throat should be tickled with a feather1 a little pepper blown up the nostrils and the body here and there scratched with pins1 or small wounds made in the legs and arms1 and plentifully rubbed with salt4 ,if there is salt enough to do it1 the patient ought to be covered all over4 ,we have instances that patients1 after two hours application1 have been brought to life again2 therefore every means possible should be tried4 ,of all the various stimulants1 salt1 or potashes1 is the best2 spirits must not be made use of1 nor indeed vinegar1 in the time of recovery2 as that is liable to congeal the blood1 and prevent it from circulation1 till the recovery is procured2 when the sage punch1 or mulled wine1 or some other cordial may be proper4 ,spirits of hartshorn1 if it is on board may also1 with propriety1 be held to the nose1 or poured a little down the throat1 as that is stimulating1 but not coagulating4 ,when at length the patient has recovered1 let him take the forementioned draught ,no4 ,,iv4 as also the warm sage punch ,no4 ,v4 and take all possible care for his recovery4--,if ,bronchotomy was obliged to be performed1 let the wound carefully be washed1 closed1 and dress'd with dry lint2 over which lay a compress with warm claret intermixed with camphor spirits2 and the more to favour the healing1 let his head constantly be inclined2 rest should also be promoted as much as possible1 for which purpose #h or #aj drops of liquid laudanum will be very proper2 likewise silence should be strictly imposed on him2 and that should be a material object to be observed1 by those who tend him4 ,in every respect else1 let him be treated as is directed under the head of fevers and other circumstances1 as they shall occur4 ,here then ,i shall conclude this lecture1 and beg leave to observe1 that as mankind are ever liable to accidents1 particularly that class ,i have here devoted myself to serve1 it behoves us ever to be provided with preconsiderations1 that we may be always ready to give our friendly assistance in the hour of distress4 ,in time of need1 the mind is too much hurried to read with any attention2 and dangers particularly from accidents admits of no delay4 ,the prudent seaman1 especially the father of his ,crew will therefore make himself acquainted with all these circumstances in his hours of tranquillity1 by which he may ever be ready with his friendly aid1 and receive the blessing of him that is benefited by his ,humanity and generous care4 ---------------------------------------- -------------------------------- ,,lecture ,,iv4 ,,on ,,external ,,diseases1 ,,and ,,their ,,cure4 ,in this lecture ,i shall treat of external disorders1 which may take their origin either from injuries1 or from internal acrimony of habit2 for whatever disturbs the animal conomy1 prevents the natural order of the fibres1 and those again when in disorder1 corrupt the fluids4 ,be the causes what they will1 certain it is1 that there is a strict connexion between the external and the internal parts1 to which due regard ought ever to be paid4 ,i shall without delay proceed to their various kinds4 ---------------------------------------- --- ,,sect4 ,i4 ,of ,inflammation ,when either the solids are so injured that they will not transmit the circulation with their natural freedom2 or when the humours are become so acrimonious1 as to constrict the small tubes1 that part of the fluids becomes confined in them1 there must then of course be an obstruction of the circulation of the fluids1 thence accumulation must follow and consequently swell the parts4 ,and this is the nature of an inflammation4 ,the blood being obstructed1 the parts must naturally swell2 the blood being forced into the small lymphatic vessels1 thence proceed the redness2 and lastly1 from the vessels being distended and irritated by the stagnated humours1 proceeds the pain4 ,an inflammation terminates three different ways4 ,when the solids relax1 or the fluids become attenuated1 so that the accumulated humours disperse1 and are admitted a free circulation again1 it is termed resolution2 and this is the best and most favourable way for an inflamed and tumified part to terminate4 ,when some of the small vessels by the over-stretching of their contained humours break1 together with the lymphatic vessels1 and the extravasated blood intermixed with lymph is converted into matter1 it is termed a suppuration2 this is also a favourable way of termination1 provided the matter is properly concocted and discharged1 and the parts properly healed up again4 ,and this ought to be the second indication when the first does not succeed4 ,when however the imprisoned humours enclosed by their tubul are inspissated1 and mix irregularly with the solids that contain them1 obstinate tumours are apt to ensue4 ,this is the third kind of termination1 and should be avoided if possible2 for it either becomes tedious1 or occasions malignant ulcers2 which in glandulous parts are the first foundation of cancers4 ,but1 when the humours that are obstructed get malignantly corrupted into a pernicious acrimony1 and stimulate the distended solids1 so that they stretch beyond their natural tone1 without admitting any circulation1 the parts become insufferably painful2 the patient is restless1 anxious1 and attended with an acute fever2 the humours become offensive and ftid1 and the parts at length turn of a livid colour1 and this is then called a gangrene4 ,gradually the parts begin to putrefy and grow black1 the humours acquire a cadaverous ftor1 the solids lose their natural texture1 and die4 ,this is called a sphacelus1 or mortification2 and unless the mortified parts are removed from the sound1 death must inevitably be the consequence4 ,these are the different terminations of inflammation2 and whether the cause is from external injuries1 or from internal acrimony1 the indication must ever be the same1 ,i shall consider each separately4 ,of ,resolution4 ,inflammation that attends wounds1 contusions1 c4 should be dispersed by the application ,i have already mentioned in the foregoing lectures1 viz4 camphorated spirit 7,a71 or liniment of soap 7,b71 the first suits best the fleshy part1 and the latter the inflammation on the joints and tendinous parts4 ,but when with the inflammation a wound is compounded1 and is obstructed in its suppuration1 recourse should be had to poultices2 as thereby the fibres may be the more relaxed1 so that the ulcer may the freer discharge the matter1 thence drain the inflamed part of the obstructed humour1 and consequently remove the cause of the inflammation4 ,of ,suppuration4 ,when an inflammation arises from an internal cause1 there generally is some acrimonious humour that wants to be discharged2 in this case resolvents is not always safe1 as it is ever apt to increase the pain and inflammation4 ,of that kind are the boils and swellings under the armpits1 hams1 and other parts4 ,in this case1 poultices should be applied as warm as possible2 the ingredients may be oatmeal1 or biscuit powdered1 honey and a little butter1 warm and largely applied4 ,when the swelling increases1 grows red1 and acquires a top1 together with constant throbbing1 it is a sign that matter is forming1 which is the more confirmed by its growing soft4 ,when the fluctuation of matter is actually felt1 and that the top becomes somewhat of a black and yellow colour1 it then is mature for being opened1 in order to let out the matter1 which is best performed with a lancet3 this being done1 apply the poultices again4 ,and when the matter is fully discharged1 lay on the diachylon plaister1 in order to heal up the part4 ,should however an ulcer be the result1 it must then be treated accordingly1 as will be directed under that head4 ,of ,tumours4 ,when inflammations will neither disperse nor come to suppuration1 it is apt to form hard tumours2 sometimes they are indolent1 at other times very painful4 ,in this case1 nothing is better applied1 than mercurial plaister 7#ba71 and especially if there is any venereal taint in the habit4 ,at the same time1 whenever tumours are dispersing1 care should be taken to use internal medicines1 in order to correct the acrimony1 and a purge now and then1 in order to incline the humours to be carried off4 ,if1 however1 they incline to suppuration1 poultices should be again applied2 and to bring them sooner to a head1 purges should be omitted1 till after the matter is discharged4 ,of ,mortification4 ,a ,mortification has two degrees2 gangrene1 the beginning1 and sphacelus the compleated mortification4 ,when an inflammation will neither disperse1 suppurate1 nor become indurated1 but1 on the contrary1 increase with a burning inflammation1 and is prodigious painful2 when the swelling continually increases1 the parts become uncommonly tender1 attended with a numbness2 the colour changing from a fiery red into a livid ash colour1 and the cuticula seems to separate on the touch1 a gangrene has commenced4 ,in this melancholy case there is no time to lose4--,apply the following powerful medicine1 which in a gangrene1 and even a sphacelus1 has proved beneficial to a miracle4 ,no4 ,,vi ,take ,mercurial ,ointment 7,p7 one ounce2 ,calomel 7,n7 and ,powder'd ,precipitate 7,o7 of each one drachm2 ,oil of ,peppermint 7,u71 one drachm2 ,spread this upon a rag1 and apply it to the gangrenous part4 ,if a sphacelus has commenced1 the skin turned livid1 attended with a cadaverous fture1 and seems to the touch to be rotten1 it must be scarified to the quick with the lancet1 and then the above remedy applied4 ,but if it has already reached the bone1 7which a mortification soon will7 and seems to make a rapid progress1 all external remedies are of little avail1 and nothing but amputating the limb can save life4 ,but as that operation ought to be performed by a skilful surgeon1 ,i shall therefore omit it here2 only observe1 that there are very few cases1 but that this dreadful catastrophe may be prevented1 if timely assistance is given4 ,to conclude this section1 ,i think it requisite to observe1 that a gangrene and sphacelus1 or mortification1 is far from being so often the case as many from the pain they undergo1 are apt to persuade themselves4 ,a common boil1 whilst it is in an inflamed state1 is sometimes so very painful as to put the patient in a fever1 and will be excessively tender4 ,but1 notwithstanding1 a suppuration is the result4 ,a gangrene and mortification is only to be dreaded1 when a whole limb is inflamed1 such as an arm1 a leg1 c4 ,when the inflammation is dreadful1 that the blood can find no passage at all1 but is obstructed on all sides1 then the part must naturally die1 and become cadaverous4 ,the cause of this misfortune may be either a heavy contusion1 a compound fracture1 a gun-shot wound1 or an internal malignity of the bone itself2 and as a caution1 ,i must also add1 that pricking a tendon in bleeding may occasion this dreadful malady4 ,there is another kind of mortification which proceeds from a bad habit of body1 a poorness of constitution1 or when the whole mass of blood is corrupted by the scurvy4 ,this shall be taken notice of in its proper place4 ---------------------------------------- --- ,,sect4 ,,ii4 ,of ,ulcerations ,this is a part of surgery that many pretend to1 but what very few really understand4 ,there are however laws in the animal conomy1 which when they are violated1 leads us to trace its many evil consequences4 ,an ulcer is a dissolution of solids1 occasioned by acrimonious humours1 which not only act spontaneously upon each other1 but prevent the remaining circulating part from the formation of unnatural substances4 ,exulceration1 strictly speaking1 is what every part of the animal fabric is subject to2 from the external surface1 to the very substance of the bone itself4 ,in this sense1 every eruption1 as well as the carius of the bones come under that denomination2 but more particularly1 the corruption of the softer parts on the surface of our body1 is here the subject4 ,i shall not enter into a detail of the many kinds of ulcers generally enumerated2 they have all in common an corruptive acrimony1 and a depraved accretion of excressence in their nature2 which differ only1 according to the parts ulcerated1 and the habit of body2 and ,i have ever found in my practice1 that one proper method serves for all2 ,i shall therefore in a simple manner give such directions as will ever be attended with success4 ,the principal intention is to correct the malignity of the humour peculiar to ulcers2 to bring them into a good suppuration1 and nature1 all kind ,,nature6 will perform the rest4 ,when an ulcer is inflamed all round1 filled up with fungous substance1 of various colours1 the matter thin1 ferous1 and is very ftid2 then first wash the sore gently with some good soap suds1 or let the part ulcerated be steeped in it for some little time1 which will draw out the malignity2 then apply the following dressing3 ,take the powder of burn'd ,allum 7#ag71 and with a little lint dab it all over the fungous part1 then spread a pledget of the salve mentioned in gun-shot wounds1 ,no4 ,i4 and over which apply a good warm poultice there also mentioned4 ,let this dressing be repeated twice or thrice a day1 till the inflammation ceases1 and the fungous substance becomes reduced2 when then1 the washing1 the allum and poultice may be left off1 but the mentioned salve continued till the sore looks of a pale red1 and begins all round the edge to heal up4 ,cleanliness is very commendable2 but in this case1 when a sore looks well1 the matter becomes of a pale yellow2 wiping should be very sparingly2 and then1 dressing once a day 7the morning7 is full sufficient2 for by wiping1 and often meddling with it1 the small granulations of the flesh is hindered from growing1 and healing is retarded4 ,a sore leg is very troublesome1 and very often attended with pain and expence1 to no purpose4 ,it generally swells1 is inflamed and troublesome at night4 ,let the leg be bathed every night1 7with the open sore7 in some good warm soap suds2 or instead of that1 take what you can have plenty of1 namely1 sea water4 ,if you can have it warm1 it is well1 if not1 make use of it cold1 rather half a dozen times of the day1 than omitting it altogether2 and by dressing the leg as before directed you'll have reason to thank me for my good advice4 ,sometimes the bone is affected2 in which case1 the cure with the best dressing in the world will frequently be tedious4 ,a sore of this kind will not heal till the bone has discharged a scale1 7termed exfoliation47 ,but tedious as it is1 very often it is made more so1 by unnecessary trouble4 ,without intending to give offence to my brother surgeons1 ,i have frequently seen bad consequences attending methods taught with diligence in hospitals2 take my word for it1 you will do no good with your scraping tools1 throw them over board1 and you'll succeed better than using them in this case4 ,the bones1 though the hardest1 are the most delicate parts in the whole body2 but when it is affected1 nature forms a new periosteum over the sound part1 and gradually pushes forward the decayed scale4 ,this wonderful work is performed by nature only1 and must not be disturbed4 ,by scraping1 and boring of it1 the tender periosteum will only be molested1 the sound bone will become foul again1 and so you may go on for ever2 and ,i never saw a sore of that kind healed up by this improper method1 till nature over-powered art1 or the surgeon was tired with scraping1 perforating1 c4 but ,i have known many amputations in consequence of it1 and many lives lost in consequence of that again2 yet there is no rule without exception4 ,there are cases where operations of that kind on the bones is required2 but that ought to be referred to a judicious and experienced surgeon4 ,when the sore remains fungous1 the proud flesh sprouts out in little bunches1 and the matter is muddy and stinking1 it is almost a sure sign the bone is foul2 and if you examine with a probe1 you may generally feel it1 or even see it1 and the bone1 is sometimes black1 brown1 c4 and generally very rough on the surface4 ,in such a case1 continue the dressing as before observed1 and frequently examine whether the scale loosens2 at the same time examine 7not too roughly7 which way the scale inclines1 also the bigness of it2 and if there is a probability of extracting it1 so that the fungosity only stops it1 then freely use a bistoury to make way for it2 but in this be not in too great a hurry1 for care should be taken 7as ,i have said above7 not to extract the scale1 till the separation from the fresh bone is mature4 ,if an ulcer is sinous1 inject in the sinus1 a mixture of burnt allum and water1 viz4 ,no4 ,,vii ,take water two ounces2 burnt allum 7#ag7 two drachms2 mix them well for injection4 ,after two or three dressings with this1 inject the antacrid injection4 ,no4 ,,viii ,take two ounces of water1 with one scruple of calomel 7,n71 as ,i have described in my treatise on the venereal disease4 ,this is the proper management of ulcers in general1 and will ever be attended with success1 even in the most inveterate kind4 ,in venereal ulcers1 the mercurial ointment with the precipitate1 may be applicable1 especially in shankers4 ,i shall therefore end this section1 for having directed the management of the worst of ulcers1 the inferior kind will of course yield to the same method4 ---------------------------------------- --- ,,sect4 ,,iii4 ,of ,diseases of the ,skin ,under this head ,i shall consider all kinds of breaking out1 exclusive of that1 which attends inflammatory and acute fevers1 as they are all of one nature1 and will all yield to one method of cure4--,all proceed from a corrupted humour1 which nature endeavours to expell from the body1 by driving them to the surface1 as that is the least resisting part4 ,of the ,itch4 ,the itch may either proceed from original acrimony1 or it may be catched from a mess-mate who is infested with the disease4 ,in itself it is of different kinds1 but the diversity in this respect depends principally on the habit of body afflicted with it4 ,sometimes it is dry1 scaly1 and attended with very great itching2 in that case1 it proceeds generally from a scorbutic habit1 and is attended with a slow inward fever4 ,sometimes it is more moist1 and utters itself with bladders all about the hands1 particularly betwixt the fingers1 and is a sufficient testimony of the disorder4 ,the principal indication is to purify the blood2 and in the mean time recourse may be had to external means4 ,a purge is first requisite4 ,no4 ,,ix ,take powder of jalap 7,r7 one scruple2 calomel 7,n7 three grains1 mix it with a little sugar and water1 and let the patient take it early in the morning1 working it off with balm or any other tea2 after this some pills may be made of calomel4 ,no4 ,x ,take stomach powder 7,m7 two scruples1 calomel 7,n7 one scruple2 sugar about one scruple2 mix them1 and with a few drops of water make it into a mass1 and divide it into twenty pills4 ,of which let him take one every morning and night4 ,externally make use of the following3 ,no4 ,,xi ,take ,turner's ,cerate 7,k7 two ounces2 ,precipitate 7,o7 two drachms2 mix them4 ,let this be sparingly rubb'd on the itchy part2 if it should be too hard1 mix with it a little sweet oil4 ,when the pills are all used1 another purge like the former may be given2 after which if requisite1 a few of the same pills1 one every night1 will not be amiss4 ,should it be very obstinate1 a little mercurial ointment 7,p7 about one drachm to the above quantity may be added2 particularly if the ship is in a warm climate4 ,should these medicines seem to affect the mouth1 as people vary much in this respect1 a purge will set all to rights again4 ,this is a safe and expeditious method of curing the rankest itch1 even of the worst kind4 ,if however there is a fever attending1 a few fever powders 7,l7 should be given when going to rest1 in order to promote perspiration2 at the same time using the before mentioned medicines4 ,in regard to the scorbutic itch1 that ,i shall take notice of1 under the title of that disorder4 ,during the cure of the itch1 a decoction of the sassafras 7#ad7 should be drank1 as that is a great purifier of the blood4 ,of ,boils4 ,boils are sometimes very troublesome1 and at times exquisitely painful2 especially when they are on tendinous parts3 they are always a sign of foul blood1 and nature very often that way frees the body from diseases4 ,they may frequently be dispersed in the beginning of their coming1 by pressing1 and gently pinching them3 but unless they are very numerous1 such a method is unsafe2 because it forces into the blood again what nature endeavours to discharge4 ,the best method is to bring them to a head as soon as possible1 to which purpose ,i shall here recommend a paste that is very powerful4 ,no4 ,,xii ,take oatmeal and make it into a paste with honey 7,e72 this will speedily ripen them1 and facilitate the collection of matter4 ,should the boil not open of its own accord1 and matter should be observed to fluctuate in it1 open it with the incision lancet2 and continue with your honey paste1 till the core is discharged2 when the diachylon plaister will heal it up4 ,of ,ring ,worms1 ,daw ,worms1 c4 c4 ,these are very troublesome1 and though at first they seem but insignificant1 very often they lay the foundation to stubborn evils4 ,in fact they are but a peculiar kind of itch2 and the very same remedy that is recommended above for the itch1 is equally powerful to remove this3 what necessity is there then1 of increasing words with a tedious description of their various appearances2 since they will all yield to one substantial remedy8 ,of the ,morbis ,pedicularis1 or1 ,lousy ,disease4 ,it is an unhappy circumstance on board a ship1 when a man is afflicted with this filthy distemper2 and such a man is as pernicious to a ship's crew1 as a rotten sheep in a whole herd4 ,if it proceeds from a lazy filthiness of body1 a gentle washing with a good scrubbing-brush1 and rubbing the back with the boatswain's towel1#ab is a pretty amusement enough to circulate the blood and to excite cleanliness4 ,but sometimes this disorder has its seat in the very blood itself1 and that filthy vermin will breed under the skin1 and eat their way through1 by clusters4--,i have opened boils as big as pigeons eggs1 from which large bunches of lice have followed the lancet4 ,footnote #ab3 ,a cat of nine tails4 ,these patients are in every respect wretched1 and are actually objects of pity4 ,they generally have a pale1 sullen1 heavy1 half-starved1 cowardly1 in short a lousy1 look2 habitually lazy1 and seem to be void of every manly passion2 neither good nor ill-natured2 and are stimulated by nothing but pusillanimity2 and as they seem neither sick nor well1 ,i say they are objects both of pity and contempt2 though the latter is unjust1 because they cannot help it4 ,the reason of all this wretchedness is because the blood is degenerated into a lifeless mass of pituitous corruption2 and wants that spirit which gives a relish to life4 ,hence we see in this one instance1 how much the mental faculties depend upon the state of the body4 ,in order to cure this unhappy patient1 the blood must be purified1 and the whole system stimulated to a brisk circulation4 ,nothing less than mercury will do the one1 and stimulants together with exercise1 effect the other4 ,in the first place give him the following medicine4 ,no4 ,,xiii ,take ipecacuanha 7,s7 one scruple2 jalap 7,r7 ten grains2 calomel1 7,n7 four grains2 make it into a draught or bolus4 ,let him take this in a morning upon a fasting stomach1 and let him drink plenty of chamomile tea after every vomiting2 then give him the following electuary4 ,no4 ,,xiv ,take lenitive electuary 7,i47 two ounces2 black pepper powdered1 two drachms2 calomel 7,n71 one scruple2 mix them4 ,of this let him take every morning one tea spoonful2 upon which let him rub himself all over with the mercurial cloth as follows1 till he comes by this exercise into a breathing sweat1 at least for an hour2 and for the rest of the day keep him in continual exercise4 ,no4 ,,xv ,the mercurial cloth4 ,take a cloth or rag as much as half a yard square1 upon which spread one ounce of mercurial ointment2 let the patient work this into the cloth with his hands1 so that it is equally all over alike4 ,with this cloth let him rub his wrists1 arms1 shoulders1 top of his head1 his back1 knees1 waist1 thighs1 and legs2 and continue this rubbing once every morning with the same cloth for a whole month1 putting the cloth in his pocket when he has done4 ,his sores may be dressed with the above ointment ,no4 ,,xi4 ,the decoction of sassafras1 and a dram of spirits1 with a little ,turlington's ,balsam after his morning's exercise1 will prove greatly to facilitate the cure4 ,this is the method ,i have pursued with this filthy disorder2 and ,i have succeeded to my most sanguine expectations4 ,and by this1 ,i have been fortunate enough to be the means of making men again1 of wretches that were a burden to themselves1 and a nuisance to the people that were obliged to associate with them4 ---------------------------------------- --- ,,sect4 ,,iv4 ,of ,promiscuous ,disorders4 ,having thus treated on the most material ailments that want immediate assistance1 ,i shall in this section consider promiscuous disorders1 that have no relation to each other2 but set them down as they occur to my memory4 ,of the ,tooth-,ach4 ,those who have experienced the tooth-ach1 best know how much they have wished for ease4 ,no man can preserve attention to his affairs1 who has bodily pain2 and a severe tooth-ach is enough to disturb both body and mind4--,but what is to be done8 ,tooth-achs are of two kinds2--,it may either proceed from cold1 or from a decayed tooth1 or from both4 ,if the tooth is decayed1 the sooner you have it out the better2 but if your tooth is sound1 then it is as unreasonable to draw it1 as it would be to sling you over board1 because you feel the pain4 ,in regard to drawing the tooth1 take this direction4 ,to draw a ,tooth4 ,observe first1 what tooth it is2 and shift the hook on the key instrument accordingly4 ,ordinarily the hook is to be inside1 and the comb outside4 ,when this is adjusted1 wrap a little rag on the comb of the key1 so that it may bear a little softly on the gums4--,then seat the patient steady on a chair or chest1 7and if he is a coward1 let somebody hold his hands1 but a man of spirit will not want this officiousness7 place yourself right before him--then fix the instrument on the tooth1 the hook inwards1 and the comb outwards2 the hook on the tooth close to the gum1 pushed a little towards the jaw bone1 and be careful that you have hold but of one tooth1 and the right one4 ,when your instrument is fixed as gentle as possible1 without giving pain1 7for if you fumble too long1 and give pain1 you intimidate the patient7 ,i say then1 when you have fixed your instrument properly on all sides1 so that you have the condemned tooth1 and no more2 then shift your hand so1 that you may have a good and firm hold1 allowing for the turning of your hand4--,thus being ready1 give your hand a gradual1 and steadfast turn1 and wrench the tooth out of its socket4 ,in this you must be calmly resolute1 neither spare your strength if requisite1 nor let an untimely compassion get the better of your duty2 but keep your hold till you have performed the operation4 ,when the tooth is out of its socket1 it will sometimes hang a little by the gum2 introduce your fingers1 and they may nimbly perform the rest if requisite4--,it will sometimes happen1 especially by the grinders1 that a little of the jaw bone follows1 sticking to the tooth2--let this not frighten you1 it is sometimes impossible to avoid it2 but not to frighten the patient with it1 pick it off before he perceives it4 ,the moment the tooth is out1 introduce your thumb and fore finger1 and compress the socket of the drawn tooth2 by which you replace every thing in order again2 and after which1 one dram of good old stingo1 for washing the mouth1 and another for comforting the heart1 will make the patient forget all the pain he felt in the operation4 ,this method is certainly the most substantial for the tooth-ach4 ,but sometimes this is not practicable1 either because that the stump is so rotted as not to suffer a hold2 or that none on board are intrepid or capable enough to perform the operation2 in this case a ,palliative will be very acceptable4--,turlington's ,balsam 7,w71 upon a little lint put into the hollow tooth will frequently give ease1 a little ,spirits of ,wine and ,camphor 7,a71 or if very raging1 a little ,liquid ,laudanum 7,t74 ,but as ,i have said1 they are only palliatives2 and neither spirits1 or any thing else can be depended upon for a certainty4 ,sometimes stopping up the hollow tooth with wax1 with lead1 or sometimes putting in a little saltpetre will give ease--each method may do1 and each method may fail3 so that sometimes if the tooth is not extracted1 all powerful ,patience at last must step in and prove the best doctor1 till nature recovers1 and comforts the patient with the balm of ,ease4 ,very frequently a cold occasions this troublesome pain2 in which case the head should be well muffled up1 in order to bring on a perspiration1 and a blister behind the ear also of singular service--rubbing the face also with some spirits of wine and camphor is of great benefit1 and attention should be had1 if there be any fever in the system4 ,of sore ,eyes4 ,bad weather sometimes will effect the eyes1 whence they will become raw and blood shot2 which ought to be remedied in time1 in order to prevent further inflammation4 ,in this case make the following eye water4 ,no4 ,,xvi ,take ,alum1 ,one ,scruple4 ,fine ,sugar1 ,two ,scruples4 ,spirit of ,wine1 and ,camphor 7,a7 ,ten ,drops4 ,fresh ,water1 ,three ,ounces4 ,mix them in a vial1 and hang it up so that it may settle2 then pour off the clear into another vial1 which keep for use4 ,of this excellent eye-water1 drop a few drops into the blood-shot eye1 which in a little time1 will bring it to health again4----,if the eye lids are raw and inflamed1 ,turner's ,cerate1 or what is yet better1 ,no4 ,,xi4 which prove very beneficial4--,should the inflammation be very heavy1 apply the following poultice1 from which you may expect great benefit4 ,no4 ,,xvii ,take ,oatmeal1 and ,sugar powdered an equal quantity1 and make it into a poultice with the yolk of eggs2 upon which pour a few drops of the spirit of ,camphor4 ,this kind of poultice you will find very cooling and agreeable to the eye1 in order to assuage the pain2 or take the following4 ,no4 ,,xviii ,take the white of an egg upon a stone1 or pewter plate1 which rub with a piece of alum1 till you get a fine white cream-like substance4 ,this is a fine cooling application4 ,the ,camphor agrees very well with some people1 but with others it will not1 in which case the last is preferable2 or the spirits of camphor may be rejected from the other receipts4 ,of the ,ear-,ach4 ,the causes of that complaint are many4 ,i shall only here observe two kinds2 namely that proceeding from cold1 and that which is occasioned from hardened ear wax4 ,in the first case1 be very cautious how you tamper with your ears--a few drops of the spirit of ,camphor upon a bit of lint1 and that gently put into the ear1 will sometimes perform great benefit2 but never drop any thing considerable into the ear itself2 it is frequently dangerous2 from more reasons than what ,i here have room to enter into4 ,in cases where the ear wax is hardened1 put in a little slice of rusty bacon1 or a bit of fat ham1 which you will find very powerful in softening the ear wax2 and then with gentleness you may pick them2 take care however not to go too deep4----,ear-ach frequently follows a heavy fit of sickness2 in which case you can't do any thing better with safety1 than keeping them warm4 ,of ,hoarseness and ,sore ,throat4 ,there are many degrees of this ailment4 ,i shall first mention that of a common cold2 which is either without a fever1 or only a slight one4 ,immediately on perceiving symptoms of a sore throat1 a gargle should be applied4 ,this1 make of the following ingredients4 ,no4 ,,xix ,take vinegar1 and water1 each four ounces4 ,alum powdered half an ounce4 ,honey about a good spoonful4 ,this gargle should be used two or three times of the day----if it is warm1 it is so much the more powerful----a mouthful at a time is sufficient4 ,if the palate is down1 ,no4 ,,xx ,take alum powdered1 common salt1 of each two drams1 black pepper1 ten grains1 mix it into a powder4 ,of this powder take a little on the tip of your spatula1 and apply it to the palate1 when it will immediately shrink up2 and frequently make the person who before was hoarse1 speak immediately quite clear again with a distinct voice2 then proceed with the gargle as above directed4 ,but if the sore throat is of a more malignant nature1 the parts inflamed and swelled1 the patient seeming almost strangled1 and attended with a high fever2 it is certainly the quincey1 and should be treated accordingly4 ,in this case you must bleed freely and repeatedly1 and give the fever powders1 as will be directed in the treatment of the fever1 and the management of the quincey4 ,the gargle notwithstanding should be plentifully used----a blistering plaister betwixt the shoulders1 and if need requires1 on the calves of the legs1 the bigness of the palm of the hand1 will also prove of singular service2 and in every respect the treatment1 as ,i shall observe under its proper head4 ---------------------------------------- --- ,,sect4 ,v4 ,of the ,venereal ,disease ,i have written and published a full treatise of this disease2 divided in three parts2 namely1 ,i4 ,an anatomical and physiological description of the genital parts of both sexes4 ,,ii4 ,an tiological enquiry in the various stages of this disease4 ,,iii4 ,a true and rational method of cure4 ,nevertheless ,i shall here concisely give a safe method of the cure1 in its various local degrees4 ,but to those who would wish to know more circumstantial the true nature of that malady1 and of the animal conomy1 ,i must refer to the above treatise4 ,the venereal disease may be considered in different degrees2 namely the first and second infection4 ,to the first1 ,i consider the gonorrha or clap1 the phimosis1 paraphimosis1 chordee1 priapism1 shankers1 dysuria1 bubo1 swelled testicles1 and venereal excrescences1 in their various degrees1 in a local state4 ,to the second infection1 ,i consider those diseases that proceed from the venereal virus1 infecting the whole mass of blood2 namely cutaneous diseases2 glandular diseases2 diseases of the bones2 dry pox2 and the confirmed lues itself4 ,the first infection is what ,i shall here briefly consider1 and give such remedies1 which though simple and few1 will prove efficacious4 ,but the second ,i shall here only consider in the general4 ,of the ,gonorrha4 ,the gonorrha or clap1 commences with an agreeable tickling in the urethra1 attended with a thin limpid ouzing1 which however soon degenerates into a disagreeable pain4 ,a discharge of sharp ftid matter1 gradually commences with a scalding of urine2 the prpuce and glans sometimes swells1 with inflammation and a painful involuntary erection1 which adds considerable pain to the patient1 and under which1 the whole system seem disordered4 ,when all these symptoms appear1 there is no room left to doubt a confirmed clap4 ,the first thing to be done1 is to take some of the fever powders 7,l7 in order to promote a perspiration1 and to abate the scalding of the urine4 ,in the next place1 and which is the principal object2 have immediate recourse to my antacrid injection1 which is simply this1 ,no4 ,,xxi ,take clean water one ounce1 ,calomel 7,n7 one scruple1 ,mix it1 and shake it when it is made use of4 ,let this be injected up into the urethra1 three times of the day1 which if duely performed will stop the evil in its first bud2 and prevent all the generally attending consequences4 ,for it perfectly eradicates all the malignities of the venereal virus2 prevents shankers1 priapism1 chordee1 and any farther spreading of the infection4 ,at the same time the calomel should be given internally2 namely the pills1 ,no4 ,x4 to be taken every morning one4 ,of the ,phimosis1 and paraphimosis4 ,a ,phimosis is when the prpuce is so swelled1 that the glans cannot be uncovered2 and a ,paraphimosis is when the prpuce is swelled behind the glans1 so as not to cover the glans4 ,either way proceeds from the venereal virus having insinuated itself into the prpuce4 ,if the injection1 ,no4 ,,xxi4 is made use of in time1 all this will be prevented2 but sometimes it is of a very stubborn nature4 ,if the inflammation is very great1 the poultice1 ,no4 ,,ii4 should immediately be applied1 to which it will yield2 being of a very powerful quality1 particularly1 if to the poultice mercurial ointment 7,p7 two drachmes is added1 by which it becomes an immediate antidote to the venereal virus4 ,of the ,chordee1 and ,priapism4 ,a priapism is an involuntary erection2 and the chordee is a stricture in the urethra1 by which the penis is bent either ways1 according to the seat of the contraction1 this however is generally downwards2 whereby it makes the involuntary erection prodigiously painful4 ,it proceeds from some imprisoned virus in the urethra2 which together with its contraction1 irritates the penis to erection4 ,the antacrid injection ,no4 ,,xxi4 will generally1 if timely applied1 prevent this2 but if by neglect1 or the great virulence of the venom1 it has actually commenced1 recourse should be had to mercurial ointment2 which should three or four times of the day be rubbed on the penis4 ,should the priapism be very violent1 the poultice1 ,no4 ,,ii4 with the addition of mercurial ointment 7,p7 must be applied4 ,of the ,dysuria4 ,the dysuria is a scalding of the urine in the urethra2 this likewise is obviated by timely using the injection1 ,no4 ,,xxi4 or ,no4 ,,viii4 ,but when it is actually become troublesome1 drink plentifully of diluting drinks1 such as balm tea1 c4 and take a few fever powders which will soon set this to right again2 particularly as that is a symptom which generally vanishes1 as the disease becomes milder4 ,of ,shankers4 ,these are little ulcers coming upon the glans1 the frnum1 and the prpuce of the yard4 ,they are not only troublesome1 but sometimes tedious in the cure2 the antacrid injection ,no4 ,,xxi4 if timely applied1 will generally prevent them4 ,but sometimes these very unwelcome visitors will appear even without a clap2 and then they generally gain great ground1 before timely remedies can be applied4 ,the injection ,no4 ,,xxi4 should in this case be injected betwixt the prpuce and glans2 but if this is not sufficient1 apply the following4 ,no4 ,,xxii ,take mercurial ointment1 two drachmes2 calomel 7,n71 two scruples2 precipitate 7,o71 ten grains4 ,mix it into an ointment4 ,by the dressing with this1 all the shankers will speedily heal up4 ,if warts sprout out1 they should immediately be cut off1 with a pair of good sharp scissars1 and then dressed with the above ointment4 ,shankers1 when they appear1 without a previous gonorrha or clap1 ought always to be taken as a forerunner of the pox itself2 and the patient must have immediately recourse to the mercurial pills1 ,no4 ,x4 one to be taken night and morning1 in order to prevent the threatening evil consequences4 ,of the ,bubo4 ,a ,bubo is a swelling that appears on a venereal infection1 sometimes in one1 sometimes in both groins4 ,this swelling proceeds either from a transposed virus1 or comes as the first messenger of a venereal infection4 ,a bubo appears with symptoms of a heavy dull pain in the groin1 which on examination discovers itself with a little kernel that is painful to the touch3 ,if left to itself it gradually encreases both in bulk as well as in pain1 and at length forms a collection of matter4 ,the moment a bubo appears1 take a purge1 ,no4 ,,ix4 rub the part in the groin with mercurial ointment1 and spread a mercurial plaister the bigness of a crown-piece1 which1 7the hair being removed17 lay on the part2 let it remain on1 till it separates from the skin1 and the swelling is dispersed2 the patient should be kept warm1 and not have much exercise2 at the same time the body should be kept open4 ,by this means the bubo will soon disperse1 and the virus be destroyed in its first bud4 ,but if it has already gained too much head to be dispersed1 and matter is formed1 it becomes larger and soft1 and a fluctuation of matter is felt1 then suppuration must be promoted2 and when ripe be opened as soon as possible1 for an outlet of the matter4 ,when it is come to its maturity1 7that is the matter plainly perceived17 open it and dress it like an ulcer1 first with the ointment1 ,no4 ,i4 and when it discharges pretty well1 dress it with the ointment1 ,no4 ,,xxii4 ,by this management1 though easy1 you will not fail of success4 ,of ,swelled ,testicles4 ,the venereal virus is liable to attack the testicles1 which makes one of the most disagreeable circumstances of all venereal diseases2 sometimes one1 and sometimes both will be the seat of this complaint4 ,it begins with a heavy dull pain1 attended with a disagreeable tightness in the spermatic vessels1 leading from the testicle into the bowels4 ,gradually the testicle swells1 becomes hard and grows very painful1 and if not timely remedied1 a suppuration1 or a scirrhus1 or even a gangrene and sphacelus1 may be the consequences4 ,the moment the pain in the testicles is perceived1 remove the hair all round the scrotum1 and apply a mercurial plaister spread upon leather2 over which put a suspensorium1 and tie it up to the body as tight as it can be borne2 which together with a purge1 ,no4 ,,ix4 will not fail of giving immediate relief4 ,the patient should be kept as quiet as possible2 for hard labour not only retards the cure1 but becomes very painful4 ,should this not be sufficient1 apply the poultice1 ,no4 ,,ii4 with the mercurial addition as warm as sufferable1 and repeat it as often as it is necessary for keeping it warm to the part4 ,by this method it will not fail of dispersing4 ,should it however against all expectation come to a suppuration1 it must be opened the same as another aposthume1 and treated accordingly4 ,but should a scirrhus1 or a mortification ensue1 extirpation is the only recourse4 ,for which see my treatise4 ,of ,venereal ,excrescences4 ,besides all these disorders before mentioned that are the consequence of impure coition1 there is one more to be mentioned1 and that is a variety of disagreeable excrescences1 which sometimes arise about the penis1 the scrotum perinum1 and about the fundament4 ,when these appear1 ,i generally take it for granted1 that the pox is in the blood1 and the patient ought to be treated accordingly4 ,if there is a possibility of extirpating them1 either by a bistoury1 or a pair of good sharp scissars1 it ought to be done1 and dressed with the following ointment4 ,no4 ,,xxii ,take mercurial ointment 7,p71 and precipitate 7,o7 equal parts3 mix them4 ,the roots of these stubborn companions are frequently seated very deep2 if this is particularly taken notice of1 together with proper internal medicines1 the excrescences taken away at the root1 and the ointment applied1 they may all of them soon be drove off from the field4 ,of the second ,infection4 ,in regard to the second infection1 this is too tedious here to enter into1 and to do properly justice1 ,i must refer the reader to the treatise itself4 ,all ,i have at present to say1 is1 that my method of cure is particularly easy and simple1 in itself2 and ,i am happy to think at the same time1 that it is more efficacious1 than any former method1 or practice1 made use of4 ,the antacrid injection ,no4 ,,xxi4 is the most efficacious for subduing the gonorrha1 and all the evil consequences in that part2 and the other mercurial preparations in the manner ,i have recommended them1 is equally powerful4 ,i am utterly averse to salivation2 it is using mercury as a poison2 very few have ever been cured by it1 and those few have been more indebted to their good constitution1 than the treatment which they have with so much danger undergone4 ,but many1 very many1 have had their constitutions ruined by salivation1 past the art of man to recover2 and thousands have been sent miserable objects to the grave4 ,i am also averse to bleeding in venereal cases1 unless the greatest necessity requires it2 for in general it serves only to infect all the fluids1 since the veins emptied1 will naturally absorb from all parts of the body1 and thence liable to infect the whole mass of blood4 ,purging needs but be used very sparingly4 ,mercury inwardly taken1 should be used with the greatest moderation1 and taken in very small doses2 for with such judicious management it becomes one of the best medicines in the whole ,materia ,medica2 but if abused1 it is converted into a poison4 ,the decoction of the sassafras should be plentifully made use of during the whole course of the venereal disease4 ,and lastly1 from the real effect that the mercury has on the blood1 ,i must add1 that the same gentle method with respect to its internal use1 as is recommended for the first infection1 must also be pursued for the second infection2 let the malignities be ever so bad1 even in the most inveterate diseases of the bones themselves2 with this difference1 that in proportion as the disease is engrafted1 time must be allowed for the cure4 ,nature may be led by the gentle hand of assistance1 and tenderness2 but he who attempts to do good by main force1 acts as a fool1 and deceives not only himself1 but those who are so unfortunate1 as to trust to his pretended skill4 ---------------------------------------- --- ,,sect4 ,,vi4 ,of the ,bite of ,venomous ,animals ,it has been observed by all diligent inquirers into nature1 that poisons are of two kinds1 with respect to their effect in the animal conomy4 ,one kind will destroy if taken inwardly1 but not have such ill consequences in wounded parts1 externally4 ,another kind will be fatal in wounds2 at the same time it does not affect the viscera4 ,the first which destroys internally1 are poisons1 either from corrosive minerals1 or vegetables2 but of the latter1 namely what seems inoffensive taken in the mouth1 is the poison that follows the bite of most venomous animals whose poison are natural2 such is the scorpion1 the adder1 the rattle snake1 c4 whose poison have by various experiments1 been found to be attended with no ill consequences internally taken4 ,this was known to the ancients1 as well as to us2 for we find ,celsus1#ac to have spoken of this in his medical works4 ,footnote #ac3 ,nam venenum serpentis1 ut quaedam etiam venatoria venena1 quibus ,galli prcipue utuntur non gusto1 sed in vulnere nocent4 ,ergo quisquis1 exemplum ,psylli secutus1 it vulnus exsuxerit1 et ipse tutus erit1 et tutum hominem prstabit4 ,medicin4 lib4 v4 c4 #bg4 ,without any farther preface1 ,i shall proceed to give the immediate remedies for such unfortunate accidents as happen by the bite of these animals4 ,to ,cure the ,bite of a ,rattle ,snake4 ,the poison from this venomous beast1 is more deadly than any other of the serpentine tribe4 ,if its venom by a wound is infused into the blood1 a mortification1 and speedy death must follow4 ,the part bit1 should immediately be sucked with the mouth1 either of the patient itself1 or one who will risk himself to be so much the friend of the wounded4 ,dr4 ,mead has recommended1 that oil should be held in the mouth all the time of sucking1 but we have it from good authority1 that the spittle itself is an antidote to that kind of poison4 ,it is needless to say1 that the person who sucks the poison1 should frequently spit out1 as not to run the risk of swallowing it2 and care should be taken1 that his mouth is free from sores1 or wounds4 ,when this is performed for a quarter of an hour1 the part should be dressed with mercurial ointment 7,p74 ,sweet oil is much recommended1 and may be plentifully used as an embrocation to the inflamed part2 particularly if the oil is impregnated with camphor4 ,no4 ,,xxii ,take oil 7,c7 two ounces2 camphor1 one scruple2 mercurial ointment1 one drachm2 mix it4 ,the patient should take a vomit of ipecacuanha 7,s7 one scruple2 and a few drops of the essential oil of peppermint 7,u71 on a lump of sugar1 and dissolved in water1 which should be repeated after the operation of the vomit as often as occasion requires4 ,the fat of a rattle snake1 is accounted a sovereign specific1 if applied immediately to the wounded part1 and the patient drinking a decoction made of snakeroot4 ,the same remedy here recommended to the bite of a rattle snake1 7namely1 sucking the fresh made wound7 is also recommended to all other venomous bites4 ,the viper1 the adder1 the santapea or scolopandra1 the scorpion1 tarantula1 c4 ,that oil is an antidote1 7or as we may say a poison7 to all these venomous animals is evident from their expiring in great agony1 when oil is poured on them2 but whether this effect is because of the penetration it has on their bodies1 or annihilating their poison1 is as yet undetermined4 ,i was once told a secret for the sting of a scorpion1 avered to have been experienced1 by a commander of a ship1 trading to the bay of ,honduras1 viz4 that the part stung by a scorpion should be touched with the glans of the penis1 which would immediately draw out the poison1 without effecting the glans that touched it2 and it differs not1 whether the patient himself or any other person does it4----,if there is any virtue in this1 ,i own it is beyond my comprehension4----,i thought proper however to mention it1 though ,i cannot advise it as a safe experiment1 unless farther confirmed by those who have actually experienced it4 ,i have however a great opinion of mercurials in such exigencies2 and would advise recourse to be had to it immediately1 both external as well as internal2 this we are at least assured of1 it cannot be attended with danger4 ---------------------------------------- --- ,,sect4 ,,vii4 ,of the ,bite of a mad ,dog ,there are many surprizing things in nature1 in so much1 that ocular demonstration can only convince us of their existence4 ,amongst those wonderful phenomenons1 the direful effect of the bite of a mad dog is equally astonishing as it is melancholy4 ,that dogs and wolves are more liable to madness of this kind1 called the ,rabies1 is because of their deficiency of external perspiration2 and are obliged to supply that defect with their open mouth and their lolling-out the tongue2 whence their blood is subject to become overheated1 and thence generate a malignant inflammation1 which infects the saliva with this direful poison4 ,but the astonishment is1 why it should have so very powerful a contagion as to infect the mass of blood of every animal that receives the least atom of it8 ,yet so it is1 confirmed by sad experience4 ,from frequent observation we are able however to communicate such signs1 which attend the symptoms of madness in a dog1 whereby we may the better avoid the danger of being plunged into the most deplorable misery by this wretched animal4 ,the ,signs of a mad ,dog4 ,the dog with symptoms of madness evidently discovers a malignant fever2 he runs confusedly forwards2 the tongue hangs out of the mouth with much slabber2 his head hangs downwards2 his eyes look dull and heavy2 his tail is drawn up between his legs2 and in every respect he has all the sign of confused wildness and pain2 he runs confusedly forward1 and snaps about him without distinction of persons or fear4 ,he is always restless2 will neither eat nor drink2 and is terrified at the sight of water2 the tongue hanging out of his mouth1 grows black2 and at last expires a spectacle of horror1 unless the poor beast is put out of his misery1 and thereby many dreadful consequences prevented4 ,the ,effect of the ,bite of a mad ,dog4 ,so subtile is this fatal poison1 that the symptoms do not appear immediately2 but the part bitten will sometimes even heal up1 the same as any other wound2 and two1 four1 or six months after the injury1 the symptoms of the malady will appear and gradually reduce the patient to the most deplorable state in nature4 ,the first symptoms of the disease are1 a pain in the part where he was bit1 which gradually spreads all around2 the whole body in general is attended with a dull heavy pain1 a lassitude and weariness4 ,the mind grows depressed and anxious1 together with a loss of appetite and a nausea at the stomach2 and1 in particular1 a difficulty of swallowing1 sore throat1 and accumulation of spittle4 ,soon these symptoms encrease4 ,the peculiar soreness of the throat1 which renders the swallowing liquids very painful1 begins to create the utmost horror and dread of every thing that is liquid2 and this first gives rise to the ,hydrophobia1 or dread of water1 which compleats the patient's misery in this terrible disorder4 ,the eyes become full and staring1 the face bloated1 florid intermixed with lividness2 the mind is impaired2 rage1 lust and mischief1 agitates the confused will2 at length1 convulsions1 foaming of the mouth1 priapisms1 and seminal emissions1 barking1 howling1 and endeavouring to bite every thing near1 ends the wretched life of the most deplorable object in nature4 ,of the ,cure of the ,bite of a mad ,dog4 ,with respect to the remedies1 we have had many delivered to us2 but few indeed with success4 ,before ,i enter on the best method that ,i know1 by experiment1 to recommend1 ,i must beg leave to mention a peculiar successful instance1 in the course of my practice1 in this deplorable case4 ,a mad dog on shore1 in the ,west-,indies1 bit two men1 one belonged to my ship's crew1 the other to a ship in the same harbour2 both were bit in the calf of the leg4 ,it happened that the surgeon of the other ship and myself were immediately at hand at the time of the accident4 ,i was for cutting the part bitten fairly out without delay2 to which the man of my ship readily contented2 and it was done accordingly upon the spot1 having fortunately my pocket instruments about me4 ,but this operation was not approved of by ,mr4 ,e----2 nor suited it the timidity of the man belonging to his care2 it was therefore omitted4 ,when ,i had performed the operation1 viz4 7as near as ,i can guess7 ,i cut more than an ounce and a half of flesh out of the gastrocnemius muscle 7every where round the bitten part7 ,i spread a pledget with basilicon1 mixed with precipitate1 and laid it on the wound1 having first let it bleed1 perhaps six or eight ounces2 over the pledget ,i laid plenty of dry lint2 and when he was carried on board1 ,i fomented it with spirits of wine and camphor1 in which sublimate mercury was dissolved 7about one grain to about four ounces of the spirit74 ,inwardly ,i gave him one grain of calomel every morning and night for at least a fortnight4 ,the sore ,i continued to dress with mercurial ointment2 which within a month healed up perfectly sound4 ,from the mercurial treatment1 the patient had a small ptyalism1 which ,i checked by gentle cathartics4 ,my patient1 by this severe1 though efficacious method1 recovered perfectly well1 and remained so at least three months after the accident1 when we parted4 ,the other unfortunate man1 however1 had not so good luck2 for1 as ,i was afterwards informed 7the ship going soon to sea after the accident7 the unhappy sufferer died a horrible object1 raving mad in the hydrophobia4 ,mercury is certainly the greatest antacrid we have2 and ,i am firmly of opinion1 that in this case it is the most powerful of any medicine that is yet known4 ,the cold bath is strenuously recommended by ,dr4 ,mead2 and since his recommending it1 is generally practised on suspicion of this misfortune2 but in real cases1 very seldom with the wished-for success4 ,yet1 ,reason says much in its favour1 and should by all means be had recourse to4 ,others have recommended strong salt brine1 which also is not to be rejected4 ,before ,i lay down the method to be observed1 ,i shall first give ,dr4 ,mead's recipe in his own words4 8,let the patient be blooded at the arm nine or ten ounces4 ,take of the herb called in ,latin1 lichen cinereus terrestris2 in ,english ash-coloured ground liverwort1 cleaned1 dried1 and powdered half an ounce4 ,of black pepper powdered1 two drachmes1 mix these well together1 and divide the powder into four doses1 one of which must be taken every morning fasting1 for four mornings successively in half a pint of cow's milk warm4 ,after these four doses are taken1 the patient must go into the cold bath1 or a cold spring1 or river1 every morning fasting for a month3 he must be dipt all over1 but not stay in 7with his head above water7 longer than half a minute1 if the water be very cold4 ,after this he must go in three times a week a fortnight longer40 ,but to speak my real sentiments1 ,i have no great opinion of this recipe2 yet as other methods may be pursued along with it1 ,i thought proper to insert it1 as in a malady of this consequence1 nothing should be left undone that is practicable with propriety4 ,celsus ,i think was the first who recommended cold bathing#ad2 but indeed to a degree of drowning and reviving the patient again alternately4 ,in the mania itself1 it carries much reason with it in this miserable extremity1 for the poor wretch at the eve of expiring1 a spectacle of horror1 may as well run the risque of drowning2 and besides1 the shock that plunging gives to the whole system1 may probably work an alteration in the malignant habit4--,but alas6 when the hydrophobia has actually commenced2 ,death1 and death only--can give relief6 ,yet let it ever be a maxim1 7and especially with a seaman7 never to forsake hope2 for despair is only a punishment reserved for the damned4 ,i repeat it2 no means should be left untried1 that has the least prospect of recovery4 ,footnote #ad3 ,unicum remedium est1 nec opinantem in piscinam non ante ei provisam projicere1 et1 si natandi scientiam non habet1 modo mersum bibere pati1 modo attollere2 si habet1 interdum deprimere1 ut invitus quoque aqua satietur3 sic enim simul et sitis1 et aqu metus tollitur4 ,lib4 v4 cap4 #bg4 ,but to avoid being tedious1 ,i will proceed to the method ,i would have pursued in an accident of that terrible kind4 ,if you by the before description find that the dog who gave the wound is actually mad1 then without a moment's delay let the piece bit1 be cut fairly out2 if that is not practicable1 apply immediately the ointment made of mercurial ointment and precipitate1 ,no4 ,,xxi4 ,over which apply mercurial plaister4 ,give one of the pills ,no4 ,x4 every morning and night1 and continue this course for a whole month4 ,let the plaister remain on the place a good while after the sore is healed up4 ,this method ,i pursued with a gentleman1 and a little boy in ,new-,york1 who both were bit by the same dog1 without provocation1 the dog having never attempted the like before2 upon which he was immediately shot1 and was found to have all the signs of madness4----,the accident happened at noon1 and ,i was immediately sent for2 but not being in the way1 my assistant dressed it with basilicon1 and laid over it a compress with spirit of wine and ,camphor1 supposing it of no consequence1 as the wound was but very small4 ,but on my hearing of it in the evening1 ,i went that moment to their assistance1 removed the dressing and applied what ,i have before mentioned4 ,i was not mistaken1 for the sore and all around1 after some time grew angry1 and had an unfavourable appearance2 but with diligent attendance gradually became better4---- ,the little boy was bit deeper than the gentleman2 ,his wounds were on both sides of the tendo achillis3 ,but the gentleman's wound was a little above the maleolus externus on the right leg1 inclining to the tendo achillis4 ,it was in the month of ,july--,i ordered bathing every morning and night1 which suited the season4 ,in the mean time1 during three months1 ,i gave one grain of calomel every morning and night2 and every thing succeeded to our wishes4 ,but to return2 should the mercurial medicines go to the mouth1 a gentle cathartic will divert this1 for ,i am an utter enemy to salivation4 ,if however these remedies are administered too late1 so that1 notwithstanding all those applications1 the patient should grow melancholy1 have a difficulty in breathing1 and a sore throat2 but especially a pain in the sore1 or bitten part1 recourse should be had to frequent cold bathing1 or rather plunging2 mercurials should be continued1 and every method pursued as will be advised in the putrid malignant fevers4 ,should the patient however be seized with madness1 care should be taken that those about him have no wounds where the least of his spittle may be introduced2 and that the deplorable patient is rendered incapable to make any wounds or mischief on himself1 or those who attend him2 as he will be apt to snap and bite about him like a dog4 ,he should be sewed up in a hammock1 to which his arms should also be confined3 in this method he may1 by help of a tackle1 be plunged up and down in the sea1 but not his head under water4 ,this is far superior to the unnatural and cruel way of smothering with beds1 where the patient has no chance at all left4 ,the subject is melancholy2 but1 willing to contribute all the relief in my power to the distressed1 ,i have been insensibly led on2 and summed up all that might promise success4 ,innumerable are the remedies delivered to us1 but few prove successful if the case be real4 ,of all1 ,i never knew any meet with better success than where mercury was concerned2 and as ,i have been so fortunate as to have experienced the exalted virtue of that great medicine1 in this and other deplorable cases1 ,i stand so much upon the firmer grounds1 to recommend it beyond any other medicine that ,i am acquainted with at present4 ,to conclude1 ,i think it requisite to observe1 that1 dreadful as the bite of a mad dog is1 when the poison has infected the unfortunate patient1 yet this unlucky accident happens much seldomer1 than mankind from the dread of the misfortune1 are apt to apprehend it does4 ,many nostrums are published as specifics1 and their virtue artfully confirmed1 with cases of being bit by dogs1 that had however not the least symptom of madness2 and thence cures enumerated1 that could have no foundation on reality2 by which artifices much mischief has been done in real cases4 ,due observance should therefore be had to the state of the dog that has given the wound1 and the circumstances attending2 that either the patient may not be brought into unnecessary pain1 or that proper and substantial remedies may not be neglected4 ---------------------------------------- -------------------------------- ,,lecture ,v4 ,,of ,,fevers ,,and ,,inflammatory ,,diseases1 ,,and ,,their ,,proper ,,method ,,of ,,treatment4 ,we now proceed to the more internal diseases2 in which1 the various steps that we intend to take of restoring health again1 must be guided with the greatest caution1 as the seat of the malady is hid from our external examination4 ,it is for this very reason ,i designed previously to prepare the reader with the two first lectures2 particularly the second1 ,i must beg the reader thoroughly to examine1 and to understand2 for on this will in a great measure depend the proper application of the various experienced remedies1 which ,i here mean to unfold4 ---------------------------------------- --- ,,sect4 ,i4 ,of ,fevers in ,general ,hippocrates1 the father of physic1 was wont to say1 8,a fever is so universal1 that no patient dies without it40 ,this is so true1 that there is hardly an exception to it1 even in the most momentary apoplexy itself4 ,to conceive this properly1 we must observe1 that every diminutive part in the animal fabric1 like in a commonwealth1 is endued with a sense of self-preservation2 and the whole fabric is in so strict a conjunction with all its various particles1 both solids and fluids1 that nothing which may cause the least disturbance can pass unnoticed2 but1 let the injury be where it will1 every individual particle1 as a member of the whole animal state1 feels the shock1 and is immediately concerned for its own preservation4 ,this then is the cause of a fever in the general sense2 and thence we shall be led to understand what this disturbance in its nature actually is2 namely1 an unnatural action of the solids upon the fluids4 ,now as the fluids are the most yielding parts1 that must submit to the pressing motion of the solids1 we may without much difficulty1 see one principle reason of its being set into a disturbed commotion1 when the irritability of the nervous fibrill are acted upon4 ,again1 when we consider that the blood is liable to become acrimonious1 and thence by its stimulus apt to act upon the coats of its containing vessels1 we see demonstratively plain1 how the solids are subject to be excited to act upon the very blood that stimulates them4 ,moreover1 as motion must naturally produce heat1 and heat motion1 and motion expansion1 and expansion rarefaction1 we at once bring to view the principal laws of mechanism1 that governs the human automaton in the various degrees of health as well as disease4 ,however1 let me not forget to whom ,i write1 but haste to the point ,i am at4 ,a fever may proceed from many different causes1 and may affect many different constitutions1 and also produce many different effects2 it is therefore just that a proper distinction should be made4 ,indeed1 it is a subject that cannot be too minutely handled2 because it is scarce possible that there is a disease void of a fever in some degree or other4--,but preciseness and utility is the object ,i have in view4 ---------------------------------------- --- ,,sect4 ,,ii4 ,of ,accidental ,fevers4 ,how uncertain is human life6 ,one moment in a perfect state of health1 the next perhaps no more2 or confined under the painful sensations both of body and mind6 ,every accident is liable1 and unavoidably must bring on a fever2 and this1 like fire1 should be extinguished in its earliest commencement4 ,but in that1 as ,i have before observed1 the constitution should principally be consulted4 ,i have in the lecture of accidents1 at every opportunity1 recommended bleeding1 but always with a proviso1 if requisite2 and1 as this is of more consequence than generally is supposed1 ,i find it necessary here to expatiate farther on it4 ,in the first place1 no man should be bled who has lost a considerable quantity of blood1 unless indeed he was known in his state of health to be very strong and robust2 and that the fever sets on with such fury1 that the system requires absolutely to be reduced2 for the solids and fluids have such a strict dependance amongst themselves1 that they keep each other in an equipoise4 ,if therefore the blood is of an acrimonious nature1 and at the same time impoverished by lessening its quantity1 the coats of the arteries and veins will be the more stimulated2 thence the fever will naturally encrease1 and generate more acrimony2 which at length will destroy the patient4 ,i have been an eye witness more than once1 that the fever has actually increased upon every repeated bleeding1 till the whole supply of life was spent2 and all my persuasions have not been listened to till too late4 ,nay1 a fever is sometimes absolutely necessary2 and proves to some constitutions a remedy on its own account1 provided it is properly treated1 and kept within due bounds4 ,secondly1 ,if the constitution of the patient before the accident was but slender1 and of a phlegmatic nature1 bleeding should be very little or cautiously performed2 for the blood of itself being but poor1 must naturally be impoverished by being lessened2 and whilst the tenseness of the fibres is lost1 it is the more acted upon and rendered more acrimonious1 and still unable to strengthen the tone of the irritated fibres2 whence a relaxed body1 together with a poor acrimonious blood1 and all its evil tendencies must be the consequence4 ,let it once for all be observed1 that all the benefit we can possibly hope and expect from bleeding1 is to lessen the whole system1 to reduce the quantity of the fluids1 and to relax the solids4 ,this lessening of the system ,i must own is very often highly necessary2 ,but1 let us not fall into the ridiculous notion to suppose that bleeding will draw off the bad blood1 and leave the good behind2 far otherwise2 the quantity of the blood is soon replenished1 but the quality becomes impoverished4 ,the principle intention in fevers of whatever kind1 should be to promote perspiration4 ,this is the grand restorative of nature2 and ,i cannot recommend it too much4 ,nature designed this evacuation in the formation of man2 and by that1 fevers were cured in time of yore1 many ages before art contrived either lance or lancets4 ,but here let me not forget another great caution2 namely1 not to mistake profuse sweating for perspiration2 for this is an extreme into which many have erroneously fallen4 ,nature frequently produces a sweat without force or compulsion2 and if so1 it should be favoured1 but never brought on by stimulants1 or strong forcing medicines4 ,perspiration1 sweat and urine1 are the natural evacuations intended1 for the purifying the system from animal acrimony2 and when these excretions are in a just balance with the secretions of the fluids and motion in the system1 without pain or fatigue2 then nature is at peace with itself4 ,lastly1 ,i must observe1 that the stomach is an organ which1 by the nervous consent1 carries on an immediate correspondence with every part in the human fabric2 whence this viscera should likewise ever be consulted in fevers2 that is1 never to impose on it any aliment against its own inclination and appetite4 ,the want of appetite in a fever is a natural cause1 and very often is in the patient's favour2 but the mistaken notion1 that a patient must eat1 even against his inclination1 in order to recover strength1 is not only highly absurd1 but has been the destruction of many1 who otherwise would have recovered1 had they with patience waited the kind dictates of ,nature4 ,let the system be free from diseases1 and the stomach will soon crave food1 when there is a probability that the aliment may be converted into good blood2 but whatever is forced into the stomach before that time1 will instead of nourishing the body1 only add fuel to the destructive fire1 and encrease the already malignant blood4 ,upon the principles of these observations1 ,i shall lay down the rules that should be religiously observed in accidental fevers2 and when they are well considered1 we shall find that they will hold good also in all other kind of fevers1 notwithstanding they arise from internal acrimony of the body2 for the difference is barely this1 whether the fire is kindled within or from without2--but to proceed4 ,whatever then be the accident1 a fall1 a wound1 a fracture1 dislocation1 bruise1 c4 observe what the patient was before the accident4 ,if the patient was a stout hearty man1 it naturally follows1 that the fibres of his body were also in a rigid robust state2 and the quantity and richness of the blood was in a due proportion2 for this very reason1 health being at such an acm1 a fever is the more to be feared1 and ought studiously to be avoided4 ,if this patient has not lost any blood by the accident1 by all means bleed him2 but never exceed eight ounces at farthest2 it is as much as the strongest man ought to lose at once4 ,in the next place1 perspiration should be the principal object in view4 ,to this end1 let the patient immediately after bleeding go to rest1 and take a dose of the ,fever ,powder 7,l72 upon which let him drink plenty of ,balm ,tea 7#ab72 which will generally bring on a perspiration4 ,if however the fever increases1 the pulse continues to beat hard and full1 the head-ach1 difficulty of breathing1 a great draught and delirium should ensue1 bleeding indeed may be repeated1 provided it is within the same twenty-four hours2 but if the symptoms come on beyond that time1 then bleeding will seldom prevail1 or do any good1 but rather mischief2 for by this time1 the fever is generally agitated by acrimony1 and the blood is of its own accord poor enough without being made more so by bleeding4 ,in the symptoms which ,i mentioned1 regard should be had to the body being gently kept open1 not by purges but by clysters2 for purges in fevers are precarious1 and liable to bring on heavy fluxes4 ,if the patient under this high fever is costive1 give him the following clyster4 ,no4 ,,xxiii ,take warm water one pint1 or something more2 in which scrape about one ounce of castile or hard soap1 and let it perfectly dissolve2 then add a spoonful of honey to it1 and let it be as warm as that it may be easily borne to your cheek4 ,let the patient keep this clyster within him as long as he can1 till it comes away with a stool4 ,if the patient is sick at the stomach1 a vomit of ipecacuanha 7,s7 or ,no4 ,,xxvi1 will be very proper1 and nothing in such a case can be given more safety and better advantage2 for it is not only the stomach that gets relieved1 but the whole body is brought thereby into perspiration1 by the universal strain it occasions4 ,after the vomit1 or after the clyster1 give the following draught4 ,no4 ,,xxiv ,take of fever powder 7,l7 one scruple2 common water or balm tea1 one ounce or half a tea cup full2 then take a lump of sugar1 on which pour essential oil of peppermint 7,u7 three drops2 liquid laudanum 7,t7 eight drops2 sweet spirit of nitre 7,d7 thirty drops2 and mix them with a tea spoon4 ,this draught will not only promote perspiration1 but it will comfort the stomach1 and incline the patient to an agreeable rest2 by which he will be greatly refreshed4 ,if occasion requires1 it may be repeated every six hours4 ,if rest comes of its own accord1 the liquid laudanum 7,t7 may be omitted2 and if the stomach does not stand in need of any carminatives1 the oil of peppermint 7,u7 may also be omitted1 c4 ,the constant drink when dry may be balm tea2 in which1 if it suits the palate of the patient1 a slice of lemon may be put1 and then sweetened with sugar4 ,the diet1 as ,i have before observed1 should be sparing2 and the patient's palate in this should principally be consulted4 ,the following water gruel1 or rather wine soup1 or whatever other name it may acquire1 ,i have often ordered to my patients at sea2 and which has suited most stomachs1 and proved an agreeable mess4 ,no4 ,,xxv ,take oatmeal1 or pounded biscuit1 a couple of spoonfuls2 water1 a quart2 a small handful of raisins2 a little allspice1 a little mace1 tied up in a fine rag2 which boil together in a tin saucepan till consumed to a pint and a half2 then add a gill of good wine1 red or white1 and sweeten it with sugar to suit the palate4 ,you may put a little lemon peel in1 to give it an agreeable flavour4 ,a little roasted fresh meat will hurt nobody2 and broths most certainly are good1 particularly if the body is costive2 but when the body is inclined to looseness1 ,i have known the best broth to produce a dangerous flux2 and this should be taken notice of4 ,if the patient however who has met with the accident is of a puny weak constitution1 or has lost a sufficient quantity of blood by the wounds1 bleeding then is not so requisite as in the former case2 though the treatment otherwise must be equally the same4 ,by this method of proceeding1 there is little fear but that the patient will soon perfectly recover1 even in the highest fever that may suddenly befall a man from an accident2 provided the injury is not of a dangerous tendency4 ,but as an acrimonious habit of body is liable on its own accord to diseases1 it is easily imagined that an accident may become accessory1 and heighten the malignity2 hence often a fever of that kind is liable to degenerate into a malignant one1 or even from the accident itself1 when of a dangerous nature2 and this ,i shall explain as ,i proceed4 ,i shall therefore leave the accidental fever that proceeds from an external cause1 and proceed to those which take their origin internally4 ---------------------------------------- --- ,,sect4 ,,iii4 ,of a ,cold4 ,the fever now to be treated of is the most common amongst mankind2 especially seamen1 who are ever exposed1 to have the perspiration obstructed4 ,it however would save many from the grave1 and almost as many from being food for the fish1 was it a little more regarded than what it actually is4 ,the sound of a cold is so gentle1 that custom has almost made it effeminacy to pay any regard to it2 and yet1 if we maturely examine1 we shall find the most malignant1 acute1 and mortal diseases1 first make their appearances by the symptoms of a cold1----,but let us proceed to particulars4 ,a cold is an obstruction of perspiration2 which may become destructive to the animal conomy if neglected1 in so much1 that it may be considered as the first foundation of most diseases4 ,in my treatise on diseases of the lungs1 ,i have enumerated the many causes of a cold to which mankind are liable1 and their precautions to avoid them4 ,to sea-faring men1 ,i have one principal cause to mention whereby they make themselves subject to colds1 and sow the seed of many dangerous diseases in their system1 and that is their carelessness in shifting1 after getting wet2 in this respect1 ,i have however a remedy to offer1 which is as valuable and as efficacious to their preservation1 as it is easily put in execution4 ,the remedy is simply this3 ,a man who has been exposed on duty in the rain1 and is become thorough wet1 should not only shift himself in dry cloaths1 but previously wash all over with sea water3 if he carefully observes this1 he will never get cold on that account4 ,i have not only experienced this personally many times1 but ever found it productive of salutary effects to those ,i have persuaded to it4----,if we but make some observations on the accidental occurrences that happen at sea1 we shall see the just foundation of this4 ,when do we find a man who is continually washed by the sea to have a cold8 while on the contrary a foul rainy day1 will almost breed a general sickness4----,these observations first brought me on the notion of washing the body with salt water1 and having verified it by experiment1 ,i soon saw the propriety of it2 namely1 that the fresh water being of a sluggish nature1 and having a tendency to putrefaction1 is not only apt to infuse a putrescency into the system1 but from its slimy nature apt to clog up the pores1 and thus obstruct perspiration2 whilst on the contrary1 salt water is not only antiseptic1 but stimulates the pores of the skin to their secretory and excretory functions4----,nay so perfectly have ,i experienced this remedy1 that ,i have persuaded the people to salute one another by way of play with buckets of sea water on a foul rainy day1 and with pleasure ,i have experienced that they have all remained brisk and hearty after it1 and evidently seen the difference1 that on a similar day the sea water play being omitted1 scarce one who has been thorough wet1 escaped a cold in some degree or other4----,i must not forget1 that a draught of grog is likewise no bad preservative4 ,but this is best taken when the watch is out1 and that rest and sleep can be indulged upon it1 as that will then be apt to throw them into a gentle perspiration2 whilst however their watch is upon deck1 the best warmth is that which is produced by exercise2 except liquors is taken with the greatest moderation4 ,but when a cold has actually commenced1 care should be taken immediately to have it subdued in time4 ,the term cold however is a very vague expression1 that includes a great many disorders1 occasioned by an obstruction of perspiration1 which all in turn shall be taken notice of3 ,but as ,i am now on the subject of fevers1 ,i shall confine myself to that at present1 and consider the cold as it affects the body universally2 namely headaches1 a weakness in all the limbs2 intermittent fevers1 intermixed sometimes with flushes of heat1 and at other times shivering1 chilling1 c4 ,these are not only the symptoms of a cold1 but of almost all inflammatory fevers2 which in fact1 the cold is a commencement of4 ,now all that nature requires is a perspiration2 for thereby the imprisoned acrimony is expelled1 and which nature is always engaged to throw off from the system4--,to this intention1 if the patient is rich of blood1 bleeding should be performed2 but with such caution1 as ,i have before recommended4 ,next give the fever powder 7,i71 together with a good quantity of balm tea1 or if the constitution is of a phlegmatic habit1 sage tea1 or even sage punch 7 ,no4 ,v47 will not be improper2 but care should be taken1 that if there is much fever1 all those things should be omitted1 as it is liable to increase the fever4 ,if there is a nausea at the stomach1 give a vomit3 take the following3 ,no4 ,,xxvi ,take ,ipecacuanha 7,s71 one scruple3 sugar a little lump3 water half a ,tea cup full1 and make it up into a draught4 ,this vomit should be well worked off with chamomile tea1 or even common luke warm water2 first letting the vomit operate1 and then drinking plenty of the water after every operation4 ,when this is over1 the patient should keep his bed or hammock1 and take either the fever powder 7,l71 or the before mentioned draught1 ,no4 ,,xxiv4 ,the catarrhal fever1 and all the other symptoms of cold1 viz4 cold in the head1 cough1 hoarseness1 c4 generally keep one another company1 leave the patient generally at one time2 and in fact1 one method of cure1 namely1 promoting a perspiration1 serves for all2 for thereby the obstructions become removed1 and nature is restored to its primitive tranquillity again4 ---------------------------------------- --- ,,sect4 ,,iv4 ,of ,intermitting fevers1 and ,agues4 ,there is scarce a disease that makes a patient more wretched1 and unhappy1 than the fever and ague4 ,the causes of these kind of fevers is principally from a pituitous1 or slimy blood1 together with its being loaded with acrimony2 and a flacidity of the moving fibres4 ,they are divided into various classes2 though in fact all of one nature4 ,when the ague with its succeeding fever comes on regularly every day1 it is called quotidian1 or every day's ague2 when every second day1 tertian1 or third day's ague1 and when every third day2 a quartan1 or fourth day's ague4 ,there are many other classes as subdivisions of these1 but they are the mere speculations of physical pedants1 who are ever sworn enemies to plain understanding1 and delight in perplexities2 which therefore1 we shall neither spend paper nor time upon to recount4 ,suffice it1 let their paroxysms return at what stated period of time they will1 either regularly or irregularly1 they differ in nothing but this1 that the farther the fits are distanced1 the severer they generally are1 when they come on2 and the more regular1 the more obstinate in their cure2 though in this even there are exceptions4 ,it is surprizing to imagine1 how many different opinions have been sent into the world concerning the returns of the periodical fits of the ague2 and equally astonishing1 how few with any probability of truth or reason4 ,i shall not here enter into an enquiry of this nature2 certain it is1 that at the stated times of these returning fits of the ague1 there is an obstruction in some particular part of the system1 that corresponds with the dated time of the circulation of fluids in such parts--which when disturbed1 effects by the nervous consent1 the whole animal structure4 ,the principal intention in all intermitting fevers1 should be to correct the petuity and acrimony of the blood2 to remove the obstructions2 and to strengthen the solids4 ,with respect to the blood1 it is an inevitable consequence1 that when it is loaded with a vicidity and lentor1 that it will ever occasion a depraved nutrition2 and hence we see1 that people labouring under agues1 and intermittent fevers of any kind1 have a depraved appetite1 and many disagreeablenesses in the first passages4 ,the intermittent fever and ague approach with the following symptoms1 viz4 a heavy dull head-ach1 a shivering chill all over the body1 with a yawning1 c4 pain in all the limbs attended with weariness1 a nausea at the stomach1 a depressed pulse2 which after it has lasted for half an hour1 changes into a burning heat1 a throbbing head-ach1 pain in the loins1 and in every limb1 a great draught1 a full hard pulse1 and which at last terminates in a profuse sweat2 this seems to give the patient ease1 for one1 two1 or three days2 and then attacks the patient with the same symptom1 increasing every time1 and reduces the patient both in body and spirit4 ,the first thing to be done is to give a vomit1 like ,no4 ,,xv4 and ,,xxvi4 ,this is best taken at the approach of the cold fit1 and worked well off with plenty of luke warm water4 ,after the operation of the vomit is over1 let the patient take the following draught4 ,no4 ,,xxvii ,take fever powder 7,l71 thirty grains2 calomel 7,n71 one grain2 elixir of vitriol 7,g71 sixty1 or seventy drops2 essential oil of peppermint 7,u71 four drops upon a little lump of sugar2 to which add water1 half a tea cup full4 ,this draught will not only promote perspiration1 but help to dissolve the siziness in the blood2 and may therefore be repeated every six hours1 for a few days4 ,but the patient should always be kept moderately warm upon it1 that it may work by perspiration4--,this simple method ,i have known put the patient to rights again1 after a severe onset4 ,but sometimes this wretched disorder will require more powerful medicines to keep it in subjection4 ,when the fibres are debilitated1 and the blood still retains its viscid corruptive quality1 the ague is apt to hang on the patient a long time1 the succeeding fever apt to melt the patient down to a mere skeleton1 and even destroy him4 ,in this it is requisite to brace up the solids1 and to infuse an astringency into the blood4 ,to this intent1 the ,peruvian bark is now frequently prescribed1 and if judiciously administered it is an excellent medicine2 but as it is liable however1 to be improperly given1 and then productive of irreparable mischief1 ,i have purposely omitted it in this catalogue2 nevertheless1 ,i shall give in its stead a medicine1 superior both in virtue1 and by far more safe in the application2 not only in this kind of complaint1 but in scorbutic cases1 as ,i shall hereafter take notice of4 ,the medicine is this1 ,no4 ,,xxviii ,elixir of ,iron4 ,take a quantity of rusty iron1 the smaller the pieces are1 the better1 for the less quantity will do2 pour on it good strong vinegar1 sufficient to cover it2 let them steep till the vinegar becomes of a deep brown colour1 which it soon will1 and at length acquire a consistence of a black elixir4 ,the vessel should be either stone or glass2 but what is yet better is an iron pot1 which of itself will contribute to the medicine4 ,if the patient therefore1 after the vomit1 and the above draught1 is attacked again with the fit of the ague1 and succeeding fever1 have immediate recourse to your elixir of iron4----,let him take after the fever is off1 every three hours1 a table spoonful of the elixir1 and should it seem to come up again at first 7which it sometimes will1 particularly if the stomach is yet foul7 give immediately another spoonful1 and repeat this at least three times of the day4 ,a little gentle exercise upon taking the elixir is highly beneficial2 and if it throws a gentle warmth over the body1 and brings it into a gentle perspiration1 you are sure of success4 ,the quantity of it should be adapted to the condition of the patient1 and the strength of the stomach2 if it sits easy1 a larger quantity may be taken1 and seldomer2 and if it is more nauseous1 a smaller dose and oftener4--,should the fits seem obstinate1 the following electuary may be used2 and is a powerful specific4 ,no4 ,,xxix ,take stomach powder 7,m71 two drachmes2 nutmeg powdered1 one drachm2 powdered alum 7#ag71 half a drachm2 essential oil of peppermint 7,u71 twenty drops2 calomel 7,n71 ten grains2 honey 7,e71 one ounce3 the whole well mixed4 ,of this let the patient take every eight1 or twelve hours1 the bigness of a nutmeg1 taking his elixir as before observed2 and this will ever prove successful in the most obstinate case4 ,as patients of that kind at sea1 have ever a taint of the scurvy in their composition1 or at least have a tendency towards it1 exercise and freshness of food1 will prove one of the restorative means4 ,the malt decoction should also be their drink1 as well as in the scurvy4 ,to conclude1 ,i shall only observe1 that bleeding in agues must at all events be omitted1 as being absolutely pernicious1 as it cannot fail of impoverishing the blood2 which is the principle source of the disorder4 ,also1 in the intermitting time1 exercise should be observed1 and the diet should1 when the stomach craves1 be good4 ,sometimes indeed1 the stomach is too ravenous and greedy2 but that is a default which proceeds from the same cause as that which makes it loath its victuals2 a vomit in either case is the most effectual medicine1 and may be repeated as often as it is requisite1 without the least fear of injury1 particularly in this disease4 ---------------------------------------- --- ,,sect4 ,v4 ,of ,putrid and ,malignant ,fevers4 ,i ,shall on this head restrain myself from saying more than what is absolutely requisite to the cure4 ,it seldom happens to infect a ship's crew at sea1 unless the ship has carried it from some place where the disease was contagious4 ,though notwithstanding1 great sickness on board may give rise to it1 if care is not taken to prevent it4 ,i would therefore ever advise1 in case of sickness1 to steam the birth with vinegar2 namely1 taking a vessel with vinegar1 in which put a hot iron1 and thereby raise a steam1 which is a powerful preservative4 ,a putrid fever may be generated from the contaminated atmosphere of a sick person1 though it rarely is the case2 yet prudence demands every precaution that is in our power4 ,the fever that ,i now speak of is of the malignant kind1 and peculiar to the hotter climates4 ,the patient is seized first with a shivering chilliness1 which is soon succeeded with a weak unequal fluttering pulse2 the body is seized with a universal pain1 together with a great debility2 the mouth is hot and dry2 the respiration depressed2 and the mind labours under a heavy anxiety4--,the fever continues1 though not very high2 and the pulse not very full2--a delirium or else a stupor ensues2 the urine becomes deep coloured1 and has an oily skim at top2 and the patient is in so imminent a state of danger1 that1 unless a favourable crisis happens soon1 twenty-four hours rapid progress is liable to put him beyond all help4 ,the first and immediate remedy should be a vomit1 ,no4 ,,xxvi1 which is the grand step to be taken in all fevers2 not so much for the sake of cleansing the stomach1 as for the universal ease it gives to nature4 ,the next step is to correct the putrescent acrimony in the system2 for which purpose make the following draught4 ,no4 ,,xxx ,take fever powder 7,l7 one scruple2 elixir of vitriol 7,g7 thirty drops2 sweet spirit of nitre 7,d7 thirty drops2 calomel 7,n7 two grains2 essential oil of peppermint 7,u7 four drops2 upon a lump of sugar2 and half a tea cup full of water4 ,let the patient take this draught every six hours2 and after four have been taken1 the calomel should be omitted4 ,if the nerves seem to be affected1 the essential oil of peppermint may be increased4 ,if a delirium should come on1 the liquid laudanum 7,t7 from ten to twelve drops and upwards may be given in the draught4 ,i know many will think it odd1 that ,i should give calomel in a fever2 but all this is merely the effect of blind prejudice2 a better medicine than calomel is not in all ,nature1 if judiciously applied2 and so fortunate have ,i been in my success with this exalted medicine in contagious fevers1 that ,i have preserved myself and my patients in the midst of ,death's spreading horror around us4 ,but to proceed2 if the patient continues to be dry on the surface of the skin1 and perspiration seems backward1 a blister betwixt the shoulders1 the bigness of the palm of the hand#ae1 will greatly facilitate the crisis or turn of the fever2 but let it not be erroneously supposed1 that a blister will draw off the bad humour1 or that it does good by such an operation2 for this notion has proved destructive to many patients4 ,all the good a blister does is to spur on the animal function2 by which sometimes the acrimony is thrown off from the system2 but if thus irritating the system be overdone1 or wrong applied1 it is productive of many additional evils to the disease2 causes spasms1 strictures1 and other acute disorders1 that of themselves may become mortal4 ,therefore blisters should never be used but when the body is defective of perspiration1 or when the debilitated system is defective in its excretory functions4 ,footnote #ae3 ,the method how to apply a blister is described under the article of ,blister ,plaister1 in the second section1 p4 #ge4 ,when the patient is rid of the fever1 a general weakness will be left behind2 this is best assisted with the elixir of iron2 and now and then as a stomachic1 a tea spoonful of ,turlington's balsam 7,w71 or some few drops of oil of peppermint 7,u71 as also the malt decoction1 and fresh diet4 ,malignant fevers are generally attended with eruptions on the skin1 which is sometimes in favour of the patient1 and therefore by no means to be hindered2 but if there appears purple spots on the skin1 and that they incline to turn black1 it is rather a dangerous symptom1 and indicates very little hope of the patient's recovery4 ,the same method as above must be observed2 which if medicine can avail1 will afford benefit4 ,on the whole1 ,i have this to observe1 that all acute fevers are liable to become malignant and putrid2 and in my practice ,i never found1 that there was any real distinction to be made in the method of cure1 whether the acrimony was generated in the habit by disease1 or introduced by contagion2 and if ,i may be allowed to judge by comparison1 it must appear that my method is superior to the more general doctrine2 because ,i have ever found it to be attended with much more success4 ---------------------------------------- -------------------------------- ,,lecture ,,vi4 ,,of ,,the ,,various ,,internal ,,diseases1 ,,and ,,their ,,method ,,of ,,cure4 ,having in the foregoing said what ,i thought most material to be observed in fevers1 as the universal disorder that attends almost every ailment in the human body1 ,i shall for regularity sake1 treat on the most material diseases1 as they may seem to follow in order in the various divisions of the human body2 and be as concise in their description and cure1 as their nature will admit of4 ---------------------------------------- --- ,,sect4 ,i4 ,of ,diseases of the ,head1 ,of the ,apoplexy4 ,the apoplexy is a disease1 wherein the patient falls down motionless1 void of sense and sensation1 and is1 in fact1 a temporary death4 ,it will scarce however admit of a strict definition2 for there are not only various degrees of this disorder1 but even different disorders under the same denomination1 that have quite distinct different causes for their effect4 ,many indeed may be accounted for1 but many more cannot4 ,the brain is the root of the nerves1 and consequently the fountain of all sensation1 and life itself4 ,that part of the human fabric is extremely delicate1 and blood vessels plentifully distributed4 ,when therefore these vessels become either so distended with blood1 so as to press the substance of the brain1 that it is hindered from its motion1 confusion to the animal conomy must naturally ensue2 thence an apoplexy in its various gradations is liable to be the consequence2 but as the vessels in such a distention are liable to break1 and the extravasated blood pressing the brain more forcibly without a chance of dispersing1 we plainly see one reason1 why such a malady is apt to turn out fatal1 as we find it sometimes does4 ,such causes may either proceed from external1 or internal injuries2 thence we see that a heavy fall1 or contusion on the head1 may occasion an apoplexy1 or at other times1 a congestion of blood to the head may produce the same malady4 ,sometimes the patient is motionless2 and to all appearance dead1 and nothing but a faint pulsation remains2 at other times there is indeed more signs of life1 but more terrible in appearance1--namely a convulsive breathing and foaming at the mouth1 without the least signs of sensation or perception2 in which case there is much to be feared1 that vessels in the brain are burst4 ,however in all these extremities1 nothing can contradict the indication of bleeding1 except extreme weakness1 and debility of the system2 which here is very rarely the case4--,after bleeding1 a large blister between the shoulders should immediately be applied1 and treated as directed in the second lecture1 page #ge4--;,a draught like ,no4 ,,xxx4 will also be of singular service1 till the patient comes to2 after which he will require such treatment as is directed under fevers2 for that disorder will always attend the shock that the apoplexy gives to the animal system4 ,of the ,frenzy and ,delirium4 ,when the root of the nerves are stimulated by acrimony1 so as to heighten their sensibility1 or set their regulated perception in confusion1 the ideas become bewildered1 and the sensations act at random4 ,this is generally the case with patients in acute and malignant fevers2 and this conception differs from dreaming in this respect1 that the phantoms of the confused imagination may be somewhat guided by the objects around them2 as they may be said to dream with their eyes open and full awake4 ,when the frenzy attends acute fevers1 the blood is generally in a great confusion1 and the pulse high and fluctuating4 ,yet bleeding should by all means be avoided1 unless indeed the disorder has come on remarkably sudden4 ,blisters here are requisite2 and in order to take off the stimulus of the nerves1 give the patient the following draught4 ,no4 ,,xxxi ,take ,fever ,powder 7,l7 one ,scruple2 ,liquid ,laudanum1 7,t7 ten ,drops2 ,spirit of ,wine and ,camphor 7,a7 twenty ,drops2 ,essential ,oil of ,peppermint 7,u71 four ,drops upon a lump of ,sugar2 ,water half a ,tea ,cup full4 ,this draught may be taken every fourth or sixth hour2 and now and then a grain of calomel may with great success be added to it4 ,cooling clysters in this case are also of singular service2 for example3 ,no4 ,,xxxii ,take cold water1 eight ounces2 ,nitre1 or instead of this#af ,fever ,powder 7,l7 two drachms2 spirits of ,camphor 7,a7 thirty drops1 mix them4 ,footnote #af3 ,the fever powder may be steept in a little water before hand1 and the clear poured off1 because nothing but the nitre here is useful4 ,if the patient is very costive1 a little honey and soap may be added1 previously dissolved2 which will both open the body1 and promote urine4 ,for the rest1 every method must be taken as is already observed in fevers4 ,of a ,stupor1 and ,lethargy4 ,this is a symptomatic affliction1 that attends acute and malignant fevers1 in its nature quite opposite to the former2 in which the nervous system is benumbed1 and have lost their sensation2 this is very apt to succeed1 but seldom precede the ,frenzy4 ,when a patient lays in that kind of stupefaction in a continual dosing1 there is in general little hopes of recovery2 nevertheless remedies must be applied4 ,blisters here are very proper1 and these should be pretty large4 ,horse radish should be frequently held to the nose1 which has a reviving quality1 and is very innocent with respect of adding acrimony to the system4 ,a vomit has often in this extremity proved very beneficial2 which the patient's weakness should not retard1 unless very weak and near the end indeed4 ,the following draught may also prove highly beneficial4 ,no4 ,,xxxiii ,take ,sweet ,spirit of ,nitre 7,d7 one drachm2 ,essential ,oil of ,peppermint 7,u7 ten drops upon a lump of sugar2 water one ounce1 mix them4 ,let the patient take this every four or six hours1 till he comes to himself again3 ,but care should be taken that a good sound sleep1 is not mistaken for a stupor2 for it frequently happens that a patient upon a favourable crisis will fall into a long sound deep1 that terminates all his danger2 if therefore the patient breathes freely1 and has a moistness all over the body1 together with a tolerable regular pulse1 disturb him not2 but let nature finish her gracious work4--,this kind of sleep is materially different from the stupor1 wherein the patient neither sleeps nor wakes1 but is equally insensible when the eyes are open1 as when they are shut4 ,of a ,violent ,head-,ach4 ,a ,violent head-ach often attends fevers1 or comes spontaneously without2 it generally precedes a delirium1 as the irritation of the nerves is the principal cause thereof4 ,the first intention must be to draw the humours from the head4 ,a compress with vinegar1 in which is dropt a little spirits of wine and camphor1 is of great service1 and will often have the defined effect to carry it off4 ,warm foot-baths also is of great use2 a blister may be applied1 and the draught ,no4 ,,xxxiv4 will also prove of great service4 ,the head-ach may proceed from many other different causes1 and in the general is only a symptomatic affection2 therefore particular attention should be had to the primitive seat of the disorder4--,frequently a foul stomach will occasion the head-ach1 and a vomit most times prove the best application4 ---------------------------------------- --- ,,sect4 ,,ii4 ,of ,diseases of the ,neck ,the diseases in that part1 are indeed very numerous2 but as they have so strict a connexion amongst themselves1 the classes may be considered but very few2 of which some have been already taken notice of4 ,of the malignant ,sore ,throat4 ,every body who is liable to catch cold1 is frequently apt to have a hoarseness and consequently in some degree1 more or less1 a sore throat4 ,if a fever attends it1 methods should be used accordingly1 as is mentioned under the head of colds3 with respect to the throat1 use the gargle1 ,no4 ,,xviii4 pretty frequently1 and the disorder will soon go off again4 ,but when an ulcerated sore throat is attended with a malignant fever and inflammation1 it is called a quincey2 this case is alarming1 and requires very careful treatment2 for first we must observe1 that the larynx is of a very complicate and curious structure2 and secondly1 it is composed of various1 and delicate materials2 namely1 cartilages1 membranes1 muscles1 and glands4 ,the glands are very numerous in the various parts of the composition1 whence the inflammation becomes not only painful1 but is apt to swell up and obstruct respiration2 wherefore an inflammation in such parts becomes highly dangerous to the life of the patient4 ,when the patient perceives a burning pain in the throat1 and the parts all round swell up1 respiration becoming difficult1 add to this a hoarseness1 great difficulty in swallowing1 there is no time to lose1 for immediate assistance is wanting4 ,bleeding is indispensably necessary1 particularly if the inflammation is sudden2 warm foot-bathing also is highly requisite2 to remove the humours downwards2 a gargle should also immediately be applied like the foregoing ,no4 ,,xviii4 with the addition of a little camphor spirits4 ,externally apply the poultice1 ,no4 ,,ii4 and give the following draught4 ,no4 ,,xxxiv ,take fever powder 7,l71 one scruple2 calomel 7,n71 two grains2 liquid laudanum 7,t71 twelve drops2 water two spoonfuls2 mix it into a draught4 ,this may be given every six hours1 for two days successively2 and this generally will break the disorder4 ,the patient should be made to drink as freely as he possibly can2 and perspiration should ever be promoted4 ,a blister as the case requires1 may also be used with much advantage4 ,if the body is bound1 clysters may tend to incline the humours to be drawn down from the part4 ,no4 ,,xxxv ,take ,glauber's salts 7#ai71 one ounce and a half2 honey 7,e71 one spoonful2 hot water1 a pint and a half4 ,sometimes the inflammation is so very great1 as to choak up both the passage of respiration1 as well as that of deglutition2 so that the poor afflicted patient can neither breathe1 nor swallow2 and is not only liable to be suffocated1 but even starved to death1 besides the danger from the malignant inflammation4 ,in this exigency1 have recourse to the following simple but excellent remedy4 ,no4 ,,xxxvi ,take a pipkin1 or a tin sauce-pan1 with a quart of water1 a pint of vinegar1 and two spoonfuls of honey2 then take a funnel that will pretty well cover the vessel2 then take a piece of iron1 or some old nails1 or a little stone1 or what you have handy2 heat it red hot1 and put it into the pipkin1 and put on the funnel so that steam may ascend through it4 ,over this let the patient hold his mouth1 so that he breathes nothing but the steam2 and to secure it the better1 put something over his head1 that he may reap the more the benefit of it4 ,when the steam ceases1 heat it again as before4 ,instead of heating it with the iron1 it may be shifted with boiling1 but the former is generally more handy4 ,in the mean time1 if the patient should by the inflammation1 be deprived of all nutriment1 recourse must be had to nourishing clysters3 milk in this respect is the best2 but in want of that1 fowl broth may be used2 and if that is wanting1 take water gruel4 ,milk however is superior to all3 ,i shall give a receipt of each kind4 ,no4 ,,xxxvii ,take milk and water1 of each a pint2 cinamon 7#af71 one drachm2 boil them and strain the liquor2 then dissolve one ounce and an half of good loaf sugar2 add six drops1 of the essential oil of peppermint 7,u71 upon a little lump of sugar4 ,no4 ,,xxxviii ,take half a fowl1 bruise the bones1 and cut the flesh small2 this boil in three pints of fresh water1 with about one drachm of cinamon2 strain it clear1 and add as before1 an ounce of sugar1 with a few drops of the oil of peppermint4--,a tea cupful of good white wine may be added1 if the patient is very weak1 and not feverish4 ,no4 ,,xxxix ,take oatmeal1 two spoonfuls2 malt1 one spoonful2 cinamon1 two drachmes4 ,boil it in two quarts of water for some time1 till when it is strained1 it becomes one quart2 put to it fine sugar1 six ounces2 a few drops of essential oil of peppermint1 and a tea cupful of good wine4 ,these clysters are perfectly safe1 and very nourishing4 ,some have added salt to the animal broth1 perhaps through a notion to make it the more palatable1 and so of course more nourishing2 but probably they forget that the part they are now about to feed1 differs widely from the depraved taste of the palate4 ,salt is stimulating2 besides1 it indurates the aliment1 that it never yields so much nourishment1 because it always opposes assimulation2 and it is universally known1 that salt victuals is by far1 less nourishing than fresh4 ,the quincey is sometimes so desperate1 as to strangle the afflicted patient1 particularly if assistance is given too late2 in so much that bronchotomy1 or opening the wind-pipe1 has been the last resource in this deplorable dilemma4 ,i have mentioned this operation1 in the third lecture1 and have only to observe1 that in this case little hope is left after that operation1 on account of the great inflammation of the parts2 though we have instances of its success4 ,if however the method which ,i have here laid down1 together with strict observance of managing fevers is duly observed1 there can scarce be a failure of success2 for if ,i may be allowed to judge from my own experience and success1 it is merely neglect1 in the first setting out of these diseases1 that for the most part1 renders them so very desperate and mortal4 ---------------------------------------- --- ,,sect4 ,,iii4 ,of ,diseases in the ,breast ,under this head1 ,i mean principally to treat of diseases of the wind-pipe1 the lungs1 and the pleura1 or membrane that lines the cavity of the breast1 and encompasses the lungs4 ,of the ,cough4 ,a ,cough is generally occasioned by a cold2 unless it is symptomatic with other inflammatory diseases1 or the relict of a heavy sickness2 in which case1 it is either near a-kin to1 or else the consumption itself4 ,if from a cold1 it seldom is deep founded1 and generally has its seat in the larynx1 or in the wind-pipe2 though indeed sometimes in the lungs4 ,it generally begins first with a tickling in the throat1 and occasions a short dry cough2 which gradually becomes strong1 and is attended with a discharge4 ,it is surprizing what absurd remedies are sometimes given for the cough2 as if they supposed that every thing taken should immediately march at the word of command into the wind-pipe1 and there set to work accordingly4 ,amongst the many celebrated nostrums1 spermaceti1 or whales fat is remarkably celebrated2 it softens the phlegm say they2 but in fact1 a little fat pork1 or hog's lard will do equally as much good4----,the truth of the matter is1 the cough proceeds from an obstructed perspiration4 ,when a person gets cold1 he generally first feels a snuffling1 and obstruction in the nose1 then a sore throat or hoarseness1 and lastly a cough2 all which is a gradual defluxion from the pituitous membrane1 which reaches from the cavity of the nose1 all down the lungs4 ,whatever medicines therefore1 are capable of yielding benefit1 must be calculated to open and remove the obstruction1 and promote universal perspiration2 whence therefore we find it is impossible to cure one1 without the other4--,medicines neither do1 nor is it fit they should come immediately farther1 than the top of the larynx2 for if they happen to come into the wind-pipe1 the most innocent medicine would certainly act the part of a poison4 ,the first indication therefore in a cough1 is to promote perspiration2 for then nature will repair the respirative organs with the rest4 ,let the patient take a draught or two of good sage punch1 ,no4 ,v4 and thereby promote perspiration2 and in order to continue this principal intention1 and to assuage the slight inflammation in the throat1 which the heavy cough occasions2 make the following electuary4 ,no4 ,,xl ,take honey1 or sugar dissolved to syrup1 two ounces2 lemon juice1 half an ounce2 or elixir of vitriol1 two drachmes2 sweet oil1 one ounce2 mix them into a linctus4 ,take of this1 every half hour1 but half a tea spoonful2 and swallow it gradually1 so that it may as it slides by1 do some service to the larynx2 and keeping the body all the time in a gentle perspiration4 ,this method is superior to all your nonsensical pectorals1 which have nothing but quackery for their foundation2 for whatever you may take for the cough1 it cannot possibly have any other effect on the part1 till the real cause is removed1 than barely to touch the larynx2 for all goes to the stomach1 and undergoes the same chance as your victuals4 ,therefore strike at the root of the evil2 namely1 to promote perspiration2 and all the rest of the complaints will vanish1 in consequence of this principal intention4 ,of the ,pleurisy1 and ,peripneumony4 ,the pleurisy is an inflammation of the lining of the inside of the pectoral cavity and lungs2 and the peripneumony an inflammation of the lungs themselves4 ,these two principal kinds of inflammation have given birth to the names of many other inflammations contiguous to those parts1 which ,i hope to be excused from entering into1 as it is of very little signification to the proper treatment of those disorders2 for ,i have often known the most skilful practitioner1 to be mistaken of these disorders in his diagnostics1 and yet been successful in his cure4 ,the signs of this inflammatory disease1 is an acute fixt pain in the breast2 on whatever side the disorder is in1 with a difficulty of breathing1 and frequently attended with a small short dry cough1 which however stings the patient like so many daggers4 ,a constant fever attends with all its symptoms2 which adds greatly to the patient's misery4 ,on the immediate signs of these symptoms1 bleeding must be had recourse to2 and if the inflammation is great1 and the pain pungent1 it must be repeated2 though with skilful management4 ,bleeding may be repeated after the first twenty-four hours2 yet in general it is needless1 and sometimes dangerous2 for my own part1 ,i never approved of it2 nor have ,i seen any necessity for it4 ,perspiration however should be promoted4 ,if the pain is violent1 let the patient use the following medicine4 ,no4 ,,xli ,take sweet ,spirit of ,nitre 7,d7 twenty drops2 ,spirit of ,wine and ,camphor 7,a7 ten drops2 ,fever ,powder 7,l7 one scruple2 mix it up with sugar and water into a draught4 ,let the patient take this every six hours2 if there is a great nausea at the stomach1 a small vomit of twelve grains of ,ipecacuanha1 7,s7 may be given first1 notwithstanding it is great pain to the patient2 and ,i have often known it productive of great good1 and laid the first foundation to a successful cure4 ,if the pain still continues1 twelve drops of liquid laudanum 7,t7 may be added to the above draught2 ,no4 ,,xli4 ,if the spirits of the patient is low1 give the essential oil of ,peppermint 7,u7 to the quantity of three or four1 or six drops upon a lump of sugar1 either put1 into the draught above-mentioned1 or give it by itself occasionally4 ,to the inflamed side1 warm cloths may be put wrapt up with a hot made trencher1 brick1 a bag of sand1 or whatever will retain heat2 as that will greatly facilitate the internal resolution4 ,perspiration is the principal object to be considered in this acute disease1 and should therefore be promoted2 but every thing forcing that produces profuse sweats should be avoided1 as that only encreases the fever4 ,if the patient is very restless1 the fever depressed1 and greatly oppressed in respiration1 blisters may be applied2 but if the patient can do without them1 it is much better2 as they very often are apt to encrease the inflammation4 ,cooling clysters1 ,no4 ,,xxxii4 which at the same time promote urine1 is of singular service2 and in every respect methods must be taken1 as have been directed in fevers1 and the ulcerated sore throat2 as all these inflammatory diseases are of one nature1 and require almost one method of treatment4 ,for farther particulars on this head1 see my treatise on diseases of the lungs4 ---------------------------------------- --- ,,sect4 ,,iv4 ,of ,diseases of the ,bowels1 and the ,alimentary ,canal ,diseases of mankind under this head are very numerous indeed2 which are for the most part owing to their deviating too much from the common path of nature4 ,but besides all this1 seamen are particularly liable2 not so much indeed on account of luxury as the confined diet1 and the different climates they visit4 ,i shall in this be as concise as the subject will admit of1 and confine myself to such diseases as occur most commonly2 and by which others that are here omitted1 may be understood4 ,of a ,depraved ,appetite4 ,there is nothing that people in general are more apt to fly to1 when appetite fails them1 than bitters2 but if we consider what bitters really are1 and by what means they act in the alimentary canal1 we shall find them1 either only to stimulate the coat of the stomach1 or else add to the strength of the bile4 ,but generally the default of a bad appetite is a pituitous slime in the stomach1 that prevents this viscera from performing its part towards assimilation2 and therefore we generally find that such stimulants only spur it on for a little while longer1 till at length it loses its tone1 so as to be wholly unable to prepare the food for a good nutrition2 or else the stomach becomes so used to these forcing stimulants1 as not to be able to do without them4 ,but this is not all2 for in bilious complaints1 when the stomach is most disordered1 bitters never fail of making evil worse4 ,the stomach is a delicate viscera1 and should ever be the most cautiously dealt with4 ,whatever part of the human body is in exquisite pain1 the stomach from the nervous consent always partakes1 and is apt to be depraved in its functions2 whence a nausea is liable to ensue2 and in such a case any stimulants1 particularly where bitters are concerned1 is ever of evil tendency4 ,in general however1 a vomit is what nature points out2 and which gives not only relief to the stomach1 but assists in giving a general effort to the whole animal fabric4 ,in short1 there are so very few cases where bitters are of any benefit at all1 except where the stomach has injuriously been used to those stimulants1 that ,i have entirely exploded them from my catalogue2 being persuaded that every body will do better without them4 ,when the stomach loaths victuals1 the mouth is slimy1 has a bitterish taste1 and attended with sour belching1 and the victuals siting heavy on the stomach1 nothing is preferable to a vomit4 ,this ,i know has also been carried into abuse1 as well as many other good medicines4----,yet that should be no rule2 for if a vomit is properly and timely given1 it will ever be attended with success4 ,take here the following direction for a foul stomach4 ,first take a vomit1 and work it well off with bare luke warm water2 then take every night1 or when going to rest1 a dose of stomach powder 7,m74 ,if the stomach seems very weak1 add a few drops of the essential oil of peppermint 7,u71 which will soon convince you of the good effects4 ,if you require a stimulant in the morning1 take ,turlington's balsam 7,w71 about a tea spoonful in a glass of wine1 previously put on a lump of sugar1 that it may the better incorporate3 which is a good stomachic1 and ever preferable to the customary bitters4 ,dram drinking is another pernicious custom1 whereby many have been sent to eternity long before the period of life prescribed by nature2 and of which ,i would advise every man1 who has the least regard for his health1 to beware1 as of a deadly poison4 ,on the whole1 the want of appetite is what many complain of without reason4 ,some fancy themselves very bad1 because they cannot eat their breakfast2 those ,i would advise to stay till dinner time2 others again have no appetite for their dinner1 unless they wet their stomach with a glass of ,stoughton1 or some other bitters3 ,those should eat nothing in the morning1 or else stay till supper time4----,in short1 nature should be consulted1 both in the state of health1 as well as in diseases1 and her salutary dictates should be followed4 ,the custom of seasoning victuals with strong stimulating condiments is often prejudicial1 and nothing should be used with more moderation2 for though it may warm and stimulate the stomach1 yet1 it frequently gives cause to great weaknesses1 and generally are the primitive causes of chronic distempers2 as it hurries on the chylefaction1 and thence is apt to feed the blood with many acrimonious humours4 ,this little dissertation on depraved appetite ,i hope will suffice1 and doubt not if attended to1 that health and longevity will become the intimate acquaintances of the man who wishes to enjoy their blessings4 ,of the ,colic4 ,if we consider the length of the ailmentary canal from the mouth to the anus1 namely six times the length of the subject they belong to2 and if we consider the delicacy of its substance1 as also1 the office for which it is ordained2 we shall not at all wonder1 that so many disorders are incident to mankind in that part4 ,the colic however is the general term for various painful sensations in the intestines2 though the causes as well as the seat1 and the manner of its affecting the system1 is materially different4 ,the general cause however1 is a stimulant1 which irritating the inner coat of the intestines to constriction2 and whence a spasmodic contraction1 and a perverted peristaltic motion is produced4 ,if the stomach is affected with the pain of the colic1 so that a nausea and reaching attends1 or has been previously felt1 a vomit is the first1 and most expedient method to be had recourse to2 for by this1 not only the crudities in the stomach gets disburdened1 but from the joint action on the internal canal1 a stool or two is generally produced1 by which frequently the offending acrimony is carried off4 ,when however this avails not sufficiently1 and the pain rather increases1 particularly if the body at the same time is costive1 recourse should be had to clysters2 for purges in this case1 do not operate speedily enough1 and in cases of costiveness1 is not always safe4 ,the clyster ,no4 ,,xxiii4 may be of great benefit1 and if necessity requires it1 occasionally repeated4 ,but more frequently1 it is from a nervous affection1 and then carminatives prove the most effectual2 in such cases give the following1 ,no4 ,,xlii ,take essential oil of peppermint 7,u71 six drops on a lump of sugar2 elixir proprietatis 7,h71 five large tea spoonfuls2 wine or water1 half a tea cupful4 ,let the patient take this immediately2 a little ,turlington's balsam 7,w7 about a tea spoonful1 also is very beneficial4 ,if the pain still continues violent2 let ten or twelve drops of liquid laudanum 7,t71 be added4 ,clysters should not be neglected1 but plentifully administered2 the same medicines as is given to the patient1 may also be added to the clyster4 ,the dry belly-ach1 is a spasmodic contraction of the intestines1 and throws the patient into the greatest misery imaginable2 clysters is the only recourse and anodynes1 together with gentle mercurials will likewise prove beneficial2 warm clothes and something that can retain the warmth should constantly be put to the bowels2 and in great extremities1 cold foot baths have often given immediate relief4 ,the bilious cholic is of a dangerous tendency1 and always attended with the bilious belching and vomiting of bile4 ,in this case vomits is the only method to be used with safety2 and if properly continued1 as long as the bile is brought up1 will never fail of success4 ,but bleeding in bilious complaints is ever pernicious4 ,if a fever attends1 method must be used accordingly4 ,of ,looseness1 and the ,bloody ,flux4 ,a ,cholic is often the forerunner of a looseness1 and if the looseness is not too violent very often is salutary1 and carries off many kind of disorders in the body4 ,but if a looseness continues after twenty-four hours1 it is time something should be done1 in order to prevent a bloody flux4 ,if the flux is attended with a nausea at the stomach1 and an inclination to vomit1 give without delay the following draught3 ,no4 ,,xliii ,take rhubarb 7,o7 one scruple2 ipecacuanha1 ten grains2 stomach powder 7,m7 fifteen grains2 calomel 7,n7 three grains2 mix them and make it into a draught or bolus1 with sugar and water4 ,this probably will vomit a few times1 and then occasion a few stools2 but as the rhubarb has an astringency as well as cathartic quality1 it will in general1 after the purging has gently carried off the acrimony1 act as an astringent2 particularly if after the above draught1 the following paragoric is taken4 ,no4 ,,xliv ,take oil of peppermint 7,u7 four drops upon a lump of sugar2 liquid laudanum 7,t7 eight drops2 sweet spirits of nitre 7,d7 twenty drops2 mixt in a glass of wine4 ,but if the patient still continues after these medicines1 with great griping1 a succession of stools1 together with a tenesmus1 7that is a perpetual inclination to go to stool7 then give the following3 ,no4 ,,xlv ,take rhubarb 7,o7 ten grains2 stomachic powder 7,m7 fifteen grains2 essential oil of peppermint 7,u7 three drops2 calomel 7,n7 one grain2 and make it into a bolus or draught4 ,let the patient take this every six hours1 for the first two days4 ,if the stools are bloody1 slimy1 and attended with great pain2 recourse must immediately be had to clysters1 such as ,no4 ,,xxxvii1 ,,xxxviii1 ,,xxxix4 mentioned in the quincey2 for the more nourishing they can be made the better2 as thereby they will lubricate the bowels1 and strengthen them4 ,in the mean time the white decoction should be used as a constant drink1 which make as follows3 ,no4 ,,xlvi ,take chalk 7#ah7 pounded small1 three ounces2 cinamon 7#af7 bruised1 two drachms2 boil them in two quarts of water for one hour1 and strain off the decoction4 ,of this let the patient drink for his constant drink2 a few drops of oil of peppermint may be dropped upon a lump of sugar1 and dissolved in it4 ,the same decoction may also be given as a clyster when the flux is very violent4 ,after the two first days the rhubarb should be given but sparingly2 for if the flux is bloody1 we may justly suppose the intestines are in a state of inflammation1 and even ulceration4 ,in such extremity1 a little calomel mixed with the clyster1 as also liquid laudanum1 will not only correct the acrimony1 but give ease to the emaciated stamina of the intestines4 ,by this treatment the most inveterate bloody flux may be subdued1 especially with the help of patience1 cautious diet1 and cleanliness4 ---------------------------------------- --- ,,sect4 ,v4 ,of the ,scurvy ,if ,i was to write as much on that subject1 as ,i have already written in this treatise1 the whole would only amount to this1 that the scurvy is a state of putrifying corruption in the living human body4 ,the causes of this disorder is a defective diet1 contaminated air1 and want of proper exercise4 ,in regard to the diet1 salt provisions and foul water are the accessory means1 which not only impoverishes the blood1 but gives it a tendency to a putrescency1 whereby it loses its spirit1 the lymph its gelatinousness1 and the crasamentous part its resinous consistency4 ,thence the serum becomes sharp and acrimonious2 the lymphatic part in the blood unable to nourish the stamina of the solids2 and the red crasamentous part becomes crumous1 and void of its vivacity3 and as the solids must in consequence suffer in proportion to the state of the blood1 from whence they have their existence1 and become maintained1 it must follow also1 that they degenerate into the same state of corruption3 thence we find not only a universal lassitude and debility in the limbs1 but gradually the smaller vessels become unable to circulate the corrupt humours1 break1 bleed1 and even mortify of their own accord1 without any other cause than the putrescent nature of their containing fluids4 ,though the symptoms are in general too well known1 not to be easily mistaken2 yet ,i shall here describe this destructive disease in its various gradations4 ,when a patient first begins to be tainted with the scurvy1 he feels a lassitude all over his body1 and a peculiar proneness to indulgence and idleness2 work becomes irksome2 and neither has he strength1 nor inclination1 to do his work with the same chearfulness as before4 ,he sleeps more in general1 but his rest is for ever disturbed with heavy and melancholy dreams2 and particularly of that nature1 as for ever to be engaged in escaping from some sad danger1 but unfortunately that his limbs are so remarkably heavy1 that he cannot move them4 ,with these and the like labour in vain phantoms his sleep is disturbed1 till at length he awakes1 and finds himself more fatigued than when he first went to rest4 ,the mouth is always foul and slimy1 and frequently attended with a disagreeable taint4 ,the appetite is depraved1 and the victuals sits very heavy on the stomach4 ,this is the first stage of the scurvy2 and when a patient is sure of those symptoms1 it is time some remedy should be used1 in order to prevent the approaching evils2 which gradually come on thus4 ,the gums begin to swell1 though not very sore2 and frequently bleed either on their own accord1 or at the least touch of any thing that comes near them4 ,the breath becomes very disagreeable1 even to the patient himself4 ,the teeth grow dark1 brown or black1 become loose1 and the very jaw bone1 together with the roots of the teeth are exposed and seem uncovered from the decayed gum4 ,sometimes a scurfy itch ensues1 and sometimes little spots appear4 ,the body becomes remarkably weak1 and sensibly falls away1 and the colour of the skin gets a disagreeable tawny hew2 which is most remarkable1 together with other emaciated features in the patient's countenance4 ,this is the second state1 and now dissolution actually begins to take place4 ,the patient loses his strength sensibly1 so as not to be able to be supported by his own limbs4 ,over his body variously appear red1 scarlet1 yellow1 green1 livid and black spots1 of various magnitude2 some of which will bleed on their own accord2 others will break into malignant ulcers1 and others again will mortify4 ,the appetite fails2 a flux frequently ensues2 the urine will be thick and stinking2 and the poor wretch gradually dies merely by putrefaction4 ,the scurvy has had many definitions1 and has been divided into various classes4 ,all the difference of the disorder is1 that sometimes it is attended with a fever1 only in some degrees1 more in one habit1 than in another2 which may be owing either to the nature of the constitution itself1 but principally depends on the climate the patient is in3 to which ,i must not forget to add1 that frequently the scurvy is complicated with other disorders4 ,i could make many observations on this head1 but1 this perhaps would serve more to indulge myself than to benefit my reader4 ,i shall therefore suppose that ,i have said enough1 to proceed to the cure2 which ,i do with the more chearfulness1 as ,i am happy in knowing it by experience to be not only easy1 but efficacious4 ,the first time ,i ever experienced1 and had it in my power to examine into the nature of the true scurvy1 ,i was fortunate enough to discover so much of its corruptive quality1 as to hit upon the true antidote2 namely1 the sacharine quality and acidity of vegetables2 and upon this foundation ,i established my method of cure with success4 ,i shall not here enumerate the many experiments that ,i made in the course of these inquiries1 but proceed to the result thereof1 and the method to be observed4 ,in the first place1 sugar is an article of more virtue1 than what is in general known2 and of so great a value to seamen1 that he ought to esteem it as one of the greatest preservatives of his health4 ,next to this is vinegar1 which is not only a resister of putrefaction1 but has a coagulating1 and condensing quality to the animal juices2 whereby it not only consolidates the fluids without adding acrimony1 but on the contrary1 absorbs animal acrimony1 and braces up the solids4 ,on the same principle1 ,i have found dried malt1 to be of great advantage in scorbutic cases2 in which1 both the saccharine and acidity of vegetables is contained even in a heightened degree1----,this being premised1 ,i proceed in the following manner3 ,when a man is found to have evident signs of the scurvy1 let his drink be acidulated with one fourth1 or third1 c4 of good vinegar1 or what is yet better1 lemon juice1 and well sweetened with sugar4 ,if there is malt on board1 let a malt decoction1 or temporary beer be made in the following manner3 ,no4 ,,xlvii ,take malt bruised1 a pound1 or three handfuls2 sassafrass chips1 a small handful2 boil it in a gallon of water for an hour1 and strain it off for use4 ,let this be the constant drink1 which in a short time will revive the already tainted habit4 ,onions1 horse-raddish1 and mustard1 c4 such as will keep on board1 should plentifully be made use of1 and the pills ,no4 ,x4 should be taken every twenty-four hours1 at a time when going to rest4 ,this method will soon bring the patient to health again1 particularly if in the first stage2 but when it is come to the second degree1 or in a state of rapid decay1 more effectual and immediate means must be taken4 ,here then ,i shall present the method1 which by experience ,i know to be efficacious4 ,no4 ,,xlix ,take a large tub1 7a butt sawed in two7 in which place a stool1 or something to sit on2 ,then let the patient be stript naked and seated in the tub2 pour into the bottom of the vessel about one gallon of good vinegar2 put a blanket all over the patient1 and the tub1 so that the whole is covered like a hut4 ,then heat a large poker2 which put into the vinegar in order to rise a steam2 which continue for about a quarter1 or half an hour1 or longer1 according to the circumstances4 ,if the patient is very scorbutic1 it should be repeated three times a day1 or even oftener1 for the effect of this steam-bath is so powerful1 that ,i have with pleasure seen the patient when not able to crawl to the tub2 he has been so revived by the operation1 as to come out of his own accord quite refreshed4 ,in the mean time the elixir of iron as is described ,no4 ,,xxviii4 should be taken2 the mouth often washed with vinegar1 lemon juice1 or rather with the elixir of the iron1 and sugar1 should be both plentifully used in the drink1 and with the victuals4 ,salt provisions should be avoided as much as possible1 or else previously well deprived of its salt4 ,by this method the scurvy may not only be prevented at sea1 but even cured in the most inveterate degree4 ,if however there is an opportunity for the patient to come on shore1 it will greatly facilitate his cure2 though he should reap no other benefit than the exhalations of the earth in the warmth of the day3 and ,i have with astonishment seen patients devour vegetables in large quantities1 and mended surprizingly1 even in a few hours2 so powerful an antidote is the vegetable effluvia to an animal putrescency4 ,to conclude1 ,i have only this to observe1 that the scurvy is principally owing to defaults with respect to provisions1 and the customary way of living in ships in general2 and such as might be much amended1 both with respect to conveniency1 wholesomeness1 and expence4 ,i speak this from long experience1 from the many observations ,i have made1 and the good success that have attended my improvements1 when it has been in my power to put them in execution4 ,i have many things to offer with respect to provisions at sea2 but as that is too extensive to be inserted in this volume1 ,i shall treat of it distinctly4 ,in the mean time give me leave to close these lectures3 and being conscious that truth and utility has guided my endeavours through the whole1 ,i lay down my pen for this time1 with the pleasing reflection1 that ,i have advanced one step farther in the performance of my duty1 and in answering the end of my existence4 ,,finis4 ---------------------------------------- -------------------------------- ,illustration3 ,medical ,instruments4 ,,explanation ,,of ,,the ,,plate4 ,fig4 #a4 ,a common bleeding lancet4 ,a4 ,the blade2 which1 when it is wiped after bleeding1 should always be laid upon the handle ,b4 and wiped but one way1 to save the point4 ,fig4 #b4 ,an incision lancet4 ,a4 ,the point of the blade1 which ought to incline one way most1 in order to make it the better fit for opening of aposthumes4 ,fig4 #c4 ,a bistoury for opening of sores1 c4 in general use4 ,a4 ,the blade4 ,b4 ,the handle in which the blade folds4 ,fig4 #d4 ,a pair of strong scissars4 ,fig4 #e4 ,a spatula4 ,a4 ,the part for spreading of plaisters4 ,b4 ,the part for pressing down the tongue2 for which reason it is made full of holes that it may the better press down the tongue4 ,fig4 #f4 ,a probe4 ,a4 the probe4 ,b4 ,a triangular point on which lint may be wrapped to wipe the sore with1 as it is easy taken off again4 ,fig4 #g4 ,a arm tied up for bleeding1 with the three veins as they generally appear when swelled up4 ,fig4 #h4 ,a vein of a kind of three orifices4 ,a4 ,is a longitudinal orifice1 which will not let the blood run freely4 ,b4 ,transverse2 in making such orifice the vein is apt to be divided2 besides it is not very easily stopped1 and will not admit of an orifice large enough to let the blood run out with freedom4 ,c4 ,an oblique opening1 the medium between the two former2 and always the best orifice4 ,fig4 #i4 ,a key-tooth instrument4 ,a4 ,the handle1 made of ivory4 ,b4 ,the comb of the instrument1 which should be wrapped round with a little rag1 and is that part which rests against the jaw bone4 ,c4 ,the hook which is brought over the tooth4 ,d4 ,the screw at the end of the key1 by which the hook is shifted as occasion requires4 ,e4 ,the screw by which the handle is fixed to the instrument4 ,fig4 #aj4 ,common splints used for fractures2 these splints are made of thin boards of pine or cedar1 glewed on to leather1 and then ridged so1 that they may easily bend and suit to the limb which they are applied to4 ,fig4 #aa4 ,a single headed rowler1 or bandage1 this bandage is generally used for a fractured arm or leg4 ,fig4 #ab4 ,a double-headed rowler1 generally for dislocations4 ,fig4 #ac4 ,a many-tailed bandage4 ,a4 ,the back part slip1 that keeps the bandage together4 ,b4 ,the stitches coming thro' the bandage4 ,c4 ,the slips of the bandage4 ,d4 ,the part next the ancle1 from whence the parts upwards have a gradual increase4 ,fig4 #ad4 ,mr4 ,sharp's invented splints1 made of paste-board4 ,a4 ,the external splint4 ,b4 ,the leather straps4 ,c4 ,the strap1 that comes under the foot4 ,e4 ,the internal splint4 ,f4 ,the loop through which the strap that comes under the foot is put4 ,g4 ,small iron buttons1 on which the straps are fastened4 ,fig4 #ae4 ,a leg with the many-tailed bandages4 ,a4 ,the slips laid over each other4 ,b4 ,the under slip that secures the whole4 ,c4 ,a slip that secures the bandage to the foot4 ,fig4 #af4 ,a leg dressed with the splints4 ,a4 ,the bandage4 ,b4 ,the splint4 ,c4 ,the tie knots of the tape that secure the splint to the leg4 ,fig4 #ag4 ,the inner view of a leg with ,mr4 ,sharp's splints4 ,fig4 #ah4 ,the external view of the same4 ,these two are copied from ,mr4 ,sharp's pamphlet4 ,fig4 #ai4 ,a clyster syringe4 ,a4 the syringe made of pewter4 ,b4 ,a pipe made in such manner1 as to enable a man to administer a clyster to himself4 ,c4 ,a common clyster pipe1 that occasionally may be screwed on to the syringe4 ,fig4 #bj4 ,a clyster pipe and bladder4 ,a4 ,the bladder4 ,b4 ,the pipe4 ,c4 ,the manner of fixing the bladder to the pipe4 ,d4 ,the tying of the bladder when it is filled1 with a slip knot2 which is handier than the customary way of the cork4 ,fig4 #ba4 ,the manner of closing a wound with plaisters1 called the dry suture4 ,fig4 #bb4 ,a common syringe made of ivory4 ---------------------------------------- -------------------------------- ,transcriber's ,notes3 ,in ,lecture ,,vi1 ,sect4 ,,vi4 has been corrected to ,sect4 ,v4 to match the table of contents4 ,in ,,sect4 ,,vi4 on page #aah there is a reference to the authors description of the skin in ,lect4 ,i41 ,sect4 ,,vii4 ,the discussion of the skin is actually in ,lect4 ,i41 ,sect4 ,,ix4 on page #dj4 ,there are two ,,sect4 ,,viii4 in ,,lecture ,i4 ,they have been left with geh duplicate number4 ,the 8recipes0 for various medicines are numbered somewhat sequentially with ,roman numerals across all ,lessons and ,sections4 ,however there are 8recipes0 with duplicate numbers 7,,xxii appears three times in ,section ,v of ,lect4 ,,iv47 and some recipe numbers are missing altogether4 ,missing or obscured punctuation was silently corrected4 ,typographical errors were silently corrected4 ,inconsistent spelling and hyphenation were made consistent only when a predominant form was found in this book4 ,text that was in italics is enclosed by underscores 7italics74