THE
CLEMENT's LIBRARY
From the -
John G. and Anna R.
Winter Fund

















AMERICAN VEGFTABLE PRACTICE.
NEW AND IMPROVED
G UID E TO H E A L T H .
DESIGNED
FOR THE USE OF FAMILIES.
in six Parrºrs.
Part I. Concise View of the Human Body, with engraved and wood-cut illustrations.
Part II. Glance at the Old School Practice of Physic. Part III. Vegetable Materia
Medica, with colored illustrations. Part IV. Compounds. Part V. Practice of Med-
icine, based upon what are deemed correct Physiological and Pathological Principles.
Part VI. Guide for Women, containing a simplified treatise on Childbirth, with a
description of the Diseases peculiar to Females and Infants.
BY MORRIS MATTSON,
PHYSICIAN TO THE REFORMED BOSTON DISPENSARY, LECTURER ON PHYs-
IOLOGY, THE PRACTICE OF MEDICINE, ETC. ETC.
Do not counteract the living principle.—Napoleon.
“It is contrary to the dictates of common sense, to suppose that a Poison, either
mineral or vegetable, can be a MEDICINE.”
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IN Two vo Lu Mi Es.
W O L. I.
B O S T O N :
PUBLISHED BY DANIEL L. HAL E,
Blackstone St....Seven doors W. of Hanover St.

1841.
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Entered according to act of Congress, in the year 1841, by -
MORRIS MATTSON,
in the Clerk’s Office of the District Court of Massachusetts.
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POWER PRESS OF JOHN PUTNAM, BOSTON.

In the summer of 1837, during my residence in Philadelphia, I
announced a Vegetable Materia JMedica for publication, which led
to a proposal from Dr. Samuel Thomson of Boston, who was favor-
ably known as a reformer in the healing art, to assist him in pre-
paring for the press a new and final edition of his Guide to
Health, connecting with it my own work on materia medica. I
gave the matter a careful and deliberate consideration—as many
of my friends were unwilling that I should form any connexion
with Dr. Thomson—and in March, 1838, after repeated and ur-
gent solicitations, made him a visit in Boston. I found him
illiterate, coarse in his manners, and extremely selfish, and be-
coming disgusted with the man, was about to return to Phila-
delphia ; but his friends urged me to remain, and enter into a con-
tract with him, if possible, representing to me the necessity of
having a work on the reformed or vegetable practice which
would meet with the approbation of an intelligent community.
Accordingly, in about three weeks, a contract was signed, sealed,
and delivered, and it was agreed between us that I was to revise
and prepare Dr. Thomson's Guide for publication, in a new form,
introducing such observations on surgery and midwifery as 1.
might deem proper and useful, and to embrace in said publication
my work on materia medica, with colored illustrations of plants.
The new publication was to be sold at ten dollars a copy, retail,
instead of twenty dollars, which Dr. Thomson had exacted for his
old and very imperfect work. A committee of four persons was


iv. TO THE AMERICAN READER.
appointed in the contract, to decide “all matters and things in
relation to the character, form, and contents of said work, as also
the style and manner of its publication.” The gentlemen com-
posing the committee, I may remark, were selected by Dr. Thom-
son himself, as his personal, warm, and long-tried friends, and
though they were strangers to me, I did not object to their ap-
pointment.
Matters being thus adjusted, I interrogated Dr. Thomson from
time to time, as critically as possible, with regard to his knowledge
of remedies, and of the principles and practice of medicine, taking
down his answers in writing. I was thus prepared to render the
new work as complete as possible, so far as his views or opinions
were concerned, and in June, 1840, it was ready for the press.
Dr. Thomson, however, would not allow the committee to examine
it, and used every effort in his power to prevent its publication,
employing an attorney to assist him in breaking the contract which
he had so anxiously and solemnly ratified. Not satisfied with
this, he devised a plan to wrest the manuscript from my hands,
and publish it for his own benefit, intending thereby to deprive
me of my stipulated share of the profit. In this, however, he
was disappointed, and justice triumphed over intrigue and ava-
rice.
About this period, I was invited to attend a convention of the
Maine Thomsonian Medical Society; and in accordance with a re-
quest made by that body, gave a full and impartial account of
Dr. Thomson’s recent transactions. The members of the conven-
tion expressed their disapprobation of his unwarrantable conduct,
and passed a unanimous resolution advising me to publish the
work in my own name, pledging themselves to use their influence
in promoting its sale throughout the state of Maine and British
provinces.
In addition to the kindness manifested toward me by the friends
of medical reform in Maine, I received letters from almost every
part of the United States, urging me to put the work to press
without delay, and in obedience to these pressing solicitations,
I announced it for publication. Dr. Thomson now offered to re-
munerate me, if I would promise to forego my intentions and
give up to him my manuscript, but finding this of no avail, he
declared he would thwart me in my plans, though it should
cost him half his fortune. I pursued the even tenor of my way,

To THE AMERICAN READER. w
however, regardless, altogether, of his vain threats, or idle boast-
ing. In the course of two or three months, he saw the dilemma
into which he had rashly precipitated himself, and sent a mes-
sage, through one of his friends, that he was willing to join
me in the publication of the work, according to the stipulations
of the contract which he had so shamefully violated. I wished
no further connexion with Dr. Thomson, however, and thus the
matter terminated.
My book was put to press in January last, and since that time I
have re-written every page of the manuscript, making many valu-
able additions, and using every effort in my power to render it
acceptable to an intelligent public. The celebrated Dr. Rush ad-
vised his pupils to lay every person with whom they met, whether
in a packet boat, stage wagon, or on a public road, under contribu-
tion for facts in relation to medicine; and in the same spirit have
I endeavored to derive useful information from every possible
source, however humble or uninviting it may have been. Dur-
ing a residence of nearly two years under the same roof with Dr.
Thomson, an opportunity was afforded me, among the numerous
patients who were constantly under treatment, of observing the
effects of innocent vegetable remedies in the removal of disease,
and whatever knowledge of a useful character was acquired during
that period, I have considered it my privilege to embody in the
pages of this work. I wish it to be understood, however, that I
do not approve of every feature in Dr. Thomson's practice, and
have only adopted his views where they were in consonance with
reason and philosophy. I will mention a case or two by way
of illustration. Mr. William A. Parker of Boston, a highly re-
spectable citizen, was under treatment for two or three years by
the medical faculty, who left him with a troublesome ulcer on his
left breast. Finally, he placed himself under the care of Dr.
Thomson, who administered several courses of medicine, and
previous to each course, applied a poultice to the ulcer, compo-
sed of slippery elm, bayberry, lobelia, and cayenne, the latter
being sprinkled in a thick layer upon the surface of the poultice.
This painful and highly injudicious application was intended, ac-
cording to Dr. Thomson's own explanation, to drive the ulcer
into the internal organs, so that, when vomiting ensued, it might
be effectually banished from the system. Notwithstanding the


vi To THE AMERICAN READER.
cayenne and lobelia poultices, however, the ulcer still continued,
and Mr. Parker was not cured until he made application to an old
woman who had some reputation in the treatment of sores. She
had sagacity enough to discover that the ulcer extended for some
distance beneath the surface, and by using injections of some ap-
propriate fluid to cleanse the cavity, very soon effected a per-
manent cure. It is with regret that I feel myself called upon to
notice such a manifestation of ignorance on the part of Dr. Thom-
son, particularly when he has been the propagator of much that
is truly valuable in the healing art. The most acute and dis-
cerning minds, however, are sometimes led away by vain and
foolish notions. The illustrious Dr. Johnson, notwithstanding his
towering intellect and brilliant literary acquirements, was weak
enough to suppose that the touch of Queen Anne could cure him
of the scrofula. Even the medical faculty, who are supposed by
some people to be incapable of doing wrong, recommend the wood-
louse as a remedy in dropsy and asthma, and spiders in the treat-
ment of ague and fever.
I will mention another case, to show that Dr. Thomson does
not exercise sufficient discernment in the treatment of some dis-
eases, whatever his advocates may say to the contrary. A gen-
tleman, who was accustomed to the free use of wine, called at
my office, leaning upon the arm of a friend, complaining of severe
indisposition. I saw at once that he was threatened with an at-
tack of delirium tremens, and upon inquiry found that he had not
tasted his accustomed beverage for two or three days. His eyes
had a glaring expression, and his whole body was tremulous. I
accompanied him without delay to Dr. Thomson's infirmary, and
administered some medicine, which relieved the urgent symptoms.
I then expressed a desire that he should have a course of medi-
cine, commencing with small doses of lobelia ; but Dr. Thomson
asserted that it would be improper to administer a course under
five or six days, as the lobelia would increase his delirium in a
tenfold degree. Such was not my experience, however, for I had
always found lobelia to be a sovereign remedy in delirium tremens,
but I could not act in opposition to Dr. Thomson's orders, in his own
infirmary. A day passed without the patient experiencing much
if any relief, and as he had placed himself originally under my
care, I insisted upon the administration of a course, telling Dr.
Thomson that I would assume the responsibility. Accordingly, a


To THE AMERICAN READER. vii
course was commenced, and in less than half an hour from the
time the lobelia was given, the patient sunk into a quiet and re-
freshing sleep, and when he awoke, which was in about two hours,
he vomited slightly, and was entirely relieved of his malady. I
do not mention this case with a view of reflecting discredit upon
Dr. Thomson, but merely to convince the reader that he does not,
in every instance, possess that degree of oracular wisdom which
some of his enthusiastic advocates seem to imagine. No one is
more ready than myself to do him full justice for all his discove-
ries, but I am not willing to acknowledge that he has originated a
perfect system of medical practice.
Dr. Thomson has accused me of having made an undue appro-
priation of his discoveries and doctrines, in the preparation of this
work, and I feel myself called upon to reply to the charge. In
the first place, I must be permitted to observe, that his Guide to
Health contains many errors and fallacies which I could not have
adopted or sanctioned without rendering myself ridiculous in the
estimation of the intelligent reader. I will quote a few random
passages from the work, to substantiate the truth of my remark.
1. On page 116, he says, “The gall-bladder grows on the
liver, and is placed between that and the stomach, so that when
the latter is filled with food, the bile is discharged into the stom-
ach to digest it.” Perhaps I need not remark that the bile is not
emptied into the stomach at all, and has nothing to do with the
digestion of food in the stomach; it is emptied into the duodenum,
several inches distant from the stomach, and there performs the
office which nature assigned it, of separating the nutritious from
the innutritious portions of food. Bile is sometimes found in the
stomach, but it is always in a diseased or morbid condition of the
organ, and makes its way there only by an inverted action of the
duodenum.
2. On page 150, Dr. Thomson conveys the idea that in
“breathing,” oxygen is exhaled or given out from the lungs,
whereas, so far as any thing is known upon the subject, the
oxygen is absorbed by the lungs, and carbonic acid gas is evolv-
ed. It is difficult to know, however, what precise meaning to
attach to his words, for by referring to pages 149-50 of his Guide,
B -

wiii TO THE AMERICAN READER.
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it will be seen that he speaks of owygen, water, and vapor, as
synonymous.
3. Dr. Thomson says there are two kinds of dropsy—page
122 of the Guide—one of which is “caused by cold and obstruc-
tion;” and that “a leak forms in the glands and lets the water
into the trunk of the body, where there is no vent to let it off.”
Dr. T. ridicules the idea of studying anatomy and physiology, but
had he been acquainted with these subjects, he would have known
that the fluid which collects in the “trunk of the body” in dropsy,
is not a glandular secretion, but an exhalation from the serous
membranes, which is not carried off with sufficient rapidity by
the absorbents, and hence the accumulation of fluid consti-
tuting dropsy.
4. In his remarks on fevers, pages 17 and 18 of the Guide,
he says, “When the outward heat becomes equal with the inward,
either by the one being raised, or the other being lowered, cold as-
sumes the power, and death takes place.” -
I once enquired of Dr. Thomson what was to be understood by
the terms “ inward heat” and “outward heat,” and he informed
me that the first implied the heat of the body or temperature of
the blood, and the second the atmosphere, or surrounding me-
dium. Were this doctrine correct, we should all perish by expo-
sure to the sun, in the hot weather of summer, the moment the ther-
mometer should rise to 98 or 100 degrees of Fahrenheit, for that
is the healthy temperature of the blood. Under these circum-
stances, there would be, according to Dr. Thomson, a “balance
between the inward and outward heat,” and we should die upon
the instant. Nor could we venture into the vapor bath, without
the sacrifice of our lives, for we seldom employ it at a lower
temperature than 110 degrees. The Finlanders go into their
vapor baths at a temperature of 150 degrees, remaining there for
half an hour or an hour; and we have an account of Dr. Fordyce,
and others, who went into an oven heated to a temperature of 260
degrees, and yet death did not occur, as Dr. Thomson would lead
us to expect. From experiments made by Boerhaave, it was
believed, for a time, says Mr. Bell, in his Anatomy and Physi-
ology, that persons could not live when exposed to a heat greater
than that which is natural to the body; but this was disproved
by some young women in the employ of a baker at Roche-
foucault, who were in the habit of going into the heated ovens

To The AMERICAN READER. ix
at the temperature of 278 degrees; and they could remain in
them for about twelve minutes. Dr. Thomson, therefore, has
been ignorantly promulgating the error of a by-gone age, and it
is not to be supposed that I have followed him in any of his erro-
neous doctrines or speculations.
I agree with Dr. T. however, with regard to the use of African
cayenne as a stimulant; lobelia inflata as a safe and efficient
emetic; and so of many other remedies which he has introduced
to the public. Many of his compounds, also, are of inestimable
value, and will no doubt transmit his name to posterity. In truth,
there is no man in the country who has labored more effectually
in the cause of medical reform than Dr. Thomson; and notwith-
standing his ignorance, he has been a prominent instrument in
accomplishing a mighty revolution in the healing art. He seems
to have verified that passage of Scripture which says, “But God
hath chosen the foolish things of the world to confound the wise;
and God hath chosen the weak things of the world to confound
the things which are mighty.” Far be it from me, therefore, to
pluck a single laurel from his brow, for as a successful medical
reformer he is entitled to respect, whatever may be the frailties
and imperfections of his character; and while I seek to unveil
his errors, I shall ever accord to him the meed of praise for his
useful discoveries.
Dr. Thomson, however, as I conceive, is chiefly entitled to
credit for having made himself acquainted with remedies in pop-
ular use, either in this or some other country, and introducing
them to the public in a connected form. His actual discoveries
seem to have been extremely limited. For example, the vapor
bath has been employed by Europeans for several centuries;
and cayenne pepper is one of the oldest remedies in the
materia medica. The lobelia inflata, also, was used by the
people of New England as an emetic, before he was born, not-
withstanding he claims to have been the discoverer of its medical
properties. I have mentioned some facts in proof of this asser-
tion, in my description of the plant, and have many more at my
disposal, which I intend to give to the public in a small volume.
Indeed, there is scarcely a plant mentioned by Dr. Thomson,
in his Guide, which has not been familiar with the New England
people for at least a century. What is technically termed a course
of medicine, is supposed to have been original with Dr. Thom-

X TO THE AMERICAN READER.
son, though the idea even of this seems to have been borrow-
ed. In my remarks on the vapor bath, I have shown that the
American aborigines employed this agent, together with cat-
nip tea, in the cure of their diseases, long before Dr. T. was
known as a medical reformer, or at all events, before his name
had reached beyond the borders of civilization. “Of all Turkish
remedies,” says Dr. Madden, “the vapor bath is the first and
most efficacious in rheumatic and cuticular diseases.” Mungo
Park, in allusion to the Mandingoes, says, “On the first attack
of a ſever, when the patient complains of cold, he is frequently
placed in a sort of vapor bath, which commonly produces a pro-
fuse perspiration, and wonderfully relieves the sufferer.” Since
this book was put to press, I have ascertained that the medical
practice of the Marshpee Indians, the remnant of whom are now
to be found at Martha’s Vineyard, Massachusetts, is closely anal-
ogous to that of Dr. Thomson. According to tradition, they
were in the habit, even a century and a half ago, of taking a
vapor bath, on the first attack of disease, followed by an emetic
of lobelia, if they could obtain it, and if not, they employed some
other emetic herb. After the lobelia had done operating, they
made use of a purgative to cleanse the bowels; and it is well
known that Dr. Thomson formerly administered purgatives after
a course. Now the fact that lobelia and the vapor bath were
known to the American Indians as medicinal agents before the
existence of Thomson, does not prove them to be any the less val-
uable, but clearly shows that he has made a claim to originality to
which he is by no means entitled. I shall examine this subject
more critically at a future time, but at present my limits compel
me to forego any further remarks.
In conclusion, I will state that I have termed my work the
ſimerican Vegetable Practice, because this appeared to be the
most appropriate title, indicating
g, as it does, a system of prac-
tice which has received the sanction of millions of intelligent
people throughout the United States; and while Dr. Thom-
son has been identified with this reform, it would be idle to
deny, that the giant strides which it has made, and the great per-
fection to which it has now attained, are to be chiefly attributed to
the zeal and philanthropy of intelligent persons throughout the
Union, who have either devoted themselves exclusively to the




TO THE AMERICAN READER. xi.
practice, making new discoveries in the use of vegetable reme-
dies, or have entered the arena of medical reform from a sense of
duty alone, determined, if possible, to save their fellow mortals
from the hazardous experiments of the medical faculty.
In preparing the American Practice for the press, I have availed
myself of the usual authorities, where they could be of any service.
The colored illustrations in the materia medica, will, I presume,
meet with the entire approbation of the public. They have been
procured at great expense; and were executed by a new process,
invented by Mr. Sharp, recently of London, being the first of the
kind ever issued in the United States. The different tints were
produced by a series of printed impressions, the brush not
having been used in giving effect or uniformity to the coloring.
Connoisseurs in the arts have spoken of them in terms of admira-
tion, and Mr. Sharp will no doubt succeed in bringing his discov-
ery to a still greater degree of perfection.
My thanks are particularly due to Miss Caroline Neagus of
Boston, who furnished me with most of the original drawings;
and I need not say that they are executed in an admirable
manner, and with strict fidelity to nature. Mrs. Anne Hill of
Philadelphia, is also entitled to my thanks, for the graceful and
pretty drawings of the fir balsam and buck horn brake, which she
kindly furnished at my request.
Boston, JUNE 17th, 1841.


|
xii ILLUSTRATIONs.
ILLUSTRATIONS IN ANATOMY.
. Page.
Human Skeleton, . - - - - - - 4.
Gall-bladder and Biliary Ducts, - - - - - 15
Stomach, . - - - - - - - 18
Stomach and Intestines, - - - - - - 20
An Artery and its Branches, - - - - - 29
Capillaries uniting to form Weins, - - - - - 31
Lungs, - - - - - - - - 34
Heart, - - - - - - - - 37
Adult Female Pelvis, vol. II, - - - - - 609
Organs within the Pelvis, vol. II, - - - - ... 616
ILLUSTRATIONS IN MEDICAL BOTANY.
Lobelia Inflata, . - - - - - - 160
Bird Pepper, . - - - - - - . 180
- Bayberry, - - - - - - - 198
Witch Hazel, - - - - - - . 200
White Pond Lily, - - - - - - 201
Wild Red Raspberry, . - - - - - . 203
Sumach, . - - - - - - - 206 -
Marsh Rosemary, . - - - - - . 210
American Aspen, { 213
Large Aspen,
Golden Seal, . - - - - - - . 214
Balmony, - - - - - - - 215
Unicorn, - - - - - - - . 218
Scullcap, . - - - - - - - 220
Lady’s Slipper, - - - - - - . 222
Balm of Gilead,
Balsam Poplar, { 251
Bitter Sweet, . - - - - - - ... 253
Buck Horn Brake, . - - - - - - 256
Cleavers, - - - - - - - . 262
Fir Balsam, - - - - - - - 268
Golden Rod, . - - - - - - . 270
Meadow Fern, - - - - - - - 276
Prickly Ash, . - - - - - - . 280
Slippery Elm, - - - - - - - 284
Spicy Wintergreen, . - - - - - . 286



A. M. E. R. I. C. A. N.
V E G E T A B L E P R A C T I C E .

P A R T F I R S T .
CONCISE
VIEW OF THE HUMAN BODY.
A NATOMY.
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1. Anatomy teaches a knowledge of the structure of the hu-
man body, and explains the uses of its various parts and organs.
2. By comparative anatomy is understood a dissection of brute
animals and vegetables, and a comparison of their structure and
functions with those of the human body.
3. Than anatomy, there is no study more deeply interesting,
or more eminently calculated to awaken our love and admiration
of the Deity, and yet, from some cause or other, it is almost en-
tirely neglected as an elementary branch of education. A young
man on leaving his academy or college, under an impression that
his education is complete, would be puzzled, perhaps, to give
an adequate explanation of the process of digestion, or to point out
the difference between venous and arterial blood.
4. With the exception of the medical faculty, who make it a
study, we are more ignorant, as a general thing, of the wonderful
structure of the human frame, than many of the uncivilized races
of men. Major Long, who travelled extensively among the
North American Indians, remarks that they are well acquainted
with the position of the vital organs, from their habit of dissecting
the “carcasses of the slain” on the field of battle. The South

1.
2 VIEW OF THE HUMAN B0DY.
Sea Islanders, also, says a writer on the subject, have a consid-
erable share of rude anatomical knowledge. When Omai went
into Dr. Hunter’s museum in London, in company with Mr.
Banks, it was found, though he could not explain himself intelli-
gibly, that he knew the principal parts of the body, and something
likewise of their uses; and manifested great curiosity or desire
. have the functions of the internal parts of the body explained to
In.
5. When I speak of the study of anatomy, I do not mean its
minutia, for that, except to the surgeon who is called upon to per-
form critical operations, would be tedious and uninteresting. This
objection does not hold good, however, with regard to the leading
organs of the body, for these may be studied with ease and facility
by all, not even excepting children. I am not alone in this opin-
ion, for Mr. Combe has expressed himself in similar terms. Lec-
turing on the subject of education, he remarked, “I take the
liberty to urge very earnestly on your attention, not only the advan-
tage, but the necessity of introducing instruction in anatomy and
physiology into popular education. * * * All I desire is, that the
structure of the leading organs of the body should be explained so
far as to render their functions intelligible; (not the minute details)
and, that on this knowledge should be founded a clear and prac-
tical elucidation of the laws of health. I can certify from obser-
vation that this instruction may be communicated to children of
ten years of age with great success.”
6. It is gratifying that the study of anatomy is beginning to
receive a portion of that attention to which it is so justly entitled;
and until we make ourselves acquainted with its outlines, we must
remain in comparative ignorance of the laws of health. Many
devotees have already entered this interesting field of labor. A
Class Book of flnatomy has been published in Boston for the use
of schools, which, I am told, has been introduced into a number
of them with success. There are other publications of a similar
nature by Drs. Alcott, Bell, and Andrew Combe. These things
look well for the cause of medical reform, and will convince the
people, sooner or later, that the human body, delicately organized
as it is, was never intended by the Creator as a receptacle for the
poisonous drugs which are now employed in the treatment of dis-
ease. -
7. The diplomatized physicians, who are anxious to monop-
olize the practice of medicine, contend that an individual must be
* Lectures on Phrenology, Amer. Edit. p. 349.


VIEW OF THE HUMAN BODY. 3
thoroughly acquainted with anatomy before he is competent to un-
dertake the cure of disease. This is not true to the extent which
has been represented. Hippocrates, who is styled the father of
physicians, and who rid Athens of the plague that was threatening
to destroy her, knew nothing of anatomy, for the dissection of
human bodies was not then allowed. To come down to our own
times, I must be permitted to say, that it is no uncommon thing
for patients, who have been given up as incurable by the medical
faculty, to be speedily restored to health by persons who are not
only ignorant of anatomy, but illiterate in every other respect, and
even incapable of writing their own names. The Sumatrans, ac-
cording to Marsden, in his history of that country, cure all their
diseases by bathing, and the use of a few simple herbs, and yet
they know little or nothing of the structure of the human frame.
The Duchess D’Abrantès relates that her mother was struck
with palsy of the right side, and that the physicians of Montpelier,
a town in France then celebrated for medical science, prescribed
for her in vain. They could neither relieve her disease nor dis-
cover its cause. She remained for three months in great agony,
scarcely able to articulate, and was at length cured by a country-
man who brought fruit and vegetables to Montpelier for sale.
When he proposed to undertake the case, the husband of the
patient summoned her physicians in consultation, all of whom,
says the Duchess D'Abrantès, were men of acknowledged talent.
They made no objection whatever to the countryman doing the
best he could for the relief of the patient, for they had declared a
short time previous that she was beyond the reach of remedies. M.
Barthez, the most distinguished of them, remarked, “Nature is
unbounded in her resources, and how do we know what she may
have in reserve through the hands of this man? Let him try his
skill.” The countryman immediately procured a quantity of
herbs, which he boiled and applied to the parts affected, and by
the expiration of a week, the patient was able to move her limbs,
and in a month she was so far recovered as to be up and in her
balcony.”
8. When I hear a physician boasting of his superior skill in
the treatment of disease in consequence of his study of anatomy,
I am reminded of the following anecdote. “Why do you not
cure all the diseases of the human body,” said a person to a cele-
brated anatomist, “since your skill in your profession is so great?”
“My skill may be great,” replied the anatomist, “but unfortu-
nately, we anatomists are like the porters of a town, who are ac-
quainted with all the streets, but are ignorant of what is passing in
the houses.”
* Memoirs of the Duchess D’Abrantès, New York, 1832-


4. VIEW OF THE HUMAN B0DY.
9. The truth of the above anecdote seems to have been real-
ized by Dr. Rush, for he says, “Dissections daily convince us
of our ignorance of the seats of disease, and cause us to blush at
our prescriptions.”
10. I have no desire to discourage the study of anatomy, how-
ever, for I hope the day is not far distant when it will be generally
introduced into our schools as a primary branch of education; but I
am satisfied, nevertheless, that an individual who is wholly ignorant
of the subject, but acquainted at the same time with the properties
and uses of innocent vegetable remedies, will be more successful
in the cure of disease, than the educated physician with his array of
º how great soever may be his knowledge of the human
raine.
11. Whether the Rev. C. C. Colton, in his admirable work
entitled “Lacon, or Many Things in a Few Words,” meant by a
“non-professional man,” one who was unacquainted with anatomy,
I do not know ; but, after remarking that “physicians have been
linkering the human constitution four thousand years, in order to
learn to cure about as many disorders,” he says, “it is better to
have recourse to a non-professional man if he can cure our dis-
orders, although he cannot explain them. In a certain consulta-
tion of physicians in this kingdom they all differed about the
nature of an intermittent, and all plausibly defined the disease. At
length a non-medical, who had been called in, thus interposed :
Gentlemen, you all seem to differ about the nature of an inter-
mittent; permit me to explain it. An intermittent fever, gentle-
men, is a disorder which I can cure, and which you cannot.”
SKELETON.—BONES.
12. The skeleton is a bony structure or frame-work which de-
termines the shape of the body, and serves as a base of attachment
to the different muscles. It consists of two hundred and forty
bones, of which there are sixty-three in the head, including thirty-
two teeth, fifty-three in the trunk, sixty-four in the upper extrem-
ities, and sixty in the lower extremities.
13. In the general formation of the skeleton, there is no obvi-
ous difference between that of the male and the female, except
that the latter, as a general thing, is more delicately formed, and
the hip bones also spread out or expand to a greater degree than
those of the male.
14. Bones. These are every where covered with a dense
membrane which takes the name of periosteum, except on the skull,


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VIEW OF THE HUMAN B0DY. 5
where it is termed pericranium. It contains the blood-vessels by
which the bones are nourished.
15. When madder is given to animals in their food, the bones
acquire a red tinge, but on desisting from the use of it for a time,
the coloring matter disappears, and the bones return to their natu-
ral color. The bones of young pigeons, it is said, will become
of a rose color in twenty-four hours by the use of madder, and of
a deep scarlet in three days. The bones most remote from the
heart are the longest in acquiring this tinge. These facts demon-
strate that the bones are supplied with blood-vessels, and are nour-
ished in the same manner as the muscles and other soft parts of
the body.
16. In a perfectly sound state, the bones are insensible, but
when they are diseased they are excessively painful.
- 17. Bone is composed of an earthy matter, which gives it
strength and hardness, and an animal substance of which a consid-
erable portion is gelatin. The first may be demonstrated by
placing the bone in dilute muriatic acid, which will dissolve the
earthy part, and leave a gelatinous mass ; and the second, by calci-
nation, which will burn out the gelatin, and leave the solid or earthy
part. In children, while the bones are soft, these two substances
are very nearly balanced, but in adults the earthy part is greatly in
excess. In rickets, there is an absorption of the earthy part of
the bones, which leaves them in a soft and flexible state.
E X P L A N A T I O N 0 F T H E P L A T E S . -
18. Bones of the Head.
. Frontal bone or forehead. - -
. Parietal or side bone.
Temple or temporal bone, to which the ear is attached.
1
2
3
4. Sphenoid or wedge-like bone, which cannot be seen without turning up
the bottom part of the skull.
5
6
7
8
Occipital bone, which is placed at the back and lower part of the head.
Malar or cheek bone.
Superior maxillary or bones of the upper jaw.
: Inferior maxillary or lower jaw bone.
19. Bones of the Trunk.
9, 10, 11. Cervical vertebra or bones of the spine, of which there are seven,
placed one above the other.
12. Dorsal vertebra, twelve in number.
13. Lumbar vertebra, five in number, constituting the loins, small of the
back, or lumbar region.
14. Sternum or breast bone. - -
15. The seven true ribs, attached to the spine and breast bone. -
-


6 VIEW OF THE HUMAN B0DY.
16. The five false ribs, unconnected with the breast bone.*
26. Sacrum or sacred bone, so called, because it was formerly offered in
sacrifices.
27. Os coccygis, a small moveable bone, which terminates the spine.f
28. Os innominatum, comprising the ilium, 29, the ischium, 30, and the
pubis or front bone, 31. The ilium is the hip bone.
20. Bones of the Upper Ewtremity.
17. Clavicle or collar bone.
18. Scapula or shoulder blade.
19. Os humeri or bone of the upper arm.
20. Radius or bone of the fore arm, which turns with the hand in its rotary
motions.
21. Ulna, the bone by which, with the aid of the muscles, the fore arm is
bent. -
22. Carpus or wrist, consisting of eight little bones of peculiar shapes.
23. Metacarpus or bones constituting the palm of the hand.
24. Phalanges or bones of the fingers.
21. Bones of the Lower Eatremity.
32. Os femoris or thigh bone.
33. Patella or knee pan.
34. Tibia or large bone of the leg.
35. Fibula or small bone of the leg.
36. Tarsus or instep, consisting of five bones, one of which is the os calcis.
or heel bone, seen at 37.
39. Metatarsus, consisting of five bones corresponding to the metacarpus of
the hand.
40. Phalanges or toe bones.
MUSCLES_TENDONS.
22. The human body is estimated to have more than five hundred
muscles, the most of which are in pairs. They constitute the fleshy
part of the body, and consist of minute threads or fibres which are
collected together in bundles, as the amatomists express it, and
enveloped in sheaths to separate one from the other. They are
of a red color, and are supplied with arteries, veins, lymphatics
and nerves. They are equivalent to the red masses of flesh which
we purchase in the market for food.
-
23. The muscles are variously shaped, some of them being
spread out like the feather of a quill, while others are square,
* There are twelve ribs on each side, making in all twenty-four. It is a mis-
taken motion that males have one rib less than females.
# In women this bone is pushed back in time of labor to admit of the more
ready passage of the head of the child. It is situated an inch or an inch and a
halfback of the anus, where it may be distinctly felt.
-
-

VIEW OF THE HUMAN B0DY. - º
round, or in the form of a triangle. Their length too varies ma-
terially, the shortest being less than a quarter of an inch, and the
longest twenty-five or thirty inches. The sartorius or tailor's
muscle, so called because tailors are enabled to cross their legs
with it, is two feet and a half long, and an inch and a half or
two inches wide. It extends from the hip bone to the inner part
of the tibia or large bone of the leg, having its attachment five or
six inches below the knee.
24. The muscles are fastened to the bones, and by their con-
traction and relaxation, produce the various motions of which the
body is capable. For instance, the arm is bent by the contraction
of a muscle on its fore part, as is evinced by the ball or mass of
flesh which is felt half way between the elbow and shoulder, and
when the arm is extended the ball disappears, because the muscle is
then relaxed, or in other words has returned to its usual dimen-
sions. The muscles by which a limb is bent, are called the flea-
ors, and those by which it is straightened, the extensors. These
two sets of muscles antagonize each other; that is, the flexors
pull in one direction, and the extensors in another, so that by their
alternate contraction and relaxation, two distinct or opposite mo-
tions are produced. The muscles being attached to the bones,
observes a writer on the subject, the latter may be considered as
levers which are moved in different directions by the contraction
of the former. That end of the muscle which adheres to the most
fixed part is usually called the origin; and that which adheres to
the more moveable part, the insertion of the muscle.
25. The muscles, says Mr. Bell, accomplish very different
purposes. They move the fluids through the intestines and blood-
vessels; sustain the body in its various positions; lengthen, shorten,
Or compress Organs, as the tongue; widen or contract apertures,
as the anus or fundament; and impart a rolling motion to the eye,
and other organs. They contract with wonderful power, as is seen
in fractures and dislocations, for they draw the bones out of place
and shorten a limb several inches. Another evidence of their
power is seen in the writhings and contortions of the body in
convulsions, which are produced by the alternate contraction and
relaxation of the muscles.
26. There are two classes of muscles, the voluntary and in-
voluntary. The first are under the control of the will, and enable
us to walk, run, leap, or perform any other act of locomotion.
The muscles by which we bend the arm, or open or shut the
mouth, are voluntary, because we can call them into play when-
ever we desire. The involuntary muscles are those over which




8 VIEW OF THE "*"
the will has no influence. The heart is a muscular texture, acting
with tremendous force in propelling the blood through the arteries;
and the stomach, intestines, and bladder, are all furnished with
muscular fibres, by which they are endowed with a contractile
power; but they are nevertheless uncontrolled by the will, and are
therefore denominated involuntary muscles.
27, TENPONs. These constitute an important part of the
muscles, binding them together at their extremities, and fixing them
into the bones. They are hard, firm, white, inelastic, and very
strong, blending themselves almost imperceptibly with the mus-
cular fibres. Some of them are round, and others flat. The
small cords which are felt on the fore part of the wrist, are the
tendons of the muscles which move the hand. The large cord
also which is felt at the heel, is the tendon of the muscles which
constitute the calf of the leg. Anatomists term it the flehilles
tendon, because, as fable reports, the mother of Achilles held him
by that part when she dipped him into the river Styx to make him
invulnerable.
LIGAMENTS.
28. These are strong, white, fibrous cords or bands, which
connect the joints, and keep the liver, spleen, and other organs in
their places. Like the bones, they possess but little sensibility
in their healthy state, but when attacked by inflammation, they be-
come exceedingly painful. The capsular ligaments, so called,
surround the joints like a bag, and prevent the escape of the syno-
via, which is intended to lubricate the parts, and enable the ends
of the bones to play easily upon each other. -
CARTILAGES.
29. These are white, elastic, glistening substances, usually
denominated gristle, which unite bones together, and cover the
ends of those which move upon each other, as in the joints.
They resemble bone in appearance, and like it are capable of
being fractured. In children, cartilage forms a substitute for bone
before the latter is formed. It is also added to bones to increase
their length, as in the front part of the ribs, which consists entirely
of cartilage. -
- - MEMBERANES.
30. A membrane is an expanded thin substance which lines
the cavities of the body, and envelopes all the organs.



""" THE HUMAN B0DY. 9
31. Membranes are of different kinds, varying in structure
and appearance as much as they do in function.
32. Senous Mºwbrane. This surrounds and defends the
brain, lines the chest and abdomen, and covers the lungs, stomach,
intestines, and other organs contained in these two cavities. It
has a smooth, shining appearance, and is constantly moistened by a
serous exhalation or vapor, in consequence of which it receives
its name. Its appellation is varied however, according to the
cavity which it lines, as pleura in the chest, peritoneum in the ab-
domen, and dura mater when it surrounds the brain. In a state of
health it is white, but in inflammation its vessels become charged
with blood, and it assumes a corresponding red appearance. The
water which collects in cavities, constituting dropsies, is an exha-
lation from this membrane, which is not carried off by the absorb-
ents. When it is inflamed, it is prone to form adhesions, so that
the lungs may become glued to the internal surface of the ribs,
or the intestines to the internal surface of the abdominal cavity, or
the intestines may contract adhesions among themselves.
33. Mucous MEMB RANE. The mucous membrane is so
called, because it secretes a peculiar fluid, of a slimy nature, which
is denominated mucus. It lines the nose, mouth, throat, air pas-
sages of the lungs, urethra, bladder, stomach, intestines, and other
free passages. In the stomach and intestines it is thrown into
folds, which increase the extent of its absorbing surface, and
prevent the food from hurrying through the intestinal canal with
too much rapidity. It has a soft or velvet-like appearance, and
is of a pale pink color in health, but red when inflamed. A
false membrane forms upon its surface, which is coughed up
from the windpipe in croup, and discharged from the boweſs
in acute and chronic diseases, but particularly in the latter.
Blood not unfrequently exudes from this membrane, constituting
hemorrhage, and this may take place from the lungs, stomach, or
any other organ which it lines. The mucous, unlike the serous
membranes, do not form adhesions when they are inflamed, or the
intestinal canal, windpipe, and other free passages, would become
closed or obliterated in severe inflammatory affections.
34. CELLULAR MEMBRANE. This is a loose membranous
structure, forming a great number of little cells, which fills up the
spaces between the muscles and other solid parts of the body.
connecting them together without interfering with their functions.
It is every where interposed between the skin and the muscles,
and imparts a smoothness and softness to the surface of the body.


2 -
10 VIEW OF THE HUMAN DY.
The cells are moistened by a watery vapor which is exhaled from
the minute branches of the arteries, and if it happens to be in ex-
cess, or rather, if it is furnished in a greater quantity than can be
removed by the absorbents, it fills and distends the cells, and con-
stitutes dropsy. The water also passes from one cell to another,
there being a free communication between them, and hence it is
that the feet and legs of a dropsical patient, who is much in the
erect, or sitting posture, become enlarged or swelled toward eve-
ning, and diminish in size during the night while he occupies the
horizontal posture in bed. The communication between the cells
of this membrane, enables butchers to blow their veal, and give it
a full or bloated appearance. -
35. Adipose membrane is only another name for the cellular, and
is so called because fat is deposited in its cells, as in the soles of
the feet, around the kidneys, and between the skin and muscles.
SKIN.
36. The skin is the external covering of the body, and con-
sists of three layers, namely, the cuticle or scarf skin, the rete mu-
cosum, for which there is no English name, and the cutis or true
skin, which is the innermost layer. -
37. The cuticle is that part which is raised in a blister. It is
devoid of blood vessels and nerves, and exhibits no sensibility.
It separates in the form of scales after certain cutaneous diseases.
It is filled with pores, some of which serve for the passage of
hairs, and others for the escape of the perspirable matter. It is
constantly wearing out, and as constantly renewed. It is very
thick on the palms of the hands and soles of the feet, particu-
larly in the laborer, which is a contrivance of nature to defend the
delicate parts beneath from the injury which they might otherwise
receive. Indeed, in every part of the body, it serves as a pro-
tection to the true skin, and prevents the too ready absorption into
the system of deleterious substances with which it comes in con-
tact. It is the thickening of the cuticle which causes corns.
38. The rete mucosum is the second layer of the skin, inter-
posed between the cuticle and cuts, and contains the coloring
matter of the races. It is black in the negro, yellowish in the
mulatto, and white in those whose skins are of a corresponding
color. - -
9 The culis or true skin is described by anatomists as con-
sisting of dense fibres, intersecting each other in various direc-
tions, and leaving between them holes for the passage of blood-


VIEW OF THE HUMAN B0DY. 11
vessels and nerves, with which it is plentifully supplied. So mu-
merous are they, in fact, that it is impossible to prick the skin with
the finest needle, without producing pain and causing a flow of
blood.
40. Within the skin, certain little glands” are placed, which
open upon its surface by minute orifices, and which secrete an
oily fluid by which the skin is lubricated and defended from the
action of moisture. It is owing to this substance that water col-
lects upon the skin in drops.
41. Besides the other uses of the skin, it is the seat of per-
spiration, which serves many important purposes in the animal
economy. This is of two kinds, insensible and sensible. It is
insensible, when it passes off in the form of an invisible vapor, and
sensible, when it collects on the surface of the body in form of
sweat. It keeps the skin moist and pliable, and separates from
the blood the useless or worn out particles of matter with which it
becomes charged in the round of the circulation. In the form of
sweat, it regulates the temperature of the body in warm weather.
An individual who perspires freely in summer, is much less op-
pressed by the heat, than one who does not perspire at all. The
reason of this is, that the surplus heat is carried off by the sweat,
together with the exhalation from the lungs. So great is the in-
fluence of perspiration in reducing the temperature of the body,
that Sir Joseph Banks, and others, have confined themselves for
a considerable time in a room 50 degrees hotter than boiling
water, without experiencing any pernicious consequences.
42. Experiments have been made to determine the amount of
perspirable matter which passes off by the skin. Sanctorius, who
was the first, and most indefatigable laborer in this field of enquiry,
came to the conclusion that about two thirds of the food and
drink taken into the system, were eliminated from it through the
medium of the skin, while the remaining third passed off by the
bowels, the lungs, and the kidneys. Admitting this estimate to be
correct, and it does not differ very materially from that of Lavoi-
sier and Seguin, it will be seen that if the insensible perspiration
is arrested for a day or two, the blood will become charged with
impurities to an almost incredible extent, and disease, in some
form or other, will be the natural consequence. The skin being
endowed with the important office of removing waste matter from
the system, we see an ample reason, says Dr. Combe, why
checked perspiration should prove so detrimental to health; and
hence his remark, that it is a powerful cause of disease and
* Called sebaceous glands.


12 VIEW OF THE HUMAN BODY.
death. People know the fact, he continues, and wonder it should
be so, that cold applied to the skin, or continued exposure in a
cold day, often produces a bowel complaint, a severe cold in
the chest, or inflammation of some internal organ; but were they
taught, as they ought to be, the structure and uses of their own
bodies, they would rather wonder that it did not always produce
one of these effects.
43. Mr. Bell says, “Some practitioners take the stomach,
others the bowels, and others the liver, on which they harp con-
tinually; let any one take the skin as his object of care, and
his practice will have equal success; and if he introduce his system
by showing that healthis enjoyed when the various functions, which
together form the animal economy, are perfect, and that one function
cannot be in health unless the whole be also, he will, in my opin-
ion, have better claims to public favor than any who has yet flour-
ished in it by promulgating doctrines in regard to the functions
and diseases of individual parts.”
GLANDS. -
44. These are organized parts, composed of arteries, veins,
and absorbents, and designed to separate some peculiar fluid from
the blood, which is termed a secretion. They differ greatly both
as to size and shape. The largest gland in the body is the liver,
which secretes the bile, and empties it by means of a duct into
the intestines. The female breast is a gland designed for the se-
cretion of milk.
45. The mucous glands are a numerous class, and consist of
little bags formed by a peculiar membrane, which open by minute
ducts through which they discharge their contents. They are found
in the nose, tongue, windpipe, stomach, intestines and urinary
bladder, and furnish the mucus with which these parts are lubri-
crated. The sebaceous glands (39) are similar in structure, but
secrete an oily fluid instead of mucus.
46. There are three principal salivary glands, which are so
called because they secrete saliva. The first or largest is the
parotid gland, situated principally between the ear and the angle
of the lower jaw, and opening by a duct upon the inner surface of
the cheek. The second in order is the submarillary, seated under
the angle of the jaw, and opening by a duct on the outside of the
frenum or bridle of the tongue. The last of these glands is the
sublingual, placed under the tongue near its back part, and furnished
* Bell’s Anatomy and Physiology, 6th Amer, edit, vol. ii. p. 361.


VIEW OF THE HUMAN B0DY.
with several excretory ducts by which its secretion is poured into
the mouth. The above glands, it will be remembered, are in
airs. -
p 47. The lymphatic glands are very numerous in some parts
of the body, and appear to have no other office than that of re-
ceiving and transmitting the lymphatic vessels. They have no
excretory ducts. They are familiar to us as existing in the groin,
armpit, and along the neck. In the latter, some of them are quite
superficial, lying immediately under the skin. They swell in
scrofulous affections, and form large tumors. The glands of the
armpit and groin are also liable to become diseased, the first
assing into a state of induration form cancer of the breast, and
H. second enlarging and suppurating in syphilitic and other affec-
tions.
URINARY ORGANs,
48. The urinary organs consist of the kidneys, ureters, blad-
der, and urethra.
49. KIDNEYs. These organs, of which there are two, are of
a red color, and resemble a kidney bean in shape. They are
about six inches long, and four inches wide. They belong to the
contents of the abdomen, and are placed on each side of the
spine, being stretched across the two lower false ribs. They
are in contact with the inferior part of the diaphragm, and it is
owing to this circumstance, that pain is felt in respiration when the
kidneys are inflamed. It has been ascertained that one of these
organs may be entirely destroyed without being indicated by any
particular symptoms, and without the individual suffering any appā-
rent inconvenience. The urine, which is secreted by the kidneys,
is collected in little tubes and poured into what is termed the cav-
ity or pelvis of the kidney, whence it passes into the ureters, and
is emptied into the bladder.
50. URETERs. These are membranous canals, which con-
vey the urine from the kidneys to the bladder, a distance of eight
or ten inches. Except at their junction with the kidneys, they
are about the size of a goose quill, and enter the bladder near its
neck, running for some distance between its coats, before they
ºpen into its cavity. By this arrangement the urine is prevented
from regurgitating. -
51. BAppER. This is the receptacle of the urine, and is
placed within the pelvis, being situated in the adult below the pubis

14 VIEW OF THE HUMAN B0DY.
or front bone when it is empty, but rising considerably above it when
it is distended. It has the rectum behind it in man, and the vagina
in woman. Its neck is contracted by muscular fibres, which
causes the urine to be retained until it is expelled by an effort of
the will. The inner coat of the bladder, when the organ is not
distended, falls into folds, like that of the stomach and intestines.
It is plentifully supplied with mucus, which defends it from the
acrimony of the urine; and in some diseases, a great proportion of
the fluid evacuated consists of mucus.
52. URETHRA. This is a membranous canal, running from
the neck of the bladder through the penis, and terminating at its
extremity in what is termed the meatus urinarius. In women it
is not more than an inch and a half or two inches long. It is
lined by a mucous membrane, which is liable to be thickened by
inflammation, thereby forming a stricture, and interfering with the
escape of the urine.
BILIARY ORGANS.
53. These consist of the liver, gall-bladder, and biliary ducts.
54. Live R. The liver is of a deep red color, and weighs in the
healthy adult from three to four pounds, being the largest organ in the
body. It is situated in the upper part of the abdomen, under the
ribs, and is divided into two principal lobes, the right and left.
- Its upper surface is convex, and corresponds to the concavity of
the diaphragm, to which it is attached by several ligaments. Its
lower surface is hollow, and is in connection with the stomach and
duodenum. The liver is thick and massy toward the right side,
but thin on the left, where it spreads itself smoothly over the sto-
mach, when the latter is distended.
55. In some cases of disease, the liver becomes enlarged, and
may be felt projecting below the ribs in front of the abdomen, on
the right side, and sometimes, though rarely, on the left. It may
however be pushed down by the diaphragm in affections of the
- chest, when the organ itself has not undergone any sensible change.
- In some instances it acquires an enormous bulk, and weighs from
twenty-five to thirty pounds. It is altered materially in its tex-
ture by the processes of disease, being in some cases of a soft
consistence, and in others extremely hard and firm. It also un-
dergoes what is termed the fatty degeneration. Magendie found
that animals which had been fed exclusively on butter, or fat, pre-
sented, on examination after death, a fatty state of the liver.

VIEW OF THE HUMAN B0DY. 15
56. The liver is supplied with blood-vessels, nerves, and ab-
sorbents, and has for its office the secretion of bile, which plays so
important a part in the process of digestion.
57. GALL BLADDER. This is a membranous bag or recep-
tacle, large enough to contain one or two ounces of bile, and is
situated on the under surface of the
right lobe of the liver. Its shape FIG. 1.
is represented in the accompanying -
figure. It appears to be a recep-
tacle for the collection of bile in the
intervals of digestion. Gall stones
are occasionally formed in the gall
bladder by a concretion or harden-
ing of the bile. These stones are
sometimes very numerous, producin
great distention of the gall bladder.
They occasion but little inconven-
ience however, unless they become
lodged in the gall ducts, and then they
produce severe pain, and by interfer-
ing with the passage of the bile into
the intestines, give rise to jaundice.
Gall Bladder and Biliary Ducts. -
58. BILIARY DUCTs. These a, gallbladder; c, cystic duct :
consist of the hepatic, cystic, and d, hepatic duct, formed by a branch
common ducts, as are represented from the right, and one from the
in the above figure. The bile is se- left lobe of the liver , e, duetus
creted in the liver, and conveyed ſº "º"...
by an infinite number of itſi, ºi, "" ; ; Pººl" ºr
y - ° tº denum, separated from the stom-
to the hepatic duct, through which ach aſ h.
it passes on its way to the duodenum.
The union of the hepatic and cystic ducts forms the common
duct, which enters the duodenum about five inches from the pyloric
ºrifice of the stomach, running obliquely through the coats of the
intestine. The bile, in order to reach the gallbladder, must pass
along the hepatic duct, and then ascend the cystic duct against
gravity. How this is accomplished, has not yet been satisfactorily
explained by anatomists.
SPLEEN.
59. The spleen is a soft spongy body, of a bluish or purple
color, situated above the º i. i. upper part of the ab-
- dominal cavity. It varies in its dimensions, but is generally about


16 VIEW OF THE HUMAN B0DY.
four inches long, three inches wide, and two inches thick. It is
connected with the left extremity of the stomach by small blood-
vessels, together with the cellular membrane, and has an attach-
ment also to the lower edge of the diaphragm, near the spine. It
is sometimes greatly enlarged, and may be felt below the ribs, in
. the º of the stomach. This often occurs in typhus ſever.
It is plentifully supplied with blood-vessels, but has no excretory
duct. The use of the spleen is unknown. The opinions regard-
ing its supposed function, says Mr. Bell, are full of loose conjec-
tures or wild hypotheses, and nothing is yet certainly known of its
office. It has been removed in animals, without being followed
by any bad consequences.
PANCREA S.
60. The pancreas or sweet bread is a glandular body, of a
pale red color, bearing a resemblance in shape to the tongue of a
dog. It lies across the spine, immediately behind the stomach,
and is in contact at its smaller extremity with the spleen. It has
an excretory duct, which opens into the duodenum, in common
with the duct proceeding from the liver. It secretes a fluid simi-
lar to the saliva, which seems to be necessary in the process of
digestion.
THORACIC DUCT.
61. The thoracic duct is called the trunk of the absorbents,
because it receives the absorbent vessels from almost every part
of the body, including of course, the lacteals and lymphatics. It
is about the size of a crow-quill. It arises at the lower and back
part of the abdominal cavity, and passes upward along the spine
as high as the sixth vertebra of the neck, where it inclines to the
left, takes a downward direction, and enters the left subclavian
vein, just under the clavicle or collar bone. It pours the chyle
which it receives from the lacteals of the intestines, into the current
of venous blood.
ABSORBENT'S AND Absorption.
- 62. The absorbents are small, delicate, transparent vessels.
which exist in every part of the body, and are denominated lacteals
and lymphatics, according to the liquids which they contain. .
62. The lacteals open on the inner surface of the intestines.
and receive into them the chyle or milk-like fluid of which the



VIEW OF THE HUMAN BODY. 17
blood is formed. They perforate the middle and outer coats of the
intestines, pass through the mesentery, and terminate in the thora-
cic duct. They may be readily traced in the mesentery of a dog
killed an hour or two after he has been fed ; for they are then fully
distended with chyle. They disappear, however, soon after
death. In their progress to the thoracic duct, they pass through
what are termed the mesenteric glands, the functions of which are
not satisfactorily known. The lacteals are an important set of
vessels, for it is through their agency that the chyle or nutricious
part of the food is conveyed from the intestines to the blood.
64. The lymphatic vessels arise from every part of the body,
and contain a transparent fluid denominated lymph. With the
lacteals they form what is called the absorbent system. They are
extremely small and delicate, and cannot be readily detected with
the naked eye; but when injected with quicksilver, they become
considerably enlarged, and present a knotty appearance, resembling
a chain of beads. They pass through what are termed the lym-
phatic glands, and in common with the lacteals, terminate in the
thoracic duct.
65. The lymphatics take up fluids from different cavities and
parts of the body, and carry them into the circulation. Hence it
is that they prevent the frequent occurrence of dropsies. They ab-
sorb medicinal substances placed in contact with the surface. It
is well known that mercury rubbed on the skin is absorbed, and
produces salivation as effectually as when taken internally. In the
same manner, croton oil rubbed on the abdomen causes purging,
and arsenic applied to cancers, and opium to burns, says a writer
on physiology, have been absorbed in quantities sufficient to poison
the patients. Blood effused under the skin, giving it a black ap-
pearance, is carried off by the lymphatics. The same vessels ab-
sorb the parts over deep seated tumors, enabling the matter which
they contain to approach the surface. According to Magendie,
fluids disappear from the stomach by absorption, with great rapid-
ity, as he has shown by passing a ligature round the pylorus. Dr.
Combe says—“So rapid is absorption from the stomach in the
morning, that I have frequently seen nine tumblers of a saline
mineral water taken at eight o'clock, and a very hearty breakfast
finished within half an hour after the water was drunk.”
STOMACH.
66. The stomach is a membranous sac or bag into which the
food passes through the esophagus or gullet, preparatory to the
process of digestion. It is placed in the upper part of the abdom-
3
18 VIEW OF THE HUMAN BODY.
inal cavity, stretching from left to right, and is shaped somewhat
like the bag of a bag-pipe, as is indicated by the accompanying
figure. Moderately distended, it is capable, in the adult male, of
Fig. 2.
ſº
W
W
§
W
External View of the Stomach.
a, cardiac or upper orifice ; b, pyloric or intestinal orifice, at which the duo-
denum commences ; c, c, c, lesser curvature or arch of the stomach ; e, e, e,
greater curvature or arch of the stomach; g, g, omentum or caul.
holding about three pints. Its left extremity, which is much
larger than the right, is situated under the ribs on the left side,
where it is in contact with the diaphragm; its right extremity ex-
tends a little beyond the sternum or breast bone, in the direction of
the right side, and is covered by the shelving edge of the left lobe
of the liver, which is interposed between it and the diaphragm.
The left extremity of the stomach is connected with the spleen,
and its lower or inferior portion with the omentum, which is
spread over the intestines like an apron. The stomach is separa-
ted from the small intestines by the arch of the colon, which passes
immediately below it from the right to the left side


VIEW OF THE HUMAN B0D.Y. 19
67. The stomach has two orifices, the cardiac or upper, and
the pyloric or intestinal. The first is formed by the termination
of the oesophagus or gullet, and the second by the communication
of the stomach with the duodenum. The intestinal orifice consists
of a valve or circular fold of mucous membrane, which is called
the pylorus, from a Greek word signifying gate-keeper, because it
does not readily admit of the passage of undigested food. The
stomach has also two curvatures or arches, the lesser of which em-
braces the spine and aorta or great artery of the body, while the
greater curvature forms the rounded outline of the abdomen, when
the stomach is distended with food.
68. The stomach consists of three coats, each of which is en-
dowed with a particular function. The outer, serous or peritoneal
coat, so called, is a firm, strong, shining membrane, which not
only covers the stomach, but also the intestines, and lines the cav-
ity of the abdomen. The middle or muscular coat, is composed
of fleshy fibres, one layer of which is longitudinal, and the other
transverse or circular. These fibres are capable of contraction
and relaxation, and produce the peculiar motions of the stomach
in digestion. The inner or mucous coat, is a soft, velvety mem-
brane, of a pale pink color in health, but red when inflamed. It
is of larger dimensions than the other two coats, and is thrown
into folds or wrinkles when the stomach is not fully distended. It
is constantly covered with a thin, transparent mucus, which
serves to protect it in some measure from the injury which it
might receive from the contact of irritating matters.
69. Blood-vessels and nerves are distributed to the stomach
more plentifully than to any other organ. Among the latter is a
branch from the great sympathetic, which causes the organ to be
injuriously affected by diseases in remote parts. The number of
the nerves, and the variety of the sources whence they are derived,
says Dr. Dunglison, explains the great sympathetic influence ex-
erted upon the stomach by affections of other parts of the system.
It sympathizes, he continues, with every protracted morbid change
in the individual organs, and hence it was termed by Hunter, the
centre of sympathies.
INTESTINES.
70. The intestines constitute that portion of the alimentary
canal which commences at the pyloric orifice of the stomach, and
terminates, after many convolutions or windings, at the anus. In

20 VIEW OF THE HUMAN BODY.
the adult, they are estimated to be six or seven times longer than
the body. They are attached to the spine by ſolds of the peri-
Fig. 3.
sº
º-
- nº s
- -
NY Nº
~
º w
ſº
- ºffſ W
% K/ | W
->
º ~ § s
N
jº§
\
\\ |
E-
º
º
View of the Stomach and Intestines.
a, the cardiac or upper orifice of the stomach; b, commencement of the duo-
denum ; c, c, c, folds of the small intestines ; d, ilium or lower part of the
small intestines, terminating in the cacum; e, caecum or commencement of the
large intestines; f, ascending colon ; g, g, arch of the colon, traversing the ab-
domen from right to left beneath the stomach, and passing downward behind the
small intestines to form the descending colon; h, h, h, sigmoid flexure of the
colon, so called from its resemblance to the letter S ; i, the rectum ; k, anus,
surrounded by a muscle called the sphincter ani, which, when it contracts,
shuts the passage through the anus into the rectum ; 1, l, two muscles called the
levatores ani, which surround the extremity of the rectum and serve to pull it
upward after an evacuation by stool ; m, portion of the mesocolon.
toneum, called the mesentery, which contains the mesenteric
glands, and is furnished with arteries, veins, lacteals, and nerves.












VIEW OF THE HUMAN BODY. 21
It spreads out from the spine like a ruffle from the bosom of a
shirt, if I may so speak, and has the intestines attached to its mar-
gin, so that, with the exception of a limited portion, these organs are
permitted to float somewhat loosely in the cavity of the abdomen.
71. The structure of the intestines is nearly similar to that of
the stomach, and they have in common with it three coats or layers
of membrane, the outer or peritoneal, the middle or muscular, and
the inner or mucous. The muscular coat, as in the stomach,
consists of two sets of fibres, the longitudinal and circular.
These, by their alternate contraction and relaxation, produce the
vermicular or peristaltic motion, which may be observed by looking
into the abdomen of a newly killed animal. The longitudinal fibres
shorten the intestines, and give rise to a motion similar to that of
the creeping of a worm, and hence the term vermicular, from a
Latin word signifying worm. The office of the circular fibres is
to diminish the diameter of the intestines, and by contracting
from above downward, in concert with the longitudinal fibres, they
push the contents of the bowels onward toward the anus. Some-
times, however, this motion is inverted, as in severe cases of
colic, and the contents of the intestines are forced upward instead
of downward, until at length fecal matter is discharged by vomiting.
72. The intestines are divided into small and large, the first
being about thirty feet in length, and the second not more than
six. The small intestines, again, are subdivided into the duo-
denum, jejunum, and ilium, and the large into the cºcum, colon
and rectum. These subdivisions however, are in a great measure
arbitrary, and are only resorted to by anatomists as a matter of
convenience in designating certain portions of the intestinal canal.
73. The duodenum is about a foot long, and commences at the
pyloric orifice of the stomach. It is larger than any other of the
small intestines, and from its size, has been considered a secondary
stomach. It is perforated three or four inches from the pylorus by
the biliary and pancreatic ducts, through which it receives the bile
and pancreatic juice. These fluids are detained in the duodenum
sufficiently long to be mixed with the chyme, which is formed in
the stomach, and by this union a new product arises, which is de-
nominated chyle, a milk-like fluid from which the blood is formed.
74. We have seen that the bile is received into the duodenum,
and not into the stomach, but the secretion occasionally finds its
way, into the latter organ, in consequence of the peristaltic motion
of the duodenum being inverted. This occurs in bilious affec-
tions, and in protracted vomiting, in which the irritability of the
stomach is communicated to the duodenum. Mr. Bell says, “it
may be of consequence to attend to this fact in the operation of an

22 VIEW OF THE HUMAN B0DY.
emetic, for the stomach will sometimes appear to be discharging
foul and bilious matter, which we naturally may suppose to have
been lodged in it, but which has actually flowed from the duo-
denum, or has even come recently from the ducts, in consequence
of the operation of the vomit.”
75. The remaining portions of the small intestines are the
jejunum and ilium; these occupy the middle and lower part of
the abdomen, and are encircled by the caecum and colon, as re-
presented in the preceding figure. The jejunum commences at the
duodenum, and is so called from being generally found empty. It
is eleven or twelve feet long. The ilium, which terminates in the
caºcum or commencement of the large intestines, is seventeen or
eighteen feet long, and receives its name from its numerous wind-
ings or convolutions.
76. The small intestines are the seat of an important function.
It is here that the chyle is separated from the immutritious part of
the food, and taken up by the absorbent or lacteal vessels for the
nourishment of the body. These vessels are very numerous, and
open their mouths or orifices upon the internal surface of the
mucous membrane. They convey the chyle into the thoracic duct,
which empties it into the subclavian vein, as already stated. The
mucous membrane lining the small intestines, is thrown into plaits
or folds similar to that of the stomach, by which its absorbing sur-
face is increased considerably in extent, and the irregularities to
which the folds give rise, prevent the food from being urged on
with too much rapidity in its downward course. The contents of
the small intestines remain in a fluid state till they arrive in the
vicinity of the cacum, and here, the chyle having been in a great
measure absorbed, they acquire a greater degree of consistency,
and begin to assume the color and smell of ordinary feces.
77. LARGE INTESTINEs. These, as I have said, are divid-
ed into three portions, the cecum, colon, and rectum.
78. The cºcum is a pouch or bag which receives the lower
end of the ilium or termination of the small intestines. It is about
three inches in length, and nearly the same in diameter. It is
situated at the lower part of the abdomen, on the right side, just
within the hip bone, where it is tied down so as to be unable
to change its position. It is furnished with a valve at its junction
with the ilium, which is designed to prevent the return of its con-
tents into the small intestines.
79. The colon is a continuation of the caecum, taking an up-
ward direction toward the liver, where it forms an angle and crosses
from the right to the left side, constituting what is termed the
* Bell's Anatomy and Physiology, 6th Amer, edit. vol. ii. p. 400.

view or the HUMAN body 23
transverse arch of the colon. It then forms a second angle and
descends, terminating in the sigmoid flewure, so named from its
resemblance in shape to the letter S. It is here that the feces ac-
cumulate, previous to their being voided by stool. I may remark,
also, that an injection, in the ordinary quantity, does not reach
beyond the sigmoid flexure. The ascending colon passes over the
right kidney, and the descending colon over the leſſ kidney. The
right portion of the transparse arch is in contact with the liver and
gall-bladder, and is usually found, after death, of a yellow color,
. the transudation of bile. The right portion of the arch is
situated under the stomach, having below it the convolutions of
the small intestines. The colon, in post mortem examinations, is
usually found empty. -
so. The recium is a continuation of the sigmoid flexure of the
colon, lying within the pelvis, and terminating in the anus. It has
the bladder in front of it in males, but in females, the vagina and
uterus are interposed between it and the bladder. It is seven or
eight inches long, and widens in its progress downward till it
reaches the amus, where it contracts into a narrow orifice.
DIGESTION.
S1. Among the various writers on the subject of digestion, I
know of no one who is more entitled to respect and attention, than
Dr. Beaumont of this country, styled by Dr. Combe of Edin-
burgh, the flmerican Physiologist. He was a surgeon in the
United States Army, and was called to the case of a young man
named Alexis St. Martin, who had been accidentally wounded in
the left side, by a discharge of duck shot from a musket, which
carried away the skin, muscles, and a portion of the ribs, and per-
forated the stomach. The patient finally recovered from the
effects of the wound, but the orifice in the stomach still remained;
and the food and drink were only prevented from passing through
it by the application of compresses and bandages. Finally, how-
ever, the orifice was filled by a small ſold or doubling of the coats
of the stomach, which acted as a valve, and which could be easily
pushed aside by the finger so as to command a view of the inte-
rior of the organ. Dr. Beaumont, therefore, had rare advantages
in making himself acquainted with the process of digestion, and after
devoting much time to the investigation of the subject, he publish-
ed an interesting work explanatory of his labors, entitled Exper-
iments and Observation on the Gästric Juice, from which I shall
have occasion to make frequent extracts throughout these volumes.

24 VIEW OF THE HUMAN BODY.
82. When food is received into the stomach, it does not re-
main quiescent, but undergoes, as Dr. Beaumont informs us, a
kind of churning motion, produced by the alternate contraction
and relaxation of the fibres composing the muscular coat. These
fibres, as I have said, are disposed in two layers, one of which is
circular, and the other longitudinal. The circular fibres lessen
the transverse diameter of the stomach, while the longitudinal
fibres draw the two extremities nearer together. The motions
which thus arise, says Dr. Beaumont, not only produce a constant
disturbance or churning of the contents of the organ, but compel
them, at the same time, to revolve around the interior, from point
to point, and from one extremity to the other. These revolutions
are completed in from one to three minutes. The contents of
the stomach, during digestion, exhibit a “heterogeneous mass of
solids and fluids—hard and soft—coarse and fine—crude and
chymified—all intimately mixed, and circulating promiscuously,
like the mixed contents of a closed vessel, gently agitated, or
turned in the hand.”
83. As the food becomes chymified or reduced to a pulp, it
passes gradually through the pylorus into the intestines; but if an
undigested portion presents itself for admission, the pylorus im-
mediately contracts and forces it back into the cavity of the sto-
mach; and it is not until after repeated efforts of the kind, that the
undigested portion is permitted to pass.
84. When the stomach is emptied of its contents, it becomes
inactive, and diminishes greatly in size.
85. Digestion, though greatly assisted by the motions of the
stomach, is mainly dependent on a fluid termed the gastric juice.
This is described by Beaumont as transparent, a little saltish, and
very perceptibly acid. When the stomach is excited or stimu-
lated by food, this juice exudes from little vessels in the inner
coat. It is powerfully antiseptic, and will check the putrefaction
of meat. By this provision of nature, it is probable that food ap-
proaching a state of decomposition, is prevented, in some measure,
from doing injury to the system. Applied to fetid sores, it dis-
poses them to heal. Unmixed with any extraneous matters, it
remains pure for many months. Combined with a large por-
tion of saliva, it becomes offensive in a few days. It will act
upon meat and vegetable substances out of the stomach, as well as
in it, but a longer time is required. It produces no effect upon
any portion of the living body; but so powerful is its action upon
dead animal matter, that it digests the toughest cartilage, and even
bone. It combines with a definite portion of food only, so that if
an undue quantity of aliment be taken into the stomach, it will re-

VIEW OF THE HUMAN B0DY. 25
main undigested, and prove a source of irritation. When the
stomach is much disordered, or in a feverish state, it is worthy of
remark that the gastric juice is not secreted, and hence it would
be improper to burthen it with food under such circumstances,
unless it be of a soothing, or mucilaginous character. Solid food
especially would be highly pernicious.
86. Digestion is retarded or accelerated in proportion to the
tenderness of the fibre upon which the gastric juice is required to
act. Hence it was observed by Beaumont, that while rice or
sago was disposed of in an hour, or an hour and a half other sub-
stances, as veal, salmon, and roasted pork, would require four or
five hours for the digestive process.
87. Oily substances are digested with great difficulty.
88. Wine, spirits, water, and other fluids, are not affected by
the gastric juice. Coffee, says Beaumont, is probably not di-
gested, but carried into the circulation without much change.
89. Fluids pass from the stomachin a very short time after they
are received, either by absorption, or through the pyloric orifice.
90. Soup is not digested until its watery portion is absorbed.
The same remark is equally applicable to all fluids containing mu-
tricious particles.
91. Milk coagulates before it receives the solvent action of
the gastric juice. This is the reason why milk is injurious to
many people. The coagulated masses remain in the stomach,
and give rise to irritation, and other unfavorable symptoms.
92. The ſat of meat is converted into oil before it is digested.
93. Moderate exercise immediately after a meal increases the
temperature of the stomach, and assists the digestion ; but if the
exercise is severe or fatiguing, it materially retards the digestive
proceSS.
94. The medium time for the digestion of a meal, is about
three hours and a half.
95. The usual temperature of the stomach is about one hun-
dred degrees. It varies, however, according to circumstances.
Beaumont observed that active exercise increased it about one and
a half degrees. He found also that it was greatly diminished by
the use of cold drinks. He gave St. Martin a gill of cold water,
and the temperature of the stomach immediately fell from one hun-
dred to seventy degrees, and more than half an hour elapsed be-
fore the organ regained the heat which it had lost. Persons in
ill-health, therefore, should be sparing in the use of cold drinks, as
they tend to chill the system, and very often give rise to sudden
colds, toothach, rheumatic pains, and other forms of disease,
while the individual is wholly ignorant of the cause. I know


4 -
26 VIEW OF THE HUMAN B0Dy.
a gentleman who cannot take an ice-cream, without being attacked
in from three to twenty-four hours with a toothach; and a -
draught of cold water will often produce the same effect.
96. T A B L E
SH owing THE LENGTH of TIME REQUIRED for THE D1 GE's Tron:
or DIFFERENT ARTICLES & F Food.
-
- Hours. Min.
Rice, Boiled, 1.
Sago, -- 1 45
Tapioca, ** 2
Barley, -- 2
Milk, -º 2
-- Raw, 2 15
Pig’s feet, soused, Boiled, I
Tripe, soused, -- 1.
Brains, -4 1 45
Venison steak, Broiled, 1 35
Turkey, domestic, Roasted, 2 30
cc . . Boiled, 2 25.
-- wild, Roasted, 2 18
Goose, (c. -- 2 30
Pig, sucking, -- 2 30
Liver, beef’s, fresh, Broiled, 2
Lamb, fresh, -- 2 30
Chicken, full grown, Fricassee, 2 45
Eggs, fresh, Hard boiled, 3 30
-- --- Soft … 3
… -- Fried, 3 30
… -- Roasted, 2 15.
-- -- Raw, 2
“ whipped, --- 1 30
Custard, Baked, 2 45
Codfish, cured, dry, Boiled, 2
Trout, salmon, fresh, -- 1 30
-- -- - - Fried, I 30
Bass, striped, “ Broiled, 3.
Flounder, -- Fried, 3 30
Catfish, -- -- 3 30
Salmon, salted, Boiled, 4
Oysters, fresh, Raw, 2 55
-- -- Roasted, 3 15
-- -- Stewed, 3 30
Beef, fresh, lean, rare, Roasted, 3 -
“ steak, Broiled, 3
** fresh, lean, Fried, 4
“ old, hard, salted, Boiled, 4 15
Pork steak, Broiled, 3 15.
“ fat and lean, Roasted, 5 15
“ recently salted, Boiled, 4 30
-- -- Fried, 4 15
-- -- Broiled, 3 15


VIEW OF THE HUMAN B0DY. 27
Hours. Min.
Pork recently salted, Raw, 3
-- -- Stewed, 3.
Mutton, fresh, Roasted, 3 15
-- -- Broiled, 3.
-- -- Boiled, 3.
Weal, fresh, Broiled, 4
… c- Fried, 4 30
Fowls, domestic, Boiled, 4
-- <-- - Roasted, 4
Ducks, domestic, … 4
“ wild, -- A 30
Suet, beef, fresh, Boiled, 5 30
“ mutton, -- 4 30
Butter, Melted, 3 30
Cheese, old, strong, Raw, 3 30
Soup, beef, vegetables and bread, Boiled, 4
“ marrow bones, --- 4 15
“ bean, -- 3
“ barley, --- - 1 30
** mutton, -- - 3 30
Green corn and beans, --- - 3 45
Chicken soup, --- 3
Oyster “ -- 3 30
Hash, meat and vegetables, Warmed, 2 30
Sausage, fresh, Broiled, 3 20
Heart, animal, Fried, 4
Tendon, Boiled, 5 30
Cartilage, * * 4 15
Beans, pod, -- 2 30
Bread, wheat, fresh, Baked, 3 30
“ corn, … 3 15
Cake, “ -- 3.
- “ sponge, -: 2 30
Dumpling, apple, Boiled, 3.
Apples, sour, hard, Raw, 2 50
-- “ mellow, -- 2
** sweet, -- 1. 30
Parsnips, Boiled, 2 30
Carrot, orange, -- 3 15
Beets, -- 3 45
Turnips, flat, -- 3 30
Potatoes, Irish, --- 3 30
-- -- Roasted, 2 30
-- -- Baked, 2 30
Cabbage, head, Raw, 2 30
“ with vinegar, -- 2
-- - Boiled, 4 30
97. The foregoing table, says Dr. Beaumont, from, whose
work it is derived, is formed from all the experiments made upon
St. Martin, taking the average from such as were generally per-
formed under the naturally healthy condition of the stomach, and
ordinary exercise.
-
-
-

28 VIEW OF THE HUMAN BODY.
HEART AND PERICARDIUM.
98. The heart is a very strong muscle, which propels the
blood through the arteries to every part of the body. It is situa-
ted in the left cavity of the chest, resting upon the diaphragm, and
is contained in a strong membranous sac or bag, called the peri-
cardium, which confines it to its proper position, and restrains its
action if too violent. Its medium weight is said to be nine ounces
in man, and eight ounces in woman. It occupies an oblique po-
sition in the chest, and is entirely covered by the lobes of the left
lung, except a small portion of its apex or point, which strikes be-
tween the fifth and sixth ribs, a little to the left of the sternum or
breast bone. -
99. The heart is divided into four cavities, termed auricles
and ventricles, and gives origin to the aorta and pulmonary artery,
all of which will be explained hereafter, in speaking of the circula-
tion of the blood. The action of the heart consists in its contrac-
tion and dilatation, and incredible as it may seem, the number of
its contractions in twenty-four hours, in a healthy adult, is some-
thing more than one hundred thousand.
100. The pericardium, by which the heart is invested, is lu-
bricated on the inside by a fluid, but does not contain water, as
was formerly supposed by anatomists, except in a diseased state.
According to Mr. Bell, there have been many curious specula-
tions in regard to what was termed the water of the pericardium.
Some said it was designed to cool the heart, and others, that it
was intended to irritate the organ by its acrimony, and keep up its
motions. “But of all the outrages against common sense and
common decorum,” says Mr. Bell, “the most singular was the
dispute maintained among the contending parties, whether it was
or was not the water of the pericardium which rushed out when
our Saviour's side was pierced by a spear.”
101. Plato, in speaking of the heart, very prettily observes,
“It is the centre or knot of the blood-vessels; the spring or foun-
tain of the blood, which is carried impetuously round; the blood
is the pabulum or food of the flesh; and for the purpose of nour-
ishment, the body is laid out into canals, like those which are
drawn through gardens, that the blood may be conveyed, as from
a fountain, to every part of the body.”
* Anatomy and Physiology, 6th American edition.

VIEW OF THE HUMAN BODY. 29
ARTERIES.
102. The arteries are strong, elastic, membranous tubes,
which arise from the heart by two trunks, and convey the blood
by their innumerable branches to
every part of the body. They
are enveloped in sheaths of a loose
cellular texture, which connect
them with the adjacent parts, and
enclose the veins, lymphatics, and
nerves, by which they are usually
accompanied. They are furnished
with three coats, the eaternal of
which is thick, strong, and elastic,
enabling it thereby to withstand the
impulse of the blood sent from the
heart. The middle or muscular
coat is composed of yellow, circu-
lar fibres, which are said by some
anatomists to have the power of
contraction, though this is denied by
others. The inner coatis smooth,
polished, and easily torn. The
density and firmness of its texture,
says Mr. Bell, is for the purpose
of retaining the blood, and its
smoothness for permitting the blood
to circulate with the least possible
interruption.
103. The blood which flows
through an artery does not afford
it any mourishment; consequent-
ly, its coats are perforated with
smaller arteries, together with veins,
by which its life or vitality is main-
tained.
104. The larger arteries are
- all deeply seated, and by this ar-
rangement are protected from in-
jury by accidents, while the veins,
FIG. 4.
An Artery and its Branches.
a, trunk; b, b, large branches into
which it subdivides ; c, c, c, small
branches, diminishing gradually in
size, and terminating in the capilla-
ries, which form a fine or delicate
net—work.
which do not involve the same serious consequences in case of
wounds, are generally placed near the surface of the body.
105. The arteries are subject to enlargement, forming what
are called aneurismal sacs or tumors; and they also, in some

30 VIEW OF THE HUMAN B0DY.
cases, become ossified or converted into a bony substance, feeling
under the fingers like indurated cords. This happens occasionally
in old people. -
CAPILLARIES.
106. The capillaries form the intermediate link between the
arteries and veins, receiving the blood from the one, and transmit-
ting it to the other. They are distributed over every part of the
body, and constitute a complete net-work. So numerous are
they indeed, that the point of the finest needle cannot be inserted
into the skin without occasioning a flow of blood. The term ca-
pillary, as applied to these vessels, says Magendie, is altogether
deficient in exactness. Compared with such tubes, he observes,
a hair is a huge cylinder ; the diameter of a hair bears about the
same proportion to that of a capillary vessel, as the trunk of a
tree does to the fibres of its roots. Some of them are too mi-
nute, in a state of health, for the admission of red blood, the glob-
ules of which are larger than the globules of white blood, but in
inflammation their diameters are enlarged, and the red blood passes
into them without difficulty, giving the part to which they belong
a red appearance. We have an example of this in inflammation
of the eye.
107. It has been decided that the movement of the blood
through the capillaries, is influenced by the action of the heart,
and that it becomes quiescent as soon as the heart ceases to con-
tract. The capillaries, however, are not the extremities of the
arteries, but minute branches from their sides, as is shown in
Fig. 4.
još. The capillaries perform the function of nutrition ; that
is, they deposit the blood by which the body is nourished, and of
which its various organs and tissues are formed. The stagnation
of the blood in these vessels is the cause of inflammation ; and,
according to Dr. Marshall Hall, the “stagnation augments as the
inflammation increases and becomes more diffused, seeming to
constitute the essential character of the disease.”* A similar ob-
struction in the capillaries produces the phenomenon of fever,
which is named according to its location, or characteristic
symptoms.
* Hall’s Practice of Medicine, by Drs. Bigelow and Holmes, p. 115. Boston.

WIEW OF THE HUMAN B0D.Y. 31
VEINS,
109. Having considered the arteries and capillaries, let us now
take a brief survey of the veins, which constitute the last link in
the great chain of blood-vessels.
110. The veins are those tubes which return the blood to the
heart, after it has been sent out by the arteries. This is illustra-
ted by the operation of bloodletting. The
bandage is applied above the elbow so as to
compress the veins, without at the same time
compressing the deep-seated artery, and
hence the blood readily flows from the ori-
fice made by the lancet; but if the bandage
should be tightened so as to compress the
artery also, the flow of blood would immedi-
ately cease.
111. The veins are formed by the union
of the capillaries, as is shown by the accom-
panying figure. They are similar in struc-
ture to the arteries, but their coats are thin-
ner and more delicate. They are without
pulsation. Unlike the arteries, they are
furnished with numerous valves, which pre-
vent any retrograde movement of the blood.
112. The veins throughout the body
terminate in three principal trunks. These
are the vena cava superior, the vena cava
inferior, the vena porta, and the pulmonary
vein. The superior cava receives the blood
from the upper parts of the body, and the capillaries uniting to
inferior card from the lower parts; and both form Veins.
empty their contents into the right auricle or a, capillaries; c, c,
chamber of the heart. The vena porta col- mall branches of vein;
lects the blood which circulates in the stom- ºy.", "ſº ºf
- - capillaries; d, d, d, d,
ach, intestines, and other organs of the abdo- i."..., uniting
men, and conveys it to the liver for the to form a great trunk.
formation of bile. The pulmonary vein,
which rises in the substance of the lungs by numerous capillary
branches, returns the .." from these organs to the left auricle
of the heart, as will be explained hereafter.
Blood.
113. The blood is that fluid which is formed from the chyle,
and circulates in the heart, arteries, capillaries, and veins. It is


32 VIEW OF THE HUMAN B0DY.
of a viscid consistence, and somewhat saltish taste. In the arte-
ries it is of a light vermilion hue, but in the veins, with the excep-
tion of those which transmit it from the lungs to the heart, it is of
a darkish color. The quantity in the body of an adult, is estima-
ted at from twenty-five to thirty pounds, three-fourths of which is
supposed to be in the veins, and one-fourth in the arteries. Its
temperature is about 100 degrees of Fahrenheit. This however
is in the arteries, for it is said to be one degree colder in the
veins. It rises above this standard in some diseases, and sinks
below it in others. In scarlet fever, the blood has indicated a
temperature of 105 and even 110 degrees, and in the Asiatic
cholera, as remarkable as it may seem, it has sunk as low in the
thermometrical scale as 70 degrees. It was a remarkable conceit
of Lord Bacon, that the heat of the blood tended to exhaust the
strength of the body; and he suggested that if it was cooled by
nitre, life might be prolonged to an indefinite period.
114. The temperature of the blood varies in different animals,
and hence they are divided into the warm-blooded, and the cold-
- blooded. In the first, which includes man, quadrupeds, and birds,
- the blood is hotter than the medium they inhabit; while in the
second, including fishes, and reptiles, the blood is nearly of the
same temperature as the surrounding medium.
115. The blood is the most important fluid in the body, and
has been very justly termed the pabulum of life. It is the solema-
terial of which every part of the human machine is formed, not even
excepting the bones. It furnishes the various secretions, as bile,
pancreatic juice, saliva, and urine, and is the source of animal heat,
diffusing warmth throughout the system, and maintaining the tempe-
rature of the body, notwithstanding the extremes of heat and cold,
at a uniform standard. Mr. Hunter, who attributed a vital prin-
ciple to the blood, observed, that “not only is it alive in itself,
but it seems to carry life everywhere.”
116. Examined with a microscope of a sufficiently º
power, the blood is found to contain an immense number of re
globules, which glide over each other in every direction, and con-
tain the coloring matter of this fluid.
117. When blood is drawn from the body, and allowed to
rest, it separates into two parts, one of which is solid, and the
other liquid. The first is the clot or crassamentum, and the other
the serum. The clot is of a thick or jelly-like consistence. It
contains the red globules, and is therefore of a corresponding
color. Upon being washed, the coloring matter disappears, and a
whitish substance remains, which is variously galled gluten, coag-
ulable lymph, adhesive matter, and fibrine. ié latter however is
the name most commonly used. It is this substance which is
_ml

VIEW OF THE HUMAN BODY. 33
thrown out in wounds, and causes parts which have been separated
to adhere. It plays an important part in the animal economy, and
is the principal material of which the muscles are formed. It
is more abundant in healthy, vigorous persons, than those who are
laboring under disease. -
118. The serum is a transparent liquid, bordering upon a yel-
lowish hue, and is said to constitute one fifth or one fourth of the
blood, in a healthy state of the body. Its use, says Mr. Hunter,
is probably to keep the red globules suspended and undissolved,
for it is found in the largest quantity where the globules are the
most abundant. It is also intended, he says, to suspend and dis-
solve any foreign substances in the blood, whether they are of use
to the body, or otherwise, acting upon them as a common solvent.
119. In diseases generally, there is an increase of serum, and
a diminution of fibrine, the latter of which, as I have already said,
is the most essential part of the blood. Magendie has demon-
strated that blood-letting will give rise to a morbid increase
of serum, and thereby favor the development of violent inflam-
matory disorders, where none previously existed.
DLAPHRAGM.
120. The diaphragm or midrif is a thin muscular partition
between the chest and the abdomen, and is attached at its circum-
ference to the spine, lower or inferior ribs, and sternum or breast
bone. (See plates I. and II. of the skeleton, following page 4.)
It rises upward within the chest and forms an arch, having the
lungs in contact with its upper surface, and the liver and stomach
with its lower surface, the two latter organs accommodating them-
selves to its concavity. It is perforated by the oesophagus or gullet,
through which the food passes into the stomach, and by several im-
portant vessels, among which is the aorta or great artery of the body.
121. The diaphragm is the principal agent in respiration.
When it contracts, it loses its roundness or convexity, and de-
scends to form a plane or level surface. This enlarges the cav-
ity of the chest, and the lungs following the diaphragm in its de-
scent, causes a vacuum in these organs, which is immediately
filled by air rushing in through the windpipe or trachea. This is
termed inspiration. The diaphragm now becomes relaxed, and
is pushed up by the organs within the abdomen, giving it a rqund-
ness ºr convexity on the upper side, as already stated, which di-
minishes the size of the chest, and causes a portion of the air with-
in the lungs to be expelled. This is called expiration. An en-
largement of the chest therefore, is accompanied with inspiration,
and a contraction of it with expiration. In the first, the diaphragm
o
34 VIEW OF THE HUMAN BODY.
is contracted, and becomes a plane; and in the second, it is re-
laxed and pushed up by the abdominal viscera.
LUNGS.
122. The lungs are soft, spongy bodies, occupying the cavity
of the chest or thorax, and are attached to the neck by means of
the trachea or windpipe. They consist of two portions, denom-
inated right and left, which are separated from each other by a
membranous curtain called the mediastinum. This curtain stretch-
es from the spine to the sternum, and divides the chest into two
cavities. There is no communication between the right and left
lungs therefore, except through the medium of the windpipe, which
is common to them both.
123. The shape of these organs corresponds with the cavity
in which they are placed, being rounded next the ribs, and hollow
or concave where they rest on the arch of the diaphragm. In
FIG. 6.
Piew of the right Lung, and Air Passages of the left Lung.
a, trachea or windpipe; b, right and left bronchia; c, c, c, the three lobes of
the right lung; d, the inferior or concave surface of the right lung, which rests
upon the arch of the diaphragm; e, e, e, air passages of the left lung or division
and subdivision of the bronchia.

VIEW OF THE HUMAN B0DY. 35
color they vary according to the age of the individual. In chil-
dren they are reddish, in adults grayish, and in old age purple or
livid. The membrane called the pleura, which lines the inside of
the chest, is reflected upon the lungs, and forms their external
coat or covering. In the one case, it is termed pleura costalis,
and in the other, pleura pulmonalis. The right lung is the largest,
and is divided into three lobes; the left lung is divided into two
lobes, between which, the heart and its surrounding membrane the
pericardium, are situated. -
124. The windpipe, through which the air passes into the
lungs, divides into two lateral branches, denominated bronchia, as
is represented in the preceding figure, and the bronchia, again, divide
and subdivide into an immense number of little tubes, constituting
the air passages of the lungs, which gradually diminish in size,
and finally terminate in what are termed the air cells. These
cells are small, and communicate freely with each other. They
are lined with a delicate mucous membrane, which is plentifully
supplied with minute blood-vessels. This membrane is continued
throughout the air passages, and is estimated by Keill to be equal
in extent to 21,906 square inches. Hence it will be seen that
the lungs are capable of containing a large amount of air. The
quantity which enters at each inspiration, is said to be about 40
cubic inches, and an equal quantity is given out at every eaſpira-
tion. Thus, if there are 20 inspirations in a minute, which are
rather more than the average number, the quantity of air that would
enter and pass out in this time, would be 800 cubic inches, and in
the same ratio it would amount to 48,000 cubic inches in an hour.
- 125. The circulation of the blood through the lungs, is carried on
by means of arteries, capillaries, and veins, as in other parts of
the body. The heart first propels it into the arteries, and then it
passes successively into the capillaries and veins. The latter
terminate in four large trunks, which enter the heart on the left side,
as will be hereafter explained. While the blood is moving through
the capillaries, it is acted upon by the air through the medium of the
delicate membrane which lines the air cells, and is changed from the
dark color which it has in the veins to a bright vermilion hue ; or,
in other words, it is converted from venous to arterial blood, and
thereby fitted to nourish and sustain the body. But for this
change, an individual could not long exist. The blood, after hav-
Ing circulated in the veins, is unfit for the support of life until it
has received the vitalizing influence of the air in the lungs, when
it is immediately changed in its character, and adapted to the pe-
culiar wants of the system. This is made manifest by experi-
ments on animals. Let a bird be confined, for instance, in a tight
-



36 VIEW OF THE HUMAN BODY.
glass jar, full of air, and at first it will exhibit no signs of incon-
venience, but in a short time it will begin to pant for breath, and
ultimately die in convulsions. A regular supply of pure fresh air,
therefore, is indispensable to the maintenance of life, and this fact
should be kept prominently in view in the treatment of the sick,
taking care not to confine them in narrow, or ill-ventilated rooms.
126. The atmospheric air undergoes important chemical
changes in the lungs. The oxygen, or vital part of the air, is
absorbed by the blood, and in its stead an equal quantity of car-
bonic acid gas is given out in breathing, together with a quantity
of watery vapor. Thus, by a remarkable process, the blood is
freed from two noxious principles, water and carbon, and furnished
with oxygen, upon which its vitality depends, and which appears to
be intimately connected with the generation of animal heat.
127. The mucous membrane, lining the internal surface of the
lungs, is the seat of various disorders, as croup, influenza, and
hooping-cough. It performs the function also of absorption, and
takes up the fumes of spirits, and other volatile substances. The
- former have been ... to the extent of producing intoxication.
CIRCULATION OF THE BLOOD.
128. Extraordinary as it may seem, the circulation of the
blood was not discovered until about two centuries and a quarter
ago, when it was first promulgated by William Harvey, an emi-
ment English physician. Instead of receiving the meed of praise
from his professional brethren, however, for this brilliant triumph
of his genius, he was violently persecuted by them; and in conse-
quence of their opposition, he was obliged to retire to an obscure
corner of London, where he lost nearly the whole of his practice.
So strong is the force of prejudice, says Dr. Dunglison, and so
difficult is it to discard preconceived notions, that it was re-
marked by Hume, in his #. of England, that no physician
in Europé, who had reached forty years of age, ever, to the end
of his existence, adopted Harvey’s doctrine of the circulation.*
129. The accompanying figure has been selected to give
some idea of the circulation. The heart has already been de-
A scribed as having four cavities, (98) two of which are auricles,
* Human Physiology, 3d edition, vol. ii. p. 156.
view of THE HUMAN B0DY. 37
and two ventricles. The blood, after it has circulated in the veins,
and is no longer fit for the support of life, is received by the two
great venous trunks, a and b, and emptied into the right auricle c.
Piew of the Heart.
a, superior vena cava; b, inferior vena cava; c, right auricle; d, right ventri-
cle; e, pulmonary artery; f, f, its right and left branches going to the lungs;
g, g, pulmonary veins, which return the blood from the lungs to the heart; h,
left auricle, into which the pulmonary veins empty their contents; i, right ven-
tricle: k, aorta or great artery, which rises out of the right ventricle, and con-
veys the blood, by its numerous ramifications, to every part of the body; l, ar-
teria innominata, dividing into the right carotid and right subclavian arteries, the
former going to the right side of the head, and the latter to the right arm; m, the
left carotid artery, going to the left side of the head; n, left subclavian artery,
going to the left arm; o, veins returning the blood from the liver, spleen, and
bowels, into the inferior vena cava, by which it is poured into the right auricle c,
p, coronary artery, which supplies the heart with blood for its nourishment;
q, the aorta, descending into the abdomen, where it divides into two branches,
one going to the right extremity, and the other to the left.
The stimulus of the blood in the auricle causes it to contract, and
thus the blood is forced into the right ventricle d. The ventricle
in its turn contracts, and sends the blood into the lungs through



38 VIEW OF THE HUMAN B0DY.
-
the pulmonary artery e, which divides into right and left branches.
While in the lungs, the blood is acted upon by the atmospheric
air, which frees it from its impurities, and gives it a bright red
color. It is then collected by the pulmonary veins, and deposited
in the left auricle h, from which it passes into the left ventricle i,
and thus, by a forcible contraction, drives the blood into the aorta,
through which, and its numerous branches, it is sent to every part
of the body.
130. The two auricles contract and dilate together; and so of
the two ventricles. Between the auricle and ventricle on the
right side of the heart, the tricusped valve is placed to prevent a
reflux of the blood; and between the auricle and ventricle on the
left side, the mitral valve is situated for a similar purpose. The
pulmonary artery and aorta also, are furnished with semi-lunar
valves at their orifices, to prevent the blood from returning into the
ventricles.
131. The cavities of the heart are not all filled at the same
time, as may be readily supposed. The auricles are filled simul-
taneously, while the ventricles are empty, and vice versa. At
every stroke of the heart, it is estimated that it forces two ounces
of blood into the aorta, and if it contracts at the rate of sixty times
a minute, it would only require about two minutes and a half for
all the blood in the body to pass through this wonderful organ.
132. Mr. Bell, in his remarks on Harvey’s doctrines of the
circulation, and the violent opposition that was made to them
by the medical profession, observes, “What new, strange, mon-
strous, and impossible circles his antagonists contrived for the
blood, it were tedious to relate : but it is most natural to men-
tion why his doctrines were opposed. It was the universal
opinion in those days, that the blood was formed in the liver, and
sént out from it by all the veins to nourish the body, proceeding
outwards during the day, and returning by night. The old phy-
sicians had thus entered into a train of thinking which it was not
easy to change : these notions about the blood were become great
and important doctrines, and had descended to them from their
oldest teachers, with many weighty dependencies, conclusions,
and rules of practice issuing from them : they were as articles of
faith which it was a heresy to forsake; and it was easy to foresee,
that should the Harveian doctrine prevail—should it be once com-
pletely proved that the blood moved outwards along the arteries,
and returned by the veins; then all the reasonings of the phy-
sicians would be confounded ; their theories embracing the whole
body of physic disturbed ; their system of practice entirely over-
thrown ; and all they had written themselves, and all the ancient

VIEW OF THE HUMAN B0DY. 39
pooks which they had read with so much diligence (for they were
really learned ;) all that they had ever been proud of, was to be
wiped out from the thoughts of that and all succeeding ages"
133. “But the doctrines of Harvey,” continues the same wri-
ter, “ did at last prevail, dispelling those idle dreams of humors,
and temperaments, and spirits, and blood –of the blood con-
cocted in the liver, and moving outwards along the veins to mour-
ish the body ; of the blood moving outwards during all the day,
and returning by night ; of the arteries carrying air only or vital
spirits, to animate the system by mixing with the blood, while the
veins alone conveyed the proper blood.”
ANIMAL HEAT.
134. From the tendency of heat or caloric to an equilibrium,
inanimate substances acquire the temperature of the air by which
they are surrounded, or of other bodies with which they are in
contact; but it is not so with man, for he has a temperature inde-
pendent of the medium in which he lives, and this he is capable of
maintaining either in a hot or cold climate, so long as he enjoys
his health. Hence the term animal or vital heat, which in the
human subject, is about 100 degrees of Fahrenheit.
135. With regard to the source of animal heat, physiologists
are yet undecided, and it would be useless to burthen these pages
with an elaborate treatise on the subject. Writers admit however,
that its production is intimately connected with the breathing pro-
cess; and this is obviously true. In the first place, it is always
the greatest in those animals who have the most perfectly develop-
ed lungs, as birds, in whom we find a temperature greatly exceed-
ing that of man. Again, if the lungs are impaired in their func-
tions, so that the blood does not circulate freely through them, a
loss of heat is the consequence. Dr. Combe, in his Principles
of Physiology, observes, “Many persons with imperfectly devel-
oped lungs, and a predisposition to consumption, complain habit-
ually, of coldness of the surface and feet; and many who were
previously in good health, become more and more sensible to cold,
in proportion as the approach of disease weakens the functions of
the lungs.”
136. “The quantity and quality of the food and state of the
digestive functions,” observes the same writer, “are important
conditions in the production of animal heat. This will be readily
* Bell's Anatomy and Physiology, 6th American edition.

40 VIEW OF THE HUMAN BODY.
assented to, when the reader considers that a due supply of well
formed chyle is required to restore the nourishing properties of
the blood, and if, in consequence either of insufficient food or of
weak digestion, this be rendered impossible, all the animal func-
tions, among others the production of animal heat, must necessarily
be impaired. This is the reason why cold is felt most severely
in the morning before breakfast, and why coldness of the feet and
chilliness of the surface are so generally complained of in indiges-
tion and bilious complaints.” º
137. Dr. Ure, in his Chemical Dictionary, considers respira-
tion as the principal, or at least the most evident source of animal
heat. Experience demonstrates, he says, that the heat of the
blood increases nearly a degree in traversing the lungs; and as it
is distributed to all parts of the body from the lungs, it carries the
heat everywhere into the organs; for we have seen that the heat of
the veins is less than that of the arteries. But in what peculiar
manner does respiration tend to the development of animal heat?
Mr. Edwards and others, attribute it to the influence of oxygen, which
is absorbed by the blood in the lungs, and which, it is said, combines
with the carbon of the blood in the arteries, thereby giving rise to
an evolution of heat. Mr. Edwards, in support of his doctrine,
remarks, that the greater the temperature of an animal, and the near-
er to the adult age, the greater is the amount of oxygen which it
consumes. Objections, however, have been urged against the the-
ory of Mr. Edwards, and against every other theory that has been
proposed, so that it is impossible to arrive at any definite conclu-
sions on the subject. It is generally conceded, however, that
oxygen plays an important part in the production of animal heat.
If blood fresh from the veins be introduced into a vessel filled
with this gas, it not only assumes a vermilion color, but its tem-
perature is also elevated ; and there is no reason why oxygen ab-
sorbed by the blood in the lungs should not produce a similar
result.
NERVOUS SYSTEM.
138. This consists of the brain, spinal marrow, and nerves.
139. BRAIN. This organ is contained within the skull, and
is the seat of the intellectual faculties. It is divided into two
parts, the cerebrum or great brain, and the cerebellum or little
brain. The first is situated above the level of the ears, and the
second below that level, in the lower and back part of the head.
It does not consist exclusively of a pulpy substance, resembling


VIEW OF THE HUMAN B0DY. 41
marrow, as was formerly supposed by anatomists, but it also has a
fibrous structure, as has been demonstrated within the last thirty
years by Gall and Spurzheim. It is surrounded by three mem-
branes, called dura mater, tunica arachnoides, and pia mater.
The dura mater is in contact with the inner surface of the skull, and
is a dense, strong membrane, having a bright, silvery appearance.
The tunica arachnoides is thin and delicate. The pia mater im-
mediately surrounds the brain, and is copiously supplied with
blood-vessels. The brain is the seat of sensation as well as of
intellect, and the connection between it and other parts of the body
is maintained by means of the nerves and spinal marrow.
140. The brain is liable to various diseases, as inflammation,
dropsy, and apoplexy.
141. SpinAL MARRow. This is a continuation of the base
of the brain, and is contained within the cavity of the spine. It is
round, and larger at the top than the bottom. It descends as
low as the third vertebra of the loins, where it terminates in a
bundle of nerves, which has a fancied resemblance to the tail of a
horse. It is similar in structure to the brain, consisting of a
pulpy or medullary matter, which is covered by a continuation
of the pia mater, tunica arachnoides, and dura mater.
142. NERVEs. The nerves are long white cords of various
sizes, which originate in the brain and spinal marrow, or rather are
prolongations of these organs, and are distributed in every direc-
tion through the body. They communicate with each other like
the blood-vessels, forming an extensive net-work; and so nume-
rous are they in their ultimate ramifications, that it is impossible to
prick the skin or flesh, with the finest needle, without wounding
one or more of their branches.
143. The great attributes of the nervous system, says Mr.
Bell, in his Anatomy and Physiology, are, the capacity of re-
ceiving impressions, the endowment of thought and feeling, and
the power of putting the muscular machine into action. The
nerves, however, cannot act independent of the brain. This is
proved in various ways. If the nerve proceeding to any sensible
part be cut, that part will lose its sensibility, because the commu-
nication between it and the brain is destroyed. Every sensation,
says Dr. Dunglison, whatever may be its nature, requires the in-
tervention of the brain. Light may make an impression on the
eye, or sound on the ear, but it is not until this impression has
been transmitted to the brain, that sensation is effected. Again,
if the skull is fractured so as to compress the brain, all conscious-
ness is lost until the compression is removed. Somewhat analo-
6
42 VIEW OF THE HUMAN BODY.
gous to this, is the effect produced by narcotics, which are ad-
ministered by the old school physicians for the temporary relief of
pain; but these poisons, instead of removing the cause of the com-
plaint, only stupify the brain, and render it incapable of receiving
impressions from the nerves. The remedy therefore, is worse
than the disease, and cannot be employed without the risk of in-
juring the patient’s constitution, or perhaps destroying his life.
144. The various organs of the body are supplied with nerves,
which are indispensable to the healthy performance of their func-
tions. For instance, if the nerves which are distributed to the
stomach were cut, the process of digestion in that organ would be
arrested. The heart would cease to contract if its nerves were
divided, for it is through these channels that it is acted upon by
the brain. But for these mysterious cords, which link the vari-
ous parts of the body in the closest sympathy, we could neither
- behold objects, hear sounds, taste food, nor exercise any of the
Senses.
145. The nerves are divided into the sensible and insensible;
the voluntary and involuntary. The first convey sensibility to
the parts to which they are distributed, as the nerves of the
skin; the second, like the brain itself, are devoid of sensibil-
ity, and exhibit no pain when irritated. Of this class are the
optic and auditory nerves, which, however, are capable of being
acted upon by light and sound. The voluntary nerves are dis-
tributed to muscles which are called into action by an effort of
the will, as those of the leg or arm. Consequently, they are the
nerves of motion. The involuntary nerves are not under the
immediate influence of the will, and perform their functions with-
out our consciousness. The nerves of the stomach and bowels
belong to the latter denomination.
146. Spinal Nerves. These are given off from the spinal
marrow, and are thirty in number. They issue through lateral
openings between the vetebræ, and are distributed to various or-
gans. They are called cervical, dorsal, lumbar, and sacral nerves,
according to the part of the vertebral column from which they pro-
ceed. -
147. Nerves of the Brain. The brain gives of nine pairs of
nerves, which are arranged by anatomists in the following order.
First, the olfactory or nerves of smell. Second, the optic nerves,
which are appropriated to the sense of sight, and which form the
internal coat of the eye. The third and fourth pairs are distribu-

VIEW OF THE HUMAN BODY. 43
ted to muscles of the eye, and influence its motions. The fifth
pair, called trigemini, send branches to the forehead, nose, upper
and lower jaws, palate, throat, and other parts. The sixth pair,
beside going to the eye, send off a branch which unites with one
from the fifth pair, thereby forming the great sympathetic nerve.
The seventh pair are the auditory or nerves of hearing. The
eighth pair or par vagum give off numerous branches, which go to
the throat, windpipe, lungs, heart, stomach, liver, spleen and kid-
neys. The ninth pair or lingual nerves go to the tongue.
148. GREAT SYMPATHETIC NERVE. This nerve is so called
from its numerous connections with other parts of the body. It
arises, as we have seen, from a branch of the sixth and one from the
fifth pair, which unite into one trunk, and descend along the spine
to the lower end of the sacrum or termination of the spinal column.
It communicates with each of the spinal nerves, and with several
of the nerves of the brain, and sends off branches to the organs
contained within the chest and abdomen. The uses of this nerve,
according to Lobstein, are, 1. To preside over nutrition, secre-
tion, the action of the heart, and the circulation of the blood;
2. To maintain a communication between different organs of the
body; and, 3. To be the connecting medium between the brain
and abdominal viscera.


P A R T S E C O N D.
G L A N C E
AT THE
OLD SCHOOL PRACTICE OF PHYSIC.
GENERAL REMARKS.
149. There is nothing which has contributed more to our pres-
ent physical deterioration, than the old school practice of physic.
The moment an individual begins to dose himself with poison,
even though he should take it from the hand of a diplomatised phy-
sician, he impairs his health, and inflicts an injury upon his consti-
tution. Under these circumstances, if it should be his lot to rear
a family, he transmits his own infirmities to his children, and they
become the victims of early disease. Thus it is that our country
is filled, from one extreme to the other, with the sick, lame, blind,
feeble, and emaciated, who have no hope of a termination of their
sufferings, but in the embrace of death. Our luxurious habits have
no doubt done much in rendering our physical condition what it
now is, but a much more fruitful source of mischief is to be found
in blood-letting, and the employment of mineral and vegetable poi-
sons. Dr. Rush has said, “We have assisted in multiplying dis-
eases; we have done more—we have increased their mortality.”
Of the truth of this there can be no doubt; and though Dr. Rush
was an advocate of the “heroic practice,” he had sagacity enough
to discover that it was founded upon erroneous principles.
150. There are many facts which go to prove that diseases
are multiplied by the use of poisonous drugs. }. a history of the


46 GLANCE AT THE
New Zealanders, published somewhat recently in Boston, as a
part of the Library of Entertaining Knowledge, it is said of these
people that they believe in the existence of a malignant demon,
named fliua, who is the cause of all their misfortunes; and, of
late years, “they have suspected that he has been very angry
with them for having allowed the white men to obtain a footing in
their country—a proof of which they think they see in the great -
mortality that has recently prevailed among them. This, how-
ever, they attribute at other times to the God of the Christians,
whom they also denounce as a cruel being, at least to the New
Zealanders. Sometimes they more naturally assign as its cause,
the diseases that have been introduced among them by the whites.
Until the whites came to their country, they say, young people
did not die, but all lived to be so old as to be obliged to creep on
their hands and knees.”
151. The present condition of the New Zealanders, so far as
their health is concerned, is very different from what it was when
they were visited by Capt. Cook. It is mentioned in the life
of that hardy and enterprising navigator, that, “one circumstance
peculiarly worthy of notice, is their perfect and uninterrupted
health. In all the visits made to their towns, where old and
young, men and women, crowded about our voyagers, they never
observed a single person who appeared to have any bodily com-
plaint ; nor among the numbers that were seen naked, was once
perceived the slightest eruption upon the skin, or the least mark
which indicated that such an eruption had formerly existed.
Another proof of the health of these people, is the facility with
which the wounds they at any time receive, are healed. In the case
of a man who had been shot with a musketball through the fleshy
part of his arm, the wound seemed to be so well digested, and in
so fair a way of being perfectly healed, that if Mr. Cook had not
known that no application had been made to it, he declared that
he should have enquired, with a very interested curiosity, after the
vulnerary herbs and surgical art of the country. An additional
evidence of human nature being untainted with disease in New
Zealand, is the great number of old men with whom it abounds. |
Many of them, by the loss of their hair and teeth, appeared to be
very ancient, and yet none of them were decrepit. Although
they were not equal to the young in muscular strength, they did |
not come in the least behind them with regard to cheerfulness and
vivacity. Water, as far as our navigators could discern, was the
universal and only liquor of the New Zealanders.”f
* New Zealanders, p. 231.
# Kippis's Life of Captain Cook, pp. 122, 123.
_*
OLD SCHOOL PRACTICE 0F PHYSIC. 47
152. It does not appear, from the testimony of travellers, that
disease prevailed to much extent among the North American In-
dians, until the white people taught them the use of poisons. Ma-
jor Long, in the account which he has given of his expedition to
the Rocky Mountains, says that rheumatism is rare among them.
No case of consumption, or jaundice, fell under his observation.
Decayed teeth were rare. Baldness seemed to be almost un-
known, the hair being always retained, however advanced the age
of the individual. Dysentery, ſever, and ague and fever, were ex-
ceedingly rare. Hypochondria, so far as he observed, was un-
known. He did not notice any one of them with his eye devi-
ating from the true line of vision ; and what was very remarkable,
their skin was not known to have been acted upon by poisonous
plants. Within the last ten or fifteen years, however, since they
have accustomed themselves to the use of calomel, and other poi-
sons, which they obtain from the whites, their diseases have mul-
". and they do not any longer experience the same strength
of body, or vigor of constitution.
153. An interesting anecdote is related by the celebrated
Montaigne, which is worthy of special attention. He mentions
that he had the patronage of a benefice, at the foot of one of the
Gascon mountains, where the inhabitants lived after a manner of
their own, and were governed by certain laws and regulations
which had descended from father to son, and to which they con-
sented to pay obedience. They had no judges, lawyers, doctors,
nor beggars, nor were they ever obliged to call in a stranger to
settle their disputes. They avoided very scrupulously all con-
nection with the other parts of France, to keep their minds in the
utmost state of purity. At length, however, a physician took it
into his head to marry a young woman of their village, and live
among them. He began by teaching them that there were such
things as ſevers, rheums, and imposthumes, and in what part of the
human body the heart, liver, and intestines were placed, of which, till
then, they were in perfect ignorance; and instead of garlic, with
which they had been accustomed to cure all their diseases, however
violent and dangerous, he ordered them for a cough, or an indiges-
tion, some strange foreign mixtures, and began to make a trade
nºt only of their healths, but their lives. Until this time they never
observed that being out at night in the dew gave them head-
achs, that it was unwholesome to eat or drink any thing warm,
or that the winds of autumn were more unwholesome than those of
the spring; but after making use of the medicines introduced by
him, they were beset by a whole legion of diseases to which they
had never been accustomed; they not only perceived a general



48 GLANCE AT THE
falling off of their ancient vigor, but they discovered also that their
lives were shortened by at least one half.
154. A useful lesson might be learned from the anecdote of
Montaigne, for people rarely reflect that their diseases are often
occasioned by following the advice of their physicians. A single
dose of a poisonous substance will sometimes lay the foundation of
an obstinate and dangerous malady. A medical man residing in a
small town on the borders of the river Delaware, above Philadel-
phia, used to recommend to the people in his vicinity to take one
or two calomel powders as the autumn approached, to guard
against bilious attacks, and keep the liver in a “healthy state.”
Many followed his advice, but they were nevertheless more sickly
than their neighbors; and at the end of each year they had enor-
mous fees to pay for medical attendance. The physician rode in
his carriage, and erected a splendid mansion; but the people who
had helped him to these comforts and elegancies, little suspected
that he had been making a trade, as Montaigne expresses it, of
their healths and lives.
155. The reflection must force itself on every candid mind,
that the medical faculty are incapable of removing disease with any
degree of certainty, or they would receive a greater degree of
public confidence than has ever yet been accorded to them; indeed,
people generally seem to regard them with an instinctive horror, and
some of our most intelligent and sagacious men, whose judgments are
not swayed by narrow minded prejudices, have frankly and openly
declared that they had no confidence in the skill of the medical
fraternity. It is stated in one of our prominent medical journals,
that Bolingbroke and Walpole, the two most powerful geniuses of
their time, fell victims to medical quackery; that is, they had no
confidence in the diplomatised physicians, and were willing to trust
their lives in the hands of those who were without diplomas.
156. One of the crowned heads of Europe sent to this country
a few years ago for Mr. Swaim, the inventor of a secret nostrum,
to curé him of the scrofula, which the most distinguished Euro-
pean physicians had been unable to remove. .
15i. Sir Walter Scott observes of Napoleon, that he never
obeyed the medical injunctions of his physician, Dr. O’Meara.
He obstinately refused to take medicine, notwithstanding all the
ersuasion that was employed, even when it was supposed that his
disease would prove speedily fatal. He held many disputes with
his medical attendant on the subject of physic, and one day an-
swered his reasoning and arguments thus: “Doctor, no physicing.
We are, as I already told you, a machine made to live. We
are organized for that purpose, and such is our nature. Do not
counteract the living principle. Letit alone—leave it the liberty of
OLD SCHOOL PRACTICE OF PHYSIC. 49
defending itself—it will do better than your drugs. The watch-
maker cannot open it; and must, on handling it, grope his way
blindfolded and at random. For once that he assists and relieves it
by dint of tormenting it with his crooked instruments, he injures it
ten times, and at last destroys it.”
158. Why was Napoleon so averse to medical treatment, but
that he had seen the ill effects of it in his court and camp : He
was always surrounded by distinguished medical men, and if he
had found them able to cure disease, he would have felt no reluc-
tance in employing them in his own case. But, no; his slaughter-
ed troops on the field of battle, were scarcely equal, perhaps, to
those who died in the hands of the physicians and surgeons after
the conflict was over, and he was convinced that their prescrip-
tions could be of no avail—that they would, in fact, add to the
violence of his symptoms, and in all probability hasten his death.
Napoleon was a shrewd observer, and if he had been a physician
instead of a warrior, he would no doubt have introduced many
salutary reforms into the healing art, and divested it of many of
its gross and palpable absurdities. His single assertion, “Do not
counteract the living principle,” speaks a volume of itself, and
shows how well he was convinced that poisonous or deleterious
substances, have no other effect than to derange the health, and im-
pair the constitution. In stomach complaints, to which he was
liable, says Sir Walter Scott, abstinence was his chief resource,
and the bath was frequently resorted to when the pangs became
more acute. He also held it expedient to change the character
of his way of living when afflicted with illness. If he had been
sedentery, he rode hard and took violent exercise; and if, on
the contrary, he had been taking more exercise than usual, he was
accustomed to lay it aside for prolonged repose.
159. Thomas Jefferson, the statesman and philosopher, who
had opportunities for becoming well acquainted with the fashion-
able practice of medicine, does not speak of it in terms of favor,
or even respect. “From the scanty field of what is known,”
says he, “the adventurous physician launches into the boundless
regions of what is unknown. * * * I have lived to see the
disciples of Hoffman, Boerhaave, Stahl, Cullen, Brown, succeed
one another like the shifting figures of the magic lantern, and their
ſancies, like the dresses of the annual doll-babies from Paris, be-
coming from their novelty the vogue of the day, and yielding to
the next novelty their ephemeral favors. The patient, treated on
the fashionable theory, sometimes recovers in spite of the medi-
cine. The mediciné therefore restored him, and the doctor re-
* Scott's Life of Napoleon, 3 vols. in one, p. 368.

7
50 GLANCE AT THE
ceives new courage to proceed in his bold experiments on the
lives of his fellow-creatures.” In another paragraph Mr. Jeffer-
son remarks, “I wish to see an abandonment of hypotheses, for
sober facts, the first degree of value set on clinical observations,
and the lowest on visionary theories.”
160. The Rev. John Wesley, so much famed for his enthu-
siastic devotion to the cause of piety and religion, was no friend to
the fashionable and speculative practice of physic. It would
afford me pleasure to quote somewhat at length from the writings
of this excellent man, but my limits compel me to rest content
with a few brief extracts. He observes, “As theories increased,
simple medicines were more and more disregarded and disused;
till, in a course of years, the greater part of them were forgotten,
at least in the politer nations. In the room of these, abundance
of new ones were introduced by reasoning, speculative men; and
these more and more difficult to be applied, as being more re-
mote from common observation. Hence rules for the application
of these, and medical books, were immensely multiplied; till, at
length, physic became an abstruse science, quite out of the reach
of ordinary men.”
161. “Physicians,” says Mr. Wesley, “endeavored to keep
the people in ignorance of the healing art, by filling their writings
with abundance of technical terms, utterly unintelligible to plain
men ; and those who understood only how to restore the sick to
health, they branded with the name of empirics. * * * They
introduced into practice abundance of compound medicines, which
consisted of so many ingredients, that it was scarcely possible for
common people to know which it was that wrought the cure ;
abundance of exotics, neither the nature nor names of which their
own countrymen understood ; of chemicals, such as they neither
had skill, nor fortune, nor time to prepare ; yea, and of dangerous
ones, such as they could not use, without hazarding life, but by
the advice of a physician.”
162. Mr. Wesley says there have been “some lovers of
mankind, who have endeavored, contrary to their own interests,
to reduce the healing art to its ancient standard; to explode it of
all hypotheses and fine-spun theories, and make it a plain and in-
telligible thing, as it was in the beginning, having no more mystery
than this–Such a medicine cures such a disease.” He commends
Dr. Cheyne for his labors in this respect, and says that he would
have communicated much more valuable information to the public,
but that he stood in awe of his medical brethren. In proof of
this he relates, that Dr. Cheyne was taken to task one day for
* Extract of a letter from Thomas Jefferson to Dr. Wistar.


OLD SCHOOL PRACTICE OF PHYSIC. 51
passages in his works countenancing the modern practice of phy-
sic, and he replied to the individual who accosted him, “Oh,
sir, we must do something to oblige the faculty, or they will tear
us in pieces.”
163. “Experience shows,” says Mr. Wesley, “that one
thing will cure most disorders as well as twenty put together "
and he then asks why so many ingredients should be employed,
as are by the physicians. He answers the question by remark-
ing, “only to swell the apothecary’s bill; nay, possibly, on pur-
pose to prolong the distemper, that the doctor and he may divide
the spoils.”
-
-
OPINIONS OF MAGENDIE.
164. No man is more distinguished as a medical philosopher
than Magendie, the celebrated French physiologist, and no one
has been more severe in his denunciations of the profession to
which he is attached by interest, as well as inclination. In his
Lectures on the Blood, delivered at the College of France in
1837-8, he spoke with a fearless independence of his medical
brethren, and applied to them the lash of censure with an unspar-
ing hand. He says, “Medical men may be divided into two
classes; those forming the first, give up all study the moment they
leave off attending lectures ; they quite conscientiously believe, and
frequently succeed in persuading others, that they understand
every disease, and can cure every variety of suffering ; these
gentry occasionally realize a handsome fortune, but I must say
they do it at the expense of science and of the interests of their
fellow-men. * * * The second class of practitioners con-
tinue, it is true, to follow clinical pursuits with zeal, but some
among them, misled by scholastic errors, retard rather than accel-
erate the progress of the science.”
165. “I hesitate not to declare, no matter how sorely I shall
wound our vanity,” continues Magendie, “that so great is our igno-
rance of the real nature of the physiological disorders called diseases,
that it would, perhaps, be better to do nothing, and resign the
complaint we are called on to treat, to the resources of nature,
than to act, as we are frequently compelled to do, without know-
ing the why or wherefore of our conduct, and at the obvious risk
of hastening the end of the patient.”
166. Addressing his class on the subject of medical theories,
he remarks, “Your chemical studies in the hospitals, and more
º Published in this country since that time in the Select Medical Library.
Philadelphia, 1839. -


52 GLANCE AT THE
especially the events of your own practice, must have supplied
you with abundance of evidence of the emptiness of past and pres-
ent theories.”
167. “I would ask,” says he, “wherein lies the difference
between the medical practitioner and the nurse, at the sick bed?
Suppose them, for example, engaged with a case of small pox.
In the course of his studies, the physician has attended clinical
practice, and has learned the symptoms and terminations of that
disease; he knows admirably well, that it is ushered in by certain
general phenomena, which are followed by a peculiar eruption of
a certain duration; that the pustules formed dry, and that desqua-
mation (peeling off of the cuticle) closes the scene. Very true;
but do you imagine the nurse, provided she be habituated to her
calling, does not know all that quite as well as he? Will he be
able to tell a whit more correctly than she, why the case of small
pox before him will prove confluent or benign or why the skin,
suddenly assuming a purple color, the sufferer is carried off in a
few hours ? No; the most skilful and experienced practitioner
knows nothing of all this: there he stands, the ignorant and too often
powerless spectator of such modifications as these of the primary
disease. All he can do is to order certain remedies, which, if
necessary, the nurse could prescribe equally well.”
168. Magendie seems to be no friend to the technical language
of the schools, and says, “it is an incoherent metaphor. Figures
and tropes,” he continues, “have their merit; but their fit place is
in a poem, or a romance, and the science we cultivate will, I trust,
cease to be ranked with such performances.” He adds that “the
language of the schools is loaded with false and grotesque com-
parisons, and calls aloud for reformation.” -
169. With regard to the practice of medicine, Magendie
observes, “the physician mixes, combines, and jumbles together
vegetable, mineral, and animal substances; administers them right
or wrong, without considering for a moment the cause of the
disease, and without a single clear idea as to his conduct. You
may prove to him, as you will, that this or that substance is insig-
nificant, useless, or even hurtful; little will he regard your expos-
tulations. And why should he, when, by readiness in prescribing
a monstrous farrago of drugs, he knows he shall acquire the repu-
tation of being profoundly versed in the materia medica, of being
a man of immense resources.” Speaking of the prescriptions of
medical men, he says—“I care little for the learned prescriptions
in which the majority of practitioners delight; the mysterious dignity
of their composition always seems to me calculated to throw chaff
in the eyes of the vulgar, and rather to enhance the merit of the
physician, than really to effect the recovery of the patient.”
-

—i.
OLD SCHOOL PRACTICE OF PHYSIC. 53
Louis AND HIS RESEARCHES.
170. Among the various system-makers of the present day, is
the famous M. Louis of Paris. He published a work some years
ago, entitled Researches on the effects of Blood-letting in some
Inflammatory Diseases, &c. which was translated in this country
by Dr. Putnam, and published with a preface and appendix by
James Jackson, M. D., Physician to the Massachusetts General
Hospital, and formerly Professor of Materia Medica in Harvard
University.
171. Dr. Jackson, in his preface, speaking of the observations
of M. Louis on blood-letting, says—“The result of them is, that
the benefits derived from bleeding in the diseases which he has
here examined, are not so great and striking as they have been
represented by many teachers. If the same results should be
obtained by others, after making observations as vigorous as those
of M. Louis, many of us will be compelled to modify our former
opinion.”
172. With regard to the new system of M. Louis, if system it
may be called, we learn from Dr. Jackson that, after having gone
through with his professional studies, he went abroad and returned
to France at the age of thirty-two, intending to engage in private
practice. “He was then led to examine anew the science of
medicine, and was dissatisfied with it. He now decided to aban-
don the thought of practice, for a time, and to devote himself to
observation, that is, to the study of disease as it actually presents
itself.” He passed nearly seven years in one of the Parisian
hospitals, “and when he thought he had attained his art, he threw
away the notes he had already collected, and began to accumu-
late new facts, and make new observations.” When he had
collected a great number of cases, he arranged them in a tabular
form, and to accomplish this, he retired to a distance from Paris,
and occupied ten months in making out his observations on acute
diseases alone. This will give some idea of the immense labor
he bestowed upon his undertaking.
173. By these tables, however, we only learn the derange-
ment of various functions during life, and the changes of structure
in different organs after death. If, for instance, the reader is de-
sirous of knowing how many times difficulty of swallowing was ex-
perienced in typhus fever, or how often a pain occurred in the little
finger or great toe, he has only to refer to these tables; but if he
wishes to know how to cure typhus fever, he will refer to the
tables in vain.


54 GLANCE AT THE
174: Dr. Jackson truly remarks, that “it is objected by some
to the labors of M. Louis, and others of the French pathologists, that
they labor with ardor on the subject of diagnosis, that they study
with the zeal of entomologists, to discriminate minute changes of
structure in the various textures of the human body, but that they
do nothing to advance the proper business of the physician, the
art of healing. Their therapeutics are decried as showing an
ignorance of what has been thought certain in England and in this
country; and they themselves are regarded as even indifferent to
this branch of science.” - -
175. The disciples of M. Louis are famed for making exper-
iments in the treatment of disease. For example, they will give
tartar emetic, to twenty patients with inflammation of the lungs, and
bleed, or blister, twenty other patients with the same disorder; and
by whichever plan of treatment the greatest number recover, that
they adopt in all subsequent cases to which they may be called,
till some new whim or caprice suggests itself to their fruitful ima-
ginations. Unfortunately for the health and lives of the American
people, the opinions of M. Louis are beginning to influence the
practice of the old school physicians on this side of the Atlantic;
and they seem to be quite as fond of making dangerous experi-
ments as their great prototype himself.
OPINIONS OF DF. BROWN.
176. The celebrated Dr. Brown, in the preface to his work
entitled Elementa JMedicinæ Brunonis, observes that he spent
more than twenty years in learning, and diligently scrutinizing
every part of medicine. The first five years passed away in
hearing others, studying what he had heard, implicitly believing
it, and entering upon the profession as a rich and valuable inher-
itance. His mode of employment the next five years, was to
explain more clearly the several particulars, to refine and give them
a nicer polish. By the expiration of another five years, he be-
came cold and indifferent to his studies; he began, with many
other eminent men, to look upon the healing art as altogether
uncertain and incomprehensible. “All this time passed away,”
says he, “without the acquisition of any thing valuable in the
healing art, and especially without that, which, of all things, is the
most agreeable to the mind, the light of truth.” He confesses
that it was not until between the fifteenth and twentieth year of his
studies, that a slight gleam of light, which he compares to first
dawn of day, broke in upon his benighted vision. -
177. “He now began to see,” says the author of the Philos-
OLD SCHOOL PRACTICE OF PHYSIC. 55
ophy of Medicine, “that he must give up the logic, the philoso-
phy, and the facts of physic as it then prevailed; that he must
forget all his reading and all his knowledge; and, if he did not
burn, as Paracelsus did, all the famous books that came in his
way, he must shut them all, and seal each of them with seven
seals, till he saw what he might make of his own thoughts.”
178. Brown, it is known, was the rival of Cullen, whose
system he endeavored to overturn, that he might establish his own
upon its ruins; and speaking of Cullen's doctrine of “spasm,” to
which I shall allude in a subsequent part of this work, he says,
“It was first suggested by Van Helmont, clumsily wrought into a
system by Hoffman, and after being banished by Boerhaave, it
found a protector and a friend in Cullen. This brat, this feeble,
half-vital, semi-production of folly, the starveling of strained sys-
tematic dulness, the forlorn outcast of the fostering care to which
it owed its insect-vitality, was now pampered by a crude and
indigestible aliment, decorated with foreign plumage, and in this
totally heterogeneous dress, was ostentatiously obtruded upon the
world as a new and respectable doctrine.”
REMARKS BY DR. CHAPMAN.
179. Dr. Chapman, Professor of the Theory and Practice of
Medicine in the University of Pennsylvania, though one of the
“heroic physicians,” seems to be somewhat skeptical with re-
gard to the use of drugs in certain diseases. The American
Journal of the Medical Sciences, contains a very good article
by him on dyspepsia or indigestion, in which we find the fol-
lowing judicious and highly sensible remarks.
180. “Tampering with medicines, (meaning of course poisons)
is very detrimental. Every ache or discomfort, real or imaginary,
must be relieved by a recurrence to some supposed remedy, till
finally the powers of the stomach are worn out, and derange-
ments, either functional or structural, take place. It would be
salutary were such people to bear in mind the epitaph of the
Italian count, who fell a victim to this habit—
* I was well,
Wished to be better,
Took physic, and died.”
Nor can the profession escape the imputation of having contrib-
uted to this mischief. Called to a case of disease of such ob-
scurity that no distinct notion can be formed of it, we go on groping
in the dark, pouring down drugs empirically till the stomach gives


56 GLANCE AT THE
way, and its derangements are added to the pre-existing affection,
by which a case is made of greater complexity, and of enhanced
difficulty of cure. It is not easy, always, to avoid this course,
from the ignorance or prejudice of mankind. The predominate
estimate of the profession, even among the most enlightened
people, leads to the delusive supposition that the materia medica has
a remedy for every disease, and that the want of success, under
any given circumstances, is owing to the poverty of resource of
the practitioner in attendance. Confidence is soon withdrawn
should he intermit his exertions, which perceiving, he too often
multiplies his administrations, to avoid a dismissal, or to have
imposed on him some one of the fraternity, who, it is expected,
will bring forth fresh supplies. The consultation taking place,
the new armory of weapons is opened and applied, with only an
exasperation of the case. Not satisfied, however, further trials of
others are made,-there is a repetition of a similar proceeding,
and the catastrophe is complete. -
181. “This, which might by some be suspected as a sketch of
fancy, is a faithful and unexaggerated delineation of reality I have
frequently seen and deplored. Convinced that he was falling a
victim to this very practice, the Emperor Hadrian deliberately
prepared as an inscription for his tomb—
“It was the multitude of physicians that killed the Emperor!”
182. In his Therapeutics, Dr. Chapman observes, “Cer-
tainly the annals of medicine, already sufficiently crowded and de-
formed with the abortions of theory, ought to moderate our ardor,
and create in future, some degree of restraint and circumspec-
tion.” -
183. Alluding to the “spirit of speculation, or what is termed
reasoning on medicine,” he says, “nothing has been more preju-
dicial than the abuse of this noble prerogative. Consulting the
records of our science, we cannot help being disgusted with
the multitude of hypotheses which have been obtruded upon us
at different times. Nowhere is the imagination displayed to
greater extent; and perhaps, says an eloquent writer, so ample
an exhibition of the resources of human invention might gratify
our vanity, if it were not more than counterbalanced by the hu-
miliating view of so much absurdity, contradiction and falsehood.”
BROUSSAIS AND HIS DOCTRINES.
184. The doctrines of Broussais were at one time Very pop-
ular in this country, but they do not now excite so much attention.

ol, D SCHOOL PRACTICE OF PHYSIC. 57
The two rival medical colleges in Philadelphia, were divided with
regard to their merits some years ago, and were engaged in a warm
and zealous controversy. Professor Revere of one of these
institutions, made the following remarks on the subject in a lecture
published in 1834 by the members of his class.
185. “At the present time, the Professor of Theoretical
Medicine in the largest medical school in this country, is a pro-
ſessed admirer and disciple of M. Broussais; and some of the
other learned professors in that most respectable institution,
though more measured in acknowledging themselves his followers,
are yet known to be the admirers, if not the open propagators of
his opinions. That institution, too, having heretofore had, in a
great degree, under its control, the medical press of the United
States, has been, and is making every effort to disseminate these
opinions and this practice. The practical maxims of the Brous-
saisan doctrines particularly extend to the diseases of this country,
and are in direct opposition to those that have prevailed among the
most eminent practitioners of medicine in the United States,
especially since the time of Dr. Rush.”
186. Dr. Revere gives an amusing picture from M. Barras,
of the medical pupils of Broussais. “They are in constant
dread,” says he, “ of inflammation of the stomach; if they
feel the slightest uneasiness in the organ, they examine their
tongues before a glass, or show them to one another; if they
perceive, or fancy they perceive, any redness on the sides or tip,
they are at once convinced, and fly immediately to leeches, gum
water, and acid slops. After a time, this debilitating process
engenders a morbid sensibility of the stomach, which renders
them incapable of taking solid food without uneasiness, when they
again have recourse to leeches and anti-phlogistics. By this plan
the stomach is enfeebled, the nervous system deranged, and the
individual often rendered miserable!”
187. As a specimen of the Broussaisan practice, the follow-
ing is quoted from M. Barras by Dr. Revere.
188. “A man 29 years old had been for a long time troubled
with indigestion. Having a recent attack of the complaint, but
without fever or vomiting, and his appetite being still tolerably
good, he applied to one of the disciples of Broussais for advice.
ºnely-six leeches were applied at different times over the region
ºf the stomach, and the patient was put on a course of gum water,
lavements and starvation. After fifty-five days of this treatment,
the attending practitioner was taken ill, and M. Barras was called
to take his place. He describes the condition of the patient in
the following language: . He appeared like a person on the point
of dying from hunger! Emaciation had arrived at the last degree

8
58 GLANCE AT THE
of marasmus, and the debility was so great that the patient could
not raise himself from the bed; his tongue was moist throughout,
white in the middle, red at the sides and extremity; face pale;
disgust for drink; vomiting for some days past; had some desire
for solid food; the pulse was weak; skin cold; urine watery and
copious; stools scanty; nothing particular about the region of the
stomach, except that the spine could be plainly felt through the
walls of the abdomen.’” - -
189. If the doctrines of Broussais are what they are repre-
sented by Dr. Revere and M. Barras, it is a melancholy reflec-
tion that they should be taught with so much assiduity in the
Pennsylvania University, in which there are five or six hundred
students annually, and nearly half that number of graduates. If
the young gentlemen who go from that institution with diplomas,
are converts to the fanciful notions of Broussais, and take his
rules of practice for their guide, it is easy to imagine how many
lives they must sacrifice, in their vain endeavors to cure disease.
190. As a specimen of the opinions entertained by Broussais
of his medical brethren, I select the following from one of his
works: “All the inflammations,” he remarks, “may produce
cancer. This is a fact which it is important to place in the
clearest light, because physicians constantly reason in a circle, in
the most incorrect manner, in relation to these diseases. When
an eroding ulcer occurs at the surface of the body, they endeavor
to discover its cause. If they can suspect a scrofulous, herpetic,
or other principle, for there are many other species of it, the
ulcer is named and treated accordingly. If it be cured, it retains
its epithet; if all attempts to arrest its progress are vain, it is
declared to be cancerous. It even sometimes happens that it is
necessary to recall this last epithet in consequence of its having
been given too soon; and it is necessary to do that whenever the
disease is cured, since it is agreed that cancer is incurable.”
REMARKS BY Misceli,ANEous AUTHORS.
192. John Lizars, Fellow of the Royal College of Surgeons,
and Lecturer on Anatomy, and Physiology in Edinburgh, makes
the following remarks on the present state of the old school prac-
tice of physic. “Let any one read the medical journals, or in-
vestigate the reports of the hospitals, and reconcile to his feelings
* Broussais's Pathology, p. 331.
-
_*-



0LD SCHOOL PRACTICE OF PHYSIC. 59
the fatal blunders which are daily committed both by physicians and
surgeons. How many are treated for colic, and die of inflamma-
tion of the bowels How many are treated for low nervous fever
or typhus, and die of acute inflammation How many are tor-
tured on the operating table, for stone in the bladder, or for aneu-
rism, (enlargement of an artery,) and die on the same or following
day, of hemorrhage, or inflammation produced by the unhallowed
hands of the surgeon
• Enter his chamber, view his breathless corpse,
And comment then upon his sudden death.”
192. “The next question,” he says, “which may naturally be
asked, is, does the same lamentable evil exist in private practice 2
and the answer is as naturally,–undoubtedly it does. This very
day I have operated on agentleman for fistulain perineo, whose ure-
thra was destroyed by one of the medical practitioners of the county,
attempting to introduce the catheter, about three years ago. I have
been obliged to lay the urethra open from the bulb to the bladder,
or rather I have been compelled to make a new urethra ; for every
vestige of the former one was obliterated by sinuses; and I here
candidly confess that all the operations for puncturing the bladder
which I have performed, and these have not been few, have been
in consequence of practitioners injuring the urinary canal by the in-
troduction of the catheter.” -
193. Dr. Good says, “ The science of medicine is a barba-
rous jargon, and the effects of our medicine on the human system
are in the highest degree uncertain, except, indeed, that they have
already destroyed more lives than war, pestilence, and famine
combined.”
194. “Medical books,” say the American editors of Marshall
Hall's Practice of Medicine, “are so prompt to point out the
cure of diseases, that the young student goes forth into the world,
believing, if he does not cure diseases, that it is his own fault.
Yet when a score or two of years have passed over his head, he
will come at length to the conviction, that some diseases are con-
trolled by nature alone. He will often pause at the end of a long
and anxious attendance, and ask himself how far the result of the
case is different from what it would have been under less officious
treatment; than that which he has pursued ; how many in the ac-
cumulated array of remedies, which have supplanted each other in
the patient's chamber, have actually been instrumental in doing
him. any good. He will also ask himself whether, in the course
of his life, he has not had occasion to change his opinion, perhaps
60 GLANCE AT THE
more than once, in regard to the management of the disease in
question, and whether he does not, even now, feel the want of
additional light º’”
195. In the paragraph following the above, it is remarked,
that “medicine has been rightly called a conjectural art.”
196. Dr. Shattuck, in a Dissertation on the Uncertainty of
the Healing Art, read before the Massachusetts Medical Society
in 1828, observes, “The Nosologica Methodica of Sauvages
comprises ten classes, twenty orders, three hundred and fifteen
genera, and two thousand five hundred species of disease ; while
Cullen has four classes, twenty orders, one hundred amd fifty-one
genera, and upward of one thousand species. Good has cast his
comprehensive mind on this difficult subject, and his nosology
presents seven classes, twenty-one orders, one hundred and thirty
genera, and four hundred and eighty species. Our distinguished
countryman, Rush, has discovered disease to be a unit, and he
proceeds fractionwise in his systematizing labors.” Again, says
Dr. Shattuck, “Physicians sometimes contradict themselves,
and oftener one another in their nosologies.” In another para-
graph he remarks, “It is true that books on medicine are abun-
dant; but they oftener abound in theory founded on hypotheses,
than in theory founded on fact ; they contain more arguments to
demolish preceding or contemporary theories, than true history of
human suffering.” - -
197. Dr. Hall, in his work on Loss of Blood, page 76, says,
“I may observe that of the whole number of fatal cases of disease
in infancy, a great proportion occur from the inappropriate or un-
due application of exhausting remedies. This observation may
have a salutary effect in checking the ardor of many young prac-
titioners, who are apt to think that if they have only bled, and
purged, and given calomel enough, they have done their duty :
when, in fact, in subduing a former, they have excited a new dis-
ease, which they have not understood, and which has led to the
fatal result.”
198. Dr. Abercrombie says, “We own our system defective,
and the action of our remedies in the highest degree uncertain.”
199. Dr. Alcott, in No. 1, of his Health Tracts, speaking of
medical poisons, observes, “We do not deny—we cannot—that
most of them are of great power and efficiency. The weakest of
* Hall’s Practice of Medicine, by Drs. Bigelow and Holmes, p. 94.


OLD SCHOOL PRACTICE OF PHYSIC. 61
them usually possesses power enough to redden and inflame the
whole lining membrane of the stomach and intestinal canal —what
then must be the result when the stronger ones are taken The
truth is, as has been found from numerous dissections, this lining
membrane may not only be in a state of sub-inflammation without
our being sensible of it, but it may also be spread over with erup-
tions and small ulcers, without causing any perceptible difference
in our feelings, except perhaps a little more thirst. The medical
man may indeed detect other symptoms of trouble within, in a
reddened tongue, hot breath, and more frequent pulse.”
“LEARNED QUACKERY.”
200. We are indebted for the above phrase to Dr. Benjamin
Waterhouse, who, after lecturing for more than twenty years in
the medical department of the Harvard University, retired, say-
ing, “I AM sick of LEARNED QUACKERY " As specimens of
this quackery, I will make a few extracts from standard works, in
relation to the treatment of particular forms of disease ; and medi-
cal men will have no reason to charge me with unfairness, if I
seek to condemn them by their own testimony. I merely wish to
satisfy the public that their works are full of speculations and dis-
crepancies, and, of course, that their practice cannot be any other
than visionary and uncertain.
201. YELLow FEVER. This disease broke out for the se-
cond time in Philadelphia in 1793, and the various and entirely op-
posite modes of treatment which were resorted to by Dr Rush in
its management, show how little he knew of the proper applica-
tion of remedies in that dreadful scourge. The disease, says Dr.
Thatcher, baffled the skill of the oldest and most judicious phy-
sicians; and they differed with regard to its nature and treatment.
It continued for one hundred days, and upwards of four thousand
died, being about thirty-eight each day. Dr. Rush now came
upon the stage of action, and tried, according to Dr. Thatcher,
‘... the gentle purges used in the yellow fever of 1762; but finding
them unsuccessful, and observing the disease to assume uncommon
symptoms of great prostration of strength, he laid them aside about
the twentieth of August, and had recourse to ipecacuanha in the
first day of the ſever, and to the usual remedies for exciting the
Action of the sanguiferous system, and gave bark in all its usual
forms, and joined wine, brandy, and aromatics with it. He ap-
plied blisters to the limbs, neck, and head. Finding them all in-
effectual, he attempted to rouse the system by wrapping the whole

62 GLANCE AT THE
body in blankets dipped in warm vinegar. He rubbed the right
side with mercurial ointment, with a view of exciting the vessels
in the whole system, through the medium of the liver. .None 0
these remedies appeared to be of any service. Perplexed and dis-
tressed by his want of success, he waited upon Dr. Stevens, an
eminent and worthy, physician from St. Croix, who happened
then to be in Philadelphia, and asked for such advice and informa-
tion on the subject of the disease, as his extensive practice in the
West Indies would naturally suggest. Dr. Stevens replied, that
“he had long laid aside evacuations of all kinds in the yellow
ſever ; that they had been found to be hurtful, and that the dis-
ease yielded more readily to bark, wine, and above all, to the use
of the cold bath. He advised the bark to be given in large quan-
tities and in every possible way, and pointed out the manner in
- which the cold bath should be used so as to derive the greatest
benefit from it.” - -
202. This plan of treatment was faithfully adopted by the
speculative Dr. Rush. He prescribed bark in large quantities,
and in various ways, and he frequently dashed cold water upon his
patients by the bucket full. The bark, however, either proved
offensive to the stomach, or was rejected by it in every instance.
The cold bath, on the contrary, was grateful, and procured relief
in several cases by inducing a moist condition ºf the skin.
203. Dr. Rush is represented by Dr. Thatcher as having
“ransacked his library, and pored over every book that treated of
the yellow fever. The result of his researches for a while was
fruitless. The accounts of the symptoms and cure of the disease,
by the authors he consulted, were contradictory, and none of them
appeared applicable altogether to the prevailing epidemic.” At
length he resolved to give “calomel in doses of ten grains, quick-
ened by ten or fifteen grains of jalap.” He also resorted to
“blood-letting, cool air, cold drinks, low diet, and the application
of cold water to the body.” These being regarded by Dr. Rush as
the grand specifics in yellow fever, he employed apothecaries, pri-
vate citizens, women, and even colored people, to go about and pre-
scribe them, none of whom, it is presumed, had ever been ſa-
vored with a diploma. Dr. Rush, however, did not seem to
think that a diploma was of much consequence, for he asserts, in
his Account of the Yellow Fever of 1793, that the success of his
two negroes in curing the disease, was “unparalleled by what was
called regular practice ;” that a hundred things are taught in the
common schools, less useful, “and many things more difficult
than the knowledge that would be necessary to cure a yellow
fever, or the plague j’’ and that “all the knowledge necessary to
discern when blood-letting is proper, might be taught to a boy or
-



















OLD SCHOOL PRACTICE OF PHYSIC. 63
a girl of twelve years old in a few hours. “I taught it,” he adds,
“ in less time to several persons during our late epidemic.” “It
is time,” he exclaims in another place, “to take the cure of pes-
tilential fevers out of the hands of physicians, and to place it in
the hands of the people.” - -
204. But did Dr. Rush cure the yellow fever with his calo-
mel purges, blood-letting, cool air, and low diet Mr. Cobbett
states that instead of saving ninety-nine out of every hundred
of his patients, as he asserted, he lost at least sixty-six out of
every hundred ; and this does not seem to be far from the truth.
He also lost four out of six of his own family. Moreover, the
leading members of the medical profession in Philadelphia, charged
Dr. Rush with killing his patients, though it is probable their own
practice was not a whit more successful. “ These gentlemen,”
observes Mr. Cobbett, in the eleventh volume of his works, page
260, “insisted that Dr. Rush's purges were of too drastic a na-
ture; they compared them to arsenic, and said they were a dose
for a horse. They said that the mercury excited salivation, even
to loosening the teeth. Rush replied to this objection by saying,
that he met with but two cases, in which there was a loss of teeth
from this medicine ; but there is some difference between loosen-
ing and losing one’s teeth. Dr. Rush probably thought it was
nothing unless his patients’ teeth dropped into their porridge.”
205. The medical gentlemen above alluded to, said that mer-
cury “inflamed the stomach and bowels ; and, in proof, they
cited a dissection made at Bush-hill, wherein were exhibited the
horrid effects of the mercurial purges. Finally, when the calls of
humanity compelled them, after long forbearance, publicly to pro-
test against these dreadful doses, they reprobated the use of them
in the strongest terms. Dr. Currie, who was one of the College
of Physicians, earnestly besought the poor deluded Philadel-
phians to open their eyes, to beware of the new remedies ; for,
said he, ‘the mode of treatment advised by Dr. Rush cannot, in
the yellow fever, fail of being certAIN DEATH.’”
206. So much for the “learned quackery” of Dr. Rush,
who, nevertheless, was one of the most celebrated of American
physicians, and who was aptly described by an eminent writer as
an " giant groping in the dark in pursuit of medical
truths. -
207. Consumption. Magendie, speaking of this disease in
his recent lectures on the blood, exclaimed, “Look at consump-
tion there is an affection which you see day after day cutting off
* Cobbett’s Works, American edition, vol. xi. p. 275.


64 GLANCE AT THE
individuals of every age, sex, and rank, yet none has been more
carefully studied on the old plan, none has proved a more fruitful
source of dogma and disquisition. Eminent observers have de-
scribed all its phenomena, even to the minutest details; but what
is all this description but so much natural history will it throw
any light on the treatment of the affection * Not a particle.”
208. Dr. Good says, “Dr. Beddoes felt justified in declar-
ing digitalis a cure for consumption as certain as bark for agues;
Dr. Barton of Philadelphia, has never known but one case cured
by it, though others may have been palliated ; and Dr. Parr as-
serts roundly, that it is more injurious than beneficial.”
209. Dr. Good recommends consumptive patients to use
what is termed artificial ass’s milk, which is made by boiling
eighteen contused snails with an ounce of hartshorn shavings, of
eryngo root, and pearl barley, in six pints of water, to half its
quantity, and then adding an ounce and a half of sirup of Tolu.
He also alludes to the practice of a celebrated Spanish physician,
who buried consumptive patients up to the chin in fresh mould.
He says “it would be most obvious to suppose that this was de-
signed to act as a tonic, and check the undue tendency to perspi-
ration by a protracted chill, but that Van Swieten tells us the
smell of fresh earth is serviceable, and approves of it on this
account.”* -
210. Dr. Wells of London was of the opinion that persons
afflicted with consumption would be benefited by removing to dis-
tricts where the fever and ague prevailed.* -
211. Dr. C. Drake of New York proposed the breathing
of cold air as a remedy in consumption,” and now physicians
have changed their views, and recommend patients to wear what
is termed a respirator over their mouths, that the air may be warm-
ed before it enters the lungs.
212. Ague AND FEver. Dr. Kellie suggests that if the
irculation of the blood be arrested in an upper and a lower
extremity, by means of a tourniquet, a check may be given to
the cold stage of an intermittent fever. “I should apprehend,”
says Dr. Eberle, who quotes the above, “that in vigorous
and plethoric subjects, considerable danger must attend this
practice, from the tendency which it must have to favor vascu-
lar turgescence of the brain; and thereby dangerous oppression
or apoplexy.”f -
* Study of Medicine, 6th American edition, vol. ii. pp. 56, 61, 66, 67.
# Eberle's Practice, 4th edition, vol. i. p. 113.
—a




OLD SCHOOL PRACTICE OF PHYSIC. 65
213. Dropsy of the BRAIN. “This disease, in chil-
dren,” observed Dr. Ware of Harvard University, to his class,
“is so generally fatal, that medical treatment is not thought
to be of any avail. We are justified in such cases in trying
experiments, until time shall develope a mode of cure; but I know
of no experiments yet, that have proved successful.”
214. DyspepsiA. Dr. Mackintosh, in his remarks on dys-
pepsia, says, “Remedies have not the same effect in any two
cases; and all plans of treatment will most generally ſail, unless
the patient himself can discover what articles of food agree with
him better than others, and has resolution enough to adhere to a
proper regimen.”
215. Again, he says, “Persons laboring under dyspeptic
symptoms, will very generally be heard to attribute their com-
plaints to a ‘fit of the bile;’ and many medical men, I fear,
confound stomach disorders with those of the liver, and too fre-
quently exhibit powerful mercurial preparations, to the great
injury of the patient.”
216. In another place he observes, “If the liver be not doing
its duty properly, calomel, or the blue pill, may be occasionally
exhibited at bed time, followed by a very small dose of salts in
the morning; but it is a despicable practice to give blue pill in
every disease connected with the digestive function. And it is
much to be regretted, that the great name of Abernethy should
ever have been associated with such insufferable quackery.”
217. “Common as dyspepsia is,” says Dr. Eberle, “ and
serious as are its consequences upon the health and happiness of
man, there is perhaps hardly any other malady which is so com-
monly misunderstood, and consequently mismanaged.”f
218. ScARLET FEveR. Dr. Francis of New York, says,
“However various may be the methods of cure in scarlet fever
adopted by different physicians, all admit the serious character of
the disease, and its too often fatal termination. * * * Its fatality,
as recorded in our annual bills of mortality, is truly alarming, and
seems to reflect little credit on the skill of our most competent
prescribers; in the city of New York alone, during the past
six years, no less than fifteen hundred have perished by it.”f
The same writer, speaking of the use of mercurials in this disease,
says—“The mortality of scarlet fever would be more within our
* Practice of Physic, 2nd American edition, vol. i. pp. 274, 275,279.
t Practice of Medicine, 4th edition, vol. ii. p. 275.
# Good's Study of Medicine, 6th American edition, vol. i. p. 601,


66 GLANCE AT THE
control, and cease to be the topic of such consternation, were
this heroic practice less popular.”
219. Dr. Fuller of Rhode Island, in a prize address on scar-
let fever, which was published in the Boston Medical Journal
about two years ago, makes the following quotation from Dr.
Armstrong. “It ought to be noticed that most of the old authors
are for, and most of the latter against, depletion, in the malignant
forms of scarlet fever; so various are the records of human opin-
ion, even on matters of vital importance. The theories of med-
ical men are constantly changing, but diseases have always been
under the same influences, as the planets revolve by the same
laws, whatever conjectures were formed of them in the lapse of
ages. The opinions of men may vary, but the operations of
nature are unchangeable.”
220. Dr. Fuller, in the course of his remarks, observes, that
“early in his professional career, he followed the practice so
constantly and so fatally recommended by almost all writers of
the last half century, who considered scarlatina to be a putrid
disease, requiring the employment of bark, wine and other cor-
dials, for its cure.” He adds, that “most writers of the last half
of the eighteenth century recommended bark, combined with
stimulants, as their sheet anchor in scarlatina;” but he says “the
very idea is preposterous, and he knows of no circumstances
which should induce him to employ bark, or any of its preparations,
during the two first stages of this highly inflammatory disease.”
221. Somebody must be in error here, but who, we will leave
for others to decide. The inference is plain, however, as we
once remarked in another publication, that thousands and tens of
thousands have been sacrificed by this “fatal” practice within the
last fifty years; and yet the world seems to be either ignorant or
regardless of these fearful enormities, which have been perpe-
trated in the name of science, and under the protection of the law.
222. DELIRIUM TREMENs. Speaking of the use of emetics
in this disease, Dr. Eberle remarks, “In several instances they
failed, in my hands, of doing any good; and in two cases, within
the last six years, they were unequivocally injurious. To one
patient who had been long a confirmed drunkard, I administered,
in divided doses, fifteen grains of tartar emetic. It produced
neither purging nor vomiting; but its sedative operation was im-
mediate and powerful. In about an hour after taking the medi-
cine, the pulse became small and extremely feeble—the extrem-
ities ice-cold, and a profuse, cold, clammy sweat broke out over
the whole body. The patient sunk rapidly, and expired about
* Good's Study of Medicine, 6th American edition, vol. i. p. 603.

ol, D SCH00L PRACTICE 01 PHYSIC. 67
four hours after the antimony was taken. In the other instance,
the emetic brought on the most profuse and exhausting diarrhoea,
and soon prostrated the patient below the point of reaction.”
223. Such is often the effect of antimony, administered as an
emetic, for it is a powerful and destructive poison; but no such
effects have ever been known to accrue from lobelia inflata. I
have given it in several cases of delirium tremens as an emetic,
and always with the most favorable results. - -
224. With regard to the use of opium in this disease, which
is employed by some of the medical faculty, Dr. Coates says,
“I have never seen, read of, or heard of an instance in which
opium was productive of harm.” Dr. Eberle however, disagrees
with his medical brother, and quoting his paragraph, remarks, “I
must, indeed, be greatly mistaken in the diagnosis, if I have not
seen one unequivocal instance of this kind. In a case which I
regarded as pure and uncomplicated delirium tremens, four grains
of opium were given every two hours. In twelve hours the
patient was comatose, became convulsed, and soon expired.”
225. During my visits to the Massachusetts General Hos-
pital, Dr. Hayward, remarking on the use of opium in delirium
tremens, said that it had been employed to an unwarrantable ex-
tent. He thought that it sometimes gave rise to apoplexy, and
thereby caused the death of the patient. He had discarded the
drug at the hospital, and either the cases were milder, or he had been
far more successful than those who resort to the opium practice.
226. ScroFULA. Dr. Mackintosh, in his remarks on scro-
fula, observes, “I was once very much amazed on hearing the
answer given by a physician, in my presence, to a lady who was
desirous of knowing how long her little girl, afflicted with this dis-
ease, was to be compelled to take the solution of muriate of lime.
She stated that it was very nauseous, and that it had done the
child no good, although she had taken it regularly for six months.
The physician replied, that it would probably require three or four
years before it would produce any beneficial effects, and that it
must be regularly taken. Whether the physician spoke, believing
what he said to be true, I cannot pretend to say, but he looked
grave enough.”
227. SMALL Pox, AND CHICKEN Pox. “With respect to
the small pox and chicken pox,” says Dr. Good, “a contest of
no ordinary magnitude arose in early times upon the subject, in
Eberle's Practice, 4th edition, vol. ii. pp. 178–9, 177.
f Practice of Physic, 2d American edition, vol. ii. p. 474.

68 GLANCE AT THE
support of which, every nation in Christendom, as in the Holy
ars, for many ages sent forth its champions, and the conflict
has been of still longer duration than the Holy Wars themselves.”
228. Dr. Bigelow, in a lecture before his class in Har-
vard University, remarked, that in “measles, small pox, scarlet
and typhus fevers, medical men could not arrest their progress;
they must have their course ; or if there were remedies by which
they could be broken up, medical science had not yet arrived at a
knowledge of them.”
229. Gout. “The following means,” remarks Dr. Eberle,
“ have been advised in the forming stage of gout, in order to
moderate or prevent a paroxysm. Emetics by Chalmers, active
cathartics by Musgrave, vegetable bitters, iron, and high seasoned
food by Grant, Dover's powder, or antimonial wine with opium
by Fothergill, large doses of musk or castor by Williams, bleeding
from the foot by Gilbert, the application of very cold water to the
feet by Giannini, and the internal use of iced water by Barthez.f
230. Here is certainly an ample variety of “means” for the
cure of gout, and the physician who happens to be in the posses-
sion of Dr. Eberle's work, will not be at a loss how to proceed!
231. Hoop ING Cough. “When blisters were formerly
employed with great freedom in this disease,” observes Dr.
Good, “it was thought to be ascertained that they always an-
swered best when they irritated the bladder and occasioned
strangury.”f
232. INFLAMMATION of THE LIVER, Dr. Mackintosh says
inflammation of the liver is often confounded with functional
and structural derangement of neighboring organs. He has seen
some remarkable cases of this. One dissection revealed inflam-
mation of the inferior lobe of the right lung, and another a collec-
tion of matter within the chest; both of which had been mistaken
during life, and treated as an affection of the liver with sundry
courses of mercury.”
233. Dr. Eberle recommends equal parts of nitric acid (aqua
fortis) and muriatic acid, as a remedy in acute inflammation of the
liver. “From a half to a whole drachm of this mixture,” says
he, “ diluted in a sufficient quantity of water, may be taken daily;
# Eberle’s Practice, 4th edition, vol. i. 415.
# Study of Medicine, 6th American edition, vol. i. p. 272.
| Practice of Physic, 2d American edition, vol. i. p. 422.
* Study of Medicine, 6th American edition, vol. i. p. 626.
5














OLD SCHOOL PRACTICE 0F PHYSIC. 69
- -
and in order to prevent the acid from coming in contact with and
injuring the teeth, it should be sucked through a small glass tube,
or quill.” -
334. If the teeth are in so much danger of being injured by the
corrosive effect of these powerful acids, what are we to expect from
them when they arrive in the stomach Physicians of the old
school frequently assert that cayenne “will burn a hole in the
stomach,” notwithstanding it is perfectly harmless, and yet they
have no objection to prescribing aqua fortis, provided they can
introduce it into the stomach so as not to burn or corrode the pa-
tient’s teeth.
- 235. SPINAL IRRITATION. The following case of spinal
irritation, which was mistaken by various physicians for other dis-
eases, was related by J. H. Griscom, M.D. in an Essay read
before the New York Medical and Surgical Society, in November,
1839. It is a forcible comment on what is termed the scientific
practice of medicine. -
236. “Mrs. Terry, of No. — Stanton street, was first seen
February 23d, 1836. She is of spare form, delicate looking,
and of slender constitution. Has had poor health for four years
back, not having passed a fortnight at a time in the enjoyment of
robust health, and freedom from pain during that period. She is
26 years old, and has had four children. Almost the first symp-
tom of disordered health which she recollects to have felt, was a
heavy dull pain through the hips, which she said felt very much
like early labor-pains. Commencing with this, a variety of symp-
toms followed, of the most strange and unaccountable kind, gradu-
ally increasing in number and severity, the patient being over-
come, at times, with a feeling of great oppression, and, at others,
suffering torturing pains. She had tried various modes of treat-
ment, and pursued them all to the fullest extent, with the vain
hope of finding relief. One respectable physician informed her
that her lungs were seriously affected; that she had only a portion
about the size of a dollar left that was sound, and put her upon a
course of medicine, what, she does not know. Another told her
she must ride, and she spent several dollars in patronising the Dry
| Dock stages, and many more in country jaunts. Another bled
her five times in as many days, “almost to death,’ as she ex-
pressed it. Another salivated her, presuming on the liver com-
plaint, but all to no purpose, as each method left her worse and
more debilitated than it found her.”
* Eberle's Practice, 4th edition, vol. i. p. 274.

70 GLANCE AT THE
MEDICAL SKEPTICISM.
237. We do not often find medical men taking their own
drugs when they are indisposed; and in many instances they man-
ifest a reluctance in giving them to their patients. This is what I
mean by medical skepticism; and it prevails to a much greater ex-
tent than is generally imagined.
238. Dr. Pierson of Salem, Massachusetts, in a memoir of
his fellow townsman, Dr. Nehemiah Cleaveland, who died about
two years ago, at the advanced age of eighty years, says that the
deceased “to the end of his life—in opposition to the opinions
and wishes of friends and of physicians—declined almost entirely
the use of those narcotics which would have relieved his pain,
lest they should deaden his moral and intellectual sensibilities.”
239. The above is some proof of our assertion that physicians
are afraid of their own drugs. With regard to Dr. Cleaveland,
however, there is no doubt that he often gave narcotics to his pa-
tients, little caring, perhaps, how much he “deadened their moral
and intellectual sensibilities;” and the question arises, whether, by
the use of these stupifying agents, individuals are not frequently
sent from time to eternity with their sins unforgiven, who might,
under other circumstances, have obtained the pardon of a just
and merciful God. When our Saviour was on the cross, ex-
piring in the agonies of death, he told the bystanders that he
was thirsty, and they offered him a drink which was intended to
produce intoxication and render the pains of his crucifixion less
acute, but he refused “for the obvious reason that he chose to
die with the faculties of his mind undisturbed and unclouded.”
How worthy of imitation is the example of our Saviour; and I do
not hesitate to say that every Christian, who has any regard for
his spiritual welfare, will abstain from poisonous or deleterious
substances in the hour of sickness or approaching death.
240. Dr. Warren, professor of Anatomy and Surgery in
Harvard University, made the following remarks last winter in one
of his lectures. “As I was walking in the street about a year ago,
I felt a sudden pain in the back part of my leg, which prevented
me in some measure from walking. The pain was seated in one
of the nerves, and was rather obstinate. here were two reme-
* Boston Medical and Surgical Journal.
# See Jahn’s Biblical Archæology.

OLD SCHOOL PRACTICE OF PHYSIC. 71
-
dies which I could employ, either a dose of laudanum, or a long
walk. I preferred the latter, and it afforded me the desired
relief.” -
241. Whether Dr. Warren, if he were called to a patient simi-
larly afflicted, would recommend the poison of opium, or a little
wholesome exercise, I am unable to determine.
242. Professor Bigelow of Boston, is said to have but little
confidence in what is termed the “fashionable practice of medi-
cine,” and this is apparent from the general tenor of his lectures.
Speaking before his class on the subject of typhus fever, he said,
“No question has been more agitated than whether this disease
can be cut short by active treatment. Six or seven years ago
this opinion was prevalent among us, but it is now entirely
abandoned; for it has been found that although a patient were
bled, blistered, purged, and salivated, the fever still continued on
in its course.
243. “There is scarcely any treatment,” continued the profes-
sor, “which has not been in vogue in typhus fever; at one time
patients were bled and purged; at another, salivated; at a third,
treated with antimony and similar remedies; but all of these modes
of practice have fallen into disrepute. Nevertheless, when we
are called to a case, we must order a prescription, for we cannot
stand by as idle spectators; and if the patient should fortunately
recover, let the physician look at the scores of bottles, and quan-
tity of medicine, which have accumulated in the sick chamber–
this being the natural consequence of an almost daily change of
remedies—and if he be a candid man, he will confess that there is
a doubt, whether the remedies employed have been of any service
whatever. In the exact sciences we admit nothing to be true
until its opposite is proved to be untrue, but in medicine we are
obliged to admit the treatment of cases in evidence, when it is
not known whether the patients would not have recovered with-
out any treatment at all.”
244. Mrs. G of Boston, a highly intellectual lady, was
attacked with hemorrhage from the lungs, which ceased without
the interposition of medical aid. Fearing she was threatened
with pulmonary consumption, she consulted Dr. W. 2
an eminent old school physician, and he advised her, very much
to her astonishment, not to take any medicine, for, said he, any
thing that we physicians could prescribe, would cause derange-
. of your stomach, and thereby sympathetically affect your
ungs.
245. Here was a species of skepticism not uncommon among



72 GLANCE AT THE
physicians; and if their drugs affect the stomach injuriously in
consumption, and give rise to a new train of morbid symptoms, I
ask whether they have not a similar tendency in every other form
of disease ?
246. Mrs. G , as a further history of her case, laughingly
remarked to me, that although Dr. L. had advised her not to
employ medicine, as he used the term, another physician almost
equally distinguished, told her that it was indispensable, and would
be the only means of saving her life.
247. Mr. John C. Mason of Philadelphia, aged about 30, re-
lated to me the following particulars a year ago. In July, 1839,
he lived in Tioga county, Pennsylvania, where he was attacked
with inflammation of the lungs. Dr. F. H. White was his phy-
sician. He gave him ten doses of calomel within three days,
which caused salivation, and the patient remained in this condition
for fourteen days. Meanwhile, he was bled seven different times.
After the fourteenth day he was given up as hopeless. At length,
however, he rallied somewhat, and gained sufficient strength to
enable him to return to his friends in Philadelphia, where he called
in Dr. McClellen of the Jefferson Medical College. At
that time he could not speak, having lost his voice soon after
the salivation commenced, and he was annoyed by a constant
hacking cough. Dr. McClellen gave him a mixture which did
not afford him any relief, and at his second visit, advised him to
go to an infirmary, and take courses of medicine. He thought
the cayenne and lobelia would be useful to him. The patient's
friends did not expect him to survive, and so wretched was his
situation, that he had no desire to live. He took nine courses of
medicine, however, and to the astonishment of all, was restored to
better health than he had enjoyed for years. During the first two
or three courses, his apartment became so offensive, as soon as
he began to perspire, that it was almost impossible for the nurse
to remain in his presence. He had continued well up to the pe.
riod that I saw him, and worked daily at his trade, which was that
of a carpenter.
248. The above case is interesting, because it shows how
little confidence Professor McClellen had in his own mode o
treatment; and he is reported to have said in one of his lectures,
that medical men must either adopt “the botanic remedies, or
lose their practice.”
249. There is something in the operation of a poison on the
human system, though it may be given in small doses, which
suggests to the intelligent physician the danger, or at least the
OLD SCHOOL PRACTICE OF PHYSIC. 73
impropriety, of employing such an agent; but as he has been ed-
ucated to believe that nothing excepting a poison can exercise any
medicinal influence, he finds it almost impossible to relinquish
his preconceived notions. Thus it is that reform in medicine is
so tardy in its progress.
250. I have observed that medical students are generally
skeptics during the first course of lectures they attend, but in
proportion as they become familiarized with their dreadful trade,
their skepticism dies away, and they fancy that they can cure
any disease with the lancet, opium, calomel, and a few other
uº.S.
. The following instance of medical skepticism is not,
perhaps, altogether unworthy of notice.
252. About ten years ago, a physician of considerable dis-
tinction, whose name I am not at liberty to repeat, though it is
well known to a number of our mutual friends, solicited me to
prescribe for him in a severe attack of disease under which he
was suffering, saying that he could not long survive unless he was
relieved, . that he was afraid to call in his medical brethren,
lest they should hasten his death. Medicines were immediately
given to him, followed by a course of medicine, which occupied,
altogether, about twenty-four hours, and at the end of that time,
he declared that his health was better than it had been for several
years.
FRUITS OF THE OLD PRACTICE.
253. Pliny informs us that Rome was five hundred years
without physicians. Her rulers forbade the practice of medicine,
and banished its professors. Would they have done this, but
that they saw the ill effects of medical treatment? Would they
have banished those who were really skilled in the healing art, and
were capable of alleviating or curing disease? On the contrary,
when Archagathus, a Peloponnesian, first established himself in
Rome as a medical practitioner, he was treated with great respect
by the citizens, and was even maintained at the public expense;
but his practice proved to be so severe and unsuccessful, that he
sºon excited the dislike of the people, and produced a complete
disgust to the medical profession, which led to the banishment of
himself and brethren.”
254. Without wishing to be unjust to the physicians of our
our own times, it appears to me that they are quite as worthy of
* Bostock's History of Medicine, chap. iv.

10
74 GLANCE AT THE
banishment as those who were driven from Rome twenty centuries
ago, for that was the period at which the event took place. To
be satisfied of the horrible effects of their practice, we have only
to glance over the page of history, and observe how many dis-
tinguished individuals have been its unsuspecting victims. Wash-
ington, for instance, after having fought the battles of his country
unharmed, was killed, according to the best authority, by his
physicians. Byron, also, England's noblest poet, met with a
similar fate; and I might mention Spurzheim, Wirt, Miss Lan-
don, and a host of others, equally distinguished for their genius
and virtues, who paid the forfeit of their lives by obeying the
injunctions of their medical attendants. With regard to the de-
cease of Washington, I will quote the observations of John Reid,
M. D., Physician to the Finsbury Hospital, England, and Pro-
fessor of the Theory and Practice of Physic.
255. “In reading the official report of the death of General
Washington,” says Dr. Reid, “I should imagine there were few
medical persons who did not feel astonishment at the extraordi-
nary manner in which that great man was treated by his physicians,
during his last and fatal indisposition.
256. “Some time in the night of the 13th of December, it is
said, the General was seized by a disease called the cymanche
trachealis or croup.
257. “During the same night he sent for a bleeder, who took
from him 12 or 14 ounces of blood.
258. “Next morning a physician was sent for, who arrived at
Mount Vernon at 11 o’clock; when, imagining danger in the
case, he advised the calling of two consulting physicians.
259. “In the interval, however, he thought proper to employ,
in spite of the 12 ounces that had already been expended, two
copious bleedings. Now, when we consider that these are called
copious, and the other is not noticed as such, and all the indiffer-
ence with which a future most copious bleeding, is afterwards
mentioned, we may presume that each of these was at least 20
or 25 ounces. -
260. “After this, “two moderate doses of calomel were ad-
ministered.” I know not exactly, what an American moderate
dose of calomel may be; but if it is fair to presume it be in
proportion to the bleedings, we may conclude that it was at least
very considerable. -
261. “Upon the arrival of the first consulting physician, it was
agreed, that, as there were no signs of accumulation in
bronchial vessels of the lungs, they should try another bleeding.
262. “Now this appears to be perfectly inexplicable. As
there were, at present, no signs of accumulation in the bronchial


OLD SCHOOL PRACTICE OF PHYSIC. 75
vessels of the lungs, they were driven to another bleeding.
Hence it will be seen, that this last bleeding was to produce an
accumulation in the bronchial vessels of the lungs! There was
great difficulty of breathing, great inflammation; but as there was
as yet no accumulation in the lungs, they were determined to
induce that also, and as a likely means of inducing it, had recourse
to the most extravagant effusion of blood. This is not an unfair
interpretation of their words; but it could not have been their
real meaning; their real meaning it is impossible to discover. In
addition to all their previous venesections, thirty-two ounces are
now drawn . The medical reader will not be surprised to find
that this was unattended by any apparent alleviation of the disease.
263. “In the next place, vapors of vinegar and water are fre-
quently inhaled. Two doses of calomel were already given, but
this is not deemed sufficient; ten grains of calomel are added :
nor is even this sufficient. Repeated doses of emetic tartar,
amounting in all to five or six grains, are now administered. It
is said, the powers of life now seemed to yield to the force of the
disorder. To many, it may appear that the yielding of the vital
principle, in these circumstances, was not altogether owing to the
force of the disorder.
264. “The patient, lying in this feeble, nearly exhausted state,
is to be still further tormented. Blisters were next applied to
his extremities, together with a cataplasm of bran and vinegar to
his throat.
265. “It is observed that speaking, which was painful from
the beginning, now became scarcely practicable. When we
reflect upon the extreme weakness to which the patient must, by
this time, have been reduced, and that he had both a blister and a
cataplasm of bran and vinegar to his throat, can we wonder that
speaking would be scarcely practicable respiration grew more
and more contracted and imperfect, until after 11 o’clock on
Saturday night, when he expired without a struggle.
266. “Think of a man being within the brief space of a little
more than twelve hours, deprived of 80 or 90 ounces of blood;
afterward swallowing two moderate American doses of calomel,
which were accompanied by an injection; then ten grains of
calomel and five or six grains of emetic tartar; vapors of vinegar
and water frequently inhaled; blisters applied to his extremities;
a cataplasm of bran and vinegar applied to his throat, upon which a
blister had already been fixed; is it surprising that when thus treat-
ed, the afflicted General, after various ineffectual struggles for
utterance, at length articulated a desire that he might be allowed
to die without interruption -
267. “To have resisted the fatal operation of such herculean



76 GLANCE AT THE
remedies, one should imagine that this venerable man ought, at
least, to have retained the vigor of his earliest youth.”
268. Thus speaks a member of the medical profession, and
it will not be denied, perhaps, that he is competent authority. As
a professor in a medical college, his opinion is certainly entitled
to respect and consideration. The official report to which he
alludes, was furnished by Dr. Craik, attending physician of Gen-
eral Washington, and Dr. Dick, consulting physician. Of its
accuracy, there is not a doubt; and Dr. Reid has not misrepre-
sented it in the slightest particular. Independent of this high
authority, however, it is generally admitted by medical men, that
Washington fell a victim to the lancet. Dr. Joseph Comstock,
speaking of the effects of blood-letting in diseases of the throat,
says, “I have long viewed Gen. Washington as having fallen a
martyr to this practice.” (Boston Medical and Surgical Journal,
vol. xx. No. 13.) William Cobbett, in the eleventh volume of
his works, page 20, says, “That the lancet, which has destroyed,
in America, many more than have been destroyed by the yellow
fever, put a period to the existence of Gen. Washington, No one
CAN Doubt.”
269. The death-bed scene of Lord Byron was equally appal-
ing with that of our beloved Washington. Moore, in his life of
the noble poet, has given us all the leading particulars. It ap-
pears that Byron, while in Greece, was making an excursion in
the neighborhood of Missolonghi, together with his companion,
Count Gamba, for the sake of exercise, and was overtaken by a
heavy shower of rain, by which he was drenched to the skin.
About two hours after his return home he was seized with a shud-
dering, and complained of fever and rheumatic pains. “At
eight that evening,” says Count Gamba, “I entered his room.
He was laying on a sofa, restless and melancholy. He said to me
“I suffer a great deal of pain. I do not care for death, but these
agonies I cannot bear.’”
270. “The following day he rose at his accustomed hour-
transacted business, and was even able to take a ride. He com-
plained, however, of perpetual shudderings, and had no appetite.
On his return home, he remarked to Fletcher, that his saddle, he
thought, had not been perfectly dried since yesterday's wetting,
and he felt himself the worse for it.
271. “On the evening of the 11th, his fever, which was pro-
nounced to be rheumatic, increased; and on the 12th he kept his
bed all day, complaining that he could not sleep, and taking no
nourishment whatever. The two following days, though the fever
OLD SCHOOL PRACTICE OF PHYSIC. 77
had apparently diminished, he became still more weak, and suffer-
ed much from pains in the head.
272. “It was not till the 14th that his physician, Dr. Bruno,
finding the sudorifics which he had hitherto employed to be unavail-
ing, began to urge upon his patient, the necessity of being bled.
Of this, however, Lord Byron would not hear. He had evidently
but little reliance on his medical attendant, and from the speci-
mens this young man has since given of his intellect to the world,
it is, indeed, lamentable,_supposing skill to have been, at this mo-
ment, of any avail, that a life so precious should have been en-
trusted to such ordinary hands.
273. “It was at this juncture that Mr. Millingen was, for the
first time, according to his own account, invited to attend Lord
Byron in his medical capacity, his visit on the 10th being so
little, as he states, professional, that he did not even, on that oc-
casion, feel his lordship's pulse. The great object for which he
was now called in, and rather, it would seem, by Fletcher than
Dr. Bruno, was for the purpose of joining his representations and
remonstrances to theirs, and prevailing upon the patient to suffer
himself to be bled,—an operation now become absolutely neces-
sary from the increase of the fever, and which Dr. Bruno had, for
the last two days, urged in vain.
274. “Holding gentleness to be, with a disposition like that
of Byron, the most effectual means of success, Mr. Millingen
tried, as he himself tells us, all that reasoning and persuasion could
suggest, towards attaining his object. But his efforts were fruit-
less —Lord Byron, who had now become morbidly irritable, re-
plied angrily, but still with all his accustomed acuteness and spirit,
to the physicians’ observations. Of all his prejudices, he declared,
the strongest was that against bleeding. His mother had on her
death-bed obtained from him a promise never to consent to being
bled; and whatever argument might be produced, his aversion,
he said, was stronger than reason. ‘Besides, is it not,” he asked,
‘asserted by Dr. Reid, in his Essays, that less slaughter is effect-
ed by the lance than the lancet—that minute instrument of mighty
mischief.” On Mr. Millingen observing that this remark related
to the treatment of nervous, but not of inflammatory complaints,
he rejoined, in an angry tone, ‘Who is nervous, if I am not?
And do not those other words of his, too, apply to my case,
where he says that drawing blood from a nervous patient is like
lººsening the chords of a musical instrument, whose tones already
fail for want of sufficient tension ? Even before this illness, you
yourself know how weak and irritable I had become;—and bleed-
ing, by increasing this state, will inevitably kill me. Do with me
whatever else you like, but bleed me you shall not. I have had

78 GLANCE AT THE
several inflammatory fevers in my life, and at an age when more
robust and plethoric; yet I got through them without bleeding.
This time, also, will I take my chance.”
275. “After much reasoning, and repeated entreaties, Mr.
Millingen at length succeeded in obtaining from him a promise,
that should he feel his fever increase at night, he would allow
Dr. Bruno to bleed him. - -
276. “During this day he had transacted business, and receiv-
ed several letters, particularly one that much pleased him from
the Turkish Governor, to whom he had sent the rescued prison-
ers, and who, in this communication, thanked him for his humane
interference, and requested a repetition of it.
277. “In the evening he conversed a good deal with Parry,
who remained some hours by his bed-side. ‘He sat up in his
bed,’ says this officer, and was then calm and collected. He
talked with me on a variety of subjects connected with himself
and his family; spoke of his intentions as to Greece, his plans
for the campaign, and what he should ultimately do for that coun-
try. He spoke to me about my own adventures. He spoke of
death also with great composure, and though he did not believe
his end was so very near, there was something about him so
serious and so firm, so resigned and composed, so different from
any thing I had ever before seen in him, that my mind misgave
me, and at times foreboded his speedy dissolution.”
278. “On revisiting his patient early next morning, Mr. Mil-
lingen learned from him, that having passed, as he thought, on the
whole, a better night, he had not considered it necessary to ask
Dr. Bruno to bleed him. What followed, I shall, in justice to
Mr. Millingen, give in his own words. “I thought it my duty -
now to put aside all consideration of his feelings, and to declare
solemnly to him, how deeply I lamented to see him trifle thus
with his life, and show so little resolution. His pertinacious re-
fusal had already, I said, caused most precious time to be lost;-
but few hours of hope now remained, and, unless he submitted
immediately to be bled, we could not answer for the consequen-
ces. It was true, he cared not for life; but who could assure
him that, unless he changed his resolution, the uncontrolled dis-
ease might not produce such disorganization in his system as
utterly and forever to deprive him of reason —I had now hit at
last on the sensitive chord; and, partly annoyed by our importuni-
ties, partly persuaded, he cast at us both the fiercest glance of
vexation, and throwing out his arm, said, in the angriest tone,
* There—you are, I see, a d-d set of butchers—take away as
much blood as you like, but have done with it.”
279. “We seized the moment,’ adds Mr. Millingen, “and
_

OLD SCHOOL PRACTICE OF PHYSIC. 79
drew about twenty ounces. On coagulating, the blood presented a
strong buffy coat ; yet the relief did not correspond to the hopes
we had formed, and during the night the fever became stronger
than it had been hitherto. The restlessness and agitation in-
creased, and the patient spoke several times in an incoherent
manner.” -
280. “On the following morning, the 17th, the bleeding was
repeated; for, although the rheumatic symptoms had been com-
pletely removed, the appearances of inflammation on the brain
were now hourly increasing.
281. “In addition to the bleeding, which was repeated twice
on the 17th, it was thought right also to apply blisters to the soles
of his feet. -
282. “It was about six o'clock on the evening of this day
when he said, ‘Now I shall go to sleep ;’ and then turning round
fell into that slumber from which he never awoke. For the next
twenty-four hours he lay incapable of either sense or motion,-
with the exception of, now and then, slight symptoms of suffoca-
tion, during which his servant raised his head, and at a quarter
past six o'clock on the following day, the 19th, he was seen to
open his eyes and immediately shut them again. The physicians
felt his pulse—he was no more.”
283. I have italicised passages which I thought were particu-
larly deserving of the reader's notice. The “twenty ounces of
blood” which were taken in the first instance, did not afford the
desired relief, but on the contrary, “the fever became stronger
during the night than it had been hitherto.” On the following
morning the bleeding was repeated, because the “appearances of
inflammation on the brain were increasing hourly.” Do not
these facts go to confirm the belief that blood-letting cannot be re-
lied on as a means of subduing fever and inflammation, even
though it should be pushed to an alarming extent? Nay, we are
told by Magendie, and others, that the loss of blood has a ten-
dency to produce inflammation, and it is confidently asserted that
if a healthy animal be killed by repeated small bleedings, its brain
will be found, on dissection, to be in a high state of inflammation.
But to return to poor Byron He was not only bled three times
on the 17th, but had blisters applied to the soles of his feet; and
it is no wonder that he soon began to sink into a state of insensi-
bility, for the same treatment was sufficient to have destroyed an
| individual in health. In a little more than a week from the com-
mencement of his attack, he closed his eyes in death—a martyr to
the most dangerous of all quackery, that of the “learned" and
diplomatised medical faculty.



80 GLANCE AT THE
284. People generally have no idea of the number of people
who are destroyed by the old school practitioners. Dr. Alcott,
in the first number of his Health Tracts, observes, “An intelli-
gent professor in one of our western colleges, thinks that each
young physician kills, upon the average, about twenty persons,
before he is fairly initiated into his profession.” Now, according
to the Christian Review, there are twenty-seven medical schools
in the United States, with about two thousand seven hundred and
fifty students; and at the lowest calculation, it is probable that
one thousand of these graduate annually, and receive diplomas.
At the same rate, we should have in the space of five years, no
less than five thousand young physicians, fresh from the colleges,
who are ready to engage as practitioners; and if each one should
kill twenty persons, as is suggested by the western professor, the
whole number killed would be on E HUNDRED THous AND.
These, however, are only the acknowledged murders; and if we
were to add those to the list which are not supposed to be the
result of medical treatment, the number would be incalculable.
Well may Thomas Jefferson have exclaimed, “I believe I may
safely affirm that the inexperienced and presumptuous band of
medical tyros let loose upon the world, destroys more human life
in one year than all the Robin Hoods, Cartouches, and Mac-
beths do in a century.”
285. Do physicians who resort to blood-letting and the use of
poisons, ever cure their patients This is a point on which I am
entirely skeptical. For example, suppose an individual is at-
tacked with a violent fever, for which he is bled copiously, blis-
tered on various parts of the body, leeched, or cupped, as the
case may be, dosed with calomel, nitre, digitalis, and sundry other
poisons, and withal forbidden to take the slightest degree of nourish-
ment. Need we be told that in a short time he will be reduced
very low, and his life in all probability despaired of Neverthe-
less, he may ultimately recover, and in that event, the }.
claims the credit of having effected the cure, and is .. to the
skies, perhaps, for his extraordinary skill. We have no evidence,
however, that there was any cure in the case, except that nature,
in her sanative operations, triumphed equally over the disease an
the treatment. This will appear obvious by supposing another
case. Take, for example, an individual in perfect health, and put
him through the above routine of treatment—that is, let him be
bled, blistered, leeched, cupped, starved, and dosed with calomel,
nitre, and other pernicious drugs, and he will soon be as danger-
* See a letter from Thomas Jefferson to Dr. Wistar.
—
OLD SCHOOL PRACTICE OF PHYSIC. 81
ously ill as the patient with the fever, and his chances of recovery
quite as uncertain. Notwithstanding all this, however, if too great
a shock has not been given to his constitutional powers, he may
finally recover, as in the case already cited; but there is no phy-
sician, in this instance, to claim the merit of having performed the
cure; and all that can be said, is, that the treatment which was
supposed to have cured the patient with fever, has given rise to
dangerous and obstinate disease in a healthy individual.
286. There is more philosophy than poetry in the assertion
of Dr. Thomson, that we cannot cure a sick man by the same
means we would employ to kill a well beast.
HOSPITAL CASES.
287. During the winter of 1838–9, I visited the Massachu-
setts General Hospital three times a week, in company with the
physicians and surgeons, and took notes of a majority of the cases
which were under treatment at the time. Some of these cases I
shall now present to the public in a condensed form, but with a
strict regard to accuracy, that it may be known how diseases are
treated in an institution which is under the control of some of the
§. distinguished physicians and medical professors in the United
tates.
288. , MARY E. BLATCHFoRD. This was a young woman with
an eruption of the skin. The backs of her hands, and the whole
of her left arm, were covered with dry looking scales or scabs.
When I first saw her, which was on the 22d of November, 1838,
Dr. Bigelow, the visiting physician to the hospital, said he did
not know what precise name to give the disease.
289. Nov. 26th. To-day a second visit was made; Dr.
Bigelow observed to the class, that the patient was taking Fowler's
solution (a preparation of arsenic)—five drops at a time. He then
turned to the patient and said, “If the medicine causes sickness,
or if your eyelids become swelled or puffy, you must make it
known to the house physician, and he will regulate your doses
accordingly.” - - -
290. Noy. 29th. Bigelow to the class. “Miss Blatchford
has been taking Fowler's solution for a week, but was obliged to
leave it off because it irritated her stomach and eyelids, as it is
Very apt to do. She is now taking the tincture . cantharides,”
(Spanish or blistering flies.)
291. Dec. 8d. No remarks to-day from Dr. Bigelow. The

11
82 GLANCE AT THE
patient told me she was much worse, and that she still continued
to take the tincture of cantharides.
292. Dec. 6th. Bigelow. “Patient has been taking Fowl-
er's solution and tincture of cantharides, but without benefit, and
she has been bled about twelve ounces. She may take sulphur and
supertartrate of potassa, (cream of tartar) one scruple each, night
and morning.
293. Dec. 10th. Bigelow. “You see the back of the
hand is considerably inflamed with cantharides, the application of
which may now be discontinued. I thought I would try the
experiment of blistering one hand, as both of them are covered
with the eruption; by establishing a new disease in this way, both
the old and new diseases may disappear together.”
294, Dr. Bigelow advised no new prescription to-day; the
patient informed me that she was growing worse.
295. Dec. 13th. Bigelow. “I blistered one hand to see
what would be the effect; it is now, you see, pretty well inflam-
ed; it gives more trouble than the other hand, and it remains to
be seen what will be the final result. Patient is pretty much in
statu quo.”
296. Dec. 17th. Bigelow. “The warm bath has been
administered five times, but it has done no good, though it generally
succeeds in cases of this kind.” Turning to Miss B, he said,
“We will put you on a new medicine to-day. You may take half
an ounce of dulcamara" three times a day, beginning with small
doses and gradually increasing the quantity. If it makes you sick
you may take less, but I do not think it will.”
297. Dec. 20th. Bigelow. “Eruption continues the same.
The patient has been bled once. The warm bath made her
worse. I hope we shall make an impression on the disease by
and by. We are now giving the decoction of dulcamara; we
commenced with a small dose, and have carried it up to two
ounces.”
298. Dec. 24th. Bigelow. “Patient says her hands are
better, and her arms worse, especially the right. We are making
an experiment with two different local applications; we have ap-
plied a cataplasm of poppy leaves on one arm, and an ointment of
ammonia and submuriate of mercury, (calomel) on the other.
She is still taking the decoction of dulcamara.”
399. Dec. 27th. Bigelow. “The case seems to have
assumed a chronic form. Hands are better, but arms and other
parts of body worse. Dulcamara has been carried to three ounces,
which is a very large dose. Patient thinks she has as much heat
* A poison, better known as the woody night shade.

OLD SCHOOL PRACTICE OF PHYSIC. 83
as ever in her skin. May change dulcamara for a tonic—may
take one grain of the sulphate of iron made into a pill with sirup,
three times a day.”
300. Dec. 31st. Bigelow. “The medicine ordered at
last visit caused sickness every time it was taken. The disease
is very obstinate; when it gets better in one place it grows worse
in another. Patient has been on low diet; her pulse is feeble,
and there is very little action in her system. She has received
but little benefit thus far from a great variety of remedies; I
thought I would endeavor to make a change in her system by a
change in diet, and have substituted animal food for vegetable.
She is now taking wine, which does not appear to increase the
heat of the skin.”
301. After the class had left, Dr. , under whose treat-
ment Miss B. had been previous to entering the hospital, directed
my attention to the appearance of her arms, and assured me that
they were worse than they had been at any previous time.
302. Jan. 3d. Bigelow. “Hands are better to-day, but
elbows and ankles are in a bad condition. Is taking owymuriate
of mercury;” two grains are put into an ounce of water, and
fifteen drops administered three times a day, increasing one drop
at each dose until it causes sickness, or produces a puffy appear-
ance about the eyes.”
303. Jan. 7th. Bigelow. “Patient says she is no better;
has had a poultice of poppy leaves on left hand; we are giving her
oxymuriate of mercury; may apply an ointment of one part of
turpentine and two of hog's lard.”
304. Jan. 10th. Bigelow. “Eruption is about the same,
and has been very troublesome on ankles, with a good deal of
swelling of feet. She lies in bed principally; when sitting up,
the swelling becomes much worse. She took oxymuriate of
mercury, until the dose was so large as to trouble her stomach a
good deal, and we were obliged to diminish it.”
305. Jan. 14th. Bigelow. “The dose of oxymuriate of
mercury has been lessened so that it does not now trouble her
stomach; we will try it a little longer. We have used various
external applications, as creosote ointment, white precipitate,
anodyne ointment, fomentations, and tincture of cantharides; we
have applied these to separate parts, but have found no advan-
tage in using any of them; the case is one which requires con-
stitutional treatment, rather than local applications. She will prob-
ably get better after a while.”
306. By the way, what does Dr. Bigelow mean by constitu-
* Corrosive sublimate, and a most deadly poison.

84 GLANCE AT THE
tional treatment, if taking corrosive sublimate and other poisons
in enormous quantities, does not come under that appellation ?
307. After the visit on Jan. 14th, Dr. informed me,
what had never been stated by Dr. Bigelow, that Miss Blatch-
ford's disease arose in consequence of having been vaccinated by
Dr. Lewis of Boston. This fact was studiously concealed during
our visits, and I presume it would not have been unbosomed to
me, had it been known that I was opposed to the doctrines of the
medical faculty.
308. Jan. 17th. The remarks of Dr. Bigelow to-day were
principally a repetition of what he said on the 14th. The nurse
told me that the patient had not taken any medicine for five days,
and had a tolerably free diet. She was somewhat better, and
her feet were not so much swelled.
309. Jan. 24th. Bigelow. “Hands and arms are more
irritable than they were. There is some extension of the erup-
tion. Omit creosote ointment on right leg, and apply stramonium
ointment.” -
310. Jan. 24th. Bigelow. “We will pass you by to day.”
311. The patient informed me that she was worse; the erup-
tion was better in her lower limbs, but it had come out worse than
ever on her back.
312. Jan. 31st. Bigelow. “We have left off the stramo-
mium ointment, and now use the creosote; stimulating applications
suit better than those of an anodyne character.”
313. Feb. 4th. Dr. Hale now took the place of Dr. Bigelow
in the hospital, and reported the condition of the patient. He
observed, “She has a violent itching of the hands, and may try a
warm bath.” Here the poor girl burst into tears, and after Dr.
Hale and the class had left the room, the house physician said to
him, “ The warm bath makes her worse; it irritates her skin; she
is crying about it.” Dr. Hale replied, “I did not know that;
then of course we will omit the bath.”
314. April 2d. The patient informed me to-day, although
several weeks had elapsed since I had taken any notes of her case,
that the eruption was still bad on various parts of her body, and her
feet were more or less swelled. She took but little or no medi-
cine, and did not expect to receive any benefit at the hospital.
She was anxious to return home as soon as she was discharged,
which she presumed would be very soon.
315. Dr. Strong, a physician of Boston, who was present
during this visit, recommended the use of Fowler's solution, but
he was told that it had been already tried without success.
316. I never saw the patient after the 2d of April, and do not
know what has been her fate. I have mentioned the case at


OLD SCHOOL PRACTICE OF PHYSIC. 85
greater length than I intended, merely to show the absurdity, and
I may say wickedness, of the fashionable practice of physic.
317. CASE of SALIVATION. This was the case of a lady who
entered the hospital on the 19th of June. Both knee joints were
much swelled. Dr. Hayward, the visiting surgeon to the hos-
pital, said that it was owing to her having been salivated, and that
such swellings often arose from that cause.
31S. NANcy Nichols. This woman was about 25 or 28
years old. I first saw her on the 13th of Dec. Dr. Bigelow said,
“The patient tells me she has been sick about five weeks; we
are yet undecided about her case; don’t know whether she has
tubercles in her lungs or not; she requires further examination;
she took a compound pill of calomel, antimony, and opium last
night; she may take an infusion of senna to-day.”
319. Dec. 17th. Bigelow. “The patient coughed a good
deal in the night; complains of nausea; sputa chiefly a watery and
mucous fluid; lungs no doubt contain tubercles; may take infusion
of rhubarb, one ounce, rochelle salt, two drachms.”
320. Dec. 20th. Bigelow. “Reports rather better. Pulse
104. Coughs rather less. Sputa contains some purulent masses.
Breathing short. I presume there are tubercles in her lungs,
but this is by no means certain. Took a Dover's powder last
night; has been taking colchicum three times a day.”
321. Dec. 24th. Bigelow. “Some indications of tuber-
cles; purulent sputa; we give her a Dover’s powder at night, and
antimony and barley water through the day.”
322. Dec. 27th. Bigelow. “Cough as usual, with purulent
sputa. Complains of faintness of stomach; may apply a blister
over that region.”
323. Dec. 31st. Bigelow. “Something better. Has chills
in the morning. Sputa not so purulent. Has commenced taking
a pill of calomel, opium, and antimony, at night.”
324. Jan. 3d. During this visit, I observed that the pa-
tient was in bed for the first time. She looked pale and de-
bilitated, and had considerable cough. The poisons she had taken
had done their work effectually. Nothing was said by Dr. Bige-
low of the treatment.
325. Jan. 7th. Bigelow. “Reports about the same. Is
taking a decoction of Iceland moss, and occasionally a cathartic.”
326. Jan., 14th. Bigelow. “Cough is the same; has a
sense of trembling and sinking at the stomach; raises purulent
spºº, takes occasional cathartics, and a decoction of Iceland
moSS.

86 GLANCE AT THE
327. The patient was in bed to-day, and looked exceedingly
pale and emaciated.
328. Jan. 17th. Bigelow. “Cough as usual. Has heats
and chills in the evening, and perspiration at night. Takes de-
coction of Iceland moss, and at night a Dover's powder. The
latter may be omitted; give her hyoscyamus * in its stead.”
329. Jan. 21st. Bigelow. “Has cold sweats at night; has
been taking Iceland moss, but is now sick of it; may discontinue
it and take acetate of morphia.”f
330. Jan. 24th. Bigelow. “Feels more comfortable, but
cough and expectoration are the same. Continues the acetate of
morphia. This is a case of phthisis (pulmonary consumption)
with purulent expectoration.”
331; Jan. 28. Bigelow. “You see in this cup the circum-
scribed masses of pus floating in water and mucus. Pulse 1.12;
moderate perspiration in the night; much cough. Takes a solu-
tion of morphia at night; also salts and the compound eatract of
colocynth to keep her bowels open.”
Feb. 4th. Bigelow. “Feels as heretofore; may take
infusion of rhubarb, one and a half ounces.”
The patient, to-day, looked more cadaverous than usual,
and it was evident that she could not long survive.
234. Feb. 12th. On the assembling of the class this morn-
ing, the patient’s bed was vacant; Dr. Bigelow stated that she
was dead. She had paid the forfeit of her life to the quackery of
the “learned” medical profession. Any comments on the treat-
ment of her case would perhaps be superfluous. It will be re-
membered, however, that when she entered the hospital, it was
not decided that she had pulmonary consumption, but this dis-
ease was soon developed after she began to take calomel, and
other poisons; and in a little more than eight weeks she was a
corpse. That her life might have been prolonged by proper man-
agement for many years, I have not the slightest doubt, if I am to
judge from the success which has attended the American practice in
similar cases. Nancy Nichols was not the only patient in the hos:
pital, however, in whom I was confident pulmonary consumption had
been developed by the use of poisonous drugs, together with
bleeding, blistering, and the various accompaniments of the old
school medical practice.
335. PARALysis or PALsy. This was the case of a lady, 40
or 45 years old, who entered the hospital on the 31st of December,
* Henbane, and an active poison. -
# The narcotic principle of opium, and, of course, more violent in its action
than the opium itself.
OLD SCHOOL PRACTICE OF PHYSIC. 87
with palsy of the right side. She was attacked suddenly in bed,
about three weeks previous to that time. At our first visit Dr.
Bigelow said nothing of the treatment he was pursuing. I was in-
formed by the nurse, however, that the only thing which the pa-
tient had been ordered to take, was barley water, with a little of
the sirup of orange peel. Her case is interesting, because she
was not dosed with pernicious drugs.
336. At our visit on the 3d of January, Dr. Bigelow re-
marked that the patient was gradually improving, and that too on
the mildest treatment; but he did not state at the time what that
treatment was. On the 17th of January, however, he observed
in a clinical lecture, that nothing had been done for the case what-
ever, except to administer a little barley water and the sirup of
orange peel. He had tried the eageriment, he said, to see how
it would succeed, and he was happy to find that the patient had
gradually improved from the time that she entered the hospital.
337. From the specimens of practice which I have seen in the
above institution, I think I may safely say that Dr. Bigelow, and
his medical brethren, would succeed much better in the management
of disease, if they would throw aside their poisonous drugs, and
rely exclusively, as in the case above reported, on barley water
and the sirup of orange peel.
338. J. P. Russ ELL. This gentleman, aged 23, entered the
hospital on the 19th of January, with disease of the hip. He was
in the surgical ward, and consequently under treatment by Dr.
Hayward. I know nothing of the history of his case. I first
saw him on the 26th of January, when Dr. Hayward remarked,
“He has been cupped in the vicinity of the hip, and has had
leeches applied. His general health is good, but he is obliged to
take opium at night, which has made his bowels costive. He
may be cupped again.”
339. During my visit on the 16th of February, Mr. Rus-
sell stated to me that his knee was stiff and considerably
bent, and he asked me with a good deal of anxiety, whether I
thought there was danger of its remaining stiff for life. I did not
feel at liberty to answer the question explicitly, for reasons that
may appear obvious to the reader, but I was fearful, notwithstand-
ing, from the course of treatment that had been pursued, that the
patient would ultimately realize his worst suspicions.
340; I saw Mr. Russell again on the 23d of February, when
he told me he had been much worse for some days past. He
had been cupped, but it afforded him no relief. His hip, he
said, was very painful, and felt as though the joint was extensively
diseased.



88 GLANCE AT THE
341. I saw nothing more of Mr. Russell, until about three
months ago, when I met him accidentally at an infirmary, where
he was taking courses of medicine. His limb was considerably
deformed, and about three inches shorter than the other. He
expressed a thousand regrets that I had not told him frankly in
the hospital, that I considered his treatment injudicious, for then,
said he, I should have been saved my present incurable lameness,
and deformity, to say nothing of my long and painful sufferings.
ABSCESS.
342. A lad, nineteen years old, entered the hospital with a
large abscess in the region of the loins. It had been forming
several weeks. It was suggested that it might be connected with
disease or ulceration of the spine, but this was not determined.
343. Professor Warren, who examined the case, said, “If I
had such an abscess, I should do nothing for it; I should go about
my business as if nothing was the matter, and make myself as
cheerful as possible. I think the boy will be better without
treatment.”
344. The above remarks were tolerably conclusive evidence
that Dr. Warren had no confidence in the employment of drugs,
but nevertheless, instead of leaving the patient to nature, he order-
ed the use of iodine, in opposition, as a matter of course, to his
own conscientious scruples. When will medical men learn to be
honest and consistent?
345. DEATH of Miss FitzgerALD. The unexpected
death of this young woman furnished another melancholy example
of the danger and uncertainty of the old school practice. During
our visits to the hospital for six or seven weeks, we had always
found her sitting by her bed-side, without having the appearance
of one who was laboring under disease; but on the 11th of Feb-
ruary she was missing, and on enquiry, it was found that she had
died suddenly the preceding night. After visiting the different
wards, we were invited into the clinical lecture room, to witness
a dissection of her heart. Dr. Hale, who had just taken the place
of Dr. Bigelow in the hospital, made the dissection. He said
he had prescribed for the patient without being fully acquainted
with the case, and hence its unfortunate termination. The catame-
nia had been irregular, and as it was about the time for their appear-
ance, he had ventured upon pretty active treatment, with a view to
their restoration. Had he been aware of the existence of so much
organic disease of the heart, he would have taken a different course.
OLD SCHOOL PRACTICE OF PHYSIC. 89
He had given aloes, sulphate of iron, and cantharides, to re-establish
the catamenial function; and contrary to his expectation, vomiting,
and a great disturbance of the heart, were the consequences. He
acknowledged his error, and hoped that it would be a lesson to
the students and medical gentlemen around him. In a word, it
was apparent, from the remarks of Dr. Hale, that he WaS COn-
scious of having killed Miss Fitzgerald by injudicious manage-
ment, though he was not willing to acknowledge it in so many
words. I do not attach any blame to Dr. Hale, however, but to the
system upon which he practises, for I presume, from all I saw of
him at the hospital, he is quite as prudent and successful in the
treatment of disease, as any other medical man who makes use of
poisonous or deleterious agents.
BLOOD-LETTING.
346. Without pretending to give a history of blood-letting, I
will remark that it was in use by Hippocrates, who flourished
nearly five hundred years before Christ; and it would seem that he
was quite as heroic in its employment as some of our modern
practitioners. In quinsies, and other acute disorders, he bled in
both arms at once, and in some particular cases, he opened veins
in various parts of the body at the same time, as those of the feet,
legs, forehead, and nostrils. He considered blood-letting per-
nicious in infancy and in old age, however, and had recourse to it
only when the patient was strong, vigorous, and middle aged.
347. Hippocrates entertained an opinion that blood should be
taken from the vein nearest to the part affected, but the Arabian
º many centuries after his time, promulgated a contrary
octrine. For example, they said that in pleurisy, “the blood
ought to be drawn from the side opposite to the disease; and
this trifling difference of opinion,” observes Dr. Clutterbuck,
“ was the cause of great and lasting dissension in the schools of
physic, and entire volumes were written and published on the
different sides of the question. To such a height, indeed, was
the dispute carried, that the University of Salamanca, in the fif-
teenth century, took part with the Arabians, and made a decree
that no one should dare let blood from the side affected; and,
to add authority to their decree, they endeavored to procure an
edict from the emperor, Charles the Fifth, to confirm it, alleging
that the contrary practice was as prejudicial to the community as
Luther's heresy itself.”
Clutterbuck's Lectures on Blood-letting, vide Select Medical Library,
vol. iii. No. 7.


12

90 GLANCE AT THE
348. Preposterous as the above may appear, it has its paral-
lel at the present day in what is termed cross bleeding. “This,”
says Magendie, in a strain of well merited satire, “is reserved for
great and important occasions,” and in illustration, he observes,
“Suppose a case in which ordinary remedies have failed. A
consultation of medical celebrities is of course held, and upon what
do you suppose the deliberation sometimes turns? Upon the pro-
priety of opening a vein in the right arm, and at the same time
another in the left foot. I was actually, some time past,” he con-
tinues, “one of a consulting party, among whom this proposition
led to a discussion worthy of taking rank with the richest scenes
of comedy. I do not seek to excite your hilarity; the patient
was a dying man who had but a few moments to live. Who
would have dreamed that in an age which judges with such sever-
ity the prejudices of our fathers, men could be found not only to
tolerate, but actually to extol such superannuated practices. Is
there, I would ask, such a very great difference between the em-
ployment of amulets, which have supplied such a capital butt for
our gibes, and the confidence attributed to bleedings, the jets of
which cross each other in the form of an X. The day will come,
and may it not be far removed, when the profession will refuse to
believe, that in the year of grace, 1837, conscientious practition-
ers of the capital of France, were found to countenance such mon-
strous absurdities.”
349. Blood-letting is extensively practised in the United
States, and is productive of immense evil. It debilitates the sys-
tem, impairs the functions of the vital organs, and lays the founda-
tion of obstinate and incurable diseases. “In the blood is the
life,” says the inspired volume, and this is obviously true; for all
the secretions are derived from the blood, as the bile, saliva, and
gastric juice; and the minutest parts of the body, whether they
consist of bone, cartilage, muscle, tendon, ligament, or any other
substance, or tissue, are formed from this fluid. It is also the
medium by which heat is diffused throughout the system, imparting
to it the necessary degree of warmth in all the changes and vicis-
itudes of climate. Should the brain, through a failure of the ac-
tion of the heart, cease, even for a moment, to receive its accus-
tomed supply of blood, a state of unconsciousness would be the
immediate result.
350. M. Louis, one of the great medical lights in Paris at the
* Lectures on the Blood, delivered at the College of France in 1837–8, vide
Select Medical Library, for 1839.
ol, D SCHOOL PRACTICE OF PHYSIC. 91
present time, has published a work on the Effects of Blood-letting
in some Inflammatory Diseases,” which shows that he does not es-
teem the lancet so highly as some of his cotemporaries. He
commences his work by saying, “The results of my researches
on the effects of blood-letting in inflammation, are so little in ac-
cordance with the general opinion, that it is not without a degree
of hesitation I have decided to publish them.”
351. In his remarks on the effects of blood-letting in pleuro-
pneumonia, (inflammation of the lungs and pleura) he says, “The
cases I am about to investigate are seventy-eight in number;
twenty-eight of them proved fatal; and all were in a state of per-
fect health at the time when the first symptoms were developed.”
252. M. Louis has furnished a table, showing the effects of
blood-letting when commenced on certain days after the first ap-
pearance of the disease, and in the column referring to those who
were bled on the sixth day, we have the subjoined statistical in-
formation: The first patient was bled once, and the disease
lasted thirteen days; the second patient was bled twice, and the
disease lasted sixteen days; the third patient was bled three times,
and the disease lasted twenty-three days; and the fourth patient
was bled five times, and the disease lasted thirty-five days. It
would seem, therefore, that the disease became obstinate in pro-
portion to the number of bleedings; but this ratio is not uniform
throughout the tables, for in one case the patient was bled only
twice, and the disease lasted forty days. In this instance, how-
ever, it is probable that the curative powers of nature were coun-
teracted by the administration of some poison, as tartarized anti-
mony, which was a favorite prescription with M. Louis in inflam-
mation of the lungs.
353. Speaking of the successful cases out of the seventy-
eight, the author observes, “It appears that blood-letting has had
but a very limited influence on the course of the disease. * * *
The facts relative to the fatal cases confirm these conclusions, and
seem still further to limit the utility of blood-letting.”
354. “Pain,” says M. Louis, “was not arrested by blood-
letting, in any of the cases bled within the first four days of the
disease; on the contrary, it generally increased during the suc-
ceeding twelve or twenty-four hours; and its mean duration, in
proportion to that of the disease, was from six to eight days, ac-
cording as the patients were bled early or late in the málady.”
He adds that “it was still present on the sixth day in a patient
who was bled on the second day, and in this case fifty ounces of
blood were abstracted by two venesections within forty-eight
* Translated by Dr. Putnam, and published in Boston with Preface and Ap-
pendix, by James Jackson, M. D.









92 GLANCE AT THE
hours, and on the fourth day, five or six ounces, more by the ap-
plication of twenty leeches over the painful part.” -
355. Acknowledging the comparative inutility of blood-letting,
as it was employed by himself, M. Louis asks, “Should we ob-
tain more important results, if, as is practised in England, the first
bleedings were carried to syncope or fainting This practice de-
serves a trial, but great success cannot, I think, be anticipated;
since many cases, the history of which I have drawn up, and
which were fatal, were bled to a sufficient extent. Among these
was one who was bled on the day of the attack, and who never-
theless died on the sixth; the vein having been opened five times,
and the quantity of blood lost twelve or sixteen ounces each bleeding.”
356. Among the practical deductions of M. Louis, with re-
gard to the effects of blood-letting are, that it has very little influ-
ence on the progress of quinsy, erysipelas of the face, and in-
flammation of the lungs, and that its influence is not more evi-
dent in the cases bled copiously and repeatedly, than in those
bled only once and to a small amount. In a word, we are
led to infer that blood-letting is neither of much utility in the
beginning, middle, nor toward the close of an inflammatory dis-
ease. The author also remarks that in the hospital la Pitié, he
has employed blood-letting in a great many cases of inflammation
of the lungs, to the extent of twenty or twenty-five ounces and
more, or even to fainting, and yet he has never seen these inflam-
mations arrested in a single instance.
357. That no one may question the high standing of M. Louis
in the medical profession, I will here enumerate a few of his titles,
as they are introduced by himself in his works: Physician to the
Hospital la Pitié, Perpetual President of the Medical Society of
Observation, Member of the Royal Academy of Medicine of
Paris, Corresponding Member of the Medical Society of Mar-
seilles, of ..". erial Medico-Chirurgical Society of St. Peters-
burg, and of the Medical Society of Edinburgh; Member of the
Legion of Honor. -
358. Dr. Marshall Hall of London, has published a work
entitled Researches Relative to the Morbid and Curative effects
of Loss of Blood, which exhibits in a striking manner, though not
intentionally perhaps, the horrible consequences which result
from the use of the lancet. He has devoted a few chapters to
an account of the immediate effects of loss of blood, and among
these he places syncope or fainting as the most familiar, remark-
ing that in ordinary cases “the patient first experiences a degree
of vertigo, to which the loss of consciousness succeeds; the
respiration is affected in proportion to the degree of insensibility,

OLD SCHOOL PRACTICE OF PHYSIC. 93
- - T-
being suspended until the painful sensation produced rouses the
patient to draw deep and repeated sighs, and then suspended as
before; the beat of the heart and of the pulse is slow and weak;
the face and general surface become pale, cool, and bedeved
with perspiration; the stomach is apt to be affected with eructa-
tion, or sickness. On recovery there is perhaps a momentary
delirium, yawning, and a return of consciousness; irregular sigh-
ing and breathing; and a gradual return of the pulse.”
359. Convulsions, according to Dr. Hall, are not unfre-
quently the immediate result of blood-letting. He mentions the
following case in illustration.
360. “A physician, aged thirty-four, became affected with
inflammation of the larynx, (upper part of the windpipe.) He was
bled freely on two successive mornings at his own instance. In
the afternoon of the second day, the disease being unsubdued, he
was bled a third time, placed in a rather inclined position upon a
sofa. The blood was allowed to flow until thirty-four ounces
were taken. He then suddenly fell upon the floor violently
convulsed; and he remained for some time afterward in such a
state of syncope as to render his recovery very doubtful; being
carried to bed, however, and cordials administered, he slowly
recovered.”
361. Dr. Hall quotes a similar case from Mr. Travers, who
remarks, “Some patients cannot bear the loss of blood; it gives
rise to prostration, attended with convulsions, in which the cir-
culation fails so alarmingly as to require watching for several
hours, and the repeated administration of stimulants to restore it.
A very intelligent surgeon in the neighborhood of London, in
bleeding a clergyman to the extent of twenty ounces, whose
idiosyncracy in this respect was not known, was compelled to
remain with him during the whole of that day; and notwithstand-
ing frequent recourse to brandy, continued long apprehensive for
the patient’s life. He represented the convulsions, which return-
ed in paroxysms, as resembling the puerperal (child-bed) in their
severest forms.”
362. In addition to syncope and convulsions, Dr. Hall asserts
that blood-letting is the immediate cause, in many instances, of
delirium, mania, stupor, and sudden dissolution. Of the latter,
he has detailed a number of aggravated cases, but I have only
room for the following.
393. “A gentleman nearly seventy years of age, the subject
of frequent gouty paroxysms, whose constitution was broken
down, and who was of a pallid complexion, was suddenly seized
with severe pain in the side, hot skin. quick full pulse, and diffi-
culty in breathing. A physician was consulted, who recommend-






























94 GLANCE AT THE
ed the abstraction of six ounces of blood. The arm was tied up
accordingly, the patient being in bed; before two ounces were
taken away, his pulse sunk, and heavy perspiration came on, with
faintness. The patient was placed horizontally in bed, and it was
some length of time before his medical attendant deemed it pru-
dent to leave the house.
364. “The blood taken away, manifested the usual character
of inflammation, but the pain in the side was not removed. On
the following morning he was again visited by his physician, who
finding that the pain and other symptoms detailed were not re-
lieved, directed the bleeding to be repeated to six ounces; this
was again attempted, but before one ounce escaped, he became so
alarmingly ſaint, that he fell back in the bed, the circulation being
suspended for a length of time, and his dissolution expected to
take place. Stimulants of every description which could at the
moment be brought forward, were resorted to ; after a consider-
able lapse of time, the heart’s action was feebly renewed, but its
power was never again restored; and the pain in his side was
not relieved. From this time he progressively sank; and in a
short time expired.”
365. Dr. Hall, in his work on Puerperal Diseases, remarks,
“I have repeatedly known the effects of loss of blood to be
mistaken for inflammation of the brain, on the one hand, and
disease of the heart on the other.” In a subsequent paragraph,
he says, “one of the characteristics of puerperal affections,
consists in the faintishness, gasping, or feeling of dissolution which
sometimes follows even a slight blood-letting;” and he adds that
“an awfully sudden death has immediately ensued upon a full
and MISTAKEN blood-letting at this critical period.”
366. Magendie, the celebrated French physiologist, delivered
a course of lectures on the blood, at the College of France, in
1837–8,” as I have already stated, in which he demonstrated in
the most satisfactory manner, that blood-letting, instead of curing
inflammatory disorders, will produce them in healthy individuals.
He observes, “We are justified in proclaiming, that men who
bleed without giving themselves the least uneasiness about the
disorders that follow the removal of blood, both in that fluid itself,
and in the different organs of the body; who look on these
disorders as curable by blood-letting, while they are in reality
produced by it, act with most reprehensible blindness. In simple
language, they do mischief when they imagine they are doing
good; and in many an instance, on their doing that mischief or
* Since translated and published in the Select Medical Library for 1839.

OLD SCHOOL PRACTICE OF PHYSIC. 95
that good, the death or recovery of the patient depends.” Again,
he remarks, “The universal practice of the ordinary run of
medical men, consists in opening a vein, whenever the pulse is in
the least frequent at the outset of an acute disease. If recovery
takes place shortly after, they maintain that they did well to bleed,
for by so doing they prevented the occurrence of inflammation;
if the disease follows its course, they congratulate themselves still
more warmly on having let the patient’s blood, and only regret
their having drawn so little.” In another place he says, “You
must remember that the treatment by blood-letting, employed in
almost every case of acute disease, but especially in pleurisy and
inflammation of the lungs, is one of the means of inducing these
very diseases in healthy animals.” To show that Magendie has
blended theory with practice, to a certain extent, he further
observes, “Truth to say, I bleed my patients very little, and I do
. perceive that they fare a whit worse than those of my neigh-
ors.”
367. Magendie has shown that if the blood is extremely thin
and watery—that is, if it contains an undue proportion of serum—
it cannot circulate freely through the minute or capillary vessels,
but on the contrary, stagnates within them, and is effused into the
surrounding parts or organs, constituting “ the various disorders,”
to use his own language, “which pathologists have vainly attempt-
ed to explain by the words irritation and inflammation.” In
proof of his doctrine that a superabundance of serum interferes with
the passage of the blood through the capillaries, he remarks, that if
we endeavor to introduce water into a tube of extremely small
diameter, the liquid will not enter it, no matter what force be
employed; but if a certain quantity of any mucilaginous substance,
as gum, or gelatin, be added to it, so as to render it more viscid,
the attempt to inject the tube becomes successful at once. On
the same principle he contends, that if the blood is materially
changed in its composition, by disease, or otherwise, and has lost
the viscidity which properly belongs to it, it cannot pass through
the capillary vessels, any more than the non-mucilaginous water
can pass through the minute tube. Having decided the point,
therefore, that a morbid increase of the serum of the blood is a
cause of inflammatory diseases, for the reasons already assigned,
Magendie asserts that the greater the proportion of serum, the
more violently will the inflammation be developed; and he has
shown by experiments on animals, startling as it may appear to
those who have not given the subject a thought, that blood-letting
has a direct tendency to augment the proportion of serum, and
thereby to induce various disorders, and finally death. “I am
anxious,” said he to his class, “to recall to your attention the
96 GLANCE AT THE
experiments we made last session on the blood. You learned,
through them, the influence that fluid exercises on our organs.
You saw me produce at will in animals, the majority of the striking
phenomena determined by the most terrible diseases, for the relief
of which, art is powerless. You saw me give rise, at my pleasure,
to inflammation of the lungs, scurvy, yellow fever, and typhoid fever,
not to mention a number of other affections, which, so to speak, I
called into being before you.”
368. Again, the lecturer remarks, “I have told you that when
a first bleeding fails, a second, a third, a fourth, may, a still greater
number, are frequently had recourse to. These repeated blood-
lettings not only diminish the loss of blood in circulation, but also
alter its constitution. Now as aqueous drinks are the only means
wherewith the patient is allowed to replace the blood he has lost,
it follows that that fluid loses its proper share of viscidity and
coagulability, and acquires, proportionately, a tendency to extrava-
sation. When we observe obstruction of the pulmonary circula-
tion supervene towards the decline of acute affections that have
been vigorously treated by blood-letting, it is rational to suppose
that the escape of blood from its vessels is due to its having lost
its normal or healthful properties. You persist in bleeding, and
the severity of the symptoms increases; it is fair to enquire if it
be not these blood-ſettings that hasten the fatal termination of the
cases.”
369. The above extract leads me to remark, that during the
prevalence of the yellow fever in Philadelphia in 1793, Dr. Rush
was charged by Dr. Currie and others, with having killed many
of his patients by bleeding them copiously; but Dr. Rush replied
that .. did not draw an ounce of blood too much, for hemor-
rhage frequently occurred after a third, a fourth, and in one in-
stance after a sixth bleeding.” According to Magendie, how-
ever, these hemorrhages were the result of the repeated bleedings,
instead of the bleedings having any tendency to check them; and
it is fair to infer that Dr. Rush, and his followers, by their unhal-
lowed use of the lancet, destroyed thousands of precious lives.
370. As a further extract from Magendie, showing the per-
nicious effects of blood-letting, I select the following.
371. “Here is the animal I pointed out to you in my last
lecture as being affected with commencing ophthalmia (inflamma-
tion of the eye), and as presenting hemorrhagic spots on the
skin, where the hair had fallen off.” (The animal, it will be
borne in mind, had been bled.) “To-day the eyes are in a more
advanced stage of the disease—the left is unfit for exercising vis-
* Cobbett’s Works, vol. xi. p. 261.
l

ol, D SCHOOL PRACTICE OF PHYSIC. 97
ion. The ulcerations I showed you have extended more "...".
perforation of the cornea (one of the external membranes of the
eye) is perceptible in two or three places. The aqueous humor
(one of the fluids of the eye) has disappeared. Do you suppose
that by applying leeches round the orbit we should have succeed-
ed in modifying the pus-like secretion, and arresting the progress
of disorganization No.: so utterly absurd does the notion appear
to me, that I would not so much as make the trial; nevertheless,
the very treatment, which I am unwilling to try on brutes, is daily
had recourse to in the case of the human subject.”
372. In another lecture Magendie said to his hearers, “Sev-
eral blood-lettings have been practised on this greyhound—and the
blood, after being deprived of its fibrine, re-injected. Besides the
usual phenomena in such cases, the skin, which was perfectly
healthy when we commenced, presents ulcerated patches of vari-
ous sizes on the surface of his body.”
373. Without making any further extracts from Magendie, I
will remark, that he has done the public an eminent service, by
the bold and fearless manner in which he has attacked the practice
of blood-letting; and I am happy to state, that many medical men
in this country, who have perused his lectures, have already
thrown aside the lancet in disgust and abhorrence.
374. “For examples of boldness in the use of the lancet,”
says Dr. Clutterbuck, “I need only refer to the practice of
some of our surgeons. In one of the great hospitals of this me-
tropolis (London) a case occurred lately, where 128 ounces of
blood (8 lbs., or 1 gallon ) were drawn at one time, in order, by
inducing syncope, to facilitate the reduction of a dislocation of the
thigh. The patient lived a week afterwards, and then, as is said,
died of inflammation of the vein punctured.”
375. Dr. Physic, who has been styled the father of American
Surgery, was attacked in 1797 with yellow fever, and was bled
by Dr. Dewees to the extent of 176 ounces. What effect this
loss of blood had upon his health and constitution, I shall not pre-
tend to say, but Dr. Horner, in his Necrological Notice of Dr.
Physic, remarks, “I have known him intimately since 1819, and
may say he never passed a day without some sensation of pain,
feebleness, and derangement in his system—sometimes a catarrh–
at other times a headach—sometimes pains in his kidneys—some-
times dyspepsia—at other times dropsical swellings of the legs—
and always a small, feeble, wiry pulse, irregular, and indicative of
ossification, (conversion into bone) or some other change about
* Lectures on Blood-letting, vide Select Medical Library, vol. iii. No. 7.

13
98 GLANCE AT THE
the left valves of the heart. To these were added frequent exas-
perations of his habitual disorders—catarrh and nephritis, (inflam-
mation of the kidney) amounting to threatening illness, and from
which he recovered very slowly. * * * For several years
his debility was so great, that when the business of the day was
over, he had to lie down for mere animal repose, and his common
hour for retiring to bed was nine o'clock.”
376. Dr. Mackintosh, in his remarks on blood-letting in in-
flammation of the lungs, remarks, “I am not an advocate for the
heroic practice of taking seventy or eighty ounces of blood at one
operation—the largest bleeding I can boast of was fifty-six oun-
ces.” He adds, “I have the history of a case before me, in
which one hundred and ninety-two ounces were taken from one in-
dividual; but I am persuaded, that if he had lost two thirds less,
it would have been better for him. Several months afterwards he
was weak and miserable, and it appeared very doubtful that he
ever could regain his health. On one occasion, early in life, I
very nearly lost a patient, from whom I had taken, at different
times, in the course of four days, one hundred and twenty ounces
of blood, but who recovered after the exhibition of stimulants.
Within the last fifteen years, I have seen several cases where con-
siderable injury had been inflicted by very large bleedings, the
medical attendants having allowed themselves to be misdirected
by the continuance of dyspnoea, (difficult breathing) which in-
creased after each abstraction of blood. It was evident that this
was owing to a want of sufficient blood in the system. In one in-
stance, the patient was on the brink of the grave, with a pale sunk
countenance, and cold extremities; the strongest stimulants were
administered, along with large opiates, and all these cases eventu-
ally recovered.”
377. “To show the extent to which bleeding has been car-
ried in hydrophobia,” says Dr. Mackintosh, in his observations
on the treatment of this disease, “I may mention a case which oc-
curred in the practice of Professor Trolliet. The patient was
bled to the extent of five pounds, when the water-dread first ap-
peared. In a few hours afterwards, the operation was repeated
to the extent of eighteen ounces, when syncope took place. In
four hours subsequently to the last bleeding, fourteen ounces were
abstracted; and in four hours after that, the patient died, being
twelve hours from the commencement of the hydrophobia. It
was remarked, that the symptoms became more aggravated after
each bleeding.”
378. Erasistratus, a celebrated Greek physician, who lived
about three hundred years before Christ, prohibited blood-letting
* Practice of Physic, 2d American edition, vol. i. p. 50s, and vol. ii. p. 143.

old School, PRACTICE OF PHYSIC. 99
in the treatment of diseases, and Dr. Clutterbuck, in announcing
this fact, remarks that the followers of Erasistratus made many
“frivolous objections to the practice of bleeding, such as that it is
not always easy to discover the vein proper to be opened, and
that there is even danger of opening an artery instead of a vein;
that many persons fall into a state of syncope either before or
after the operation; and that some have actually died of fright
under it; that we cannot always tell the precise quantity of blood
required to be taken in any particular case, in order to subdue
the disease; and that if less than this be taken it does no good,
and if more, we run the risk of killing the patient.”
379. With regard to the two latter objections, however “frivo-
lous” they may appear to Dr. Clutterbuck, they seem to have some
weight with his cotemporary, Dr. Mackintosh, who says, “No
physician, however wise and experienced, can tell what quantity
of blood ought to be taken in any given case. To bleed in a
quantity much under that which is required to subdue a disease
completely, is almost worse practice than not to bleed at all; be-
cause the patientis robbed of much strength, without destroying or
decidedly mitigating the diseased action, and thereby the subse-
quent treatment is embarrassed.”f
380. One of the arguments in favor of blood-letting is, that
an individual often becomes fat by being bled frequently and in
small quantities. Van Sweiten mentions the case of a woman
who was bled more than sixty times in one year, and who mean-
while became extremely corpulent. It will be seen, however,
that in cases such as the above, there is no actual increase of
flesh, but a bloated or dropsical condition of the patient, arising
from a derangement of function in the absorbent vessels; and it is
well known that dropsies of an inveterate character are frequently
the result of copious blood-lettings.
381. Dr. Dunglison, in his General Therapeutics, page 185,
remarks, “When an individual is attacked with haemoptysis,
(bleeding from the lungs) the greatest alarm is usually felt, and in
all cases it is expected, that the practitioner should have recourse
to blood-letting to arrest the flow. Such is the opinion of the
vulgar, and occasionally it is that of the professional attendant
also. This is not, however, philosophy. Every one, who has
had an opportunity of seeing many cases of bleeding from the lungs,
is aware, that the flow of blood may be arrested, at a less expense
Lectures on Blood-letting, vide Select Medical Library, vol. iii. No. 7.
t Practice of Physic, 2d American edition, vol. ii. p. 103



100 GLANCE AT THE
of fluid, when due attention is paid to ventilation and to posture,
than when the lancet is used. A coagulum soon forms around
the ruptured or transuding vessel, and the hemorrhage ceases.”
382. In suspended animation, says Dr. Currie, in his work on
the art of restoring persons, apparently dead, to life, blood-letting
has been generally thought indispensable. The practice, how-
ever, he adds, does not appear to have been founded upon any
natural principle at first, and has been continued from the force of
custom, rather than from any experience of its good effects.
383. To bleed just as reaction is about to take place, while
the heart is struggling to propel the blood to the different parts of
the body, as a medical professor has expressed it, is highly dan-
gerous; and the first touch of the lancet, by weakening the already
enfeebled powers of life, may seal the patient’s fate, and render
his recovery impossible. -
384. Some of our most distinguished medical authors, even
while they advocate the employment of blood-letting, are prone to
speak of it as a dangerous or hazardous remedy.
385. The famous Broussais remarks, “General or local
bleedings in a person who is deficient in blood generally, always
produce much uneasiness, increase its accumulation in the internal
organs, and often in that way give rise to convulsions and fever.”
386. A London physician says, “It is a bad principle to
bleed young people; it lays the foundation for a larger quantity of
blood being formed than should be.”f
387. “Large and often repeated blood-letting,” say the Amer-
ican editors of Dr. Hall’s Practice of Medicine, page 87, “tends
to the establishment of debility and anemia in some subjects, and
of reaction or of plethora in others.”
388. Dr. Hall says in the same work, page 138, “Dogs fed
upon indigestible food by M. Magendie, and bled to a state of ex-
haustion by myself, became affected with inflammation of the eye,
tending to ulceration.”
389. “The ordinary remitting fevers of the temperate lati-
tudes,” says Dr. Eberle, in his Practice of Mediciné, vol. i. p.
135, “often terminate in intermitting fevers before the final dis-
appearance of the disease; and it is not uncommon for the milder
varieties of the malady to assume the intermittent form at an early
period of their course. This conversion of form appears to be
* Broussais's Pathology, p. 514.
# London Practice of Midwifery, 4th London edition, p. 29.
01, D SCH00L PRACTICE OF PHYSIC. 101
particularly favored by blood-letting practised during the first few
days of the fever.” -
390. Professor Lobstein, in his well known work on Blood-
letting, says, “Were bleeding and mercury totally prohibited, a
great many physicians would find themselves in a sad dilemma—
their time easily disposed of. It is astonishing that so many
physicians have fallen into this extravagance. Blood, as the most
precious matter of life, is lavishingly squandered where there is no
necessity; yes, often without knowledge for what purport. * * *
So far from blood-letting being beneficial, it is productive of the
most serious and fatal effects. Should I contribute by these
remarks, to save more lives in future, and arrest this cruel prac-
tice, I shall feel that gratification which arises from the con-
sciousness of having performed a good act. How much it is to
be regretted that such an awful scourge to humanity should exist.
* * * During my residence of fourteen years past in this
happy country of liberty and independence, I am bound to say
that in all my practice of twenty-seven years as a physician,
never have I seen in any part of Europe such extravagance of
blood-letting, as I have seen in this country. How many thousands
of our fellow citizens are sent to an untimely grave! how many
families deprived of their amiable children! how many husbands
deprived of their lovely wives! how many wives of their hus-
bands, who have fallen victims to bleeding; and the same may be
said of mercury.* * * It is proved by numerous º
ments, that the most simple fevers, by bleeding, become nervou
or putrid, to many instances of which I can attest. * * *
nervous affections, bleeding is no remedy; I have seen, durin
the nine years of my residence in Philadelphia, many ladies with
nervous affections, and of such, four . respectable ladies,
whose physician I had the honor to be. Their former physician,
in all slight indispositions, ordered them to be bled, whereby º
became more and more nervous, and they had no nervous
attacks when I stopped the bleeding. I treated in a similar
manner a respectable lady of Philadelphia, who was attacked
with a very severe pleurisy, and I saved her without bleeding,
which to many in that city was very astonishing.”
391. Many frightful accidents occur in the operation of blood-
letting, which deserve a passing notice. An artery may be
wounded, rendering it necessary to perform a painful operation in
securing it with a ligature; or a nerve may be partially cut, giving
rise to excruciating pains, followed by convulsions, or locked
jaw; or inflammation may occur in the punctured vein, “produ-
cing abscesses, the matter of which may sometimes becºme blend-






102 GLANCE AT THE
ed with the circulating fluids, and produce dangerous conse-
quences.” These accidents, and others which I have not
enumerated, are well known to physicians and surgeons, and
occur much more frequently than is imagined. An interesting
young lady in Philadelphia lost her arm, and subsequently her
life, in consequence of being bled, and her case is only one in
a great number which I could mention. Dr. Mackintosh says,
it behoves physicians either to use the lancet themselves, or to
see the operation properly performed, as he is persuaded that
valuable lives are often lost by neglecting these cautions. Dr.
Mackintosh should carry his reform one step further, and renounce
the lancet altogether.
LEECHES.
392. These disgusting animals are employed by the antiphlo-
gistic doctors as a substitute for general blood-letting. Their
bites are more or less dangerous, and death happens not unfre-
quently from the profuse bleeding which they occasion. “A
child may be bled to death by leeches,” says a London physi-
cian, “and an infant has been known to die under the operation of
a single leech.”f - -
393. Boisseau, in his work on Fever, says, “We are bound
in conscience here to note the fact, that leeches are capable of
destroying life. In addition to sufficient evidence to be drawn
from books, the writer of this has himself been a witness, in more
than a single instance, to the fact. The best method of suppres-
sing the hemorrhage, is said to be, to dip a straw in oil of vitriol,
and let a drop run into the bite.” - -
394. The author further observes, “that if the bleeding of
leech bites become excessive, it should be checked by styptics,
or, these ſailing, by cauterization, either with a sharp pointed piece
of lunar caustic, a mineral acid, or the point of a red hot wire.”
396. Professor Bigelow used to remark in his lectures, “I
have known children to be killed by the bites of foreign leeches;
caution should be observed in their application, as it is extremely
difficult to stop the bleeding.”
396. “The bleeding from leech-bites,” says Broussais, in
his Pathology, page 514, “is often excessive in infants and young
subjects, ". skin is full of blood, and the action of the heart
* Cooper's Practice of Surgery, 3d American edition, p. 396.
+ Practice of Physic, 2d American edition, vol. ii. p. 103.
# London Practice of Midwifery, 4th London edition, p. 105.
OLD SCHOOL PRACTICE OF PHYSIC. 103
arrested as soon as ſaintness is perceived.”
397. Dr. Marshall Hall, in his remarks on blood-letting in
infancy and childhood, remarks, “I must, once for all, protest
against the usual plan of applying leeches in infancy, and allowing
the bites to continue to bleed. Nothing can be more indefinite—
nothing more replete with danger. Most of all, it is dangerous to
apply leeches late at night; the bleeding may go on unobserved
and unsuspected, and precipitate the little patient into a state of
irremediable sinking.”
398. “If it is intended that the leech shall draw a large quan-
tity of blood,” says Dr. Hooper, “the end of the tail is cut off,
and then it sucks continually.” - -
399. It is stated in a German periodical, that the syphilis
was communicated to an infant by a leech, which had been pre-
viously employed on a patient with that disease.
400. A foreign medical journal says, it is estimated that there
are two hundred million of leeches consumed annually in Europe,
independently of those exported to the United States, the cost of
which is placed at about two million of dollars. They are prin-
cipally imported from Hamburgh, and are procured from the
north of Europe. People pay dearly for having their health and
lives destroyed. - - -
very emergetic. The bleeding from the bites should therefore be
2x
SCARIFICATION AND CUPPING.
401. Scarification is performed by a surgical instrument,
made in the form of a box, in which are fitted from ten to twenty
lancets. These, by means of a spring or trigger, are all dis-
charged at once, and driven equally into the skin.
402. Scarification was so common among the Egyptians at
one time, says Prosper Alpinus, that out of a hundred children
you might meet in the street, you would scarcely find forty whose
ears were not covered with cotton, on account of the scarification
they had undergone.f
403. “Simple scarification,” remarks Dr. Clutterbuck, “is
sometimes practised as a topical remedy, on parts where the
vessels run superficially, and are easy of access, as on the tonsils
and other parts within the mouth. It is always a question, how-
ever,” says he, “whether, in these cases, more good or harm is
done by the operation, on account of the local irritation produced
* Researches on the Effects of Loss of Blood, p. 166.
t Lectures on Blood-letting, vide, Select Medical Library, vol. iii. No. 7.



104 GLANCE AT THE
by it. Upon this point, practitioners are found to differ; and ex-
perience, which is usually appealed to in these cases, as in many
others, is not altogether so satisfactory and conclusive, as the
advocates of different opinions are apt to imagine.” -
404. When the physician wishes to take more blood than
can be obtained by simple scarification, he makes use of what is
termed a cupping glass, which enables him by rarefying the air
within its cavity, and placing it over the scarifications, to obtain a
considerable flow of blood from the wounded vessels. I need
not occupy further space in describing the barbarous operation.
COUNTER IRRITATION.
405. It is well known that the medical faculty endeavor to
cure one disease by establishing a new one in its stead; and this
they term counter irritation. For instance, if a patient has
inflammation of the lungs, they apply a blister externally over the
affected organs, and inflame the skin; and iſ questioned as to
the propriety of this practice, they will tell you that the new
inflammation is intended to carry off the old one, and in that way
they hope to effect a cure. As another example of counter irri-
tation, | will mention a case which came under my observation
about two years ago, and which I reported at that time in a med-
ical journal, of which I was editor. The patient was a young
man by the name of Gorham Clapp, residing in Boston, who was
afflicted with the hip disease, and after being under treatment by
an eminent physician for five months, without receiving any ben-
efit, he was advised to go to the Massachusetts General Hospital.
Accordingly, he entered that institution on the 20th of March,
1837, where he was ordered to take a dose of salts every other
day, and on the intermediate days to be cupped, which treatment
was continued for six weeks. After this, leeches were applied
near the seat of the disease every other day, and the salts contin-
ued. The patient, as might naturally be expected, continued to
grow worse, and was exceedingly weak and debilitated.
406. No change having occurred for the better, it was deci-
ded that an issue should be established by means of caustic, and
accordingly several thicknesses of adhesive plaster were applied
over the hip, with a space of the requisite dimensions cut out in
the centre, and in this the caustic was confined by another layer
of the adhesive plaster. The caustic was removed in about nine
hours, and an ointment applied. In the course of two or three
* Lectures on Blood-letting, vide Select Medical Library, vol. iii. No. 7.
01, D SCHOOL PRACTICE OF PHYSIC. 105
days, the flesh, which had been deadened by the caustic, came
away, leaving a cavity about half an inch deep, an inch long, and
three quarters of an inch wide. This was filled with dried peas,
to the number of a dozen or more, and retained by bandages.
Every other day the old peas were removed, and fresh ones in-
serted ; and this process was continued for a fortnight. The heat
and moisture of the part caused the peas to swell, giving rise to ex-
cruciating pain, and the patient relieved himself occasionally by ab-
stracting four or five of them, unknown to the medical attendants.
407. Nine weeks from the period of his entrance, he was
told by the superintendant of the hospital that he was considered
well. The patient, somewhat surprised at this information, espe-
cially as he had not been out of his bed for nine weeks, prepared
to leave the institution, and was taken home in a carriage. Here
he was informed that the physicians were anxious to be rid of him;
that they considered his case incurable, and thought it was unne-
cessary for him to remain any longer under their charge.
408. Among the counter irritants usually employed in the an-
tiphlogistic or old school practice, are blisters, mustard poultices,
setons, issues, and moxas.
409. BLISTERs. These are composed of pulverized Span-
ish flies, and act by producing a violent inflammation. They
raise the cuticle or outer skin, in the form of a blister, which is
detached by the physician or surgeon with a pair of scissors; and
the raw or excoriated surface is then dressed with some irritating
ointment, to promote a constant discharge from the sore. Whether
blisters are of any service in the treatment of disease, may be learn-
ed by the following extracts from medical authors.
410. “Within five years,” says the distinguished M. Louis,
“I have treated about one hundred and forty cases of pleurisy at
la Pitié,” (I include here only those who were in perfect health at
the time they were attacked) and I have not had recourse to blis-
tering in a single instance.”f
411. The same writer says, “I was induced to reject vesica-
tion (blistering) in the treatment of acute inflammations of the
chest, because, as I have before said, an attentive study and vigo-
rous analysis of facts, forced me to acknowledge that acute inflam-
matory affections, instead of preserving organs which are not the
primitive seat of disease from inflammation, are in truth an exciting
* A celebrated hospital in Paris.
it Researches on the Effects of Blood-letting, &c., translated by Dr. Putnam.
Boston, 1836.

14
106 GLANCE AT THE
cause of inflammation; insomuch that the more severe the primi-
tive inflammatory affection, and the more severe the accompany-
ing ſever, the more are the secondary inflammations to be dreaded.
And how then are we to believe that the effect of a blister is to
check an inflammation, when the blister is one inflammation super-
added to another ?” -
412. “Dr. Rush affirmed,” says Dr. Dunglison, “that there
was a period in ſevers, when blisters might be had recourse to with
advantage, and to this period he gave the name ‘blistering point.”
If the excitement was above this point, blisters were improper;
if below, the contrary. The difficulty manifestly would be, to
know this point. It is not fixed with thermometric accuracy,
and, consequently, the idea of the blistering point fell to the
ground with its distinguished professor.”
413. The same writer, speaking of what he terms the stimu-
lant or excitant effects of blisters, remarks, “In the low conditions
of the frame, in which they are conceived to be indicated, the dis-
charge of a large quantity of the serous part of the blood, cannot
fail to add to the debility more than the excitant property can de-
tract from it; whilst they produce excessive irritation, and are,
withal, transient in their operation.”
414. Dr. Joseph Comstock, in his remarks on the use of
blisters in scarlet fever, says, “They sometimes put on very
alarming appearances, being visited by canker, turning black, and
threatening mortification.”f -
415. Dr. Eberle expresses the belief that blisters are some-
times useful in typhus fever, if “applied about the period when
the stage of collapse is approaching, that is, about the seventh
or eighth day of the fever;” but “at an earlier period,” he re-
marks, “they are apt to increase the general irritation of the
system; and at a more advanced stage, vesication tends to increase
. exhaustion, and there is much danger from gangrene of the
blistered surface.”f
416. Dr. Mackintosh recommends the application of a blister
to the temple, behind the ears, or to the back of the neck, in in-
flammation of the eyes, but in the same paragraph observes, “In
young infants the blistered surface is liable to slough (mortify) and
death will so frequently follow such an occurrence, that I enter-
tain considerable repugnance at applying a blister to a new-born
child; and it is impossible I shall ever forget the fright experi-
enced on the last occasion I applied one in purulent ophthalmia,”
* General Therapeutics, pp. 63, 103.
+ Boston Medical and Surgical Journal for May, 1839.
+ Practice of Medicine, 4th edition, vol. i. p. 186.

ol, D SCHOOL PRACTICE OF PHYSIC. 107
(inflammation of the eye with a purulent discharge.) The case
was severe; the parents had heard of the good effects of blister-
ing, and I was urged by them to apply one. My objections were
honestly mentioned, but they still insisted; and a blister was ac-
- cordingly applied, with the precaution too of placing a piece of
-
the child made a narrow escape from death.”
417. Dr. Samuel Thomson says, “What would be thought
if a scald should be caused by boiling water to remove disease ?
Yet there is no difference between this and a blister made with
flies. I have witnessed many instances of great distress and inju-
rious effects from the use of blisters; and believe I can truly say
that I never knew any benefit derived from their use. They fre-
quently cause strangury, and in that case they are more to be ſear-
ed than the disease which they are intended to cure.”f
fine gauze between it and the skin; a deep slough took place, and
418. MUSTARD Poul.TICEs. These, in medical language,
are termed sinapisms, and are composed of flaxseed, mustard,
and vinegar. They are very speedy in their effects, and “usu-
ally become insupportably painful in less than an hour.” “When
removed,” says the United States Dispensatory, “they leave the
surface intensely red and burning; and the inflammation frequently
terminates in desquamation, (peeling off of the cuticle) or even
blistering, if the application has been too long continued. Obsti-
nate ulcers and gangrene also sometimes result from the protracted
action of mustard, especially on parts possessed of little vitality.
As a general rule, the poultice should be removed when the pa.
tient complains of much pain; and in cases of insensibility should
not, unless greatly diluted, be allowed to remain longer than one,
or at most two hours; as violent inflammation, followed by obsti-
mate ulceration, is apt to occur upon the establishment of reaction
in the system.” -
419. Professor Bigelow of Boston, said in a lecture, “I
have frequently seen patients in the cholera hospitals in this city
and in New York, who were groaning in the greatest distress; and
upon interrogating them as to the cause, it was usually found to be
. º poultice upon the feet, bowels, or other parts of the
Ody.
420. Issues. These, in the words of a medical writer, are
artificial ulcers, made by cutting out a portion of the skin, or des-
troying it with caustic, and burying a pea or some other substance
in it, so as to produce a discharge of purulent matter.
* Practice of Physic, 2d American edition, vol. ii. p. 212.
# Thomson's Guide, p. 19. -

108 GLANCE AT THE
421. SEToNs. These are also artificial ulcers, but they are
made with an instrument called the seton needle, by which a
“long strip of fine linen or cotton twist” is passed through the
skin, and moved backward or forward every day to keep up a
constant irritation. Dr. Dunglison, in his General Therapeutics,
remarks, that “issues and setons are uncleanly, by means of the
discharge which they excite;” but this is not the only objection
to them, for they gradually exhaust the strength of the patient,
and doom him to a premature grave.
422. MoxAs. These are of different kinds, but the moxa
usually employed in this country, is composed of a roll of cotton
wool, wrapped in cotton cloth, and impregnated with saltpetre.
The moxa thus prepared is laid on the skin, set on fire at the top,
and blown with the bellows till it is entirely consumed. This
destroys the parts beneath, and gives rise to an ulcer, which is
kept open by irritating applications. Moxa is employed by the
diplomatised physicians in various diseases, as asthma, pleurisy,
consumption of the lungs, and rheumatic inflammation of the joints.
It was first used in savage nations, and was in perfect accordance
with their rude and barbarous notions, but that it should have found
favor with educated physicians in civilized countries, is truly a
matter of wonder. -
MERCURy.
423. Mercury or quicksilver is chiefly obtained from a red col-
ored ore, termed cinnabar, and is the only metal which preserves its
fluidity at ordinary temperatures. There are various preparations
of this mineral, all of which are more or less poisonous. The
more common of them are calomel, corrosive sublimate, red pre-
cipitate, and blue pill.
424. “When mercury is introduced into the system so as to
excite its specific action,” remarks Professor Eberle, “it at first
increases the action of the heart and arteries; the pulse becomes
quick, tense, and occasionally full; the gums become tender, ac-
companied with a peculiar metallic taste of the mouth and fetor of
the breath. If the mercury be pushed further, the tongue, gums,
and salivary glands, begin to swell; the teeth become painful and
loose; the saliva flows in great abundance; small ulcerations make
their appearance on the tongue, gums, and roof of the mouth; the
appetite fails; occasional pains are felt in the stomach and bow-
els; the countenance acquires a peculiar expression, indicative of


OLD SCHOOL PRACTICE OF PHYSIC. 109
a distressful morbid irritability of the system; and much debility
and emaciation ensue. These are the or DINARY phenomena of a
regular mercurial course. Instances however occur, in which,
owing to peculiar susceptibilities of the system, the action of mer-
cury produces a train "... which, so far from being salu-
tary, are attended with much distress and danger, and perma-
ment injury to the constitution. Palsy, epilepsy, and even death,
have been known to supervene, in consequence of the action of
mercury.”*
425. One would scarcely think that a substance capable of
producing such effects as the above, could be regarded as a very
safe or salutary medicine.
426. “From the general tendency of mercury to produce
salivation,” says Dr. Good, “those who are engaged in working
quicksilver mines, as those of Idria or New Spain, are almost
constantly in a state of salivation; and when, which is often the
case, condemned as criminals to such labor for life, drag on a
miserable existence, in extreme debility and emaciation, with stiff,
incurvated limbs, total loss of teeth, and equal loss of appetite, till
death, in a few years, with a friendly stroke, puts a period to their
sufferings.”
427. “From the facility with which quicksilver evaporates,”
continues Dr. Good, “and combines, not only with other metals,
but with almost all other substances, and especially with many of
the elastic gases, a considerable degree of injury is often sustained
by workmen in manufactories, in which quicksilver is occasionally
employed, without their being for a long time aware of the cause.
An instance of a similar kind occurred on board the Triumph
man-of-war, which had received on board thirty tons of quick-
silver, contained in leathern bags of fifty pounds each, that had
been picked up on the shore at Cadiz, from the wreck of two
Spanish line-of-battle-ships, that had been lost during a storm in
March, 1810. The bags were stowed in the hold, and other low
parts of the ship; but being saturated with sea-water, they soon
decayed and burst. The quicksilver, thus let loose, was collect-
ed as well as it could be, and committed to proper casks; but
much of it escaped into the recesses of the ship; and not a little
was secreted by the sailors, who amused themselves with it in
various ways. The quicksilver that had escaped unnoticed, sunk
into the bilge water, became partially decomposed, and ascending
soon after, amidst an intolerable stench, with the vapor of the
water, coated every metallic substance in the ship with a black
hue; and at the same time a general affection of the mouth took
* Materia Medica, 4th edition, vol. ii. pp. 37.2–3.

110 GLANCE AT THE
place among the men and officers, to such an extent, that no less
than two hundred became severely salivated, and did not
recover till the ship, being carried into Gibraltar, was docked
and cleaned to its lowest planks.”
428. The very principle upon which mercury is administered
in the treatment of disease, should be sufficient to condemn its
use. It was asserted by John Hunter, and has since been quoted
by various medical writers, that two different diseases cannot existin
the body at the same time, unless they occupy different structures;
and as mercury is capable of producing a disease or irritation
peculiar to itself, this agent is resorted to with a view of exciting
a new disease, that it may take the place of the old one already
existing. “Hence the great advantage,” says Dr. Dunglison,
“of mercury in obstinate fevers, and, indeed, in most chronic
irritations. In such cases,” he adds, “it is but necessary to
affect the mouth, occasion mercurial fetor of the breath, falling
away of the gums from the teeth, and slight irritative fever, in
order that we may produce the full remedial influence of mer-
cury.” He remarks, however, that salivation is unnecessary;
that “it is now admitted by almost all to be an evil;” and that
“ the whole efficacy of the mercurial medication is dependent on
the new disease which is established in the economy, detracting
from, or being incompatible with, that already existing.”f
429. Such doctrine as this would be regarded as a manifest
absurdity, were it not countenanced by men who claim to be
learned and scientific; and I am satisfied that if the people understood
it in all its odious features, they would cease to employ medical
men who make it the ground-work of their practice. The day, I
trust, is not far distant, when the citizens of this Republic will
look with distrust upon the man, who says he cannot break up or
cure a disease, without establishing a new one in its stead.
430. On this subject the learned Professor Waterhouse re-
marks, “The regular physician finds it necessary sometimes to
make a great change in the human frame, or to make a very
strong counter irritation, so as to obliterate the morbid or destruc-
tive one. This he accomplishes by quicksilver, that is, mercury,
in its various preparations, which, when pushed to the extent of
salivation, dissolves the human fluids, on the health of which
depends the vital integrity of our bodies. After the hazardous
process of salivation, the physician may, perhaps, be able to say—
now I have so far changed the morbid state of the patient, that
* Study of Medicine, 6th American edition, vol. i. p. 62.
# Dunglison's General Therapeutics, p. 99.

OLD SCHOOL PRACTICE OF PHYSIC. 111.
his disease is conquered, and entirely overcome by the powerful
operation of the mercury. But then in what condition does he
find the sufferer? His teeth are loosened, his joints are weak-
ened, his healthy countenance is impaired, his voice feeble, and
he is more susceptible of cold from a damp state of the
weather. His original disorder is, to be sure, overcome, but it is
by paying a great price for it. Secret history conceals from public
notice innumerable victims of this sort.”
431. Passing over the primary effect of mercury, which is
well known to be salivation, Dr. Marshall Hall observes, that its
secondary effect is what Mr. Pearson has denominated the mercu-
rial erethismus. This form of disease is described by Mr. Pear-
son as “a state of the constitution produced by mercury acting on
it as a poison.” He mentions that it “is characterized by great
depression of strength, uneasiness in the region of the heart, pal-
pitation, frequent sighing, trembling, a small, quick, sometimes
intermitting pulse, occasional vomiting, a pale, contracted counte-
nance, and a sense of coldness. In this state, any sudden exer-
tion will sometimes prove fatal.”
432. “To this affection,” says Dr. Hall, “the late Dr.
Bateman fell a victim, and that from the want of a prompt diag-
nosis. The first symptoms of the terrible malady occurred on
the ninth day of the mercurial inunction; this was nevertheless
continued to the thirteenth.” -
433. “The erethismus described by Mr. Pearson,” continues
Dr. Hall, “is not the only morbid effect of mercury. This rem-
edy, instead of producing a kindly effect on the system, and on the
disease, sometimes induces a quickened pulse, with feverishness
and general inquietude, a ſurred tongue, a harsh and intolerable
feeling about the stomach and bowels, perhaps with sickness, per-
haps with diarrhoea. Each dose and every form of the medicine
produces these painful and untoward effects, and we are frequently
compelled to relinquish the use of our most important remedy.”
434. “In the course of two or three years after my appoint-
ment to the care of the Lock Hospital,” remarks Mr. Pearson,
“I observed, that in almost every year, one and sometimes two
instances of sudden death occurred among the patients admitted
into that institution; that these accidents could not be traced to
any evident cause; and that the subjects were commonly men who
had nearly, and sometimes entirely, completed their mercurial
course. I consulted Mr. Bromfield and Mr. Williams upon this
* Marshall Hall’s Practice of Medicine, by Drs. Bigelow and Holmes, pp. 216, -
219.

112 GLANCE AT THE
interesting subject but they acknowledged themselves unable to
communicate any satisfactory information: they had carefully ex-
amined the bodies of many who had died thus unexpectedly,
without being able to discover any morbid appearances; and they
confessed that they were equally ignorant of the cause, the mode
of prevention, or the method of treating, that state of the system
which immediately preceded the fatal termination.”
435. “As the object of my enquiry was of considerable im-
portance,” continues Mr. Pearson, “I gave a constant and minute
attention to the operation of mercury on the constitution in gene-
ral, as well as to its effects on the disease for which it was admin-
istered; and, after some time had elapsed, I ascertained that these
sinister events were to be ascribed to mercury acting as a poison
on the system, quite unconnected with its agency as a remedy; and
that its deleterious qualities were neither in proportion to the in-
flammation of the mouth, nor to the actual quantity of the mineral
absorbed into the body.”
4. We have here the most abundant proof of the power of
mercury to injure the system, and produce death; and as further
testimony, the reader's attention is solicited to the following ex-
tracts and observations.
437. “In persons of a highly irritable temperament,” says
Dr. Good, “I have known salivation produced by a single dose
of calomel; and that it is sometimes caused by dressing ulcers
with red precipitate, is a fact mentioned by Hildanus, and well
known to all experienced surgeons. In scorbutic, scrofulous, and
other debilitated habits, very small quantities of mercury will some-
times act in the same manner; and hence a considerable degree of
caution is requisite in all cases of this kind. Even the wearing of
a leathern girdle, or the occasional application of white precipitate
or mercurial ointment to the head to destroy vermin, has often
excited salivation.”
Dr. Bigelow of Harvard University, was in the habit of
saying to his class, “I have known an ordinary dose of calomel,
given as a cathartic, to produce salivation in twenty-four hours.”
439. Dr. Jackson, formerly a professor in the same institu-
tion, observes, “In our practice,” (alluding to that of the Massa-
chusetts General Hospital) “calomel is rarely used, by design, to
such an extent as to induce any marked or free salivation; but
occasionally, it must be allowed, such an effect takes place.”f
*Marshall Hall's Practice of Medicine, by Drs. Bigelow and Holmes, p. 217.
# Study of Medicine, 6th American edition, vol. i. p. 62.
# Researches on the Effects of Blood-letting, &c., by M. Louis, translated by
Dr. Putnam; Preface and Appendix by Dr. Jackson. Boston, 1836.



OLD SCHOOL PRACTICE OF PHYSIC. 113
440. Dr. Anthony Hunn, a practitioner of the old school, re-
marks, “Has any physician yet discovered the modus operandi of
calomel? No! Can any body tell what calomel will do when
taken No! Calomel acts quite independently of the physician’s
wish, or design. At one time three grains will purge the patient
nearly to death—at another time, in apparently the same situation,
one hundred grains will produce no sensible effect.”
441. Dr. Denman says, “There is reason to think, that
causes, seemingly too trifling to produce convulsions, have some-
times been equal to the effect, as I recollect two instances of
women who had convulsions at the time of labor, preceded by
violent headachs, brought on, as it appeared, by the use of some
mercurial preparation mixed with the powder used for their hair.”f
442. The wife of a distinguished clergyman in Boston, and a
lady of the most undoubted veracity, informed me that she had
known at least one hundred cases, in which salivation had been
produced by small doses of mercury, contrary to the wishes or ex-
pectation of the attending physician. This may seem a large
number to come under the observation of a lady, but her benevo-
lent visits among the sick or afflicted members of her husband's
congregation, gave her an opportunity of witnessing the bad effects
of medical treatment, not commonly enjoyed by her sex.
443. I shall never forget a case of salivation which occurred
in Philadelphia nine or ten years ago. The patient was a Miss
Lehman, residing in Eighth street, above Arch, who was attacked
with a slight dropsical affection of the lower extremities, and
called in Dr. Hartshorn, a somewhat noted physician. He gave
her, according to his own confession, a small dose of calomel, but
not with a view of producing salivation. Nevertheless, salivation
occurred in its severest form, and the patient was doomed to
suffer the most indescribable agonies. Her tongue swelled enor-
mously, and protruded from her mouth, so that she could not
speak, and it was with the greatest difficulty that a small quantity
of fluid could be poured down her throat from time to time, to
keep her alive. Her joints also swelled, and were exceedingly
painful. She lingered in this situation for several weeks, when
death, with a friendly hand, put a period to her sufferings.
444. About a year ago, I accompanied Dr. Comfort of Phil-
adelphia, to see a child of Mr. Becktel, which had been a victim
to mercury. It was attacked when about five months old with
ague and fever, and Dr. Small being consulted, he ordered
calomel, which was given in grain doses every three days for four
* See a series of Essays by Dr. Hunn in the Southern Botanic Journal for 1837.
f Practice of Midwifery, New York edition, p. 521.
15
114 GLANCE AT THE
months. At the end of this time the drug was discontinued, from
an apprehension on the part of the mother, that it was doing the
child an injury. The little sufferer was three years old when I
saw it, and the dreadful effects of the calomel were fully apparent.
It was º of the use of its lower limbs, and in a great
measure of its hands and arms. Its teeth were rotten, accompa-
nied with a constant dribbling of saliva from its mouth, and its head
rolled from side to side, varying with the movements of its body.
Its lower limbs were imperfectly developed, and not more than half
the usual size of a healthy child of the same age. Its intellectual
faculties were impaired, and the power of speech wholly lost. It
was only capable of uttering a low, muttering sound. Dr. Com-
fort had prescribed the use of vegetable medicines, as composition
and spiced bitters, and with a considerable degree of benefit, but
there was no probability that the little patient could ever be re-
stored to permanent health.
445. I recollect an equally aggravated case which occurred in
the child of a Mr. McIntire, who resides in the eastern part of
Boston. At the age of six months, it was attacked with some
trifling complaint, and a physician ordered it a dose of calomel.
From that time it became an invalid, and was attended by differ-
ent medical men, who gave it mercury and other poisons by the
quantity. At length it was seized with the hip complaint, which
has continued till the present time, the patient now being about
thirteen years old. heard from him a few months ago, and
was informed that his limb on the affected side was considerably
shortened and bent, and he was obliged to go on crutches. In
the treatment of the case, an incision a foot long had been made in
the fleshy part of the thigh, and the wound kept open by irri-
tating applications for four months. The patient is not only a
cripple for life, but his mental faculties are considerably impaired.
A physician of Boston called to see him about three years ago,
who attributed his afflictions to the use of calomel, and said his
flesh was so poisonous that a small portion of it would kill a dog.
446. “Some practitioners,” says Dr. Mackintosh, “trust
almost exclusively to the action of mercury in yellow fever, and
in India more particularly, it is deeply to be regretted that a great
waste of human life has consequently taken place. Some years
ago,” he continues, “Dr. Haliday of the Honorable East India
Company service, was, by order of the Marquis of Hastings, put
under arrest, and deprived of rank and pay, for showing by most
incontrovertible evidence, that in the general hospital of Calcutta,
the enormous quantity of twenty-six pounds of calomel was con-
sumed by eight hundred and eighty-six patients; and that under


OLD SCH00L PRACTICE OF PHYSIC. 115
the painful digestion of this mineral, the proportion of deaths was
one in about sia and three quarters of the whole sick list—whilst
under a more rational treatment, the mortality was reduced about
one half: in fact, the mortality bore almost an exact ratio with the
quantity of calomel exhibited. After a delay of many years, Dr.
Haliday was restored to his rank by the express order, more than
once repeated, of the India Directors. This transaction has
never been brought before the British public, but having carefully
perused all the evidence, I have no hesitation in declaring that as
a piece of persecution from beginning to end, there is no parallel
case to be found in the annals of any free country. Wherever
the story is known, it must cause a blot, never to be effaced, upon
the memory of the then Governor General of India, and all his
advisers, military as well as medical.”
447. “In 1796,” observes the same writer, “the deaths in
the West Indies under Dr. Chisholm's mercurial plan were never
exceeded, amounting to nearly one half of the whole number of
the troops.”
448. Dr. Clutterbuck says, “A few years back, a mercurial
course was said by an American physician to cure consumption
with almost certainty; but in this country, (England) the disease
is almost invariably aggravated by such a course.” The same
writer remarks, “ For a good many years past—not so many,
however, but that I well recollect the introduction of the practice
—mercury has been looked up to as a sort of specific in chronic
affections of the liver, to the exclusion, not only of blood-letting,
but of almost all other means. Patients, in consequence, have
been doomed, almost without discrimination, to undergo torturing
salivations, with a numerous train of other evils.”f
449. Dr. Ware of Harvard University, said in a lecture,
“Mortification of the face in children, which is often peculiar to
them, is supposed to be owing to mercury.”
450. Dr. Bigelow of the same institution, remarked, “I have
known the tongue to be so much swelled from the use of calomel
as to be pushed out of the mouth, and to remain out for three or
four weeks before it could be restored. Infants are sometimes
terribly salivated by it, and extensive sloughing of the mouth and
gums takes place. A child will be affected by its mother’s milk,
if she is under the influence of mercury.”
451. Dr. Good observes, “Gangrene and necrosis (death or
mortification of the bones) may be the consequences of immod-
*Mackintosh’s Practice of Physic, 2d American edition, vol. i. pp. 173–4.
t Lectures on Blood-letting, vide Select Medical Library, vol. iii. No. 7. pp.
81, 98


i 16 GLANCE AT THE
erate mercurial salivation. Large sloughs of the parts of the
mouth are very common. Cullerier has seen a partial necrosis of
the lower jaw produced in this manner, and, in one young woman,
a complete necrosis of the upper and lower alveolary processes,”
(sockets of the teeth.) The English editor of Dr. Good’s work.
remarks that he has “witnessed several melancholy examples of
the same kind.”
452. Professor Thomson, in his Elements of Materia Medica,
vol. i. p. 371, asserts that “mercury, in whatever form it is ad-
ministered, and in whatever manner it is introduced into the living
body, acts as an excitant; a febrile state of the body is induced,
evidenced both by the condition of the pulse, and that of the
nervous system; and also by an augmented secretion and excre-
tion of urine.” -
453. Dr. Anthony Hunn, from whom I have already quoted,
very emphatically remarks, “Calomel sometimes produces con-
sumption, fever, rheumatism, and scrofula—it occasionally causes
purging of blood, terrible salivation, even unto mortification; it
produces local diseases of many kinds, a great depression of
strength, and great anxiety, sighing, trembling-a small, frequent
and sometimes intermitting pulse, frequent vomiting, paleness, a
sense of shivering. It also brings on the mercurial leprosy, and
mercurial syphilis.”f -
454. ith regard to the operation of calomel upon the liver,
Dr. Hunn observes, “It throws that organ into a morbid, convul-
sive action, and causes it to secrete an increased quantity of de-
praved bile, which must be evacuated.” In cholera, he expresses
the belief that this poison causes the force of the disease to be
almost entirely expended on the liver, producing a still greater
irritation in the organ than the cholera itself. But if you should
succeed in affording relief by the use of calomel, he continues,
“woe to the liver; death by cholera would be preferable to a
miserable existence with such a liver—torn to pieces by the uni-
ted action of cholera and calomel. But,” he adds, “the attacks
are oftentimes so violent, and the course of the disease so rapid,
that calomel has not time to exercise its specific powers before the
atient expires. This was the case in Lancaster, Kentucky; and
it may be asked whether more than half, who are said to have been
cured of cholera, do not die afterwards of calomel, typhus, flur,
or alvine hemorrhages, not to mention Hooper's catalogue of dys-
pepsia, rotten teeth, rheumatism, king's evil, consumption, and
other horrible diseases.” -
*Study of Medicine, 6th American edition, vol. i. p. 63.
#See a series of Essays by Dr. Hunn, published in the Southern Botanic Jour-
nal for 1837.

OLD SCHOOL PRACTICE OF PHYSIC. 117
455. Professor Chapman has somewhere said, that he has
known the mercurial action to develope itself after the poison had
lain dormant in the system for years. I can testify to the truth of
this assertion, having met with more than one instance of the
kind. I recollect a gentleman who exhibited unquestionable marks
of salivation, during the operation of a course of medicine, and he
assured me that he had not taken a particle of mercury for five or .
six years previous to that time.
456. A London physician says, “There is no measure to the
effects of mercury: after giving it, we can only say, we think we
have cured the disease; we dont know that there may not arise a
second set of symptoms a long time after.”
457. Dr. Robinson, in his Lectures, quotes the following case
to show that mercury may lie inert in the body for years, and then
become active. -
458. “A lady, the mother of four children, in the twenty-
eighth year of her age, had a bad miscarriage at the end of the
fourth month. When the author was called, she was much redu-
ced by the loss of blood, and required the ordinary palliative rem-
edies. Three days after the first visit, she complained of a bad
taste in her mouth, with soreness in her gums, and on the follow-
ing day, salivation took place. On enquiring into the circumstan-
ces of her previous history, it was learned that four years before,
she had, for a fortnight, a course of the blue pill, which had only
slightly touched her gums, and it was solemnly asserted, that
she had never again taken any preparation of mercury, and had
been in general in good health. The salivation was, therefore, at
first, attributed to some accidental cause; but when it was found
to be proceeding with great violence, the medicines which the lady
had been taking for the abortion were carefully analyzed, but they
contained no mercury. The most anxious care, and unremitting
attention, proved unavailing, as did all the remedies used in sim-
ilar cases. The salivation, with the usual consequences of exces-
sive emaciation, debility and irritability, continued for above twelve
months; occasionally, for a day or two, it was checked; but alarm-
ing symptoms, vomiting, with threatened sinking of the living pow-
ers, supervened.”
459. It is strenuously contended by the generality of medical
men, that mercury does not enter the circulation, and they tell
their patients that it is only necessary to combine it with a portion
of jalap, or to follow it in a few hours with a dose or two .."castor
* London Practice of Midwifery, 4th London edition, p. 35.
+ Lectures on Medical Botany, p. 118. Boston, 1838.



118 GLANCE At the
- -
oil, in order that every vestige of this drug may be removed from
the system. Even Professor Chapman of the Pennsylvania Uni-
versity, has lent his influence to sustain this clumsy hypothesis.
. . e notions relating to the modus operandi of mercury,”
says he, “that which alleges its entrance into the circulation, is
surely the most gratuitous and absurd.” To show the sagacity of
• Dr. Chapman on this point, I will make a few quotations from
medical authors of standard authority. -
460. “That mercury is carried into the circulation,” says Dr.
Eberle, “and conveyed with the blood throughout every part of
the system, is demonstrated by the fact of its presence having been
detected in the solids and fluids of the body, and particularly in
some of the secretions. Zeller states, that he found quicksilver
in the bile; and Laborde, Brodbelt, and others, mention instances
in which this metal was found in the bones of persons who had
died after severe and tedious mercurial courses. Dr. Hamilton
detected globules of mercury in the milk of women in a state of
salivation; and it is a fact well attested, that gold worn near the
skin, by persons taking mercury, occasionally becomes covered
with a white amalgam—a circumstance which proves the presence
of mercury in the cutaneous discharges. The absorption of mer-
cury into the circulation, may also be inferred from the peculiar
metallic taste of the tongue, and the well known mercurial odor of
the breath and perspiration of those who are under the specific in-
fluence of this metal.”
461. “We have the most undoubted evidence,” says Profes-
sor Dunglison, “that mercury enters the blood. Dr. Colson de-
tected it by introducing plates of polished brass into the blood,
which became covered with a coating of mercury; and Dr. Chris-
tison affirms, that it has been obtained from the crassamentum
(fibrine) of persons salivated, when no mercury could be detected
in the serum. We know, too, that iodine enters the circulation.
It was detected in the blood of persons using it medicinally, by
Dr. Cantu of Turin; and as neither iodine nor mercury produces
its effects on the constitution, until its use has been persisted in
for some time, it is to be inferred that they act upon the economy
through the medium of the blood.”
462. The same writer remarks, “If we force mercury through
the skin by fiction, we can affect the salivary glands, and whilst
the system is pervaded by the mercury, a gold watch will exhibit
by its white coating, that the mercury is exhaled by the cutaneous
surface. In like manner, if the blue pill, or calomel, be adminis-
*Treatise on the Materia Medica and Therapeutics, 4th edition, vol. ii. p. 371.
# General Therapeutics, p. 75–6. -

OLD SCHOOL PRACTICE OF PHYSIC. 119
- - -
tered in adequate quantity internally, the watch will be equally
coated by the mercury. We do not know the exact condition of
the exhaled metals in these cases; whether, in the case of the mer-
curial ointment and the blue pill, it is still oxide,-in the state of
calomel;-or whether, in these instances, it is not decomposed,
and given off in the form of mercurial vapor. The fact, that me-
tallic mercury has been detected in the bodies of such as have
died under its influence, leads us to presume, that the metal may
be reduced, and be exhaled in the form of vapor, so as to occa-
sion the coating in question.” -
463. “In Hufeland's Journal,” says Dr. Good, “it is stated -
that a pelvis” infiltrated with mercury, and taken from a young
woman who had died of syphilis, is preserved in the Lubben Mu-
seum of Midwifery.”f -
564. Dr. Coxe, formerly a professor in the University of
Pennsylvania, quotes the following paragraph from Dr. Mead,
who, he says, “stands high in the annals of medicine.” “I re-
member,” says Dr. Mead, “that I once found a quantity of mer-
cury in the perinaeum of a subject taken from the gallows for dissec-
tion, (whose rotten bones discovered what disease had required
the use of it, and that, I suppose, by unction) without any marks of
corrosion of the parts where it was collected.” Dr. Mead also
refers to others who had affirmed the same. “It is no wonder,”
he remarks, “if they often met with very untoward symptoms
from so severe a treatment; and if (as some of them declare) they
now and then found mercury in the rotten bones of their patients,
who had, it may be, suffered too much both from their disease
and their physician.”f
465. “In Woodal’s Surgery, p. 244,” says Dr. Coxe, “a
reference is made to Cardanus, who took two ounces of crude
mercury out of the head of a patient, who had been attended by
himself.” Dr. Coxe also refers to a French Journal, in which
he says there “is an account of mercury having been detected in
its metallic state in the mammary glands (breasts) of a young
woman, as also in the mesentery, large intestines, and saliv
glands; and reference is there likewise made to the authorities of
Fourcroy, Dumeril, Orfila, and Cruveilhier, who have also found
this metal in their examination of bodies, in different parts. In the
same Journal noticed above,” continues Dr. Coxe, “metallic
mercury has even been discovered in the urine, by Dr. Canter.
* The bony structure at the lower part of the abdomen.
f Study of Medicine, 6th American edition, vol. i. p. 62.
# Appeal to the Public, by John Redman Coxe, M. D. pp. 62, 63. Phila-
delphia, 1835.

120 GLANCE AT THE
- T
- That gentleman took sixty pounds of the urine of syphilitic patients,
- who had been treated by mercury—a sediment formed, and the
fluid part, separated therefrom, was evaporated, and distilled at a
red heat, with charcoal and carbonate of potash. It showed,
however, no trace of mercury. He then treated the sediment in
the same manner, and obtained more than twenty grains of mer-
cury, exclusive of what remained in the neck of the retort.”
466. Dr. Alcott, in his remarks on the effects of poisons in
small doses, says, “They appear to accumulate in the system,
and break forth in terrible consequences at a future period. This
may seem unaccountable to many, but the fact is indisputable,
whether it can be accounted for, or not. * * * The full
effects of calomel, for example, especially when taken in small
doses, as in Ching's worm lozenges, and in sundry other nos-
trums which are frequently advertised, are not always manifested
till months and years have elapsed. Thousands and millions of
diseases, whose cause was not suspected, have been the legiti-
- mate fruits of seed sown long before, in the shape of lozenges,
drops, cordials, pills, and conserves. Lead—white lead, and su-
gar of lead, in all their various forms, are well known to accumu-
late or remain in the system for years, and afterwards, when per-
haps least suspected, break out and destroy the individual, or at
least leave him miserable for life.”f
467. CALoMEL. This, as we have seen, is a preparation of
mercury, and is termed by chemists the protochloride of mercury,
because it contains one part of chlorine, and one part of the metal.
- It has other names, as submuriate of mercury, and mild chloride
of mercury. To show the vast consumption of this drug in the
United States, Professor Bigelow stated in one of his medical
lectures, that “a single druggist in the city of Boston, engaged in
the manufacture of the article, exported two tons of it in one sea-
son to New Orleans.” It is no wonder that the people in the
Southern States complain of aching bones and mercurial rheu-
matism.
468. Corrosive SUBLIMATE. This is the bichloride of mer-
cury, and contains, as its name indicates, two parts of chlorine,
and one of the metal. It is sometimes called orymuriate of mer-
cury, and is one of the most violent metallic poisons, known, a
grain or two of it being sufficient to destroy life. The United
* Appeal to the Public, by John Redman Coxe, M. D. pp. 62, 63. Phila-
delphia, 1835. -
# Health Tracts, No. 1. Boston, 1839.


OLD SCHOOL PRACTICE OF PHYSIC. 121
-
States Dispensatory says, “it produces a sense of burning heat in
the throat, excruciating pain in the stomach and bowels, excessive
thirst, anxiety, nausea and frequent retching, with vomiting of
bloody mucus, diarrhoea and sometimes bloody stools, small and
frequent pulse, cold sweats, general debility, difficult respiration,
cramps in the extremities, ſaintings, insensibility, convulsions, and
death.” It is used by the medical faculty in various diseases, as
rheumatism, syphilis, and eruptions of the skin. The only differ-
ence between corrosive sublimate and calomel is, that the latter
contains only one part of chlorine, and the former two parts.
469. RED PRECIPITATE. This consists of small scales, of
a bright red color, and is known to chemists as the red owide of
mercury. It is of a caustic nature, and is used by physicians as
an external application in ulcers, and eruptions of the skin. “It
must be cautiously applied, however,” says Eberle, in his Thera-
peutics, “and not upon too large a surface at once, since it has
been known, in common with many other external applications, to
produce dangerous effects, by suddenly repelling the eruption for
which it was employed.”
470. The United States Dispensatory remarks, that red pre-
cipitate “is too harsh for internal use,” but Dr. Eberle entertains
a different opinion, and recommends it, on the authority of some
German writers, as being useful in rheumatism, tetter, and enlarge-
ment of the bones.
471. BLUE PILL. The blue pill is made by rubbing an
ounce of mercury with an ounce and a half of conserve of roses,
and half an ounce of powdered liquorice root, until the whole is
formed into a mass. This is one of the milder preparations of
mercury, but it is capable, nevertheless, of producing salivation,
and all the other horrible consequences of that drug. The blue
pill was a favorite prescription of the celebrated Abernethy, who,
it is said, recommended it in almost every form of disease. With
him it was the beginning and the end of the materia medica.
472. In every three grains of the mass composing the blue
pill, there is, according to the American formula, one grain of
mercury. -
ANTIMONY.
473. The antimony of commerce is a brittle metal, of a blu-
ish white color, and is chiefly obtained from an ore called the sul-
phuret of antimony.


16
122 - giance AT THE
474. Antimony, says Dr. Eberle, was known to the an-
cients, but it was not employed internally till about the middle
of the sixteenth century. In the plague which ravaged Bohemia
in 1562, it was extensively used. From its violent effects, how-
ever, the Medical Faculty of Paris denounced it as a fatal poison;
and its use was prohibited in France by an edict of Parliament.
In 1609, an eminent physician named Besnir, was expelled the
medical faculty of Paris, for having given it to his patients; and
another physician of equal eminence was prosecuted, for having
sold antimonial preparations, contrary to the decree of Parliament.
This wise and salutary law, however, after it had been in force
about half a century, was repealed; and antimony, poisonous as it
was known to be, “soon became one of the most boasted and pop-
ular articles of the materia medica.” -
475. The distinguished M. Orfila, in his work on poisons,
says, “The antimonial preparations occasion copious and obsti-
nate vomiting, large evacuations by stool, great difficulty of breath-
ing, and often such a constriction in the throat, that the patient is
unable to swallow anything; and finally very painful cramps, a
sort of intoxication, and a greater or less prostration of the vital
forces.”
476. TARTAR EMET1c. This is one of the preparations of
antimony, and is used extensively by the medical faculty, both as
an emetic, and for other purposes. It is composed of tartaric
acid, antimony, and potash, and is called by chemists the tartrate
of antimony and potassa. It is also known in common medical
language as tartarized antimony. It is a violent poison, producing
in some cases, according to Professor Ware, “long continued
and ineffectual retching, spasms, failure of the pulse, coldness of
the extremities, and great prostration.”
477. “Experience proves,” says M. Orfila, “that tartar
emetic, if it does not excite vomiting, may produce death when
given in the quantity of a few grains; instances, indeed, have oc-
curred, in which an extreme prostration and debility have succeed-
ed the administration of a single grain of this poison, when it has
not occasioned any evacuation. Sometimes, on the contrary,
and particularly in infants, it excites vomiting so copious and pain-
ful as to require an immediate arrest.”
478. “Mixed with lard and other substances,” continues the
same writer, “and applied as an irritant to the surface of the body,
tartar emetic may produce poisoning and death.”
* Eberle's Therapeutics, 4th edition, vol. i. p. 62. -


OLD SCHOOL PRACTICE OF PHYSIC. 123
479. Magendie injected a portion of tartar emetic into the
veins of a dog, which was soon followed by vomiting, difficult
breathing, and ſever, and death tºok place in the midst of symp-
toms proper to inflammation of the lungs. He infers that this
poison “attacks the blood chemically, and decomposes some of
its elements.” He employed it at the Neckar Hospital, but after
a few weeks' trial, ceased to use it altogether.”
480. Dr. Heustis of Alabama, whose opinions, says Dr. Eb-
erle, are entitled to much respect, remarks, “As far as my ob-
servation extends, I think I am warranted in saying that tartar
emetic can never be prudently exhibited in the high and malignant
grades of bilious fever. I am confirmed in this opinion from
having seen and known so many instances of alarming, and some-
times fatal prostration produced by its exhibition. I have known
a person in a high fever, with a strong and full pulse, and generally
increased temperature of the body, in less than two hours after
taking this medicine, to be affected with a death-like coldness; the
pulse at the wrist no longer perceptible, the eye inanimate, the
lips, cheeks, and extremities exhibiting the lividity of death, a cold
and copious sweat exuding from the general surface of the body,
and every symptom of approaching dissolution. Frequent occur-
rences of this nature, have for the last two years, almost entirely
banished the use of tartar emetic from my practice.”f
481. Dr. Good, in his remarks on the antimonial emetics,
says, “Given in small doses, the nausea they produce is accom-
panied with the most deadly langour, and with an atomy, (weakness)
that, in numerous cases, has been succeeded with more mischief
than any degree of benefit that could have been proposed by their
use. ‘Many in this manner,” observes Dr. Percival of Dublin,
in his manuscript remarks on the volume of Nosology, ‘have
sunk under the nauseating doses of emetic tartar, employed, upon
the hypothesis of Dr. Cullen, in low fevers. The heart of a frog
is so torpified by this antimonial, as not to be excited by galvan-
ism, which is not the case with opium. The fraction of a grain
of tartar emetic, in a gouty habit, subject to melaena (black vomit)
and palpitation, produced fainting to an alarming extent.’”f
482. Dr. Jackson of Boston, mentions the case of a laborer,
named Connelly, who entered the Massachusetts Hospital with
inflammation of the lungs, and died in eight days afterward from
the effects, as it was supposed, of tartar emetic. “The medi-
cine was stopped,” says the writer, “from an apprehension of
* Lectures on the Blood, vide Select Medical Library for 1839.
it Eberle's Practice, 4th edtion, vol. i. p. 137.
# Study of Medicine, 6th American edition, vol. 1. p. 95.


124 GLANCE AT THE
evil, though none appeared at the time; but afterwards the patient
had copious and very urgent vomiting.” Dr. J. also observes,
“I well remember that we feared the medicine might have con-
tributed to the fatal issue.” Again, in some general remarks on
antimony, he says, “The powers of life are much depressed
under its long continued use, and it has been suspected of con-
tributing to a fatal issue of the disease for which it has been
given.”
483. Professor Bigelow, in one of his lectures at Harvard
University, spoke as follows of tartar emetic : “It causes long
continued contractions of the stomach, inverts the action of the
duodenum, and causes bile to be thrown up in vomiting. It is
sometimes given in small doses to produce slight nausea, and in
two or three days the patient can take ten times the quantity with
which he commenced, without being affected. It is so harsh as
an emetic, that we cannot give it to children with any degree of
safety. I have known a small quantity of it to throw them into
convulsions. Rubbed on the skin in the form of ointment, it
causes pustules; and when the scabs fall off, ill-conditioned ulcers
are sometimes left; I have known these to be three months in
healing.”
ARSENIC.
484. This is known as white arsenic or arsenious acid, and is
principally obtained from cobalt ores, found in Bohemia and
axony. It is a virulent poison, and is frequently employed for
criminal purposes. Taken in any considerable quantity, says
Bigelow, in his Sequel, “it speedily manifests its presence by a
train of distressing symptoms. These are, dryness of the throat,
intense thirst, a burning sensation in the stomach, gripings, vomit-
ing, tremors, convulsions, delirium, palsy, cold sweats, hiccup,
and finally death. It speedily corrodes the coats of the stomach
and intestines, and leaves the whole body in a swollen and highly
putrescent state. When the quantity taken is not sufficient to
destroy life, it leaves the patient with a train of lingering symp-
toms, such as hectic, tremors and paralysis.”
485. The following case of poisoning by arsenic is quoted by Dr.
Christison from Henke's Journal of Medical Jurisprudence: “A
young man who obtained an arsenical solution from an old woman, to
cure ague, was attacked, after taking it, with vomiting; and after loud
* Researches on the Effects of Blood-letting, etc., by M. Louis; translated
by Dr. Putnam. Preface and Appendix by Dr. Jackson. Boston, 1886.


OLD SCHOOL PRACTICE OF PHYSIC. 125
cries and incoherent talking, he fell into a deep sleep, and per-
ished in convulsions, in five hours.”
486. Improbable as it may seem to the non-professional
reader, arsenic is given internally by the medical faculty in a great
variety of complaints, as ague and fever, chronic rheumatism,
cancer, ulcers, affections of the bones, periodical headach, and
nervous and cutaneous diseases. How far it exercises a medicinal
influence, may be judged from its specific effects, which are “a
general disposition to dropsy, swelling of the face and eyelids, a
feeling of stiffness in these parts, itching of the skin, tenderness of
the mouth, loss of appetite, and uneasiness and sickness of the
stomach.” When these effects are produced, says the United
States Dispensatory, it “must be immediately laid aside.” In-
stead of removing disease, therefore, arsenic, like all other poisons
of the old school materia medica, tends directly to produce dis-
ease, and this is the grand principle upon which it is prescribed.
Of the fallacy of this doctrine I have spoken heretofore, and
need not dwell upon it here. -
487. A medical man once informed me that he gave arsenic
to a patient with the ague and fever, which he could not remove
by any other treatment, and though the disease disappeared in a
short time, the patient was soon after attacked with general
dropsy, and ultimately died. I presume a majority of the cures
by arsenic are similar to the above; the old disease is supplanted
º a new one, which, in a majority of instances, proves inevitably
atal. -
488. Among the various preparations of arsenic, are the
tasteless ague drops, and Fowler's solution, both of which are
dangerous poisons. It enters into the composition also of various
cancer plasters, which are vended by quacks, and which not
unfrequently destroy the lives of those who are foolish enough to
employ them. -
OPIUM.
489. This powerful narcotic is the juice of a species of
poppy, and is sent to this country in large quantities from India,
Persia, Egypt, and Asiatic Turkey. -
490. “Opium,” says Dr. Christison, “produces three lead-
ing effects. It acts on the brain, causing congestion and pro-
found sleep; on the general nervous centre as an irritant, exciting
convulsions; and on the muscles as a direct sedative. It is poi-
sonous to all animals. * * * On man the effect of a small dose

126 GLANCE AT THE
seems to be, in the first instance, to stimulate. The action of
the heart and arteries is increased, and a slight sense of fulness is
caused in the head. The effects of a full medicinal dose, which
is three grains of solid opium, or a drachm of the tincture, are in
general a transient excitement and fulness of the pulse, followed
very soon by torpor and sleep, which terminate in six, eight, or
ten hours in headach, nausea, and a dry tongue. * * * The
symptoms of poisoning with opium, when it is administered in a
dangerous dose, begin with giddiness and stupor, generally with-
out any previous stimulation. The stupor rapidly increasing, the
person soon becomes motionless, and insensible to external im-
pressions; he breathes very slowly, generally lies quite still, with
the eyes shut and the pupils contracted ; and the whole expres-
sion of the countenance is that of deep and perfect repose. As
... "..." advances, the features become ghastly, the pulse
feeble and imperceptible, the muscles excessively relaxed, and
unless assistance is speedily procured, death ensues. If the
person recovers, the stupor is succeeded by prolonged sleep,
which commonly ends in twenty-four or thirty-six hours, and is
followed by nausea, vomiting, giddiness, and loathing of food.
* * * Another symptom of poisoning with opium is delirium,
which occurs now and then, with convulsions.”
491. “On some individuals,” says the United States Dispen-
satory, “ opium produces very peculiar effects, totally differing
from the ordinary results of its operation. In very small quanti-
ties it occasionally gives rise to excessive sickness and vomiting,
and even spasm of the stomach; in other cases it produces rest-
lessness, headach, and delirium; and we have known it, even in
large doses, to occasion obstinate wakefulness. The headach,
want of appetite, tremors, etc., which usually follow, in a slight
degree, its narcotic operation, are uniformly experienced by some
individuals to such an extent, as to render the use of the medicine
very inconvenient.” -
492. Again, says the Dispensatory, “An occasional effect of
opium, which has not yet been alluded to, is a disagreeable itch-
ing or sense of pricking in the skin, which is sometimes attended
with a species of miliary eruption. We have found the effect to
result equally from all the preparations of this narcotic.”
493. Opium diminishes sensibility, and conceals or cloaks up
a disease, but does not remove the cause upon which it depends.
It is frequently used in cough, rheumatism, and similar complaints.
* Manual of Practical Toxicology, pp. 206-7-9. Baltimore, 1833. -
—l

*OLD SCHOOL PRACTICE OF PHYSIC. 127
but people do not seem to be aware that the temporary relief
which it sometimes affords, is owing entirely to the stupifying
effect it has upon the brain and nervous system. It also dimin-
ishes appetite, impairs digestion, and gives rise to costiveness.
A medical writer says, if it be taken at night, the individual will
be ſeverish, and complain of headach in the morning.
494. “In chronic diseases,” said Professor Bigelow, in one of
his lectures, “we give opium to mitigate the symptoms without any
hope of effecting a cure; but if life should be unfortunately pro-
longed for several months, the dose must be increased till we are
obliged to give a very large quantity; the patient becomes peevish
and fretful under its influence, and various bad symptoms are apt
to arise. Hence, opium is an evil in such cases, but not a neces-
sary evil, for it need not be employed.” -
495. Individuals who have made free use of opium, are liable,
while undergoing a course of medicine, to be affected with deliri-
um. I have met with several cases of the kind; and in one of
these, the patient assured me he had not taken a particle of the
drug, in any of its forms, for more than a year. This can only
be explained upon the supposition that opium, like mercury, re-
mains dormant in the system, (455 et seq.) and is roused into ac-
tion by the renovating influence of our mode of practice. A
young lady of my acquaintance, who had taken an immense deal
of laudanum for a nervous disorder, was delirious during three suc-
cessive courses of medicine. This, however, is a very rare oc-
currence, delirium not generally manifesting itself more than once,
or twice at the furthest.
496. MoRPH1A. This is obtained from opium, and is the
poisonous principle of that drug. A single grain has been known
to produce death. Sprinkled upon a wound, it produces the same
effect as though taken into the stomach. Professor Bigelow stated
in one of his lectures, that a girl came to the Massachusetts Hos-
pital with an obstinate nervous affection; he blistered the back of
her hand, and ordered the application of morphia, commencing
with two grains, and gradually increasing the quantity till the de-
sired effect was produced. After the second application, the
apothecary applied one or two scruples. Dr. Bigelow went to
the hospital by accident, and found the girl completely narcotised;
she was stupid, breathed only ten or twelve times in a minute,
and would have died had he not removed the plaster, and made
efforts to recover her.”


128 GLANCE AT THE
497. LAUDANUM or Tincture of Opium. This is prepared
by dissolving an ounce and a quarter of opium in a pint of alcohol.
Twenty-five drops of this is equivalent to a grain of the drug.
Children are often killed with it by inconsiderate parents. “Lau-
danum, when long kept, with occasional exposure to the air,”
says the United States Dispensatory, “becomes thick, in conse-
quence of the evaporation of a portion of the alcohol, and the de-
position of opium. If given in this state, it often acts with unex-
pected energy; and cases of death have resulted in infants from
its use in doses which would have been entirely safe (') if the tinc-
ture had been clear.”
498. PAREgo Ric. This is composed of opium, benzoic
acid, oil of anise, liquorice, clarified honey, camphor, and diluted
alcohol. It is employed by the medical faculty in asthma, con-
sumption, hooping cough, and various other affections. Mothers
also give it to their infants to procure sleep. It is not so strong
as laudanum, but its use is more or less pernicious. Two other
preparations of opium, similar to paregoric, are Bateman's drops,
and Godfrey’s cordial.
499. Dov ER’s Powder. This consists of opium, ipecac-
uanha, and sulphate of potash, rubbed together into a very
fine powder. It is used by medical men in a great variety of
diseases.
500. BLAck D RoP or fleetated Tincture of Opium. This
is prepared with opium, vinegar, and alcohol. One drop of it is
equal to three of laudanum. It is given, says the United States
Dispensatory, when “laudanum or opium itself produces un-
pleasant effects, such as nausea, and vomiting, intense headach,
and great nervous disorder.” The black drop, therefore, must be
an important agent in the hands of the diplomatised physicians.
When the stomach rejects the other poisonous preparations of
opium, they can give this with impunity.
--
colonicum of MEADow sa FFRON.
501. This plant grows in the temperate parts of Europe, and
is cultivated occasionally in the United States. The root is used
by the medical faculty in gout, rheumatism, dropsy, asthmatic and
other affections. “When fresh,” says Dr. Eberle, “it posses-
ses extremely active ..". producing, according to the obser-
vations of Stoerk, w
en taken in a dose less than a grain, “a

OLD SCHOOL PRACTICE OF PHYSIC. 129
burning heat and pain in the stomach and bowels, strangury, tenes-
mus, thirst, total loss of appetite,’ and in larger doses, violent
and even fatal effects.” -
502. Speaking of the use of colchicum in gout, Dr. Eberle
remarks, “It is not allowed on all hands to be always a very safe
remedy. It is stated by very high authority, that although gener-
ally speedily effectual in removing the local symptoms of pain and
inflammation in gout, it has a tendency ..º. the disposition
to the disease much stronger in the system, leading to still more
calamitous results.”
503. “Several cases of poisoning with the meadow saffron,”
says Dr. Christison, “ have occurred in consequence of its too
free use in the treatment of gout. A case is noticed of a man
who took, by mistake, an ounce and a half of the tincture, and
died in forty-eight hours, after suffering much from vomiting,
acute pain in the stomach, colic, purging, and delirium.”f
MINERAL ACIDs.
504. The principal of these are the nitric and sulphuric.
505. Nitric acid is obtained from saltpetre, by the action of
sulphuric acid, and is known to the people by the name of aqua
fortis. It produces “a burning heat in the mouth, gullet, and
stomach; acute pain; abundant eructations; nausea and hiccup.
Soon after, there occur repeated and excessive vomiting, the
vomited matter having a peculiar odor and taste; swelling of the
abdomen, with exquisite tenderness; a feeling of coldness on the
surface; icy coldness of the extremities; a small depressed pulse;
horrible anxieties; continual tossings and contortions; extreme
thirst. The breath becomes very fetid, and the countenance
exhibits a complete picture of suffering. The cases are uni-
formly fatal.”f -
506. The lips, and “inside of the mouth, are generally shriv-
elled, and often more or less corroded. As the poisoning ad-
vances, the teeth become loose and yellowish, and finally they
change to a brown color. The matter vomited is mixed with
shreds of membrane, which resemble the coats of the stomach.
The duration of this variety of poisoning, is commonly between
half a day, and two or three days, though life is sometimes pro-
* Eberle's Therapeutics, 4th edition, pp. 292, 294.
i Manual of Practical Toxicology, p. 275. Baltimore, 1833.
# United States Dispensatory, 4th edition.



17
130 GLANCE AT THE
longed for a week or fortnight. * * * The shortest duration of
any case on record is two hours.”
507. If the stomach be examined after death, it will be “found
extensively disorganized, and the other viscera in the abdomen
sometimes inflamed.”
508. Aqua fortis applied externally, “operates as a strong
caustic, and irritates, inflames, and corrodes the skin.”
509. Sulphuric acid, better known as oil of vitriol, acts upon
the human system very similar to the above, and does not, there-
fore, require a separate consideration.
510. In poisoning from these acids, says Dr. Christison, cases
occur in which the symptoms above described abate in violence,
and a lingering death ensues “from organic disease of the sto-
mach and bowels. The patient becomes affected with general
fever, dry skin, spasms and pains of the limbs, difficult breathing,
tension of the abdomen, salivation, and occasional vomiting, par-
ticularly of food and drink. Afterwards membranous flakes are
discharged by vomiting, and the salivation is accompanied with
fetor. These flakes are often very like the mucous membrane of
the stomach and intestines; and such they have often been de-
scribed to be. More probably, however, they are of adventitious
formation; for the mere mucous coat of the alimentary canal, could
not supply the vast quantity that is discharged. Sometimes worms
are discharged dead, and evidently corroded by the poison. Diges-
tion is at the same time deranged, the whole functions of the bod
are languid, and the patient falls into a state of marasmus, whic
reduces him to a mere skeleton, and in the end brings him to the
grave—the vomiting of membranous flakes continuing to the last.
Death may take place in a fortnight, or not for months. In one
case the patient lived eight months.”
511. Dreadful as are the effects of nitric and sulphuric acids,
medical men prescribe them in a dilute state in various diseases, as
debility, night sweats, loss of appetite, ague and fever, and bleeding
from the lungs. Aqua ſortis, diluted with water, says the United
States Dispensatory, “forms a good acid drink in febrile diseases,
especially typhus.” During my visits at the Massachusetts Hos-
pital, I noticed that aqua fortis was frequently prescribed. In
the French hospitals, they administer what is termed sulphuric
lemonade in fevers, which consists of sulphuric acid, water, sugar,
and I believe some other ingredients.
512. When the above acids are employed, says Dr. Eberle,
* Manual of Practical Toxicology, pp. 52–3, 54. Baltimore, 1833.


01, D SCHOOL PRACTICE OF PHYSIC. 131
they should be sucked through a quill, (233) that they may not
corrode or injure the teeth; but he suggests no provision whereby
the delicate coats of the stomach may be protected from their
violent or dangerous effects. -
PRUssic ACID.
513. Prussic or hydrocyanic acid, says the United States
Dispensatory, “is the most deadly poison known, proving, in
many cases, almost instantaneously fatal. One or two drops of
the pure acid, are sufficient to kill a vigorous dog in a few seconds.
Notwithstanding its tremendous energy as a poison, it has been
ventured upon in a dilute state as a medicine. When given in
medicinal doses gradually increased, it causes a peculiar bitter
taste; increased secretion of saliva; irritation in the throat; nau-
sea; disordered respiration; pain in the head; giddiness; faintness;
obscured vision, and tendency to sleep. Occasionally salivation
and ulceration of the mouth are produced.”
514. “The application of a drop or two of prussic acid to
the eye or tongue of a dog,” says M. Orfila, “is sufficient to
produce death in one or two minutes.”
515. Birds have been speedily killed by being exposed to
the vapor of prussic acid. A French physician took a teaspoon-
ful of the acid in a dilute state, and soon fell down insensible, with
difficult breathing, bloated countenance, and locked jaw. Pro-
fessor Bigelow, in one of his lectures, called the attention of his
class to the uncertain operation of this poison as a remedial agent.
He recollected cases in which a very slight increase of the dose
had caused sudden death. He said it had been recommended by
some writers in hooping cough, but he had known it to be admin-
istered to children without any good effect, till they were thrown
into convulsions. -
516. In one of the Parisian hospitals, prussic acid was given
in immediate succession to seven epileptic patients, in an over
dose, and they all instantly died, the first one expiring by the time
the poison was administered to the last.
517. Miss Landon, the poetess, was killed by taking prussic
acid, which was prescribed by her physician as a medicine.
518. Among the diseases in which medical men employ prus-
sic acid, are hooping cough, asthma, tightness of the chest, pul-
monary consumption, and pains or spasms of the stomach.

132 GLANCE AT THE
WHITE WITRIOL.
519. White vitriol or sulphate of zinc, is composed of sul-
phuric acid and zinc, and is used by the diplomatised physicians as an
emetic. They also employ it in minute doses in various affections,
as dyspepsia, ague and ſever, epilepsy, and hooping cough. “The
morbid appearances after poisoning with sulphate of zinc, taken
internally,” says Dr. Christison, “ have been described as follows:
The stomach and intestines, but particularly the intestines, were
found contracted—their outer surface healthy—the inner membrane
of the stomach grayish green, with several spots of effused blood,
and greenish, fluid contents—the inner membrane of the small in-
testines similarly spotted—the rest of the body quite natural.
The poison was detected in the body, not only in the contents,
but likewise in the coats of the º intestines.”
BLUE WITRIOL.
520. This is the sulphate ofopper, and is obtained by evap-
orating waters which hold it in solution. It is an active emetic,
and is used by physicians in cough, ague and fever, chronic
diarrhoea, and various other diseases. The dose for an emetic,
as directed in medical books, is from two to five grains, but Dr.
Bigelow, in his Sequel, remarks, “I have rarely found the stomach
of a female patient capable of retaining a quarter of a grain, and
have often seen vomiting produced by a much smaller quantity.”
Physicians, therefore, who give two grains, or more, at a time, incur
the risk of doing serious mischief, if they do not in some instances
kill their patients. The United States Dispensatory observes,
“Orfila cautions against the giving large doses of this salt as an
emetic in cases of poisoning, as it is apt, from its poisonous ef-
fects, to increase the mischief. Upon the whole, such is the ac-
tivity of sulphate of copper, that it ought to be exhibited with the
greatest caution.” The same work, speaking of the combinations
of copper, says, they produce, when taken in doses sufficiently
large, “a coppery taste in the mouth; nausea and vomiting; vio-
lent pain in | stomach and bowels; frequent, black and bloody
stools; small, irregular, sharp, and frequent pulse; faintings;
burning thirst; difficulty of breathing; cold sweats; paucity of
urine; violent headach; cramps, convulsions, and finally death.”
* Manual of Practical Toxicology, p. 146. Baltimore, 1833.
—l



ol, D SCHOOL PRACTICE OF PHYSIC.
- -
GREEN VITRIOL OR COPPERAS.
521. This is the sulphate of iron, and is given by the medical
faculty in scrofula, hemorrhage, cold sweats, obstruction of the
menses, fluor albus, and other complaints. “In large doses,”
says the United States Dispensatory, “it is apt to produce nausea
and vomiting, and griping of the bowels; and if its use be too
long continued, it injures the stomach.” Dr. Christison remarks,
“Two drachms of the sulphate of iron will sometimes prove fatal
to dogs, either when administered internally, or when applied to a
wound; and it has likewise been known to act injuriously on the
human subject. A case is related of a girl, who took as an em-
menagogue, an ounce of the sulphate dissolved in beer, and who
was seized in consequence with colic pains, and constant vomiting
and purging for seven hours.”
squili,
522. The squill is a plant which grows on the seacoast of
Spain, France, Italy, Greece, and the other countries bordering
on the Mediterranean. It has a very large bulb or root, which is
frequently employed by the old school physicians. In the recent
state, it “abounds in a viscid, very acrid juice, which causes it to
inflame and even excoriate the skin, when much handled. It is
expectorant, diuretic, and in large doses emetic and purgative.
In over doses it has been known to occasion hypercatharsis, (ex-
cessive purging) strangury, bloody urine, and fatal inflammation of
the stomach and bowels.”f -
523. The root of the squill, says Dr. Christison, “causes
sickness, vomiting, diarrhoea, gripes, and bloody urine, when given
in over doses. It has likewise produced narcotic symptoms. An
instance is mentioned of a woman, who died from taking a
spoonful of the root in powder to cure tympanites,” (disten-
sion of the abdomen with wind.) She was immediately seized
with violent pain in the stomach, and in a short time expired in
convulsions. The stomach was found every where inflamed, and
in some parts eroded. Twenty grains of the powder have proved
fatal; and a quarter ºf a jºin. sirup of squill, which is
a common medicinal dose, has been known to cause severe vom-
iting and purging.”
* Manual of Practical Toxocology, p. 161. Baltimore, 1833.
t United States Dispensatory, 4th edition, 1839.
# Manual of Practical Toxicology, pp. 27.2–3. Baltimore, 1833.

















134 GLANCE AT THE
524. Among the numerous preparations of this plant, is the
sirup of squill, which is so frequently given to children in croup,
and other diseases of the respiratory organs. -
STRAMONIUM or THORN APPLE,
525. This is a well known plant, with large leaves, and a very
rank smell. It grows by the road-sides, near houses, and in the
suburbs of villages, where the soil is rich. It is a poisonous
herb, and is therefore esteemed by the medical faculty as an ar-
ticle of their materia medica. “It usually causes more or less
disturbance of the brain, indicated by vertigo, headach, dimness
or perversion of vision, and confusion of thought, sometimes
amounting to slight delirium or a species of intoxication.” Taken
in doses sufficiently large to produce death, it causes “heartburn,
excessive thirst, nausea and vomiting, a sense of strangulation,
anxiety and faintness, partial or complete blindness with dilatation
of the pupil, vertigo, delirium of a furious, or whimsical charac-
ter, tremors of the limbs, palsy, and ultimately stupor and con-
vulsions.” -
BELLAT)ONNA OR DEADLY NIGHT SHADE.
526. This is the atropa belladonna of botanists, and is a na-
tive of Europe. Every part of the plant is poisonous, and acts
upon the system with great violence. It causes dryness of the
mouth and throat, intolerable thirst, retching, vertigo, and de-
lirium. The latter, says Dr. Christison, is generally extravagant,
and mostly of a pleasing kind, being accompanied with laughter, or
constant talking. “Sometimes the state of the mind resembles
that of a somnambulist, as in the instance of a tailor who was poi-
soned with a belladonna injection, and who for fifteen hours, though
speechless and insensible to external objects, went through all the
customary operations of his trade with great vivacity, and moved
his lips as if in conversation.” -
527. The delirium is followed, sooner or later, by stupor.
“The pupil is dilated and insensible to light, the face red and
tumid, the mouth and jaws spasmodically affected, the stomach
and bowels insusceptible of impressions, in fact the whole nervous
system prostrate and paralyzed. A feeble pulse, cold extremi-
ties, subsultus tendinum, (twitchings of the tendons) deep coma,
* United States Dispensatory, 4th edition, 1839.


- - -
-
-
0 LD SCHOOL PRACTICE OF PHYSIC. 135
or delirium, and sometimes convulsions, precede the fatal ter-
mination.” -
528. Belladonna applied to the eye, has the effect to dilate
the pupil, and improve the vision temporarily where it is de-
ficient; hence it is frequently employed by ignorant quacks, who
go about the country under the name of oculists, seeking to im-
pose upon the credulity of the people. They make an applica-
tion of the plant, and the patient, who has been partially or wholly
blind, is restored to sight; but by the time the oculist has pock-
eted his fee, and escaped to some other part of the country, he
finds himself as blind as ever.
IPECACUANHA.
529. Ipecacuanha is the root of a plant growing in Brazil,
and also, according to Humboldt, in New Granada. It is the
most harmless emetic employed by the medical faculty, but is
nevertheless not without objectionable properties. It is frequently
harsh in its operation, and in “full doses,” says Dr. Bigelow, in
his Sequel, “inverts the action of the duodenum, producing dis-
charges of bile.” It often leaves the patient in a weak or debili-
tated state, which is not the case with lobelia inflata. It is also
purgative, acting violently, in some instances, on the bowels,
and hence it cannot be employed with safety in consumption,
typhus fever, or any low form of disease. -
530. The emetic property of ipecacuanha resides in an alka-
line principle called emetin or emetia, “ten grains of which,” says
Dr. Eberle, “ have been found sufficient to destroy animals in
twenty-four hours; and on dissection, the mucous membrane of
the whole tract of the alimentary canal, as well as of the respiratory
passages, exhibits marks of strong irritation. It is said also to
manifest narcotic powers. When given so as to excite vomiting,
it generally leaves the patient in a very drowsy disposition.”f
IoDINE.
531. Iodine, which is obtained principally from sea-weeds,
was first discovered in 1812, and since that time has become a
prominent article in the old school materia medica. It is a highly
pernicious drug, and has no doubt destroyed a great many lives.
* United States Dispensatory, 4th edition, 1839.
i Eberle's Therapeutics, 4th edition, vol. i. p. 60.


136 GLANCE AT THE
It occasionally induces salivation, and “in an over dose,” says
the United States Dispensatory, “acts as an irritant poison. In
doses of two drachms administered to dogs,” continues the same
authority, “it produced irritation of the stomach, and death in
seven days; and the stomach on dissection was found studded with
numerous little ulcers of a yellow color.”
532. “Iodine,” says Dr. Marshall Hall, “appears to exert a
singular power over absorption, which is said to have sometimes
led to wasting of the mammae, (breasts) or the testes, during its
employment as a remedy.”
533. “In medicinal doses, such as a quarter of a grain, fre-
quently repeated,” says Dr. Christison, “it is a dangerous poi-
son, unless its effects are carefully watched. For in consequence
of absorption and accumulation in the system, it produces, when
long used, some very singular and hazardous symptoms; and
like mercury, foxglove, and some other poisons, it may remain in
the body for a considerable period inactive, and at length begin to
operate suddenly. The symptoms which it then occasions, are
sometimes irritation, incessant vomiting and purging, acute
pain in the stomach, loaded tongue, rapid and extreme ema-
ciation, violent cramps, and small frequent pulse. These symp-
toms may continue many days, and even when subdued to a cer-
tain extent, vomiting and cramps are apt to recur for months.
534. “Among the leading effects of iodine,” continues Dr.
Christison, “when slowly accumulated in the body, the follow-
ing ". been summarily specified,—absorption of the fat; in-
crease of all the excretions; dinginess of the skin, with frequent
clammy sweats; hurried, anxious breathing; diuresis, and an ap-
pearance of oil floating in the urine; increased discharge of feces,
which are usually bilious, but free of mucus; increased menstrual
discharge; swelling of the superficial veins, and lividity of the
lips; feebleness of the pulse, with a superabundance of serum in
the blood; impaired digestion, and diminished secretion of saliva
and mucus. The affection thus induced has been termed iodism.”f
535. Among the various diseases in which the systematic
physicians employ iodine, are swelling or enlargement of the
glands, scrofula, nervous affections, palsy, gleet, fluor albus, and
dropsy of the abdomen. They use it both internally and ex-
termally. - -
* Practice of Medicine, by Drs. Bigelow and Holmes, p. 77.
# Manual of Practical Toxicology, p. 64. Baltimore, 1833.


oLD SCHOOL PRACTICE OF PHYSIC. 137
CANTHARIDES.
536. Cantharides or Spanish flies, are applied externally by the
diplomatised physicians to raise a blister, and given internally in
typhus and malignant fevers, dropsy, asthma, cutaneous º
pulmonary consumption, and so on to the end of the chapter.
their acrid or poisonous character, we may be convinced by
perusing the following extract from Orfila.
537. “Applied to the skin, or introduced into the stomach,”
says he, “cantharides often occasion serious accidents which may
be followed by death. The symptoms which arise when they
have been swallowed, are, an unpleasant and nauseous smell; a
very disagreeable, acrid taste; burning heat in the stomach, and
other parts of the abdomen; frequent vomitings, which are often
mixed with blood; copious and more or less bloody evacuations
from the bowels; violent pain in the abdomen, especially about
the pit of the stomach; obstinate and very painful priapism; heat
in the bladder; great difficulty in passing the urine; sometimes
the latter is entirely suppressed, and when the patient succeeds in
passing a few drops, it is with the greatest difficulty and pain;
sometimes it is mixed with blood; the pulse is frequent and hard;
in some cases it is impossible to make the individual swallow
drinks—they are rejected with horror; the jaws are tightly closed;
at length dreadful convulsions, a general stiffness, and delirium,
manifest themselves, and death hastens to close the scene.”
538. Mrs. Gove of Boston, was in the habit of stating in her
lectures on Anatomy and Physiology, that she knew a female
with fluor albus, to whom cantharides were administered by direc-
tion of her physician, and the patient went on increasing the dose
from time to time, until she took the enormous quantity of one
thousand drops a day.
DIGITALIS OR FOXGLOVE.
539. This is a beautiful but poisonous plant, which grows
wild in the temperate countries of Europe, and is cultivated in the
United States as an ornament in gardens. It is described by
Professor Chapman as a narcotic sedative, and from its effect in
weakening the action of the heart, it reduces the pulse from the
ordinary standard to 50, 40, or even 30 strokes in a minute. It
also diminishes the temperature of the body; Dr. Currie remarks,
* Orfila on Poisons, pp. 75–6. Boston, 1826,


1S
138 GLANCE AT THE
that repeated doses of it have reduced the heat to 89 degrees,
which is 10 or 11 degrees below the healthy standard.
540, “When administered in quantities sufficient to bring the
system under its influence,” says the United States Dispensatory,
“it produces a sense of tightness or weight with dull pain in the
head, vertigo, dimness or other disorder of vision, and more or
less confusion in the mental operations.” It also gives rise in
some instances to hoarseness, salivation, disturbance of the bowels,
nausea, and even vomiting. “A peculiarity of the digitalis,”
continues the Dispensatory, “is, that after having been given in
moderate doses for several days, without any apparent effect, it
sometimes acts suddenly with an accumulated influence, endan-
gering even the life of the patient. It is, moreover, very per-
manent in its operation, which, having once commenced, is main-
tained like that of mercury, for a considerable period, without any
fresh accession of the medicine. * * * In numerous in-
stances death has resulted from its incautious employment.”
541. Digitalis is used by the diplomatised physicians in
catarrh, asthma, difficulty of breathing, rheumatism, hemorrhage,
and a wide range of febrile and inflammatory diseases. They
formerly regarded it as a specific in consumption; but do not now
esteem it so highly in that complaint, and Dr. Parr has even
asserted that it is more injurious than beneficial. (208)
542. Professor Chapman expresses the belief that digitalis is
occasionally useful in the early stages of consumption, but he says
“even here it proves exceedingly precarious, and very often is
manifestly injurious, by prostrating strength, and accelerating the
progress of the disease. Like mercury, and some other articles
of the materia medica, it seems, in many instances of consump-
tion, to exchange its medicinal for a poisonous action on the
system, and whenever this happens, we have a train of affections
induced, which hurry the case to a fatal issue.”
NUX WOMICA.
543. This is the fruit of a tree growing in the East Indies,
and is one of the most powerful and destructive of all known
poisons. Nevertheless, it is used by the medical faculty in vari-
ous disorders, as ague and fever, mania, epilepsy, hydrophobia,
rheumatism, gout, dysentery, fluor albus, palsy, scrofulous sores,
and chronic eruptions. It is a narcotic, and acts, upon the brain
and nerves, producing insensibility, and powerful muscular Con-
* Chapman's Therapeutics, 6th edition, vol. ii. p. 177.



ol, D SCHOOL PRACTICE OF PHYSIC. 139
tractions, similar to those in locked-jaw. It is frequently employ-
ed to kill dogs, and causes in them “great anxiety, laborious and
confined breathing, nausea, retching, tremors, violent convulsions,
and frequently death.” In the human subject, as in animals, the
muscles become rigidly fixed from the use of this poison, and
death is the inevitable result.
544. Strychnia is the active principle of nux vomica, and is
generally used instead of the drug itself. Professor Ware of
Harvard University, told his class that he saw a patient with
tetanic symptoms, whose death, he had every reason to believe,
was occasioned by an over dose of this article.
545. Some of the medical faculty entertain strange motions
with regard to the action of nux vomica. Dr. Chapman says,
“What is very singular, it is declared, that by a sort of elective
affinity, the action of the medicine, when it is given in the proper
dose, is directed to the affected limb, leaving all the sound parts
untouched, and this is apt to take place in proportion as the limb
is deprived of sensation and motion.”
546. This brilliant conception is well worthy of the profes-
sion with which it originated.
NITRE OR SALTPETRE.
547. Nitre or saltpetre, called by chemists nitrate of potassa,
is found in a natural state in earths, the fissures of calcareous
rocks, and in caves. Large quantities of it come to us from
India, and it is also obtained in considerable abundance in various
parts of the United States.
548. Nitre is one of the “cooling remedies” of the orthodox
physicians, and is much used by them in febrile and inflammatory
diseases. It is somewhat similar in its action to digitalis, weak-
ening the action of the heart, and thereby lessening the heat of
the body, and the frequency of the pulse. It is so effectually
“cooling” in some instances, as to deprive the patient of motion
and life. One of its common preparations, is sweet spirit of nitre,
which is formed by mixing two pounds of saltpetre with a pound
and a half of the oil of vitriol, in a glass retort, and adding nine
pints and a half of alcohol; a gallon of the liquid is then distilled,
and an ounce of potash added to it, which constitutes the prepa-
ration in question. -
549. “Notwithstanding the opinion of many physicians,”
remarks M. Orfila, “ nitre is poisonous to man and other animals,
* Chapman's Therapeutics, 6th edition, vol. ii. p. 180.







140 GLANCE AT THE
unless vomited up. It gives rise to obstinate, sometimes bloody
vomitings, to active inflammation of the stomach, and of course
to the whole train of symptoms which are the consequences of
such inflammation. It is to be remarked particularly, that it
affects the nervous system, and frequently occasions a sort of
intoxication, a palsy of the limbs, and convulsions.”
550. Dr. Christison says, that nitre appears to have a two-
fold action on animals, the one irritating, the other narcotic.
“An ounce and a half killed a dog in ninety minutes, when the gul-
let was tied, and a drachm killed another in twenty hours. Death
was preceded by giddiness, slight convulsions, dilated pupils,
insensibility, and palsy. After death, the stomach was externally
livid, and internally reddish black. When nitre was applied ex-
ternally to a wound, it excited violent inflammation, passing into
gangrene, but without any symptoms which indicated a remote or
indirect operation.”
551. With regard to its effects on man, Dr. Christison re-
marks, “In the quantity of a drachm, or a drachm and a half,
recently dissolved in four ounces of water, and repeated every
ninety minutes, it was found that the third or fourth dose caused
chillness, stinging pains in the stomach, and over the whole
body. These sensations became so severe with the fourth
dose, that it was considered unsafe to attempt a fifth. Two cases
which were actually fatal have been described, the one caused
by an ounce of the drug, and the other by an ounce and a half.
In the latter, the symptoms were those of the most violent chol-
era, and the patient died in two days and a half; in the former,
death took place in three hours, and in addition to the symptoms
remarked in the other, there were convulsions, and twisting of the
mouth. In both, the pulse failed at the wrist, and a great ten-
dency to fainting prevailed for some time before death. Similar
effects have been remarked in several cases which have been
followed by recovery.”
552. The following case of poisoning by nitre, is detailed by
Dr. Christison: “A woman, after swallowing an ounce of the drug.
instead of Glauber's salt, lost the use of her speech, and the
power of voluntary motion; she then became insensible, and was
attacked with tetanic spasms. This state lasted till the next day,
when some amelioration was procured by copious sweating. It
was not, however, till eight days after, that she recovered her
speech, or the entire use of her mental faculties; and the palsy of
the limbs continued two months.”
* Orfila on Poisons, p. 65. Boston, 1826.
+Manual of Practical Toxicology, pp. 86–7. Baltimore, 1833.



OLD SCH00L PRACTICE OF PHYSIC. 141
- -
553. It is a common practice to apply saltpetre to pork and
beef to preserve them, and there is no doubt that the meat, cured
in this way, is more or less injurious to the system. Rafinesque
speaks of it as highly pernicious.
554. Dr. Samuel Thomson remarks, that of all the poisons
he ever undertook to expel from the human body, saltpetre has
proved to be the most difficult.
ERGOT OR SPURRED FRYE.
555. Ergot is a term applied by the French to grains of rye
of a morbid growth, which resemble the spur of a cock. They
are of a dark color, unpleasant taste, and brittle texture. Bread
made of grain, containing much of the ergot, is highly poisonous.
The effects which are thereby produced, are thus described by
M. Orfila. “The affection begins,” he observes, “by a disa-
greeable sensation in the feet, a kind of pricking; severe pain in
the stomach, and a desire to vomit soon come on ; the hands and
the head are affected; the fingers are so forcibly contracted that
the strongest man can hardly straighten them, and the joints ap-
pear dislocated. The sufferer utters acute cries, and is tortured
by burning pains in the hands and feet. Heaviness of the head
and apparent intoxication succeed to these pains; the eyes be-
come veiled by a thick mist, and the individual is blinded, or
sees objects double; the mental faculties are deranged; mania,
melancholy, or drowsiness manifests itself; the intoxication in-
creases, and the body is bent backward so as to form an arch;
the mouth is filled with a bloody, yellow, or greenish froth; the
tongue is often injured by the violence of the convulsions, and is
sometimes so swollen as to interrupt the voice, embarrass the res-
piration, and produce a great salivation. -
556. “When ergot has been taken in a large quantity, or for
a very long time,” continues M. Orfila, “the disorder commences
with a very acute pain and intolerable heat in the toes. The pain
rises, gains possession of the foot, and mounts upward on the leg.
The foot soon becomes cold, pale, and livid; the coldness rises
upon the leg, which is very painful, while the foot has become insen-
sible. These pains are more acute in the night than in the day.
There is thirst, but the patient does not lose his appetite, and
the vital functions are performed regularly. He cannot move
nor support himself on his feet. Violet spots and blisters soon
appear; gangrene displays itself in all its horrors, and extends up
to the knee. The leg falls off at the joint, and leaves to view a
bright red wound, which heals up readily, unless the patient, being



142 OLD SCHOOL PRACTICE OF PHYSIC.
badly fed, living in cold and moisture, and sleeping in a bed in-
fected with gangrenous matter, imbibes anew the putrid effluvia.”
557. Professor Chapman says, “By a series of well con-
ducted experiments, Dr. Charles Byrd has shown that pigs,
ducks, and fowls, eating food containing the ergot for a week or
two, acquire a gangrenous state, by which the former lose their
hoofs, and the latter their bills.”f
558. Ergot is given by the old school physicians to women
in labor, to facilitate the expulsion of the child. The mode in
which it acts, says the United States Dispensatory, is, to “pro-
duce a constant unremitting contraction and rigidity, rather than
that alternation of spasmodic effort and relaxation which is ob-
servable in the natural process of labor. Hence, unless the os
uteri (mouth of the "... and external parts are sufficiently re-
laxed, the medicine would be likely to produce injury to the child
by the incessant pressure which it maintains. Such in fact has
been the observation of numerous practitioners, and the death of
the infant is thought not unfrequently to result from the injudicious
employment of the medicine.”
559. The ergot, however, does not only endanger the life of
the infant, but also that of the mother, for the violent uterine con-
tractions which it excites, may lead to a rupture of the organ, or
cause a dangerous hemorrhage, which the practitioner cannot
arrest. -
560. Ergot, administered in the usual doses, has no effect, it
is said, on the system of the male. Its whole force, remarks Dr.
Chapman, is directed exclusively to the uterus. “Given to
pregnant animals,” he continues, “it never fails, in a short time,
to occasion abortion; and in women not with child, some uneasi-
ness about the womb is generally experienced after taking it.”
561. Ergot is a most dangerous article, and should be ex-
- *cluded from the practice of every humane physician.
* Orfila on Poisons, pp. 131–2. Boston, 1826.
t Elements of Therapeutics, 6th edition, vol. i. pp. 339, 341.
-

*** *
P A R T T H I R. D.
VEGETABLE MATERIA MEDICA.
INTRODUCTION.
562. By materia medica is understood a treatise on those
substances which are employed in the cure of disease. The
remedies mentioned in this work, as worthy of the notice and ap-
probation of the public, are derived entirely from the vegetable
kingdom, and are devoid of poisonous or deleterious properties.
The classification which I have adopted, was the only one of a
convenient character which suggested itself to my mind. I have
made six principal divisions, consisting of emetics, stimulants, as-
tringents, tonics, nervines, and purgatives; and under these heads
I have described the more important and useful herbs, according
to their properties; and referred the others to the miscellaneous
department, in a subsequent part of the treatise, introducing them
in alphabetical order. At the end of the work, I have inserted a
chapter entitled “Recapitulation of the Materia Medica,” com-
prising the divisions already named, with some others of a secon-
dary character, which I did not think expedient to introduce
into the body of the treatise. This arrangement will prove a
convenient one for the reader, and will enable him to ascertain the
different plants which may be used for a specified purpose, with-
out travelling over the whole range of the materia medica. For
instance, if it is desirable to know how many emetics there are,
it is only necessary to refer to that head in the recapitulation, and
so of the tonics, nervines, diuretics, or any other class of remedies.

i44 VEGETABLE MATERIA MEDICA.
563. I have but rarely spoken of the chemical analysis of
plants, because I believed with Cullen, that it would be of “no
use in explaining or ascertaining the virtues of medicines.” The
only proper mode of testing the value of a remedy, is by trying
its effects on the living body, and if it be found to act in harmony
with the laws of the animal economy, it may be regarded as a safe
and useful medicine. Chemical analysis is always vague and un-
certain. Cullen says that those who devoted themselves at one
time to this pursuit, “soon perceived, that substances of very
different, and even of opposité qualities in medicine, gave out in a
chemical analysis, very much the same products, and it was there-
fore also perceived, that these analyses hardly threw any light upon
the medicinal virtues of the substances treated in that manner.”
564. The term medicine, I have employed in its legitimate
sense, meaning by it any substance or agent which is capable of
curing disease; but the medical faculty interpret it as synonymous
with poison, and we hear them speak very gravely of opium, cal-
omel, and prussic acid, as medicines. This, however, is an abuse
of language, for as it is the tendency of a poison to generate dis-
ease, it cannot with any propriety be termed a medicine.
565. “To know the name of a plant, and to be able to ascer-
tain its place in the Linnaean system,” says Dr. Waterhouse, “is
- in the opinion of many, to be a botanist, although such a person
may be entirely unacquainted with its structure, and ignorant of its
peculiar or medical properties.” Rosseau, in his Letters on the
- Elements of Botany, . “I have always thought it pos-
sible to be a very great botanist, without knowing so much as one
plant by name.” This leads me to remark, that while the medical
profession, with all their boasted science, have neglected the study
of botany, at least so far as it relates to the properties of indi-
genous plants, it has received the warm and earnest attention even
of uncivilized man. Bosman, in his Description of the Coast of
Guinea, speaking of the different herbs ... by the natives,
says, “I have seen several of my countrymen cured by these
medicines, when our own physicians were at a loss what to do.”
Again he says, “I have several times observed the negroes cure
such extensive and dangerous wounds with these herbs, that I
have looked on with amazement.”
566. Le Vaillant also, in his Travels into the Interior Parts
of Africa, gives an interesting account of the use of vegetable
remedies by the savages of that country. Upon one occasion
*Cullen's Materia Medica, 3d Amer, edition, vol. i. p. 24. Philadelphia, 1808.
__

WEGETABLE MATERIA MEDICA. 145
they cured him of a violent attack of quinsy, after he had given
up his case as hopeless. His tongue and throat were so swelled
that he could only speak by signs; and his breathing became so
much impeded that he expected to be suffocated. In the mean-
time, he was visited by a party of savages, who, feeling an interest
in his situation, pledged themselves to cure him. He had at this
time despaired of his life for nearly a week. The remedy was a
hot local application of a certain herb. It was also to be used as
a gargle. The poultice was renewed several times in the night,
and the gargle still more frequently repeated. When day ap-
peared he was greatly eased. He could breathe more freely, and
the swelling and inflammation of the throat were abated. By the
third day he found himself cured. He then went out to examine
the plant by which he had been restored to health. Nothing in
the country, says he, was more common; it grew all round the
camp, and was to be met with in every direction. He describes
it as a species of sage, about two feet high, with a pleasant
smell, and balsamic taste.
567. Le Vaillant, abounding in gratitude, no doubt, for his
unexpected cure, and regretting that so few of the plants which
cover the surface of the globe, should be unknown, says, “If
there be any of real importance to us, we have been almost
always indebted to savages, or even to beasts, for their dis-
covery.”
568. “The art of healing among the Sumatrans,” says
Marsden, in his history of that country, “consists almost en-
tirely in the application of simples, in the virtues of which they
are surprisingly skilled. All the old men and women in the coun-
try are physicians, and their rewards depend upon their success.”
Marsden also says, “The Sumatrans have a degree of botanical
knowledge that surprises an European. They are in general, and
at a very early age, acquainted not only with the names, but the
qualities and properties of every shrub and herb amongst that
exuberant variety with which their country abounds.”
569. Leaving these rude people, and bestowing a momentary
glance upon the medical faculty, how great do we find the con-
trast. The latter, instead of employing simple vegetable reme-
dies in the treatment of disease, not only make use of violent and
dangerous poisons, but also adopt the most nonsensical modes of
practice that can be imagined.
570. “It is not much more than one hundred years,” says
Dr. Dunglison, in his General Therapeutics, “since the doctrine
of curing the scrofula or king's evil by the royal touch, was
implicitly credited, and not unfrequently followed. The first
English sovereign, who touched for the affection, was Edward


19
146 VE GE TABLE MATERIA MED H CA.
-
the Confessor, who lived in the middle of the eleventh century,
and the last that encouraged it, was Queen Anne, who died about
the commencement of the last century. One of the very last
subjected to the degrading mummery, was the illustrious Dr.
Samuel Johnson, who, by the advice of Sir John Floyer, a
celebrated physician, was carried to London in 1712, where he
was actually touched by Queen Anne, but without effect.”
571. “ The illustrious Bacon,” continues the same writer,
“believed in the virtue of charms and amulets; and Boyle thought
the thigh-bone of an executed criminal, a powerful remedy in dysen-
tery. Celsus advises the warm blood of a recently slain gladiator,
or a certain portion of human, or horse flesh, for the cure of
epilepsy; and remedies of this description are said to have been
actually exhibited for the cure of epileptics, in the poor-house of
Haerlem, by Boerhaave, who lived so recently as the middle of
the last century.”
572. Again, observes the writer, “Calculi found in the
stomach of different animals, and at one time generally presumed
to have the power of warding off contagious diseases, are still
found in the pharmacopoeias of Amsterdam, Brunswick, Spain,
and Wirtemberg. A distilled water of young swallows, exists in
the pharmacopoeias of Manheim, as an anti-hysteric, and anti-
epileptic. The wood-louse is in most of the European phar-
macopoeias, as a remedy in dropsy and asthma. The powder of
the dried frog, is in the pharmacopoeias of Spain, and Wirtem-
berg, as an anti-hydrophobic; the powder of the human skull in
the same pharmacopoeias, as an anti-epileptic; the dried liver of
the mad dog, and that of the wolf, in the pharmacopoeia of Wir-
temberg, as an anti-hydrophobic; the .." mummy, in
those of Spain and Wirtemberg, with the hoof of the stag, for-
merly regarded as a specific in epilepsy; besides many other
articles equally absurd.”
573. Sir Henry Halford, in his account of the deaths of
eminent persons, says, he has “seen a prescription in which a
ortion of the human skull was ordered, in a powder, for Sir
K. Throckmorton.”
574. The United States Dispensatory for 1839, which is the
standard authority of medical men in this country, speaks of the
spider's web as a useful remedy in intermittent fever, periodical
headach, asthma, hysteria, and other diseases, remarking that,
“according to Dr. }. Jackson, it is superior to bark or ar-
senic in the cure of intermittent ſevers.” Dr. Chapman and Dr.
Eberle, in their respective works on Therapeutics and Materia
Medica, have highly extolled its virtues. “It is affirmed,” says
the Dispensatory, with all the gravity in the world, “that the


VEGETABLE MATERIA MEDICA. 147
web of the field spider is inefficacious, while that collected in the
cellars of houses, and similar places, has extraordinary medical
virtues.” “ Spiders themselves,” continues the same authority,
“were formerly employed in the treatment of ague and fever, and
the application of the web to the cure of this disease, is not a
measure of recent date.” -
575. An oil obtained from the liver of the cod-fish, is spoken
of in the Dispensatory as a remedy in various affections. The
same authority recommends cuttle-fish bone, and ow gall, as reme-
dial agents. After this, we need not laugh at the physicians of
Wirtemberg for using the dried liver of a mad dog, as a cure for
hydrophobia. -
576. Such is medical practice at the present day, according
to the pharmacopoeias and elementary works on medicine, and
though we may be disposed to ridicule the idea of employing
horse flesh, the bones of executed criminals, woodlice, frogs,
human skulls, dried livers, Egyptian mummies, spider’s web, and
even spiders themselves, as agents in the cure of disease, they are
no doubt much less deleterious than the thousand and one poisons
in daily use by the physicians. I would rather eat a dozen frogs
than be salivated with calomel, or feast upon an Egyptian mum-
my for a month, than take opium, tartar emetic, arsenic, or any
of those fashionable poisons in their ordinary doses.
577. Before closing my introductory remarks, I will observe,
that, although a few well selected plants are all-sufficient for the
cure of disease, yet there is an advantage in having a somewhat
extended knowledge of the vegetable productions of our country,
as this will enable us, in cases of emergency, to administer to the
wants and necessities of the sick, when our accustomed remedies
are not at hand. I will mention a case in point. While travers-
ing the woods of New Jersey, on a botanical excursion, I was
accosted by a woman who came out of a cottage, and enquired
whether I was a physician. She was led to this conclusion from
the fact that she had frequently seen medical men from Philadelphia,
rambling the woods in that section, in search of plants. She said
her husband was very ill, and desired me to see him. I found
him in bed, with all the symptoms of a violent fever. His skin
was hot and dry, and his tongue covered with a thick fur. His
head also ached violently. The disorder commenced with a pain
in the face, for which a poultice of pipsissewa leaves were ap-
plied to the back of the neck, the object being to draw the pain
in that direction. This was the advice of a colored woman living
near the patient, and she no doubt borrowed the notion from the
routine, antiphlogistic physicians. The poultice, however, irri-


148 VEGETABLE MATERIA MEDICA.
tated the skin, and the patient’s wife removed it, and substituted
a fly blister, which she happened to have in the house. Between
these two applications, the back of the neck became extensively
ulcerated, and had an offensive smell. Wishing to afford the
suffering man every relief in my power, I went out and gathered
some plants, consisting of pennyroyal, fleabane, blue vervain, and
leaves of the sumach, which I found in the course of half an
hour's ramble. I employed the blue vervain as an emetic, which
cleansed the stomach effectually, and administered a tea of the
fleabane as an injection, which I was enabled to do by means of a
bladder and pipe. The patient now began to perspire. I gave
him pennyroyal tea to drink, in any quantity he pleased, and
washed the sore on the back of the neck with soap suds, follow-
ed by a tea of sumach leaves. This rendered it tolerably clean,
and divested it of its unpleasant smell. I then applied a poultice
of bread and milk, with a small portion of ginger, which I found
in the house, directing that it should be renewed two or three
times a day, and the sore washed each time as already mentioned.
The patient was now quite comfortable, and I left him with orders
to continue the treatment until the fever was subdued. In a
month or six weeks, I passed near the cottage, on another botan-
ical excursion, and was told by his wife that he recovered soon
after my departure. Now had he been bled, and dosed with
poison, how different might have been the result! Instead of a
speedy and effectual cure, he might have been stretched upon the
bed of sickness for months, and his little family, in the meantime,
suffering for want of the common necessaries of life. I do not
make these remarks with a view to reflect discredit upon physi-
cians, but with the hope that they may be induced to "...! their
practice, and place more reliance, than they ever have done, upon
the vegetable productions of our country.
578. Dr. Chapman, in his Therapeutics, observes, “It is
more than probable, that on some Alpine height, or along the
margin of some stream that pervades our wide-spread continent,
there blooms many a plant, wasting its virtues on the desert air,
which, were it known, might be peculiarly adapted to the various
forms of disease, and capable of reducing the lengthened catalogue
of the opprobria medicorum.”
579. Let me add, that this golden dream has already been
realized by thousands, nay, millions of the intelligent people of
this country, while the medical faculty still continue to adhere to
their favorite dogmas and long cherished delusions, ignorant, as
they were in the days of Celsus, of the first principles of the
healing art.
VEGETABLE MATERIA MEDICA. 149
PROXIMATE WE GETABLE PRINCIPLES.
580. These are numerous, and of very different kinds. They
are not all to be met with in every plant, or in every period of
vegetation. I shall describe those only which are of a prominent
medicinal character. -
581. GUM. This is one of the most abundant proximate
principles in plants. It exudes spontaneously from the peach,
plum, cherry, and other trees, and is obtained by making inci-
sions into their trunks and branches. It is soluble in water, but
insoluble in alcohol, or oil. It is precipitated by the addition of
alcohol to its watery solution. No proper distinction exists be-
tween gum and mucilage; the former, however, differs from resin,
as will be explained hereafter.
582. Gum, in a state of watery solution, is soothing to the
stomach and bowels, and is therefore useful in many forms of dis-
ease. It is sometimes employed as a medium to combine bal-
sams, resins, or oils, with water.
583. OILs. Vegetable oils are divided into two classes, the
fired and volatile. -
584. Fived oils are found in various parts of plants, but more
particularly in the seeds, and are obtained by bruising the seeds,
and submitting them to pressure, so as to force out the oil, or by
boiling them in water, and skimming off the oil as it rises to the
surface. The term expressed oil, is generally used as synonymous
with fired, but it is incorrectly applied, for the volatile oils are
sometimes obtained by expression. The fixed oils, in the pure
state, have but little taste or smell. They are insoluble in water,
and sparingly so in alcohol. They do not evaporate even at the
boiling point of water, and hence the term fived in contradistinc-
tion to that of volatile—the volatile oils passing off in vapor at a
low temperature. The fixed oils combine with alkalies, and form
soap. By exposure to the air, they generally become thick and
rancid. They freeze at various temperatures, olive oil becoming
solid at about 32 degrees of Fahrenheit, and linseed oil continuing
fluid at 4 degrees below zero. -
585. Wolatile or essential oils, exist in all aromatic plants,
and give to them their odor or fragrance. They are usually pro-
cured by distilling the plants which contain them, with water; but
in some instances they are obtained by pressure, as from the ber-
gamot, and the rind of the lemon, and orange. Their taste is aro-
matic and pungent. They are soluble in alcohol, and slightly so

150 WEGETABLE MATERIA MEDICA,
in water. Dissolved in the former, they constitute essences.
They evaporate at a low temperature, and are speedily converted
into vapor at the heat of boiling water.
586. Volatile oils, says the United States Dispensatory, are
frequently adulterated with the fixed oils, turpentine, and alcohol,
and sometimes a volatile oil of little value, is added to one which
is more costly. In the latter instance, the taste and smell will
afford some clue to the fraud. The fixed oils may be discovered
by the permanent stain which they leave on paper, while that occa-
sioned by a pure volatile oil, disappears entirely when exposed to
heat. If alcohol is present, the oil becomes milky when agitated
with water.
587. Volatile oils should be preserved in small, well-stopped
bottles, entirely filled with the oil, and excluded from the light.
588. RESINs. These are obtained chiefly from the vege-
table kingdom, either by spontaneous exudation, or from incis-
sions made into vegetables affording juices which contain this prin-
ciple. They differ from gums in being insoluble in water, but
soluble in alcohol, and the essential oils. They melt at about the
temperature of boiling water. The existence of a resin in a veg-
etable is discovered by infusing it in alcohol; this dissolves the
resin, if any is present, and it can then be precipitated from the
solution by the addition of water. Rosin is a well known resin,
which is separated from the oil of turpentine by distillation.
Copal, of which varnish is made, is another resin. This principle
is sometimes associated with gum, and is then termed a gum-
resin. Under this head, aloes and myrrh may be ranked. The
gum-resins, as a general thing, are most effectually dissolved in
equal parts of water and alcohol.
589. Resins are employed in making ointments, plasters, and
similar preparations.
590. BALsAMs. These are vegetable juices, consisting of
essential oil, resin, and benzoic acid. They have a strong odor,
and a pungent taste. Water will not dissolve them, but they are
readily soluble in alcohol, from which they are precipitated by the
addition of the former. They are usually thick, and tenacious,
but become concrete by age. The balsam of the silverfir is one
of the medicines recommended in this work.
591. CAMP Hon. This well known substance is found em-
bedded in the trunk of a tree growing in Sumatra and Borneo,
and is also contained in lavender, sage, peppermint, and other
plants. It is soluble in alcohol, but not in water, though it

vegetABLE MATERIA MEDICA. 151
communicates its smell to the latter. It is useful, sometimes, as
an external application. -
592. TANNIN. Tan or tannin, is the astringent principle of
plants, and is well known as the substance employed in tanning
leather. It combines with the hides, and renders them firm and
tough. It exists plentifully in oak and hemlock bark, and in veg-
etables which are astringent to the taste, as bayberry, pond lilly,
and marsh rosemary. It has the property of uniting with animal
jelly, and forming a substance insoluble in water. Vegetables
containing tannin are among the most valuable employed in the
healing art.
593. AcIDs. There are a large number of vegetable acids,
but those most commonly mentioned in works on materia med-
ica, are the acetic, malic, citric, oxalic, benzoic, tartaric, and
gallic. -
594. Acetic acid or vinegar, is generally the product of fer-
mentation, but exists already formed in the sap of some plants.
Wine, cider, and beer, are capable of affording vinegar by pass-
ing through what is termed the acetic fermentation.
595. Malic acid exists in the juice of apples.
596. Citric acid is often associated with the malic acid in
fruits, but exists in a purer form in the juice of the lime and
lemon, from which it is extracted. It is present also in the juice
of the strawberry, and garden currant, imparting to them their
acid taste.
597. Ovalic acid is found in a number of plants, and particu-
larly in the ovalis acetosella or wood sorrel. It is a fatal poison,
producing death in some cases in ten minutes. Chrystallized ox-
alic acid bears a resemblance to Epsom salt, and is sometimes
sold by mistake for this article in the drug stores. Death fre-
quently occurs from this cause.
598. Benzoic acid is found in the vegetable balsams.
599. Tartaric acid is contained in the juice of the grape,
combined with potash. It is also found in other fruits. It is ob-
tained for domestic use from a substance denominated tartar,
which collects on the inside of wine casks, during the fermentation
of the wine. This, being purified, is termed cream of tartar, and
by a chemical process is converted into the tartaric acid of the
shops. This acid, dissolved in water and sweetened, is some-
times used as a substitute for lemonade. The soda powders which
are vended by druggists, consist of twenty-five grains of tar-
taric acid, and half a drachm of bicarbonate of soda, put up in
separate papers. An effervescing draught is formed by dissolving

I52 - VEGETABLE MATERIA MEDICA.
each powder in a separate portion of water, and mixing the
solutions.
600. Gallic acid is found in vegetables possessing astringent
properties, and was at one time supposed to be the principle of
astringency, instead of the tannin, with which it is combined. It
is an ingredient in ink, and is extensively used in coloring black.
weights AND MEASUREs.
601. Weights.
20 grains, . . . . . . . . . I scruple.
3 scruples, . . . . . . . . 1 drachm.
8 drachms, . . . . . . . . 1 ounce.
12 ounces, . . . . . . . . 1 pound.
602. A moderately heaped tea-spoonful of green lobelia,
weighs 40 grains; of brown lobelia, 44 grains; of cayenne, pure,
59 grains; of bayberry, 56 grains; of unicorn root, 56 grains; of
golden seal, pure, 56 grains; of lady’s slipper, pure, 48 grains;
of skull cap, 38 grains, and so of the various roots, herbs, and
barks, according to their bulk, or density.
603. JMeasures.
8 fluid drachms, . . . . . . I fluid ounce.
16 fluid ounces, . . . . . . . pint.
2 pints, . . . . . . . . 1 quart.
4 quarts, . . . . . . . . I gallon.
604. A gill is equal to four fluid ounces, or the half of a
common half pint tumbler.
605. Another Scale.
A tea-spoonful is nearly equal to a fluid drachm.
Six tea-spoonfuls are equal to a fluid ounce.
A table-spoonful is equal to three tea-spoonfuls.
Ten table-spoonfuls are equal to a tea-cupful.
Three tea-cupfuls are nearly equal to a pint.
606. If it is desirable to make very nice distinctions in quan-
tity, it will be necessary to procure a graduated measure, which
can be purchased at the glass, or drug stores, in any of our prin-
cipal cities.
__

VEGETABLE MATERIA MEDICA. 153
COLLECTING, DRYING, AND PRESERVING PLANTs.
607. Instructions on this subject will be given, when neces-
sary, in describing the different plants, but a few general hints in
a connected form, will be of service here.
608. Roots should be collected in the spring before the sap
rises, or in the autumn after it descends. They are to be freed
from dirt, deprived of their decayed or useless parts, and dried in
the sun, or in a warm, airy room. Artificial heat, varying from
60 to 100 degrees, may be employed, if necessary. If roots are
large, or juicy, they should be split, or cut into slices, before at-
tempting to dry them. If the bark of the root only is wanted,
as in the bayberry, it should be peeled off, or separated in some
convenient manner, and the woody fibre thrown away. Annual
roots should be collected just before the flowers appear, and bi-
ennial roots either in the summer of the first year, or in the
spring of the second. After the roots are dried, they should be
º in drawers, covered boxes, or barrels, where they will not
e exposed to the damp. It should be borne in mind, that they
lose their strength, if ground or pulverized a long time before re-
quired for use.
609. Barks are collected in the spring and autumn, and if
requisite, deprived of their outside coat, as in the elm and poplar.
The bark of young trees is generally the best. After it is de-
tached, it should be dried in the same way as roots, using the pre-
cautions to keep it out of the rain, and not expose it to a damp
atmosphere. -
610. Herbs should be gathered in clear weather, when there
is no dew or moisture upon them, and spread thinly upon the
floor of a chamber or loſt, where there is a free circulation of air.
In the process of drying, they should be frequently turned.
611. Herbs are generally in the greatest perfection ust before
or during the flowering period. If dried in the open air, they
should not be left exposed to the rain, or dew, as this would be
likely to change their color, and impair their virtues. If the at-
mosphere continues damp for any length of time, they may be
dried with a gentle heat from a fire or stove; after this, they are
usually put into boxes, or cannisters, and excluded from the air.
Plants which are exceedingly volatile, should be preserved in well
stopped jars. Sumach berries, and other medicines which are in
danger from worms, or * require to be kept in covered glasses.
0

154 VEGETABLE MATERIA MEDICA.
-
612. Leaves are mostly collected when they are full grown.
They are to be dried and preserved in the same manner as herbs.
Those that are thick and juicy, may be exposed to an artificial
heat, gradually raised to 100 degrees of Fahrenheit.
613. Flowers are to be collected in clear, dry weather, just
before, or immediately after, they have bloomed. They require to
be dried in the shade, and in as short a time as possible, that they
may retain their odor and color.
614. Seeds are gathered when they are fully ripe, separated
from the chaff or dirt, and deposited in a clean, dry place, secure
from worms and insects.
615. Families in the country may sometimes find it conve-
nient to prepare their own medicines, and with this view they
should be supplied with a mortar, break, and pestle, to reduce the
different articles to powder. My friend Dr. A. C. Logan, has
adopted a simple and well contrived plan, for this purpose. He
has a mortar weighing about thirty pounds, covered with a hood,
which is fastened below the rim of the mortar with two or three
moveable wooden pins. He then employs an iron break, weigh-
ing five pounds, and inserted into a handle three feet and a half
long, which enables him to reduce the toughest roots and barks
to a tolerably fine powder, in a very short time. The break is
worked up and down through a hole in the centre of the hood.
Its face is rounding, three inches and a half in diameter, and cut
into teeth with a file from the centre to the circumference, in the
form of a star. The process of pulverizing is completed by an
iron pestle, weighing nine pounds, which is similar to the break,
excepting that the face is smooth.
616. A newly invented coffee or spice mill, has lately come
into use in New England, by which barks, roots, and especially
gum myrrh, are reduced to powder with comparatively little
trouble. I am not aware that there is any thing peculiar in the
construction of the mill, except perhaps that it is a little stronger
than those in common use, and is designed to be nailed to the
edge of a heavy table, or counter.

-
-
VEGETABLE MATERIA MEDICA. 155
EMETICS.
617. Emetics are substances which are employed to evacuate
the stomach by vomiting. They produce this effect independently
of any nauseous taste or smell. Vomiting is also excited by riding,
swinging, the motions of a ship at sea, a disagreeable flavor,
the sight of a disgusting object, or some sudden or unexpected
news.
618. Emetics appear to act through the agency of the brain
and nerves. For example, if lobelia be administered by injection,
it will occasion vomiting as effectually as though it had been in-
troduced into the stomach. Here a local impression is made on
the nerves of the intestines, which is communicated to the brain,
and the stomach is excited to discharge its contents. If the brain
is stupified with narcotics, however, vomiting will be produced with
difficulty, for it is incapable of receiving the impressions which
would otherwise be transmitted to it by the nerves. For the
same reason, it is sometimes extremely difficult to excite vomit-
ing in the delirium of typhus fever, the brain being unable, from
the morbid excitement under which it labors, to perform its func-
tions in a natural or healthy manner.
619. The importance of emetics in the treatment of disease,
will be readily acknowledged by those who take into consideration
the intimate sympathy existing between the stomach and other
organs and parts of the body. Dr. Good very justly observes,
“As the stomach is the common centre of sympathy, it is not to
be wondered at that nausea, or sickness, should be a symptom
common to a variety of diseases, seated in organs more or less
remote from itself; hence we find it occurring in colic, chol-
era, stone, the accession of fevers, repelled gout, and various
complaints of the head.”
620. A severe local affection will very soon disorder the
stomach, and produce a new train of symptoms, unless prevented
by the use of appropriate remedies. I was once asked by a med-
ical man, in way of derision, whether I would give an emetic in
case of a broken leg. I replied, that if the local irritation, occa-
sioned by the fracture, was likely to affect the whole system, and
thereby derange the stomach, I would certainly administer an
emetic, for I knew of no better means of preventing the devel-
opment of constitutional symptoms, which might ensue, and per- -
haps prove fatal to the patient.
621. The sagacious Dr. Cullen, for he was sagacious in many
respects, was led to perceive the important influence of the



156 VEGETABLE MATERIA MEDICA.
stomach in certain diseases, but it does not appear that he adopted
any adequate or specific means to change its morbid condition.
For example, he says, “the paroxysms of gout are commonly
preceded by an affection of the stomach,” but in the treatment of
gout, he produced a still greater derangement of the organ, by
making it the receptacle of poisonous drugs. Consequently, he
retarded rather than accelerated the progress of cure. Hence his
well known exclamation, “I am much disposed to believe the
impossibility of a cure of the gout by medicines; and more cer-
tainly still incline to think that, whatever may be the possible
power of medicines, yet no medicine for curing the gout has yet
been discovered.”
622. The stomach possesses to a great degree the control of
every other organ in the body, and it is only through its influence,
that the system is enabled to overcome disease. In wounds, for
example, the healing process is very much retarded, if the sto-
mach is in a diseased or morbid state; but on the other hand, if
the organ is healthy and vigorous, a wound will heal with surpris-
ing rapidity, and almost without any care or attention on the part
of the patient. In my visits to the public hospitals, I have seen
indolent ulcers of one or two years' standing, which I was confident
might have been cured in a few weeks, by adopting the proper
means to cleanse and invigorate the stomach, and improve the
general health.
623. The stomach is frequently the seat of disease, when no
suspicion of the fact is entertained by the medical attendant.
Professor Revere of Philadelphia, stated to his class, that he was
called to a blacksmith, who was pronounced by another physician,
previously in attendance, to have inflammation of the brain; but
on an examination of the symptoms, Professor R. came to the
conclusion, that the difficulty arose from some indigestible substance
in the stomach, and prescribed an emetic, which afforded imme-
diate and entire .." Had the lancet been employed, continued
the professor, under the impression that the brain was the seat of
the malady, the constitutional energies of the patient would have
been impaired, and weeks might have elapsed before his recovery.
624. A familiar story is related of a young man who was at-
tacked with a violent fever, and was bled, blistered, and dosed
with calomel for nearly a week, without any benefit, when he ac-
cidentally vomited, and discharged a quantity of fat pork, which
he recollected to have eaten about the time his sickness com-
menced. He began to recover as soon as his stomach was thus
unloaded of its vitiated or indigestible contents.
625. “The dissection of dead bodies,” says Cullen, “shows
that the stomach has been very often affected with inflammation,
WEGETABLE MATERIA MEDICA. 157
when the characteristic symptoms of it had not appeared; and
therefore we cannot lay down any general rule for the cure of this
disease /*
626. Beaumont had occasion to observe that the stomach of
St. Martin was at one time unusually morbid, without any essen-
tial aberration of its function being manifested. Its lining mem-
brane was inflamed, and covered with livid spots, from which small
drops of blood exuded, and yet St. Martin had a good appetite,
a uniform and regular pulse, and complained of no symptom indi-
cating any general derangement of the system. At other times,
however, symptoms in a remote part were clearly referable to
the stomach; and Beaumont remarks, that “the violent spasms
and contortions affecting different parts of the body, which occa-
sionally supervened on the introduction of crude or indigestible
food into the stomach, were pretty clear indications of the power-
ful sympathy which existed between that and other organs.”
627. Dr. Eberle, in his Therapeutics, remarks, “The effects
of impression on the stomach, are often manifested in other parts
of the body in an exceedingly violent and sudden manner. De-
bility, syncope, and even death, are sometimes suddenly produced
by the action of indigestible food on a weak stomach. Seeing,
therefore, such violent affections excited by articles that suddenly
resist or prostrate the energies of the stomach, there is reason to
believe, on the other hand, that whatever has a tendency to give
vigor to this organ, will communicate a corresponding vigor to the
general system.” - -
628. The length of time that indigestible substances remain
in the stomach, is truly astonishing. Dr. Good quotes from an
old author as saying, that the stones or kernels of fruits, as cherry
stones, have been found to remain in the organ for even three
years, undergoing little or no change. Professor Elliotson has
seen a coagulum of milk, like birdlime, which had remained a
week in the stomach, producing great uneasiness. He has also
seen a piece of salmon vomited by an infant, a month after it had
been swallowed. Dr. Barlow has recorded an instance in which
sulphate of iron pills were discharged per anum, a year after they
had been taken. A case is related of a boy who swallowed thirty
grapes without chewing them, and after frequent vomiting, and se-
vere suffering for three months, he was cured by an active purga-
tive, and ten of the grapes came away whole, even then.”
629. I met with a case in my own practice, similar to those
above related. Mr. Bradbury, a printer, applied to me for ad-
* Beaumont’s Experiments. Plattsburgh, 1833.
+ Study of Medicine, 6th American edition, vol. i. pp. 80, 100.
.

15S VEGETABLE MATERIA MEDICA.
vice, after having been unwell for ten days. Suspecting the
difficulty to be in the stomach, I recommended an emetic of lo-
belia, which caused a number of raisin skins to be ejected. Mr.
B. assured me that the raisins had been eaten eleven days pre-
vious to that time, and he was satisfied that they had been the
exclusive cause of his sickness.
630. Mr. Bell, in his Anatomy and Physiology, remarks,
“We shall frequently find food of difficult digestion lying in the
stomach, and oppressing it for days, while food more récently re-
ceived, may have undergone the natural changes, and have, at all
events, passed through the pylorus into the duodenum.” No one
will question the truth of this assertion, who makes himself ac-
quainted with the anatomy of the stomach. The sac or left ex-
tremity of the organ, is lower in the cavity of the abdomen than
the pylorus, (see illustration on page 18) and consequently, if the
stomach is in a feeble or relaxed condition, any morbid matter, or
indigestible food which it may contain, will accumulate in the sac,
and cannot be dislodged without the agency of an emetic. Hence
it is, that emetics are of so much importance in the treatment of
disease, and I do not hesitate to say, they will afford speedy re-
lief in many instances, where a patient might otherwise continue
ill for weeks, or even months.
631. Emetics are particularly useful in ſevers, because, what-
ever be their type or character, they are invariably accompanied
with a deranged or morbid condition of the stomach. Indeed,
the various symptoms constituting ſever, seem to radiate from
this organ as from a focus, and it is important therefore to remove
its vitiated contents, with as little delay as possible. The emetic
may also be repeated at proper intervals, till the ſever is subdued.
It will not produce debility, as is often supposed, but on the con-
trary, impart strength and vigor. Dr. Good has very truly re-
marked, that vomiting rouses rather than depresses the vital ener-
gies, and he further observes that “there are few persons so
debilitated as not to bear vomiting.”
632. Emetics are not only useful in emptying the stomach of
irritating matter, but they also have a beneficial influence upon the
general system. They give an impetus to the circulation, cause
the blood to move freely in the different vessels, and counteract
all local congestions or determinations. They promote a healthy
tion in the various internal organs, and exercise a particularly ben-
eficial influence over the liver. Indeed, there is no part or organ of
the body, to which they do not communicate a salutary impression.
* Study of Medicine, 6th American edition, vol. i. p. 95.



VEGETABLE MATERIA MEDICA. 159
633. Emetics favor absorption, and are therefore useful in
dropsies. On the same principle they tend to the dispersion of
tumors and swellings; and even tubercles in the lungs are no
doubt carried off by the process of absorption, which is rendered
more active by the operation of vomiting.
634. An emetic generally affords relief in mental derange-
ment, unless the case is very obstinate. A quantity of highly
offensive matter is usually discharged from the stomach in such
Case.
635. The administration of an emetic at the commencement
of the cold stage of ague and ſever, giving cayenne freely at the
same time, and employing the vapor bath, will generally shorten
the paroxysm, and greatly diminish its violence.
636. Emetics are invaluable in croup, and should never be
dispensed with. Administered early in the disease, a single emetic
will break it up; and if it has continued for some time, one or
two repetitions of it, conjoined with the vapor bath, and the other
requisites of a course of medicine, will scarcely fail to effect a
permanent cure.
637. In severe injuries, an emetic should be given, especially
if the patient has just been eating a full meal; for if the food re-
mains undigested in the stomach, it will affect the whole system,
and a cure is not only thereby retarded, but a violent ſever or in-
flammation may ensue.
638. The passage of gall stones, either through the biliary
ducts, or ureters, is greatly facilitated by emetics. -
639. The intimate sympathy existing between the stomach
and surface of the body, render emetics highly useful in all cu-
taneous diseases. In measles, or ..". for example, if the
eruption is slow in appearing, an emetic
and effectual manner.
640. In hemorrhage from the lungs, emetics are decidedly
useful, for they not only recal the blood from the lungs to the
stomach, but determine it to the skin, and other parts of the body.
Thus an equilibrium is established in the circulation, and the flow
of blood is arrested. Emetics are equally beneficial in hemorr-
hages from other organs, and in conjunction with stimulants and
the vapor bath, may be employed with perfect safety.
641. Asthma and sick headach, are generally associated with
a disordered state of the stomach, and vomiting therefore is one
of the best of remedies. -
l develope it in a speedy
642. In dyspepsia, jaundice, and the usual routine of chronic
complaints, it is generally necessary to evacuate the stomach with
an emetic, before a very strong impression can be made upon the
disease. It is only through the medium of this organ that we can
- -


160 WEGETABLE MATERIA MEDICA.
suffer it to remain in a morbid condition.
643. In pleurisy, lung ſever, or any other internal inflamma
tion, emetics are particularly useful, because, by their tendency to
equalize the circulation, they counteract the determination of blood
to the diseased organs.
644. Emetic substances in nauseating doses, are useful in
hope to effect a cure, and but little can be accomplished while we
and often afford signal relief.
645. An emetic, by its operation, increases the action of the
diaphragm, and thereby becomes an expectorant. Hence it is
serviceable in diseases of the lungs. It causes the vitiated mat-
ters which have accumulated in the air passages, to be expelled,
and not unfrequently, produces a free expectoration, where the
cough was previously harsh and dry. -
646. In apoplexy, and other determinations of blood to the
head, an emetic should be promptly administered, particularly if
the patient has been indulging in a hearty meal. It was supposed
at one time, that an emetic would increase the determination to
the head, but this opinion is now generally abandoned. Dr.
º in his remarks on the use of emetics in apoplexy,
aCIVan
s, “In the opinion of many, no mischief arises, but rather
tage, in those very cases in which the doubt has been raised
by others.”
647. In the preceding remarks on the value of emetics, the
reader need scarcely be told, that they refer principally to the
lobelia inflata; for that is the only emetic among those of an
active character, which can be employed with safety, or advan-
tage in every form of disease. The emetic poisons in use by the
old school physicians, as tartrate of antimony, and sulphate of zinc,
kill the unfortunate patient to whom they are administered.
-
LOB ELIA.
Lobelia Inflata—The Leaves and Seeds.
448. This invaluable herb is variously called emetic weed,
uke weed, colic weed, eye bright, bladdered lobelia, wild to-
- - | cco, and Indian tobacco. ". genus or family of plants which
. Plumier denominated lobelia, in the latter part of the
-
* Dunglison's Therapeutics, p. 213.
deep seated pains, strictures, inflammations, and hemorrhages,
almost invariably do more harm than good, and not unfrequently





- Lobelia .
º ºgº we
- - -
In or alia Inflata
shºp Mºcº ** " ºr Raº
- -
-




VEGETABLE MATERIA MEDICA. 161
sixteenth century, in honor of M. de Lobel, a distinguished Ger-
man botanist, was subsequently introduced by Linnaeus into his
Species Plantarum, under the title of Scaevola, while the original
name was conferred by this botanist on the family of plants now
universally comprehended under the title lobelia. This change
was made to prevent confusion, for it was found that the latter
genus was much better known by the name in question, than the
one to which it was originally applied.
648. There are, altogether, about one hundred species of
lobelia, peculiar to different countries. Twelve or fourteen of
these grow in the United States, the most common of which,
besides the inflata, are the claytoniana, syphilitica, and cardinalis,
The latter is remarkable for the profusion of its beautiful red
flowers. The inflata, however, is the only species employed in
the American practice, and is the only one, so far as my know-
ledge extends, which possesses medicinal properties of any par-
ticular value.
649. The lobelia inflata has a whitish, fibrous root, and an
upright, hairy, angular stem, which is much branched about
midway, and from ten inches to two feet in height. The branches
are considerably shorter than the stem. The leaves are tapering,
hairy above . below, bordered with small, irregular teeth, and -
generally without footstalks. Some of them are broad, and others
long and narrow. The flowers are palish blue, thinly scattered
along the branches, and upper part of the stem, and continue to
bloom from July till late in autumn. I saw them two years ago,
near Philadelphia, in the first week of November, when the
weather was cold and wintry. The blossoms are succeeded by
inflated pods or seed vessels, somewhat in the shape of an egg,
which contain a multitude of brownish, and very minute seeds.
650. The plant, when broken, exudes a milky juice.
651. Many botanists describe lobelia inflata as an annual, but
it is naturally a biennial. The young plant may be seen in the
latter part of summer, and during the autumn, with its leaves flat
upon the ground, spreading out in the form of a star; and it
remains in this situation through the winter, resisting the effects of
frost and snow, and arrives at maturity the ensuing year. By
cultivation, however, lobelia becomes an annual; that is, if the
seeds be deposited in the ground early in the spring, and the
season is favorable, they ...i. rout and shoot up stems; and by
the expiration of the autumn, the plant will have passed through
the various stages of its growth,
652. Lobelia is common in almost every part of the United
States, growing in pastures, neglected fields, thickets, woods, on
the banks of streams, by the roadsides, and indeed in almost every

21

162 VEGETABLE MATERIA MEDICA,
-
possible locality. It often springs up abundantly in stubble fields, the
year subsequent to the removal of the grain. Cultivated in gardens,
it is more vigorous in its growth than in the wild state, and often
attains the height of three feet. It does not grow in England, nor
is it probable that the climate of that country would admit of its
cultivation, excepting in gardens, or hot houses. Europe, accord-
ing to botanical works, affords only three species of lobelia, nei-
ther of which is the inflata.
653. Was it used by the Indians? There is a general im-
pression, that lobelia inflata has been long and familiarly known to
the North American Indians, as a medicine, but this is true only
in a very partial degree. There is abundant traditionary evidence,
that it was used by the Penobscot Indians, long before the time
of Dr. Samuel Thomson, its reputed discoverer, but with the
exception of that tribe, I have not been able to discover, by
any researches I have made, that the American aborigines had
any knowledge of its properties, or virtues. The well known
Bartram, who traversed the Floridas, and the western parts of
Carolina and Georgia, in 1773–4, for the discovery of rare and
useful productions of nature, describes a great number of plants,
and communicates much valuable information with regard to their
use by the Indians, but he makes no mention of their having
employed lobelia inflata.
65
The enterprising Carver, who set out from Boston on a
tour through the interior parts of this country, in 1776, travelling
five thousand miles, and visiting the Indian tribes in the neighbor-
hood of the lakes, gives an account of the modes adopted by the
aborigines in the cure of diseases, and describes a number of plants
which they employed in their practice, but does not make any
mention of lobelia.
655. Lewis and Clark, who commenced their expedition to
the sources of the Mississippi in 1804, had every opportunity of
becoming acquainted with the medical practice of the Indians, but
it does not appear that the latter had any knowledge of lobelia,
though they were well acquainted with the use of the vapor bath.
656. Major Long, also, who crossed the Rocky Mountains as
late as 1819, particularizes many of the diseases which prevailed
among the Indians in that region of country, and gives an inter-
esting account of their medical practice; but he says they were
ignorant of the use of emetics, and observes, that when they
wished to produce vomiting, they would tickle the throat with a
feather.
657. In conversation with Professor Nuttall, who is famed
both as a botanist and a traveller, I enquired whether, in his jour-
WEGETABLE MATERIA MEDICA. 163
-
ney across the Rocky Mountains, he saw any evidences that the
Indians employed lobelia inflata as an emetic. He promptly re-
plied in the negative, as I naturally anticipated. Indeed, I may
here remark, that the Indians have but a very slender knowledge
of the healing art. We are informed by the Rev. Mr. Parker, a
recent traveller among them, that they do not profess to be ac-
quainted with remedies, beyond a few simple specifics. “They
have what are called medicine men, who are furnished with a bag,
in which is deposited various relics, not to be administered to
their patients, but to operate as a charm. The patient is stretched
upon the ground; a number of persons collect around him in a
circle, and sing what is termed the medicine song. The medi-
cine man enters the circle, and commences his magical incanta-
tions; uses many gestures and inarticulate sounds; pats or kneads
the patient with his hands; blows into his ears, and practises other
like ceremonies. When it is supposed that the bag has insensibly
imparted its virtues, the medicine man presents some trifling ar-
ticle, as a small bone, stick, or pebble, and says he has taken it
from the body of the patient, and that it was the cause of the dis-
ease; or he gives a heavy puff, and says the disease has come out
of the patient, and gone upward, and then asks him if he does not
feel better.”%
658. As a further proof that the Indians were unacquainted
with the properties of lobelia, previous to the time of Thomson,
with the exception of the Penobscot tribe, which I have already
mentioned, the reader's attention is solicited to a work by Samuel
Stearns, M. D., entitled the American Herbal, which was issued
originally in 1772, and published in an improved form in 1801.
The author was a native of Massachusetts, where he was instruct-
ed in the medical art. He professes to have given a full account
of the virtues of the mineral, vegetable, and animal productions of
North and South America, as far as they were then known, in-
cluding a knowledge of a large number of new medical discove-
ries and improvements, compiled from the best authors. He also
states that in order to render his work as complete as possible, he
travelled in nine of the American governments, and in England,
Ireland, Scotland, and France, including a distance, by land, in
this country, of eleven thousand miles. He passed a consider-
able portion of his time among the aborigines, and appears to have
been well acquainted with their remedies. He mentions five
species of lobelia, four of which he has named. These are the
cardinalis, dortmanna, kalmii, and syphilitica. He describes the
root of the latter as purgative, says it was used by the Indians,
* Exploring Tour beyond the Rocky Mountains.
- *- :


164 WEGETABLE MATERIA MEDICA.
and gives particular directions for its employment. He does not
name the lobelia inflata, however, and hence we are led to infer,
that it was not generally known by the Indians at the time he
W. or he would, undoubtedly, have given it a place in his
work. -
659. The Discovery of Lobelia. Dr. Samuel Thomson
claims to have discovered the medical properties of lobelia, but
independently of the Penobscot Indians, there is conclusive testi-
mony that it was used by many people in New England, long be-
fore his time. They called it colic weed, and Indian tobacco,
and administered it in the form of tea, to produce vomiting.
They did not consider it dangerous, and employed it without any
fear, or precaution. It was their unfailing remedy in colic, and
hence the name of colic weed.
660. With regard to the early history of lobelia, as a medi-
cine, I am indebted for many interesting particulars to Mrs. Stone,
of Brunswick, Me. She informs me that her townsman, Mr.
Philip Owen, now eighty years old, relates, that when a boy, he
was sent into the field by his mother, to collect some for a child,
sick with the quinsy, and that the herb, administered in the usual
manner, afforded speedy and entire relief.
661. Mr. William Coburn, the father of Mrs. Stone, who
has also reached his eightieth year, says that lobelia has been used
as a medicine, in the State of Maine, both by the people, and the
Penobscot Indians, ever since he can remember, which is a pe-
riod of not less than seventy years. Mr. Coburn is well known
to many of the citizens of Maine, as having been an interpreter
between the French and Indians, during the old French war.
662. According to Mrs. Stone, also, we have the testimony
of Dr. John A. Hyde of Freeport, Me., a very old physician,
that the people in that vicinity were in the habit of using lobelia
under the name of colic weed, when he first settled in the town,
which was about fifty years ago. He says they employed it in
various complaints, but particularly in colic, and considered it
perfectly safe and harmless.
663. I have before me a letter from Dr. E. Harlow of New
Lebanon, Ct., to a gentleman in Boston, dated May 15th, 1835,
in which he says, “I commenced the vegetable or botanic prac-
tice of medicine about 1796, under the instruction of Dr. Root,
of Canaan, Ct., who was esteemed as an able botanic physician.
He made use of lobelia inflata, under the name of Indian tobacco,
and taught me the use of it; and from that period to the present,
I have continued to employ it in my practice. I may also state
WEGETABLE MATERIA MEDICA. 165
that Dr. Forbes of Lebanon, used it when I was a boy, and
from that circumstance it received the name of Forbes’s weed.”
664. The same letter states that Doctress Charity Shaw
Long of Albany, N. Y., secured a patent for the use of lobelia
inflata, in 1812, which was one year in advance of Dr. Thomson's
patent.
665. Were it necessary, I might adduce a large amount of
testimony, to prove that Dr. Thomson was not the original dis-
coverer of lobelia, but he has, nevertheless, been chiefly instru-
mental in introducing it into general use, and is therefore entitled
to the respect and gratitude of his fellow men.
666. JMedical fluthorities. I have availed myself of the sub-
joined authorities, because a certain class of medical men have
been laboring, very industriously, for the last fifteen or twenty
years, to convince the people that lobelia is a poison. Nothing
has been left undone, to prejudice the public mind against the use
of the plant, and it has only won its way to popular favor, through
its incomparable virtues as a medicine. Dr. Thatcher, Dr.
Coxe, and other writers, have said, that “even cattle and horses
have been supposed to be killed by eating it accidentally,” and
yet they inform us that it has been long used by the North Amer-
ican Indians, as though the red men of the forest had no more sa-
gacity, than to employ an herb that was sufficiently poisonous to
kill a beast. Medical men, however, are becoming ashamed of
this stereotyped falsehood, and in the last edition of the United
States Dispensatory, it has been prudently omitted.
667. Dr. Cutler, who wrote on the subject of lobelia, in 1810,
indulges in the following remarks. “It has been my misfortune,”
says he, “to be an asthmatic for about ten years. I have made
trial of a great variety of the usual remedies, with very little benefit.
The last summer I had the severest attack I ever experienced.
It commenced early in August, and continued eight weeks. Dr.
Drury of Marblehead, also an asthmatic, made use of the tincture
by the advice of a friend, in a severe paroxysm, early in the
spring. It gave him immediate relief, and he has been entirely
free from the complaint since that time. In a paroxysm which, per-
haps, was as severe as any I ever experienced, and the difficulty
of breathing extreme, I took a table-spoonful of the tincture made
of the fresh plant. In three or four minutes, my breathing was as
free as it ever was, but I felt no nausea at the stomach. In ten
minutes, I took another spoonful, which occasioned sickness.
After ten minutes, I took the third, which produced sensible
effects upon the coats of the stomach, and a very little vomit-
ing, with a kind of prickly sensation through the whole system,

166 VEGETABLE MATERIA MEDICA.
even to the extremities of the fingers and toes. The urinary pas-
sage was perceptibly affected, by producing a smarting sensation
in passing urine; but all these symptoms very soon subsided, and a
vigor seemed to be restored to the constitution, which I had not
experienced for years. Besides the violent attacks, I had scarcely
passed a night without more or less of it, and often so as not to
be able to lie in bed. Since that time I have enjoyed as good
health as, perhaps, before the first attack.”
668. Dr. Good, in his Study of Medicine, remarks, “Dr.
Andrews prescribed the tincture of lobelia inflata in hooping cough,
with striking success. He says there is no other medicine that
so effectually frees the air passages of the lungs of their viscid
secretions.”
669. Dr. Eberle, in his Materia Medica, observes, “I
have had several very striking examples of the good effects of
lobelia, in asthma. Its operation is, indeed, often surprisingly
prompt and effectual. I have known the most frightful parox-
ysms completely allayed in less than fifteen minutes. Even
where the disease depended on organic affection of the heart, it
has speedily, as a general thing, mitigated the distressing difficulty
of breathing. As an emetic, I have employed it in several cases
of croup, with very great benefit.”
670. In his Practice of Medicine, the same writer says,
“The lobelia inflata has proved an excellent remedy in my hands
in hooping cough. It not only mitigates the violence of the
cough, but it has appeared to me unequivocally to shorten the
course of the disease, in several cases.”
671. Professor Tully of Yale College, who has employed lobelia
inflata in his practice, for twenty-seven years, remarks, “As an emet-
ic, I am satisfied that it is as kind and as destitute of all hazard as
ipecacuanha, though perhaps it may be somewhat more efficient. I
have occasionally known it to produce powerful nausea without vom-
iting, and with considerable prostration; but by no means so often
as I have known inecacuanha do this. I have a considerable number
of professional friends who use it more than any other emetic,
and on the whole, consider it one of the very best agents of this
class in the whole materia medica. * * am confident,
the old women's stories in the books to the contrary notwithstand-
ing, that lobelia is a valuable, a safe, and a sufficiently gentle
article of medicine; and I think the time will come when it will
be much better appreciated. Little, however, of its value can be
specified within the compass of a single sheet of paper.”
672. Dr. Waterhouse, for many years a professor in the
* Thatcher’s Dispensatory, 3d edition, p. 279. Boston, 1817.



WEGETABLE MATERIA MEDICA, 167
medical department of Harvard University, observes, “I have
had ample proof of the efficacy and safety of lobelia in a number
of cases, and have reason to value it as equal to any article in our
materia medica. * * * I not only give it to my patients,
but take it myself, whenever I have any occasion for an emetic.”
673. Dr. Samuel Thomson says, “In the fall of 1807, I
introduced lobelia, tinctured in spirit, as a remedy in asthma, and
other complaints, and used it successfully in several cases of
consumption. In 1808, I cured a woman in Newington, of the
asthma, who had not been able to lie in bed for six months.
* * * I can assure the public that it may be used without
any apprehension of danger. I have given it to infants a day old.
It tends to remove obstructions from every part of the system, and
occasionally produces a prickly sensation, which is felt even in
the fingers and toes. * * * It not only cleanses the stomach,
but exercises a beneficial influence over every part of the body. It
is very diffusible, however, and requires to be used with cayenne, or
some other pure and permanent stimulant. The effects of lobelia
may be compared to a fire made with shavings, which will soon go
out, unless other fuel be added. Cayenne, therefore, may be
said to keep alive the blaze which the lobelia has kindled.”
674. PROPERTIES AND Us Es. Lobelia, when first taken
into the mouth, has but little taste, but it very soon produces a
pungent sensation, which is experienced for a considerable time.
To some people it is very nauseous, while others would rather
take it, than a draught of pennyroyal, or composition tea. It yields
its properties readily to water, wine, vinegar, and alcohol. Ad-
ministered according to the directions in this book, it is the most
thorough evacuant of the stomach that has ever been discovered;
and it possesses the rare advantage of not irritating or inflaming the
organ, as is generally the case with tartar emetic, sulphate of zinc,
and other poisons of a similar nature. Hence, it may be safely
used in every form of disease. It is also destitute of cathartic
properties, and does not weaken or exhaust the patient, by acting
upon the bowels. This cannot be said of the emetics ordinarily
employed by physicians, for even ipecacuanha, the most innocent
them, will sometimes occasion debility, or prostration, by its
irritating or purgative effects upon the intestinal canal.
675. It is a favorite theory with many people, that all emetics
are poisons, and hence, they rank lobelia as a poison. We find,
however, that a draught of warm water, a disgusting smell, or the
thought of some offensive object, will produce vomiting, but we
do not see in either of these, the operation of a poison. If the
º


168 WEGETABLE MATERIA MEDICA.
stomach is much disordered, a dose of bayberry, or composition
tea, will cause vomiting, but after the stomach is cleansed, a
pint of the tea would produce no such effect, nor even excite
nausea.
676. With regard to lobelia, however, I am satisfied that it
has no tendency to operate as an emetic, independent of a morbid
or diseased condition of the stomach. This is Dr. Thomson’s
theory, and it is abundantly sustained by facts. He speaks in his
Narrative, of a Mrs. Burleigh, a rheumatic patient, to whom he
administered several courses of medicine, with the usual good
effects, but in the last course, though he gave her three tea-spoon-
fuls of lobelia, it excited neither sickness, nor vomiting. She
perspired freely, however, and was entirely cured of her malady.
677. The first case of the kind I ever met with, occurred
in the daughter of Russell Jarvis, Esq. of Philadelphia, to whom
lobelia was administered on two successive days. In the first
instance, it operated efficiently as an emetic, but in the second, it
produced no effect whatever, excepting a moderate perspiration.
Since that time, I have seen a number of similar cases; and have
known individuals to take lobelia, by way of experiment, soon
after going through a course of medicine, without experiencing
the slightest nausea.
678. The wife of Mr. Ira Cheney, residing in Cross street,
Boston, resolved to take a portion of lobelia, while in health, to
see what would be its effects. Her husband, accordingly, gave
her a tea-spoonful of the strongest tincture, and in fifteen minutes,
followed it with a tea-spoonful of the pulverized herb, in compo-
sition tea, together with two tea-spoonfuls of rheumatic drops.
In another fifteen minutes, he administered an additional tea-
spoonful of the herb, with a tea-spoonful of composition, and a
tea-spoonful of cayenne. Notwithstanding these repeated doses,
no effect was produced, and Mrs. Cheney, in the meantime, at-
tended to her household affairs.
679. Dr. N. Smith of Hallowell, Me., informed me, that a
Mr. Libby came to his infirmary, in a state of mental derange-
mant, from over-excitement of the mind, and took a course of
medicine, which had a very favorable operation, the patient vom-
iting a large quantity of bilious, and º offensive matter. In
three days the course was repeated, with equally favorable results,
and in three days more, though the patient’s appetite was good,
and he talked rationally, it was thought expedient to administer a
third course, lest he should have a return of the disease. The
third preparation was freely employed, as in the previous courses,
but it produced no visible effect, excepting a copious perspira-


WEGETABLE MATERIA MEDICA. 169
tion. Mr. Libby dressed himself, ate a hearty dinner, and re-
turned home in the stage-coach.
680. Dr. Smith also informed me, that Miss Paul of Hallow-
ell, anxious to satisfy some of her friends that lobelia was not a
poison, took two ounces of the third preparation, while in health,
and though she expected to vomit, the medicine did not even ex-
cite nausea. She had previously taken lobelia in sickness, and it
never failed to operate as an emetic. -
681. Dr. Locke of Chelsea, near Boston, who has been in
the habit of using lobelia for nearly thirty years, assured me, not
long since, that he could take the herb with impunity, even in tea-
spoonful doses, by previously employing it to cleanse or evacuate
e stomach. -
682. I know of no explanation of the phenomenon in ques-
tion, excepting, perhaps, that the lobelia, by acting as a peculiar
stimulus upon the nerves of the stomach, increases its sensibility,
and renders it more susceptible of a morbid impression from any
irritating or offending matter which it may contain. In those
cases in which lobelia does not produce vomiting, it is probable
that the stomach, besides being in a healthy state, is entirely free
from any morbid accumulation within its cavity.
683. Frequent attempts have been made to analyze lobelia,
but never with uniform, or satisfactory results. Dr. Hare of the
Pennsylvania University, says it is composed of an oil, and an acri-
monious alkali, and to the latter, he attributes what he terms
its poisonous effects. Dr. Hare, however, should be sufficiently
learned in his profession to know, that lobelia, as it is compounded
in the great laboratory of nature, is very different from lobelia
which has been made the subject of experiment in the laboratory
of the chemist. The great principle should never be overlooked,
that substances become harmless or destructive, according to their
peculiar combinations. Table salt, for instance, which we eat daily
upon our food, is composed of soda and chlorine, the latter of
which is a deadly poison. The air we breathe, is composed of
the same materials as aqua fortis, and yet in its particular com-
bination, it is one of the grand supporters of life. The same re-
marks are equally applicable to lobelia; and though chemists may
tell us that it contains a poisonous principle, we know, from expe-
rience and observation, that it is perfectly harmless in its opera-
tions upon the human system. Dr. William Hunter has beauti-
fully said, that there is a wide difference between the chemistry of
the stomach, and the chemistry of the laboratory, and Professor
Chapman, improving upon this hint, remarks, that “the only
mode of determining º virtues of a medicine, is at the bed-
2

170 WEGETABLE MATERIA MEDICA.
side of the patient, where we can witness its effects on a dis-
eased body.” He also says—“Experience has fully demon-
strated, that articles widely different in their general nature, as the
most salutary food, and the rankest poisons, frequently exhibit
nearly the same results, on analysis.” Hence, we are not to re-
ject the use of lobelia, merely because some idle chemist asserts
that it contains a poison, which he might detect with equal cer-
tainty in the meat, or vegetables, upon which we daily subsist.
684. Writers on materia medica inculcate the doctrine, that
lobelia is a cathartic, but this is one of their erroneous specula-
tions. If they were in the habit of using the article, they would
come to a different conclusion. Those who have employed it
for a long series of years, uniformly bear testimony, that it is
not cathartic in the least, and this is one of its peculiar recommen-
dations. Professor Tully, from whom I have already quoted,
says, he “has never been able to produce a lawative, or even an
opening effect with it; but he has occasionally, though not often,
known it to produce costiveness.” The truth is, lobelia regulates
the bowels, by the salutary impression which it makes upon the
general system, and if purging follows its administration, in a few
solitary instances, we are to regard it as an indirect result of the
medicine.
685. It is amusing to observe with what pertinacity some of
the medical profession pronounce lobelia to be a narcotic. Here
again they have hazarded an opinion without any experimental
knowledge. “Dr. Bigelow,” remarks Professor Tully, “was
the first person who ascribed narcotic powers to this agent, and
this he did in 1817, but not from his own observation; and after
he first pronounced it narcotic, subsequent writers very speedily
converted ‘something as black as a crow, into three black crows;’
and Dr. Ansel U. Ives of New York, at last pronounced lobelia
inflata to be a ‘deadly narcotic,” and that its action as an emetic,
“is secondary or symptomatic of the primary impression upon the
brain, like that caused by tobacco, and other narcotic poisons.”
“But all this,” continues the professor, “is mere stuff, and closet
speculation, and does not contain a single truth. There is no
probability that Dr. Ives ever used the article in his life.”
686. The quieting influence of lobelia on the nerves, when
they are in a state of irritation, has no doubtled the medical ſac:
ulty to suppose that it is a narcotic, for they have not yet learned
to distinguish between nervines and narcotics, the former of which
merely allay the excitement or irritability of the nerves, while the
WEGETABLE MATERIA MEDICA. 171
latter destroy nervous sensibility, and give rise to stupor, and a
heavy, death-like sleep.
687. I recollect a woman in Boston, who, from a disorder of
her nervous system, was unable to obtain any rest for ten days,
and upon lobelia and cayenne tea being administered in frequent
doses, she sunk into a refreshing sleep, from which she did not
awake for nearly twelve hours. Her skin, during this interval,
continued moist, and of a natural temperature. Here, it may be
said, that the lobelia acted as a narcotic, but it only had the effect
to quiet the excitement of the nervous system, and afford to na-
ture an opportunity of recruiting her exhausted energies.
688. In some instances, I have known lobelia to produce a
directly opposite effect, and occasion watchfulness, the patient
being unable, after a course of medicine, to close his eyes in sleep
during the night. It is remarkable, however, that he does not
usually complain of languor or fatigue in the morning, as he would
naturally do, if the watchfulness proceeded from any other cause.
689. If poison has been taken into the stomach, lobelia is the
most prompt and active emetic that can be employed. I have
known dogs to be completely stupified with laudanum, and speed-
ily recovered by the administration of lobelia, which has never
failed to evacuate the stomach. Dr. J. T. Crossman of Philadel-
phia, a respectable and intelligent physician of the old school, told
me he was called to a child, three years old, who had swallowed
an ounce of laudanum, by mistake. He found it insensible, and
breathing with great difficulty. He gave it large quantities of
ipecacuanha, tartar emetic, and sulphate of zinc, but all to no
purpose. He then thought of the tincture of lobelia, some of
which he immediately procured at a drug store, and poured an
ounce of it down the child’s throat. In fifteen minutes vomiting
ensued, and the laudanum was discharged. The child immedi-
ately recovered, and in a short time, was running about with its
playmates.
690. I have found lobelia a very useful remedy in small doses,
administering a quarter of a tea-spoonful of the powder, more or
less, at a time. This may be given at night, on going to bed, in
composition tea, or it may be taken through the day, provided the
patient is not exposed to the open air. In cough, difficulty of
breathing, ſever, hoarseness, colic, croup, delirium tremens,
hooping cough, strangury, pains, strictures, palpitation of the
heart, and nervous affections, it is particularly useful. It pro-
motes a gentle perspiration, and has a renovating influence upon
the digestive organs. Taken at bed time, the patient generally




172 VEGETABLE MATERIA MEDICA.
finds himself refreshed on the ensuing morning. Where the con-
tinued use of the medicine is required, the dose may be repeated
every hour or two, according to circumstances. It need not
be taken to the extent of producing nausea, unless particularly
required. I know some practitioners who introduce a small por-
tion of lobelia into nearly all their preparations, not even excepting
the spiced bitters.
691. Lobelia possesses powerful antispasmodic properties,
and as such, will be spoken of, hereafter, under the head of third
preparation.
692. The infusion of lobelia is very useful in sore, or weak
eyes, and hence the name of eye bright. Injected into the ear,
also, in case of deafness from hardened wax, it will generally
afford relief. -
693. Where it is necessary to produce muscular relaxation,
as in fractures, dislocations, and tedious or difficult labors, lobelia
is highly beneficial. The powder, administered in lukewarm
water, has a more relaxing influence, than when given in bayberry,
or composition tea. In sore throat, attended with an inability to
swallow, a tea-spoonful of lobelia, administered by way of injec-
tion, and repeated if necessary, will soon relax the constricted
. of the throat, and enable the patient to swallow without diffi-
culty.
. Lobelia is a valuable expectorant, and for that purpose
may be employed in the form of tincture, cough sirup, or cough
balsam, as will be directed under these heads, in a subsequent part
of the work. -
695. Green lobelia is a term applied, in common language, to
the pulverized leaves of the herb, and brown lobelia to the pul-
verized seeds. A tea-spoonful of the former, is about equal in
strength, to two-thirds of a tea-spoonful of the latter. The green
lobelia is preferable in the treatment of children, and delicate
females, and also in the administration of a light course of medi-
cine.
696. A foolish opinion is entertained by some people, that in
vomiting, occasioned by lobelia, the food is not ejected. This is
an error which a slight attention to physiology would put at rest.
The food during the digestive process, undergoes what Dr.
Beaumont has termed a “churning motion,” and is also acted
upon by the gastric juice, (82,85.) so that it is reduced from a
pulpy, to a liquid mass, denominated chyme, in from thirty min-
utes to an hour. This is under ordinary circumstances, and iſ
stimulating teas are administered, as is usually done previous to
a course of medicine, the motions of the stomach become still
VEGETABLE MATERIA EEDICA. 173
more active and vigorous, and the solid portions of food are no
doubt reduced to chyme in even less than half an hour. When
vomiting occurs, therefore, the food is unquestionably discharged,
though it cannot be detected on account of its fluid character. The
stomach, moreover, in the action of vomiting, contracts equally
upon the entire mass of its contents, and forces them indiscrimi-
nately from its cavity, whether food be blended with them, or not.
Lobelia is not endowed with an intelligent power, that it can
search out the vitiated matters in the stomach, and cause them to
be expelled, while the food is suffered to remain. But we are
told, that even the gruel, or milk porridge, which is taken during
the operation of a lobelia emetic, is not discharged. This is true,
as a general thing, but it does not involve any mystery, for the
porridge passes rapidly out of the stomach into the intestines,
through the pyloric orifice. (67.) In tedious or protracted vom-
iting, however, the porridge is usually rejected, because there is
an inverted action of the duodenum, which prevents its passage
through the pylorus. In such cases, also, there is generally a
discharge of bile, which is forced by the duodenum into the cavity
of the stomach, in consequence of its inverted action.
697. When solid, or indigestible food is discharged in vom-
iting, which occasionally happens, it is to be attributed to the
feeble state of the digestive organs, the stomach not being suffi-
ciently active or vigorous, notwithstanding the use of stimulating
teas, to resolve the food into chyme. -
698. The rules for administering lobelia as an emetic, will be
given in the directions for a course of medicine, to which the
reader is referred.
699. Collecting and Preserving Lobelia. Where the herb
is required for use, it should be collected in August, before the
leaves begin to fade, and spread thinly in a chamber or loſt to
dry, previously separating the stems from the roots. The air
should be admitted into the apartment in the day time, and ex-
cluded at night, provided the atmosphere is damp.
700. If it is desirable to obtain the seeds, the plant should
not be collected until the leaves begin to assume a yellowish
appearance, which will generally be in the latter part of August, or
the first week in September. After the herb is dried, which is to
be done according to the directions in the preceding paragraph,
the seeds are to be shaken from the pods, and passed through a
fine sieve, to free them from dirt. The leaves also, even at this
period, possess more or less value, and may be employed as an


174 WEGETABLE MATERIA MEDICA.
emetic, though they are by no means so active as when pro-
cured at an earlier period.
701. It should be remembered that both the pulverized leaves,
and seeds of lobelia, lose a portion of their properties by exposure
to the light. Hence, they should be preserved in boxes, drawers,
or well stopped jars.
702. The root of lobelia is not used in medicine. It is
pungent in the young plant, but loses its taste as the summer
advances. I make this remark, because writers on materia med-
ica, who compile books without any practical knowledge, assert
that it is the most active portion of the plant. The lecturer on
botany, in the Transylvania University, told his class that the root
was the only part which should be employed in practice.
BLUE WERWAIN.
Verbena Hastata—The Herb.
703. The blue vervain is found by roadsides, and in dry,
grassy fields. It has a woody, fibrous root, and an erect, square,
branching, and somewhat hairy stem, rising three or four feet
high. The leaves are narrow, rough, sharp at the point, and
edged with acute teeth. The lower ones are generally lobed at
the base. The flowers are blue, or purplish, and thickly crowded
upon erect, slender spikes; they bloom from July to September, a
few of them only expanding at a time.
704. The white or nettle-leaved vervain, (verbena urticifolia)
is sometimes used indiscriminately with the blue; but with the
exception of the root, which is bitter, it is not endowed with
medicinal properties of any value.
705. PRoPERTIES AND Uses. The blue vervain is bitter,
somewhat astringent, and very nauseous. One or two tea-cup-
fuls of the strong decoction will operate as an emetic, and is used
for that purpose, by people in the country. It also produces
perspiration. In severe colds, and the early stages of ſever,
where the stomach is much disordered, it may always be employ-
ed with advantage.
706. In some sections of the state of New York, where the
ague and fever prevails, vervain is much employed as a remedy.
The decoction is given as an emetic, just as the paroxysm is
coming on, and in many instances, a single dose has effected a
permanent cure.
WEGETABLE MATERIA MEDICA. 175
707. After the stomach is thoroughly cleansed, it does not
produce nausea. At all events, this has been my experience, in
the few instances in which I have had occasion to employ the
erb.
708. A strong tea of vervain, sweetened with molasses, and
administered in the dose of a table-spoonful, every half hour, or
hour, is an excellent remedy in cough.
BONE SET.
Eupatorium Perfoliatum—The Leaves and Flowers.
709. This plant is common in almost every part of the United
States, inhabiting meadows, and low, moist grounds. It is vari-
ously called thoroughwort, Indian sage, sweating plant, ague weed,
crosswort, vegetable antimony, and joepye. It received the name
of boneset, from the fact of its having been employed in a painful
disease, called breakbone fever. The root, which is horizontal
and somewhat fibrous, sends up a number of round, hairy stems,
which are branched at the top, and from two to five feet high.
The leaves are peculiar in their character, and serve to distin-
guish the plant, the lower ones being united at the base, and
perforated by the stem, making, in fact, one entire leaf, which
tapers in each direction to an acute point. They are wrinkled,
and deep green upon the upper surface, wooly, and paler be-
neath, with roundish teeth along the margins. The leaves upon
the upper portion of the stem and branches are seldom united.
The plant remains in bloom from August to October. The
flowers are numerous, of a dullish white color, crowded to-
gether, in spreading flattened clusters, at the tops of the stem
and branches. -
710. This plant should be collected when in bloom, carefully
dried, and the leaves and flowers separated from the stalks.
711. PRoPERTIES AND Us Es. Boneset has a disagreeable
and very bitter taste, yielding its properties readily to water, and
alcohol. The warm infusion, given in large doses, operates as an
emetic, and as such, is in common use by the people of New
England. Boiling, I will remark, appears to diminish its emetic
properties:
712. The infusion, in small and frequently repeated doses, in-
duces a free perspiration, and on this account, has acquired con-
siderable reputation in the treatment of ague and fever, and affec-
tions of the skin.


176 WEGETABLE MATERIA MEDICA.
713. The decoction of boneset, administered cold, is both
laxative and tonic. A tea-cupful of the tea, sweetened with mo-
lasses, may be taken every hour, until the desired effect is pro-
duced. It does not appear to irritate the bowels, or occasion
thin or watery stools, and may therefore, be regarded as a lax-
ative, rather than a purgative. -
714. In preparing the decoction, a half an ounce of the pow-
dered leaves may be boiled in a pint of water. A table-spoonful
of this tea, administered occasionally, is useful in coughs. It may
be sweetened with molasses, as already mentioned.
715. A lady in Randolph, Mass., informed me that boneset
was the only medicine she had used in her family for fifteen years,
and she had never known it to ſail, in a single instance, to effect
a cure. She gave it as an emetic, to cleanse the stomach; as
- a tonic, to improve the digestive powers; and as a laxative, to
keep the bowels open. She further stated, that during the fifteen
years, she had never availed herself of the services of a physician,
though members of her family were sometimes dangerously ill.
Boneset was her unfailing panacea, and it had always proved
triumphantly successful. -
STIMULANTS.
716. Pure, healthy stimulants, are those substances which act
in harmony with the laws of the human system, and, while they
- stimulate, do not injuriously affect the brain, or increase the fre-
quency of the pulse, beyond its natural standard. Taken into
the mouth, they have a pungent taste, and when swallowed, im-
part to the stomach a genial sensation of warmth, which is soon
communicated to other parts of the system, and accompanied,
under favorable circumstances, with a flow of perspiration.
717. Stimulants, such as I have described, determine the
blood in its requisite proportions to every part of the body, or in
other words, restore a balance to the circulation, and hence, they
may be safely and efficiently employed in ſever, inflammation,
and every species of congestion. They excite a healthy action,
without irritating the F. with which they come in contact, im-
pairing the integrity of the nervous system, or producing any other
derangement in the animal economy.
718. Food may be regarded as a stimulant, acting, as it does,
upon the vital machinery, and keeping the wheels f life in mo-
tion, but when it fails to impress the stomach in a healthy man-
ner, it is necessary to resort to the stimulus of medicine.
WEGETABLE MATERIA MEDICA. 177
719. “Health,” says Dr. Eberle, in his Therapeutics, “ is
very intimately connected with the regular performance of the
perspiratory function. Whenever the transpiration by the skin is
suddenly checked, more or less derangement of the system is in-
variably the consequence. That portion of the circulating fluid
which nature designs to be cast off by the cutaneous emunctories
(pores of the skin) is retained, and becomes a source of irritation
to the heart and other organs. * * * The sudden suppres-
sion of the perspiratory discharge, disturbs the regular current of
the circulation; the blood retreats to the vessels of the internal or-
gans, giving rise to congestion, inflammation, and fever. * * *
A hot and dry skin, is invariably attended with augmented distress,
in whatever disease it may occur; and when this is the case,
nothing affords so much relief to the patient as a free flow of per-
spiration.”
720. From the above remarks, it will be inferred, that stimu-
lants, of a proper kind, are not only useful, but indispensable, in
the treatment of disease; and we are confirmed in the belief,
when we take into consideration, that “five out of every eight
pounds of substance taken into the system, pass out of it again
by the skin, leaving only three to pass off by the bowels, the
lungs, and the kidneys.” We readily perceive, therefore, that
if the skin is inactive, or the circulation feeble, the blood will soon
become charged with impurities, and unless appropriate stimulants
are administered, to keep a determination to the surface of the
body, so that the impurities may escape through their natural out-
lets, disease will be the sure and necessary consequence. If,
also, the blood recedes from the surface, leaving the skin pale,
cold, and contracted, and flows into the internal vessels, stim-
ulants must be employed to determine it to the surface, or some
serious, or perhaps fatal inflammation of an internal organ, may
be the result.
721. In contending for the use of stimulants, however, we
must be careful not to employ those of an acrid, narcotic, or poi-
sonous nature, or our success in the treatment of disease, will be
no better than that of the diplomatised physicians. Mustard, for
example, is an acrid stimulant, and will blister the skin, if applied
externally, or irritate or inflame the stomach, if taken internally.
Opium is a well known narcotic stimulant, and not only stupifies
the brain, but in doses sufficiently large, occasions convulsions,
and finally death. Phosphorus, which is frequently employed by
medical men, is a poisonous stimulant, and produces a variety of
dangerous symptoms. Among the narcotic stimulants, also, alco-
* Combe’s Physiology, p. 38. New York, 1838.

23
178 VEGETABLE MATERIA MEDICA.
hol holds a conspicuous place, and in the form of wine, or brandy,
is usually employed by the medical faculty, in an exhausted or
sinking state of the system. Its effects in health, are, “giddi-
ness, confusion of thought, delirium, and various mental affec-
tions, followed, ultimately, by vertigo, stupidity, headach, sick-
ness, and vomiting.” Dr. Christison relates the case of a young
man in Paris, who died by drinking brandy immoderately for sev-
eral days in succession, and on examination after death, his stom-
ach was found to be in a state of mortification, and the whole of
the small intestines were in the incipient stage of inflammation.
722. If such be the morbid changes which are induced by al-
cohol in healthy individuals, we cannot, with any degree of pro-
priety, resort to it as a medicine, in sickness. It may rouse the
energies of an exhausted frame for the moment, but it will soon
be followed by drowsiness, stupor, and death.
723. During my visits to the Massachusetts Hospital, my at-
tention was attracted to a case of typhus ſever. The patient was
delirious, with contracted pupils, wild expression of countenance,
pulse 120, dry, and brownish tongue, and black incrustations on
the teeth. Dr. Bigelow directed that he should have an ounce of
wine every hour, provided it did not increase his delirium, or the
force and frequency of his pulse. What better proof could we
have, that Dr. Bigelow regarded wine as a precarious and highly
dangerous stimulant, and yet it was the only remedy that he
proposed for the relief of the patient. The next morning the
unfortunate man was a corpse.
724. Dr. Hunter made an interesting experiment to show the
ill effects of an alcoholic stimulant upon the human system. “He
gave one of his children a full glass of sherry wine every day after
dinner, for a week. The child was then about four years old,
and had never been accustomed to wine. To another child of
nearly the same age, and under similar circumstances, he gave a
large orange, for the same space of time. At the end of the
week, he found a material difference in the pulse, heat of the
body, and state of the bowels of the two children. In the first,
the pulse was quickened, the heat increased, and the bowels de-
ranged; while the other had every appearance indicating high
health. He then reversed the experiment—to the first mentioned
child he gave the orange, and to the other the wine. The effects
followed as before ; a striking and demonstrative proof of the per-
nicious effects of vinous liquors on the functions of life, in a state
of full health.”
725. Tartar emetic may be ranked as one of the poisonous
stimulants of the faculty, and is employed by them to an alarming
* Called in * language, a diaphoretic.

WEGETABLE MATERIA MEDICA. 179
extent. To say nothing of other dangerous symptoms, it never
ſails to produce a morbid condition of the stomach, accompanied,
not unfrequently, with irritation, or inflammation. Given in small
doses, it relaxes the pores of the skin, and induces perspiration,
but it does not tend, in the remotest degree, to establish a healthy
action in the system. Besides, it cannot be depended upon as a
means of producing perspiration. I recollect an elderly lady, to
whom it was administered, in flaxseed tea, for three successive
days, with a view of exciting perspiration, but her skin at the end
of that time, was as dry as ever. Displeased with her medical
attendant, she consulted me, and I prepared a tea-cupful of com-
position tea, into which I put half a tea-spoonful of cayenne, and
the same quantity of green lobelia. This was administered at one
dose, and in ten minutes, the patient was covered with perspira-
tion. Meanwhile, the former physician, not having been informed
that his services were no longer needed, came in by accident, and
supposing me to be a member of the family, expressed his delight
that the symptoms were so favorable, believing that the tartar
emetic, and flaxseed tea, had wrought the wonderful change, but
when he ascertained what medicine had been given, he said it
could not fail to kill the patient, and left the house in the utmost
ill-humor. - -
726. The well known Dr. Lambe has made some interesting
remarks on the subject of pure, and impure stimulants. He is a
dietetic reformer, and so rigid in his notions, that he discards
even milk, as injuriously stimulant. Nevertheless, in speaking of
“spices,” he says, “however hot and fiery they are in |. mouth,
they do not appear to be deleterious. They do not derange the
brain, nor stupify the nervous system; they do not even appear
to heat the body, nor greatly to accelerate the pulse.”
727. Dr. Lambe quotes the opinion of Mr. Bruce, the well
known traveller, on the subject of stimulants, who expresses
himself as follows: “I lay it down as a positive rule of health,
that the warmest dishes the natives delight in, are the most whole-
some strangers can use, in the putrid climates of Lower Arabia,
Abyssinia, Senaar, and Egypt itself; and that spirits and all fer-
mented liquors, should be regarded as poisons.” Mr. Bruce
remarks in another paragraph, that ardent spirits occasion “im-
moderate heat of the skin, and violent pains of the head,” and
asks, “if like sensations were ever produced by black pepper, or
any other pepper eaten to excess at every meaſ?”
* Effects of a Peculiar Regimen, pp. 263–4. London, 1815.



180 VEGETABLE MATERIA MEDICA.
728. Stimulants of a healthy character, cause a determination
to the surface of the body, and thereby diminish the pressure of
blood to any internal organ which may be the seat of disease.
- Hence in pleurisy, lung ſever, or inflammation of the stomach, or
bowels, they are of great value. If the symptoms are severe,
they should be conjoined with the vapor bath; or heated stones,
wrapped in damp cloths, should be placed at the patient’s feet, in
bed, and as soon as he begins to perspire, he will experience
relief. Dr. Eberle, speaking of inflammatory affections of the
lungs, remarks, “When the skin is moist with perspiration, the
breathing is generally more free, the pain and distressful feeling
in the throat less severe, and expectoration easier.”
729. Clutterbuck, in his remarks on hemorrhage from the
lungs, observes, “It is not an uncommon practice to expose the
naked body of the patient to cold air; or to apply cold water, or
even ice, to the surface of the chest. But the effect of this is,
by contracting the external vessels, to throw the blood in greater
quantity upon the lungs, so as to produce distention of the vessels
there—a most likely cause of increasing the hemorrhage at the
moment, and of aggravating the local inflammation afterward. It
would be far more advisable to keep up an equable circulation
by friction, external warmth, and even the use of internal stimu-
lants—a practice which I have often found successful.”
730. In diarrhoea, and dysentery, stimulants are particularly
indicated, and afford relief by counteracting the undue determina-
tion of blood to the bowels. In ſever, inflammation, and con-
gestion also, they are indispensable, because they tend to restore
a balance to the circulation, which is the grand object to be
accomplished, in the treatment of these affections.
CAYENNE-
Capsicum—The Pods or Seed-vessels.
731. Capsicum is the botanical name of a large genus or
family of plants, which grow in various countries, as Africa,
South America, and the East and West Indies. The pods or
seed-vessels of any one or more of the species, reduced to a
powder, is distinguished by the name of cayenne. The capsicum
baccatum or bird pepper, common both to Africa, and the West
Indies, furnishes the best cayenne with which the market is
- T
* Eberle's Therapeutics, 4th edition, vol. ii. p. 197. -
# Lectures on Blood-letting, vide Select Medical Library, May, 1839.

-
-
Bird Pepper Capsicum Baccaturn
sharp Michelºr & Co. 17 Treº ºn
-




WE GE TABLE MATERIA MEDICA, 181
supplied. It is a shrubby plant, with a greenish, woody, branch-
ing stem, narrow and pointed leaves, white blossoms, and small,
erect seed-vessels, which are of a lightish red color, when fully
.." The drawing opposite to this page, was taken from a shrub
of the capsicum baccatum, which was cultivated near Boston.
The seed was planted early in the spring, in common garden
mould, and sprouted in May. The plant was found to droop in
cold or damp weather, but in a hot sun, it would immediately
regain its freshness, and vigor. By September, it was nearly
three feet high; and before it was half grown, it put forth a
number of small, white blossoms, which were succeeded by pods,
similar in shape to those obtained from Africa, or the West I
dies. They were tasteless in the green state, however, and as the
plant was killed, in October, by accidental exposure to the frost,
they had no opportunity to ripen.
732. The African and West India pepper pods, closely re-
semble each other in shape, and appearance, but the latter, so far
as I have observed, are more acutely pointed than the former.
The color of each varies, according to the season in which they
are collected, but those of a reddish tint, are considered the best.
When they are of a green, yellow, or whitish color, it is an evi-
dence that they have withered upon the shrubs, or have been
gathered at too early a period. Peppers readily imbibe moisture,
and if long exposed in a damp place, will undergo a change of
color from that circumstance. -
733. The East India pepper is far inferior to that of Africa,
or even of the West Indies. Indeed, the plant does not appear to
flourish very well in that country. Dr. Roxburgh, in his Flora
Indica, published in 1832, in Calcutta, mentions six species, all of
which are shrubby, but they produce so badly after the first year,
that they are seldom suffered to remain longer than one season.
The most common species, is the capsicum frutescens, which
produces curved and tapering pods, an inch and a half, or two
inches long. When ripe, they are of a yellow, or bright orange
color. They are more used by the Hindoos than any other
species, particularly when dried, in which state they are found
in every market. These peppers are sent to the United States
from Bombay and Calcutta, in large quantities, and are known
here as the Bombay or chilly peppers. They come to us closely
packed in palm-leaf bags, and are sold at from three to six cents
a pound. Consequently, they are frequently employed in adul- -
terating good cayenne, and were it not for their unpleasant taste
and smell, the fraud could not be easily detected. They are hot
and fiery in the mouth, but do not possess the permanent and
gently stimulating properties of African cayenne.


182 - vegetable Materia medica.
734. The West Indies furnish numerous species of the
capsicum. Mr. Hughes, in his History of Barbadoes, published
in London, in 1750, mentions thirteen, which he found in that
island alone. Among these, were the negro, cherry, bonnet, olive,
white, bird, and bell peppers. Many of the species enumerated
º * Hughes, are also found in other of the West India Is-
ancis. -
735. Dr. Sloane, who made a voyage to Barbadoes, and
Jamaica, in 1707, says, that if “the cherry pepper be swallowed
whole, it will help digestion, corroborate the stomach, and expel
wind. It is also steeped in vinegar,” he adds, “ or pounded and
mixed with salt, for a similar purpose.” The bonnet pepper is
described by Dr. Sloane, as being used throughout the West
Indies, both as food and medicine. Besides being eaten with
salads, the Spaniards put it into their chocolate. It is useful,
observes the same writer, “in colic, pains of the womb, ob-
structed menstruation, quinsy, and dropsical affections; and made
into a plaster, with honey, is beneficial in sciatica.”
736. I have no accurate knowledge of the different species of
capsicum growing in Africa. Judging from the specimens of pep-
per which I have seen from that country, however, varying as they
do in size, shape, and color, I should think they were somewhat nu-
merous. The bird pepper is the most valuable, and generally com-
mands a high price in the United States. It is worthy of remark,
perhaps, that nine-tenths of the African cayenne, so called, which
has been sold in this country, for the last twenty years, has been
manufactured from the West India peppers, and these not un-
frequently adulterated with the still inferior pepper from Bombay,
and other ports in Hindostan. Our best supplies come from
Madagascar, the east and west coasts of Africa, and Guiana, in
South America. The nearer the equator, the better, it is said,
is the pepper.
737. Cayenne an old remedy. Capsicum has been esteem-
ed as a valuable remedy for several centuries. Parkinson, who
published a work on plants, in 1640, just two centuries ago,
quotes from Gregorius de Reggio, as recommending a mixture of
flour and pepper, (meaning the capsicum) to be made into cakes
or loaves, and baked as bread until dry and hard, when they are
to be pulverized, siſted, and kept for use. This preparation.
says the writer, will do to season meat, broth, or sauce; it
will give relish to wine, and other drink, cure the colic, and
expel wind from the stomach. Parkinson observes—“A scruple
of said powder, taken in a little veal or chicken broth, doth won-
derfully comfort a cold stomach, helping digestion, and provoking



VEGETABLE MATERIA MEDICA. 183
-
an appetite to meat. * * * The powder, taken for three
days together, in a decoction of pennyroyal, expelleth the dead-
birth. * * * It helpeth an old inveterate cough, and being
mixed with honey, and applied to the throat troubled with quinzy,
it helpeth it in a short space; made up with a little pitch or
turpentine, and laid upon any hard tumors or kernels, it will dis-
perse them. * * * A decoction of the pods made with
water, and the mouth gargled therewith, easeth the toothach, and
preserveth the teeth from rottenness; the ashes of them rubbed
on the teeth, will make them white. * * * The pods
steeped for three days in aqua vitae, (ardent spirit) and any part
affected with the palsie bathed therewith, will receive a great deal
of ease; steeped for a day in wine, and two spoonfuls thereof
drunk every day fasting, will helpe an offensive breath, although it
hath continued long. * * * The powder of the pods snuft
up the nostrils, will correct any unpleasant smell in them, pro-
ceeding from corrupted phlegm.”
738. Parkinson may be regarded as good authority, for he
was a distinguished botanist, and was appointed as herbalist to the
king. He has described a greater number of plants, perhaps,
than any other writer in the English language. He was contem-
porary with Lobel, whose name is now used to distinguish an
extensive genus of plants, among which, lobelia inflata stands con-
spicuous.
739. “Among the spices which the Indies produce,” says
Dr. Thunberg, the traveller, “none is more commonly used than
cayenne pepper, with which almost every dish is seasoned. Rice,
mixed with the powder of this spice, is frequently eaten without
any other addition. To fish, flesh, and all kinds of sauces, this
hot spice is always added; and in soup, called currie, cayenne
pepper is the chief ingredient.”
740. The above soup, continues the writer, strengthens the
tone of the stomach, and assists digestion.
741. Marsden, in his history of the Sumatrans, remarks,
“Cayenne pepper is one of the ingredients of their dishes.
These may be composed of various kinds of edibles, but gen-
erally of flesh or fowl, and prepared after the manner of our
curry.” He adds, “It is not a little remarkable, that the com-
mon pepper, the chief product and staple commodity of the coun-
try, is never mixed by the natives in their food. They esteem it
heating to the blood, and ascribe a contrary effect to the cayenne;
which I can say my own experience justifies.”f
* Travels in Europe, Africa, and Asia, performed between 1770–79, vol. ii.
p. 269. London.
t Marsden’s History of Sumatra, p. 56. London, 1783.

184 WEGETABLE MATERIA MEDICA.
742. From the testimony of Marsden, therefore, we are led
to infer, that cayenne is a purer and better stimulant than black
pepper, and of this, no one will entertain a doubt, who has been
in the habit of using the two articles.
743. The natives of tropical countries make free use of cay-
enne, and do not find it injurious. Dr. Sloane, already quoted,
- says the Indians and negroes of the West Indies “will scarcely
abstain from it in hot diseases,” which shows that they do not
consider it injurious. Dr. Watkins, who has frequently visited
the West Indies, informed me, that the negroes of these islands,
steep the pods of capsicum in hot water, adding sugar, and the
juice of a sour orange, and drink the tea freely when sick, or at-
tacked with fever.
744. Medical fluthorities. According to the doctrines of the
medical faculty, the use of cayenne in ſever, inflammation, or
hemorrhage, is pernicious, if not fatal; and yet, if we consult their
works, we shall find that they prescribe cayenne in those very
complaints.
745. The United States Dispensatory says, “ Cayenne is a
powerful stimulant, producing when swallowed, a sense of heat in
- the stomach, and a general glow over the body, without any nar-
cotic effect. * * * It is much employed as a condiment,
and proves highly useful in correcting the flatulent tendency of
certain vegetables, and bringing them within the digestive powers
of the stomach. * * * As a medicine, it is useful in cases of
enfeebled and languid stomach, and is occasionally prescribed in
dyspepsia and atonic gout, particularly when attended with much
flatulence, or occurring in persons of intemperate habits. It has
also been given as a stimulant in palsy, and certain lethargic affec-
tions. * * * Its most important application, however, is to
the treatment of malignant sore throat and scarlet fever, in which
it is used both internally and as a gargle. No other remedy has
obtained equal credit in these complaints. * * * Applied ex-
ternally, cayenne is a powerful rubeſacient, very useful in local
rheumatism, and in low forms of disease, where a stimulant im-
pression upon the surface is demanded. It has the advantage,
under these circumstances, of acting speedily without endangering
vesication,” (blistering.)
746. Dr. Thatcher, in his remarks on the different species of
capsicum, says, “There can be little doubt, that they furnish us
with one of the purest and strongest stimulants that can be intro-
duced into the stomach; while, at the same time, they have noth-
- ing of the narcotic effects of ardent spirits.”
* Thatcher’s Dispensatory, 3d edition, pp. 168, 641.

WEGETABLE MATERIA MEDICA. 185
747. Again, in some observations on the treatment pursued
by Dr. Wright, in the yellow fever of the West Indies, he says,
“Where the stomach was too irritable for calomel, he resorted to
the use of cayenne, made into pills; and it has cured, even after
the commencement of the black vomit.” He further remarks,
“this pepper has been given in the putrid sore throat, in the West
Indies, with the most signal benefit.”
748. The editor of the Boston Medical and Surgical Journal,
in contrasting ardent spirit and cayenne as stimulants, remarks,
“Ardent spirit first excites, then depresses the vital energy, and
then causes the very difficulty it is intended to relieve; therefore
it is less safe and useful than cayenne, because the latter is not
followed, as a part of its operation, by exhaustion, or any kind of
stupor. It may be repeated without any danger of producing
torpor or insensibility.”
749. “Cayenne,” says Paris, in his Pharmacologia, “ has
lately been given with success in the advanced stages of acute
rheumatism; and as a gargle in malignant sore throat, it furnishes
a valuable remedy.” The same writer remarks, that the surgeons
of the French army, have been in the habit of administering cay-
enne to the soldiers, who were exhausted by fatigue.
750. Dr. Ware of Harvard University, in a lecture on scar-
let fever, asserted, that “a gargle of cayenne, used at the com-
mencement of the disease, would arrest the affection of the
throat.”
751. We have the testimony of medical writers, that cayenne
does not occasion thirst, or produce that feverish condition of the
system, which is sure to follow the use of impure, or narcotic
stimulants. Dr. Doane, the American editor of Good’s Study
of Medicine, mentions the following example: “A case occur-
red,” he remarks, “within the observation of Drs. Hosack and
Francis, of a gentleman then aged about thirty-five, who had no
recollection of having ever experienced the sensation of thirst.
He had long enjoyed good health, and was very muscular; even
when using excessive quantities of stimulating condiments, as cay-
enne pepper, he had no desire for fluids.”f
752. It is probable that the use of the cayenne, in the above
case, obviated any tendency to thirst; at all events, I have usually
observed, that those who make free use of the article, as a condi-
ment, do not evince any morbid craving for drink. In ſevers,
also, accompanied with burning thirst, I have never found a more
* Thatcher’s Dispensatory, 3d edition, pp. 168, 641.
+ Vol. ix. p. 346.
f Study of Medicine, 6th American edition, vol. i. p. 78.


24

186 VEGETABLE MATERIA MEDICA.
speedy or effectual remedy, than cayenne tea. The acrid, nar-
cotic, or poisonous stimulants, however, would produce an oppo-
site effect, and therefore cannot be employed in medical practice,
without injury to the patient. -
753. Cayenne is employed by the old school physicians, even
in bleeding from the lungs. “According to Dr. Miner's expe-
rience,” says Dr. Eberle, “powdered cayenne, given in doses
of three to five grains every ten minutes, is a most efficient
remedy in hemorrhage from the lungs. I have had occasion to
prescribe this article in one instance lately, and the result has
given a very favorable impression of its powers in this respect.”
754. Professor Channing of Harvard University, recommends
the use of cayenne in flooding, after delivery. “In critical cases,”
said he to his class, “a very good remedy will be found in cay-
enne. It renders the pulse more regular than brandy, and acts
kindly upon the general system. Brandy raises the pulse, and
causes it to flutter, but it does not continue uniform.”
755. “A few bird peppers swallowed whole,” says Dr.
Titford, in his Hortus Botanicus Americanus, page 46, “will
relieve the heart-burn, and prevent dyspepsia.”
756. Dr. Fuller, in his prize essay on the treatment of scar-
let fever, says, “Powdered cayenne, made into pills with crumbs
of bread, and given three or four at once, four times a day, is a
most valuable stimulant in the last stage of this disease, and I be-
lieve it to be an article of great utility in all cases of debility, from
whatever cause it may originate.” Again, he says, “The tinc-
ture of cayenne, saturated with common salt, forms a most excel-
lent gargle after the process of sloughing has taken place; it sep-
arates the dead from the living parts, and communicates a healthy
stimulus to the mouth, and the glands of the throat.”f
757. The same writer informs us, that the late Dr. Perkins,
put his whole dependence upon the internal and external use ºf
cayenne, salt, and vinegar, in the treatment of scarlet fever. “In
an epidemic malignant scarlatina,” says he, “which prevailed in
Connecticut, forty years ago, the practitioners of those days em-
ployed the then popular remedies of bark and wine, and the result
of their practice was, that four out of five died of the disease.
When the epidemic was at its height, Dr. Perkins visited that
region, and prescribed his favorite salt, pepper, and vinegar, with
an effect to cure four out of five, and he often affirmed, that not
one individual died who commenced his treatment at the begin-
ning of the disease.”f
* Eberle's Practice, 4th edition, vol. i. p. 569.
f Boston Medical and Surgical Journal for 1838.
WEGETABLE MATERIA MEDICA. 187
758. Cayenne was also used by Dr. Stephens, with marked
success, in a very fatal epidemic scarlatina, which prevailed in the
West Indies, in 1787. “He took two table-spoonfuls of small
red pepper, or three tea-spoonfuls of common cayenne, and two
tea-spoonfuls of fine salt; mixed them together, and poured upon
them half a pint of boiling water; this was strained, and half a pint
of good vinegar added. Of this liquor, when cold, a table-spoon-
ful was given to an adult every half hour, and the throat frequently
gargled with it. Dr. Stephens asserts, that he employed this
remedy in about four hundred cases, and with surprising success.
The ulcers in the back part of the mouth soon cast off their
sloughs, and began to heal; a general pleasant warmth was diſ-
fused throughout the system, and the vital powers speedily resumed
a more active condition.”%
759. The Bethania Palladium related an interesting story, a
few years ago, with regard to the use of cayenne. The writer
- remarked, that his attention was arrested one morning, by an old
and very active woman, who was picking up brush, and who,
according to the statement of her son-in-law, Joshua Newman,
was ninety years old. She had just concluded a walk of two
miles, when he saw her, and he attributed her surprising energy
and vigor, to the fact of her having been in the habit, for forty
years, of drinking cayenne tea, every morning, as soon as she was
out of bed. During the forty years, her health had been remark-
ably good, and her prospect for a much longer period of life,
was also very promising.
-
760. The reader who is at the trouble of perusing the fore-
going extracts, will probably concede that cayenne is all we claim
for it, namely, a pure, healthy stimulant, which acts in harmony
with the laws of the human system. It is admitted not to be a
narcotic, and of course it does not injuriously affect the brain,
or occasion disorder of the nervous system. Nor is it an acrid
stimulant, for the authors of the United States Dispensatory
admit, that it may be applied externally as a rubefacient, without
endangering vesication. I have mixed it with water, and bound
it upon my arm in the form of a poultice, but I never, knew it
to produce a blister. Mixed with alcohol, however, it would
probably have this effect, but here a new agent is called into
º by which the action of the cayenne is modified. I have
ad occasion to notice, in more than one instance, that men
employed in preparing pepper sauce—working among the green
pods of the capsicum from morning till night—complain of a
* Eberle's Practice, 4th edition, vol. i. p. 494.
l_


188 VEGETABLE MATERIA MEDICA.
severe, burning sensation in their hands, which continues for
twenty-four or thirty-six hours after they have desisted from their
labor, but their hands, in the meantime, do not present any un-
natural appearance, or exhibit even the slightest marks of redness.
761. Adulterations of cayenne. People should be very cau-
tious of whom they purchase cayenne, for it is adulterated in
a great variety of ways. Even those who should be above
suspicion, are known to mix it with one-fourth Indian meal, and
color it with red paint, or dye-stuff. Logwood, red saunders,
ginger, salt, red lead, the bark of the sycamore, and various other
barks, and dye-woods are added to it, with a view to its adultera-
tion. The African cayenne is also mixed with the Bombay or
chilly peppers, but the fraud may be readily detected by the taste
and smell. The grocers and druggists seldom have a pure article,
and frequently it is little better than poison.
762. Some of the substances used in the adulteration of
cayenne, may be readily detected, but others, again, elude the
most rigid scrutiny. Paris, in his Pharmacologia, says, red lead
may be detected by boiling some of the suspected pepper in
vinegar, filtering the solution, and adding to it the sulphate of
soda; by this process, a white precipitate will be formed, which,
after being dried, exposed to heat, and mixed with a little
charcoal, will yield a metallic globule of lead. Those who have
not an opportunity of trying this experiment, may burn some of
the cayenne in a shovel, over the fire, and iſ a black sediment
remains, red lead, or some other injurious mineral may be sus-
pected.
763. The bright red color of cayenne, which we sometimes
observe, is owing to the presence of dye-wood, or some kind
of red paint.
764. Properties AND Uses. Cayenne is known as pos-
sessing an extremely pungent taste, which continues for a consid-
erable length of time. Its properties are imparted to water, and
alcohol, but more completely to the latter than to the former. The
African cayenne, as I have said, is superior to that of the East or
West Indies. It is not so pungent or fiery, when first taken into
the mouth, but it possesses more real strength, is more gentle in its
operation, and much more enduring in its effects. The Bombay or
chilly pepper, is liable to occasion distress, and should not be
used in medicine. The cayenne from Guiana, in South America,
appears to be equal in every respect to the African, but it is very
rarely imported into the United States. - -
765. Cayenne is the best and most efficient stimulant known,

WEGETABLE MATERIA MEDICA. 189
- -
and though freely employed, does not occasion any of the evil
consequences which flow from the use of acrid, narcotic, or
poisonous stimulants. Taken into the stomach, it produces a
pleasant sensation of warmth in that organ, which soon diffuses
itself throughout the whole system. It has the effect to equalize
the circulation, and hence its value in fever, inflammation, and all
those diseases which depend upon a morbid increase of blood in
any particular part of the body. By its equalizing influence, it
reduces a full and bounding pulse, or gives it force and vigor,
where it is thread-like, and feeble.
766. In a sudden cold, nervous debility, weakness of the di-
gestive organs, flatulency, heartburn, distress occasioned by indi-
gestible food, faintness of the stomach, cold hands and feet, and
pains in any part of the body, cayenne may be used with the ut-
most advantage. If the stomach is very cold, it should be taken
in a small quantity at a time, gradually increasing the dose, or it
may occasion severe pain and distress. The same precaution
should be observed, if the stomach is empty. Preceded by a
tea-cupful of broth, milk porridge, or any soothing liquid, it may be
taken in the usual dose, with impunity. I knew a gentleman who
had been unwell for several days, to take a large tea-spoonful of cay-
enne in the morning, on an empty stomach, and such was the dis-
tress which it caused for a few minutes, that he declared the med-
icine was a dangerous one, and would never touch it again. The
difficulty arose, however, from the want of a little prudence, or
judgment, in its administration.
767. Half a tea-spoonful of cayenne two or three times a day,
mixed with molasses or honey, is an excellent remedy in costive-
ness, and affords relief, without weakening the patient, or giving
rise to profuse discharges. It procures a natural evacuation of
the bowels, without leaving them in a weak or torpid condition,
as is the case with purgatives. The pepper pods, swallowed
whole, may be used for the same purpose. I have known persons
to take thirty or forty of them in a day, where the bowels were
extremely sluggish or inactive.
768. Copious hemorrhage from the lungs, is speedily checked
by the use of cayenne and the vapor bath. These have the effect
to render the circulation active in every part of the body, and
consequently, they diminish the pressure of blood to the lungs,
thereby affording an opportunity for a coagulum to form around
the ruptured or bleeding vessel. (38.) By a similar agency, con-
gestion of the brain, inflammation of the brain, pleurisy, rheuma-

190 VEGETABLE MATERIA MEDICA.
tism, dysentery, and all kindred diseases, are cured with a fa-
cility that is sometimes truly astonishing.
769. In irritation of the bladder, cayenne sometimes increases
the distress, but if the skin is kept moist and warm, by the patient
being in bed, or seated near the fire, the unpleasant symptoms
will be either prevented, or greatly modified.
770. The thirst which arises in scarlet, typhus, and other fe-
vers, is effectually allayed by giving cayenne tea, in small and fre-
quent doses. If the skin is hot and dry, it will also have the
effect to excite a perspiration.
771. Where it is necessary to produce an immediate effect
upon the system, the cayenne should be scalded, because it is
then more active and diffusible.
772. Cayenne made into pills, is a convenient form of the
medicine, in some cases, as will be specified hereafter, under the
head of compounds.
773. A tea-spoonful of cayenne, mixed with molasses, or
honey, and taken on going to bed, at night, is a valuable remedy
in cough. I have prescribed it in repeated instances, and always
with favorable results. Combined with a portion of slippery elm,
it is still more efficacious.
774. In wounds, or sores of any description, which are pain-
ful, and in a high state of inflammation, great benefit is to be de-
rived by º them slightly with the dust of cayenne, pre-
vious to the application of a poultice, or other dressing. It eases
the pain, allays the inflammation, and disposes the part to assume
a healthy action. Sprinkled on fresh cuts, also, it is equally
beneficial, but it should be so finely pulverized, as not to act as a
mechanical irritant.
775. Cayenne may be beneficially used as a snuff in head-
ach, and in any obstruction of the nostrils arising from a cold.
776. Weak cayenne tea is an excellent wash for sore, or in-
flamed eyes. This is admitted by the medical faculty. It should
be employed milk warm, as it has been found that cold applica-
tions to the eye, although they may produce temporary relief, are
followed, in many cases, by subsequent injury.
777. We are informed that the juice of pepper pods, is put
into the eyes of slaves in the West Indies, by way of punishment,

VEGETABLE MATERIA MEDICA. 191
but it is thought by some to clear their eyes, and the Indians use
it accordingly, when they go on a fishing excursion.*
778. Dr. Thomson informed me, that his sight became im-
perfect when he was fifty years old, but by working among cay-
enne for three days, he was enabled to see the smallest print as
legibly as he could before see the large letters of a sign, across
the street. He mentioned to me the case of a Mrs. Mitchell, an
aged woman, whose sight was very dim, but by an application of
cayenne, it was immediately restored.
779. I was consulted several months ago, by a gentleman who
had nearly lost the sight of one of his eyes. He had called upon
an oculist, who suggested that a cataract was probably forming,
and intimated that it would be necessary to perform an operation.
I advised him to wash his eye two or three times a day with
weak cayenne tea, milk warm, to which was added a small por-
tion of bayberry and lobelia, and in a fortnight, his sight was en-
tirely restored.
780. The burning sensation which is produced by the ex-
ternal application of cayenne, is varied according to circumstan-
ces. If the sensibility of the skin is blunted, the strongest tinc-
ture may be used with impunity, but in other cases, weak pep-
per sauce may be sufficient to occasion burning. If the sen-
sation is very severe, relief may be obtained by sponging the part
with cold water, and taking a dose or two of cayenne, or black
pepper, internally.
781. Cayenne is sometimes brought in contact, by accident,
with external sensitive parts, and in such cases, the frequent appli-
cation of cold milk, or cream, will serve to allay the pain.
782. Dose. If the cayenne is pure, it may be given in the
dose of from a half to a whole tea-spoonful, steeped in hot water, or
added to bayberry, or some other tea. It is frequently taken in
cold water, or milk, with sugar to suit the taste, and this is al-
ways preferable, where the individual is exposed in the open air.
Given to produce a perspiration, the warm tea should be employ-
ed, and the patient should be in bed, or seated by the fire, with a
blanket around him, if the season renders it necessary. The dose
should be repeated every hour, until the skin becomes moist.
* Barham's Manuscripts, vide Sloane’s Voyage to Barbadoes, etc. London,
707.
192 WEGETABLE MATERIA MEDICA.
BLACK PEPPER.
Piper JN'igrum—The Fruit or Berries.
783. Black pepper is the product of a vine or creeping plant,
which grows wild in the East Indies, and is cultivated in Suma-
tra, Java, Borneo, the Philippines, and other neighboring islands.
The supplies for the United States are chiefly derived from Su-
matra. In the cultivation of the pepper, the ground is divided
into regular squares of six feet, and planted with a species of
thorny shrub, which is intended for the support of the vines.
Young shoots from the plant are then inserted into the ground,
and suffered to grow, without much attention, for three years, when
they reach the height of ten or twelve feet, and begin to bear
fruit. They are then cut off about three feet from the ground,
and being loosened from the shrubs to which they cling, are bent
into the earth. This process gives fresh vigor to the plants, and
in the ensuing season, they yield a plentiful crop, instead of ex-
hausting themselves in leaves.
784. The fruit is five months in maturing, hanging in thick
clusters upon the vines, and assuming, when fully ripe, a bright
red color. It is gathered at this period, and spread upon mats,
in the sun, to dry, when it soon becomes black, and shrivelled.
If collected at too early a period, it turns to dust in its removal
from place to place, and especially on being rubbed between the
hands, which is the usual test for good pepper.
785. As a general rule, the vines produce two crops annually,
one of which is gathered in September, and is called the greater
crop, and the other in March, called the lesser, or half crop. In
some districts, however, where the soil and climate are particu-
larly favorable, there is a constant succession of blossoms and
fruit, so that the latter is gathered the whole year round.
786. The pepper plant is in its greatest perfection during the
seventh or eighth year of its growth, and by the expiration of two
or three more years, it commences gradually to decline.
787. The white pepper is nothing more than the berries de-
prived of their outer coat, which is done by steeping them a fort-
might in water, drying them in the sun, and rubbing them briskly
between the hands. By this process, however, they are deprived
of some of their properties, for a peculiar flavor resides in the
outer coat, which is not found in any other part of the berry.
For a long period, the Europeans thought the white pepper was
the product of a plant differing from that which furnished the
black, and believing it to be of superior quality, were in the habit
of purchasing it at exorbitant prices.

VEGETABLE MATERIA MEDICA. 193
788. PROPERTIES AND Us Es. Black pepper has an aro-
matic smell, and a pungent and very agreeable taste. It yields its
virtues partially to water, and entirely to alcohol. It is a perma-
nent stimulant, and may be used as a substitute for cayenne, when
that article cannot be obtained. In flatulence, indigestion, nau-
sea, and want of appetite, it may be usefully employed.
789. It is worthy of remark, that Dr. Louis Frank, physician
to her majesty, Maria, Duchess of Parma, resorted to the use of
black pepper in ague and fever, when other remedies had failed,
and cured fifty-four out of seventy of his patients. He gave the
seeds in the form of pills, administering from five to eight a day,
and he says no one of his patients required more than seventy or
eighty of these seeds, to effect a perfect cure.”
790. Black pepper is not so pure a stimulant as cayenne, but
is nevertheless a valuable remedial agent. The infusion, made
by steeping a tea-spoonful of the powder, in a tea-cupful of hot
water, may be given with great advantage in the exhausting diarrhoea
which sometimes accompanies scarlet and typhus fevers. The
dose may be repeated at the expiration of two hours, if necessary.
I have known this medicine to arrest the discharges, in critical
cases, when all other treatment seemed to be of no avail.
791. The ordinary dose of black pepper, is a tea-spoonful,
steeped in hot water, as already mentioned. It is sometimes
steeped in boiling milk, and in that form, is comparatively pleas-
ant to the taste.
GINGER.
Zingiber—The Root.
792. Ginger is the root of a plant which is cultivated both in
the East and West Indies. The stalks wither in January or
February, when the roots are dug, and prepared for use. If in-
tended for what is termed black ginger, they are washed, scalded,
and dried; but if for white ginger, they are scraped very carefully,
and dried in the sun. The latter is mostly prepared in Jamaica,
and comes to us in jars. The West India ginger is considered
better and stronger than that of the East Indies. In the former
country, the roots are eaten with salads, and when three or four
months old, are preserved in sirup.
793. Our principal supplies of ginger are derived from
Calcutta.
* Eberle's Therapeutics, 4th edition, vol. ii. p. 189.

25
194 WEGETABLE MATERIA MEDICA,
794. PRoPERTIES AND Uses. Ginger has an agreeable,
pungent, aromatic taste, and is a very good substitute for cayenne,
as a stimulant. It is grateful to the stomach, and is particularly
useful in flatulency, colic pains, and a cold, languid, or feeble
state of the system. Made into tea, and drank warm on going
to bed, it will relieve a sudden cold, or slight attack of disease.
A large tea-spoonful of the powder may be taken at a dose. It
should never be boiled, as this impairs its strength, and dissipates
its aromatic taste. The tea, sweetened with sugar, molasses, or
honey, is a wholesome and refreshing drink, in summer. Milk
may be added, if desirable. -
795. A piece of ginger root held in the mouth, and slowly
chewed, is recommended by Dr. Thomson, as useful in coughs.
796. Preserved Ginger. Take green ginger root, scrape it
clean, cut it into thin slices or shavings, and simmer it in water
over a slow fire until it is soft, or tender; then remove the ginger,
and add sugar in proportion to the liquid, simmering it gently, as
before, until a thick jelly is formed; this done, pass the whole
through a sieve or cloth; add the ginger which was removed, and
simmer again for two or three minutes. This is an excellent, as
well as a wholesome preserve. It is warming and strengthening
to a weak stomach, and is beneficially employed in coughs, and
colds.
797. Ginger Sirup. Take of ginger root, bruised, three
ounces, boiling water, a pint; steep for twenty-four hours, strain,
add three pounds of loaf sugar, and dissolve with a gentle heat,
so as to form a sirup. This is used to give a pleasant flavor to
drinks, and is frequently employed to cover the taste of nauseous
medicines.
798. Ginger Beer. This beverage, which was formerly so
opular in England, under the name of ginger pop, is made as
ollows: Take of loaf sugar, one pound, cream of tartar, one
ounce, bruised ginger, two ounces; add two gallons of boiling
water, and ferment for twenty-four hours with yeast.
799. Ginger Beer Powders. These are prepared in the
manner of soda powders. One drachm and two scruples of pul-
verized loaf sugar, five grains of pulverized ginger, and twenty-six
grains of the bicarbonate of soda, are put into a blue paper; and
thirty grains of tartaric acid into a white paper. Each powder is
dissolved in half a pint of water, and the solutions mixed, which
form a pleasant effervescing draught.


WEGETABLE MATERIA MEDICA. 195
800. Ginger Wine. Take of bruised ginger, six pounds,
water, five gallons; boil for half an hour, and add fourteen pounds
of sugar; continue the boiling till this is dissolved, then cool, and
add seven lemons, sliced, and a pint and a half of brandy; fer-
ment with a little yeast, confine in a tight cask for three months,
and then bottle. -
ASTRINGENTS.
801. Astringents, on being chewed, pucker the mouth, and
communicate a sense of roughness to the tongue and palate.
Those recommended in this work, are derived from the vegetable
kingdom, and are not of a deleterious nature. They are depend-
ant for their astringency on tannin, (592) a substance well known
to the intelligent reader, as being used in the tanning of leather.
It is found in a large number of plants, and is associated with
gallic acid, which was at one time supposed to be the astringent
principle itself.
802. The old school physicians rarely employ vegetable as-
tringents, but make use of those from the mineral kingdom, as
aqua fortis, sugar of lead, and white vitriol. These are violent
poisons, and necessarily injurious to the human system, even
though they should be taken in very minute doses.
803. Astringents render the parts to which they are applied
more dense and firm, or in other words, they produce a “con-
densation of the living animal fibre or muscular tissue.” Em-
ployed in the form of a poultice, they have a tendency to dry and
shrivel the skin, and for that reason, should not be used in poulti-
ces where it is necessary to promote suppuration, and hasten the
discharge of matter.
804. “Cold,” says Dr. Cullen, “is a powerful astringent,
causing a contraction of the vessels on the surface of the body,
and thereby producing paleness, and a suppression of perspiration.”
805. Cold water is a well known astringent, and is employed
as such to check the bleeding of slight wounds.
806. Astringents, and animal jellies, or any gelatinous sub-
stance employed to nourish the sick, should not be taken into the
stomach at the same time, as the tannin of the astringents com-
bines with the gelatin, and forms a solid, indigestible mass.
807. Vegetable astringents may be properly termed detergent
or cleansing medicines, for they have the effect to cleanse the in-
ner or mucous coat of the stomach and bowels, by combining


196 VEGETABLE MATERIA MEDICA.
with its vitiated secretions, and carrying them out of the body.
Hence the great value and importance of this class of remedies.
For example, the morbid substance which collects on the tongue
and roof of the mouth, in fevers, and which is sometimes present
in the morning, on rising from bed, particularly if the individual has
been indulging in a late supper, or the use of spirituous liquors, is
effectually detached by a gargle of some astringent tea; and it is
by a similar process, that the astringent medicines act upon the
mucous membrane of the stomach and bowels, removing its mor-
bid or vitiated secretions, and enabling it to perform its functions
in a natural and healthy manner.
808. Dr. Thomson has applied the term canker, to the mor-
bid substance in question, and therefore, he denominates the as-
tringents which he employs in its removal, anti-canker medicines.
I may here remark, that he borrowed the term canker from the
New England people, for they almost universally make use of it,
in speaking of disease. Whether they have a sore mouth, an
eruption of the skin, or any bad humor of the body, they say it is
caused by canker, and they certainly employ the word in a correct
sense, for, according to the best authorities, canker signifies any-
thing that corrodes, corrupts, or destroys.
809. Attention is required in the proper selection of astrin-
gents, for some of them are so binding, that they cannot be used
with safety. Marsh rosemary, or hemlock, for example, taken for
any length of time, will occasion difficult breathing, and other dis-
tressing symptoms. Dr. Thomson has established the rule, that
any astringent which, on being chewed, excites the secretion of
saliva, and leaves the mouth clean and moist, may be safely em-
ployed in medicine. Bayberry answers to this description, for in
addition to its astringency, it is sensibly pungent and stimulating.
810. An emetic should always be preceded by an astringent,
in order that the latter may detach the vitiated matter from the
mucous coat of the stomach, previous to vomiting.
811. Astringents are useful in hemorrhage from the stomach,
because they come in immediate contact with the bleeding vessels,
and also from the rectum, administered in the form of an injection.
They are likewise given to restrain hemorrhages from organs with
which they cannot be brought in immediate contact, as the lungs,
and uterus, but the particular mode in which they operate, has not
been exactly ascertained. Dr. Thomson of Edinburgh, supposes
that they pass into the blood, and thus produce their beneficial
effects; but others are of the opinion, that they act upon the
VEGETABLE MATERIA MEDICA. 197
general system, through the medium of the stomach, and control
the hemorrhage in an indirect manner. The latter opinion is the
more plausible.
812. In the treatment of diarrhoea, and dysentery, astringents
are important remedies, but they require to be used in combina-
tion with some stimulant, as cayenne, or rheumatic drops. As-
tringents alone, would check the discharges at the risk of doing
injury to the patient. The acrid or vitiated contents of the bow-
els would be retained, the local inflammation, already present,
would be increased, and colic, fever, headach, or some other
form of disease, would be developed. In diarrhoea, and dysen-
tery, we must endeavor to counteract the undue determination of
blood to the bowels, which we can always accomplish by the use
of stimulants, and the vapor bath, and in conjunction with these,
astringents may be employed with safety and advantage.
813. Astringent injections into the urethra, are very useful in
gonorrhoea, after the local inflammation has been subdued, or in
the early stage of the disease, previous to the development of the
inflammation. They may consist of raspberry, sumach, bayberry,
pond lily, or witch hazel tea, adding cayenne, or rheumatic drops,
to give them pungency. The bayberry, however, is pungent of
itself, but its pungency may be increased, if desirable. The in-
jections should be milk warm. In gleet, the same treatment is
equally beneficial. Dr. Thomson does not approve of injections
into the urethra, however, notwithstanding he inculcates the doc-
trine, that a remedy should be applied, if possible, to the seat of
a disease, but I have succeeded in curing cases of gomorrhoea,
by this practice, using also some diuretic, when even courses of
medicine have failed.
814. In prolapsus uteri or falling of the womb, in which there
is more or less relaxation of the parts, astringent injections into
the vagina, are productive of beneficial results. In falling of the
palate, also, as it is termed, astringent gargles will be of service.
815. Astringent teas are particularly useful as a wash for
sores. They are cleansing, and induce a healthy action in the
parts. If the sore is irritable, astringents devoid of pungency
should be employed, as the raspberry, witch hazel, or sumach ;
but if it is indolent, or wanting in sensibility, bayberry is pre-
ferable, and it may be used in combination with cayenne, or
rheumatic drops.

198 VEGETABLE MATERIA MEDICA.
- paypenny.
JMyrica Cerifera—The Root.
- -
816. This shrub, called also candle berry, and wax myrtle,
extends from New England to Louisiana, inhabiting both dry and
wet soils. It is usually found, however, in neglected fields, and
on the sides of stony hills. Its growth is much influenced by
soil and climate. In Louisiana, it reaches to the height of ten or
twelve feet, but in Massachusetts, where it is very abundant, I
have seldom known it to exceed four or five feet. -
817. The stem of the bayberry is covered with a grayish
bark, and is thickly branched at the top. The leaves are narrow
and tapering at the base, twisted in their mode of growth, and
covered with a scarcely perceptible down. They are of a shin-
ing green upon the upper surface, and generally have a few re-
mote teeth near the apex or point. The flowers appear in May,
and in the fruitful shrub, are succeeded by small berries, which
adhere to the branches either separately or in clusters. They are
green at first, but gradually change to a grayish tint, and in the
autumn, assume a dullish white color.
818. A bushel of these berries will yield about four pounds of
wax, which is procured by boiling the berries in water, when the
wax will separate, and float upon the surface. To render it more
pure, it is melted again, passed through a cloth, or sieve, and
cast into cakes. In this state, it is brittle, of a greenish color,
and similar in texture to beeswax. It is used for a variety of pur-
poses, entering into the composition of lº"; soap, tapers,
sealing wax, and even a species of blacking. It is also mixed
with tallow in the manufacture of candles, which burn with a clear
light, and emit a fragrant odor.
819. Bayberry growing in a sandy soil, has a thicker bark
upon the root, than that found in other localities, and is consid-
ered of a better quality. The roots should be collected early
in the spring, or late in the autumn, freed from dirt, and pounded
with a mallet, or club, to separate the bark. This should be
thoroughly dried, without exposure to a wet or damp atmosphere,
and reduced to powder, previous to being used.
820. Coarse bayberry, so called, is the residue or bran,
which is left after the powder has been bolted, or siſted.
821. The leaves and berries of this shrub, have an aromatic
* and smell, but are not used in medicine.

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WEGETABLE MATERIA MEDICA. 199 |
822. PRoPERTIES AND Us Es. Bayberry is the most valu-
able of the astringent or cleansing medicines, and is now used
by Dr. Thomson, in preference to the compound of these articles,
which he formerly recommended. It has an astringent and bitter
taste, conjoined with a good deal of pungency. It produces a
stimulating effect upon the mouth, and leaves it clean and moist.
It tends in an especial manner to cleanse the inner coat of the
stomach, which it does by combining with the morbid or vitiated
secretions upon its surface, and causing them to be detached.
Hence, it should always be given before the administration of an
emetic. It produces the same cleansing effect upon the mucous
membrane of the bowels. Used as a gargle, also, in putrid or
ulcerated sore throat, it detaches large flakes or masses of very
offensive matter.
823. Professor Barton, in his Collection toward a Materia
Medica, quotes Dr. Matthew Wilson, as saying that bayberry often
acts as a gentle purgative, but this is an erroneous opinion, for in-
stead of being cathartic, it rather tends, in large and frequent
doses, to constipate the bowels, and therefore should be com-
bined, as a general thing, with a portion of cayenne.
824. Dr. Bigelow, in his Medical Botany, observes, on the
authority of Dr. Dana, that bayberry, in “doses of a drachm,
(a large tea-spoonful) produces a powerful burning sensation, and
vomiting.” Dr. Thatcher further informs us, that Dr. James
Mann employed bayberry as an emetic, and that it was equal in
strength to ipecacuanha. These writers are more theoretical than
practical, for it is well known to those who have employed bay-
berry extensively, that it has no ". whatever to occasion
vomiting, unless the stomach is in a very disordered state. A pint
of the tea, after the organ is thoroughly cleansed, would not even
eXC1te nauSea.
825. There is no form of disease, in which bayberry, if pro-
perly administered, will not prove beneficial. In some parts of
Massachusetts, the decoction is in common use as a remedy in
scarlet fever; and it is given without any particular regard to
quantity. If the throat is affected, it is also employed as a gargle.
I have been credibly informed by parents, who knew nothing of
Dr. Thomson, that they have cured their children of scarlet
fever, by this article alone, after the attending physicians had given
them up as hopeless. -
826. Bayberry is a valuable remedy in diarrhoea, and dysen-
tery. The decoction, administered in the dose of a tea-cupful,
with a table-spoonful of rheumatic drops, and repeated two
or three times, will rarely ſail to effect a cure, in any ordinary
case.

200 VEGETABLE MATERIA MEDICA.
827. The tea is a useful wash in badly conditioned sores, and
should always be employed, where its pungency is not an objection.
828. The powder makes a very good dentrifice, and not only
cleanses the teeth, by its mechanical action with the brush, but
renders the gums more sound and healthy. Scented with the fra-
grant oils, as golden rod, or spicy wintergreen, it furnishes a delight-
ful snuff, which may be used to advantage in headachs, and colds.
829. The dose is a tea-spoonful of the powder, steeped in a
tea-cupful of boiling water, and sweetened to suit the taste.
WITCH HAZEL.
Hamamelis Virginica–The Leaves.
830. The witch hazel has an oblique trunk, from six to
twenty feet high, which is divided into irregular, knotty branches.
The bark is smooth and grayish, diversified with ash colored
spots. The leaves, which vary considerably in size and shape,
have wavy, irregular margins, and tapering, or roundish ends.
The blossoms are yellow, and scattered along the branches in
clusters of from three to five. They do not appear until the
leaves begin to decay, and remain in bloom until the snow falls,
imparting to the woods a gay, and spring-like appearance. The
nuts or fruit, are contained in a brownish colored shell, and do
not ripen until a year after the appearance of the blossoms.
831. The witch hazel is a native of the United States, and
extends from Canada to Florida. It is found in damp woodlands,
and along the banks of streams. Impostors have made use of the
branches for divining rods, pretending they could thereby dis-
cover water, and precious ores. The bark and leaves dye brown,
and with the addition of copperas, an excellent black.
832. Properties AND Uses. The leaves are an excel-
lent astringent, and in combination with cayenne, may be freely
º in those cases in which astringents are necessary.
They have the reputation, also, of being antiseptic and tonic.
The infusion is useful in bleeding from the stomach, and adminis-
tered in the form of an injection, affords great relief in irritable
piles. Dr. Thomson also recommends an injection of it into the
vagina, as a remedy in the bearing down pains of women, which
occur at other periods than during labor. He has told me that it
will always afford immediate relief, but I suspect, although a
useful remedy, he has somewhat overrated its virtues. The

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WEGETABLE MATERIA MEDICA. 201
tea is of great value in washing or cleansing irritable sores, and
corroded surfaces. The bark is made into a poultice by the In-
dians, and applied to painful tumors, and sore or inflamed eyes.
WHITE POND LILY.
JNymphaea Odorata—The Root.
833. The white pond lily, called also water lily, is found in vari-
ous parts of the United States, growing in ditches and stagnant pools.
It is chiefly remarkable for a large white flower, of delicious fra-
grance, which closes at night, and opens again about sunrise in the
morning. The roots creep through the mud to the distance of
several feet. They are rough, blackish, somewhat fibrous, and
two or three inches in diameter. The leaves float upon the water,
and are nearly round, with a cleft or opening at the base. The
upper surface is smooth, glossy, and of a bright green ; the under
surface is reddish, having prominent veins radiating from the cen-
tre. The stems, both of the leaves and flowers, spring directly
from the root, and vary in length from ten inches to five feet, ac-
cording to the depth of the water. They are about as thick as a
common pipe stem, and are perforated from one extremity to the
other with small tubes. The flowers expand in June or July, and
are of a beautiful white color, variegated occasionally with a deli-
cate shade of red.
834. In some parts of Canada, the leaves of the pond lily are
boiled, when they are young, and eaten with salt and vinegar.
The roots are the only part used in medicine. They should be
procured in the autumn, freed from dirt, and cut into thin slices,
preparatory to drying. Dr. Withering says they are used in Ice-
land to dye brown.
835. PRoPERTIES AND Us Es. The root of this plant possess-
es a high degree of astringency, with a small portion of bitterness.
The tea is useful in bowel complaints, and all diseases requiring
an astringent medicine. It is beneficial as a wash for sores, and
also as a gargle in putrid, or ulcerated sore throat. Injected into
the urethra, or vagina, it is a valuable remedy in gleet, fluor albus,
and other diseases to which these parts are liable. It should not
be taken internally in large and repeated doses, without the addi-
tion of cayenne, as it is liable, from its astringency, to render the
bowels costive. One or two tea-spoonfuls of the powder, added
to some slippery elm, or pounded cracker, with a small portion of


26
202 WEGETABLE MATERIA MEDICA.
ginger, forms an excellent poultice for indolent, or ill-conditioned
ulcers. -
836. A tea-spoonful of the powder, steeped in hot water, may
be taken at a dose.
837. The root of the yellow water lily, which also grows in
ponds, and stagnant waters, is similar in properties to the above,
but is not considered quite so efficient. -
-
BLACK BIRC H.
Betula Lenta–Bark of the Trunk.
838. The blackbirch is a stately and beautiful tree, and is found
from Canada to the mountainous regions of Georgia. According
to Michaux, it abounds in the middle states, particularly in New
York, Pennsylvania, and Maryland, but further south, it is confin-
ed to the summit of the Alleghanies, on which it flourishes to their
termination in Georgia. In Virginia, it is called mountain mahog-
any, while in New England it is known by the names of sweet,
spicy, cherry, and black birch, but the latter is the most common.
In situations favorable to its growth, it attains the height of seventy
or eighty feet, with a diameter of two or three feet. The young
trees and branches are covered with a brownish bark, dotted with
white transverse lines, about an eighth of an inch long. In thick
woods, the bark of the trunk hangs in shreds, of a whitish color,
and silken lustre, detaching itself transversely in a number of layers.
The leaves have some resemblance to those of the cherry tree,
and are about three inches long; they are heart-shaped at the base,
bordered with acute, double teeth, acutely pointed, and have
parallel veins on the under surface. . . . .
839. The wood of the black birch is of a reddish color, hav-
ing some resemblance to mahogany, especially when deepened by
exposure to the atmosphere, and is much used in cabinet work.
Michaux recommends it to the lovers of foreign vegetables, as
eminently adapted, by the beauty of its foliage, to figure in their
parks and gardens. If an incision be made into the bark in the
spring, when the leaves are beginning to appear, the sap will exude
almost spontaneously, and in very large quantities.
840. Properties and Uses. The bark of the black birch
has a fragrant smell, and an aromatic and sweetish taste, very
nearly resembling that of the spicy wintergreen. Hence, it is very
useful in flavoring medicines. It is moderately astringent, and is




vegetABLE MATERIA MEDICA. 203
an excellent remedy in bowel complaints. Dr. Thomson says he
has made much use of it in dysentery. In the form of sirup, with
the addition of peach-meats, or the meats of cherry-stones, it is a
valuable restorative in convalescence from that disease. The tea
makes a pleasant drink for children, and may be given to patients
freely during the operation of a course of medicine.
WILD RED RASPBERRY.
Rubus Strigosus—The Leaves.
841. The stem of this plant is upright, branching, three or
four feet high, of a reddish color, and thickly covered with very
stiff bristles. The leaves are in one or two pairs, supported on a
hairy foot-stalk, with an odd and larger one at the end. They are
edged with acute teeth, wrinkled, and marked with parallel lines
on the upper surface, of a silvery whiteness beneath, and termina-
ted by long, slender points. The flowers are white, and disposed
in little nodding clusters, succeeded by a profusion of red berries.
842. This plant is found throughout the Northern and South-
ern States, growing in dry, waste lands, and on stony hills. It is
very abundant in New England. In Tennessee, it grows on the
mountains among the rocks. I never saw it in Pennsylvania, ex-
cepting on the farm of Dr. Logan, near Philadelphia, where it was
cultivated. Dr. L. informed me that he had been in search of it
for more than two years, and at length found it in abundance on the
top of the Pokono Mountains. It blossoms in June, and again in
the latter part of summer, producing, if the season permits, a sec-
ond supply of fruit in September.
843. The leaves of this plant are becoming very fashionable
in some sections of the country, as a substitute for tea and coffee.
The strong infusion can scarcely be distinguished from black tea,
and is infinitely more wholesome. With the addition of sugar and
milk, it is a very pleasant beverage.
844. “The fruit of the raspberry,” says Dr. Alcott, in his
Young Housekeeper, “is a good deal like the strawberry in its
nature, being cooling, gently laxative, and in the language of med-
ical books, antiseptic—by which is meant, that it corrects any
putrid tendency in the stomach and bowels, especially during the hot
weather. It is as nutritious as the strawberry, if not more so; and
it does not more readily become acid in the stomach.”


204 WEGETABLE MATERIA MEDICA.
845. PROPERTIES AND Uses. The leaves of the raspberry
are moderately astringent, with a slightly bitter, and very agreeable
aromatic taste. The infusion is an excellent remedy in the bowel
complaints of children; and if used in season, will generally effect
a cure. It should be given in warm draughts, and administered
also by way of injection. The addition of a small portion of slip-
pery elm, will render it still more efficacious. -
846. Dr. Thomson observes that a strong tea of raspberry,
with the addition of a small quantity of cayenne, and nerve powder,
is a valuable medicine for women in labor, quieting the pains if
untimely, and rendering them more efficient, if labor has really
commenced. There is no doubt that the remedy is a good one,
but I presume that composition, black birch, or any warming and
gently stimulating tea, would answer the purpose equally well.
847. Raspberry tea is a soothing and cleansing wash for ul-
cers, scalds, burns, and all excoriated surfaces, which are very sore
or irritable.
848. Raspberry Cordial. Take a quart of raspberries, and a
pound of loaf sugar; mash the raspberries, and strew the sugar
over them, having first pounded it slightly. Let the raspberries
and sugar stand till next day, keeping them well covered, then put
them into a thin linen bag, and squeeze out the juice. To each
quart of this, add a quart of double rectified whiskey. Cork
tightly, and set it away for two or three days, when it will be
fit for use.*
849, Raspberry vinegar is made in the same manner as the
cordial, only substituting the best white vinegar for the whiskey.
Mixed with water, either of these preparations is a pure, delicious,
wholesome drink, particularly in summer.
850. Raspberry Jelly. Gather the fruit when fully ripe, on a
dry day; put it into a jar, and cover it closely. Set the jar in a
sauce-pan, about three parts filled with cold water; place the pan
over a gentle fire, and let the fruit simmer for about half an hour.
Take the pan from the fire, and pour the contents of the jar into
a jelly bag; pass the juice through the bag twice, without squeez:
ing or using any pressure; to each pint of the juice, add a pound
and a half of good loaf sugar, pounded; when this is dissolved, put
the juice into a preserving pan, over the fire, and boil gently until
the scum ceases to rise, stirring and skimming it all the time;
pour the jelly, thus formed, into pots, while it is warm, and after
it has cooled, cover the pots with paper wetted with brandy.”
* Housekeeper’s Register.
WEGETABLE MATERIA MEDICA. 205
851. Half a pint of this jelly, dissolved in a pint of brandy, or
vinegar, will afford excellent raspberry brandy, or vinegar.”
852. Raspberry Jam. Take equal parts of powdered loaf
sugar and raspberries; put the fruit into a preserving pan, and bruise
or mash it well with a silver spoon; let it boil six minutes, and
then add the sugar, stirring it well with the fruit; as soon as it boils
a second time, skim, and continue the boiling fifteen minutes.”
This, dissolved in water, is also a refreshing drink for the sick,
and is particularly useful in putrid, or ulcerated sore throat.
EWAN ROOT.
Geum Rivale—The Root.
853. This plant, known by the names of chocolate root, throat
root, bennet, purple avens, water avens, and cure-all, grows in
Canada, New England, New York, and Pennsylvania, inhabiting
swamps, and wet spongy meadows. It is somewhat conspicu-
ous in the month of June, for its dark colored, and rather hand-
some flowers. The root is six or seven inches long, and about
as thick as the little finger, with a number of brownish colored
fibres. It sends up one or more stems, which are two feet high,
purple, hairy, and branching near the top. The leaves of the
root stand on long, hairy foot-stalks, and are generally in threes, or
fives; the odd or terminal one is the largest, and is divided into
lobes, with a number of leaſy appendages along the foot-stalk.
They are wrinkled, hairy above and below, and bordered with
double teeth, of unequal sizes. The stem leaves are small and
few, consisting usually of three acute lobes or divisions. The
flowers are nodding and purple, standing singly upon the tops of
the branches. The seeds are furnished with feathery bristles,
which are about half an inch long, and slightly hooked at the end.
854. PRoPERTIES AND Us Es. The Evan root is moderately
astringent, with a slightly bitter taste, and is used both as a com-
mon drink, and medicine. The root should be collected early in
the spring, cut into slices, carefully dried, and reduced to a coarse
powder. For table use, this is boiled, and sugar and milk added,
which renders it a very pleasant beverage. Its taste resembles that
of chocolate, which has given rise to the name of chocolate root.
This preparation is much used in some parts of New England, in-
* Housekeeper's Register.

206 WEGETABLE MATERIA MEDICA.
stead of tea and coffee, and though astringent, it does not appear
to constipate the bowels. It is useful in dysentery, diarrhoea,
bleeding from the stomach, a weak or languid appetite, and a variety
of similar complaints. The tea may be used as a wash for irrita-
ble or smarting sores; and it is also recommended by Dr. Cutler
as a gargle, and drink, in ulcerated sore throat, in which I have
found it very beneficial.
SUMACH.
Rhus–Three Species—Leaves and Berries.
855. Smooth or Upland Sumach–Rhus Glabrum. This is
the species most commonly used. It grows along fences, in neg-
lected fields, and on the sides of stony hills. The stem rises
from four to twelve feet high, and is divided into straggling branch-
es. The leaves are arranged in two rows, on a smooth foot-stalk,
consisting of nine or ten pairs, with an odd one at the end. They
are narrow, three or four inches long, of a dark green upon the
upper surface, whitish beneath, and terminated by a long slender
point. In the autumn their color changes to crimson or scarlet.
The flowers are disposed in thick clusters, and succeeded by red
berries, which, in the fertile plant, are very dense. A whitish
powder collects upon them soon after the occurrence of frost,
which has received the name of “Indian salt.” The berries
should be collected before this substance is washed away by the
rain.
856. Stag-horn or Welvet Sumach–Rhus Typhinum. This
is called stag-horn sumach, from the resemblance of its branches to
the horn of a stag. It is a larger species than the preceding, and
rises usually to the height of ten or twelve feet. Occasionally,
however, it acquires double that altitude, with a trunk ten or
twelve inches in diameter. Growing wild, it is mostly found in
low, damp grounds, but it appears to flourish equally well in more
elevated situations. In New England, it is cultivated in gardens
and pleasure grounds, for ornament. The leaf-stalks and young
branches are covered with a soft, velvet-like down. The leaves
are similar to those of the smooth sumach, but are more numerous,
hairy underneath, and somewhat longer. The berries are in a
dense cluster, and of a rich, scarlet, velvety appearance. They
are liable to be eaten by worms almost as soon as they are ma-
tured. The bark and leaves of this, and the preceding species, on
being broken, exude a milky juice.
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VEGETABLE MATERIA MEDICA. 207
857. Mountain or Dwarf Sumach–Rhus Copallinum. The
dwarf sumach is a smaller shrub than either of the above, attaining
only the height of five or six feet. It grows in dry, rocky ground.
The leaves are tapering at both ends, sharply pointed, and an inch
and a half or two inches long; they are of a deep, shining green
upon the upper surface, downy beneath, and arranged in pairs, on a
winged and hairy foot-stalk. The leaves are palish red, and grow
in open, spreading clusters. The leaves, in addition to their as-
tringency, have an acid, and somewhat aromatic taste.
858. These shrubs flower in June, or July, and put forth a
profusion of greenish colored blossoms. The berries ripen in
autumn, when they should be gathered, selecting for the occasion
a clear, dry day. The bark and leaves are astringent, and are
used in tanning, and dyeing. The leaves should be collected when
full grown, and before they have changed color. The berries of
all the species are used in medicine, but those of the smooth su-
mach are the best. Their only medicinal portion, is the powder
or mealy substance which covers them, and this may be readily
separated by rubbing them, when perfectly dry, in a sieve, which
will allow the powder to pass through, while the berries are retained.
859. The leaves of the dwarf sumach are more astringent than
those of either of the other species. The root of this plant, according
to Lewis and Clark, is regarded as a specific by the Chippeway In-
dians, in the venereal. “They use the decoction without any limi-
tation, and it is said to soften the violence of the disease, and to
be a sovereign cure in gonorrhoea.”
860. Prop ERTIES AND Us Es. Sumach berries are astrin-
gent, and pleasantly acid. The tea, sweetened, is useful in stran-
gury, and bowel complaints. It has the color of wine, and makes
a pleasant medicinal drink for children. Sweetened with honey, it
is beneficial as a gargle in sore throat, and for cleansing the mouth
in fever. It is an excellent external application for ring-worms,
tetters, and other cutaneous diseases, and also as a wash for offen-
sive sores, having the effect to render them clean and white.
861. Both the leaves and berries are diuretic, but the latter
are the most efficient. The leaves may be employed, in combi-
nation with other articles, for all the purposes of an astringent.
862. The bark of the root, says Dr. Smith of New York, is
considered a valuable antiseptic; in the form of a poultice for old
* Lewis and Clark’s Expedition to the Sources of the Missouri, etc., vol. ii. p.
136. Philadelphia, 1814.



208 vegetABLE MATERIA Medica.
ulcers, it is scarcely equalled by any other remedy. Taken in-
ternally, it operates as a purgative.
863. The gum which exudes from the bark, on being punc-
tured, during the summer, is beneficial in gleets, and obstruc-
tion of the urine. It is most conveniently administered in the
form º pills, which will be described, hereafter, among the com-
Ounds.
864. The excrescences which form upon the leaves of the
sumach, are nearly equal in astringency to galls, and if finely
powdered, and made into an ointment with fresh lard, afford a
soothing application for piles.
BETH ROOT.
Trillium Pendulumº-The Root.
865. The beth root grows in damp, rocky woods, delighting
in a rich soil, and is variously called Indian balm, rattlesnake
root, cough root, birth root, ground lily, and drooping trillium.
It has a thick, short, wrinkled, fibrous root, and an erect, smooth
stem, from one to two feet high, surmounted at the top with three
leaves, which are large, roundish, narrow at the base, supported
on very short foot-stalks, and terminated by an abrupt point. The
flower is white, and drooping, being sheltered beneath the leaves.
In the Southern States, it blooms in April, but further north, it
does not make its appearance till some time in May.
866. Prop ERTIES AND Uses. The root has a bitter and
..". taste, somewhat resembling that of unicorn. Chewed
or some time, it communicates a pungent sensation to the mouth
and throat. It is astringent, tonic, and antiseptic, and is employed
internally in uterine hemorrhage, immoderate menstrual discharges,
fluor albus, spitting of blood, coughs, asthma, and all difficulties
of breathing. The Indian women, both in Canada and Missouri,
make much use of it after parturition. The dose is a tea-
spoonful of the powder, steeped in hot water.
867. The root powdered, and made into a poultice, is recom-
mended by Rafinesque as useful in indolent, or offensive ulcers.
* This is the T cernuum of Barton and Bigelow, and the T. latifolium of
Beach and Rafinesque.
WEGETABLE MATERIA MEDICA, 209
HARD HACK.
Spirapa Tomentosa—Leaves and Flowers.
868. The hardhack grows in meadows and low grounds
throughout the Northern and Southern States. It is very abun-
dant in many parts of New England. It has a hard, woody root,
with a number of erect, purplish, and downy stems, which rise
to the height of two or three feet. The leaves are on short foot-
stalks, nearly oval, unequally toothed along the margins, deep
green above, and of a whitish or silvery color beneath. The -
plant blooms in July and August. The flowers are red or pur-
ple, and disposed in elegant clusters at the tops of the stems,
being large at the base, and gradually tapering to their extremity.
869. Prop ERTIES AND Us Es. The leaves and flowers are
bitter, and prominently astringent. The infusion, combined with
cayenne, or rheumatic drops, is useful in diarrhoea, and all bowel
complaints. It is also a good tonic, and may be given in cases of
debility, and want of appetite. Prepared with sugar and milk,
says Rafinesque, it forms a very pleasant drink in the protracted
stage of cholera. The same writer observes that it never disa-
grees with the stomach. The Mohegan, and other tribes of In-
dians, are said to have employed this plant.
HEML.0CK SPRUCE.
Pinus Canadensisº Inner Bark, and Leaves.
870. The hemlock spruce is a large forest tree, attaining the
height of seventy or eighty feet, with a trunk four or five feet in
diameter, which is of nearly uniform dimensions for nearly two
thirds of its length. The branches are horizontal, tapering, and
somewhat drooping at their extremities. The leaves, which
are arranged in two irregular rows, are flat on the under surface,
slightly rounding above, and about an inch and a half in length.
The cones are somewhat longer than the leaves, of a brownish
color, pendulous, and situated at the ends of the branches.
S71. This tree, according to Michaux, forms two thirds of
the evergreen woods in Nova Scotia, Maine, Vermont, and the
upper part of New Hampshire; but it is less common further
-
*.4bies Canadensis of Michaux.

27

210 WEGETABLE MATERIA MEDICA.
south, and in the Middle and Southern States is found only on
the Alleghanies. It is frequent in the woods of Massachusetts.
The bark is used for tanning, but is considered inferior to the bark
of the oak. It imparts a deep red color to the leather. The
hemlock gum, which is sold in the shops for strengthening plasters,
is procured by stripping the bark from a full grown tree, breaking
it into fragments, and boiling it in water. The gum rises to the
surface, is skimmed off, purified by boiling a second time, and
straining through linen or canvass. In this state it is brittle, and
of a dark brown color.
872. PR op ERTIES AND Us Es. The inner bark of the hem-
ock spruce was formerly used by Dr. Thomson as an astrin-
gent or anti-canker medicine, but he found that it was of too bind-
ing a nature, and from a belief that it was capable of doing injury,
discarded it altogether from his practice. Taken freely for any
length of time, it causes a choking sensation, and renders the
breathing difficult. The same objection does not apply, how-
ever, to the leaves, which are bitter and aromatic, with a slight
degree of pungency. Made into a tea, by steeping them in hot
water, and drank freely, they produce perspiration, and are bene-
ficial in sudden colds, and rheumatic affections. They are also
highly useful in gravelly complaints, and obstructions of the urinary
passages. The oil may be employed to flavor medicine. It is
also a valuable addition to bathing drops, intended as an application
for sprains, bruises, swellings, and rheumatic joints.
MARS H R O SEMARY.
Statice Limonium”— The Root.
873. The marsh rosemary, called also sea lavender, sea thrift,
and ink root, grows in salt marshes, and on the sea coast. It has
a fleshy, branching root, of a brown or reddish color, which sends
up a smooth, round, naked stem, a foot or more high, and thickly
branched at the top. The leaves grow in tufts or branches from
the root, and are supported on long footstalks. They are smooth
on both sides, very firm and thick, and rounded, or somewhat ta-
ering at the end, which is terminated by a sharp point or prickle.
}. edges consist of transparent, silvery borders, which may be
seen by looking at them against the light. The flowers are small,
* The S. Caroliniana of Pursh.

ſº del
Marsh Rosemary
stance ºne
ºr ºn a tº 7 ſº

WEGETABLE MATERIA MEDICA. 211
erect, very numerous, of a bluish purple, and arranged upon the
upper sides of the terminal branches.
874. The marsh rosemary extends along the sea coast
from New England to Florida. It is very abundant in the salt
marshes about Boston and Salem. The flowering season is Au-
gust and September. The roots should be dug early in the
spring, or in the autumn after the leaves have decayed, selecting
those which inhabit a sandy soil. They should be freed from dirt,
cut into thin slices, dried, reduced to a powder, and packed in
dry boxes, or drawers, as they are liable to imbibe moisture, and
become mouldy. They afford a jet black ink, which is equal to
that prepared from galls.
875. PRoPERTIES AND Us Es. The root is powerfully as-
tringent, and on being chewed, manifests a bitter and saltish taste.
Its virtues are imparted to water, and alcohol. It is a well known
antiseptic, and is much used by the people of New England as a
remedy in sore mouth, for which purpose they either chew a piece
of the root, or employ the decoction as a gargle.
876. The root finely pulverized, and made into an ointment,
with tallow, is a soothing application for piles, and may be con-
fined to the parts by means of a bandage, and a piece of lint or
folded rag. -
877. Benefit is derived from the marsh rosemary in the treat-
ment of cancers. The pulverized root may be made into a paste
with the cancer balsam, and applied to the affected part, or the
powder may be sprinkled upon the cancer in a thin layer, and the
balsam applied over this.
878. The decoction is useful in washing offensive sores,
which require to be cleansed.
879. The marsh rosemary is too astringent for internal use,
unless combined with a large portion of cayenne. It renders the
mouth dry, and parched, gives rise to costiveness, and produces a
choking sensation, accompanied with great difficulty of breathing.
TONICS.
880. Tonics are bitter or restorative medicines, and are used
in loss of appetite, feeble digestion, and general weakness or de-
bility. They act first upon the stomach, and then upon the re-
mote parts of the body, imparting to the whole system an increase
of strength and vigor. It is probable, also, that they enter the
circulation, and produce their good effects, in some measure, by
their action upon the blood. -


212 WEGETABLE MATERIA MEDICA,
881. Tonics are generally bitter, but there are bitter sub-
stances which are devoid of tonic properties. Opium, for exam-
ple, is bitter, but not tonic. A bitter substance, also, may be
objectionable as a tonic, on account of some narcotic or purgative
property which it contains.
882. The tonics employed by the medical faculty, are fre-
quently of a poisonous, or deleterious nature. As examples of
these, I may mention arsenic, oil of vitriol, aqua fortis, verdigris,
and green, blue, and white vitriol. These substances are neces-
sarily injurious to the human system, and should be utterly dis-
carded by those who have any regard for their health, or lives.
883. Tonics are of no advantage where the stomach is very
much disordered, but after it has been cleansed by an emetic,
they have the effect to promote appetite and digestion, and to in-
vigorate the whole system. In severe acute disorders, as ſevers,
and inflammations, they should not be employed until the disease
is subdued. Until this time, they are more injurious than bene-
ficial. In chronic diseases, however, they may be used freely,
and always with benefit, provided the stomach is not too much en-
cumbered with morbid or vitiated matter.
884. Tonics are rendered still more beneficial, by combining
them with about one twentieth part of cayenne. The best tonic
compound with which I am acquainted, is the spiced bitters.
885. If the stomach is very weak, or irritable, these remedies
should be given in the form of tea, and not in substance, or the in-
digestible woody matter may increase the derangement of the or-
gan, and perhaps give rise to ſever.” The same remark is
equally applicable to all other medicines, in powder.
886. Tonics should not be employed after the appetite is
sufficiently restored, for if taken to excess, they will excite so
keen a relish for food, that the individual may be tempted to eat
more than can be digested, and thus, the excess of food will
irritate the stomach, and occasion, perhaps, a renewal of the
disease. -
887. If a particular tonic is used for a considerable time,
it loses its effect, and should be laid aside for another, but after
a few days, or a week, it may be advantageously resumed.
* Dunglison's General Therapeutics, p. 123.



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WEGETABLE MATERIA MEDICA.
POPLAR.
Populus—Two Species—Inner Bark.
888. 'ſlimerican ºffspen–Populus Tremuloides. This tree,
called also quaking aspen, and white poplar, is common in Lower
Canada, and in the Northern and Middle States, inhabiting open
lands, thickets, and the borders of woods. It blooms about the
first of April. The flowers or aments are pendulous, and consist
of downy or silken plumes, from an inch and a half to two inches
long. The bark, unless the tree is very old, is smooth, and
sometimes nearly white. The leaves are roundish, edged with
small, irregular teeth, abruptly pointed, and supported on long,
flat footstalks. The slightest breath of air puts them in motion,
and hence the name of quaking aspen. The Highlanders, says the
Rev. John Lightfoot, entertain a superstitious notion that our
Saviour's cross was made of this tree, and for that reason suppose
the leaves can never rest.
889. Large ſıspen–Populus Grandidentata. The large
aspen or bitter poplar, attains the height of forty or fifty feet, -
with a trunk ten or twelve inches in diameter. It grows both in
dry and wet lands, and is by no means so common as the
American aspen. The upper part of the trunk, and branches,
are covered with a smooth, and somewhat greenish bark. The
flowers or aments are two or three inches long, and bloom in
May. The leaves, when they first appear, are covered with a
thick, white down, which gives them a silvery, or velvet-like
appearance; but as they continue to expand, the down gradually
disappears, and in a fortnight, or three weeks, they assume their
natural color. When fully developed, they are roundish, acute at
the end, and bordered with large, unequally sized teeth. They
are supported, like the preceding species, on long, flat footstalks,
and grow in clusters at the extremities of the branches.
890. The proper season for collecting the bark, is in the
spring, just as the sap begins to rise, for it can then be separated
from the trunk, or branches, without difficulty. Either before or
after it is detached, the epidermis or outside coat should be sep-
arated, by an instrument adapted to the purpose. This done, the
bark is to be laid in the sun, for a day of two, with the smooth
side upward, and then removed to a loſt where the sun shines
upon the roof, to complete the process of drying, taking care that
the pieces of bark are not in contact. -
-

214 VEGETABLE MATERIA MEDICA,
891. PROPERTIES AND Us Es. The bark of the American
aspen is a mild and pleasant tonic, and may be given freely to
children, where a tonic medicine is required. The bark of the
large aspen is more active and bitter, and if taken from a tree
growing in wet, or swampy land, will operate as a purgative.
A mixture of the two, however, in the proportion of one third
of the latter, to two thirds of the former, will keep the bowels
gently open, without inducing copious, or watery stools. I am -
not aware, however, that the bark obtained from the aspen grow-
ing in a dry, or sandy soil, will occasion purging under any cir-
cumstances.
892. Poplar bark has the advantage of being a very pleasant
bitter, and with the addition of sugar, is not considered disagree-
able by the generality of patients. The tea is a valuable remedy
in debility, emaciation, want of appetite, feeble digestion, ſaintness
at the stomach, headach, diarrhoea, worms, and an impure state of
the blood. It possesses superior diuretic properties, and is par-
ticularly useful in gonorrhoea, gleet, strangury, obstructed urine,
and other diseases of the urinary organs. Consumptive people,
and those who have been suffering long from disease, are greatly
benefited by its employment. The ordinary dose, is a level tea-
spoonful o "...º.º. with double the quantity of sugar, steeped
in hot water, and repeated two or three times a day.
893. Poplar bark is one of the principal ingredients in the
spiced bitters. The bark of the root possesses properties similar
to that of the trunk, but being more difficult to obtain, it is very
seldom used. |
GOLDEN SEAL.
Hydrastis Canadensis—The Root.
894. The golden seal is distinguished by a variety of common
names, as Ohio kercuma, orange root, tumeric root, yellow puc-
coon,” eye balm, and Indian paint. The root is one or two
inches long, and rough or knotted, giving off a number of yellow
fibres. The stem is round, somewhat hairy, and from six inches
to a foot in height. It divides at the top into two footstalks, of
unequal length, each of which is terminated by a rough leaf, con-
sisting of a number of lobes, and edged with sharp, irregular teeth.
The upper leaf is the smallest, and rarely has more than three or
four lobes, while the lower leaf is frequently divided into six or
* The Indians call all roots “puccoon,” which dye red, orange, or yellow.




Golden seal. Hwarasus canaaensus "wº-
1 sº dº ºarn ºn a rº 17 ºr Hor



WEGETABLE MATERIA MEDICA. 215
seven. The flower appears in May, but dies in a very short
time. It is of a white, or pale rose color, and rises on a short
footstalk from the base of the upper leaf. It is succeeded by a
red berry, very much resembling a raspberry.
895. Golden seal is occasionally to be found in the New
England States, but is very rare. Small quantities of it have
been collected in Vermont, and Connecticut. I have never seen
it in Massachusetts. It is most abundant westward of the Alle-
ghany mountains, and is very common in Kentucky, Indiana, and
Ohio. It grows in rich woodlands, deep valleys, and on the
banks of streams. It is occasionally noticed in Pennsylvania,
springing up at the base of hills, and generally on their northern
side.
896. The root loses two thirds of its bulk in drying. It dyes
a yellow color, and is used by the Indians to stain their baskets,
and clothing. It is frequently adulterated with barberry, and a
variety of worthless barks.
897. PRoPERTIES AND Us Es. Golden seal has a pleasantly
bitter, and somewhat pungent taste, and is highly esteemed
throughout the United States, wherever it is known, as a tonic
and laxative. It keeps the bowels moderately open, without
acting as a purgative, or reducing the strength of the patient. It
is an excellent medicine in dyspepsia, loss of appetite, general
debility, and affections of the liver. The powder, mixed with an
equal quantity of pulverized loaf sugar, and eaten dry, will often
afford relief in faintness of the stomach, and languor or debility of
the general system. The decoction is in much repute in the
western states, as a wash in sore or inflamed eyes, and it is also
used as a wash for sores. A level tea-spoonful of the powder,
more or less, is given at a dose, and repeated according to cir-
cumstances. It should be steeped in hot water, and rendered
palatable by the addition of sugar.
bi 898. Golden seal enters into the composition of the spiced
itters.
BALM ONY.
Chelone Glabra–The Herb.
899. This plant, variously called bitter herb, snake head, shell
flower, and turtle bloom, is found near the borders of streams, and
in thickets and meadows, where the ground is wet. It has a pe—
rennial, fibrous root, which sends up a number of erect, smooth;
bluntly four cornered stems, from three to five feet high, and


216 WEGETABLE MATERIA MEDICA.
occasionally branched near the top. The leaves are opposite,
tapering, five or six inches long, sharply pointed, and edged
with acute teeth. The flowers are white, tinged in some in-
stances with a delicate shade of red. They are disposed in a
cluster, as is seen in the drawing opposite the preceding page,
and do not bloom until late in the autumn. They are remarkable
for their resemblance to the head of a snake, and hence the famil-
iar name of snake head.
900. The herb should be collected in clear, dry weather, and
as soon as it is in bloom, as the leaves frequently become mil-
dewed after that time. It should be dried in the sun, or in a
warm chamber, or loſt, and carefully guarded from a moist or
damp atmosphere, or it will acquire a dark or black color.
901. PROPERTIES AND Us Es. This herb is exceedingly
bitter, and has been long known in New England as a tonic and
laxative. It is employed in costiveness, dyspepsia, loss of appe-
tite, and general languor or debility. Given to children afflicted
with worms, it will generally afford relief. It is a valuable med-
icine in disorders of the liver; and in jaundice, it tends to remove
the yellow tinge from the skin and eyes. A level tea-spoonful of
the powder, is the ordinary dose. Balmony, as well as poplar
bark, and golden seal, is an ingredient of the spiced bitters.
MYRB-H.
JMyrrha—The Gum.
902. Gum myrrh is the juice of a small tree growing in
Abyssinia and Arabia; it exudes spontaneously, and collects
into masses on the bark. Sometimes it falls to the ground, and is
buried in the dirt. The myrrh which reaches us from the East
Indies, called India myrrh, is said to be procured in Abyssinia,
while that imported from Turkey, and known as Turkey myrrh, is
collected in ''. The latter is more free from impurities, and
is generally of a better quality.
903. Good myrrh, when broken, exhibits a light brown color,
and is somewhat transparent. It is fragrant to the smell, an
pleasantly bitter and aromatic to the taste. When of an inferior
quality, the taste and smell are rank and offensive.
904. The myrrh of a soft consistence, and very light color,
is a recent exudation from the tree, and has not had time to ac-
quire a brittle texture. It is unpleasant to the taste, and on that
__

Glabra
Cºte lon
---


VEGETABLE MATERIA MEDICA. 217
account is not employed in medicine, where a better article can
be obtained.
905. Myrrh is partly dissolved by water, and partly by alco-
hol, but a mixture of the two, is the best adapted to extract the
whole of its virtues. In order to reduce it to powder, families
will find it convenient to be supplied with a portable spice
mill, such as we have previously mentioned. (616.)
906. PROPERTIES AND Us Es. Myrrh is a very old remedy,
and is well known as a stimulant, tonic, and antiseptic, with a
tendency to act, as is supposed, upon the lungs and uterus. It
is usefully employed in diminished appetite, obstruction of the
menses, asthma, cough, sore mouth, spongy or unhealthy gums,
offensive breath, worms, and a low or exhausted state of the
system. Half a tea-spoonful of the powder, steeped in hot
water, may be taken at a dose, or the medicine may be employed
in the form of a tincture. The latter, says a writer on the sub-
ject, “is recommended internally for warming the habit, attenu-
ating viscid juices, strengthening the solids, opening obstructions,
particularly those of the uterine vessels, and resisting putrefac-
tion.” Injected into deep wounds, or applied to offensive sores,
it will cleanse them, and gradually promote the healing process.
Mixed with water, it makes an excellent gargle for the mouth,
where the gums are unhealthy, or the teeth carious. A flannel
wet with it, and applied to a weak back, will often afford relief.
It is particularly valuable, also, as an addition to injections, in case
of diarrhoea, or dysentery, and for this purpose, may be employed
in the quantity of two or three tea-spoonfuls.
907. Half a tea-spoonful of the tincture, more or less, may
be taken at a dose.
908. Myrrh is a component part of the rheumatic drops,
which is a most valuable form of the medicine.
909. The alcoholic tincture of myrrh is rendered opaque or
milky by the addition of water, but the myrrh is not precipitated.
PEACH TREE.
ºffmygdalus Persica—The JMeats or Kernels.
910. This tree is said to have been brought originally from
Persia, and is too well known to need a description. The dried
fruit, stewed with sugar, is laxative, and very wholesome for
invalids who are troubled with costiveness. The peach kernels


28

218 WEGETABLE MATERIA MEDICA.
have a bitter and agreeable taste, and constitute a very valuable
medicine. Made into a sirup, or cordial, with other appropriate
articles, they improve the tone of the stomach and bowels, and
invigorate the digestive powers. They are particularly service-
able in convalescence from dysentery. A tea, prepared by
steeping the pounded kernels in hot water, and adding sugar to
make it palatable, may be used as a substitute for the sirup, or
cordial.
911. It has been intimated that peach kernels contain prussic
acid, but this is not admitted by scientific men. Dr. Wood, pro-
ſessor of Materia Medica in the Pennsylvania University, is in the
habit of stating in his lectures, that peach kernels, and the bark of
the wild cherry tree, are devoid of prussic acid in their natural
state, and that this product is the result of chemical action, during
the process of distillation.
912. Peach Jam. Take ripe peaches, peel and remove the
stones; put them into a preserving pan, and mash them over the
fire until they are hot; rub them through a sieve, and to a pound
of the pulp, add a pound of loaf sugar, and an ounce of well
bruised peach kernels; simmer gently for ten or fifteen minutes,
stirring all the time, and removing the scum which rises to the
surface. This, dissolved in water, makes a pleasant and whole-
some drink for the sick.
UNIC ORN.
Helonias Dioicia”—The Root.
913. This plant is known by various names, as false unicorn,
blazing star, devil's bit, and drooping starwort. It has a tapering,
fibrous root, which is an inch and a quarter long, and not quite so
thick as the little finger. It is very hard, transversely wrinkled,
and mostly abrupt at the end, appearing as though it had been bit:
ten off. The root leaves continue green all winter, and spread
upon the ground in the form of a star. They are four or five
inches long, narrow at the base, and terminated by a somewhat
tapering point. The stem of the male plant is a foot or more in
height, and terminates in a long, drooping, and very graceful spike
of flowers, which are of a dirty white color. They remain in
bloom from June to July. The stem of the female plant is erect,
* The veratrum luteum of Linnaeus and Nuttall,
Unicorn Helor las Dio- a
º C Weague del ºarezº º ſº. Tº ºr


WEGETABLE MATERIA MEDICA. 219
much taller than the other, and is furnished with flowers of a
larger size.
914. The unicorn is abundant in some of the Western States,
and is found also in Pennsylvania, New York, and Connecticut.
It grows in woodlands and meadows, delighting in a moist
situation.
915. The aletris farinosa or star grass, which has also re-
ceived the name of unicorn, is often mistaken for this plant. It
is similar in growth and appearance, but may be identified by its
sharply pointed leaves, and brittle, scaly looking root. It pos-
sesses tonic properties, but is also a narcotic, and purgative, which
renders its use objectionable, and sometimes hazardous. Rafin-
esque, in speaking of it, says—“It is a powerful and dangerous sub-
stance, drastic even in small doses, and in larger ones, it causes
vertigo, and bloody stools.” He also observes that the Indians
attribute to it the power of producing abortion. Notwithstanding
the dangerous properties of the plant, it has been introduced by
Dr. Hersey into his work on midwifery, as the helonias dioicia
or unicorn, which is now so extensively used throughout the
United States.
916. PR op ERTIES AND Us Es. The root of the unicorn
has a bitter, but not unpleasant taste, and is a very excellent tonic.
It is said that the Indian women employ it, under an impression
that it will prevent miscarriages. It is beneficial in stomach com-
plaints, loss of appetite, and the various maladies which accrue
from a derangement of the digestive organs. It is chiefly em-
ployed, however, as an ingredient in Dr. Thomson’s woman’s
friend, which he recommends to be used both before and after
delivery, and also in weakness or debility of the organs concerned
in the process of labor. I prescribed the unicorn recently, in
a case of uterine difficulty, recommending half a tea-spoonful of
the powder to be taken three times a day, in warm water, sweet-
ened, and by the expiration of a week, the patient was very much
relieved, but I was disposed to attribute the favorable change to the
influence of the medicine as a tonic, rather than to any specific
action which it had upon the uterine organs. The appetite was
very much improved, the food better digested than for a long time
previously, and of course, it was natural to infer that the local
malady would yield, in some measure, to the salutary impression
which had been made upon the general system. The doctrine of
specifics is now becoming unpopular, even with the medical ſac-
ulty, and reformers in the healing art, should be the last to give it
countenance or support.









































220 WEGETABLE MATERIA MEDICA.
917. The solid root of the unicorn, retained in the mouth,
and the substance swallowed as it becomes dissolved, is beneficial
in coughs. Sometimes, however, it renders the mouth sore by
mechanical irritation, and then the use of it should be discontinued.
NERVINES.
918. Nervines are medicines which soothe and quiet the nerves,
when they are in an excited or irritable state, without impairing or
blunting their sensibility. There is scarcely a disease in which
they may not be employed with advantage. In spasmodic pains
of the stomach and bowels, gravelly complaints, strangury, hys-
teria, restlessness, asthma, tenesmus, inability to sleep, and ner-
vous pains and affections of every description, they are particu-
ularly useful.
919. Nervines are essentially different in their action from nar-
cotics, for the latter, such as opium, morphia, stramonium, bella-
donna, and prussic acid, impair the functions of the brain, as well
as of the whole nervous system, and the patient becomes stupid,
or insensible, sinking into a dull, heavy sleep. At length he
awakes, if the poison does not prove fatal, and finds himself
afflicted with headach, tremors, nausea, a parched tongue, and
a hot and dry skin. Nervines, however, do not occasion any of
these distressing symptoms, but compose or soothe the nerves,
without destroying their sensibility, or rendering the patient dull,
or stupid.
920. Nervines may be added with benefit to injections, partic-
ularly in diarrhoea, dysentery, piles, and nervous diseases.
SCULLCAP.
Scutellaria Lateriflora—The Herb.
921. This plant is generally known as the blue scullcap, and
is also called side-flowering scullcap, mad-dog weed, and hood
wort. It grows in damp places, and along streams. Meadows
which are overflowed with water in the spring, and become dry
during the summer, often produce it abundantly.
922. Scullcap has a small, fibrous root, and an erect, sharply
four cornered stem, which varies from ten inches to two feet in
height. It is branched similar to lobelia inflata, the lower branch.
es being the longest, but none of them reaching above the top of
the stem. The leaves are rounding, or heart-shaped at the base,


VEGETABLE MATERIA MEDICA. 221
acutely pointed, and divided along the margins into teeth of irreg-
ular sizes. The flowers are blue, making their appearance in
July, and are arranged in pairs on the under sides of the branches.
They are succeeded by small seed vessels, of a light green color,
and somewhat in the shape of a hood. They open laterally by a
valve, each one containing four seeds.
923. PRoPERTIES AND Uses. Scullcap has a prominently
bitter taste, and is the best nervine I ever employed; it is also
tonic and antispasmodic. My attention was first called to this
plant by a distinguished merchant in Boston, who told me that he
had been subject to great nervous excitement, and severe tremors,
so that he could not hold a pen to write. He was recommended
to use a tea of scullcap, and accordingly, on retiring to bed, he
ordered a pint of the tea to be prepared, the whole of which
he drank during the night, and when the morning came, greatly
to his astonishment, he found himself perfectly calm, and able to
write without difficulty. He continued to use the tea after that
period, when occasion required, with uniformly good results.
924. I recollect a gentleman with delirium tremens, to whom
a course of medicine was administered, and though the disease
was arrested at the time, the symptoms returned in the course of
twelve hours, and the patient became as delirious as ever. I di-
rected the use of scullcap tea, which he drank freely, and in a
short time, was rendered quiet and comfortable, and sunk into a
calm repose.
925. Scullcap is particularly useful in St. Vitus's dance, con-
vulsions, locked jaw, tremors, ague and fever, tic douloureux,
and all nervous affections. It may be given with advantage to
children, whose health is impaired from the effects of teething. I
generally employ it in a course of medicine, instead of the lady’s
slipper, and have found it of great value after a course, where
the patient was faint or languid. Besides its other good effects,
it has a tendency to keep the skin moist.
926. The warm infusion may be drank freely through the
day, or a heaped tea-spoonful of the powdered leaves, with rather
more than an equal quantity of sugar, steeped in a tea-cupful of
boiling water, may be taken at a dose, and repeated as often as
the symptoms require.
927. Scullcap, says Rafinesque, has lately become famous as
a cure in hydrophobia. This property, he continues, was discov-
ered by Dr. Vandesveer, about 1772, who used it with the ut-
most success, and until 1815, when he died, he is said to have
prevented four hundred persons, and one thousand cattle, from be-



222 WEGETABLE MATERIA MEDICA.
coming hydrophobic, after they were bitten by rabid animals.
His son is stated to have relieved or cured forty persons, in three
years, in the States of New York and New Jersey, by the use of
this medicine. What reliance is to be placed in these statements,
I am not prepared to say, but from the well known effects of
scullcap on the nervous system, I should be disposed to think fa-
vorably of it as a remedy even in hydrophobia.
928. My friend, Dr. A. C. Logan, to whom I wrote on the
subject of scullcap, informs me that he has been in the habit of
employing the scutellaria hyssopifolia, by some considered a vari-
ety of the scutellaria integrifolia, and that he can say with confi-
dence, it is much more powerful than the scutellaria lateriflora or
blue scullcap. Dr. L. further states in his letter, that he has
made extensive use of the plant in question, as a nervine, and that
he has never been disappointed in its effects.
LADy’s slipp ER.
Cypripedium—Four Species—The Roots.
929. Red or Purple Lady's Slipper–Cypripedium humile.*
This species of the lady’s slipper is more common than either of
the others, and is variously called low lady's slipper, dwarf umbil,
American valerian, nervine, Noah’s ark, and moccasin flower.
The latter name was given to it by the Indians, who employ it in
the decoration of their hair. It grows in open woods, particularly
where the pine tree prevails, and not unfrequently in shady
swamps. It is tolerably frequent in some parts of Massachusetts.
Maine also yields it abundantly. It was formerly very plenty in
the woods of New Jersey, but in an excursion there, about two
years ago, I found that it had almost entirely disappeared. It is
not confined to particular states, but is scattered over the Union
from Maine to Louisiana, extending west to Detroit, and the
North Western Lakes. It is collected annually in this country, and
sent to England, where the gardeners pay a high price for it as an
ornamental plant. During my travels in England, I was informed
by them, that it seldom continued to thrive more than two or
three years, after its removal from the United States. It should
be transplanted when in bloom, which is in May or June, according
to the season or locality, as it will not flourish with any degree of
certainty, at any other period.
* The C. acaule of the older botanists.

Cypripedium Hºle
…
-->
Luº Lº




WEGETABLE MATERIA MEDICA. 223
930. The root consists of a number of long, and yellowish, or
blackish colored fibres, which diverge horizontally from a common
centre. The leaves are radical—that is, they proceed directly
from the root, and never exceed two in number. They are oppo-
site, tapering, palish green, covered with a fine down, and sup-
plied with nerves, which extend from the base to the point. The
flower is large, inflated, pendulous, of a light purple, streaked
with veins of a darker hue, and supported at the top of a naked
stem, which varies from six to eighteen inches in height. The
seed vessel is an inch and a half long, and opens in September by
three valves, disclosing a multitude of minute seeds, resembling
sawdust.
931. Yellow Lady’s Slipper–Cypripedium Parviflorum or
Pubescens.” This plant grows in similar localities with the former,
but generally prefers a moist or wet soil. It is called yellow
umbil, bleeding heart, and Indian shoe. The root is horizontal,
knotty, fibrous, and matted together. The stem is twelve or eigh-
teen inches high, and supports from three to seven alternate,
clasping leaves, similar in appearance to those already described.
The flowers are yellow, inflated, handsome, and bloom in May, or
June. They are supported at the top of the stem, and vary from
one to three. The leaves and stem are generally covered with
thick down, but in some instances they are nearly smooth.
932. This plant is not so abundant as the purple lady's
slipper, but has an equally wide geographical range. It abounds
in various parts of Maine, New Hampshire, Vermont, Connec-
ticut, New York, and the western prairies. According to Barton,
it is rare in the middle states, but becomes more frequent to-
ward the West. Attempts to cultivate it, do not generally prove
successful.
933. White Lady's Slipper–Cypripedium Candidum. The
white lady’s slipper grows principally in swamps, and blooms in
May or June. The flower is white and inflated. In other re-
spects, the plant resembles the yellow lady’s slipper. The roots
are fibrous, and form large clusters or beds.
934. Gay or Tall Lady’s Slipper–Cypripedium Specta-
bile. This plant grows in woods and swamps, and is compar-
atively rare. It is about two feet high, with roots like those of
*The parviflorum and pubescens are considered as distinct species by some
botanists, and only as varieties by others,
# The C. canadense of Michaux.
-



224 VEGETABLE MATERIA MEDICA.
the white lady’s slipper. The stem and leaves are hairy. The
latter are tapering, pointed, narrow at the base, and almost ex-
actly resemble those of the hellebore or poke root. The flowers
are nodding, inflated, and variegated with stripes of purple and
white. They bloom in June, or July.
935. The roots of these plants are nearly similar in virtues.
Those of the purple and yellow lady’s slipper, however, are the
most active and efficient. They have a peculiar, slightly bitter,
and rather nauseous taste. The roots should be procured in the
spring, or autumn, cleansed from dirt, and carefully dried. Col-
lected in the summer, they lose two thirds of their substance in
drying. After they are ground, they should be preserved in
covered boxes, or barrels, to prevent any deterioration of their
strength.
936. PRoPERTIES AND Us Es. The lady's slipper is a very
good nervine, and as it possesses no narcotic properties, may be
used freely without any apprehension of danger. do not con-
sider it so valuable a medicine as the scullcap, but it nevertheless
makes a very good substitute. Dr. Thomson says, “he has
made great use of it, and in hysterical symptoms, and all nervous
diseases, he has always found it to produce the most beneficial
effects.” It is considered an excellent remedy in nervous head-
ach, epilepsy, tremors, restlessness, and low fevers, having the
effect to quiet the nerves, allay pain, and promote sleep.
937. The powder may be taken in the dose of half a tea-
spoonful, steeped in a tea-cupful of hot water, sweetened, or it
may be added to a tea of composition, or spiced bitters, the latter
of which is preferable. The fibres of the lady’s slipper, and
cinnamon, which are left after these articles have been ground, and
siſted, make a very pleasant tea for weak or nervous people, and
may be given advantageously to children, with slight bowel com-
laints.
p 938. Boiling impairs the strength of the lady's slipper.
GINS ENG.
Panaw Quinquefolium—The Root.
939. The ginseng is scattered over the hilly regions of the
Northern, Middle, and Western States, delighting chiefly in deep,
rich woodlands. The root is about the thickness of the little
finger, four or five inches long, frequently forked, transversely
—º



VEGETABLE MATERIA MEDICA. 225
wrinkled, and terminated by several slender-fibres. The stem
is smooth, round, and one or two feet high, divided at the top
into three leafstalks, each of which contains from three to five,
and sometimes seven leaves. These are narrowest at the base,
from two to four inches in length, acutely pointed, smooth on
both sides, and bordered with teeth, which enlarge toward the
end. The flowers are small, white, and arranged in a little clus-
ter, which rises from the centre of the leafstalks. They make
their appearance in May or June, and are succeeded by a number
of scarlet berries.
940. This plant is said to correspond with the ginseng of
Chinese Tartary, which the inhabitants of that country formerly
held in such high repute. It sold among them at one time for
twice its weight in silver. Their eminent physicians wrote vol-
umes upon its virtues, and no medicine was thought to be of any
value unless it contained a portion of ginseng. Indeed, they re-
garded it as a remedy for all diseases; and among the remarkable
names which they bestowed upon it, was one, signifying, the
plant which gives immortality. The wonderful virtues ascribed
to it, attracted the attention of a Jesuit missionary in China, who
subsequently discovered the plant, in his travels through Canada.
Large quantities of it were immediately collected and sent to
China, where, from the scarcity of the article in that country, it
commanded an exorbitant price. People in the United States
also engaged in the enterprise, and it is said that the shipments of
the root from Boston, collected on the hills of Vermont and
New Hampshire, laid the foundation of many a splendid fortune in
New England. The medicine, however, from some cause or
other, finally became unpopular, and did not even pay the cost
and duties of exportation.
941. ProPERTIES AND Us Es. The ginseng, although un-
doubtedly overrated by the Chinese and Tartars, possesses some
very excellent properties. It is a pleasant bitter, and manifests
on being chewed for some time, a sweetish, and slightly aromatic
taste, resembling that of liquorice. It strengthens a weak stomach,
º appetite, and gives tone and vigor to the whole system.
t may also be used to advantage in nervous affections. Many
persons are in the habit of chewing it as a substitute for tobacco,
and to give them an appetite. The more wealthy portion of the
Chinese and Tartars, use an infusion of the leaves as a common
drink, instead of tea. The leaves of the American ginseng are
also used in Kentucky and Virginia for a similar purpose. A
tea-spoonful of the powdered root may be taken at a dose. It is
usually administered, however, in the form of tea, which may be


29

226 WEGETABLE MATERIA MEDICA.
prepared by slicing the roots, and boiling them in water until the
requisite degree of strength is obtained, adding sugar to the liquid
to make it palatable. A tea-cupful of this may be taken several
times a day, either as a nervine or tonic.
PURGATIVES OR CATH ARTICS.
942. With the exception of calomel and the lancet, there are
no agents employed by medical men, which do more injury to the
human system than purgatives. Nevertheless, they enjoy an al-
most unbounded popularity, and are considered indispensable in
the treatment of disease. Their use is the more objectionable,
because, where they do not prove suddenly fatal, they gradually
undermine the vital powers, and ultimately destroy the patient,
while neither he, nor his physician, suspects the cause of the
difficulty. -
943. It is estimated by medical writers, that a brisk cathartic
will evacuate a pint of the serum or watery portion of the blood.
Admitting the truth of this estimate, and no one, it is presumed,
will call it in question, we need no other proof that cathartics are
emphatically a source of depletion, and cannot be employed in
medical practice, with any more consistency than the lancet. If
we discard the one, we must necessarily discard the other, be-
cause they both operate upon the same principle. It is said,
however, that cathartics merely evacuate the serum of the blood,
which is incapable of nourishing the body, while blood-letting
causes each of the constituent parts of the vital fluid to be re-
moved; and hence the doctrine, or I would rather say, the hypoth-
esis, that cathartics may be employed with comparative impunity,
while blood-letting is productive of the most serious consequen-
ces. For my own part, I consider blood-letting less pernicious,
as a means of depletion, than cathartics, because the latter, besides
diminishing the quantity of blood in the system, irritate the intes-
timal canal throughout its whole extent, and thereby lay the foun-
dation, in many instances, of an obstinate, or perhaps incurable
form of disease. Broussais, the well known French physiologist,
acting upon this hint, prohibited purgatives in ſevers, and gave
his patients gum water, or some simple mucilaginous fluid, which
could do no harm. He says that an acute inflammation of the
mucous membrane of the stomach and bowels, is often rendered
chronic by the use of saline purgatives, which only mask the dis:
ease; and he attributes a similar effect to calomel and the neutral
VEGETABLE MATERIA MEDICA. 227
salts, which allay the malady by keeping up a diarrhoea, the termi-
nation of which is in emaciation and dropsy.”
944. Dr. Eberle, in his remarks on the treatment of indiges-
tion, accompanied with inflammation of the stomach, says, “Some
writers recommend cathartics in this as in the milder varieties of
the disease; but their tendency to irritate the tender and inflamed
mucous membrane of the stomach and intestines, renders them, I
think, decidedly objectionable. Slight relief will, it is true, usu-
ally follow the operation of a purgative, but this relief is always
but temporary, and is very often succeeded by an aggravation of
the distress and tenderness of the stomach.”f
945. Again, says Dr. Eberle, “Nothing is more common
than the repeated use of active purgatives in diarrhoea. An indi-
vidual becomes affected with looseness of the bowels. If it does
not soon cease spontaneously, he takes a purge. The bowel
complaint, however, continues, and convinces him that there is
still something left which must be removed. To make himself
sure of his object, he takes a more active dose; but the pains and
discharges instead of being mitigated, acquire greater violence.
Astonished at the obstinacy with which the offending matter sticks
to the bowels, he determines to rid himself of the cause of his
complaint, and swallows a double dose of the most active cathartic.
He now begins to experience tenderness in the abdomen; the
pains and diarrhoeal discharges continue; in short, he has developed
inflammation, which the most judicious management may not be
capable of removing.”f
946. Dr. Withering, a physician of the old school, prohibited
purgatives in scarlet ſever, on account of their tendency to irritate
the bowels. He believed that they caused the “matter of con-
tagion” to be “diffused along the course of the intestinal canal.”f
Dr. Blackburne, in his treatise on scarlet fever, remarks, that
“so great was Dr. Withering's fear of purging, that he suffered
one of his patients to remain costive eight days.” We have the
most undoubted testimony, therefore, that purgatives irritate the
bowels, and this should be a sufficient argument against their use.
What would be thought of a physician, if he were to direct one of
his patients to apply an ointment to the skin, which would irritate
it from head to foot, and yet this would be no more irrational, and
perhaps far less injurious, than to administer a purgative, which
would irritate that much more delicate tissue, the mucous mem-
* Broussais's Pathology, p. 519.
i Practice of Medicine, 4th edition, vol. ii. pp. 290, 297.
# Good’s Study, 6th American edition, voli. p. 600.



228 VEGETABLE MATERIA MEDICA.
brane of the stomach and bowels, with which every other part of
the body so strongly sympathizes.
947. Professor Hamilton of Edinburgh, although he wrote a
book in favor of purgatives, and imagined that he could cure al-
most every form of disease by their administration, very frankly
observes, that they “undoubtedly debilitate the body, by causing a
flow of fluids greater than usual, into the cavity of the intestinal
canal.” In other words, he wishes to convey the idea, that they
destroy the equilibrium of the circulation, and this is no doubt one
of the principal reasons why they are so mischievous in their effects.
Dr. Hamilton also observes, that purgatives probably weaken
the body “by hurrying off the chyle, and precluding its passage
into the system.” This idea was originally suggested, if I mis-
take not, by Darwin, and is worthy of consideration. The chyle,
after it is formed in the intestines, is taken up by the absorbent
vessels, denominated lacteals, and carried into the circulation for
the nourishment of the body, but if the bowels be irritated by ca-
thartics, before it reaches its place of destination, it flows back
into the intestinal canal, in common with the serum of the blood,
and is finally evacuated by stool. Here, then, is an unfailing
source of debility, for the chyle is the material of which the blood
is formed, and in proportion as it is withdrawn from the body by
purgatives, so will the patient sink into a state of feebleness, or
exhaustion.
948. I have expressed the opinion, that blood-letting is less
injurious than purgatives, and this notion seems to have been en-
tertained by the celebrated Cullen. “In those cases of ſever,”
says he, “in which a dangerous state of debility is likely to occur,
purging is to be employed with a great deal of caution; and this
caution is more difficult to be observed than in the case of blood-
letting.”f
949. Purgatives do not act in harmony with the laws of the
human system, and therefore are pernicious. Taken frequently,
they impair digestion, and give rise to permanent disorder.
“The tongue of the most healthy individual,” says the author
of Medical and Surgical Observations, “will become foul, and he
will lose his appetite, if he take neutral purgative salts, for several
days in succession.”f
* Hamilton on Purgatives, 5th Edinburgh edition, 1815.
+ Cullen’s First Lines of the Practice of Physic, by Dr. Rush.
# Eberle's Practice, 4th edition, vol. i. p. 140.
VEGETABLE MATERIA MEDICA. 229
- - -
950. Griffith Hughs, in his Natural History of Barbadoes,
speaking of a severe affection of the bowels peculiar to that cli-
mate, says, “ The method of cure adopted at one time, was to
purge the patients, but the unhappy creatures were subject to lose
the use of their limbs by this practice.” In 1700, the physicians
changed their mode of treatment, and as late as 1750, when Mr.
Hughs published his work, they had not again returned to the use
of purgatives. - -
951. Purgatives are frequently resorted to in costiveness, but
although they afford relief . the time being, they rarely ſail to
enhance the difficulty. Dr. Marshall Hall says, “ The habitual
use of active cathartics, although attended with temporary relief,
seldom fails to bring on or aggravate a permanent state of cos-
tiveness.” - - -
952. Mackintosh, in his remarks on the treatment of gout,
says, “The bowels should form a chief object of attention; they
must not be allowed to be constipated; but the opposite extreme
is fully, if not more injurious. Many individuals are injured by
the pernicious habit of taking some strong physic now and then ;
but it will be invariably observed, that the bowels become after-
wards more torpid.”f
953. Professor Bigelow of Boston, remarked to his class,
that “Purgatives lose their power by habitual use, and if taken
daily or periodically for any length of time, cannot be dispensed
with, and three, four, or five times the dose is required to ope-
rate. It is a ruinous practice, and the patient can only rid himself
of this slavery, by attention to diet, plenty of exercise, and other
appropriate means.” . The lecturer further observed, that “if re-
lief cannot be obtained by dieting, it is better to use injections, in-
instead of cathartics.”
954. Formerly, I was of a very costive habit myself, and
made use of bitter root, and other cathartics, to no purpose. As
soon as the purging ceased, the bowels became as torpid as ever.
I then resorted to courses of medicine, which afforded temporary
relief, but did not effect a permanent cure. Ultimately, I was in-
duced to change my mode of living, and quitted the use of tea,
coffee, fat meat, butter, and all oily or greasy substances, and sub-
sisted principally on fruits and vegetables, eating the unbolted
wheat bread, instead of that manufactured from superfine flour,
and from that period to the present, which is more than two years,
I have been free from the complaint. In addition to the regulated
* Hall’s Practice of Medicine, edited by Drs. Bigelow and Holmes, p. 87.
f Practice of Physic, 2d American edition, vol. ii. p. 457.


230 VEGETABLE MATERIA MEDICA.
diet, I also took plenty of exercise, and paid particular attention to
the state of the skin, employing the shower bath every morning in
the summer, and the hand bathin the winter, following them by a
brisk use of the flesh brush, or a coarse towel, to produce a warm
glow of the skin. I did not wholly abstain from lean meat, but
ate it very sparingly, finding that it had a tendency to render
the bowels costive, especially when I had not the advantage of
free exercise in the open air. I have been in the habit of recom-
mending the above treatment in cases of costiveness, and have
never known it to ſail in producing the desired results.
955. Purgatives may be taken from day to day, in small
doses, so as to procure regular evacuations, and yet the bowels
continue in a loaded state. A striking instance of the kind came
under my observation several years ago in Philadelphia. The pa-
tient was a Dr. Harlan of that city, a graduate of the Pennsyl-
vania University, and a practitioner of about three years’ standing,
who had been much reduced by a disease of long continuance,
and who had taken calomel, and other drugs of a similar nature,
without receiving any benefit. I met him one day in the street,
and besought him to make a trial of the vegetable remedies. He
thought favorably of the proposition, but said he had just com-
menced a new plan of treatment, which he was anxious to test.
This consisted of the administration of small doses of a mild ca-
thartic, which was intended to keep the bowels gently open, with-
out the risk of purging. He promised me, however, if he was no
better at the end of a fortnight, that he would make a trial of the
remedies I had proposed. When the time expired, I called at his
residence, and found him in bed, much more indisposed than when I
had last seen him. He told me his bowels had been daily evacuated,
but nevertheless, I prepared an injection, in the usual form, which
was administered, and greatly to the surprise of the patient, it
caused a large quantity of hardened feces or scybala, to borrow a
term from medical books, which looked as though they had been
impacted in the bowels for weeks, or even months. The injec-
tion was repeated, with a similar result, and the patient readily ac-
knowledged, that a daily evacuation by stool, was no evidence
that the bowels were free from a morbid accumulation of feces.
956. Many cases, similar to the above, are recorded in med-
ical books. Professor Hamilton, in his work on Purgatives, re-
lates the particulars of a patient who entered the Royal Infirmary,
Edinburgh, on the 10th of May, and died on the i7th of May,
taking, in the interval, frequent cathartic doses, as senna, mag-
nesia, calomel, jalap, and aloes; and although he had frequent
evacuations, it was found, on opening the abdomen, that the lower


WEGETABLE MATERIA MEDICA. 231
portion of the small intestines, contained “a few hard scubala, of
a dirty green color, and very fetid; and in the sigmoid flex-
ure of the colon, (see Fig. 3, page 20) and the whole of the
rectum, a large quantity of these scybala had also collected, re-
sembling, in every respect, those in the small intestines.” Such
is the language of Professor Hamilton; and I ask, if purgatives are
capable of freeing the bowels from obstructions, why they did not
accomplish it in the above instance, for they were repeated suffi-
ciently often, and some of them were of the most drastic kind
It is said of Dr. Hamilton, that, although he purged his patients
daily, for months, the hardened feces were frequently found, in
post mortem examinations, adhering to the inner coat of the intes-
tines, while the purgatives had escaped by working a little channel
through this indurated mass. -
957. A writer in the British Foreign Medical Review, re-
marks, “We were lately assured by a lady, to whom we were
called in the country, and where we had not an opportunity of
seeing the evacuations, that her bowels were in perfectly good
order, and acted daily; when, on examining the abdomen, to re-
move our skepticism on that point, we found it distended with
feces. On ordering a succession of active purgatives, and injec-
tions, for their removal, the patient remonstrated, and stated that,
as she had repeatedly taken salts of late, which operated freely, it
would weaken her too much to give her more, and that she could
not require them. We of course insisted; and when, to her great
surprise and relief, an enormous quantity of solid feces made their
appearance, she then said it was many weeks since she had
passed a natural evacuation of that kind; but not knowing that
liquid excretions were insufficient, she had answered our question
as she did.” Whether the purgatives or the injections were
mainly instrumental in evacuating the bowels, the writer does not
state, but it is probable, from what we have learned of Professor
Hamilton’s practice, that the former had but little agency in effect-
ing the desired result.
958. A collection of feces, constituting an obstruction, rarely
takes place in the small intestines. The innutritious portion of
the food, and the other matters blended with it, passes through
the small intestines in a liquid form, and with comparative rapid-
ity, not acquiring the character or consistence of feces, till it has
reached the lower or large intestines. Here, according to com-
petent authority, the feces pass onward to the sigmoid flexure,
(see Fig. 3, page 20) where they accumulate previous to being
voided by stool; and as this portion of the intestinal track is
but a short distance from the anus or fundament, it is always

232 WEGETABLE MATERIA MEDICA.
within the reach of an injection. In the treatment of disease,
therefore, in which it is necessary to evacuate the bowels, shall
we employ an injection, which will bring away the accumulated
feces at once, or shall we administer a purgative which may not
operate for several hours, and irritate the intestinal canal through-
out its whole extent? An injection is prompt in its action, as
well as safe and efficacious, but a purgative is often slow in its op-
eration, and is frequently productive of serious consequences.
Which, then, shall we choose 2 If the evacuation of the bowels
is the only object to be attained, an injection will answer every
purpose, but if we wish alsó to deplete the patient, we may as well
employ a more speedy method, and resort to the lancet at once.
959. The use of purgatives for any length of time, will often
give rise to black and fetid stools, especially in ſevers of a low
grade ; and medical men generally consider this as certain evi-
dence, that the purgatives should be continued. On this subject,
the author of Medical and Surgical Observations, indulges in the
following appropriate remarks. “There is one fault,” he says,
“which a physician sometimes commits in the treatment of bilious
fevers, and that too, for the most part, when he thinks he is doing
right. I allude to the too long continuation of purgative medi-
cines. He is apt to think that the impurities have been long fixed
in the bowels, and in order to cleanse his patient thoroughly,
and to leave nothing noxious behind, persists in the use of purga-
tives. What is worse, any appearance of these cases would seem
to justify his suspicion of the existence of fixed impurities of long
standing in the bowels, and confirms him in his design of at once
making a clean house. The longer he continues to give his pur-
gatives, the fouler does the tongue become, and the more distressed
the stomach; the symptoms, in short, of intestinal impurities be-
come more and more conspicuous, while he continues to dilute
and to evacuate, without reflecting or knowing that he is himself
the cause of all the noxious matter in the intestines, and constantly
irritating them with his purgatives, and keeping up an aflux of
fluids to the internal or mucous coat.”
960. Professor Dewees of Philadelphia, incredible as it may
appear.has fallen into the error which has been commented upon
with so much severity in the above paragraph; for he tells us, in his
Practice of Physic, after ridiculing what he terms the popular preju-
dice which sometimes exists against purging, that he has known
large and fetid evacuations to take place after the purging process
had been continued for a considerable time. Professor Chapman,
* Eberle's Practice of Medicine, 4th edition, vol. i. p. 139.


VEGETABLE MATERIA MEDICA. 233
also, of the same city, coincides with his learned brother, and
says, according to Dr. Dunglison, another professor in Philadel-
phia, that “in obstinate remittent and intermittent autumnal fevers,
cathartics should be continued until dark, tarry, fetid stools are
induced. This dark appearance he conceives to be a glutinous
matter, which adheres to the intestines, and requires cathartics for
its removal; but it appears by no means clear,” continues Dr.
Dunglison, “that it may not be, in part, the effect of the repeated
employment of cathartics deteriorating the intestinal secretions.”
961. I may here remark, that Dr. Jackson of the Pennsyl-
vania University, concurs with Dr. Dunglison in opinion, and
says that black and fetid stools rarely occur in ſevers, unless the
patient has been purged a considerable time.
-
962. Dr. Benjamin Bell, speaking of the action of mercury
on the human system, observes, “Local pains may be for a time
suspended, by irritation of a different kind being excited either in
the contiguous or some more distant parts of the body; but we
know of no constitutional disease, that has hitherto been cured by
such means.” It is upon this principle that temporary relief is
afforded by purgatives, in particular forms of disease, as inflamma-
tion of the liver, kidneys, or bladder. The purgatives excite an
irritation in the stomach and bowels, which is followed by a cessa-
tion of the local pains, but these are extremely liable to return.
Dr. Comfort of Philadelphia, says, “I have known active cathar-
tics to afford relief in rheumatic pains of long standing, by irri-
tating the intestinal canal, and weakening the circulation in the
part affected; but as soon as the irritation in the bowels subsided,
the pains returned with increased violence, and the patient was in
a worse condition than before.”
963. There is a popular belief, that cathartics are sometimes
necessary to purge away the bile, and if an unusual quantity of it
appears in the alvine discharges, the patient expresses a great deal
of satisfaction, believing that he was extremely bilious, but he does
not consider, that this increased flow of bile may have been caused
by the operation of the cathartic. Dr. Dunglison has made some
very appropriate remarks on this subject, which I shall quote at
length. “ The alvine discharges,” he says, “may assume an un-
healthy bilious character, under the operation of a cathartic, owing
solely to the irritation it induces in the various secretory organs of
the digestive apparatus. If we administer calomel as a cathartic,
* Dunglison’s Therapeutics, p. 250.
t Treatise on Gonorrhoea Virulenta, &c.


30
234 VEGETABLE MATERIA MEDICA.
it irritates the lining membrane of the duodenum, (commencement
of the small intestines) and this irritation extends along the biliary
ducts to the liver, the secretion from which is augmented.
* Hence we can understand, that after the operation of
calomel, or of any purgative, whose action is chiefly exerted on
the upper portion of the intestines, there may be manifest appear-
ances of bile in the evacuations, without our being justified in in-
ferring that the individual is bilious; and, that the increased flow
of bile is occasioned by the purgative, may be proved by discon-
tinuing its use for some days, when the signs of bile in the evacu-
ations will cease, and be reproduced, when its use is resumed.”
964. Another prominent objection to the use of purgatives
is, that their action cannot, in all cases, be controlled, even though
they should be given in minute doses with a view only to their
laxative effects. When it is least expected they may excite
purging, and hurry the patient to the grave. Many cases of this
kind have come under my observation. I recently attended a
child with the smallpox, to whom I administered a course of med-
icine, and left it in a very comfortable state, giving directions for
its further treatment. I called the next day, and to my surprise,
found it rapidly sinking, and with all my exertions, could not re-
store it. Upon enquiry of its parents, as to the cause of this un-
favorable change, they informed me, to use their own language,
that they had given it a “little physic to move its bowels,” and as
soon as the physic began to operate, the child became immedi-
ately worse. } recollect a gentleman who was recovering from a
severe attack of typhus fever, and not content with the treatment
he had received, concluded to take a dose of bitter root, to “move
his bowels gently,” but instead of the “gentle” operation which
he anticipated, purging was induced, followed by a speedy re-
lapse, and in a short time he was a corpse. I might mention a
number of similar cases, but the above, I presume, will suffice.
The medical faculty themselves, are fully aware of the fatal ten-
dency of purgatives under certain circumstances, and it would be
well if some of those who assume to be reformers in the healing
art, would consult their works on this subject. Dr. Dewees, in
his remarks on the treatment of fevers, observes, “Purgatives
should not be used so as to interfere with the night's rest of the
patient; nor should they be used so that they shall interfere with
the “sweating stage of the disease.” Again, he says—“They
should not be given in the decline of ſevers, where the patient
is rapidly convalescing, lest they produce a relapse. * * *
* General Therapeutics, pp. 234–5.

WEGETABLE MATERIA MEDICA. 235
Nor must we use them when the patient is much exhausted by
colliquative diarrhoea; nor near the decline of a febrile parox-
sm.” Here are golden rules for the administration of purgatives,
which should be kept prominently in view by those who employ
this class of agents. With regard to some of the reformed prac-
titioners, however, who are clamorous for the use of purgatives,
I have observed, that they do not specify the circumstances under
which they may be employed without manifest injury to the par
tient, but content themselves by saying, that there are “particular
cases in which purgatives are indispensable,” and with this general
view of the subject, they dismiss it, without further investiga-
tion; while perhaps, the very cases which they would cite, as re-
quiring the use of purgatives, are those in which a purgative would
prove almost inevitably fatal.
965. Medical men, though constantly in the habit of using ca-
thartics, are aware that in many conditions of the system, they ex-
ercise a baneful and destructive influence. “Purging immedi-
ately before a paroxysm of the gout,” says Cullen, “will be
always employed with the hazard of developing it the more
speedily.” -
966. “In two instances of acute inflammation of the bowels,
reported by Dr. Abercrombie,” says Professor Eberle, “a relapse
was the consequence of the use of drastic purgatives.”f This
writer, speaking of diabetes or an excessive flow of urine, also
observes, “Prout asserts, that he has known the most serious
consequences brought on by a small dose of calomel, which by
inducing diarrhoea, and consequent debility, aggravated all the
symptoms.”f -
967. Dr. Benjamin Bell remarks, “In certain stages of gon-
orrhoea, a strong purgative never fails to increase the pain; to ex-
cite a more frequent desire to pass water, and to increase the
discharge; nay, I have known various instances of a return of all
the symptoms of gonorrhoea, in consequence of the operation of a
brisk purgative, long after the patient considered his cure as
complete.”
968. Dr. Channing of Harvard University, said in one of his
lectures, “I have been in the habit of giving women a purgative
immediately after delivery, but have discontinued the practice,
because it oftentimes produced inflammation of the bowels.”
* Dewees’s Practice of Physic.
t First Lines of Physic.
# Eberle's Practice of Medicine, 4th edition, vol. i. p. 229, and vol. ii. p. 392.
§ Treatise on Gonorrhoea Virulenta, etc.


236 vegetABLE MATERIA MEDICA.
969. Dr. Ware of the same institution, in some remarks on
the treatment to be pursued in inflammation of the external coat
of the bowels, called peritonitis, said, “It is a question whether
the benefit derived from purgatives is not more than counterbal-
anced by the irritation which they produce.”
970. Were I prohibited from using injections, in the treat-
ment of disease, I would rather the bowels should continue in a
costive state until I could restore them to a healthy action by
general treatment, than to solicit an evacuation by irritating or
perhaps inflaming them with a cathartic. Costiveness is by no
means so unfavorable a symptom as diarrhoea, and in many of the
fevers, it will not be denied, that more danger is to be apprehended
from the latter than the former. Dr. Nathan Smith of New Eng-
land, was in the habit of remarking, that he never knew a case
of typhus ſever to terminate fatally when costiveness prevailed
throughout the disease; but on the contrary, when diarrhoea was a
symptom, the patients frequently died. It is very easy to obviate
costiveness by the use of physic, but it is not so easy to counter-
act the debility and other unfavorable symptoms, which follow
its administration. Some practitioners, however, who claim to
be reformers, assert that purgatives in their hands are not pro-
ductive of any evil, and if such be the fact, it is because they
administer medicines to counteract their evil tendency. This, to
say the least, is but a poor argument in favor of purgation, and by
adopting a similar precaution, the lancet might be employed in
many instances, with the same impunity.
971. Speaking of typhus fever, I am reminded that this is
one of the diseases in which some of the reformed practitioners
contend for the use of purgatives. I am constrained to say, how-
ever, so far as my experience has extended, that there is no
malady in which catharties are employed with greater risk to the
patient; and I am satisfied, that every physician of enlightened
views, and extensive practical knowledge, will sustain me in the
assertion. The fact that typhus fever is frequently accompanied
with an inflamed, or ulcerated state of certain glands of the
small intestines, is a sufficient reason why they should not be em-
ployed; for under these circumstances, a very small dose of a
cathartic will act upon the bowels, induce a copious diarrhoea,
and very soon destroy the patient. Physicians of the old school,
consider the chances of recovery much more uncertain in typhus
fever, where diarrhoea takes the place of costiveness. Dr. Dung-
lison, in his General Therapeutics, remarks, “It has often fallen
to my lot to witness the bad effects resulting from the administra-
WEGETABLE MATERIA MEDICA. 237
tion of cathartics in cases of ſever—of the typhoid kind especially
—in which the powers of the system have been worn down by
the irritation resulting from the specific action of the medicine,
and the exhaustion caused by the repeated evacuations.” Indeed,
it appears to me, that purgatives are more dangerous in a low case
of typhus fever than blood-letting itself; and if we wish to be
consistent with the principles which we advocate, and promulgate
a reform that will be as useful as it is enduring, we must discard
depletion in all its forms, and employ those remedies only which
act in harmony with the laws of the animal economy.
972. Nothing is more uncertain than the time required for the
operation of a purgative. This may be two hours, or it may be
twenty-four, according to circumstances. I have known patients
to take cathartics for several days in succession, without any
evacuation from the bowels. Admitting the efficacy of these
agents, therefore, it will be seen how little they are to be depend-
ed upon in particular cases. In some diseases, a very large
quantity of a purgative is required to produce the desired effect,
while in others, a very small portion will suffice. Medical men
say that children with dropsy of the brain cannot be purged with
less than thirty or forty grains of jalap, whereas, under ordinary
circumstances, ten or fifteen grains will be sufficient. In ſevers
generally, a cathartic requires to be given in increased doses, par-
ticularly if the brain is affected, but in typhus a very minute por-
tion will suffice, for the reasons already assigned. (971.)
973. Colic or “stoppage of the bowels,” as it is sometimes
termed, is one of those diseases in which purgatives are regarded
by many people as indispensable. The intestines, however, are
in a state of spasm, being contracted to a small cord, and under
these circumstances, the action of purgatives would be effectually
resisted. The spasm should be overcome by the use of injec-
tions, the vapor bath, and the usual warming medicines, and then
the bowels will return to a healthy condition; but if we employ
cathartics, we may not only ſail in relieving the patient, but incur
the risk of adding to the violence of the disease. Professor
Ware, in one of his lectures on the treatment of colic, said, “It
is better that the bowels should remain costive a few days, than to
persevere in the use of purgatives, for they occasion irritation
along the whole intestinal canal.”
974. The ileus or iliac passion, so called, is another form of
disease which is known as stoppage of the bowels, and in which
cathartics are thought to be particularly indicated. This malady
is a species of colic which has its seat in the ilium or lower part

238 WEGETABLE MATERIA MEDICA.
of the small intestines. It commences with a dull pain in the
bowels, chilliness, and great irritability of the stomach. The
intestine is in a state of spasmodic contraction, which closes or
obliterates its cavity. Vomiting at length ensues, consisting at
first of the contents of the stomach, and then of the fecal matter of
the bowels. In the treatment of this distressing malady, we must
employ the same remedies that we do in colic, for the indications
of cure are the same ; but I need not say that purgatives would be
wholly useless, for they cannot operate while the intestinal canal
is in a state of rigid spasm. Dr. Ware, from whom I have just
quoted, says he has known more than one case of ileus in which
the bowels resisted the action of purgatives, and the patient has
been without an evacuation for ten or twelve days.
975. The assertion is frequently made by practitioners of the
new school, who are not thorough in their reform, that there is a
“particular spot” in the bowels which cannot be reached by the
ordinary routine of treatment, and hence it is supposed that a
cathartic is necessary. We are not told in what this particular
difficulty consists, but it may be an inflammation in some part of
the intestinal canal; and if so, it is impossible to effect a cure at
once, whatever may be the plan of treatment, for some time is
necessarily required for the inflammation to subside. Hence the
idea that there is “a particular spot” which the medicines cannot
reach. In some instances, however, a cathartic is given by way
of experiment, and as soon as it begins to operate, the patient says
he is relieved. Without any further reflection upon the subject,
the cathartic is thought to be a judicious remedy, but it is not
taken into the account, that it afforded relief only by irritating the
mucous membrane of the bowels, and causing an extension of the
inflammation along the intestinal canal. On the same principle,
an inflammation of the lungs is sometimes relieved by the external
application of a blister, but this, in the language of M. Louis, is
only “superadding one inflammation to another;” (411) and the
propriety of such treatment is not admitted by any substantial re-
former in the healing art.
976. I do not condemn the use of cathartics from any love of
theoretical speculation, but because I believe them to be as useless
as they are pernicious. In acute diseases, in which it is necessary
to make an immediate impression on the system, it is very easy to
employ injections, and they are much more safe and efficacious
than cathartics. On this point, I have the concurrent testimony
of a number of respectable practitioners, who have employe
them exclusively, to evacuate the bowels, for a long series of
years.


WEGETABLE MATERIA MEDICA.
977. One broad and important ground upon which I would
object to the use of cathartics is, that they cannot be employed
with safety by the people. A practitioner, who is well acquainted
with symptoms, may frequently prescribe them with impunity, but
the people, who do not know in what condition of the system they
would be likely to prove injurious, or perhaps fatal, cannot admin-
ister them indiscriminately, without the risk, in many cases, of
doing irreparable injury.
978. Injections have the effect, as I have said, to evacuate
the large intestines; and in conjunction with these, laxatives may be
employed to free the small intestines from any acrid matter which
they may contain. We must be careful, however, to make a dis-
tinction between laxatives and purgatives. The latter are some-
times administered in small doses, under the name of laxatives,
but as they are capable, under some circumstances, of purging
violently, even in the minutest quantity, the term is not appropri-
ately applied. Laxatives, therefore, are those medicines which
keep the bowels gently open, without the risk of purging. Among
the laxatives mentioned in this work, are golden seal, and the bark
of the American aspen. The unbolted wheat bread is a laxative,
but not a purgative. Cayenne is a most excellent laxative, and
taken in the dose of half a tea-spoonful, more or less, two or three
times a day, will have the effect to regulate the bowels, without
diminishing the strength of the patient, or giving rise to copious or
watery stools. It restores the natural peristaltic action of the
bowels, and does not leave them in a weak or torpid condition, as
is almost invariably the case with purgatives.
979. Many of the reformed practitioners throughout the United
States, have renounced the use of cathartics altogether, and many
others now employ them very sparingly. Dr. Patten of Danvers,
Mass., who has been in practice seven years, informs me, that
with one exception, he has not given a particle of physic for the
last five years. The exception alluded to, was a woman who was
very costive, and at the urgent solicitation of the patient, he con-
sented that she might take a cathartic, but it was productive of
more harm than good.
980, Dr. Cameron, recently of Boston, says in a letter, “I
formerly used bitter root in my practice, but observing its bad effects
on many of my patients, have abandoned it altogether. I am satis-
fied that physic is not necessary in any possible case. I never found
any difficulty in procuring an evacuation of the bowels, in the most
obstinate case of colic, by using cayenne freely, together with in-
jections and the vapor bath. I have had at least one hundred and


240 WEGETABLE MATERIA MEDICA.
-
fifty patients under my care within the last six months, comprising
all ages, and almost every form of disease peculiar to our climate,
and in these cases did not use a particle of physic. In truth, it
only aggravates disease, and has no tendency to remove the cause
of a complaint. I have been in practice, altogether, about six
years, and during the last four years, have not employed cathar-
tics in any form or shape. I may further add, also, that during
this period, I have not lost more than twelve patients, although
constantly and laboriously engaged in my profession.
981. Dr. Comfort of Philadelphia, who is a very prominent
and successful practitioner, told me some months ago, that he had
not used purgatives in any form, for three years, and he had no
disposition ever to employ them again. He expressed the belief
that he has been much more successful in his practice since he laid
them aside.
982. I have a letter from Dr. Smith of Newtown, Bucks
County, Pa., in which he states that he has been constantly en-
gaged in the practice of medicine for the last ten years, and for
the last five or six years, has entirely dispensed with the use of
cathartics. He first became convinced of their deleterious effects,
during the prevalence of an epidemic fever in his neighborhood, in
which the diplomatised physicians lost seven out of eight of their
patients, while he did not lose more than one in twelve. He did
not employ cathartics in this affection. He also mentions the
case of a child, with convulsions, to which he was called, as
showing the evil tendency of purgatives. “It had been success-
fully treated,” he says, “but from some cause or other suffered a
relapse, and its parents insisted that it should have a cathartic:
Thé dose was accordingly administered, and for a time it seemed
to operate mildly and favorably, but the child soon began to sink,
and in less than twelve hours was a corpse. Since that time I
have never given cathartics, and have uniformly raised my voice
against their employment.”
983. Dr. Chapman of Boston, who has had an extensive
infirmary practice for the last three or four years, assures me that
he has not used a purgative of any description during this period,
and his success has been equal to that of any other practitioner in
the country.
984. Dr. Weeks of Chester County, Pa., in a communica-
tion to the Manual, says, “When I first engaged in practice in
this county, I was called to a case in which the evacuations from
the bowels, after the repeated use of the syringe, did not give me
entire satisfaction; and from some circumstance, not now remem-
bered, I was led to think a purge would probably produce the de-
sired result. I procured one, and upon my next visit carried it



WEGETABLE MATERIA MEDICA. 241
in my pocket. I looked at the evacuations, felt the patient's
pulse, and was on the eve of prescribing the pills, but concluded
to defer it a little longer. I ordered an enema, then an emetic,
and the continued use of cayenne. On my way home, I acci-
dentally broke the box containing the pills, whereupon I threw
them away, and had occasion to thank my stars, for at the next
visit the patient was better, and he very soon recovered. My can:
did opinion now is, that had I administered the pills, he would
have died from their effects.
985. Dr. Samuel Thomson long ago discarded the use of ca-
thartics. He says, “They should not be used in any case what-
ever. They irritate the bowels, and destroy the equilibrium of
the circulation. Since my agents have discarded butternut and
bitter root, they are much more successful in their practice.”
986. Notwithstanding all that may be said in opposition to the
use of cathartics, there are many conscientious and intelligent peo-
ple who consider them useful agents in the treatment of disease,
and as one individual is as much entitled to his opinion as another,
especially in matters relating to health, I have concluded, at the
suggestion of my friends, to describe a few of the cathartics in
common use, that the purchasers of this work may employ or re-
ject them, according to their own discretion. Let it be borne in
mind, however, that cathartics are injurious in proportion as they
are active or drastic, and though they may be used with compara-
tive impunity in the early stages of disease, before the patient is
much reduced in strength, they should be particularly avoided in
cases of great debility. I would remark, also, that they appear
to be highly injurious in cutaneous affections, such as measles, and
smallpox, for they cause the eruption to disappear, in many in-
stances, and direct the force of the disease to the internal or
vital organs. In speaking of the properties and uses of the differ-
ent cathartics, I shall avail myself, to a considerable extent, of the
remarks of medical authors, who have employed them extensively
in their practice.
BUTTERNUT.
Juglans Cinerea—Inner Bark.
987. This species of walnut, says Michaux, is known in the
United States by different appellations. In Massachusetts, New
Hampshire, and Vermont, it bears the name of oil mut; in Penn-
sylvania, Maryland, and on the banks of the Ohio, it is generally


31

242 WEGETABLE MATERIA MEDICA.
known by that of white walnut ; and in Connecticut, New York,
New Jersey, Virginia, and the mountainous districts of the upper
parts of the Carolinas, it is called butternut, the latter of which
is the most universal. It frequently attains the height of fifty
feet. The leaves are two or three inches long, rounded at the
base, acutely pointed, toothed along the edges, and somewhat
downy. They are arranged in pairs on a long footstalk, with an
odd one at the extremity. The tree yields a well known fruit,
which, when half grown, is made into pickles, and in the ma-
ture state, is esteemed for its kernels, which have an oily and
pleasant taste, and are much used as an article of food.
988. On the living tree, says Michaux, the inner bark, on its
first exposure, is of a pure white, but it immediately becomes of
a beautiful lemon color, and soon after changes to a deep brown.
If the bark be perforated just before the leaves expand, a co-
pious discharge of sap ensues, which, by evaporation, affords
sugar of a very good quality, but inferior to that of the sugar
maple.
989. PROPERTIES AND Us Es. Dr. Beach says, “During
the American Revolution, when medicines were scarce, the but-
ternut was brought into use by the physicians of the hospitals,
and was esteemed by them an excellent substitute for the ordinary
cathartics. The extract made from the inner bark is alone
employed. When given alone, in doses of from fifteen to thirty
grains, it operates as an active cathartic, without ‘occasioning
heat and irritation.” It is thought to be very applicable in indi-
gestion, and as an aperient in habitual costiveness, as it is not apt
to leave the bowels in a costive state, like other cathartics. The
extract should be made from the bark, in the months of May or
June.”
990. Dr. Thomson says, “A sirup made by boiling the bark,
and adding one third molasses, with a little spirit, is a useful rem-
edy in the worm complaints of children. The buds and twigs
may be used for the same purpose, and are more mild. The bark
is the principal ingredient in Dr. Hawkes's rheumatic, and can-
cer pills, and also of Chamberlain's bilious cordial.” I will do
Dr. Thomson the justice to say, however, that, although he has
given butternut the above recommendation in his Guide, he has
not used the article in his own practice for many years.
991. Dr. Howard says, “Butternut may be prepared in the
form of extract, pills, sirup, or cordial. For the latter, take any
quantity of the fresh bark, split it into slips half an inch wide, and
bruise it well with a hammer; put it into an earthen vessel, pack-
ing it close, and add boiling water sufficient to cover the bark;
WEGETABLE MATERIA MEDICA.
set the vessel on coals near the fire, having it closely covered,
and allow it to simmer for one or two hours. This done, strain
the liquor, make into a sirup with sugar or molasses, add one
third or one fourth the quantity of proof spirit to preserve it, and
bottle for use. The dose for a child is from a half to two tea-
spoonfuls, repeated every half hour, or hour, until it operates.
For grown persons, the dose must be larger.”
992. The bruised bark of the butternut, applied to the skin,
will produce a blister.
BARBERRY.
Berberis Vulgaris–Bark of the Stem and Root.
993. The barberry is a common shrub in the New England
States, and grows as far south as Virginia. It is found usually
along fences, and in rocky or stony fields, rising to the height
of eight or ten feet. The stem is covered externally with an
ash colored bark, and is armed with triple thorns, which point
downward. The inner bark is of a beautiful yellow color. The
leaves grow in clusters somewhat in the form of a cup, varying
from five to ten in number; they are unequal in size, narrow at
the base, rounding, or blunt at the point, and bordered with teeth,
which terminate in bristly points. The flowers are yellow, and
appear in May or June, hanging in loose clusters. These are
succeeded by oblong, scarlet berries, each of which contains two
hard, brown seeds. They remain upon the shrub during winter,
and are often seen in the spring, after the leaves have expanded.
994. It is a popular belief that barberry injures rye or wheat,
growing in its vicinity, but this opinion is contradicted by late em-
Inent Writers.
995. PROPERTIES AND Us Es. The bark of the barberry
is bitter, and slightly astringent. In small doses it is regarded as
tonic and laxative; but in larger doses operates as a mild pur-
gative. The following preparation of it was formerly used by Dr.
Thomson, in jaundice. Take a gallon of cider, add four ounces
of the powdered bark, and four ounces each of the American
aspen, and wild cherry tree bark; let them steep in a closely
covered vessel by the fire, or some other warm place, for sev-
eral days, when the liquid will be fit for use. Half a tea-cupful of
this, with sugar or molasses to suit the taste, may be taken three
or four times a day, but particularly in the morning and evening.








244 VEGETABLE MATERIA MEDICA.
Dr. Thomson informs me that it improves the appetite, removes
the yellow tinge from the eyes and skin, and produces a peculiar sen-
sation throughout the whole system. It is also used as a restora-
tive medicine in the spring, in case of languor or debility. Those
who employ it, should not take it in quantities sufficiently large to
excite purging.
996. The powder, with a view to its cathartic operation, is
taken in the dose of a tea-spoonful, and repeated every two or
three hours, until the desired effect is produced. -
997. Barberry jelly, dissolved in water, makes an agreeable
and useful drink in dysentery, putrid sore throat, and malignant
fevers. It quenches thirst, and is said to be an excellent anti-
Septic.
BLACK Root.
Leptandra Virginica–The Root.
998. This plant has a number of common names, as Brinton
root, Bowman root, Culver’s physic, and tall veronica. It is
found throughout the Northern and Southern States, in the neigh-
borhood of streams, and in dry, open situations. The root is
perennial, irregular, of a dark or black color, and very fibrous.
The stem is erect, round, and from three to six feet high,
furnished with leaves in whorls, and supporting at its top a long
spike of white flowers, which make their appearance in August.
999. PROPERTIES AND Uses. The root is prominently
bitter, and has been represented to me by some practitioners as
operating mildly upon the bowels, without producing debility or
prostration, while others contend that it is extremely harsh in its
effects. Dr. Howard says, “The black root is highly celebrated
as an efficient purge, operating with mildness and certainty, with-
out producing that depression of the living powers so common to
other purgative medicines. In typhus and bilious fevers, it re-
moves the black, tarry, morbid matter from the intestines, in a
most natural manner, without weakening the tone of the bowels,
or leaving behind it the poisonous sting so often remaining after
the use of calomel, that almost universal cathartic in fevers. The
black root is also a diaphoretic, antiseptic, and tonic. It may be
taken in the dose of a heaped tea-spoonful, in half a gill of boiling
water, sweetened, if most agreeable, and repeated in three hours,
if it does not operate.”
1000. Dr. Smith of New York, remarks, “This root is an

VEGETABLE MATERIA MEDICA. 245
excellent purge, particularly in pleurisy; it possesses consider-
erable narcotic property, and sometimes it is necessary to rouse
the patient, to keep him from falling asleep during its operation.”
1001. Rafinesque says, “The roots lose much of their
virulence by drying, and a drachm of the powder becomes an
uncertain purgative; when fresh, however, they are drastic and
dangerous, and are said to produce bloody stools, dizziness, ver-
tigo, and abortion.” The safest mode of employing it, he adds,
is in a weak and cold infusion.
MANDRAKE.
Podophyllum Peltatum—The Root.
1002. The mandrake or May apple grows in rich soils, and
has a jointed, creeping root, about half the size of the finger.
The stem is smooth, round, a foot or more in height, and divided
at the top into two leafstalks, each of which supports a large,
hand-shaped leaf at its extremity, somewhat resembling that of the
golden seal. A solitary white flower expands in May, and is sup-
ported in the fork of the stem, on a nodding peduncle one or two
inches long. It is succeeded by fruit of a yellowish color, and
acid taste, which many people eat with avidity. It resembles
a lemon in shape, but is smaller, and has a smooth skin.
1003. The plant is often found in large patches, growing lux-
uriantly in moist shady woods, and low, marshy grounds.
1004. Prop ERTIES AND Uses. The root is bitter and nau-
seous. Dr. Howard says, “It is considered poisonous and unfit
for medicine by some, while others regard it as a most valuable
article. The dose usually given is from a half to a whole tea-
spoonful. The best time to give it, is at night, on going to bed,
and it will commonly ...i. the next morning.”
1005. “Podophyllum,” says the United States Dispensatory,
“is an active and certain cathartic, producing copious liquid dis-
charges without much griping or other unpleasant effect. In
some cases it has given rise to nausea, and even vomiting, but
the same result is occasionally experienced from every active
cathartic. Its operation resembles that of jalap, but is rather
slower, and it is thought by some to be more drastic.”
1006. The Cherokees use mandrake, says Rafinesque, to ex-
pel worms. They also employ the fresh juice of the root as a
remedy in deafness, putting a few drops of it into the ear. The


246 VEGETABLE MATERIA MEDICA.
leaves, continues the same writer, are narcotic, two ounces of
them, in decoction, being sufficient to kill a dog.
1007. Dr. Lobstein says he has never known mandrake to
fail in giving immediate relief in incontinence of urine.
1003. Were I disposed to use a cathartic, there are many
which I would select in preference to the mandrake, as I have
met with several cases in which it has been productive of serious
Injury.
BITTER R00T.
Apocynum ſindrosſemifolium—Bark of the Root.
1009. The bitter root, called also wandering milk weed,
honey bloom, catch fly, American ipecacuanha, and dog's bane,
is a perennial and rather handsome plant, flourishing in al-
most every part of the United States. It blooms in June and
July, and is found along fences, and in the borders of woods,
usually preferring a dry or sandy soil. The root is smooth,
creeping, and not quite so thick as the little finger. It is cov-
ered with a thick bark, and gives up stems at various distances.
These are erect, branched, from two to three feet high, some-
times reddish on the side exposed to the sun, and invested with a
tough or fibrous bark. The leaves are opposite, not very numer-
ous, smooth upon the upper surface, pale and somewhat downy
beneath, acute at the end, and about two inches and a half in
length. The flowers are bell-shaped, white externally, tinged
with red within, and resembling those of the buckwheat at a dis-
tance, though the similitude vanishes on a closer inspection.
They are arranged in little drooping clusters, on the ends of the
branches. The seed vessels or follicles are four or five inches
long, slightly curved, slender, pointed, and suspended from the
branches in pairs. They contain a feathery or silken down,
which is attached to very minute seeds.
1010. In New Jersey and Pennsylvania, the blossoms usually
disappear about the first of July, but in different parts of Massa-
chusetts, I have observed them in bloom as late as the middle of
August. Every part of the plant abounds in a milky juice, which
exudes when it is wounded.
1011. Prop ERTIES AND Uses. Bitter root has a nau-
seous, excessively bitter, and somewhat pungent taste. A tea-
spoonful of the powder will frequently operate as an emetic, and is
sometimes used by physicians in the country for that purpose, in-
WEGETABLE MATERIA MEDICA. 247
stead of ipecacuanha. It occasions weakness or languor, how-
ever, from which the patient is sometime in recovering. It is
also in popular use as a cathartic, and in the recent state, is very
drastic, but its power is diminished by keeping, and destroyed by
age. I am told by those who have employed it extensively, that
after it has been collected six months, its action upon the bowels
is comparatively mild.”
1012. Dr. Thomson says, “Bitter root is one of the best
correctors of the bile with which I am acquainted, and is an ex-
cellent medicine to remove costiveness, as it will cause the bow-
els to move in a natural manner. A strong decoction of the root,
made by steeping it in hot water, will operate as a cathartic, if
taken freely, and sometimes as an emetic, and is almost sure to
throw off a fever in its first stages.”
1013. Since Dr. Thomson published the above recommenda-
tion of bitter root, he has renounced the use of it altogether, and
considers it a dangerous article.
1014. Bitter root is much esteemed by many people as a
tonic, combined with other medicines, and administered in small
doses; but from its tendency to irritate the bowels, and act as a
cathartic, its employment is somewhat hazardous. I have known
it to excite violent purging, when given only with a view to its
tonic effects.
1015. “A wash made by steeping the root,” says Dr. Howard,
“is good for ulcers, and scald head, and probably may be found
useful as an external application in many diseases of the skin.”
1016. Dr. Eberle has introduced this plant into his Materia
Medica, and highly extolled its virtues as an emetic and tonic,
but he says nothing of its active cathartic properties.
1017. Some experienced practitioners have informed me that
bitter root exercises a specific influence over the liver, but I sus-
pect its action in this respect, is somewhat analogous to that of calo-
mel, which, according to Professor Dunglison, “irritates the lining
membrane of the duodenum, and this irritation extends along the
biliary ducts to the liver, the secretion of which is augmented.”
(936.). From the well known effects of bitter root upon the
stomach and intestinal canal, it is reasonable to infer, that it pro-
duces an irritation consecutively in the duodenum, biliary ducts,
and liver, in the same manner as calomel, and if such be the fact,
it cannot be of much value as a “specific” in affections of the
latter organ.


248 WEGETABLE MATERIA MEDICA.
MISCELLANEOUS PLANT'S AND ARTICLES OF
THE MATERIA MEDICA.
ALCO HOL.
1018. Alcohol or rectified spirit of wine, is the active ingredi-
ent in all intoxicating liquors. It is formed during what is termed
the vinous or alcoholic fermentation of vegetable juices containing
sugar, as those of the apple, grape, and sugar-cane. Wine and
cider contain alcohol, but in limited quantities compared with
ardent spirits, which are the product of distillation. Chemists
have estimated that a person who drinks a bottle of strong Ma-
deira, swallows at least a pint of ardent spirit, of the strength of
brandy or gin; and even currant wine, which is generally regard-
ed as an entirely innocent beverage, is nearly one half ardent
spirit. The older a wine becomes, the more alcohol it con-
tains, and consequently the more sparingly it should be used.
Brandy contains about 60 per cent of pure alcohol, rum 54 per
cent., and gin 514 per cent. The first is distilled from wine, the
second from the juice of the sugar-cane, and the third from fer-
mented grain, with the addition of juniper berries, to give it a pe-
culiar flavor. Brandy and rum have each a flavor of their own,
dependent on a volatile oil contained in the material from which
they are derived.
i019. Alcohol is obtained by frequently distilling any of the
ardent spirits. That which is sold under the name of alcohol,
however, contains a considerable portion of water, and other im-
purities. It has a strength of about 80 per cent. Pure alcohol
º'. the same properties from whatever substances obtained.
t is so volatile as to evaporate speedily, and has never been known
to freeze in the coldest temperature. It burns with a blue flame
without smoke, and leaves no residuum. Combined with an equal
proportion of water, it forms proof spirit.
1020. Alcohol dissolves the essential oils, and makes the es-
sences. It is also a solvent of soaps, balsams, camphor, an
many other substances which do not yield their properties to
water. It does not act upon the gums, properly so called, as
those of the peach, plum, and cherry trees. It unites with water in
every proportion.
1021. Alcohol is not much used in the new practice, except
in the preparation of rheumatic drops, and the various tinctures; an
the milder forms of it, as wine, and cherry spirit, will generally
suffice for these. Much injury is undoubtedly done, by taking al-

WEGETABLE MATERIA MEDICA. 249
cohol into the stomach with medicine, and the sooner there is a
reformation in this respect, the better it will be for the health and
lives of the people.
1022. The habitual use of alcohol, in any of its forms, gives
rise to many serious diseases, as inflammation of the stomach,
nausea, vomiting, liver complaints, dropsy, inflammation of the
lungs, hoarseness, cough, eruptions of the skin, epilepsy, gout,
palsy, and apoplexy. It not only destroys the body, but also the
mind, and renders the individual entirely reckless of his character,
and moral obligations. In the form of wine, or brandy, it is used
by the medical faculty as a stimulant in the low or sinking stages
of disease, but it is difficult to imagine that a substance which is
so destructive to those in health, can be of service in strengthen-
ing or invigorating the sick. (721.)
1023. Many people imagine that ardent spirits are beneficial
in cold weather, but this is a mistaken idea, for, although they stim-
ulate for the moment, they leave the system in a state of languor
or debility, and the individual finds that his susceptibility to the
effects of cold is greatly increased. Cullen very properly enu-
merated wine and brandy among the narcotics.
1024. In warm weather, also, alcoholic drinks are thought by
some to be indispensable; and until the temperance cause com-
menced its reformation, a bottle of rum would be found in the
harvest field, almost as constantly as the scythe, or sickle. But
instead of invigorating the laborer, it impairs his strength, and
renders him ſeverish, and oppressed. Dr. Bell, speaking of the
use of rum in the West Indies, says, “whether . habitually,
moderately, or in excessive quantities, it always diminishes the
strength of the body, and renders men more susceptible of disease,
and unfit for any service in which vigor or activity is required.”
ALRALIES.
1025. Alkalies are well known as substances which neutralize
acids, and render them inert. Hence their frequent use in dys-
pepsia, heartburn, and other diseases accompanied with acidity of
the stomach. They only afford temporary relief, however, and
do injury if frequently employed. Some practitioners are in the
habit of prescribing the use of an alkaline draught three or four
times a day, instead of adopting means to restore the tone of the
stomach, and thereby prevent the formation of acid. Persons,
however, who indulge in habits of gluttony, and “keep a brewery
of vinegar in their stomach,” as a celebrated writer has observed,
must expect to suffer evil consequences.



32
250 VEGETABLE MATERIA MEDICA.
1026. It is a common practice in our towns and cities, where
drug shops are scattered in every direction, to take soda water
several times a day, under an impression that it will keep the
stomach healthy, but it has a directly contrary effect, and tends to
disorder the stomach, because the soda neutralizes the acid of the
gastric juice, and thereby interferes with the digestive process.
1027. The alkalies in common use, are pearlash, and salaratus.
The first is the potash of commerce, deprived of its impurities;
the second is the pearlash º charged with carbonic acid gas,
constituting what is termed the bicarbonate of potash.
1028. Pearlash is too acrid for internal use, but the sal aeratus
is more mild and agreeable, and may be taken in the dose of a
level tea-spoonful, dissolved in two thirds of a tea-cupful of water.
A still better alkali, however, is the bicarbonate of soda, which is
free from irritating properties. The usual dose is a moderately
heaped tea-spoonful.
1029. If an emetic is slow in operating, after cayenne and
bayberry tea has been administered freely, an alkaline draught
should be employed. The addition of an alkali to the injections,
also, is highly serviceable, where acid in the bowels is suspected.
A patient with the smallpox, or any severe cutaneous disorder, is
greatly benefited by sponging him, while in the vapor bath, with a
tepid solution of sal aeratus, or bicarbonate of soda, dissolving two
tea-spoonfuls of the alkali in a pint of water. -
ARCHANGEL.
Lycopus—The Herb.
-
1030. There are two species of archangel used in medicine,
one of which is of a red or purple color, and the other green.
The names of Gipsey weed, Paul’s betony, water hoarhound,
and bugle weed, appear to be common to both. They are usually
found side by side in meadows, and along ditches and creeks,
generally preferring a wet or damp soil. . . . .
1031. The purple archangel (lycopus virginicus) has a creep-
ing and fibrous root, which sends up a stem from six to eighteen
inches high, bluntly four cornered, sometimes branched, and fur-
nished with opposite leaves. These are tapering at both ends, of a
red or purple color on the under surface, and bordered with teeth ºf
various sizes. The flowers are white, very small, and grow in
whorls around the stem. They continue in bloom during July
and August.
i032. The green archangel (lycopus europºus) has a branch-


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WEGETABLE MATERIA MEDICA. 251
ing stem, with four sharp corners. The leaves are narrower than
those of the other species, and the teeth more acute. The flow-
ers are disposed in similar whorls, but are rather more crowded,
and remain in bloom during the summer, and a portion of the
autumn. -
1033. Between these two species, there are a number of vari-
eties, which possess analogous properties.
1034. The purple archangel has a balsamic, somewhat astrin-
gent, and slightly bitter taste. It is in popular use in some parts
of the country as a cure for diarrhoea and dysentery. Cutler says
the juice of it will impart a permanent black to linen, woolen, and
silk. According to Withering, the Gipsies use it to stain their
skin, whence the name of Gipsey weed. It is frequently put into
beer, and makes a very wholesome beverage. The green archan-
gel is exceedingly bitter, and rather nauseous. It has acquired
considerable reputation in Europe as a remedy in ſevers.
1035. PR op ERTIES AND Us Es. These herbs are astrin-
gent and tonic, and may be usefully employed in various slight
affections, as ſevers, and bowel complaints, in their early stages.
They are beneficial also in indigestion and loss of appetite. The
people in some parts of New Jersey, use the infusion as a drink in
indolent or badly conditioned sores, and employ it externally, at
the same time, as a cleansing wash.
BALM OF GILEAD.
Populus Candicans—The Buds.
1036. This tree rises to the height of forty or fifty feet,
and has a diameter of eighteen or twenty inches. It is very com-
mon in New Hampshire, Massachusetts, Rhode Island, and Con-
necticut, where it is cultivated as an ornamental tree, or rather,
perhaps, as a shelter from the sun. In some places it is called
heart-leaved balsam poplar. It grows in open, airy situations,
being rarely, if ever, found in woods or forests. The upper
portion of the trunk and branches are clad in a smooth, whitish
bark. The leaves are broad and heart-shaped at the base, edged
with small teeth of irregular sizes, acute at the apex or point, and
of a deep, rich green upon the upper surface, variegated with yel-
lowish or straw colored veins. The blossoms are arranged in
long, slender, pendulous clusters, and appear in April, in advance
of the leaves. They are succeeded by a silky substance, which



252 WEGETABLE MATERIA MEDICA.
is carried in every direction by the wind, and becomes annoying
sometimes from its abundance.
1037. There is another species of this tree, which is prized
for its buds. It is called balsam poplar and tacamahaca, and is
distinguished by botanists as the populus balsamifera. Its leaves
are three or four inches long, tapering at both ends, of a silvery
or dullish white color on the under surface, and bordered with
a few indistinct teeth. The elder Michaux, in his travels through
Lower Canada, observed this tree in considerable quantities on
the shores of Lake St. John, and at Malebay, near the river St.
Lawrence, but it became less common as he approached Mon-
treal. Mr. Thomas Say, who made a collection of plants in the
North Western Territory, mentions it as growing in the neighbor-
hood of Lake Superior. It is found occasionally in New York,
Vermont, Massachusetts, and Connecticut. I never saw it in
Pennsylvania, excepting a small tree which grew on the farm of
Dr. Logan, near Philadelphia.” In Canada, notwithstanding the
severity of the winter, it attains the height of seventy or eighty feet,
and is often three feet in diameter.
1038. The buds of both these species, have a very pleasant
odor, and are covered in the spring with a glutinous, yellow bal-
sam. They should be gathered just before they burst into leaves.
The balsam of the tacamahaca is collected in Canada in shells, and
sent to Europe, where it is sometimes used as a stimulant and
tonic, and for external applications. In Liberia, where the tree
flourishes, the inhabitants prepare a medicated wine from the buds,
which they use in scurvy, and cases of obstructed urine.
1039. PRoPERTIES AND Us Es. The buds are balsamic,
somewhat bitter, and very pungent. For internal use, they should
be employed in the form of tincture, as water will not extract the
whole of their virtues. To a pint of cherry spirit, or New Eng-
land rum, an ounce or an ounce and a half of the buds may be
added, previously pounding or bruising them in a mortar. Let
them steep for a week or fortnight in a closely stopped bottle,
shaking them three or four times each day, when the tincture will
be fit for use. This is a restorative, and is useful in cases of de-
bility. It strengthens a weak stomach, and promotes appetite and
digestion. A tea-spoonful, sweetened with loaf sugar, may be
* Mr. Nuttall informs me that the leaves of this tree vary in size according to
locality, or rather, he is disposed to think that there are different species of it
which have not been acknowledged by botanists. The leaves figured by Michaux
as the populus balsamifera, are much larger and broader than those represented
opposite the preceding page.
-




WEGETABLE MATERIA MEDICA. 253
taken three or four times a day. It is a valuable application for
bruises, sprains, cuts, unhealthy gums, and ulcers of the mouth.
1040. The buds are an ingredient in the meadow fern oint-
ºment.
BITTER SWEET.
Celastrus Scandens—Bark of the Root.
1041. The bitter sweet is a woody vine, attaining, in favor-
able situations, the height of thirty or forty feet. It twines around
the branches of trees, similar to the grape-vine, and creeps upon
hedges, fences, and rocks. It has various names, as staff tree,
red root, fever twig, and wax work. It is common throughout
the Northern and Southern States, thriving the most luxuriantly
in a rich, damp soil.
1042. The root is creeping, of a bright orange color, about
the size of the middle finger, and several rods in length. The
stem is covered with a brown or reddish bark, and rarely exceeds
an inch in diameter. The leaves are somewhat tapering at the
base, with minute teeth along the margins, and a sharp and ex-
tended point. The blossoms are of a greenish yellow color, and
very fragrant, blooming the first or second week of June. The
berries grow in clusters, and remain upon the vines during
winter. Early in the autumn, they are of an orange color, but
after the first or second frost, the external covering divides into
three valves, which turn backward, and disclose a beautiful scar-
let berry in the centre.
1043. The solanum dulcamara or woody nightshade, is some-
times confounded with this plant, because the name of bitter sweet
is common to them both. The dulcamara possesses poisonous
properties, and hence the necessity of this caution. It has a
slender, vine-like stem, seldom exceeding eight feet in length,
with leaves of a dull green color, and clusters of elegant purple
blossoms, which remain in bloom from June to August.
1044. PRoPERTIES AND Us Es. The bark of the root has -
a sweetish, and rather nauseous taste. A strong tea, made by
boiling four ounces of the bark in a quart of water, has been
given in the dose of a gill three times a day, in diseases of the
skin, liver complaints, and impurities of the blood, but not, I
presume, with any particular advantage. In some instances, it ap-
pears to have a favorable action upon the kidneys. Taken for a

254 VEGETABLE MATERIA MEDICA.
week, or more, it is, apt to produce a prickling and very un-
pleasant sensation of the skin. It is not much used in the new
practice, excepting as a component part of the nerve ointment.
BITTER THISTLE.
Centaurea Benedicta—The Herb.
1045. The bitter or lovely thistle is an annual plant, which is
cultivated in gardens both for ornament and medical use. It
blooms in June and July. The root is straight, and four or five
inches long. The stem is erect, grooved, hairy, from one to two
feet high, and branched near the top. The leaves are six or
seven inches in length, broad at the base, of a light green color
upon the upper surface, whitish beneath, with curling margins,
and very large teeth, each of which is terminated by a sharp
point. The flowers are yellow, and surrounded by a cluster of
ten leaves, the exterior five of which are the largest.
1046. The bitter thistle should be gathered when in bloom,
quickly dried, and kept in an airy place, to prevent it from
moulding.
1047. PRoPERTIES AND Us Es. This plant has an intensely
bitter taste, which it loses in some measure by drying. Dr.
Thomson recommends it as an excellent corrector of the bile.
Its virtues are extracted by warm, or even cold water. The in-
fusion may be advantageously employed in weakness of the stom-
ach, or loss of appetite. Taken warm, and in sufficient quan-
tities, it produces a copious perspiration, especially if the patient
be seated by the fire, or covered up in bed. The decoction is
nauseous, and in large draughts, causes vomiting. The dose of
the powdered leaves is a tea-spoonful, which may be taken three
or four times a day in molasses or honey, or in combination with
other medicine.
BLOOD R.O.O.T.
Sanguinaria Canadensis—The Root.
1048. This plant is found in woods, thickets, and in damp.
rocky grounds. It blooms early in the spring. The root is two
or three inches long, about the size of the finger, and abruptly ter.
minated. When broken, it emits a bright orange colored juice.

WEGETABLE MATERIA MEDICA. 255
The leaves grow on channelled footstalks, and are divided into
large, roundish lobes. The flower is mostly white, but sometimes
tinged with rose, or purple, and is supported at the top of a naked
stem, which rises from six inches to a foot in height.
1049. PRoPERTIES AND Us Es. Some practitioners entertain
a high opinion of blood root as an emetic, and consider it but little
inferior to lobelia inflata, but medical authorities are not very
strongly in its favor. “Sanguinaria,” says the United States Dis-
pensatory, “is an acrid emetic, with stimulant and narcotic powers.
In small doses it excites the stomach, and accelerates the circula-
tion; more largely given, it produces nausea and consequent de-
pression of the pulse, and in the full dose occasions active vomiting.
The effects of an overdose, are violent emesis, a burning sensation
in the stomach, ſaintness, vertigo, dimness of vision, and alarming
prostration.” -
1050. Whatever objections there may be to blood root as an
emetic, however, it is a valuable remedy in polypus of the
nose, and has been frequently employed with success. Dr.
Brice of Newark, Ohio, narrates three cases which he cured by
the use of this article. One of the patients was a youth, in whom
the polypus projected out of the nostril. A physician in a neigh-
boring town tore away part or the whole of it, and the operation
was followed by a profuse hemorrhage. The polypus returned,
however, and acquired its original dimensions, but by the appli-
cation of blood root, both in powder and decoction, it soon began
to assume a pale color, and to shrivel. Another patient was a
little girl, in whom the polypus was distinctly seen, but did not
present itself entirely. The same application effected a radical
cure. The third case was a man rather advanced in life, whose
nose was much obstructed by the size of the polypus, but it was
permanently removed by the same treatment.*
1051. I have known two cases of polypus to be radically
cured by using the powdered sanguinaria as a snuff, several times
a day. Steeped in vinegar, also, it may be applied with advan-
tage to warts, ring worms, and tetters.
1052. The dose of the blood root as an emetic, is from ten
to fifteen grains of the powder. As a purgative, it is employed
in smaller doses.
* Western Journal of Medicine and Surgery for 1840.




256 VEGETABLE MATERIA MEDICA.
BUCK HORN BRAKE.
Osmunda Regalis—The Root.
1053. The buck horn brake is found in meadows, and low,
moist grounds. The main root, which is the only medicinal part
of the plant, is about two inches long, and somewhat in the shape
of a horn. It consists of a number of longitudinal scales, which
have silky, transparent borders. The other portion of the root is
composed of small, brownish fibres, which are very numerous,
and firmly matted together. The stems are smooth, slender,
branched, and about three feet high. The leaves are accurately
delineated in the opposite drawing, and therefore do not require a
description. The flowers appear in June, arranged in a cluster
at the top of the stem, and are succeeded by numerous seed
vessels, which are at first green, and subsequently of a brownish
color.
1054. The roots should be collected in August, or about
the first of April. I have generally found them to be in the
greatest perfection at the latter period. They should be dried
with care, as there is danger of their becoming mouldy.
1055. The flowering fern or polypod (osmunda cinnamomea)
is sometimes used as a substitute for the buck horn brake, but it is
not so good. It grows in damp woods and meadows, forming
elevated tufts by the matting together of the roots. When the
stems first appear in the spring, they are hairy, and of a whitish
color, surmounted by the young leaves, curiously rolled up in the
form of a scroll, and covered with a downy or wool-like sub-
stance. The full grown stems are sometimes four or five feet
high. They are furnished with two rows of long, tapering leaves,
which are divided into numerous lobes. The flowers are at the
top of a separate footstalk, and are disposed in a cluster similar
to those .." the buck horn brake. They appear in June, and
are followed by minute, brownish seed vessels. The root is sim-
ilar in shape to that of the brake, but considerably larger.
1056. PROPERTIES AND Us Es. The roots of these plants
are mucilaginous, particularly that of the buck horn brake. The
mucilage is obtained by steeping the roots in hot water, and this,
with the addition of loaf sugar, ginger, brandy, and some other
ingredients, constitutes an excellent jelly, which is useful in cough;
diarrhoea, dysentery, and soreness of the stomach and bowels. It


WEGETABLE MATERIA MEDICA. 257
is beneficial, also, in recovery from sickness. Half a wine-glass-
full is the ordinary dose, and it may be frequently repeated.
1057. The mucilage, mixed with fourth proof brandy, is used
in the country as an external application for sprains, and weak-
ness of the back. A single root of the buck horn brake, infused
for half an hour in a pint of hot water, is generally sufficient to
convert the whole into a thick jelly.
Buſ RDOCK.
Arctium Lappa–The Root and Leaves.
1058. This plant is equally common in Europe and America,
growing by roadsides, on ditch banks, among rubbish, and about
houses and barns. The root, which is spindle shaped, is a foot
or more in length, and thick in proportion. The stem is branch-
ing, hairy, round, and three or four feet high. The leaves are
very large, and stand on long footstalks; they are heart-shaped at
the base, and have wavy or curling margins. The flowers are
purple, and disposed in clusters at the top of the stem and branch-
es. They have a globular form, and are furnished with small
hooks, by which they become attached to clothes and animals.
The flowering period is July. -
1059. The stalks are eaten in some parts of Europe with oil
and vinegar, as a salad, being cut before the plant is in bloom, and
the rind peeled off. Three pounds of the ashes, procured by
burning the leaves and stems ..., the time of flowering and
seeding, will yield sixteen ounces of white alkaline salt, equal to
the best potash.
1060. PROPERTIES AND Us Es. The root, which loses
four fifths of its weight by drying, has a sweetish and mucilaginous
taste, with a slight degree of bitterness. A decoction of it, pre-
pared by boiling two ounces of the fresh bruised roots in a quart
of water, may be employed in diseases of the kidneys, and ob-
struction of the urine. A pint may be taken in the course of
twenty four hours.
1061. The leaves bruised with a roller, and moistened with
rheumatic drops, form an excellent application for sprains, bruises,
and other external injuries. They speedily allay the pain, and
inflammation. In gouty affections, where the feet are swelled, the
same application is equally beneficial.


33

258 VEGETABLE MATERIA MEDICA.
CAMPHOR.
Camphora.
1062. There are two trees which yield the camphor of com-
merce. One is the laurus camphora, which grows in China and
Japan, and is occasionally found in the botanical gardens of Eu-
rope and America. The camphor is procured by cutting the
roots and branches into chips, and placing them, with a little water,
in an iron vessel, covered with an earthen receiver. A moderate
heat is then applied, and the camphor ascends in volatilized parti-
cles with the vapor of the boiling water, and collects upon rice-
straw with which the vessel at the top is lined. In this state it is
sent to Europe, or the United States, where it is freed from
impurities, and converted into white semi-transparent cakes, as we
see it in the shops. Michaux observes that the laurus camphora
is susceptible of cultivation in the southern parts of the United
States.
1063. The other tree producing camphor, is a native of the
northern parts of Sumatra, where it grows wild, attaining the height
of one hundred feet. It is found also at Borneo. The camphor
is embedded in the trunk of the tree, occupying cavities or fis-
sures, which are a foot or more in length, and three or four inches
in diameter. A large tree yields from fifteen to twenty pounds.
1064. Camphor has a fragrant, penetrating odor, and a bitter,
pungent taste, with a slight sensation of coolness. When of a good
!". it totally evaporates on exposure to the air. It is slight-
y soluble in water, and wholly so in alcohol. By the addition of
water to the spirituous solution, the camphor is precipitated.
1065. There are a number of plants containing camphor,
among which are the elecampane, sage, ginger, sassafras, and pep-
permint, but not in sufficient quantities for extraction.
1066. Prop ERTIES AND Uses. Camphor is a narcotic
poison, and should not be employed as a medicine, internally. It
acts upon the brain, producing giddiness and stupor. Christison
speaks of a case, in which forty grains had been swallowed, and in
the course of twenty minutes, the individual “ became weak and
languid, and in an hour, giddy, confused, and forgetful. At length
he lost all consciousness, during which he was attacked with
strong convulsive fits, and maniacal frenzy.” In the solid form:
according to Orfila, it is capable of producing inflammation of
the stomach. The United States Dispensatory says, “immod-
erate doses occasion nausea, vomiting, ſaintness, vertigo, de-
WEGETABLE MATERIA MEDICA. 259
lirium, insensibility, drowsiness, convulsions, and sometimes
death.”
1067. Camphor is an ingredient of Dr. Thomson's volatile
liniment, which he recommends for bathing sprains, bruises, and
painful or rheumatic joints. Added to the rheumatic drops, it
may be employed for the same purpose. Dissolved in spirits,
and applied to the nostrils, its agreeable and penetrating odor
renders it highly serviceable in headachs, ſainting fits, and languor
or debility occasioned by sickness.
CANADA SNARE R00T.
..ſlsarum Canadense—The Root.
1068. The Canada snake root or wild ginger, is an inhabitant
of woods, and dry shady places. The root is creeping, jointed,
and somewhat fibrous, showing itself sometimes upon the surface
of the ground. The stem is five or six inches high, and divided
near the root into two hairy leafstalks. Each of these is termi-
nated by a roundish, kidney-shaped leaf, hairy on both sides,
whitish beneath, with a net-work of veins upon the upper surface.
The blossom rises from the fork of the stem, and is of a purple
color, remaining in bloom from May to July. It is frequently
concealed from view by decayed leaves or dirt.
1069. The pulverized roots of this plant furnish a brownish
colored powder. A drink, known as ginger beer, was formerly
manufactured from them, and sold extensively in many parts of
New England. The dried leaves, reduced to a powder, make an
.." and slightly pungent snuff, which is useful in disorders of
the head.
1070. PROPERTIES AND Us Es. The root has a strong,
fragrant odor, and an aromatic, pungent, and slightly bitter taste.
Its virtues are imperfectly extracted by water, for which reason it
should be taken in substance. It is a warming, aromatic stimu-
lant, giving rise to perspiration, and like many articles of its class,
is useful in flatulency, and pains of the stomach and bowels. The
ordinary dose is a moderate tea-spoonful, which may be taken in
warm water sweetened, and frequently repeated. In larger doses,
it is apt to produce nausea and vomiting.

260 WEGETABLE MATERIA MEDICA.
CATINIP. -
JNepeta Cataria—The Herb.
1071. Catnip or catmint grows abundantly by roadsides, and
about houses and barns. It has a branching, quadrangular stem,
varying from one to three feet in height. The leaves are broad,
and heart-shaped at the base, obtusely pointed, dentate, green
above, and whitish on their under surface. The whole plant is
covered with a very fine down. The flowers are of a reddish or
purple color, and appear in July or August. They are disposed
in whorls at the ends of the stem and branches. They also grow
from the axils formed by the leaves and stem.
1072. PROPERTIES AND Us Es. Catnip has a strong odor,
and a bitter, pungent, and aromatic taste. It is a tonic and stim-
ulant, and in the form of tea, promotes perspiration. It is highly
useful in colds, suppression of the menses, bowel complaints,
colic, and slight febrile attacks. Some of the North American
Indians are in the habit of using catnip tea, with the vapor bath, in
curing chronic diseases, as rheumatism, and stiffness of the joints.
A medical writer says, “Many people consider catnip too simple
to deserve much attention; however, it is well for physicians that
it is slighted, for if it were used in all cases where it might be
with advantage, their services would be less frequently required.”
CHAMOMILE.
JMetricaria Chamomilla–The Herb.
1073. This plant is frequently cultivated in gardens for family
use, and is generally known by the name of garden chamomile.
Its roots are small and fibrous, sending up a number of stems,
which are three or four inches high, and become entangled with
each other so as to form a compact bed or mat. The leaves have
a feathery appearance, and consist of long flat footstalks, which
branch up thickly from the top of the stem, giving off on either
side a number of thread-like filaments, or leaflets. The flowers
are white, and make their appearance in May.
1074. The chamomile flowers which are sold in the shops,
are the product of a plant which grows wild in the temperate parts
of Europe, and is also cultivated on that continent for medical
purposes. It is generally called European chamomile, and is

WEGETABLE MATERIA MEDICA. 261
designated by botanists as the anthemis mobilis. It has a slender,
downy stem, from six inches to a foot in length, and lies partly
upon the ground. Its leaves bear a resemblance to those of the
garden chamomile. Its flowers are also similar, but are consider-
ably larger, and do not bloom until August. Eaton states, in his
Manual of Botany, that he saw this plant in 1820, growing wild in
cultivated fields near Pittsfield, Mass. Mr. Nuttall also observes
that it is naturalized in Lewistown, near Delaware.
1075. The flowers of the European chamomile have a fra-
grant odor, and a bitter, aromatic taste. They contain a volatile
oil, upon which their virtues partly depend, and which is driven
off at the boiling temperature. The tea should be prepared,
therefore, by steeping the flowers in warm water. The garden
chamomile is closely allied to this in medical properties, but is not
so bitter, and rather more agreeable to the stomach.
1076. PRoPERTIES AND Us Es. Cold chamomile tea is a
useful tonic in dyspepsia, and loss of appetite. Taken warm,
and in sufficient quantities, it is nauseating, and not unfrequently
operates as an emetic. By drinking the tea on going to bed, it
produces perspiration, and generally has the effect to arrest a sud-
den cold. It is also serviceable in violent attacks of colic. Dr.
Cullen informs us that he employed it with considerable success
in ague and ſever, but he found that by giving large doses, it pass-
ed off readily by stool, and thereby defeated his expectations of
a Cure.
1077. Chamomile is a valuable external application for sprains,
bruises, and swellings, and for this purpose is generally employed
in the form of nerve ointment. -
CINNAMON.
Laurus Cinnamomum–Inner Bark.
1078. Cinnamon is the inner bark of the above tree, which
grows in the East Indies, and rises to the height of twenty or
thirty feet. It is also cultivated in the Isle of France, Brazil,
Cayenne, and some parts of the West Indies. The bark is ob-
tained from young shoots of the tree, which do not exceed two or
three inches in diameter, and when of a good quality, is thin,
smooth, and of a light yellow color. It is said to be frequently
mixed with that from which the oil has been obtained. Good
cinnamon has a pleasant, sweetish, slightly pungent, and highly

262 WEGETABLE MATERIA MEDICA.
aromatic taste, with some degree of astringency. It is very good
in bowel complaints, flatulency, nausea, and vomiting. It is very
useful also in disguising the taste of unpleasant medicines, it
yields a fragrant oil, which, from its high price, is frequently adul-
terated with alcohol, and some of the fixed oils. The latter,
however, may be detected by the greasy stain which they leave
on paper. The cinnamon from China is termed cassia, in com-
mercial language, while that from other countries, is designated by
the common name.
CLEAVER.S.
Galium—Several Species—The Herb.
1079. Pointed Cleavers–Galium ºffsprellum. This plant is
found in various parts of the United States, but is especially
abundant in New England. It has several common names, as
rough bed straw, catch weed, and goose grass. It grows along
hedges, in damp meadows, and near the margins of streams and
ponds, creeping upon bushes, or whatever there is to afford it
support. It remains in bloom from June to September, putting
forth a profusion of small white blossoms. The root consists of
a few hair-like fibres, of a reddish color, sending up a creeping,
brittle, four cornered, branching stem, which is rough backward,
and from two to four feet in length. The leaves, which are ar-
ranged upon the stem and branches in the form of a star, usually
including six in number, are from a half to three quarters of an
- inch long, rough along the ribs and margins, tapering at both ends,
and terminated by a delicate and scarcely perceptible point. The
- flowers are dispersed in terminal clusters, and are succeeded by
. round, and very minute seed vessels. The plant is
abundantly supplied with prickles, which cause it to adhere tena-
ciously to the hands.
1080. Common Cleavers—Galium ſparine. This does not
differ materially from the above, excepting that its leaves are in
whorls of eight, and its seed vessels rough and bristly. It blos-
soms in May or June.
1081. Yellow Bed Straw—Galium Verum. This species of
cleavers receives its name from the color of its flowers, which are
yellow. Its leaves are also in whorls of eight. It has a slender,
- branching stem, from one to two feet high, and is found on river
banks, and in dry, open pastures. Its blossoms appear in June
and July, and are followed by smooth seed vessels.



__


WEGETABLE MATERIA MEDICA. 263
1082. Small Cleavers–Galium Trifidum. This plant grows
in damp or wet places, and is often found along the margins of
stagnant water. It seldom exceeds a foot and a half in height.
The leaves are in fives upon the stem, and in fours upon the
branches. The blossoms are white, and appear in July, succeed-
ed by small, round, smooth seed vessels. -
1083. There are several other species of the galium, which
are very similar in general appearance to those already described.
1084. Linnaeus informs us that the stems of the cleavers are
used in Sweden for straining milk, instead of a sieve. The tops
are also cut fine, and put into broth, or gruel, in the spring,
under an impression that they will purify the blood. Hippocrates,
Galen, and Pliny, have all mentioned these plants in favorable
terms as medicines.
1085. PROPERTIES AND Us Es. These herbs, in the green
state, have an unpleasant odor, and a slightly bitter taste. They
have been employed for a variety of purposes, but are chiefly use-
ful as a diuretic. They are of great value in suppression of urine,
gravelly complaints, and other affections of the urinary organs.
The author of the Botanic Physician says, “When urinary ob-
structions proceed from a collection of cold, slimy, or muddy sub-
stance in the kidneys, or bladder, they effectually clear it out in
all cases. In inflammatory affections of the kidneys, or bladder,”
he further remarks, “the infusion is peculiarly applicable, from its
cooling, as well as diuretic quality. It gives great relief in the
scalding of the clap.”
1086. An ounce and a half of the dried herb may be steeped
in a pint of warm water, and the infusion employed freely as a
drink. It may be rendered more agreeable by the addition of
sugar. Boiling water impairs its strength. I have found great
benefit from cleavers, by using it alternately with other diuretics.
CLOWES.
Eugenia Caryophyllata—The Flower Buds.
1087. These are the product of a tree indigenous to the Mo-
lucca Islands, and now cultivated at Amboyna, Cayenne, and
Sumatra. They consist of the unexpanded flower buds, which
are collected when green, dried in the sun, and sent to this coun-
try in chests, or bags. They have a hot, aromatic taste, and a


264 VEGETABLE MATERIA MEDICA.
strong, fragrant odor. They are useful in nausea, flatulency, and
colic, and are employed in flavoring medicines, especially the
spiced bitters. The oil of cloves is used as a remedy in toothach.
C0 CASH.
.4ster Puniceus—The Root and Leaves.
1088. This plant is known by various names, as squaw weed,
frost weed, meadow scabish, and red stalked aster. The root is
perennial and fibrous. The stem is erect, easily broken, two or
three feet high, of a reddish color, covered with short, stiff
bristles, and thickly branched at the top. The leaves are clasp-
ing, rough on the margin and upper surface, tapering at both ends,
sharp at the point, and bordered with remote teeth. The stem
leaves are five or six inches long; those of the branches are much
shorter, and narrow in proportion. The flowers are of a light
blue, and grow in spreading clusters at the tops of the stem and
branches.
1089. The cocash grows in wet grounds, and by the edges of
small streams. The flowers make their appearance about the first
of September, and remain in bloom until late in the autumn.
The lower or radical leaves, especially about springs, and warm,
sheltered places, continue green all winter. They have an agree-
able, aromatic taste, with some astringency, and bitterness. The
leaves of the stem are endowed with similar properties, but in an
inferior degree. The root possesses little or no medical virtue,
with the exception of the long fibres which it sends off during the
summer; these acquire the size of a pipe stem, and have a pun-
gent or aromatic taste. They are frequently collected in the win-
ter or spring, together with the radical leaves, and used for medi-
cinal purposes.
1090. PRoPERTIES AND Us Es. Cocash is an agreeable
stimulant, and promotes perspiration. It is perfectly innocent,
and may be taken without any particular regard to quantity. The
infusion, prepared by steeping the fresh bruised roots and leaves
in hot water, is useful in rheumatism, sudden colds, nervous de:
bility, dizziness, headach, pains of the stomach and bowels, and
irregularity of the menstrual discharges. The Canadian Indians
employ the cocash in rheumatism, and consider it an excellent
remedy. They mix the infusion with a small portion of spirit,
with a view to its preservation, and use it as occasion requires.


VEGETABLE MATERIA MEDICA. 265
COMFREY.
Symphytum Officinale—The Root.
1091. The comfrey is cultivated in gardens, and grows spon-
taneously by roadsides, and about houses and barns. The root
is perennial, very brittle, black externally, and white within. The
stem is upright, hairy, branching, angular, and three or four feet
high. The lower leaves are tapering, acute, somewhat wrinkled,
and supported on long footstalks; they are hairy upon the upper
surface, and also upon the midrib and veins beneath. The upper
leaves are shorter, and without footstalks, having a continuation o
their margins down the stem. The flowers are of a yellowish or
dirty white color, and grow in clusters at the tops of the branches.
They remain in bloom from June to August.
1092. Prop ERTIES AND Uses. The virtues of comfrey
are chiefly owing to its mucilage, which is very abundant in the
root. The latter, boiled in water, or milk, is employed in diar-
rhoea, dysentery, and soreness of the stomach, or bowels. It is
also useful in coughs, and affections of the lungs. People in the
country frequently employ it in combination with other medicines.
Comfrey makes an excellent poultice for white swelling, as will
be mentioned hereafter, in speaking of that disease.
COOL WORT,
Tiarella Cordifolia–The Leaves.
1093. Cool wort, called also mitre wort, gem fruit, and com-
mon tiarella, is found in woods, on shady banks, and in rich cedar
swamps, where the ground is not very wet. The leaves are
*. divided into lobes, bordered with roundish teeth,
hairy on both sides, and supported on footstalks eight or ten inches
high. The flowers are white, and make their appearance in June.
They are arranged in a spike, about an inch long, on the top of a
naked stem.
1094. The green leaves of the cool wort are remarkable for
having the taste and smell of a cucumber. They should be col-
lected in July, or about the first of August, dried without ex-
posure to a damp atmosphere, and preserved in sealed papers, or
covered boxes,

34

266 VEGETABLE MATERIA MEDICA.
1095. PROPERTIES AND Uses. Cool wort is a diuretic,
and is beneficial in gravelly complaints, gonorrhoea, and suppres-
sion of urine. In all cases where the urine is acrid, or thick and
high colored, it may be used with advantage. In burning or scald-
ing of the urine, also, it rarely fails to afford relief in two or three
hours. It is employed with advantage in affections of the liver,
dyspepsia, and acidity of the stomach. In the latter complaint, it
appears to counteract the acidity, and to restore the stomach to a
healthy tone. Women who are troubled with strangury, soon
after confinement, as happens now and then, will derive great ben-
efit from the use of this plant. The infusion, prepared by steep-
ing a handful of the dried leaves in a quart of boiling water, may
be employed freely as a drink. -
1096. My attention was first attracted to the coolwort by Dr.
Smith of Hallowell, Me. He informed me that eighteen years
ago, his wife was laboring under a difficulty of the urinary organs,
and one of her neighbors recommending cool wort as a remedy, a
trial of it was made with entire success, and Dr. Smith has con-
tinued to use the herb in his practice, ever since. I have recom-
mended cool wort to a number of patients within the last six
months, and they have all reported favorably of its effects. I be-
lieve this is the first time it has ever been introduced into any
work on materia medica.
ELECAMPANE.
Inula Helenium—The Root.
1997. Elecampane is a showy, luxuriant plant, cultivated in
gardens, and growing wild by roadsides. It has a thick, branch-
ing, fibrous root, and a straight, hairy, furrowed stem, four or five
feet high, and branching near the top. The leaves are large, ta-
pering, waved along the margins, deep green upon the upper sur-
ace, downy and whitish beneath, and from six to eighteen inches
in length. The flowers remain in bloom from July to August,
standing singly upon the ends of the stem and branches. They
are of a golden yellow color, and resemble those of the sunflower,
with the exception that they are considerably smaller.
1098. PRoPERTIES AND Uses. The root, when º
has a glutinous, nauseous, and slightly aromatic taste, succeede
by some bitterness, and a good deal of astringency. Its virtues
are yielded to alcohol, and water. A tea of it has been employ:
ed, both internally and externally, as a remedy in tetter, itch, and

WEGETABLE MATERIA MEDICA. 267
other diseases of the skin. It has been esteemed for its tonic and
diuretic properties, but it possesses these in a very inferior degree.
It is often made into a sirup for coughs, and was formerly em-
ployed by Dr. Thomson for this purpose, but of later years, he
has discarded it as rather too acrid and drying. A tea-spoonful of
the powder may be taken two or three times a day, in molasses
or honey.
1099. Those who value the elecampane, should dig the roots
in the autumn, and cut them into slips previous to drying. The
second year's growth is considered the best, as they are apt, after
this time, to be tough and fibrous.
FEATHERFEW-
Chrysanthemum Parthenium”—The Herb.
1100. The featherfew or feverfew, both of which names are
in common use, is occasionally found in a wild state, but is gem-
erally cultivated in gardens. It blooms in June and July. The
root is short and fibrous, with a round, branching stem, from six
inches to a foot in height. The leaves are numerous, of a yel-
lowish green color, and deeply cut into lobes or divisions, which
are bordered with acute teeth. Each of the branches is termi-
nated by a single flower, which consists of a white border, and a
yellow centre or disc.
1101. Prop ERTIES AND Us Es. The featherfew is a stim-
ulant and tonic, having a fragrant smell, and a bitter and aromatic
taste, with a slight degree of pungency. The warm tea is an
excellent remedy in colds, sudden attacks of disease, hysteric
complaints, irregularity of the monthly discharges, obstruction
of urine, flatulency, loss of appetite, dizziness, and unpleasant
sensations in the head. It should be prepared by steeping the
leaves and flowers, either recent or dried, in hot water. Boiling
diminishes some of its active properties. It is perfectly harmless,
and may be taken in almost any quantity. The green herb, in
the form of a poultice, is a valuable external application, in severe
pain or swelling of the bowels.
1102. The plant should be gathered when in bloom, divested
of its roots, and carefully dried in a chamber or loft, where the air
circulates freely. -
*
h -Metricaria parthenium of some botanists, and metricaria vulgaris of
others,

268 WEGETABLE MATERIA MEDICA.
FILEA.B.A.N.E.
Erigeron Canadense—The Herb.
1103. This plant, called also prideweed and coltstail, is to
be found by roadsides, and in pastures and neglected fields. It
varies from one to five feet in height, has a spindle-shaped,
fibrous root, an erect, furrowed, hairy, and branching stem,
which is thickly set with long, narrow, pointed leaves. These
are edged with hairs, and the lower ones are furnished with a few
remote teeth. The flowers are very small, white, numerous, and
disposed in little clusters on the branches. It blooms from July
to September.
1104. PRoPERTIES AND Uses. This plant is highly pun-
gent to the taste, with a slight degree of bitterness and astringency.
It is stimulant, tonic, and diuretic, and has high reputation as a
remedy in dysentery. The herb is steeped in hot water, and a
tea-cupful of the infusion administered every hour or two, until a
cure is effected. The plant possesses a combination of proper-
ties which renders it particularly useful in this disease. A gentle-
man in whom I have every confidence, informed me that he was
attacked with the cholera, while travelling in a stage coach, and by
chewing the leaves, and swallowing the juice of the herb, checked
the discharges without difficulty. I recollect a patient in Boston,
who was laboring under a severe attack of dysentery, and was under
treatment by Dr. Warren, but without any prospect of recovery.
He was much reduced in strength, and the discharges were pro-
fuse and bloody. Under these circumstances, he was induced
to drink freely of an infusion of fleabane, and in twelve hours, all
the unfavorable symptoms were arrested, and the patient consid-
ered himself entirely out of danger. He very soon recovered.
1105. The herb should be collected while in bloom. The
erigeron philadelphicum is said to be identical with this in med-
ical properties.
FIR BALSAM.
Pinus Balsamegº. The Balsam and Bark.
1106. Fir balsam is known by other names, as silver fir, and
balsam of Gilead. It is a native of the coldest North American
* .4bies balsamifera of Michaux.

Fir Balsarn.
ºr a rºle ºz º.
Pinus balsarnea
ºn ºchº & cer rºom, º,

WEGETABLE MATERIA MEDICA. 269
regions, inhabiting Canada, Nova Scotia, and Maine, where it at-
tains the height of forty or fifty feet. Michaux observes that it
does not appear to constitute masses of woods, but is scattered
in greater or less abundance through the forests of hemlock and
black spruce. In the United States, it extends as far south
as North Carolina, where it is chiefly confined to the moun-
tains. It is found also upon the summit of the Alleghanies,
and in the mountainous regions in the North Western Terri-
tory. In Massachusetts, it is much prized as an ornamental
tree, and is frequently cultivated in pleasure grounds. The
trunk, at the base, is twelve or fifteen inches in diameter, and
tapers gradually to the top. It has numerous branches, which di-
minish in length in proportion to their height, and form a beauti-
ful pyramid. The leaves are narrow, flat, grooved upon the up-
per surface, of a silvery whiteness beneath, and inserted in irregu-
lar rows on the sides and tops of the branches. The cones are
erect, of a purple color, and four or five inches long.
1107. The balsam is a transparent liquid, which collects spon-
taneously in blisters upon the trunk and branches, and exudes also
by making incisions into the bark. It is usually obtained by
puncturing the blisters, and receiving their contents into a spoon,
or some similar instrument. It is sold in England and the United
States, under the name of Canada balsam. It is feebly acted
upon by spirit of an inferior strength, but is dissolved in alcohol in
the proportion of one part to three.
1108. PROPERTIES AND Us Es. Fir balsam has a pleasant
odor, and an oily, and slightly bitter taste. In the form of tinc-
ture, it is useful in coughs, affections of the lungs, gleet, fluor
albus, gravelly complaints, and soreness of the stomach and
bowels. A tea-spoonful may be dropped on sugar, and taken at
a dose, repeating it three or four times a day.
1109. A plaster of fir balsam, says Dr. Logan, will heal bad
wounds in a very short time. It is also applied to burns and
scalds with great benefit.
1110. A decoction of the bark is an excellent remedy in diar-
rhoea and dysentery. It may be prepared as follows. Take a
piece of the bark about a foot long, and an inch and a quarter wide,
cut it into shreds, add a pint of water, and boil slowly in a cover-
ed vessel for half an hour; strain the decoction, and sweeten with
loaf sugar. The liquid thus obtained is of a reddish color, some-
what mucilaginous, and of a balsamic, and slightly bitter taste.
Children will take it freely, and it is particularly valuable in the
bowel complaints with which they are so often affected. It rare-
ly fails to cure, even in the very worst cases. It diminishes the

270 VEGETABLE MATERIA MEDICA.
pain and soreness of the bowels, and gradually checks the dis-
charges. Combined with slippery elm, it is still more efficient.
In this form also, it is highly beneficial in coughs, asthma, sore-
ness of the lungs, and diminished appetite.
GARDEN PEPPER.
Capsicum ſinnuum—The Pods.
1111. This is an annual plant, cultivated in gardens for do-
mestic use. The stem is one or two feet high, and furnished with
long pointed leaves. The blossoms are white. The pods are of
various sizes and shapes, but generally of a conical form, pointing
downward, and assuming a bright red color in the autumn. They
- have a biting, pungent taste, similar to that of the African pepper,
and may be used as a stimulant where the latter cannot be ob-
- tained. They should be collected when fully ripe, and dried in a
chamber or loſt, where there is a free circulation of air. They
are frequently plucked in the green state, and made into pickles.
The garden capsicum is far inferior, as a medicine, to that obtained
from Africa and the West Indies.
GOLDEN ROD. -
Solidago Odora—The Leaves and Flowers.
1112. The golden rod has a woody, branching, fibrous root,
which sends up a number of slender, hairy stems, rising sometimes
- to the height of five or six feet. The leaves are broad at the
base, three or four inches long, and taper gradually to an acute
- point. They are of a light green color, smooth upon the upper
- and lower sides, but rough along the edges. Held before the
light, they exhibit a number of beautiful transparent dots and veins.
The flowers, which are of a golden yellow color, are thickly
crowded upon the upper sides of horizontal branches, which are
given off toward the summit of the stem.
1113. According to Eaton, there are seventy species of the
golden rod in the United States, but the plant described above,
although nearly resembling many of them in appearance, may be
identified by the taste of the leaves or flowers, which is similar to
that of fennel or anise. Hence it has been distinguished by the
name of sweet-scented golden rod. It grows along hedges, and in
woods and fields, remaining in bloom from August to September.
I found an abundance of it in the summer of 1838, on the farm

S.
.-
Golden Rod Solidago tº do
ºzº Mºeº & Cº --
º ºst
-




VEGETABLE MATERIA MEDICA. 271
of Mr. Aaron Pollard, in the town of Berlin, Mass., where it was
confined to a piece of rocky ground, which had been newly clear-
ed, but not cultivated.
1114. Prop ERTIES AND Us Es. The leaves and flowers of
the golden rod have a warm, aromatic, and very agreeable taste.
They are moderately stimulant, and the tea, administered warm,
produces perspiration. It may be usefully employed in allaying
nausea, and as a remedy in pains of the stomach and bowels,
occasioned by wind. It is also a pleasant drink for children, and
may be administered freely. The strength of the plant is im-
paired by boiling. Its active properties reside in a volatile oil,
which has a pleasant odor, and is used to scent the bayberry snuff.
According to Pursh, the dried flowers are used in some parts
of the United States, as a substitute for common tea. The es-
sence, says Dr. Thomson, is beneficial in headach. The head
should be bathed with it, and a tea-spoonful taken internally. It
is also a pleasant addition to nauseous or disagreeable medicines.
GOLD THREAD.
Coptis Trifolia–The Root.
1115. This is an evergreen plant, and is found in Canada,
New England, and New York. In some places it is known by
the names of yellow root, and mouth root. Where the situation
is favorable, it grows in large beds, and entirely covers the ground.
It delights in swamps, morasses, and low damp woodlands, but is
found also on the W. Mountains in New Hampshire, and other
elevated regions.
1116. The roots are six or eight inches long, and of a bright
yellow color, appearing like threads of gold. The leaves are
smooth, polished, and veiny, resembling those of the strawberry,
being in threes at the top of a slender stem. They have an acute
base, and scolloped edges, with very minute, projecting teeth.
The flower is white, and supported at the top of a naked stem.
It makes its appearance in May, and is succeeded by a number of
seedvessels, disposed in the form of a star.
1117. PRoPERTIES AND Us Es. The root is bitter, and
yields its virtues to water, and alcohol, forming with the latter a
bright yellow tincture. It is not easily reduced to powder.
The people of New England chew it as a remedy in sore mouth,
and also employ the decoction as a gargle in putrid sore throat.


272 VEGETABLE MATERIA MEDICA.
It is a pleasant tonic, and in debility, or loss of appetite, may be
taken in the dose of a tea-spoonful, two or three times a day.
The tincture, prepared by adding an ounce of the roots to a pint
of alcohol, may also be taken in the dose of a tea-spoonful.
HOLLYHOCK.
ºfflthaea Rosea—The Blossoms.
1118. The hollyhock is a common plant in our gardens,
where it is chiefly cultivated for ornament. It has a branched and
tapering root, which sends up an erect, hairy, light green stem,
from six to eight feet high. The leaves are roundish, heart-
shaped at the base, wrinkled, hairy on both sides, and supported
on long, round footstalks. The margins are formed by angles or
projections, varying from five to seven in number, and bordered
with semi-circular teeth. The flowers exhibit a variety of colors,
but the most predominant are red, white, and purple. They are
thickly crowded upon a long, terminal spike, and bloom from
July to August.
1119. ProPERTIES AND Usps. The blossoms contain a
large proportion of mucilage, both in the recent and dried state,
which renders them useful as a demulcent. The root is also
mucilaginous, and if cut into shreds, and boiled, yields this prop-
erty in considerable abundance. The blossoms are sometimes
used in making the anti-dyspeptic bread.
HORSE RADISH.
Cochlearia Armoracia—The Root.
1120. Horseradish is cultivated in gardens for culinary pur.
poses, and is too well known to need a description. The grated
roots, mixed with water, or vinegar, are in general use as a condi-
ment. They are of a warming nature, but too volatile to be of
much service as a stimulant. They invigorate the digestive or
gans, and render the appetite more keen. The infusion, taken
warm, operates as an emetic. It also increases the secretion of
urine, and is sometimes employed by the old school physicians
for that purpose. A blister may be raised by an external appli-
cation of the leaves. Horseradish is not used as a medicine in
the reformed practice.
_.

VEGETABLE MATERIA MEDICA. 273
HOARHOUND.
JMarubium Vulgare—The Herb.
1121. Hoarhound is cultivated in gardens, and grows wild by
roadsides. It has a fibrous root, and a whitish, hairy, four cor-
nered stem, which rises from twelve to eighteen inches high:
The leaves are roundish, wrinkled, edged with teeth, covered
with a white down on the under surface, and supported in pairs on
short footstalks. The flowers are small and white, growing in
whorls around the stem, and expanding in July and August.
1122. Prop ERTIES AND Uses. The hoarhound has an
aromatic smell, which is diminished by drying, and a bitter,
though not disagreeable taste. It is a stimulant, and tonic, and if
given in large doses, will act upon the bowels. An infusion ºf
the leaves, sweetened with molasses or honey, is beneficial in
asthma, coughs, hoarseness, jaundice, suppression of the menses,
indigestion, and worms. Dr. Withering observes, that a young
man who had been salivated by mercury, and continued in that
state for a year, baffling the application of all remedies, was
speedily cured by the use of hoarhound tea.
IRISH MOSS.
Fucus Crispus.
1123. This is a sea weed, called also carrageen, which I have
found on the Nantasket, Mansfield, and other beaches in Massa-
chusetts. It is thrown up in large clusters by the tides, in July
and August, and may be collected in great abundance. The
leaves, if they may be so termed, are small, thick, and branched.
The moss at first, has a blue, yellow, or darkish tint, but assumes
a beautiful white color, on being soaked in fresh water. It is sold
in Boston, and other cities, for various domestic purposes. It is
manafactured into size, and is sometimes used instead of glue, and
isinglass. It makes superior blanc mange, the directions for
which will be given in a subsequent place. The imported Irish
moss was sold at a high price in this country, but is now consid-
ered inferior to this article, which may be obtained at a trifling
cost.
35

274 VEGETABLE MATERIA MEDICA-
JUNIPER.
Juniperus Communis–Berries and Leaves.
1124. There are two varieties of the juniper, one of which
attains the height of twelve or fifteen feet, while the other is a low
shrub, spreading its branches upon the ground, and forming circu-
lar beds several rods in circumference.* The latter is peculiar to
New England, and is usually found in dry woods, and on stony
hills, where the soil is poor, and uncultivated. The leaves are
in threes, very numerous, sharply pointed, about a half an inch
long, and grooved upon the upper surface. The flowers expand
in May, and are succeeded by berries, which do not ripen until
the ensuing year, when they assume a dark purple color, and
are about the size of a pea.
1125. The medical virtues of the juniper berries depend on a
volatile oil, which may be obtained by distillation. It is this oil
which imparts to Holland gin its peculiar flavor, and well known
diuretic properties. The berries of this country are inferior to
those which come from Europe. Caution should be observed,
however, in the purchase of the latter, as the refuse berries which
have been employed in making gin, are sometimes spuriously
vended by the druggists as a genuine article. In some parts of
France, the inhabitants steep the berries in water, which they em-
ploy in a variety of diseases. In Germany, they put them into
sauce which they eat with meat, to give it a flavor.
1126. PROPERTIES AND Us Es. Juniper berries have a
sweet, pungent, and aromatic taste, and on being chewed for some
time, manifest a slight degree of bitterness. They are a pleasant
diuretic, and impart a violet odor to the urine. They may be
used to advantage in dropsical complaints, flatulency, and diseases
of the urinary passages. The berries may be eaten, or employed
in the form of a tea, prepared by steeping two large table-spoonfuls
of them, previously bruised, in a pint of boiling water, the whole
of which infusion may be taken in the course of twenty four hours.
If the oil is employed, the usual dose is from ten to fifteen drops,
three times a day. The leaves are also diuretic, but rather more
bitter than the berries, and may be used as a substitute.
* This variety is the prostrata of Muhlenberg, and the depressa of Eatºn:
Mr. Nuttall told me he thought Dr. Torrey would make a new species of it in his
forthcoming work on botany.
VEGETABLE MATERIA MEDICA. 275
LIFE EVERLASTING.
Gnaphalium Polycephalum—The Herb.
1127. This plant inhabits dry pastures, and neglected fields,
and rises to the height of one or two feet. The stem is thickly
branched toward the top, and covered with a whitish down. The
Heaves are long, narrow, acute, waved or irregular along the mar-
gin, green above, and wooly beneath. The flowers are of a dull
white color, and grow in thick, terminal clusters, making their
appearance in July or August.
1123. Prop ERTIES AND Uses. The herb has a pleasant
odor, and an aromatic, and slightly bitter taste. The infusion,
taken in warm draughts, produces perspiration, and is useful in
colds, fevers, and influenza. It is employed also in fluor albus,
and consumption. The leaves and blossoms are in much repute
as a fomentation in quinsy, and other forms of sore throat.
MAYW.E.E.D.
Anthemis Cotula–The Herb.
1129. The mayweed is an annual plant, growing along road-
sides, in old fields, and near towns and villages. It is distinguish-
ed by a variety of names, as wild chamomile, stinking chamomile,
dilweed, dilly, and fieldweed. The root is small and fibrous.
The stem is smooth, round, branching, and a foot or eighteen
inches high. The leaves have a ragged or feathery appearance,
and consist of little threads or fibres, which are disposed in two
rows along a slender footstalk. The flowers are white, supported
singly on the tops of the branches, and continue in bloom from an
early period in summer until late in the autumn.
1130. PROPERTIES AND Uses: Mayweed has a strong,
bitter, pungent, and rather disagreeable taste. Its peculiar smell
resides in a volatile oil, which is the most concentrated in the
flowers. It is usually employed in the form of tea, which should
be prepared by steeping the herb in hot water. Drank freely on
going to bed, it is an excellent remedy in sudden colds, and slight
attacks of disease. It produces a copious perspiration, and is ſol-
lowed, in some instances, by vomiting. The ordinary dose is
one or two tea-cupfuls, but if necessary, it may be taken in a much
larger quantity.

276 VEGETABLE MATERIA MEDICA.
MEADOW FERN.
JMyrica Gale–The Burrs or Seed Vessels.
1131. The meadow fern, sweet gale, or bog myrtle, as this
shrub is variously called, is to be found in wet meadows, and
about the edges of ponds and streams, where it often grows in
large beds or patches. The stem is much branched, from two to
five feet high, and covered with a reddish bark. The leaves are
narrow at the base, increasing in width toward the end, and bor-
dered with a few remote teeth. During the summer, small buds
may be observed to form on the male shrub, which expand about
the first of the ensuing May into long, scaly looking flowers. On
the fruitful shrub, the flowers present a different appearance, and
are succeeded by small green burrs or seed vessels, which
grow in clusters upon the branches.
1132. The meadow fern is abundant in Massachusetts and
Connecticut, but is rare in many of the other States, although it
has a tolerably wide geographical range. A few of the shrubs
grow in Bartram's Botanic Garden, near Philadelphia, where I pro-
cured specimens for illustration. They were introduced into the
garden by Dr. Logan, who obtained them several years ago from
New England. The burrs attain their full size about the middle
of August, when they should be collected and carefully dried.
Rubbed upon the skin, they stain it yellow. The leaves are used
in some parts of Scotland instead of hops, for making beer. In
Sweden, the inhabitants employ them to cure the itch.
1133. PRopp RTIES AND Us Es. The meadow fern burrs
have a fragrant odor, and an aromatic, bitter, and pungent
taste. Infused in spirit, they make a yellow tincture, which is
used in some parts of New England as a tonic or restorative.
They are particularly valuable as an external application in itch,
poison, and all troublesome humors, or eruptions, and may be em-
ployed either in decoction, or as a component part of the meadow
fern ointment. The decoction, sweetened with honey, and taken
in the quantity of a tea-cupful, three times a day, is also beneficial
in the above complaints, having the effect to invigorate the stom:
ach, purify the blood, and restore the skin to a healthy tone. I
have frequently recommended it as an injection into the urethra,
in gonorrhoea, and gleet, and always with good results.

-
--- re-
--
-
-
-º-, -e -
ºn-º-º-º: --> ---------


WEGETABLE MATERIA MEDICA. 277
MULLEIN.
Verbascum Thapsus—The Leaves.
1134. The mullein is a biennial plant, growing by roadsides,
and in neglected fields. The root is large, tapering, and some-
what fibrous. The stem is erect, hairy, and from three to ten
feet high. The leaves, which gradually diminish in size as they
approach the top, are tapering, wooly on both sides, slightly
waved along the margins, and prominently veined beneath. The
flowers are yellow, blooming from June to August, and thickly
crowded upon a long round spike terminating the stem.
1135. Prop ERTIES AND Us Es. The leaves of the mullein
are mucilaginous and bitter, and are sometimes employed as an
emollient poultice. Boiled in vinegar, or bruised, and saturated
with rheumatic drops, they may be applied with advantage to
offensive sores, swellings, and contracted sinews. A decoction
of the leaves, prepared with new milk, and sweetened with sugar,
is used as a remedy in diarrhoea and dysentery.
MUSTARD.
Sinapis Nigra—The Seed.
1136. Mustard is an annual plant, and is cultivated in gar-
dens. It also springs up spontaneously in waste grounds, and
about houses. The stem is smooth, branching, and three or four
feet high. The lower leaves are lobed at the base, and bordered
with teeth of various sizes. The upper leaves are narrow, taper-
ing, and smooth along the edges. The flowers are yellow, appear-
ing in June and July, and arranged on long, thread-like receptacles.
The seed vessels are erect, four cornered, and bluntly pointed.
1137. PROPERTIES AND Us Es. Mustard, when reduced to
a powder, has a pungent smell, and an acrid, fiery taste. Mixed
with water, it is much used as a condiment. It does not ap-
pear, however, to be a very pure stimulant. Beaumont, in his
experiments on St. Martin, found that it produced a morbid con-
dition of the stomach, and retarded the process of digestion.*
This may not uniformly be the case, but experience has proved
* Beaumont’s Experiments, p. 242. Plattsburgh, 1833.

278 VEGETABLE MATERIA MEDICA. -
that the internal use of it is rather injurious than otherwise. A
large tea-spoonful of the powder, mixed with warm water, acts
promptly as an emetic. Applied to the skin in the form of a
poultice, it causes redness and burning pain, the latter of which
usually becomes insupportable in less than an hour, and if the
. be continued beyond this time, it is apt to be “fol-
owed by severe local inflammation, which frequently ends in gan-
grene, and may even destroy the patient.”
PENNYROYAL.
Hedeoma Pulegioides—The Herb.
1138. This is a well known annual plant, which grows in dry
fields and pastures, and is common throughout the United States.
The root is small, yellowish, and fibrous. The stem is erect,
hairy, a foot or more high, and very branching. The leaves are
small, acute, somewhat hairy, bordered with a few remote teeth,
and supported on short footstalks. The flowers are small, of a
pale blue color, arranged in whorls around the stem and branches,
and continue in bloom from July to September.
1139. PRoPERTIES AND Us Es. Pennyroyal has a pungent
and aromatic taste. Its active properties reside in a volatile oil,
which may be procured by distillation. The infusion is *..."
and grateful to the stomach, and is useful in allaying nausea an
vomiting. In large draughts, it promotes perspiration. Taken
freely on going to bed, it is an excellent remedy for a sudden
cold, or slight attack of disease. Combined with gayenne, it may
be given with great advantage in obstruction of the menses, and
hysterical complaints. It affords relief in flatulency, and pains of
the stomach and bowels, and for this purpose may be given freely
to children. It is an excellent drink, also, during a course o
medicine. A tea-spoonful of the essence, or a few drops of the
oil, may be advantageously employed to correct the taste of un-
pleasant medicines. The herb put into water which has become
unwholesome during a sea-voyage, will give it an agreeable flavor,
and render it less injurious to the system.
- -
* Eberle’s Therapeutics, 4th edition, vol. ii. p. 264.


VEGETABLE MATERIA MEDICA. 279
PEPPER SAUCE.
Pods of the Capsicum steeped in Vinegar.
1140. Pepper sauce is made of the West India bird peppers,
which are collected when green, and packed in barrels, with salt
sufficient to preserve them. When they arrive in this country,
they are taken from the brine, put into bottles, and covered with
good cider vinegar, which constitutes the pepper sauce. If the
peppers are of a good quality, and have been well preserved, vin-
egar may be applied to them a number of times, before their
strength will be exhausted. -
1141. PRoPERTIES AND Us Es. Pepper sauce, though hot
or fiery in the mouth, has a pleasant taste. It is an excellent con-
diment, and gives a fine relish to meat, and other articles of food.
A table-spoonful several times a day, will generally relieve cos-
tiveness. In dyspepsia, coldness of the stomach, flatulency, loss
of appetite, ague and fever, pain in the bowels, and a chilly, or
languid state of the system, it is highly beneficial. If the food
causes distress, a table-spoonful of it will in most cases afford re-
lief. It is also a valuable external application in pains, swellings,
bruises, and gouty, or rheumatic affections.
PIPSIS SEWA.
Pyrola Umbellata”-The Roots and Leaves.
1142. This is a small evergreen plant, known by a variety
of names, as umbelled wintergreen, prince's pine, king's cure,
green leaf, rheumatic weed, and ground holly. It has a yellowish,
creeping root, which forms a net-work just beneath the surface of
the ground, and sends up stems at various distances. These
are somewhat angular, rough with the scars of preceding leaves,
and six or eight inches high. The leaves vary from one to two
inches in length, and are tapering at both ends; they are firm and
thick, edged with acute teeth, of a dark, shining green upon the
upper surface, paler beneath, and disposed in irregular whorls, of
which there are generally two on the same stem. The flowers are
of a white color, tinged with red, supported on nodding footstalks,
which rise two or three inches above the leaves. The seed-vessels
*The chima phila wimbellata of Pursh, Eaton, and Barton.


280 WEGETABLE MATERIA MEDICA.
are roundish, divided into five cells, and contain a large number of
minute seeds.
1143. The pipsissewa is found in all parts of the United States,
growing in dry woods, and on mountainous ranges shaded by trees.
The flowering season is June and July. It is much in use as a
domestic remedy, and was employed by the aborigines in a variety
of complaints, especially rheumatism. It should be collected early
in the spring, or late in the autumn, as the leaves become of a
dark color in drying, and lose a portion of their strength.
1144. PROPERTIES AND Us Es. The root of the pipsissewa
has an astringent, sweetish, and bitter taste, succeeded, on being
chewed, by a pungent or biting sensation, which continues in the
mouth for two or three hours. The plant is tonic, diuretic,
and in some degree a nervine. A decoction of the fresh bruised
roots and leaves, is employed in cancers, scrofulous tumors,
dropsy, rheumatism, and diseases of the urinary organs. Where
the powder is the most convenient form of the medicine, a tea-
spoonful of it may be administered at a dose, steeping it in hot
water, and repeating it two or three times a day. Sugar may be
added to suit the taste. The decoction is an excellent wash for
offensive or badly conditioned sores. I have frequently employed
pipsissewa, in combination with other articles, as an alterative or
purifying medicine, but am inclined to think that it is too acrid
for internal use. The leaves, it will be remembered, if applied
externally in the form of a poultice, will irritate the skin, and
produce a blister.
PRICRLY ASH.
Zanthorylum Frawineum—The Bark and Seed Wessels.
1145. The prickly ash or toothach bush is a shrub, rising to
the height of ten or twelve feet. It is covered with a grayish or
ash colored bark. The branches are armed with scattered
prickles, which grow singly, or in pairs. The leaves are ar:
ranged in two rows along the sides of a footstalk, with an odd
and generally a larger one at the end; they are an inch and a half
or two inches long, with prominent veins beneath, and an acute,
tapering point. The footstalk is sometimes prickly, and some-
times unarmed. The flowers are small, and of ºyellow coloſ;
growing in little clusters close to the branches. They appear in
May, in advance of the leaves. The seed vessels have the ap-
pearance of small berries, and during the summer change from a







VEGETABLE MATERIA MEDICA. 281
green to a red; in the autumn, they assume a brownish color, and
open by three valves, exhibiting a black, polished seed in the
Centre. - -
1146. The prickly ash is found in the Northern, Middle, and
Western States, inhabiting woods, and moist shady places. It
appears to be rare in Massachusetts. The only specimen of it
which I have seen, was in West Cambridge, near the dwelling
house of Mr. Nathaniel Hill. Dr. Bigelow, however, speaks
of a thicket of the shrubs which he accidentally discovered in
a wood near Medford, six miles from Boston. The prickly ash
is sometimes confounded with the aralia spinosa or angelica tree.
The latter has a yellowish bark, with leaves arranged upon a di-
viding footstalk, and flowers disposed in large, spreading clus-
ters. -
1147. PR ope, RTIES AND Us Es. The seed vessels have an
aromatic taste, and on being chewed for some time, produce a
burning sensation in the mouth, which continues for a quarter or
half an hour. The bark of the stem and root is also pungent, but
in an inferior degree, and has a slightly bitter taste. The seed
vessels are very strong and active in the recent state, but their
power is greatly diminished by keeping.
1148. Prickly ash warms and invigorates the stomach, strength-
ens the digestive powers, and promotes a free perspiration. It is
an approved remedy in ague and fever, rheumatism, pains in the
stomach and bowels, dyspepsia, drowsiness, cold hands and feet,
and all affections i. on a sluggish circulation. Half a
tea-spoonful of the powdered bark, or seed vessels, steeped in
two thirds of a tea-cupful of sweetened water, may be taken at a
dose, and repeated two or three times a day.
1149. The seed vessels are employed to flavor the wine bit-
ters, and other medicines.
1150. The bark of the prickly ash is sometimes chewed to
relieve the toothach, and hence the name of toothach bush. A
species of the shrub grows in the West Indies, which is used in
decoction, both internally and externally, for the cure of malig-
nant sores.
1151. Carver, who travelled among the North American In-
dians, in 1740, says that they make much use of the prickly ash.
They prefer the bark of the root, which they steep in boiling water.
He relates the case of a trader, who was violently attacked with
gonorrhoea, and was soon unable to travel. Application was
made to an Indian chief, who promised a speedy and effectual
cure. He prepared a tea of the prickly ash bark, by the use

36
282 VEGETABLE MATERIA MEDICA.
of which, great relief was afforded in a few days, and in a fort-
might the trader was perfectly cured, and enabled to pursue his
journey.”
PEPPERMINT.
JMentha Piperita—The Herb.
1152. The peppermint is a native of Great Britain, but has
been introduced into this country, and is common throughout the
United States. The root is creeping and fibrous. The stems are
erect, four cornered, channeled, purplish, somewhat hairy, branch-
ed toward the top, and from one to two feet high. The leaves
are tapering, somewhat wrinkled, hairy, edged with acute teeth,
and supported on short footstalks. The flowers are of a purple
color, and appear in August, arranged in blunt, terminal spikes.
1153. The peppermint prefers a wet or damp situation, and
is usually found in meadows, and along the margins of streams.
It is extensively cultivated in some parts of the United States for
its volatile oil, which is in popular use as a domestic medicine.
It has been observed, however, that it requires to be transplanted
every three years, or it degenerates in quality, and becomes little
better than spearmint.
1154. PROPERTIES AND Us Es. Peppermint has a pleasant
odor, and a pungent, aromatic, and somewhat bitter taste, accom-
panied with a remarkable sensation of coolness. The infusion
promotes perspiration, and may be usefully employed in colds,
flatulency, pains in the stomach and bowels, headach, nausea, and
vomiting. A tea-spoonful of the essence in warm water, sweet-
ened, may be used as a substitute for the tea. Dropped on loaf
sugar, also, the essence is very grateful to the stomach, and is a
convenient form of the medicine for children.
RED CLOWER.
Trifolium Pratense—The Blossoms.
1155. Red clover is too well known to need a description.
The blossoms boiled in water, until a strong decoction is pro-
cured, and the liquid simmered over a slow fire until it becomes
* Carver's Travels, p. 369.


VEGETABLE MATERIA MEDICA. 283
about the consistence of tar, forms the cancer plaster of Dr.
Thomson, which has gained so much reputation in the cure of
cancers, burns, and various ill conditioned sores. The particular
mode of preparing the plaster will be described hereafter among
the compounds.
SARSAPARILLA.
..?ralia .N’udicaulis—The Root.
-
1156. This plant is called wild sarsaparilla, false sarsaparilla,
and small spikemard. It is found in woods and thickets, from
Cañada to Carolina, delighting in a rich soil. It has a perennial,
creeping root, about as thick as the finger. The stem is one or
two feet high, and divides into three branches, each of which is
furnished with three, or five leaves. These are roundish at the
base, acute at the point, and bordered with fine teeth. The
flowers are of a yellowish or greenish color, appearing in May, or
June, and disposed in clusters at the top of a naked stem, which
does not rise so high as the leaves. The fruit consists of berries
about as large as those of the common elder.
1157. Prop ERTIES AND Us Es. Sarsaparilla is a gentle
stimulant, and in infusion or decoction, is capable of exciting per-
spiration. It is a popular remedy in scrofula, chronic rheumatism,
syphilis, diseases of the skin, and mercurial salivation. It is given
also in coughs, and affections of the lungs, but I have known it to
do more injury than good in these complaints. It is generally
used in the form of sirup, but may be employed in decoction,
sweetened with sugar, or honey. The Indians apply the roots, in
the form of a poultice, to wounds, and ulcers.
SRUNK CAB.BA.G.E.
Ictodes Foetidusº-The Root.
1158. This plant, known also by the name of fetid hellebore,
is the product of swamps, and wet or damp meadows. It has an
offensive odor, resembling that of the animal after which it is
named. The root is as large as one's wrist, and gives off numer-
* This plant has various generic names, as pothos, symptocarpus, and dra-
contium.


284 WEGE TABLE MATERIA MEDICA.
ous horizontal fibres, which creep through the wet soil or mud to
the distance of one or two feet. The flowers appear in March or
April, before any other part of the plant, covered by an appen-
dage somewhat in the shape of a boat, which is generally of a pur-
ple color, variegated with spots of yellow and green. The
leaves are numerous, very large, and grow from the root on long
footstalks, which are grooved or hollowed in front.
1159. The skunk cabbage is abundant throughout the North-
ern and Middle States. The root should be collected early in
the spring, or in the autumn after the leaves have decayed. It
loses a portion of its strength by drying, and after the first season
becomes almost inert.
1160. PROPERTIES AND Us Es. The root has a pungent
or fiery taste, which becomes very painful to the mouth and lips,
and continues for several hours. The powder is given to children
in half tea-spoonful doses, to cure the worms, and to adults in
double the quantity, two or three times a day, as a remedy in
asthma, coughs, and diseases of the lungs. Mixed thoroughly
with molasses, or honey, it may be swallowed without much in-
convenience from its pungency.
1161. Dr. Thomson formerly employed the root in his
cough powder, but he has now entirely laid it aside, and desired
me to omit a notice of it in the new edition of his work. It is
a narcotic, and cannot always be used with safety. The United
States Dispensatory says, “In large doses it occasions nausea
and vomiting, with headach, vertigo, and dimness of vision.”
Dr. Bigelow asserts, that these effects are produced by thirty
grains of the freshly powdered root, which is about a tea-spoonful.
SLIPPERY ELM.
Ulmus Fulda. The Inner Bark.
1162. The slippery elm, called also red, and sweet elm, is
found in almost every part of the United States, preferring a dry
soil, and an open, elevated situation. Michaux observes that it is
the most abundant in Ohio, Kentucky, and Tennessee. It rises
to the height of forty or fifty feet, with a diameter of fifteen or
twenty inches. The leaves are hairy and rough on both sides,
terminated by a long, slender point, and bordered with acute,
double teeth, which are slightly hooked at the ends. A fort-
night previous to the development of the buds, they are, coy-
ered with a dense, yellowish wool. The flowers appear in April,



VEGETABLE MATERIA MEDICA. - 285
in advance of the foliage, and grow in clusters upon the ends of
the young shoots.
1163. The bark of the elm should be procured in the spring,
just as the sap begins to rise, as it can then be detached without
difficulty. The mode of drying it, is the same as that recom-
mended for the poplar bark. (890.) When of a good quality, it
is brittle, and highly mucilaginous. It is sometimes adulterated
with the bark of the white elm,” which is tough, fibrous, and of
but little value in medicine.
1164. PRoPERTIES AND Uses. Slippery elm bark abounds
in mucilage, which is readily extracted by water. It is very nu-
tritious, and has supported life in the absence of other food. Dr.
Strong mentions the case of a soldier who lost his way in the
woods, and subsisted entirely on this bark, and the bark of sassa-
fras, for ten days. The inhabitants of Norway, according to Dr.
Cutler, use it in making bread, when there is a scarcity of grain.
It is a nourishing article of diet, and may be given advantageously
to feeble or emaciated patients, particularly those in consumption.
The infusion is of great value in diarrhoea, dysentery, coughs,
pleurisy, strangury, sore throat, and inflammation of the stomach
and bowels. It produces a soothing effect throughout the whole
system. In dysentery it is particularly beneficial. Dr. Eberle
acknowledges, that in this complaint it has effected a cure when all
other remedies were unavailing. He seldom prescribed for the
disease, without ordering it to be taken in copious draughts. -
1165. The following preparation of elm is an excellent rem-
edy in coughs. Take half a tea-spoonful of cayenne, a tea-spoon-
ful of powdered elm, and two or three tea-spoonfuls of loaf sugar;
rub them together, and add a tea-cupful of hot bayberry tea; stir
until a jelly is formed, and flavor with nutmeg, cinnamon, or some
other spice. A tea-spoonful of this jelly may be taken whenever
the cough is troublesome.
1166. A table-spoonful of powdered elm, boiled in a pint of
new milk, affords a nourishing diet for infants, weaned from the
breast. It prevents the bowel complaints to which they are sub-
ject, and renders them fat and healthy. -
1167. Slippery elm is a prominent ingredient in poultices, as
will be specified hereafter. In diarrhoea, dysentery, tenesmus,
and piles, it is also an important addition to the injections. For
further information respecting the different preparations of elm,
the reader is referred to the index.
* Ulmus Americana.
t Eberle's Therapeutics, 4th edition, vol. ii. p. 453.


286 WEGETABLE MATERIA MEDICA.
SPEARMINT.
JMentha Viridis—The Herb.
1168. The spearmint is abundant throughout the United States,
growing in meadows, and low damp ground. The root is creep-
ing, and fibrous. The stems are erect, branching, four cornered,
and one or two feet high. The leaves are without footstalks, nar-
row, tapering, sharp at the point, and bordered with acute teeth.
The flowers are small, of a light purple, and disposed in scattered
whorls upon long slender spikes.
1169. This plant is extensively cultivated in some parts of
the United States for the sake of its volatile oil. The essence,
prepared by the druggists, is frequently mixed with turpentine,
and if employed internally, will sometimes occasion strangury,
and a burning sensation in voiding urine. The herb should be
collected in clear, dry weather, just as the blossoms are beginning
to expand.
1170. PROPERTIES AND Us Es. Spearmint has a pleasant,
aromatic odor, and a pungent, agreeable, and slightly bitter taste.
It is a stimulant, and tonic, and will strengthen and invigorate the
stomach. The infusion is used to allay nausea and vomiting, for
which it sometimes answers an excellent purpose, though it is by
no means a specific, as Dr. Thomson seems to imagine. It is
also beneficial in pains of the stomach and bowels, and to expel
wind. The essence, in the dose of a tea-spoonful, mixed with
sweetened water, may be used instead of the tea. This form of
the medicine is very beneficial in the bowel complaints of chil-
dren, and will often effect a speedy cure. Cotton or lint, mois-
tened with the essence, and applied to piles, will usually give im-
mediate relief. I have recommended the remedy in a number of
instances, where the patient was threatened with an attack of the
piles, and never knew it to ſail in removing the complaint. The
application may require to be repeated two or three times. It
produces a pungent sensation, which becomes very painful in
fifteen or twenty minutes, when it may be removed.
SPICY WINTERGREEN.
Gaultheria Procumbens—The Leaves.
1171. This pretty little evergreen is found in pine woods,
and on hills and mountains, beneath the shade of trees. It is
scattered over the country from Canada to Georgia, and grows in


Secº wintergreen Gaul the
ºſ- ºn º
A-


VEGETABLE MATERIA MEDICA. 287
large beds, delighting in a dry, cold soil. It is known in different
places by the names of partridge berry, deer berry, box berry,
grouse berry, and mountain tea. It is also called chequer berry,
but this name more properly belongs to the mitchella repens,
which has a creeping stem, and small round leaves, about the
size of the finger nail. - -
1172. The spicy wintergreen has a creeping root, and small,
round stems, of a reddish color, and four or five inches high.
These are crowned at the summit with a tuft of unequally sized
leaves, which are tapering at both ends, and bordered with a few
minute teeth, terminating in bristly and scarcely perceptible points.
The flowers are white, drooping, and contracted at the mouth,
appearing from June to September. The berries are red, about
the size of a pea, and of a spicy and agreeable taste. -
1173. The spicy wintergreen is well known for its fragrant
oil, which it yields in a small quantity by distillation. The ber-
ries remain on the plant until late in the spring, when they are
collected by people in the country, and sent to market, or used for
domestic purposes. They have the reputation of being a diuretic,
and are frequently employed for that purpose. They are also
given to children, in milk, sweetened with sugar, or molasses, to
regulate the bowels. They are eaten with avidity by partridges,
deer, rabbits, and various other kinds of game, and it is said they
impart a fine flavor to their flesh. A cordial of an agreeable taste
is made from the berries and leaves, which is employed, among
other things, in diseases of the urinary organs.
1174. PRoPERTIES AND Us Es. This plant is aromatic,
and somewhat astringent. The infusion, prepared by steeping
the leaves in hot water, and adding a portion of sugar and milk, is
pleasant to the taste, and invigorating in its effects, being preferred
by some people to common table tea. It is also a useful remedy
in diarrhoea, and the bowel complaints of children. The United
States Dispensatory says, the spicy wintergreen has been employ-
ed with a view to increase the secretion of milk, but this is pro-
bably a wild and foolish conjecture. The oil closely resembles
that of the black birch in taste, and odor, and is used to flavor
medicines, and impart a scent to the headach snuff.
SUMMER SAVORY.
Satureja Hortensis—The Herb.
1175. The summer savory has a small, tough, fibrous root,
sending up an erect, somewhat hairy stem, which is thickly


288 VEGETABLE MATERIA MEDICA.
branched, often of a purplish color, and a foot or eighteen inches
high. The leaves are acute, narrow, of a dark green color, and
from a half to three quarters of an inch in length. The flowers
are small, and of a light purple, growing along the stem and
branches somewhat in the form of whorls, and making their ap-
pearance in August and September.
1176. Summer savory is cultivated in gardens for culinary
purposes; and it is also used by people in the country as a remedy
in colds, and slight attacks of disease. Within a few years, it has
been sold extensively as an article of medicine.
1177. Properties and Uses. This excellent little herb
has a sharp, pungent, and aromatic taste. Its active properties
reside in a volatile oil, which may be separated by distillation.
The infusion warms and invigorates the stomach, promotes per-
spiration, and iſ taken at bedtime, will usually arrest a sudden
cold, or slight febrile attack. It may also be used as a drink dur-
ing the operation of an emetic. The water, which is left after
distillation, will answer all the purposes of the infusion. It is hot
and penetrating to the taste, and a very active stimulant. It may
be preserved in bottles a long time, by adding a pint of brandy to
the gallon. The oil dropped on cotton, or lint, and inserted into
a carious tooth, will often afford relief.
*Assy.
Tanacetum Vulgare–The Herb.
1178. Tansy has a woody, creeping, fibrous root. The
stems are erect, slightly grooved, two or three feet high, and
branched toward the top. The leaves are formed by a number
of narrow leaflets, arranged in two rows along a common foot-
stalk, and divided into small lobes, which are bordered with acute
eeth. The flowers are yellow, and grow in thick clusters at the
tops of the branches. -
1179. The tansy is cultivated in gardens, and grows wild, by
roadsides. It remains in bloom from July to September. The
leaves dye green, and the flowers yellow. In some parts of
Sweden and Lapland, a decoction of tansy is employed in the
form of a bath, to assist in child-birth. The odor of the plant is
much diminished by drying.
1180. Prop ERTIES AND Uses. The tansy has a stronº
penetrating odor, and a bitter and pungent, though not disagree”


WEGETABLE MATERIA MEDICA. 289
ble taste. It is moderately stimulant, and tonic. The country
people infuse it in rum, and employ the tincture, thus prepared,
to give them an appetite, taking half a wine-glassful in the morn-
ing before breakfast. The practice, however, often leads to in-
temperance, and is therefore objectionable. The infusion of tansy
is usefully employed in nausea, indigestion, hysteria, suppression
of the menses, strangury, and weakness of the kidneys. It is also
given to children afflicted with worms. The powdered leaves,
warmed or heated by the fire, are an excellent application for sprains
and bruises, tending to allay the pain, and diminish the swelling.
UNBOLTED WHEAT BREAD.
1181. It may appear somewhat novel to mention bread as an
article of the materia medica, but believing as I do, that, when
properly prepared, it is of inestimable value, both as food and
medicine, I cannot refrain from giving it a place. If there is any
one thing comprised in our daily food more injurious than another,
it is the bread made of superfine flour, and it is often rendered
still more pernicious by the addition of alum, pipe clay, plaster of
paris, blue vitriol, and many other injurious or poisonous substan-
ces, employed by the bakers. It gives rise to costiveness in its
most obstinate form, and with this springs up the ten thousand dis-
eases with which poor human nature is afflicted. People then
avail themselves of Brandreth's pills, or some other purgative,
hoping thereby to obtain relief, and thus they go on from week to
week, and from month to month, eating the white bread, and irri-
tating the bowels with physic, until they finally sink into the
grave. Near the close of the last century, owing to a scarcity of
provisions, eighty thousand English soldiers were fed on bread
made of unbolted meal, and such were its effects, that the officers
and physicians of the army declared the soldiers were never before
so healthy and robust—and that disease of every kind had almost
disappeared from among them.*
1182. The inhabitants of Westphalia, says a writer in Ree's
Cyclopedia, are a living testimony to the salutary effects of this
sort of bread—and it is remarkable that they are very seldom at-
tacked by acute fevers, and those other diseases which arise from
bad humors.
1183. Magendie, says a medical writer, tried the experiment
of feeding dogs upon white bread and water, but all the animals
* Science of Human Life, vide Memoirs of the Philadelphia Agricultural So-
eiety, vol. i.

37

290 VEGETABLE MATERIA MEDICA.
died within fifty days, whilst those to whom he had given house-
hold bread, which only differed from the white bread by retaining
a quantity of the bran, continued to thrive upon it very well. It
is remarkable, that one of the dogs which died, had been put upon
his usual diet between the fortieth and forty fifth days, but nothing
could save him from the fatal effects of the white bread.
1184. The great objection to the bread manufactured from
fine wheat flour, is, that it is too concentrated, and requires the
bran or innutritious part of the grain, to adapt it to the peculiar
wants of the system. Man cannot long subsist upon highly con-
centrated food. Magendie, already quoted, ascertained that ani-
mals fed exclusively on butter, or fat, presented a fatty state of the
liver after death. He also fed dogs on sugar and water, and found
that they soon drooped, became emaciated, diseased with ulcers,
and usually died in about a month. “Children,” says the author
of the Science of Human Life, “whose food consists for a con-
siderable time of superfine flour bread, and other concentrated sub-
stances, as sugar and butter, generally become weak and sickly,
and are often covered with sores—but by putting them on a diet
of good bread made of unbolted wheat meal, with milk and water,
or pure soft water for drink, allowing them also to indulge freely
in the use of good fruits in their season, none of the evils which re-
sult from concentrated forms of aliment will be experienced, and if
properly treated in other respects, they will be perfectly healthy,
robust, and sprightly.”
1185. I have been the means of introducing the unbolted
wheat bread into a large number of families, and always with the
best results. Persons who have been costive for years, have
been relieved of it in a week or fortnight, and oftentimes in two or
three days. I scarcely ever knew it to ſail, and have recom-
mended it in a great number of cases. By continuing the use of
it as an article of food, it will keep the bowels regular, unless the
habits of the individual, and the gross abuse of his digestive organs,
are such as to counteract all its good effects. In piles, and sick
headach, it is a remedy of great importance. In the latter disease
it is necessary that tea, coffee, butter, and all animal fats be
avoided.
1186. If those who are in the habit of drugging themselves
with physic, would make use of the unbolted wheat bread, eat-
ing a clever slice at each meal, they would cease to complain
of costiveness, and find themselves gaining strength, and becom:
ing every day more healthy and vigorous. It has been objected
to the bread, however, that it irritates the bowels, and acts as
a purgative. This is a mistake, for the bran is soothing to the
bowels, and unlike physic, does not leave them ultimately in a
VEGETABLE MATERIA MEDICA. 291
torpid or inactive state. Besides, it produces natural stools, and
not the copious or watery discharges which follow the administra-
tion of a purgative. In some instances, however, if the bowels
are in a very disordered state, the stools may be more frequent
than natural, but this will only continue for a limited time; and
the bread, under such circumstances, may be taken in a smaller
quantity, or eaten in conjunction with rice, tapioca, or some simi-
larly concentrated article of diet.
1187. It was my lot to be obstinately costive for many years,
which I endeavored to remove by small doses of bitter root, and
other purgatives, but being dissatisfied with the effect, I employ-
ed courses of medicine, which, however, afforded me temporary
rather than permanent relief; at length I changed my mode of
living, eating the unbolted wheat bread, and subsisting principally
on vegetable food, taking a little lean meat now and then, when I
felt a desire for it, and from that period, which was more than two
years since, I have not been troubled with the malady in the slight-
est degree. (954.)
1188. JMaking the Bread. The wheat should be of good
quality, cleansed from dirt and all impurities, and ground with
sharp stones to cut the bran fine. After the flour is thus pre-
pared, the bread is to be made with good yeast, and baked so as
to be light and sweet. It should not be eaten until twelve hours
after it is baked, for every body knows that warm bread, cakes,
and every thing of the kind, are highly pernicious.
1189. Bread made as follows, is light and wholesome, and
has the sweet and peculiar taste of the wheat in its natural state.
Take of the unbolted meal any desirable quantity, adding salt to
your wish, and make it into a stiff dough with milk somewhat sour
or changed, which has been previously sweetened by the addition
of sal aeratus. It is better to dissolve the sal aeratus in warm
water before it is used, and no more should be put into the milk
than is necessary to give it a sweet taste. If any sourness remain
in the milk, it will cause the bread to be heavy. As soon as the
dough is put into the pan, preparatory to being baked, a case
knife should be plunged through it to the bottom, cutting across
two thirds of the mass. This prevents the loaf from becoming
solid in the middle. The .." will be more light by allowing
the dough to stand fifteen or twenty minutes before putting it into
the oven. -
1190. Bread thus prepared is fit for the table of an emperor,
and besides being nourishing, and easy of digestion, is one of the
best medicines in the world. It is not necessary, however, that


292 WEGETABLE MATERIA MEDICA.
sal aeratus should be used in its preparation, for good milk and
yeast are quite sufficient to render it light and sweet.
1191. Persons with dyspepsia should eat the unbolted wheat
bread at every meal. It excites the secretion of saliva, and leaves
the mouth moist, whereas the fine wheat bread often dries the
mouth, and can scarcely be swallowed without frequent draughts
of tea, coffee, or other drink. It is delicious to the taste, and
with new milk, boiled, and thickened with fine flour, adding cream
if desirable, it makes superior toast, which is excellent for persons
recovering from sickness. The bread cut into thin slices, and
toasted until quite hard and brown, affords an excellent coffee,
especially when boiled with sugar and milk. There is no bev-
erage more delicious and nourishing. I know of many families
who use it instead of the ordinary tea and coffee, and they find it
much better for their health.
1192. Those who cannot obtain the unbolted wheat bread, as
a means of regulating their bowels, should substitute some of the
preparations of Indian corn. Dr. Alcott, speaking of this grain,
says, “it is one of the most wholesome articles for human suste-
nance in the known world; and it may justly be doubted whether
the exclusive use of any other article, except wheat, would be
so well adapted to develope our whole nature—physical and
moral—as this substance. It forms a large proportion of the
food of many individuals, and even of some whole tribes of men;
and there is nothing against the belief, that if used in a proper
manner, it would impart full vigor of body and mind, and an
unusual degree of health and longevity.” Rye bread is also
a very wholesome article of diet, when made of the entire sub-
stance of the grain, but it is not considered quite so good as
either the wheat, or corn bread. Dr. Alcott says, “In many
parts of New England, it forms a very large proportion of the
ordinary diet.”
VINE GAR.
.Acetic Acid.
1193. Vinegar is prepared by allowing cider, wine, or mºt
liquor, to undergo what is termed the acetous fermentation. Very
good vinegar may be procured by dissolving sugar in water, adding
a little yeast, and exposing it to a temperature of 80 or 90 de-
grees of Fahrenheit, so that it may undergo the process of ſer
mentation.
* Young Housekeeper, p. 117.
WEGETABLE MATERIA MEDICA. 293
l
1194. Vinegar, if kept for a long time, is liable to become
ropy or muddy, but may be purified by adding powdered char-
coal to it, or by boiling a few minutes, and putting it into bot-
tles, corking them closely. It may also be purified by distilla-
tion.
1195. PRoPERTIES AND Us Es. Vinegar is appropriated to
a variety of domestic, and other useful purposes. It is a valuable
antiseptic, resisting putrefaction in a remarkable degree; and is
an antidote to the alkalies, when taken in an over dose. It is
often burnt in sick rooms, under an impression that it will purify
the air, but it only covers an offensive smell by its agreeable odor,
without removing the vitiated particles of the air. Diluted with
water, it is beneficial in cleansing the eye from lime dust. The
vapor or steam of vinegar, is an excellent remedy in putrid sore
throat, and dry, consumptive coughs. It is to be inhaled by
means of a blanket thrown over the head, taking care that the vapor
is not so hot as to injure the lungs.
VIRGINIAN THYME.
Pycnanthemum Virginicum”—The Leaves and Flowers.
1196. The Virginian thyme, high pennyroyal, or flax-leaved
basil, grows on the banks of streams, in thickets, and on the bor-
ders of damp, open woods. It blossoms in June or July, and
varies from two to three feet in height. The stem is upright,
hairy, somewhat rough, and gives off short, opposite branches.
The leaves are an inch or an inch and a half long, narrow, tapering,
pointed, and without footstalks. The flowers are white, and dis-
posed in a spreading and somewhat flattened cluster, at the tops of
the stem and branches.
1197. PRoPERTIES AND Us Es. This plant has almost pre-
cisely the odor and taste of pennyroyal, and may be used for
similar purposes. It is a warming stimulant, and makes a pleasant
tea. The dried flowers are much more active and pungent than
the leaves. The only objection to the plant is, that the leaves are
small, and few in number, and cannot be collected in any consider-
able quantity.
* Eaton.

294 VEGETABLE MATERIA MEDICA.
WAKER013IN.
Arum Triphyllum—The Root.
1198. This plant, variously called Indian turnip, pepper turnip,
and dragon root, is common in almost every part of the United
States, growing along ditches, and in moist, shady places. The
root is similar in shape and appearance to that of the onion, and is
about an inch in diameter, giving off a circle of fibres at its upper
edge. The stem is round, spongy, and from one to three feet
high, usually divided about midway into two branches, each of
which is surmounted by three leaves. These have a narrow base,
and a slender, acute point, but in other respects they vary in
shape, some being roundish, and others four sided, with unequal
angles. The flower is supported at the top of a footstalk,
which rises from between the branches containing the leaves.
It consists of a tube about two inches long, terminating on one
side in a leaf-like appendage, which bends over like a hood,
and tapers to an acute point. The color, internally, is some-
times green, but it generally consists of a purple ground, vari-
egated with white lines. The flowering period is June. The
fruit is a compact cluster of berries, which are green at first, but
subsequently change to a beautiful scarlet.
1199. The root may be preserved for several months in the
green state, by burying it in sand, and placing it in a cellar. Boiled,
or roasted, it may be eaten with impunity, notwithstanding its acri-
mony, and is considered by some people an excellent article of food.
1200. PROPERTIES AND Uses. The green root of the wake-
robin has an intolerably pungent and fiery taste, which continues
in the mouth and throat for several hours, causing the tongue to
swell, and leaving an unpleasant soreness. Applied to the skin,
however, it is not followed by pain, or even redness. Its pro-
perties are imperfectly yielded to water, and alcohol, and should
therefore be employed in substance, by those who esteem it as a
remedy. When dried and pulverized, it loses its acrimony, an
soon becomes almost tasteless. -
1201. Dr. Thomson formerly employed the wakerobin in
coughs, and diseases of the lungs, º half a tea-
spoonful of the powdered root, recently dried, in honey or mo-
lasses, two or three times a day, but he found it to be so acrid or
irritating, that he judiciously laid it aside. It is nevertheless a
valuable external application in poison from ivy, or dogwood; and
in several severe cases which came under my observation, it aſ-

WEGETABLE MATERIA MEDICA. 295
forded speedy and entire relief. The fresh root should be cut
into slices, and rubbed upon the part affected three or four times
a day, until a cure is performed. The powder, mixed with cream,
may be applied in substance, instead of the green root.
WILD CHERRY.
Prunus Virginiana–Inner Bark and Fruit.
1202. The wild cherry is one of the largest productions of
the American forest. On the banks of the Ohio, where it is fully
developed, it attains the height of eighty or one hundred feet,
with a trunk measuring twelve or sixteen feet in circumference.
In the Atlantic States, however, it is of much smaller growth.
In open situations, observes Mr. Eaton, the limbs spread into an
elegant oval summit, but in dense forests it grows to a very great
height, with only a few contracted branches. The young trees
are covered with a reddish bark, but as they advance in age, it
assumes a darker appearance, and detaches itself semicircularly in
thick, narrow, transverse layers. The leaves are tapering at both
ends, sharply pointed, bordered with fine teeth, smooth and pol-
ished on both sides, and supported on long footstalks, each of
which is furnished with two, or four little protuberances on its
upper side.
1203. Prop ERTIES AND Us Es. The inner bark of the
wild cherry has a spicy and bitter taste, with some little astringen-
cy. It loses its strength by keeping, and should, therefore, be
employed in the recent state. Either hot or cold water extracts
its sensible properties, affording a reddish colored infusion. Its
virtues are impaired by boiling. From its taste and odor, says
the United States Dispensatory, it has been supposed to contain
prussic acid, but the presence of this principle has not been de-
monstrated. Dr. Wood, one of the authors of the Dispensatory
and now Professor of Materia Medica in the Pennsylvania Uni-
versity, is in the habit of saying to his class, as I have already
observed, that the bark of the wild cherry tree is devoid of prus-
sic acid in its natural state, and that this product results from
chemical action during distillation. (91.1.)
1204. This bark is an agreeable tonic, and is used in dys-
pepsia, ague and fever, diarrhoea, worms, jaundice, and female
obstructions, when more efficient remedies are not at hand. It is
*The cerasus virginiana of Michaux.




296. VEGETABLE MATERIA MEDICA.
usually employed in infusion, which may be prepared by adding
an ounce of the powder, to a quart of water or cider, and allowing
it to steep for twelve hours. A wine-glassful of this may be taken
three or four times a day.
1205. The cherries of this tree are also used in medicine,
and may be employed indiscriminately with the peach kernels.
(910.) Bruised, and steeped in hot water, with the addition of
loaf sugar, they are useful in promoting appetite and digestion.
They also afford the cherry spirit, which is so well known for
its agreeable flavor.
WILD LETTUCE.
Pyrola Rotundifolia–The Roots and Leaves.
1206. This is a modest little evergreen, with a slender, creep-
ing root, and small angular stems, one or two inches high, and
channelled upon the upper side. Each of these is surmounted by
a roundish leaf, about two inches in diameter, with a number of
small, prominent veins upon the upper surface, which are some-
times of a milky color. The flowers are white and fragrant, sup-
ported at the top of a footstalk rising six or eight inches in height.
1207. The wild lettuce is very common in pine woods, and
on hills and mountains, growing beneath the shade of trees. It is
generally found in the same locality with pipsissewa, to which it is
closely allied in medical properties. The flowering period is June.
In some sections of the country it is called consumption weed, and
round leafed wintergreen.
1208. PR operTIES AND Us Es. The root, in addition to a
- slight degree of astringency, is pleasantly bitter and aromatic,
with a good deal of pungency. The leaves are also bitter, but do
not possess any of the other properties of the root. The decoc-
tion is useful internally as a remedy in rheumatism, gravel, dropsy,
- and diseases of the skin; and externally as a wash for cancerous
and scrofulous sores. Dr. Thomson states, that he cured a
woman of the dropsy, by using the wild lettuce, bruised and
steeped in hot water. He also observes that the roots of this
plant, and the pipsissewa, in equal parts, are an excellent remedy
for weak nerves. The dose is a tea-spoonful of the powder, ad-
ministered two or three times a day.

WEGETABLE MATERIA MEDICA. 297
WO RMW 00D.
..?rtemisia .1bsinthium—The Herb.
1209. This plant has a large, woody, fibrous root, which
sends up numerous erect, ſurrowed, branching stems, rising two
or three feet high. The leaves are divided into several ob-
tusely pointed lobes, which spread out somewhat like the fingers
of the open hand, and in common with the stem and branches,
have a white or mealy appearance. The flowers are small, nod-
ding, and of a greenish yellow color, supported on the branches
by short footstalks. , , , ,
1210. Wormwood grows wild by roadsides, among rubbish,
and is cultivated in gardens. The flowering period is July and
August. Few plants are more disagreeable to the taste, and
hence its specific name, absinthium, which signifies unpleasant.
Pliny speaks of it as a remedy for the itch, and observes also that
it will heal old sores. The odor of the plant depends upon a vol-
atile oil, which may be obtained by distillation. This is some-
times rubbed on the skin as a safeguard against troublesome in-
sects. The green herb is used to preserve clothes from moths
and worms. The fresh leaves are put into sour beer to correct
its unpleasant taste. Dr. Cutler observes, that if women who
suckle take an infusion of this plant, it imparts a bitter taste to
the milk.
1211. Prop ERTIES AND Us Es. Wormwood is nauseous
and exceedingly bitter. It is used successfully as a tonic in loss
of appetite, and debility of the digestive organs. Previous to the
introduction of Peruvian bark, it was employed by the medical
faculty as a remedy in ague and fever. The flowers are more
aromatic and less bitter than the leaves, and have a slightly pun-
gent taste.
1212. Wormwood is a valuable antiseptic, and in the form of
a poultice may be usefully employed in wounds, or sores that have
become offensive. Parkinson, who published a work on plants
about two centuries ago, says, that “wormwood will cure the
pain of sore and running ears, if the warm vapor of the decoction
be introduced into them by a funnel.” The tincture is beneficial
in bathing sprains and bruises, having the effect to allay the pain,
and prevent swelling and discoloration.

38

298 VEGETABLE MATERIA MEDICA.
YARROW.
ºftehilled JMillefolium—The Herb.
1213. Yarrow is a very common plant throughout the United
States, growing by waysides, and in dry pastures. It has a
woody, fibrous root, and a furrowed, hairy stem, rising one or
two feet in height, and dividing at the top into a number of short
branches. The leaves have a feathery appearance, consisting of
a number of minute divisions and subdivisions, and are arranged on
either side of a long, flat footstalk. The flowers are of a dull white
color, and disposed in dense, flattened clusters, at the tops of the
stem and branches. They remain in bloom from June to Sep-
tember.
1214. In Sweden, this herb is sometimes put into beer, in-
stead of hops. In this country, the juice is used to give a green
color to cheese. It should be gathered when in full bloom, care-
fully dried, and packed in closely covered boxes or drawers. -
1215. PROPERTIES AND Us Es. Yarrow has a strong, aro-
matic, and pungent taste, with some bitterness and astringency. It
is a very good tonic and stimulant, and useful in a low or debilitated
state of the system, accompanied with nervous weakness. From
its warming nature, also, it is serviceable in flatulent colic. The
infusion should be employed, and this, sweetened with sugar, may
be taken freely as a drink. It has proved beneficial in diseases of
the skin, and all impurities of the blood. I have recommended it
frequently in fluor albus, and it has always been productive of
good results. It should not only be employed internally, but
injected also into the vagina, several times a day.
-
YELLOW DOCK.
Rumex Crispus—The Root.
1216. Yellow dock, called also curled dock, narrow dock,
and sour dock, is found in meadows, by roadsides, and about
houses and barns. It has a yellow, spindle shaped root, which
sends up a smooth, round, furrowed stem, occasionally tinged
with red, and from two to three feet high. The leaves are long,
narrow, and pointed, with the margins waved and curled. The
flowers appear in crowded spikes at the top of the stem, each one
producing a small, brown, triangular seed.
VEGETABLE MATERIA MEDICA. 299
1217. The roots are used to dye yellow. The leaves are
somewhat laxative, and are boiled as an article of food, being
eaten with salt and vinegar. -
1218. PROPERTIES AND Us Es. The root is bitter, and
moderately astringent. Internally administered, it acts as a pur-
gative. It is not used by Dr. Thomson, excepting as an external
application in itch, for which it is highly beneficial. He bruises
the fresh roots in a mortar, and adds cream sufficient to make an
ointment. This mixture is kept in a warm place for twelve
hours, when it is fit for use. It should be applied on going to
bed at night, and in two or three days will effect a cure. It is
rendered still more efficient by the addition of a small quantity of
turpentine, and rheumatic drops. To a tea-cupful of the oint-
ment, add a table-spoonful of the drops, and half that quantity of
turpentine. Dr. Thomson informs me that this preparation, with
the internal use of composition, will speedily cure the most
inveterate form of the disease. The powdered root is recom-
mended as an excellent dentifice, especially when the gums are
Spongy.
RECAPITULATION
1219. The object of this recapitulation is, to group the plants
according to their properties; and in addition to the general divi-
sions of the materia medica, as emetics, stimulants, and tonics,
others of a secondary but important character will be introduced,
including antispasmodics, diuretics, demulcents, antacids, expec-
torants, laxatives, antiseptics, and aromatics. These, it will read-
ily be perceived, could not have been introduced into the body of
the work, without rendering it necessary to describe many of the
plants under several different heads.
EMETICS.
1220. These are substances which produce vomiting. The
principal emetic is lobelia inflata. The secondary emetics are,


300 WEGETABLE MATERIA MEDICA.
boneset, bitter thistle, blue vervain, chamomile, Canada snake
root, horseradish, mayweed, mustard, skunk cabbage, and blood
root. If the stomach is very much disordered, a tea of bayberry
will operate as an emetic, but not otherwise. We are not to
understand that all the secondary emetics can be employed with
safety; on the contrary, some of them are harsh, and even dan-
gerous.
- -
STIMULANT.S.
1221. Stimulants are medicines which excite an action in the
living body. The best and purest stimulant is cayenne. Among
the others may be enumerated black pepper, bayberry, fleabane,
Canada snake root, catnip, cinnamon, cocash, featherfew, garden
pepper, golden rod, ginger, hemlock leaves, myrrh, mustard,
mayweed, pennyroyal, prickly ash bark and seed vessels, pepper-
mint, sarsaparilla, summer savory, tansy, Virginian thyme, and
yarrow. We should always be careful to distinguish the pure,
healthy stimulants, from those which are acrid, poisonous, or nar-
cotic. Mustard, although a stimulant, is of an acrid character,
and should not be used.
-
ASTRINGENTS.
1222. Astringents pucker the mouth, and render the parts to
which they are applied more dense and firm. They include
bayberry, witch hazel leaves, raspberry leaves, sumach leaves and
berries, white pond lily, black birch, evan root, marsh rosemary,
bark of the hemlock tree, purple archangel, fleabane, cinnamon,
cocash, hardhack, spicy wintergreen, beth root, yarrow, and
yellow dock. - -
TONICS.
1223. Tonics promote appetite and digestion, and strengthen
the body when it is weak or debilitated. The leading tonics are
balmony, golden seal, bark of the American aspen, bark of the
large aspen, unicorn, myrrh, and the kernels of peach and cherry
stones. Among the other plants and vegetable substances which
possess tonic properties, and some of them valuable, are green
WEGETABLE MATERIA MEDICA. 301
archangel, boneset, bitter thistle, buds of the balsam poplar, bar-
berry bark, chamomile, fleabane, bayberry, featherfew, ginseng,
goldthread, hoarhound, hardhack, mayweed, pipsissewa, pepper-
mint, spearmint, tansy, wormwood, wild cherry tree bark, leaves
and root of the wild lettuce, raspberry leaves, yarrow, scullcap,
elecampane, catnip, witch hazel leaves, and beth root.
NERVINES.
1224. These have the effect to compose or tranquilize the
nerves, without impairing or deadening their sensibility, as is the
case with narcotics. They include scullcap, lady’s slipper, cay-
enne, lobelia, cocash, yarrow, wild lettuce, ginseng, and pipsissewa.
PURGATIVES,
1225. Purgatives are agents which quicken the peristaltic mo-
tion of the bowels, and increase the secretion of fluids from their
mucous or inner coat. They include butternut, bitter root, black
root, mandrake, barberry, chamomile, hoarhound, yellow dock,
blood * and sumach bark.
ANTIS PASMOD.I.C.S.
1226. These are medicines which have the power of allevia-
ting spasm. Lobelia, and especially that form of it denominated
antispasmodic tincture, is the most prompt and efficient agent in
this class of remedies with which I am acquainted. Among the
other antispasmodics, are scullcap, lady’s slipper, and cayenne.
DiURETICS,
1227. Diuretics are substances which increase the secretion
of urine. It is supposed that they enter the circulation through
the medium of absorption, and are thereby brought into contact
with the kidneys, which they stimulate to a more vigorous action.
The diuretics consist of coolwort, cleavers, bark of the American
and large aspens, juniper berries and leaves, fir balsam, hemlock
leaves, fleabane, wild lettuce, leaves and berries of the sumach,
burdock root, elecampane, and featherfew. -



302 VEGETABLE MATERIA MEDICA.
-
DEMULCENTS.
1228. Demulcents or mucilages are soft viscid substances,
which have a soothing effect upon the parts with which they
come in contact, protecting them from the irritation of acrid or
offending matters. Hence they are useful in diarrhoea, and dys-
entery, and in the form of poultices for external application.
They are also beneficial in coughs, irritation of the lungs, and
irritation or inflammation of the urinary passages. In what man-
ner they produce their good effects, however, is not precisely
known. It is supposed by some that they enter the mass of the
blood, and impart to it a mucilaginous quality, while others con-
tend that the soothing impression which they make upon the
stomach and bowels, is communicated to other parts of the sys-
tem by means of the nerves. Whatever may be the theory of
their operation, however, there is no question that they exercise
a beneficial influence in the diseases specified. The principal
demulcents are slippery elm, comfrey, buck horn brake, Irish
moss, and hollyhock blossoms and root. The fixed oils (584)
are also classed as demulcents.
- -
ANTACID S.
1229. These are alkaline substances which are employed to
neutralize acids in the stomach. The principal antacid recom-
mended in this work is the bicarbonate .."soda. (1028.) Potash,
pearlash, and sal aeratus, are all alkalies, and of course antacids.
ExPECTORANTs.
1230. Expectorants are remedies which promote the discharge
of matter from the lungs, whether it be mucus, pus, or any other
morbid accumulation. Medicines which determine the blood to
the surface of the body, as cayenne, or any of the pure, healthy
stimulants, have an expectorant º ; other expectorants, says
au
Dr. Mitchell, act upon the mouth and ſauces by virtue of the sym-
pathy between those parts and the lungs. Of these, honey,
liquorice, sirups, and mucilagi - may be …
Emetics may be justly denominated expectorants, for by their ac:
tion upon the lungs through the medium of the stomach and

WEGETABLE MATERIA MEDICA. 303
diaphragm, they effectually unload the windpipe and bronchial
tubes of their vitiated secretions. The vapor of water, or vinegar,
or the dry fumes of cayenne, are all expectorants, because they
excite an action in the membrane lining the air passages of the
lungs, and not unfrequently convert a dry cough into a loose one.
1231. The principal expectorants are lobelia, cayenne, slip-
pery elm, buck horn brake, Irish moss, hoarhound, fir balsam, blue
vervain, boneset, elecampane, skunk cabbage, and Indian turnip.
The last two I would not recommend, as they possess objection-
able properties.
LAXATIVES.
1232. Laxatives are to be distinguished from purgatives, in-
asmuch as they have the effect to keep the bowels open without
the risk of purging, even though they should be employed in full
doses. (978.) Among the laxatives are cayenne, balmony, gold-
en seal, and the bark of the American aspen. The unbolted
wheat bread (1181, et seq.) is an excellent laxative. Boneset,
also, I am disposed to regard more as a laxative than a purgative.
ANTISEPTICS.
1233. Antiseptics are employed both internally and exter-
mally, to arrest the process of putrefaction. Among the various
remedies of this class, are wormwood, vinegar, cayenne, myrrh,
the bitter or tonic medicines, marsh rosemary, and the yeast and
carrot poultices. Cayenne is particularly valuable as an antisep-
tic, because it tends to keep up an action in the vessels of the
gangrenous part, and thereby to prevent stagnation of the blood,
without which putrefaction cannot ensue.
1234. “The presence of air,” says Dr. Webster, in his
Chemical Dictionary, “though not necessary to putrefaction, ma-
terially accelerates it, and those gases which contain no oxygen,
are very efficient in checking or altogether preventing the process.
Carbonic acid also remarkably retards putrefaction; and if boiled
meat be carefully confined in vessels containing that gas, it re-
mains a very long time unchanged, as seen in Mr. Appert’s
method of preserving meat.
1235. “There are several substances which, by forming new
combinations with animal matter, retard or prevent putrefaction,


304 WEGETABLE MATERIA MEDICA.
such as chlorine, and many of the saline compounds; sugar, alco-
hol, volatile oils, acetic acids, and many other vegetable substan-
ces, also stand on the list of antiputrefactives, though their mode
of operating is by no means understood.
1236. “The alkaline earths and salts are antiseptics, and act
by absorbing the acids formed in the process of putrefaction.
Carbon or charcoal of wood is one of the most powerful antiseptics.
It will restore tainted meat, and purify offensive water. Casks
are now charred to contain water on long sea voyages, and it will
continue pure and sweet in these for a great length of time.”
AROMATICS.
1237. These are a numerous class of medicines, having a
grateful odor, and an agreeable, aromatic taste. They are black
birch, balm of Gilead buds, fir balsam, camphor, cloves, Canada
snakeroot, cinnamon, cocash, featherfew, golden rod, ginger, gin-
seng, hemlock leaves, juniper berries, meadow fern burrs, penny-
royal, seed vessels of the prickly ash, purple archangel, pepper-
mint, spearmint, summer savory, tansy, Virginian thyme, worm-
wood flowers, wild cherry tree bark, wild lettuce root, raspberry
leaves, yarrow, and spicy wintergreen.

P A R T F O U R T H
LIST OF C O M P O U N D S.
DRY PREPARATIONS.
COMPOSITION.
1238. Take of bayberry six pounds, ginger three pounds,
cayenne six ounces, cloves six ounces, all pulverized. Mix thor-
oughly, and siſt.
1239. If there is a panacea in the world, it is this preparation.
It is a safe and gentle stimulant, equalizing the circulation, strength-
ening the digestive organs, obviating costiveness, producing a moist
condition of the skin, and, in a word, enabling the different organs
of the body to perform their functions in a natural and healthy man-
ner. It operates in harmony with the laws of the human system, and
may, therefore, be safely employed in every form of disease. It is
particularly useful, as a convenient family medicine, in sudden
colds, febrile attacks, hoarseness, sore throat, coughs, influenza,
earach, toothach, pains in the stomach, bowels, or other parts
of the body, rheumatism, cold hands and feet, diarrhoea, dysen-
tery, colic, croup, giddiness, hysteria, mumps, headach, derange-
ment of the stomach, jaundice, worms, nervous disorders, and the
various affections of the skin. It rarely fails to bring out the
eruption in measles, and smallpox, and these diseases are often
cured with composition alone. In wounds, bruises, or any severe

39
306 LIST OF COMPOUNDS.
local injury, the free use of it, so as to keep the skin moist, will
generally allay the pain, and prevent the development of in-
flammation. - - -
1240. In violen audiº of disease, where it is necessary to
produce an immediate effect upon the system, half a tea-spoonful
of cayenne, or a tea-spoonful of rheumatic drops, may be added
to each dose of the composition. It may also be combined with
nervines, diuretics, or any other medicine, according to the nature
of the complaint which requires to be treated.
1241. If the stomach is very much disordered, it will operate
as an emetic, but after the organ is cleansed, it will have no such
effect, nor even occasion nausea.
1242. A strong tea of composition is very convenient and
serviceable as an injection to evacuate the bowels, particularly in
the treatment of children.
1243. MoDE of ADMINISTRATIon. For an adult, take a
moderately heaped tea-spoonful of the powder, and an equal quan-
tity of sugar; rub them together, and add a tea-cupful of boiling
water; drink the tea when sufficiently cool. There is no occa-
sion for swallowing the grounds, as is a common practice, for the
strength of the medicine will be extracted by the boiling water,
and the sediment can have no other effect than to clog or irritate
the stomach. When the patient takes the tea, he should be in
bed, with a heated stone, or bottle of hot water, wrapped in a
damp cloth, at his feet, or seated by the fire, if the season requires
it, covered with a blanket, to favor perspiration. If composition
be taken during the day, while the individual is exposed to the
open air, it should be mixed, together with the sugar, in a small
quantity of cold, or lukewarm water, and swallowed in substance.
This precaution is necessary, in order to prevent, a perspiration,
which might be suddenly checked, and thereby injure the patient.
The medicine is also very pleasant in this form, and may be given
easily, and with great advantage, to children, especially in chronic
affections. -
1244. In an obstinate cold, or any lingering complaint, a dose
of warm composition tea should be taken every night, at bed time,
as directed above, until a cure is effected. The tea is sometimes
prepared with equal parts of boiling water and milk, and in this
form, if well sweetened, is a very pleasant beverage.
SPICED BITTERS.
1245. Take of pulverized poplar bark six pounds, golden
seal, cloves, ginger, and prickly ash bark, each a pound and a half,



LIST OF COMPOUNDS. 307
-
balmony a pound, cayenne three quarters of a pound, and sugar
seven pounds. Mix thoroughly, and siſt. If the prickly ash is
omitted, the quantity of cayenne may be somewhat increased. It
is usual to add about one twentieth part of cayenne to the tonic or
restorative preparations.
1246. Spiced bitters is one of the best medicines in use for
restoring the tone of the digestive organs, and creating an appe-
tite. It is an excellent remedy in jaundice, dyspepsia, worms:
flatulency, piles, headach, giddiness, pains in the stomach and
bowels, diarrhoea, gravelly complaints, strangury, gonorrhºea, fluor
albus, heartburn, rickets, mercurial salivation, consumption, and
the whole train of chronic diseases. It is a laxative, and keeps
the bowels gently open, unless they are obstinately costive. Its
use would be improper during the continuance of a violent febrile
or inflammatory affection, but as soon as the disease is subdued,
it may be freely and beneficially employed. In the form of a
weak tea, well sweetened, it is a refreshing drink for weak pa-
tients, and is grateful also to those in health, during the hot weather
of summer. If food occasions distress, a dose of it will gen-
erally afford relief. -
1247. MoDE or ADMINISTRATION. Take a moderately
heaped tea-spoonful of the powder, and double the quantity of sugar;
stir them together, add a tea-cupful of boiling water, and drink the
tea when sufficiently cool. The proper time to take the bitters, is
fifteen or twenty minutes before each meal. If the patient is
obliged to be in the open air, a tea-spoonful of the powder, with
sugar to suit the taste, should be mixed in half a wine-glass of cold,
or milk warm water, and taken in substance. The bitters need
not be used after the appetite is fully restored.
FEMALE REstor ATIVE.”
1248. Take of pulverized poplar bark ten pounds, balmony
two pounds, golden seal two pounds, unicorn two pounds, beth
root two pounds, myrrh one pound, cinnamon one pound, cloves
one pound, cayenne half a pound, and loaf sugar ten pounds.
Mix well, and siſt.
1249. This medicine is an excellent tonic and stimulant, and is
particularly designed for the complaints of females, such as fluor
* This, with some improvement in the compound, is Dr. Thomson's woman’s
friend.



308 LIST OF COMPOUNDS.
albus, weakness of the uterine organs, and irregularity of the men-
strual discharges. It is also beneficial in loss of appetite, dyspep-
sia, worms, diarrhoea, spitting of blood, coughs, asthma, difficulty of
breathing, a low or exhausted state of the system, and the various
diseases in which the spiced bitters is employed. It is beneficial
both before and after child-birth, especially if there is debility of
the organs concerned in the process of labor. Taken two or
three times a day, in suppression of the menses, it rarely fails, ex-
cepting in obstinate cases, to relieve the difficulty.
1250. MoDE of ADMINISTRATION. A moderately heaped
tea-spoonful of the powder, with double the quantity of sugar, may be
taken three times a day, in the same manner as has been directed
for the spiced bitters. (1247.) As a general thing, however,
unless the stomach is very irritable, it had better be taken in
substance, mixed with a small portion of cold, or lukewarm
water, as the patient will then derive the full benefit of the myrrh,
which is only partially dissolved by the water.
- INJECTION POWDER.
1251. Take of bayberry one pound, scullcap, or lady's slip-
per, half a pound, cayenne a quarter of a pound, all finely pow-
dered. Mix, and sift.
1252. DIRECTIONs. For an ordinary injection, intended only
to evacuate the bowels, two large tea-spoonfuls of this powder may
be steeped in a tea-cupful and a half of boiling water, and the liquid,
when about milk warm, administered with an appropriate syringe.
The injection may be repeated, if necessary. The quantity of liquid
specified, is generally sufficient, but a pint or more may be em-
ployed, if deemed advisable. The sediment should always be
omitted, for it is liable to choke the syringe, and in piles, dysen-
tery, and other forms of disease, it adheres to the mucous
membrane of the bowels, occasioning irritation, and tenesmus.
There can be no advantage in employing the sediment, if the med-
icine has been steeped in boiling water, so as to extract its
strength. In severe or violent attacks of disease, half a tea-
spoonful or more of green lobelia may be steeped with the two
tea-spoonfuls of the injection powder, and when the infusion is of
the proper temperature for use, two, three, or four tea-spoonfuls
of rheumatic drops may be added. See injections or enemas in
the index. -
-
LIST OF COMPOUNDS. 309
Cough POWDER.
1253. Take of beth root, scullcap, and the leaves of boneset,
each three quarters of a pound, cayenne, and green lobelia, each
half a pound, all pulverized. Mix thoroughly, and siſt.
1254. Us Es. Take three tea-spoonfuls of the powder, and add
a pint of boiling water; steep for twenty minutes by the fire, strain,
sweeten with honey, and stir in a tea-spoonful of powdered slip-
ery elm, so as to render the liquid somewhat mucilaginous.
alf a tea-cupful of this tea may be taken five or six times a day,
the patient in the meantime occupying a warm chamber or apart-
ment, if the season renders it necessary. I know of no better
remedy for a cough, hoarseness, difficulty of breathing, or sore-
ness of the lungs. It is of great value also in croup, and whoop-
ing cough. The quantity of lobelia is probably too small to oc-
casion nausea, but if this should occur, the dose may be somewhat
diminished. Nausea, or even vomiting, however, is objectiona-
ble only as being disagreeable to the patient. - -
-
LIQUID PREPARATIONS.
RHEUMATIC DROPS.
1255. Take of cherry spirit, thirty, or thirty-five per cent.
above proof, five gallons; best Turkey myrrh, reduced to a pow-
der, four pounds; bayberry one pound; balmony three quarters
of a pound; scullcap half a pound; cayenne five ounces. Put
these into some convenient vessel, and stir or shake them several
times a day for a week or fortnight, when the liquid may be poured
off, and bottled for use. If cherry spirit cannot be obtained,
good fourth proof brandy may be substituted, taking care to pro-
cure that which is free from adulteration. -
1256. This preparation is a stimulant and tonic, and is bene-
ficial in loss of appetite, and a feeble or languid state of the diges-
tive organs. When it is desirable to produce an immediate effect
upon the system, one, two, or three tea-spoonfuls of it may be
added to a dose of composition, or other tea, with great advan-
tage. In this form, it is useful in colic, hysteria, delirium tre+
mens, rheumatism, mortification, hemorrhage, convulsions, and all
violent attacks of disease. A table-spoonful of it, more or less,
in a tea-cupful of strong bayberry tea, is a valuable remedy in
| -

310 LIST OF COMPOUNDS.
diarrhoea, and may be repeated every two hours, until a cure is
effected. Dropped on loaf sugar, and swallowed, it is service-
able in coughs, tightness of the breast, difficulty of breathing, and
soreness or irritation of the throat. A tea-spoonful mixed with
two-thirds of a wine-glassful of warm water, sweetened, is bene-
- ficial in nausea, giddiness, headach, pains of the stomach and
bowels, and distress occasioned by over-eating. It also has the
effect to sweeten an offensive breath. Diluted with water, it affords -
an excellent wash for the mouth, particularly if the gums are
spongy or ulcerated; and if the teeth are incrusted with tartar, it
should be used every morning, with a tooth-brush. Mixed with
the dust or powder of sumach berries, it is an excellent wash for
ring worms, and similar affections of the skin. A piece of raw
cotton, or lint, moistened with the drops, and inserted into the
ear, will frequently cure the earach; and if a tooth is hollow and
painful, a similar application may be made with equal advantage.
Deafness, also, where it is occasioned by hardened wax, is sig-
nally relieved by injecting the drops, diluted with water, into the
ear, with a small syringe, repeating the operation every night
and morning.
1257. Where the skin is hot and dry, and the tongue parched,
the use of the drops is improper, excepting in combination with
cayenne, composition, or some other stimulating tea, intended to
produce a perspiration, for the alcohol which they contain, has a
tendency to increase rather than diminish the febrile symptoms.
1258. The rheumatic drops are of unequalled value for bath-
ing sprains, and bruises, and as an application to fresh wounds,
cuts, offensive sores, and parts that are approaching a state of
mortification. -
1259. Dos E. From a tea-spoonful to a table-spoonful in
composition tea; warm water, sweetened; or in the pure state.
WINE BITTERS.
1260. Take of poplar bark six pounds, golden seal two
pounds, balmony two pounds, scullcap one pound, unicorn one
pound, and cayenne three quarters of a pound. The balmony
and scullcap may be used in the crude state, but the other articles
should be reduced to a coarse powder. Put these materials
into some convenient vessel, add four gallons of water, and boil
gently for half an hour, or until the liquid is reduced to about
three gallons, keeping the vessel, in the meantime, closely cover-
ed; strain through a coarse cloth, add twenty pounds of sugar,

LIST OF COMPOUNDS. 3.11
and boil again until the scum ceases to rise, which will be in about
five minutes. This done, strain the liquid a second time through
a cloth, or sieve, and when nearly cold, add the infusion of half a
pound of pulverized prickly ash berries, and a pound of cinnamon,
prepared by steeping them in a close vessel, together with twelve
gallons of sweet, Malaga wine. The preparation is then fit for
use, and should be put into clean bottles, or kegs.
1261. Uses. This prºmºtion is an agreeable restorative
cordial, and is useful in dyspepsia, loss of appetite, ſaintness,
sinking at the stomach, heartburn, flatulency, drowsiness, head-
ach, and all diseases dependant on a deranged condition of the
digestive organs. It is beneficial also to persons recovering from
sickness. Taken after a meal, it will relieve the distress occa-
sioned by indigestible food, or the unpleasant sensations which
accrue from an overloaded stomach. Added to cold water, it
makes a refreshing and wholesome drink in summer. The dose
is a wine-glassful, more or less, according to circumstances.
Dys ENTERY or CHOLERA SIRUP.*
1262. Take of poplar bark, black birch bark, lady’s slipper,
and bayberry, each one pound, wild cherry tree bark, golden seal,
and balmony, each half a pound, all reduced to a coarse powder.
Add five gallons of water, boil gently for half an hour in a covered
vessel, and strain through a flannel, or coarse cloth. Add fifteen or
twenty pounds of sugar to the liquid, and boil again until the scum
ceases to rise, which will be in a few minutes. Take the vessel
from the fire, and stir in a pound of bruised peach meats, and half
a pound each of powdered cloves and cinnamon. When the
sirup is cold, add one gallon of rheumatic drops. Strain a second
time, and bottle.
1263. Uses. This sirup is an excellent remedy in diarrhoea,
and the forming stages of dysentery, and cholera. From a half to
a whole wine-glassful may be taken at a dose, repeating it every
hour and a half or two hours until a cure is effected; or if the
case is severe, one-third or one-fourth the quantity of rheumatic
drops should be added. The sirup is also useful in worms, the
summer complaints of children, and pains or soreness of the sto-
mach and bowels. -
This preparation is infinitely superior to the one specified by Dr. Thomson,
in his new patent. -


312 LIST OF COMPOUNDS.
COUGH SIRUP.
1264. Take of poplar bark, and beth root, each a pound;
water nine quarts; boil gently in a covered vessel for fifteen or
twenty minutes; strain through a coarse cloth; add seven pounds
of loaf sugar, and simmer until the scum ceases to rise. When the
sirup is nearly cold, add a pint of the tincture of lobelia, and a
gallon of pure French brandy.
1265. Us Es. This is beneficial in coughs, difficulty of breath-
ing, tightness of the breast, and pain or soreness of the lungs. A
* more or less, may be taken three or four times a
ay.
ANTISPASMODIC TINCTURE.
-
1266. Take of pulverized lobelia seeds one pound, cayenne
and scull cap, each a quarter of a pound, rheumatic drops, pre-
º with fourth proof brandy, or strong cherry spirit, one gallon.
nfuse for a week, or more, in a closely stopped vessel, shaking
it two or three times a day. The liquid only is to be used, and
not the dregs, as is a common practice. The latter have no
strength, and of course should not be introduced into the stomach.
1267. This is an invaluable preparation, and is used in violent or
critical cases of disease, such as locked jaw, epilepsy, convulsions,
croup, delirium tremens, ſainting, hysterical attacks, apoplexy,
poisoning, hydrophobia, and suspended animation. It traverses
the system with wonderful rapidity, and rarely fails to restore the
patient. Drowned persons have frequently been recovered by
its use, even under the most unfavorable circumstances. Sever
gentlemen, who were incredulous with regard to its effects, im-
mersed a dog in water until he was apparently dead, and then
poured a quantity of the tincture down his throat, which revived
the animal in a very short time. I witnessed the experiment
myself, and can vouch for the truth of the statement.
1268. . In locked jaw, where teeth are rigidly clenched, the
antispasmodic tincture may be regarded as a sovereign remedy.
The liquid requires to be poured into the mouth between the
teeth, and as soon as it comes in contact with the parts about the
throat, the spasm will yield, and the jaws open.
1269. Epileptic patients should carry a vial of this prepara-
- -


LIST OF COMPOUNDS. 313
tion about their persons, and swallow a portion of it whenever
they are threatened with a convulsion. I knew a young man with
epilepsy, who prevented many severe attacks in this way, though
he rarely had any other than a momentary warning of their ap-
roach.
p 1270. If an individual is rendered insensible by a fall, blow,
or injury of any description, the tincture may be employed with
the greatest advantage, and is much more speedy and effectual in
rousing the dormant energies of life, than any mode of treatment
which has ever yet been devised by the medical faculty. Every
º should supply himself with a bottle of it, as a substitute
or the lancet.
1271. The antispasmodic tincture is an active and powerful
emetic, and in case of poisoning by arsenic, laudanum, or any
other substance, will evacuate the stomach in a speedy and effec-
tual manner. Many instances have occurred in which it has freed
the stomach from a dangerous poison, when ipecacuanha, tartar
emetic and sulphate of zinc have failed to produce any effect.
It is also an excellent emetic in difficult parturition, and should be
administered without the dregs, as those are liable to occasion
protracted nausea and vomiting. -
1272. As an external application, the tincture is employed in
bathing sprains, bruises, rheumatic joints, and any part of the
body which is the seat of pain. It is also beneficial in erysipelas,
having the effect to arrest the progress of the inflammation, and
may be used in any stage of the complaint.
1273. Dos E. This varies from a tea-spoonful to a table-
spoonful, or more, according to the nature of the disease. In
convulsions, apoplexy, and similar affections, it may be adminis-
tered largely, and also added to the injections, if these are em-
ployed, in the quantity of a table-spoonful to each. The ordinary
dose, however, by way of the stomach, is a tea-spoonful, repeated
frequently, until relief is obtained, and if the patient is in a condi-
tion to swallow readily, it may be administered in composition tea,
or a tea of cayenne and bayberry.
TINCTURE OF LOBELIA.
1274. This is prepared in a great variety of ways, but the
following directions will suffice for all practical purposes.
1275. Tincture of the Leaves. Take of the pulverized leaves
half a pound; water and spirit, equal parts, a quart. Infuse for
ten days in a closely stopped bottlé, and strain.



40
314 LIST OF COMPOUNDS.
1276. When the tincture is of good quality, it is of a dark
or black color. Prepared merely for the purpose of an emetic,
no more spirit need be used than is sufficient to preserve it, for
lobelia yields its properties to water as readily as to alcohol. In-
tended as an addition to some other tinctures, however, it requires
to be equal in strength to that with which it is to combine. For
example, if we were to add the tincture of lobelia, prepared with
equal parts of cherry spirit and water, to the tincture of fir balsam,
prepared with pure cherry spirit, the balsam, or at least a portion
of it, would be precipitated. Hence the necessity of having
tinctures of equal strengths, where they are to combine one with
another.
1277. Tincture of the Seeds. Take of the pulverized seeds
four ounces; water and spirit, equal parts, a quart. Infuse for
ten days, and strain.
1278. This is probably about equal in strength to the tincture
of the leaves, prepared according to the preceding formula.
1279. Tincture of the Green Herb. Collect the herb in
autumn, before the leaves begin to fade; pound it in a mortar until
it is reduced to a pulpy mass; add Malaga wine sufficient to cover
it; infuse for a week or ten days, and strain.
1280. This is pleasant to the taste, and upon being swallowed,
can scarcely be distinguished from the pure wine. After a few mo-
ments however, the pungency of the lobelia is felt in the mouth
and throat. This preparation is a very convenient one for
children.
1281. Instead of the Malaga wine, vinegar may be employed,
which makes an excellent tincture; or equal parts of water and
spirit, as previously directed; or pure cherry spirit, rum, gin, or
fourth proof brandy.
1282. Uses. The tincture of lobelia possesses all the pro-
perties of the herb, and is frequently employed as an emetic, but is
not to be preferred, for general use, to an infusion of the leaves,
or seeds. The dose for an adult, is a table-spoonful, which
should be given in a tea of composition, or of cayenne and bay-
berry, and repeated every twenty or thirty minutes, until the stº:
mach is sufficiently cleansed. The dose for a child two years old
is a tea-spoonful, repeating as above, and two tea-spoonfuls for one
of ten or twelve years old.
1283. The tincture of lobelia is a convenient as well as val-
uable remedy in asthma, and croup, and generally affords very
speedy relief. A tea-spoonful of sugar moistened with it, and taken

LIST OF COMPOUNDS. 315
in divided portions, is useful in coughs, tightness of the breast,
and difficulty of breathing. I have found it beneficial as a wash
in tetter, and similar eruptions of the skin, and also in poison
from ivy, or dogwood. Where an infant is restless, and will not
sleep, six or eight drops of it may be administered in a tea-spoon-
ful of warm water, sweetened, with the most favorable results.
The dose may be repeated, if necessary, and also increased in
quantity.
TINCTURE OF CAYENNE.
1284. Take of cayenne a quarter of a pound, alcohol a pint.
Infuse for ten days, and strain.
1285. Us Es. This is a valuable external application for
swellings, rheumatic joints, and parts that have lost their sensibil-
ity. It is particularly beneficial in palsy, and a wasting of the
limbs, where ordinary stimulating washes produce no effect. -
A flannel moistened with it, and applied to the side in pleurisy,
will generally afford relief. It is superior to the rheumatic drops
for bathing, because of the absence of myrrh, which closes the
pores, and leaves the skin sticky or glutinous.
TINCTURE OF SCULLCAP.
1286. Take of scullcap, powdered, four ounces; alcohol a pint.
Infuse for ten days in a close vessel, and strain.
1287. Uses. This is employed in nervous tremors, St. Vi-
tus's dance, convulsions, locked jaw, and hydrophobia, but is by
no means so efficient as the antispasmodic tincture. The dose is
from one to three tea-spoonfuls, mixed with a tea of cayenne, or of -
composition. It may also be added to injections, in the quantity
of table-spoonful to each, where a nervine is required. (923, et
Seq.
TINCTURE OF MYRRH.
1288. Take of myrrh, powdered, an ounce and a quarter; al-
cohol a pint. Infuse for ten days or a fortnight, and strain.
1289. Usºs. This is applied to fresh wounds, and indolent or
offensive ulcers, Diluted with water, it is used as awash for sore

316 LIST OF COMPOUNDS.
mouth, spongy gums, and ulcerated throat. A table-spoonful of
it is a valuable addition to an injection intended for the relief of
diarrhoea, or dysentery. For internal use, half a tea-spoonful may
be taken at a dose. (906.)
TINCTURE OF FIR BALS AM.
1290. Take of fir balsam an ounce, alcohol a pint. Shake
them well together. -
1291. Us Es. This is applied to fresh wounds, burns, and ul-
cers, and is taken internally as a remedy in coughs, soreness of the
bowels, gravelly complaints, gleet, and fluor albus. The dose is
a tea-spoonful, repeated two or three times a day. (1108, et seq.)
WEGETABLE JELLY.
1292. Take of Irish moss (1123) half an ounce; wash it
in water as hot as the hand can bear until it becomes slimy,
which will be in about a minute; rinse in water milk warm. This
done, cut two lemon peels into shreds, and put them, together
with the moss, and half a pound of maple sugar, into a vessel
over the fire, containing two quarts of water. Stir constantly
until a jelly of the proper consistence is formed, removing the
scum in the meantime, and taking care that the liquid does not
boil. Strain through a cloth or sieve, and while the jelly is
warm, the infusion of cayenne or ginger may be added, if desirable,
to give it pungency. Instead of the lemon peel, it may be fla-
vored with cinnamon, cloves, or any of the spices. When nearly
cold, add a pint of brandy, or a quart of good wine.
1293. Instead of the Irish moss, a jelly may be formed by
infusing six or eight roots of the buck horn brake (1053) in two
quarts of hot water, and adding the sirup of two pounds of loaf
. with cayenne or ginger, and the spices, as already di-
rected.
1294. Uses. The vegetable jelly is employed in coughs,
diarrhoea, dysentery, soreness of the stomach and bowels, and as a
restorative in recovery from sickness. It is of a soothing nature,
and may be taken freely. The dose is half a wine-glassful, re-
peated four or five times a day. The jelly of the buck horn
brake is used in bathing sprains, and weak backs.


LIST OF COMPOUNDS. 317
COUGH BALSAM.
1295. Take of fir balsam an ounce, honey two ounces, alco-
hol a pint. Let these stand in a closely corked bottle for three
or four days, shaking them frequently, and when the honey is en-
tirely dissolved, add a pint of the tincture of lobelia,
1296. Uses. This is a most excellent cough preparation,
and may be given in the dose of half a tea-spoonful, three or four
times a day. It is beneficial also in asthma, pain in the breast,
difficulty of breathing, croup, gravel, gleet, gonorrhoea, fluor albus,
sore throat, hooping cough, and nervous complaints. An addi-
tional portion of molasses, or sirup, may be added to improve the
taste, but in that case, the preparation must be shaken before
it is used, or the balsam will float upon the surface.
ESSENCES.
1297. These are prepared by adding the volatile or essential
oils to alcohol, in the proportion of one ounce of the former to a
pint of the latter. The essences most commonly in use, are those
of peppermint, spearmint, and pennyroyal. Mixed with warm
water, sweetened, they may be employed instead of the herbs them-
selves. They are useful in allaying nausea, and in quieting cramps
or pains of the stomach and bowels. The usual dose is a tea-
spoonful. -
PILLS.
LOBELIA PILLS.
1298. Take of pulverized lobelia seeds, cayenne, and scullcap,
equal parts; form into pills with the mucilage of slippery elm,
buck horn brake, or gum tragacanth.
1299. Uses. I have found these pills beneficial in a great
variety of complaints, as ague and ſever, asthma, tightness of the
breast, hoarseness, croup, consumption, dyspepsia, jaundice, pal-
pitation of the heart, rheumatism, nervous tremors, hooping cough,
and St. Vitus's dance. They may be employed with advantage
in all febrile and inflammatory affections, administering them be-
tween the courses of medicine. They are equally beneficial in


3.18 LIST OF COMPOUNDS.
chronic complaints, strengthening the digestive organs, and grad-
ually invigorating the whole system. Taken at night on going to
bed, with a dose of composition tea, they afford great relief in
coughs, and enable the patient to expectorate freely. They also
serve to regulate the bowels, and produce natural stools, without
causing debility or griping pains.
1300. Dos E. One or two of these pills may be taken every
two hours during the day, or from three to five at bed time, with
composition tea.
CAYENNE PILLS.
1301. Take of cayenne any desirable quantity, and make it
into pills with some convenient mucilage, as previously mentioned.
(1298)
1302. Us Es. These pills are useful in any complaint in
which cayenne is required, and may be conveniently taken by
those who dislike the medicine in the form of tea. They are
frequently employed in dropsical affections, administering four or
five of them after each meal. They are thought to be partic-
ularly beneficial in these complaints, because they stimulate with-
out increasing the quantity of fluid in the body. They also re-
lieve distress occasioned by food.
SUMACH PILLS.
1303. Take of sumach gum (863) and fir balsam, equal parts;
pulverized loaf sugar-sufficient to form them into pills. These
are beneficial in gonorrhoea, gleet, fluor albus, and strangury.
They increase the secretion of urine, and lessen its burning or
scalding sensation on being voided. One or two may be taken at
a dose, and repeated three times a day.
LINIMENT.
WOLATILE LINIMENT.
1304. Take of Candia soap, cut or scraped into shreds, three
ounces; camphor an ounce and a half; tincture of cayenne half a
pint; alcohol half a gallon. Inſuse in a closely stopped bottle for
a week, shaking it two or three times a day.


LIST OF COMPOUNDS. - 319
1305. Uses. This liniment is superior to any other with
which I am acquainted for bathing sprains, bruises, rheumatic
joints, and parts that are the seat of pain. It is equally beneficial
in numbness. When it is applied, the part should be rubbed
briskly for ten or fifteen minutes with the hand. It is highly
useful as an application to the side in pleurisy, and to the abdomen.
in tenderness or swelling of the bowels. If it is not sufficiently
powerful, an additional quantity of the tincture of cayenne may be
added.
STIMULATING LINIMENT.
-
1306. Take of gum elastic, cut into shreds, four ounces; lin-
seed oil a pint. Simmer these over a slow fire, stiring constant-
ly, until the gum is dissolved, which will be in five or six hours.
Then add three quarters of a pound of fresh beef’s tallow, and
continue the simmering until it is melted. When about blood
heat, add an ounce each of the oils of cedar and hemlock, and
a wine-glassful of the best antispasmodic tincture, stirring them
well together.
1307. Uses. This liniment is highly serviceable as an ap-
plication to the surface of the body after a vapor bath, or a course
of medicine, particularly in the winter season. The skin should
be rubbed with it thoroughly from head to foot. Patients who are
laboring under chronic diseases, and possess but little animal heat,
are greatly benefited by this practice. The liniment forms a
coating upon the skin, and shields it from the air, without inter-
fering at all with its functions. In night sweats, rheumatism,
ague and fever, asthma, croup, consumption, dyspepsia, and tic
douloureux, it may always be employed with advantage. If not
sufficiently stimulating, it may be combined with a portion of cay-
enne, reduced to a very fine powder.
OINTMENTS, SALVES, AND PLASTERS.
MEADOW FERN 0INTMENT.
1308. Take of meadow fern leaves and balm of Gilead buds,
well bruised or pounded, each three ounces; fresh lard a pound.
Moisten the buds with water, and simmer them in the lard, over
a slow fire, until they cease to be glutinous, which will be in
three or four hours. Then add the meadow fern burrs, also


320 LIST OF COMPOUNDS,
moistened with water, and continue the simmering until their
strength is extracted, which may be determined by rubbing them
between the fingers, and ascertaining that they do not emit a fra-
grant smell. Pass the ointment through a coarse cloth, or sieve,
and pour it into some convenient vessel.
1309. Uses. I have had considerable experience with this
ointment, and can recommend it as an excellent application in
tetter, scald head, soreness of the lips, or nose, itch, poison from
ivy, or dogwood, and various cutaneous eruptions. A lady of
Boston applied to me with an eruption upon her hands and arms,
of six months standing, which appeared in a succession of little
vesicles, followed by dry, brown scales or scabs. When I first
saw the patient, her hands were swelled and painful, and several
of the vesicles had been succeeded by troublesome ulcers. I
directed the hands to be washed once a day with Castile soap and
water, and the ointment applied morning, noon and night, preced-
ed by a wash, now and then, of the tincture of lobelia. }. this
treatment, together with a moderate use of composition and spiced
bitters, a perfect cure was effected in less than three weeks. I
mention this case as one out of many to show the value and effi-
cacy of the above ointment. -
NERVE 01NTMENT.
1310. Take of purple archangel, bittersweet bark, wormwood,
chamomile, and meadow fern burrs, equal parts; pack them close-
ly in a suitable vessel, and cover them with porpoise, goose, or
turtle oil—the latter is the best. Simmer over a slow fire for
twelve hours, stirring occasionally, and keeping the vessel covered.
Strain, and when milk warm, add half an ounce of the oil of
spearmint to each pint of the ointment. Preserve in a well cork-
ed bottle.
1311. Instead of the oil of spearmint, Dr. Thomson adds
one ounce of the spirit of turpentine, but I consider the former
preferable. -
-
1312. Uses. This is employed in bathing sprains, bruises,
swellings, stiff joints, and contracted sinews or tendons, rubbing
the affected part briskly with the hand, when the application is
made, and wrapping it in flannel to shield it from the air. The
ointment is also applied to corns, as will be mentioned hereafter,
in speaking of that complaint. It may be rendered more stimula:
ſing, iſ desirable, by combining with it a portion of antispasmodic
tincture, or tincture of cayenne.



List of Compounds. 321
PILE 0INTMENT.
1313. Take of the excrescences which form "upon the leaves
of the sumach, (864) very finely powdered, an ounce; fresh lard
six ounces. Blend them together thoroughly. This is bene-
ficial in piles, and often affords surprising relief. It may be con-
fined to the parts by means of a bandage, and a piece of lint, or
folded rag.
1314. Instead of the excrescences, mentioned above, an equal
quantity of the root of marsh rosemary, reduced to a fine pow-
der, may be substituted, but it is not quite so efficient.
1315. Gall ointment is an excellent application in piles, and
deserves a passing notice. Take of galls, in very fine powder,
an ounce, lard seven ounces. Mix. This is the formula of the
United States Dispensatory. -
HEALING SALWE.
1316. Take of Venice turpentine, beeswax, and fresh lard,
each a pound, fir balsam three quarters of a pound, tincture of
myrrh four ounces. Melt the solid articles, simmer slowly for
ten or fifteen minutes, and strain. This salve is applied to wounds
and sores after they have been cleansed by poultices, or otherwise,
and the inflammation subdued.
GREEN SALWE.
1317. Take of Venice turpentine, and bayberry wax, (818)
each half a pound. Melt, and add sweet oil to render the salve
of a proper consistence. This is recommended by Dr. Smith of
New York, as an application to scrofulous ulcers.
COMMON SALWE.
1318. Take of Venice turpentine, beeswax, and mutton
tallow, equal parts; add the yolk of an egg, and a small portion of
honey. , Melt. This salve is applied to fresh wounds. It ex-
cludes the air, and favors the healing process.
41

322 LIST OF COMPOUNDS.
AD HE SIVE AND STRENGTHENING PLASTER.
1319. Take of rosin a pound and a half, beeswax, hemlock
gum, and fresh lard, each two ounces. Melt; add half a gill of
brandy, and a quarter of an ounce each of sweet oil, sassafras oil,
and camphor. When the different articles are thoroughly incor-
porated, pour them into a vessel of cold water, and work them
with the hands, as a shoemaker works his wax. The proportion
of rosin requires to be increased in the summer, and diminished
in the winter.
1320. Uses. This compound, spread on soft leather, is
applied to a weak back, or any other part of the body which is in
a state of debility. The relief which follows its application, is no
doubt owing, in a great measure, to the mechanical support which
it affords to the muscles. It is also used as an adhesive plaster
to confine the lips or edges of wounds together. For this pur-
pose it is spread on cotton or linen cloth, which is cut into slips,
warmed by the fire, and applied across the wound according to
the circumstances of the case. This plaster is extremely useful
also, for confining poultices to different parts of the body, which
it might be inconvenient, or perhaps almost impossible to bandage.
CANcer PLAst ER.”
1321. Take of red clover blossoms any desirable quantity,
and water sufficient to cover them; boil gently until the strength
of the blossoms is extracted, which will be in about an hour;
strain through a coarse cloth, and use pressure sufficient to force
out all the liquid; pour this into some convenient vessel, and place
it in a kettle of water over the fire; boil until the liquid is of the
consistence of tar.
1322. Uses. This is spread on a piece of linen, or soft
leather, and applied to open of running cancers, and ill conditioned
sores of every condition. The success which has attended its
employment in these cases, has won the approval even of the
medical faculty. The Boston Medical Journal says, “We are
assured by Dr. Corbett, that on ulcerated surfaces, deep, ragged-
edged and otherwise badly conditioned burns, there is nothing to
*The Shakers of Canterbury, N. H. manufacture this article, and call it the
extract of red clover.

List of COMPOUNDS. 323
be compared with this plaster. In connection with a peculiar
soothing property which it imparts to an inflamed, irritable sore, it
roves an efficacious detergent, and promotes a healthful granu-
|. - -
MISCELLANEOUS PREPARATIONs,
-
-
ANTI-DYSPEPTIC BREAD.
1323. Take of pulverized poplar bark, bayberry, golden seal,
cloves, cinnamon, and lady’s slipper, each two ounces; cayenne
one ounce; loaf sugar four pounds and a half. Mix thoroughly,
and siſt. Knead these articles into a stiff dough with mucilage of
slippery elm, adding an ounce each of the oils of pennyroyal and
spearmint. During the process of kneading, the table should be
sprinked occasionally with fine flour. If slippery elm cannot be
obtained, a mucilage may be prepared with buck horn brake, Irish
moss, or hollyhock blossoms, which will answer an equally good
purpose. After the bread is sufficiently kneaded, it may be made
into cakes or loaves of a convenient size, or rolled into pills.
1324. Us Es. This preparation may be carried in the pocket,
and eaten freely, whenever there is any occasion for its employ-
ment. It is beneficial in coughs, consumption, ſaintness at the
stomach, dyspepsia, jaundice, loss of appetite, sore throat, mercu-
rial salivation, and scrofulous affections. It warms and invigo-
rates the system in cold weather, and dissipates the languid or
drowsy feelings which are so often experienced on the return of
. Travellers, and seamen, who are much exposed to a
changeable climate, would find it a valuable preventive of disease.
Dr. Thomson recommends it as a substitute for tobacco, with this
difference, however, that the bread is to be swallowed, as it
dissolves in the mouth.
HEADACH SNUFF,
,1325. Take finely powdered bayberry, and scent it with the
oil of spicy wintergreen, or golden rod. This is useful in head-
ach, and colds. I know an inveterate snuff taker, who has substi-
tuted it for the preparations of tobacco. It has been employed
beneficially in polypus of the nose, but is not so efficient as the
powdered blood root.



324 LIST OF COMPOUNDS,
SMELLING SALT5.
1326. Take of pearlash one ounce, sal ammoniac half an
ounce. Pulverize each by itself, and mix. Preserve in a closely
stopped bottle, or it will liquefy. This is useful in headach, ſaint-
ness, and vertigo.
WEGETABLE CAUSTIC.
1327. Take of the common sheep sorrel, any desirable quan-
tity; bruise or pound it in a mortar, and press out the juice;
evaporate this in the sun, until it is of the consistence of tar.
The caustic, thus prepared, is to be spread on a piece of linen,
bladder, or soft leather, and applied to the cancer, removing it
occasionally if it becomes too painful. When the skin is broken,
and the cancerous tumor extracted, other applications may be
made, such as the cancer plaster, or poultices, according to the
peculiarities of the case. See cancer in the index.
1328. Another form of vegetable caustic is made as follows.
Boil the ley of hickory, or oak ashes until it is of the consistence
of tar. Mix this with a small portion of honey, and apply as
already directed, taking care to confine the caustic within the cir-
cumference of the tumor.

P A R T F I F T H .
P R A C T I C E O F M E D I C IN E .
PRELIMINARY OBSERVATIONS.
FEWER. -
1329. This is a disease which seems to be regarded by the
medical faculty as a profound and impenetrable mystery. Pro-
fessor Jackson of the Pennsylvania University, says, “This
problem has continued unsolved to the present period, has been
the most disquieting question of our science, and has heretofore
defied the attempts, even of the most gifted, to give it permanent
form, or settle it on an established basis.” Again, he observes,
“For the greater part, the professed treatises on ſever, have been
works of imagination, composed in the style of romances—ſancy
sketches—or are profound metaphysical abstractions, filled with
subtleties, and hypothetical reasonings.”
1330. Dr. Good, than whom no man is more distinguished
for his researches in medical science, observes, “No complaint is
so common as fever, and none so difficult to be defined. In re-
ality, no writer seems to have been fully satisfied with his own
definition; and it is not extraordinary, therefore, that he should
seldom have given satisfaction to others.”
1331. Dr. Southwood Smith, physician to the London Fever
* Principles of Medicine, by Samuel Jackson, M. D. p. 608.
# Study of Medicine, 6th American edition, vol. i. p. 325.
326 PRACTICE of Medicine.
Hospital, pursuing the same train of reflections, says, “The
slightest glance at the history of the doctrines which have been
taught relative to the nature and seat of fever from remote an-
tiquity, and more especially a consideration of the variety and
even the contrariety of the received opinions respecting both, in
the present day, but too clearly show that if the ancients were in
error, there cannot be many points with regard to which the mod-
erns are right, since there is scarcely one in which they are
agreed.”
1332. Dr. Eberle falls into the views of Dr. Smith, and says,
“From a retrospective glance over the history of our science, we
are forced to acknowledge that there is, perhaps, no subject which
is more eminently calculated to humble the pride of human reason
than this one. In relation to it, pathology has been in a continued
state of revolution and instability. The human mind has been
engaged with it for near three thousand years. Theories have
risen and sunk in a continued and rapid series of succession; each
has had its hour to strut upon the stage,’ and its votaries to yield
it faith ; but the stream of time has hitherto overturned all these
insubstantial, though often highly wrought fabrics.”f
1333. With these acknowledgments of the medical faculty,
that they are totally ignorant of the nature of ſever, how are they
to prescribe for it with safety or success If their treatises on
the subject are mere “works of the imagination”—“fancy
sketches”—“metaphysical abstractions,” what are we to expect
from their practice but devastation and death Is it any wonder
that fever is a scourge of the human race : Need it excite our
surprise that the learned Dr. Bostock should have pronounced it
“the opprobrium of the medical faculty?” Need we be astonished
at the exclamation of the late Dr. Hosack, that “ſever and fe-
brile diseases still constitute the great outlets of human life, and
continue to be almost as fatal as in the time of Sydenham, who
calculated that eight out of nine of all the deaths occurring in the
human family, were caused by febrile complaints * -
1334. It has been said of the celebrated John Hunter, that if
he once formed an opinion, he would obstinately adhere to it
under all circumstances; and Dr. Rush has facetiously character:
ized him as one “who would never give up any thing he asserted
until he gave up the ghost.” This is unfortunately the case with
the great body of medical men, especially with regard to their
* Smith's Treatise on Fever, p. 19. Philadelphia, 1830.
# Eberle's Practice, 4th edition, vol. i. p. 14.
# Thatcher’s American Medical Biography.

practice of Medicine.
doctrines concerning ſever, for although they consider the dis-
ease as one beyond the powers of their comprehension, they
continue to adhere to their dogmas respecting it, and denounce all
who have the hardihood to differ from them in opinion.
1335. It is amusing to take a retrospective glance at the
various theories which have existed in relation to ſever. Hippoc-
rates, who is styled the Father of Medicine, supposed there were
four humors in the body, consisting of blood, phlegm, and yellow
and black bile, and that if either of these were in excess, nature
rallied her efforts to expel it, and gave rise to a commotion which
terminated in some one of the forms of ſever. This doctrine
was advocated by Galen, five or six centuries after the time of
Hippocrates, and though the former is still regarded by modern
physicians as a brilliant light in the medical firmament, his fan-
ciful speculations can have no other effect than that of exciting our
laughter, or ridicule. He believed, says Dr. Southwood Smith,
“that ſevers were modified by the prevalence or putrefaction of
one or other of the four humors of Hippocrates; that of the three
kinds of ague and fever, one arose from the corruption of phlegm,
a second from that of the yellow bile, and the third from that of
the black bile; that in whatever part of the body the heat or ſever
commenced, it ultimately extended to the heart; that as soon as
this happened, the genéral commotion of the vessels commenc-
ed, and in this manner nature was employed in exciting her
powers, endeavoring to assimilate the good humors to the parts
which were to be nourished, and to expel the bad, but that if
at any time nature was unable to expel all the morbid humor, either
from its thickness, abundance, or tenacity, or from some obstruc-
tion of the passages, it would necessarily undergo putrefaction, and
produce the most fatal effects.”
1336. During the seventeenth century, the famous Sydenham
came before the world with a new theory, and taught that dis-
eases were owing to an impure state of the air, the particles of
which became incorporated with the blood, and produced in it
a “morbific contagion;” that nature provided herself with a
method to expel this morbid matter, which would otherwise ruin
the patient; that the gout was nothing but nature's contrivance to
purify the blood of old men, and to purge the deep parts of the
body; and that ſever was also a contrivance of nature to separate,
either by perspiration, looseness, or some kind of eruption, the vi-
tiated particles of the blood which had been drawn in by the air.
* Smith’s Treatise on Fever. Philadelphia, 1830.
† Dr. Southwood Smith. -




328 PRACTICE OF MEDICINE.
1337. Boerhaave, who succeeded Sydenham, supposed that
fever was owing to a viscid or glutinous state of the blood, which
was forced into improper vessels, and became stagnant “in the
extremities of the capillaries,” thereby causing the cold and hot
stages of the disease.
1338. Clutterbuck and Broussais attributed fever to a local
inflammation, but they differed as to its seat, the one referring it
to the brain, and the other to the mucous membrane of the sto-
mach and bowels. They both appealed to their dissections of
dead bodies to prove the correctness of their views, but neither of
them, at the present time, appear to have many advocates.
Broussais, however, deserves credit for having adopted a less
pernicious plan of treatment than that in common use, for instead
of administering calomel, nitre, and other poisonous drugs, he
relied chiefly on abstinence from food, and the use of acid-
ulated gum water, as a drink. In other words, he amused the
patient, while nature was performing a cure.
1339. Among the various authors of distinction who have
written on the subject of fever, no one, in all probability, has ap-
proached nearer to the truth, in many respects, than Dr. Cullen,
though some of his opinions, it must be admitted, have been dis-
carded as having no foundation in truth. In his doctrine of fever,
he remarks, the most noted of the remote causes, among which he
includes contagion, miasmata, and cold, are of a sedative nature,
and diminish the energy of the brain, thereby producing a debility
of the whole system, and particularly of the minute or capillary
vessels of the skin. “It is evident,” he thinks, “that there
are three states which always take place in ſever, a state of de-
bility, a state of cold, and a state of heat. The cold stage,”
he affirms, “appears to be universally a means of producing the
hot, because cold, externally applied, will often give rise to sim-
ilar effects.” He also says, “the more powerful the debilitating
causes, and the greater the debility produced, the longer and more
frequent will be the paroxysms.” }. doctrine seems to have
met with the approbation of Dr. Rush, who says explicitly, and
almost in the language of Cullen, that “fevers of all kinds are
preceded by general debility, natural, or accidental.” -
1340. There can be no doubt, that previous to the com-
mencement of ſever, whether it be ushered in by a chill, or not,
the minute or capillary vessels of the skin are in a state of debility,
and as soon as febrilé action ensues, the blood rushes into these
vessels in a preternatural quantity, giving rise to an increase
of heat, which has been denominated ſever. The diameters
of the vessels are necessarily enlarged by the passage of the




PRACTICE OF MEDIC IN E. 329
blood into them, just as a delicate India rubber tube is enlarged
by injecting it forcibly with water, and under these circumstances,
there is a natural tendency of the blood to accumulate at the sur-
face of the body. We see a familiar illustration of this principle
in a red or bloodshot eye. When the organ is in a healthy con-
dition, its blood-vessels are so exceedingly minute as to carry
only white blood, the globules of which are smaller than the
globules of red blood, but when the vessels are weakened by dis-
ease, or the irritation of some foreign body, there is an enlarge-
ment of their diameters, and the red blood is forced into them,
giving to the eye a red or inflamed appearance.
1341. Again, if the hand be immersed for a quarter of an hour
in very cold water, and then withdrawn, it will soon become red
and hot; the explanation of this is, that the blood-vessels have
been weakened by the sedative effects of the cold, and are ca-
pable of receiving a greater quantity of blood than belongs to
them in a natural or healthy condition. The application of snow
to the back of the hand will produce the same effects, and this
experiment can be performed by any individual for his own satis-
faction. When the snow is removed, the skin will be pale and
contracted, and the vessels destitute of blood, but presently it
will return, giving them quite a swollen appearance, and even
the neighboring vessels will be more full of blood than usual.
Every one knows, that after exposure for any length of time to a
cold and searching wind, the face becomes red and hot, which is
another illustration of the principle in question. The Russian, or
Finlander, who takes his vapor bath, and rolls in the snow, or
plunges into a stream of icy coldness, as is his constant habit, soon
experiences a warm or hot glow of the skin, accompanied with a
bright red color, which a physician might readily mistake for a fe-
ver, if he were unacquainted with the circumstances of the case.
I heard Professor Ware remark, in a lecture, that he knew a gen-
tleman who, after riding eight or ten miles in the wind, an exercise
to which he was not accustomed, had all the symptoms of a ſever,
and for two days he (the professor) was certain there was a ſever.
Now in this instance, the exposure had no doubt slightly debili-
tated the capillary vessels at the surface of the body, which ſa-
vored the accumulation of blood within them, and gave rise,
thereby, to an increase of temperature; but as there was probably
but little derangement of the system in other respects, the vessels
soon recovered their tone, and the circulation became equalized.
Izet an individual roll in the snow for a few minutes, previously
divesting himself of his clothes, and then wrap himself warmly in
blankets, and his skin will soon become as hot as though he were
attacked with a violent ſever. If, however, his health was not
-

42 -

330. PRACTICE OF MEDIC INE.
previously impaired, the energies of his system will soon restore a
balance to the circulation, and the heat of the skin will then
subside.
1342. Debility of the capillary vessels at the surface of the
body, therefore, is indispensable to the development of ſever, and
this debility may be produced by various causes, as exposure to
cold, impure air, wounds, checked perspiration, intemperance in
eating and drinking, the use of mineral or vegetable poisons, or
any thing which has a tendency to disorder the system. Dr.
Beaumont observes, that undigested food in the stomach appears
to produce all the phenomena of fever. An injudicious use of
the cold bath will sometimes give rise to the disease, as I have
had occasion to notice in several instances. Magendie has pro-
duced all the symptoms of a dangerous fever in an animal, by in-
jecting a few drops of putrid water into its veins.
1343. Fever may be complicated at its commencement with
inflammation of some internal organ, or it may exist without it;
but as a general thing, the inflammation no doubt arises as a second-
ary symptom. We have examples of this in the sore throat of
scarlet ſever, and the inflammation of the small intestines in typhus
fever, either of which may be prevented by timely, appropriate.
and sufficiently active treatment. The doctrine of Broussais, that
fever has its origin in an inflammation of the mucous membrane of
the stomach and bowels, is denied by the medical faculty gener-
ally, and is not deserving of serious notice. Fever is most em:
phatically a disease of the whole system, and of course is followed
by a great variety of symptoms, differing according to the circum-
stances or pecularities .."the case. Dr. Fordyce, in his remarks
on ſever, says, “It affects the head, the trunk of the body, and
the extremities; it affects the circulation, the absorption, and the
nervous system; it affects the skin, the muscular fibres, and the
membranes; it affects the body, and likewise the mind. It is,
therefore, a disease of the whole system, in every sense of the
word. It does not, however, affect the various parts of the sys-
tem uniformly and equally; but, on the contrary, sometimes one
part is affected in proportion to the affection of another part.”
1344. With regard to the symptoms of ſever, it is said of
Boerhaave, that “he collected from a great number of authors, all
the symptoms which had been observed to attend the disease in
its different forms. He then struck from the list all those which
do not appear in all, but only in certain modifications of ſever-
retaining such only as by the common consent of authors, and his
* Good's Study of Medicine, 6th American edition, vol. i. p. 334.
PRACTICE OF MEDIC INE. 33i
own observations, were found to be present in every instance of
the disease. The result was, that only three symptoms were left
standing—namely, a quick and frequent pulse, preternatural heat
of the surface of the body, and a sense of cold or chilliness in the
commencement.”
1345. “Inequilibrium of the circulation,” says Dr. Eberle,
“is one of the most important characteristics of fever,” and this
is an obvious and familiar truth, which no one will pretend to deny.
The increased heat of the skin indicates that there is an excess of
blood in its vessels, and consequently, there is a corresponding
deficiency in some other part of the body. In the chill which
|...". a ſever, the skin is pale and contracted, because the
lood has retreated to the internal organs, but when the febrile re-
action ensues, it is returned to the surface, and the skin acquires
its natural fulness and color. Whether ſever is general or local,
the capillary vessels of the part or organ in which it is manifested,
are surcharged with blood, and this presupposes a loss of balance
in the circulation. In brain ſever, for example, which has termi-
nated fatally, the membranes of the organ are found, on dissection,
to be more or less congested, having a red or inflamed appearance.
When we speak of an organ, therefore, as being in a ſeverish
condition, we understand that it contains an excess of blood, and
of course there must be a deficiency of blood in some other or-
gan, constituting what Dr. Eberle terms an “inequilibrium of the
circulation.” *
1346. How are we to account for the preternatural heat of the
skin, in ſever, unless we admit that its vessels are surcharged with
blood; for this fluid is the only medium by which heat is diffused
through the system. Magendie remarks, that “the temperature
of the body depends on the passage of the blood through the
tissues, and it is evident that it will increase in direct ratio of the
volume of the blood.” This is verified in wounds, which soon
become hot and feverish by the flow of blood into the small and
debilitated vessels of the injured part; and some of the French
surgeons, availing themselves of this knowledge, recommend that
wounds be frequently wetted with cold water, which, to use the
language of a French writer, “prevents the blood from rushing
in the natural quantity toward the affected part, and in a word, pre-
vents the phenomenon of inflammation.” -
1347. The temperature of the skin, in ſever, notwithstanding
it is hot to the touch, does not exceed that of the blood, whether
* Eberle's Practice, 4th edition, vol. i. p. 15.
t Lectures on the Blood, vide Select Medical Library for 1839.



332 PRACTICE OF MEDICINE.
the latter be above or below the natural standard. In health, the
skin is several degrees colder than the blood, but when its vessels
are distended with this fluid, as is the case in ſever, its tem-
perature is proportionably increased. Magendie, whom I have
quoted so frequently, remarks, that “when the blood rushes to
a part in abundance, a certain rise of temperature no doubt oc-
casionally follows, but it only reaches a few degrees above the
natural standard, and never exceeds that of the blood in the left
cavity of the heart.” -
1348. As to the precise temperature of the blood in the
various fevers, nothing seems to be definitely known. Dr.
Thomson tells us that it is always below the natural standard, but as
this is a mere assertion on his part, unaccompanied with any proof,
it is not entitled to notice. It is evident, however, that the animal
temperature sinks below or rises above the natural standard,
according to circumstances. In cholera, according to Profes-
sor Espy, the heat of the body has been reduced as low, in some
cases, as 60 degrees; while in scarlet ſever, it has been known
to rise as high as 105, or even 110 degrees. In ague and
fever also, in which it is usually supposed, from the severe chills
which accompany the disease, that the animal temperature is more
or less diminished, we have the authority of some able experi-
menters, that it is considerably augmented, even during the cold
stage. “M. Gavarret,” says Dr. Dunglison, “has made nu-
merous observations on the temperature of the human body during
different stages of intermittent ſevers, as well as in health, and
from these it appears, that even during the stage of rigor (chil-
liness) the heat of the body is elevated from two to three degrees
above its usual temperature. In the hot stage he has found the
temperature still more elevated, but never more than one degree
above that attending the stage of rigor; while in the sweating
stage, though the temperature was above that of health, it was
much below that of the two preceding stages.”f -
1349. Whether any confidence is to be placed in the exper-
iments of M. Gavarret, I do not know, but they will at least
serve to convince us, that there is a great deal of uncertainty
with regard to the temperature of the body in ſevers.
1350. I need scarcely say that the diplomatised physicians
are without any principles to govern them in the treatment o
fever. Some of them are opposed to depletion, in all its forms,
and contend that even the mildest purgative is capable of doing
* Lectures on the Blood, vide Select Medical Library for 1839.
+ American Medical Library for September, 1840, p. 169.
PRACTICE OF MD DIC INE. 333
injury, while others employ the lancet with a bold and ſearless
hand, and administer cathartics, and a great variety of poisonous
drugs, without much regard to quantity. Dr. Bostock, in some
remarks on the different kinds of treatment which have been insti-
tuted in ſever, says, “in a space of less than forty years, we have
gone through three revolutions of opinion with respect to our
treatment of a disease of very frequent occurrence, and of the
most decisive and urgent symptoms.”
1351. With this candid acknowledgment of an eminent med-
ical writer before us, how is it possible to regard the established
practice of physic in any other light than that of the most absolute
quackery Instead of being a science, it is a mere system of
guess-work, made up of jarring and discordant theories, and alto-
gether unworthy the sanction of an enlightened or philosophic
mind. As well might the astrologer, who pretends to read the
stars, claim to be infallible in his predictions, as for the routine
physicians to assert that they can cure disease, when they ac-
knowledge that their practice is destitute of any fixed principles,
and is swayed by “every tide of professional opinion.”
1352. Professor Jackson believes that “fever is a provision of
nature for the safety of the animal economy;” that “it is sanative
and salutary in design—the evidence of power and force which
admits of remedial and curative operations.” If this distinguish-
ed writer imagines his premises to be correct, why does he, in
common with his medical brethren, recommend a plan of treat-
ment which tends to destroy the vital energies, and counteract the
sanative operations of nature * Dr. Southwood Smith truly ob-
serves, “ the physician can easily weaken, but he cannot easily
strengthen ; he can depress to any extent he pleases, but he can-
not communicate power as he wishes.” This is obviously true,
and though a fever may be subdued by blood-letting, together
with the administration of pernicious drugs, the patient may never
recover from the debility which the treatment has occasioned.
Cases of this kind are occurring daily, and while the physician
gazes upon the wreck he has made, no one appears to suspect that
he has been the sole cause of the fatal catastrophe.
1353. With regard to what is deemed the appropriate treat-
ment of fever, as it is pursued in the reformed or vegetable prac-
tige, adequate directions will be given when we come to speak
of the different forms of the disease, and therefore it need not
occupy our attention here. I will remark, however, that as ſever
* History of Medicine, chapter xiii.
t Principles of Medicine, p. 606.
#Treatise on Fever, p. 39.


334 PRACTICE OF MEDICINE.
-
-
does not occur without the equilibrium of the circulation having
been destroyed, it should be our object to restore that equilibrium
as speedily as possible, and this is to be accomplished by the use
of stimulants, the vapor bath, and if necessary, thorough courses of
medicine, which will remove the disease without lessening the
quantity of blood in the system, impairing the constitutional pow-
ers, or laying the foundation of some obstinate malady which is
more dreadful than death itself.
INFLAMMATION. -
1354. According to medical authors, the phenomenon of
inflammation is as difficult to solve as that of ſever. Professor
Gross, a recent writer, says, “In the whole range of medical
science, there is no topic which has attracted so much attention,
and been the source of so much discussion, as this. Theory after
theory has been formed, each in its turn to live for a while, and
then to give way to some other, either more ingenious, or fos-
tered and protected with more talent and pertinacity by its au-
thor.”
1355. Inflammation, according to this writer, plays a conspic-
uous part in a great variety of diseases. He says, “it may be
assumed as a general proposition, liable to few exceptions, that all
..". diseases, whatever be their seat or extent, are the result
of inflammatory action, either of an acute or chronic kind.”
1356. Clutterbuck, in his remarks on inflammation, says, “It
is a subject about which widely different, and even opposite opin-
ions still prevail among practitioners. It is often asked, What is
inflammation ? In what does it essentially consist? These are
questions to which, I fear, no very satisfactory answer can be
given.”
1357. In inflammation, as in fever, there appears to be a weak-
mess or debility of the blood-vessels, which allows the blood to flow
into them in an unnatural quantity, giving rise thereby to an enlarge-
ment of their diameters, and the various phenomena of the disease.
In inflammation of the eye, we have no difficulty in perceiving that
there is an enlargement of the vessels, for we can then distinctly
trace them in the delicate coats of that organ. Dr. Martyn Paine
asserts, that the vessels of an inflamed part contain a preternatural
quantity of blood, because a profuse hemorrhage often follows the
* Pathological Anatomy.
+ Lectures on Blood-letting, vide Select Medical Library for May, 1889.


PRACTICE OF MEDICINE. 335
application of leeches to an inflamed surface. He also observes,
that many physicians have objected to scarification in erysipelas,
on account of the great flow of blood which is liable to take
place.”
1358. SIGN's of INFLAMMATION. These are redness, swel-
ling, pain, and augmented heat, each of which is owing to an in-
crease of blood in the capillary vessels. With regard to the swel-
ling, there is also an effusion of the lymph or fibrine (117) of the
blood into the surrounding parts, which “glues the whole struc-
ture together, and consolidates them into one mass.” The com-
pression of the nerves by the distended vessels, is said to be the
cause of the pain. The throbbing which is sometimes experi-
enced, is attributed to the pulsation of the arteries.
1359. The heat of an inflamed part never exceeds that of the
blood. In the inflammation of an internal organ, therefore, it is
probable that there is no increase of heat, but when the inflamma-
tion is seated externally, there is an elevation of temperature, be-
cause the skin, in health, as already stated, is several degrees
colder than the blood. -
1360. Parts that are insensible in health, as ligaments, carti-
lages, and bones, are extremely sensitive when inflamed.
1361. Suppuration. When an inflammation does not sub-
side without the production of matter, it is said to terminate in
suppuration. The matter thus formed, is technically termed pus,
and is described as a cream-like fluid, heavier than water, and
generally of a pale straw color. It is found in boils, and other
swellings or tumors, and on the surface of sores. When it col-
lects in the substance of an organ, it constitutes an abscess, and
this abscess or cavity, is surrounded by a hard or indurated wall,
which prevents the pus from escaping into the adjacent texture.
This is verified in boils, the hardened circumferences of which
may be traced with the fingers. Sometimes, however, no such
boundary is established, and the pus makes its way into the neigh-
boring parts. This is particularly the case in weakly constitutions,
or persons of a scrofulous habit.
1362. Pus varies in appearance according to circumstances,
and is sometimes extremely poisonous, irritating and inflaming the
parts with which it comes in contact. Of this character is the
- discharge in gonorrhoea, the contents of a smallpox pustule, and
the matter employed by the diplomatised physicians in vaccination.
sº." of Inflammation, vide American Journal Medical Sciences for May,
-



336 PRACTICE OF MEDICINE.
1363. When suppuration commences, or, in other words,
when matter begins to form, the patient is attacked with chills,
succeeded by flushes of heat, and other disturbance of the general
system. Meanwhile the tumor or swelling, if it is situated exter-
nally, becomes soft and pointed, and finally bursts. The chills,
however, may be usually prevented by the use of cayenne, or
composition, so as to keep the skin moist, or if the case is severe,
by the administration of one or two courses of medicine.
1364. Suppuration may be promoted by the application of
emollient poultices, as these produce a soft and relaxed condition
of the skin. The local application of vapor, also, where it is con-
venient, is exceedingly useful for the same purpose.
1365. ULCERATION. This is understood to be an absorption
of any part of the body, resulting from previous inflammation, and
may be defined therefore, as an increased action of the absorbent
vessels. For instance, the parts over a deep seated tumor or
swelling, are absorbed, to allow the matter to approach the surface
of the body, or in common language, it may be said that the tu-
mor has ulcerated through the skin. It is a wise provision of na-
ture, that matter always tends to the surface of the body, or it
might be discharged into some internal cavity, as the abdomen,
or chest, and do irreparable injury. Dr. Cooper observes,
“. Even where there is but a delicate membrane between the
matter and some internal cavity of the body, the abscess gener-
ally bursts externally, though it may have to make its way through
a considerable thickness of substance.”
1366. “An ulcerating sore,” says Dr. Hunter, “is made up
of little cavities or hollows; and the edge of the skin, which is
scolloped or notched, is thin, turned a little out, and overhangs
the sore, more or less. Further, the sore is always foul, being
composed of parts not absolutely absorbed, and discharges a thin
matter. When the ulceration stops, the edge of the skin becomes
regular, smooth, a little rounded or turned in, and of a purple
color, covered with a semi-transparent white.” -
1367. “Parts at a considerable distance from the source of
circulation,” says a writer on Surgery, “are generally more dis-
posed to ulcerate, than others situated near the heart. This ac-
counts, in a measure, for the greater number of ulcers on the
lower extremities, than on the arms. Newly formed parts of the
body, as cicatrices, callus, and all adventitious new matter, like
tumors, are more liable to be absorbed than those which have long
existed. In Lord Anson's voyage, when the crew of the ship
began to suffer from great privations, fatigue, and scurvy, it was
remarked, that those men who formerly had ulcers and broken

PRACTICE or MEDICINE. 337
bones, became again disabled by the old sores breaking out afresh,
and the callus of the old fractures being removed by absorption.
When the men arrived on shore, where they could obtain fresh
vegetables, they recovered their health, their bones united, and
their sores heałed.”
1368. Bones, as well as other parts of the body, are subject
to ulceration, but the ulceration is termed caries, and if they be-
come completely dead or decayed, it is called necrosis.
1369. Mortification. This is one of the modes in which
inflammation terminates, where it has been neglected, or im-
properly treated. Its symptoms will be detailed under the appro-
priate head.
1370. CAUSEs. Among the various causes which operate to
produce inflammation, blood-letting stands conspicuous; and it is
melancholy to reflect, that the very means which are employed by
medical men to subdue inflammation, very frequently render it
much more violent.
1371. Dr. Mackintosh says, “Inflammation of the substance
of the brain may take place, when the body is much weakened by
long continuance of hemorrhage.”
1372. Dr. Eberle says, he has met with cases in which in-
ternal inflammation occurred, apparently, in consequence of er-
cessive losses of blood. --
1373. Magendie practised blood-letting on dogs, to see if it
would arrest inflammation, but the disease raged with still greater
intensity than before...i
1374. M. Louis says, “We daily see persons who have been
copiously bled, D1E of INFLAMMATION.”
1375. If these statements are true, and they have the sanction
of high and distinguished names, it is unnecessary to add any thing
further in condemnation of the lancet, as an agent in the treatment
of inflammation, for it not only fails to arrest the progress of the
disease, but absolutely serves to develope it in a healthy state of
the system. (350, et seq.)
* Practice of Physic, 2d American edition, vol. ii. p. 109.
f Eberle's Practice, 4th edition, vol. ii. p. 427.
# Lectures on the Blood, vide Select Medical Library for 1839.
§ Researches on the Effects of Blood-letting, &c., translated by Dr. Putnam.
Beston, 1836.
43


338 PRACTICE OF MEDICINE.
Dise As E-what is it 2
1376. Dr. Gross, in his Pathological Anatomy, says, “Dis-
ease may be defined to be a departure from the sound state,
whether this departure consists simply in a derangement of func-
tion or structure.”
1377. “Disease,” says Dr. Marshall Hall, “is characterized
by some derangement in the vital actions.”
1378. According to Professor Ware, “disease is a deviation
of the body from its healthy state—a perversion of the natural
functions of the organs.”
1379. These definitions accord with each other, and appear to
be correct and philosophical. However slight may be the devia-
tion from the healthy standard, we must nevertheless regard it as
disease, or we shall be unable to fix the boundaries between a
sound and morbid condition of the body.
1380. A disease is either general or local, functional or or-
ganic. It is general, where the whole system is affected, and
local, where it is confined to a particular part. A disease is
functional, when an organ is laboring under some simple derange-
ment, and organic, when there is an alteration in the structure of
the organ. We have an organic disease in tubercles of the lungs.
PULSE.
1881. Every time the heart contracts, it forces the blood
through the arteries, causing them to swell or increase in size,
and when they are superficial, as in the wrist, temple, and top of
the foot, the current of blood may be felt passing through them,
constituting what is termed the beating of the pulse.
1382. There is a great difference in the strength and velocity
of the pulse, in different persons. In some it is extremely slow.
Napoleon’s pulse, it is said, did not average more than forty-four
beats in a minute. In females it ranges much higher than in
males. It is faster after a meal than before, from the excitement
of the digestive process, and is greatly increased by exercise. It
is also influenced by climate. Among the Greenlanders, it is
often as slow as forty or forty-five in a minute.
1383. The pulse is quicker in children than in adults; but in
old age it grows feeble in proportion to the diminished energy of
the heart. The average number of pulsations in healthy persons;
at different ages, laying aside individual peculiarities, is estimated
as follows:–
PRACTICE OF MEDICINE. 339
At birth, it is . . . . . 135 in a minute.
At one year, . . . . . 125 do.
At two years, . . . . . 105 do.
At seven years, . . . . 88 do.
At fourteen years, . . . . 80 do.
At adult age, . . . . . 70 do.
At old age, . . . . . . 60 do.
1384. Disease, the narcotic poisons, or any thing which irri-
tates, enfeebles, or disorders the system, exercises a material in-
fluence on the state of the pulse, and either increases or diminishes
its velocity. Digitalis, by weakening the action of the heart, re-
duces the pulse in a very short time from one hundred to thirty
beats in a minute.
1385. There are several descriptions of pulse, which are
thus briefly summed up by Dr. Mackenzie : “A full, smooth,
and strong pulse,” says he, “is when the artery swells boldly
under the finger, and resists its pressure more or less; if, in ad-
dition to this, the pulsation be very rapid, it is called quick, full,
and strong; if slow, the contrary. A hard, corded pulse, is that
in which the artery feels like the string of a violin, or a piece of
tightened catgut, giving considerable resistance to the pressure of
the finger. In extreme debility, in some particular diseases, and
on the approach of death, the artery vibrates under the finger like
a thread.”
1386. If the pulse is unusually slow, it indicates an affection
of the brain, though there are exceptions to this rule. A rapid
and intermittent pulse, according to M. Louis, is an evidence of
softening of the heart. A pulse of one hundred and twenty, is
thought to indicate considerable danger, particularly in males, and
if it exceeds one hundred and forty, a physician rarely anticipates
the recovery of the patient. I have occasionally found the pulse
at one hundred and forty, however, particularly in low cases of
typhus fever, but by the use of injections, stimulating teas, and
lobelia in small doses, have generally succeeded in reducing it, in
the lapse of an hour or two, to very nearly the natural standard.
1387. The pulse is extremely variable, and physicians who
depend upon it as a guide in their practice, not unfrequently de-
stroy their patients.
1388. Dr. Eberle says, “I have often found a difference
of more than twenty pulsations in a minute, between an examina-

340 PRACTICE OF MEDFCINE.
tion made immediately upon entering the room of the patient, and
a second one, some ten or fifteen minutes afterward.”
1389. “As to the pulse of a very young inſant,” observes a
London physician, “ very little judgment can be formed from it,
for merely pinching the finger will, in a few seconds, occasion it
to be too quick for the pulsations to be numbered.”
1390. Professor Ware, in one of his lectures, spoke of a
young lady who was attacked with fever, and had the pulse at
ninety six throughout the disease, but during her convalescence,
and after she had left her bed, it rose to one hundred and forty-
four, and continued at that rate for several days.
1391. Dr. Mackintosh, in his remarks on lung fever, says,
“The pulse is variable in many respects, and practitioners should
be wary in depending upon it, in the confident manner so gener-
ally followed, and more particularly in this disease, which I have
known to go on rapidly to a fatal termination, the pulse never ex-
ceeding the natural standard. * * *. Morgagni noticed the
uncertainty of the pulse in lung ſever, long ago. Many suppose
that recovery is rare, when the pulse beats more than one hundred
and thirty. Andral makes this remark, and I have no doubt,
from the milk-and-water practice which is too frequently adopted
by French practitioners in inflammation of important organs, that
they may find it se.”f
1392. Blood-letting does not appear to have a decided
influence in reducing the frequency of the pulse in ſever and in-
flammation, though it is so frequently employed by medical men
for that purpose. M. Louis says, “In three patients with lung
fever, bled on the second day of the disease, the pulse fell on the
following day from 120 and 100 beats per minute, to 108, 80, and
96; but the next day, after a second bleeding, the beats were 104,
108, and 90 per minute; that is to say, it had diminished in fre-
quency very little after two bleedings.” The author speaks of
other patients who were bled for the first time on the fourth day,
and in some of them there was no improvement in the pulse at all
on the following day. §
* Eberle's Practice, 4th edition, vol. i. p. 81.
t London Practice of Midwifery, 4th London edition, p. 275.
# Practice of Physic, 2d American edition, vol. i. p. 502.
§ Researches on the Effects of Blood-letting, &c., translated by Dr. Putnam-
Boston, 1836.

PRACTICE OF MEDICINE. 341
FALSE MEMB RAN.E.
1393. This is a substance which covers the mucous mem-
brane of the stomach and bowels, both in acute and chronic dis-
eases, and is detached by the administration of courses of med-
icine, or any equivalent mode of treatment, which tends to exalt
the vital powers, and thoroughly renovate the system. It is of a
grayish, or whitish color, and possesses considerable firmness.
There is every reason to suppose that, in many cases, it lines the
whole extent of the intestinal canal, together with the stomach;
for I have known it to pass off by stool for weeks in succession,
amounting, in the aggregate, to several quarts. It is usually dis-
charged in shreds, or patches, but sometimes passes in a tubular
form, exactly resembling an intestine. It is thick, firm, and
tough, but evidently unorganized, appearing to be wholly destitute
of blood-vessels and nerves. It is similar to the membrane
coughed up by children in croup, and is no doubt an effusion of
lymph, which is soft at first, but gradually hardens, and assumes
the form of a membrane. Dr. Marshall Hall supposes it to con-
sist of mucus, but this is undoubtedly an error.
1394. The ancients, according to Bichat, supposed this
membrane to consist of the inner coat of the intestines. This
writer says, “A character peculiar to dysentery is, dejection by
the anus of membranes of right sizes and of different degrees of
thickness, which sometimes present the shape of the intestines:
this is the reason why the ancients thought that we passed por-
tions of intestines. It is incontestible that they are not portions
of the intestines, but false membranes formed by the same pro-
cess as those that we find in the stomach after poisoning with
nitric acid.”
1395. Professor Thomson of Edinburgh, seems to have im-
bibed the notion of the ancients, that false membrane is actually
a part of the intestines. He has published an elaborate paper on
the subject, which contains an abstract of thirty-five cases, in
which false membrane was discharged, and he uniformly speaks
of it as a portion of the intestinal canal, observing that in twenty-
two of the cases, the discharged portion consisted exclusively of
small intestine. “In respect to length,” he says, “there ap-
pears to have been every variety from six to forty inches, and
there does not seem to have been any relation between the length
of the "...º. portion, and the part of the canal from which it -
came. In a few of the cases, it is said that subsequently to the
Bighat's Patholºgy, from the French, by Dr. Togno, p. 87.
t Wide Edinburgh Medical and Surgical journal for 1835.

342 PRActice of Medicine.
discharge of the principal portion, shreds of intestine, or some-
thing resembling them, were discharged.” In 1836, however, we
find Professor Thomson publishing another paper on the subject,
in the same Journal, in which he rather discards the idea, that the
membrane in question is a portion of intestine. He says, “Dur-
ing the progress of dysentery, it not unfrequently happens that a
layer of coagulable lymph is deposited on the inner surface of the
intestinal canal, and subsequently discharged by stool, resembling
those layers which occasionally form on the inner surface of the
windpipe and air passages of the lungs. If such layers assume a
tubular form,” he adds, “the incautious may very readily mistake
them for portions of the intestinal canal.”
1396. A moment’s reflection must convince us, that the sub-
stance denominated false membrane is not the inner or mucous coat
of the bowels, or it is apparent that its detachment, in pieces
several feet in length, according to the testimony of Professor
Thomson, would be followed by hemorrhage, and death. But
such is not the case, for Professor Thomson speaks of a number
of patients who speedily regained their health, after the discharge
of this morbid substance took place. The inner coat of the in-
testines is a delicately organized membrane, containing blood-
vessels, nerves, and absorbents, and if these were torn or lacera-
ted by the detachment of the membrane, the ſountains of life
would be at once unsealed, and nothing could stay the progress of
death. Mr. Bell, who is distinguished for his work on Anatomy
and Physiology, very beautifully observes, that the external and
middle coats of the intestines, are merely subservient to the inner
or mucous coat; and those who have accurately studied the
physiological relations of this tissue, will not only perceive the
truth of Mr. Bell's remark, but acknowledge that the detachment,
even of a small portion of it, would be attended by serious con-
Sequences.
1397. False membrane, as I have said, is coughed up. by
children in croup, and in some cases of post mortem examination,
it has been found to line even the minute air passages of the lungs:
It is easily separated from the mucous membrane, however, which
shows that it is a distinct formation. The same thing occurs in the
stomach, in mild cases of poisoning by nitric acid. An exudation
of lymph takes place on the inner coat of the organ, intended to
protect it from the corrosive effects of the poison, and this is
ormed into a membrane which is discharged by vomiting. Dr.
Christison observes that the quantity is too great to suppose that it
consists of the mucous membrane of the stomach.
1398. I have stated that false membrane is unorganized—that


PRACTICE OF MEDICINE. - 343
is, that it is devoid of blood-vessels and nerves. Some eminent
anatomists, however, entertain a different opinion. Dr. Gross
quotes two Russian physicians as affirming, that in cholera sub-
jects, they have several times seen the finest capillary vessels
shooting into it from the natural membrane, but their testimony is
regarded as somewhat equivocal.” Professor Thomson, in his
last publication on the subject, favored the opinion that it is un-
organized; and Dr. Good, in his Study of Medicine, says, “it
has no vascular structure, will not bear extension, and loses its
form as soon as handled.” There does not appear to be the
slightest evidence that it is an organized substance, or it would
be identical with the mucous membrane itself, containing blood-
vessels and nerves; and its detachment, under these circumstan-
ces, would be followed, as I have said, by hemorrhage, and death,
neither of which I have ever known to occur.
1399. A thorough knowledge of this morbid substance is of
great practical importance in the treatment of disease, for it plays
a conspicuous part in many of the disorders to which the human
system is liable. When it coats the internal surface of the
stomach and bowels, it interferes with the digestive process, and
prevents, to a certain extent, the absorption of chyle from the in-
testinal canal, without which the body cannot be adequately nour-
ished. This will account for the lean and cadaverous appearance
of many people afflicted with chronic disorders. The presence
of a false membrane in the stomach and bowels, interferes with
the functions of these organs, and though the patient may have a
good appetite, as occasionally happens, the food is not digested,
and of course is not appropriated to the wants of the animal econ-
omy. By a judicious routine of treatment, however, this ex-
crescence may be detached, and then the mucous membrane will
resume its functions, and the individual recover his health.
1400. We have seen that in poisoning by nitric acid, a false
membrane is formed on the inner coat of the stomach; and the
same thing ensues as an effect of the poisonous drugs employed
by the diplomatised physicians. Administered in small and fre-
quently repeated doses, the stomach becomes inured to their
presence, and at length a large quantity may be given with im-
punity. How is this to be explained, excepting on the suppo-
sition that a false membrane is developed, by which the internal
ºat of the stomach is protected from the ravages of the poison? -
Tartar emetic, for example, will produce violent vomiting in the
* Gross's Pathological Anatomy, vol. ii. p. 214.



344 PRACTICE OF MEDICINE.
dose of two grains, but by repeating it several times in the course
of a day, no vomiting will ensue, and it is said that twenty,
thirty, and even fifty grains of the drug may then be adminis.
tered without producing any sensible effect. The Italian phy-
sicians prescribe tartar emetic, in doses varying from a grain to
two grains and a half every two hours, but we are told that it
rarely produces vomiting. Now why is it that the poison, admin-
istered in these large quantities, does not almost immediately de-
stroy life, excepting that the stomach is shielded from its effects
by the interposition of a false membrane Kings have sometimes
resorted to the expedient of taking poison in small doses, that it
might not prove fatal, if administered secretly with a view to their
destruction. The story of Mithridates, king of Pontus, says a
medical writer, is probably familiar to all. “Living in an age
when poisoning was a frequent mode of removing obnoxious indi-
viduals, and knowing, as he was heir to the throne, that he should
be exposed to assassination from this source, he commenced in
early life to take poisons in small quantities, gradually increasing
the amount, until he was finally able to take immense quantities
without danger. He thus succeeded in rendering himself poison-
proof; so that when he experienced reverses of fortune, and at-
tempted to employ the common means of suicide, namely, poison,
he found that the largest quantities of the most active substances
of that class produced no effect, and was finally obliged to fall
upon his own sword to end his life.”
1401. I know not what explanation can be given of this curi-
ous circumstance, excepting that the stomach was lined with an
adventitious membrane, which prevented the poison from taking
effect.
1402. In all chronic diseases there is a discharge of false
membrane by stool before a perfect cure is effected; and this oc-
curs also in some of the acute diseases, in which there has been
sufficient time for its formation. The period at which it is de-
tached, after the treatment has been commenced, varies accord-
ing to circumstances; it may be a few days or a number of weeks;
and the membrane may be wholly discharged in two or three co-
pious stools, or it may continue to make its appearance for a ſort-
night, or a month. In some instances, it is ejected from the
stomach in shreds, or patches, during the operation of an emetic:
Its detachment, so far as I have observed, is never accompanied
with hemorrhage, or any other unfavorable symptoms, unless the
patient abuses his digestive organs by improper eating, or drink-
ing, and as soon as it makes its appearance in the alvine dis-
charges, his restoration to health commences. In the cases re-
PRACTICE OF MEDICINE. 345
ported by Professor Thomson, in which the membrane was de-
tached by the efforts of nature alone, he says that in many of them,
a very short space of time elapsed between the discharge of the
portion of the bowel, as he terms it, and the return of the individ-
ual to exercise. The appetite, too, he adds, “seems in many
instances to have been very keen during the progress of recovery,
and in some of those which ultimately proved fatal, death seems to
have been occasioned by its too free indulgence, and particularly
by the employment of unsuitable diet.”
1403. Writers on pathology assert, that false membrane is not
often detected in the stomach and bowels, in post mortem exami-
nations; and hence the inference that it very rarely exists, ex-
cepting in the imagination of the theorist. Its actual discharge
from the bowels, however, is probably the best proof we can have
of its existence, and if we find this discharge taking place in every
case of chronic disease which has been successfully treated by the
reformed practice, we must conclude that its existence is by no
means a phenomenon. -
1404. With regard to post mortem examinations, I believe
that the exudation of which the false membrane is composed, fre-
quently imparts a roughness or thickening to the mucous mem-
branes, without the cause being suspected. I heard Dr. Jackson
of the Pennsylvania University assert, in one of his lectures, that
there were some cases of chronic disease which could not be
cured, because the mucous coats of the stomach and bowels were
disorganized. Instead of any disorganization, however, I suspect
that they had been rendered thick and rough by an exudation of
lymph, constituting a false membrane in its partially developed
state. It is further probable, that this adventitious formation may
be fully developed, and yet suddenly disappear in the tissues of
the membrane which it covers, thereby eluding our observation in
a post mortem examination. This, at all events, would be no
more miraculous, than that a thick coat should disappear from the
tongue, without separating or peeling off, burying itself in the very
substance of the organ, and leaving no trace of its existence.
1405. It is somewhat remarkable that medical men, enlighten-
ed as they claim to be, should be so entirely ignorant of false
membrane as one of the grand consecutive links of disease, and of
the necessity of its detachment and removal from the stomach and
bowels, before a permanent restoration to health can ensue.
Where they know any thing of its existence, they invariably re-
gard it as a phenomenon. I once showed a specimen of it to a
distinguished medical professor in Philadelphia, and he acknow-

44
346 PRACTICE OF MEDICINE.
ledged that he could tell me nothing about it, excepting that it was
a morbid production. A portion of it was taken to Professor
Warren of Boston, for his inspection, and after a critical and
elaborate examination, he pronounced it to be the remnants of a
tape worm. The individual who discharged the membrane, had
been one of his patients, but finding no relief, was disposed to
try the efficacy of a few courses of medicine. So little did Pro-
fessor Thomson know of the nature of false membrane, that,
in his abstract of cases, from which I have quoted, he says, “I
am not aware that any attempt has been made in this country,
(England) to bring these cases together, or to state the general
conclusions to which they lead, respecting this singular example
of the vis conservatria natura, and I trust an attempt of the kind
may prove serviceable to the profession.” Professor Thomson's
paper was published in 1835, as I have stated, which shows how
little was known on the subject by the medical profession even six
years ago, and previous to that time, it appears that the celebrated
Andral was not aware of the existence of such cases.
1406. Dr. Good, in his Study of Medicine, mentions a pa-
tient who discharged this morbid substance for six weeks, and in
tubes so perfect as to excite no small alarm in the attendants by
whom it was noticed. He also quotes from Dr. Powell, who
speaks of a case in which “tubes were passed, some of which
were full half a yard in length, and of sufficient quantity to have
lined the whole intestinal canal.” Dr. Good considered the dis-
charge a disease, which he called “tubular diarrhoea;” but he
appears to have been wholly ignorant of its true character, and
recommended the “milder preparations of mercury” to be used in
such cases.
1407. False membrane does not only arise in consequence
of disease, but is also produced by the use of purgatives, and
the whole host of mineral, animal, and vegetable poisons, as calo-
mel, tartar emetic, arsenic, aqua fortis, cantharides, opium, and
digitalis. Medical men do not reflect, that by the administration
of these poisons, they occasion a deranged or morbid condition of
the stomach and bowels, which either retards the progress of re-
covery, or converts an acute disease into an obstinate chronic
malady, for which they have no remedy. I have invariably ob-
served, that patients who have been long in the hands of the diplo-
matised physicians, are exceedingly difficult to cure, and it appears
to be almost impossible, in some cases, to restore the tone of the
stomach and bowels. The false or adventitious membrane ac-
quires so much firmness and tenacity, that it cannot be detached.
excepting by a patient and thorough course of treatment. This
accomplished, however, the patient speedily recovers.


PRACTICE OF MEDICINE. 347
APPEARANCE OF THE TONGUE.
1408. Although we may be greatly deceived in the pulse, as
one of the signs of disease, an examination of the tongue is of con-
siderable practical importance, inasmuch as it enables us to judge
with tolerable accuracy of the condition of the stomach and bow-
els. Andral, however, and some other writers, have attempted
to show that the tongue may present a healthy appearance, while
the stomach and bowels are diseased; and they teach, therefore,
that it is not to be regarded as an index to the condition of these
organs. Beaumont, who had an opportunity of examining the
interior of St. Martin’s stomach, under all circumstances, and
comparing its aspect with that of the tongue, inculcates a differ-
ent opinion. He found that there was always an identity of ap-
pearance between these two organs, and says, “When a healthy
state of the stomach was restored, the tongue invariably became
clean.” It is not necessary that the tongue should be coated,
to indicate disease in the stomach and bowels, for we all know
that in inflammation of these organs, the tongue is often red, and
clean. Dr. Marshall Hall observes that “the tongue is apt to
become clean in protracted and severe cases of dyspepsia; but
we are not to infer from this, that the stomach and bowels are
exempt from disorder. In truth, I would rather see the tongue
coated, than clean, and unnaturally red; for in the latter instance,
it will generally be found, that no very decided impression has
been made upon the disease, until a coat is developed. In low
chronic cases, where there is not sufficient vitality to favor the
operation of the medicine, a coat does not make its appearance,
and the patient rarely experiences any other than temporary relief.
1409. The gradual manner in which the coat developes itself
in some chronic diseases, is a matter of considerable interest.
It is first observed during the operation of a course of medicine,
and it may then disappear until the course is repeated; but at
length it becomes firm and thick, particularly towards the root of
the tongue, and is of a white, yellow, or brownish color. Ulti-
mately, it begins to soften and peel off, leaving the surface to
which it was attached of a clean and natural appearance, and the
patient, in the meantime, rapidly regains his health. During this
period also, quantities of false membrane are found in the alvine
discharges, and in some instances it is ejected from the stomach
by vomiting, making its appearance in shreds, or patches, the
latter of which are sometimes as large as the hand.
* R. s Experi , p. 109. Plattsburgh, 1833.
-



348 PRACTICE OF MEDICINE.
1410. I have observed that in obstinate chronic affections,
there is no assurance of a permanent cure, until the tongue be-
comes entirely clean. While the coat remains, therefore, the
treatment should be continued; and even after the removal of the
coat, a new one is liable to form, unless proper attention is paid to
the diet, and an occasional stimulant and tonic employed to in-
vigorate the system. To illustrate, I will mention a case which
came under my observation, of a young man with epilepsy. At
first his tongue was red, but after taking a few courses of medicine,
a thick, brown coat was developed. He had daily paroxysms
until the coat began to peel off, when they became less frequent,
and finally ceased. His health being so much improved, he went
into the country, where he indulged his appetite freely, and in a short
time his epileptic attacks were renewed with increased violence.
saw him soon after this period, and found his tongue was as
thickly coated as ever. He took two or three additional courses
of medicine, which caused a separation of the coat, leaving the
tongue clean, and the disease once more disappeared. The young
man was twenty-two years old, and had been subject to epileptic
attacks from his childhood.
1411. The tongue assumes various appearances, according to
the nature of the malady which is present. In simple ſever, it is
usually covered with a thin, white coat. In typhus fever, the
coat, at first, is also white, but gradually assumes a brown, or
black appearance, according to the severity of the disease; while
the tongue itself is frequently dry, swelled, and sometimes cracked,
so as to bleed. The coat separates in some instances, before a
cure is performed, disclosing ulcerated patches beneath. The
same general appearance of the tongue is observable in some other
diseases.
1412. In the incipient stage of scarlet fever, red points are
occasionally seen projecting through the white coat; and some
writers consider this as a distinguishing mark between scarlet
fever and measles.
1413. In hectic fever, says Cullen, the tongue becomes free
from fur, and appears very clean.
1414. A yellow coat on the tongue, accompanied with a bitter
taste in the mouth, is generally attributed to disorder of the biliary
organs. -
1415. In inflammation of the stomach, or bowels, the tongue
mostly assumes a deep red appearance, having the surface rough
in some instances, and in others glazed. In dysentery, which
consists of an inflammation of the lower or large intestines, the
tongue is usually red along the edges, covered in the centre with
PRACTICE OF MEDICINE. 349
Lim-
a dry, brown coat. In chronic inflammation of the stomach, or
bowels, the tongue is of a much darker red, than in the acute form
of the disease. - - -
1416. When the tongue is tremulous, or pointed, it indicates
an affection of the brain; and is one of the symptoms in the se-
verer forms of typhus fever. A soft, flat, spreading tongue, is an
evidence of great debility, and a gradual sinking of the vital
powers.
1417. If the tongue is inclined to one side, it indicates a par-
alytic affection. -
1418. A smooth and glossy tongue, is a very common symp-
tom in lingering chronic complaints.
-
PRACTICE OF MEDICINE.
FOOD FOR THE SICK.
1419. When the stomach is much disordered, solid food
digests very imperfectly, if at all, and on this account, light nour-
ishing broths, liquids, vegetable jellies, and other similar prepara-
tions should be used, until the digestive powers are re-established.
The following receipts will serve as a guide to those who have
charge of the sick. -
1420. MILK Por RIDGE. Take two table-spoonfuls of wheat
flour, and beat it into a paste with cold water; pour this gradually
into a quart of boiling water ; season with salt, continue the boil-
ing a few minutes, skim, and pour in a tea-cupful of milk, slowly,
just as you are about to take it from the fire. This is better for
the sick than when it is made very rich with milk; and if the di-
gestive organs are extremely feeble, the quantity of flour may be
reduced one half. It is strengthening to the stomach, and may
be given freely during a course of medicine, especially just after
vomiting. It is generally relished by patients, and may be sweet-
ened to suit the taste. The addition of black pepper, or cayenne,
renders it still more beneficial. If the unbolted wheat meal (1188)
can be obtained, it should be substituted for fine flour, particu-
larly if the bowels are in a languid or torpid condition.

350 PRACTICE OF MEDICINE.
1421. BEEF TEA. Fill a quart porter bottle two-thirds full
of warm water, and put into it half a pound of fresh lean beef, cut
into thin slices; place the bottle in a kettle of boiling water, and let
it remain for three quarters of an hour, when the liquid may be
poured off, and more water added to extract the remaining strength
of the meat. This tea, seasoned with pepper and salt, and ad-
ministered warm, is strengthening to a weak patient; and in the
exhaustion attendant on bilious, scarlet, or typhus fever, may be
used with great benefit.
1422. CHICKEN TEA. This is made in the same way as
the above, using only the lean part of the chicken. Season with
pepper and salt. It is light, nourishing, and very useful for weak
patients, but is not so beneficial as beef tea, especially in fevers.
1423. WINE WHEy. Put a pint of new milk into a vessel
over the fire; as soon as it begins to boil, dash in two wine-glass-
fuls of Muscat or Greek wine, and take the vessel off. The
whey, which will separate from the curd, may be sweetened with
loaf sugar, and flavored with any of the spices. This is a gentle
stimulant, useful in debility, and recovery from long sickness.
The wines I have mentioned are preferable to either Sherry, or
Madeira, because they contain less alcohol.
1424. UN Bolt Ed W HEAT MEAL GRUEL. Take a table-
spoonful of the meal, (1188) and beat it into a paste with cold
water; add salt to the taste, and stir it slowly into a pint of boiling
water; continue the boiling four or five minutes, and skim. Milk
may be added, if desirable, as in the directions for milk porridge.
This is highly useful in dyspepsia, costiveness, and all cases of a
weak or languid state of the digestive organs. It may be given
also, during a course of medicine, and is preferable, as I have
said, to the porridge made with superfine flour.
1425. O.At MEAL GRUEL. Take three table-spoonfuls of
oat meal, a quart of water, and a handful of raisins; simmer over
a slow fire for two or three hours, keeping the vessel covered.
This is soothing to the bowels, and useful in diarrhoea, and dys-
entery.
1426. INDIAN MEAL GRUEL. Boil a quart of water, add a
little salt, and stir in two table-spoonfuls of the meal, as in m
mush or hasty pudding. Boil it fifteen or twenty minutes, an
add any desirable quantity of milk. This gruel is not only good
for the sick, but may be used instead of tea or coffee. It will
answer very well without milk.

PRACTICE OF MEDICINE. 351
-
1427. SAGo GRUEL. Stir two table-spoonfuls of pearl sago
into a pint of boiling water, and season with salt to suit the taste.
Boil until it is converted into a thickish jelly, which will be in ten
or fifteen minutes. It may be sweetened with sugar if the patient
desires. This is soothing and grateful in irritation of the stomach
and bowels.
1428. INDIAN TEA. Pour a pint of boiling water on a table-
spoonful of Indian meal. Add salt if desired. When cool and
settled, it is transparent. It has a pleasant taste, and will remain
in the stomach, when other drinks are rejected.
1429. CRUst CofFEE. Toast two or three thin slices of
unbolted wheat bread until they are brown and hard; put them into
boiling water, with sugar and milk; continue the boiling five or
six minutes, by which time the coffee will be fit for use. This
is a nourishing and delicious beverage, but rather too rich for
the sick.
1430. Ric E CoFFEE. Burn rice as you do coffee, and re-
duce it to a powder; take a heaping tea-spoonful of this, and add
half a tea-cupful of boiling water; when settled, pour off the
coffee, and sweeten with sugar. Used as a medicine, this is a
dose for an infant. For an adult, a table-spoonful of the powder
may be added to a tea-cupful of water. It is pleasant to the taste,
and somewhat astringent. It is beneficial in acidity of the stomach,
and the bowel complaints of children, gradually diminishing the
discharges, and rendering them less green and sour. It is better
to use a strong infusion of the coffee, than to dilute it, and admin-
ister a larger quantity.
1431. SLIPPERY ELM AND MILK. Beat a tea-spoonful of
powdered elm bark into a paste, with water, adding a small por-
tion of salt, and stir it into a pint of milk just beginning to boil.
Take the milk from the fire, and continue the stirring two or three
minutes, until the elm is dissolved. This is very useful in di-
arrhºea, and the bowel complaints of children. It affords a nour-
ishing diet for infants, weaned from the breast, and renders them
fat, and healthy. If the infant is very young, the milk should be
diluted with one third water.
1432. TAProca JELLY. Pick the tapioca clean, soak it five
or six hours in water, and spread it in a broad dish, pouring on
additional water until it covers the tapioca an inch in depth. Sim-
mer over a slow fire until the jelly is formed. This contains a



352 PRACTICE OF MEDICINE.
large amount of nutriment, and is easy of digestion. It may be
eaten with sugar and milk. Weak patients should begin with the
jelly quite fluid, and as they gain strength, it may be taken a little
more ". If milk disagrees with the individual it should be
Omitted.
1433. ARRow-R00T JELLY. This is made by mixing half
a tea-spoonful of arrow-root, with a tea-cupful of boiling water.
Season with nutmeg and loaf sugar. This sits lightly on the
stomach, and is very good for children. Some are in the habit of
boiling the arrow-root four or five minutes. Half a table-spoonful
of cream, added to a tea-cupful of the jelly, while hot, makes it
.." more acceptable to children, who have been accustomed to
milk.
1434. Ric E JELLY. Take a quarter of a pound of ground
rice, and double the quantity of loaf sugar; boil them in a suit-
able quantity of water, until the whole has acquired a proper con-
sistence. The jelly may be eaten with sugar and milk.
1435. WHEAT JELLY. Take of wheat, in its natural state,
any desirable quantity; soak it twelve hours in soft water, and
boil it four hours, allowing the water to evaporate, excepting
enough to form the wheat into a jelly. This may be eaten with
sugar, or molasses, and is an invaluable article for the sick, and
convalescent. I know of no preparation that I am disposed to
recommend more highly. It is agreeable to the taste, does not
oppress the stomach, and is very nourishing. It also serves to
régulate the bowels, without possessing any of the objectionable
properties of a purgative. Mr. Graham, in an account which he
gave of his recent sickness, says, “Wheat thus prepared was
very grateful to the taste, and incomparably the most salutary
nourishment I took during my convalescence. Within twenty-
four hours after I commenced the use of it, I had a natural move:
ment of the bowels, and from that time to the present, have had
no need of aperient medicine.”
1436. Slippery E.M Custard. Put a tea-spoonful of
slippery elm, two of loaf sugar, and a small portion of cinnamon
into a tea-cup, and fill it nearly full of boiling water. Stir for
four or five minutes, till a thick jelly is formed. Wine and a
little nutmeg may be added, if desirable. This is good for con-
sumptive people, and all persons in a weak condition of body.
* Health Journal, edited by Mrs. Gove, vol. i. No. 25.
PRACTICE OF MEDICINE. 353
1437. BLANC MANGE. Wash half an ounce of Irish moss
in water as hot as the hand can bear until it becomes slimy, and
rinse it in water about blood heat; (1292) add the moss, together
with two lemon peels, cut into thin slices, and a small portion of
salt, to a quart of milk; put these ingredients over a slow fire, and
stir constantly until the liquid becomes of the consistence of thick
cream, taking care that it does not boil; strain through a cloth, or
fine sieve, and pour it into moulds or cups to harden, previously
dipping them into cold water. Instead of the lemon peel, it may
be flavored with Preston’s extract of lemon, adding three quar-
ters of a table-spoonful of it after straining. The blanc mange is
turned upon a plate, and eaten with sugar and milk. It may be
made with water, instead of milk, and in this form is relished by
...” when the stomach is too irritable to bear other kinds of
ood. -- -
DOSE OF ME DICINE S.
1438. As the medicines recommended in this work are free
from any deleterious properties, the same precision is not requi-
site with regard to the dose, as when poisonous drugs are em-
ployed. Remedies which act in harmony with the vital princi-
ple, are incapable of doing injury, if administered with common
judgment, or prudence, and a slight error in the quantity of a dose,
therefore, or the mistake of one article for another, is not accom-
panied with fatal consequences, as happens so frequently in the
practice of the diplomatised physicians. It is necessary, notwith-
standing, that we should be governed by some general rules, for
the dose of medicines is varied according to age, sex, tempera-
ment, habit, peculiarities in diet, and other circumstances. The
following table is a general outline of doses proportioned to the age,
though instances may occur in which it will be necessary to depart
materially from this standard.
If the dose for an adult is one tea-spoonful,
A youth twelve years old may take half a tea-spoonful,
A child six years old one third of a tea-spoonful,
And an infant a year old one tenth of a tea-spoonful.
1439. In determining the quantity of medicine for a dose, we
must be satisfied that it is perfectly pure. Cayenne, for example
is often adulterated with worthless barks, or Indian meal, and of
course its strength is considerably diminished. The same re-
mark is applicable to many other medicines, which are adulterated
in a great variety of ways.

45
354 PRACTICE OF MEDICINE. |
1440. Women, from their greater sensibility, or habits of
life, generally require a smaller dose than men.
14 Persons of a sanguine temperament are more easily
affected by medicine than the cold or phlegmatic.
1442. There are many peculiarities and circumstances which
control the action of medicines. I know a lady upon whom a
tea-spoonſul of the tincture of lobelia will operate as a powerful
emetic. Vegetable eaters do not require half as much medicine as
those who indulge freely in animal food. I have tested this matter
- in repeated instances, and have been astonished at the effect pro-
duced by very small doses. Those who avoid ardent spirits, do
not require as much medicine as the intemperate. If the brain is
affected, as in the delirium of typhus ſever, medicine is very
tardy in its operation. It is slow to produce the desired effect,
also, where the stomach and intestines are lined with false mem-
brane, (1393, et seq.) as is always the case with those who have
been drugged with the poisons of the medical faculty.
BATHING.
1443. Bathing, in some form or other, has been in high re-
pute, from the earliest periods of history, as a means of promoting
health. We are told that Pharaoh’s daughter, and her attendant
maidens, went down to the Nile to bathe. Elisha the prophet
- commanded Naaman the leper to wash seven times in the river
Jordan. Moses the law-giver enjoined the frequent use of bath-
ing; and the Jewish priests always washed their bodies before
officiating in their sacred office.
1444. In Egypt, baths were erected at the public expense.
1445. History informs us, that the Greeks and Romans were
remarkably fond of bathing. The latter constructed baths of the
most magnificent description. Those of Caracalla are described
as having been embellished with two hundred pillars, and furnished
with sixteen hundred seats, capable of containing three thousand
people. -
*. Among the Mahommedans, says Mr. Buckingham, the
oriental traveller, baths are as numerous as their mosques. He
doubts, if in their cities a single street can be found, without one
or more of them. They all bathe once a day, at least. There
is a general conviction in the East, that personal cleanliness is
favorable to morality; while on the other hand, vice and filt
naturally go together. Baths are to be had from a single para, in
value about one fourth of our cents, to four or five dollars.
this country, however, bathing seems to be neglected, or the
-



PRACTICE OF MEDICINE. 355
-
people are too much engaged in other pursuits to give it their at-
tention. -
1447. Those who are acquainted with the functions of the
skin, will acknowledge the importance of bathing. It is the seat
of perspiration, both sensible and insensible, (41) and is the prin-
cipal channel through which the useless or worn-out matter of the
system makes its escape. It is estimated that two thirds of all we
eat and drink, pass out of the body by the skin, leaving only one
third to be discharged by the bowels, the lungs, and the kidneys.
(42.) How important is it, therefore, to preserve the skin in a
healthy and vigorous state, for if it does not perform its functions
properly, the matter which should be eliminated through the pores,
is suffered to remain in the circulation, and is deposited in the
different organs and tissues of the body, giving rise to ſevers,
inflammations, consumptions, and diseases of every name and
character.
1448. Cold BATHING. This is highly conducive to health,
if employed under favorable circumstances. It is never beneficial,
excepting when followed by a warm glow of the skin. For this
reason it is generally pernicious to those of a cold habit, and a
feeble or languid circulation. The temperature of the water should
be regulated according to the feelings of the individual. What
is cold to one, may be agreeable and pleasant to another.
1449. The most suitable time for bathing is in the morning,
when the body is strong and vigorous, and not after it has been
enfeebled by hard labor, or over exertion. It should be heated
by exercise also, before going into the water. The idea is gen-
erally inculcated that persons should not attempt to bathe while in
a perspiration, but this is a serious, and sometimes a fatal error.
The more free the perspiration, the greater is the safety in col
bathing. The Roman youth were in the habit of plunging from
the Campus Martius into the Tiber, and swimming across it im-
mediately after the most violent gymnastic exercises. The Rus-
sians, and North American Indians, remain in their sweating houses
until they are in a profuse perspiration, then roll in the snow, or
plunge into a river in which the ice has been broken. Dr. Bell
very correctly observes, in his work on Baths, that “the best
means of supporting great cold is to be previously subjected to
high heat.”
1450; I have found great advantage in supplying myself with
a small bottle of pepper sauce, and taking a portion of it just be-
fore going in to bathe. It invigorates the system, and causes a
Warm: pleasant glow of the skin. Persons should not remain too
long in the water, as this is liable to cause a determination of blood



356 PRACTICE OF MEDICINE.
from the surface to the centre of the body, and the accumulation
of this fluid in the internal organs, may give rise to some dangerous
form of disease.
1451. Show ER BATH. This is decidedly the best and most
agreeable way of applying cold water to the body; and it should
be done in the morning as soon as the individual is out of bed, or
after he has been heated by a brisk walk, or other exercise.
Those who are accustomed to the shower bath, consider it their
greatest luxury, and continue to use it during the coldest weather
of winter. The quantity of water to be employed, must be de-
termined by circumstances. Those who are not very strong or
vigorous will be satisfied with a quart, while the robust and ple-
thoric often require two or three gallons. The temperature of
the water also, is varied according to individual peculiarities.
There are some who use it several degrees below that of ordinary
spring water, while others employ it of an almost icy coldness.
After the bath, the body should be wiped as speedily as possible,
and rubbed with a coarse towel, or flesh brush, which produces a
pleasant feeling of warmth. -
1452. The water of the shower bath should be passed through
a perforated board, or piece of zinc, which allows it to come in
contact with every part of the body at nearly the same moment.
This produces a sudden shock, which is followed by strong reac-
tion, and the blood returning to the skin from which it has been
momentarily driven, imparts to it a warm, pleasant glow.
1453. The shower bath invigorates the system, strengthens
the digestive organs, equalizes the circulation, and enables those
who use it to encounter the vicissitudes of heat and cold with
but little inconvenience, or risk to health. In the hot weather of
summer, it is truly refreshing, as well as beneficial. In many
obstinate chronic disorders, it is productive of the greatest ad-
vantage. It should never be employed, excepting where it has a
tendency to invigorate, and is followed by a warm glow of the
skin. Under other circumstances, it is manifestly injurious; and
I have known the health to be seriously impaired by its injudicious
use. Preceded by the vapor bath, however, there is no objection
to its employment, as will be explained hereafter. -
- -
1454. Sponge Bath. This is beneficial where the individ-
ual is chilled by the ordinary shower bath. It consists of the ap-
plication of water to the body with a sponge, followed by friction
with a coarse towel, or flesh brush, as already mentioned.
bowl-ſul of water will be sufficient, and iſ caré is observed, the
floor or carpet need not be wetted.

PRACTICE OF MEDICINE. 357
1455. HAND BATH. This does not differ from the preced.
ing, excepting that the water is applied with the hands, instead of
a sponge. If an individual possesses but little animal heat, it is
preferable to the sponge bath, particularly in cold weather, as the
warmth and friction of the hands prevent the body from becoming
chilled. To obviate this difficulty, also, the water may be applied
to the trunk of the body, and the skin wiped perfectly dry, before
it is applied to the extremities. Friction with a coarse towel, or
flesh brush, should never be omitted as a concluding part of the
process. Patients in feeble health, who may deem it advisable to
employ the hand bath in the winter season, should be furnished
with a warm apartment, as by this precaution, a tendency to chil-
liness will be counteracted. Preceding the bath with a dose of
cayenne, or composition, is always beneficial, and should never
be dispensed with. -
1456. WARM BATHING. Houses at the present day are
rarely constructed with any conveniences for bathing, notwith-
standing it is of the utmost importance to health. If we visit the
mansions of the rich, we are dazzled with fine apartments, and ele-
gant furniture, but may look in vain for a simple bathing appa-
ratus. The poet has said, “E’en from the body’s purity, the
mind receives a secret, sympathetic aid,” but this noble precept
seems to have been neglected by people of the present day. If
an individual should find his way to a bath tub two or three times
a year, he thinks he has performed wonders and prides himself
upon his personal cleanliness. If, however, the face and hands
require to be washed every morning, the entire surface of the body
should certainly be cleansed at least once a week. We should
do well to imitate the practice of some of our heathen brethren,
who, however benighted they may be in other respects, are in
the habit of bathing two or three times a week, if not oftener,
and paying the strictest attention to the cleanliness of their per-
sons. People in general, have no idea of the impurities with
which their skin is loaded, and if they could be induced to pass
a flesh brush over it, they would be startled, perhaps, at the cloud
of white or scaly looking particles, which would be detached. It
has been said that a Frenchman is often found with a clean skin
under a dirty shirt; but there are those who reverse this rule, and
are found with a dirty skin under a clean shirt.
1457. Dr. Bell quotes a lady of fashion as saying, that “the
frequent use of warm baths is not more grateful to the sense, than
salutary to the health, and to beauty. By such ablution, all ac-
cidental corporeal impurities are thrown off; cutaneous obsº



358 PRACTICE OF MEDICINE.
tions removed; and while the surface of the body is preserved in
its original brightness, many threatening disorders are removed, or
prevented. * * *. By such means the women of the East
render their skin softer than that of the tenderest babes in this
climate, and preserve the health which sedentary confinement
would otherwise destroy.”
1458. The celebrated Darwin remarks, “Those who are past
the meridian of life, and have dry skins, accompanied with emacia.
tion, will find the use of the warm bath for half an hour twice a
week, eminently serviceable in retarding the advances of age.”
Darwin himself, at the suggestion of Dr. Franklin, acted upon
this precept, and used the warm bath twice a week until near his
death, which occurred in his seventy first year.
1459. I would recommend the warm bath, however, with a
view to cleanliness, and the preservation of health, rather than as
an agent in the treatment of disease, for in this respect, it is infi-
nitely inferior to the vapor bath. Water being a dense medium,
it presses heavily on the surface, and interferes, to a certain ex-
tent, with the escape of the perspirable matter, which should
be eliminated through the pores; but no such objection can be
urged against the vapor bath, for it affords a light, pleasant me-
dium, and favors the passage of the perspirable fluid through its
appropriate channels. Besides, in the warm bath, we seldom
have a temperatu re !". than ninety or ninety five degrees,
which is several degrees colder than the blood, and though the
water produces an agreeable sensation of warmth, it is constantly
abstracting large portions of the animal heat. This I conceive to
be a prominent objection to the warm water bath, particularly in
cases of debility, or loss of vital action, for it tends in most in-
stances to increase the difficulty. The vapor bath, on the other
hand, which we seldom employ at a lower temperature than one
hundred and ten degrees, rarely ſails, if properly administered, tº
invigorate the most feeble and delicate patient, and may be used
without any apprehension of danger. -
1460. There is no question that the warm water bath, em-
ployed in a casual manner for the removal of disease, is often pro-
ductive of more harm than good; and invalids very frequently
complain that they have been injured by its application. It ap-
pears to debilitate the system, and increase its susceptibility to
the effects of cold. Followed by the shower bath, however, the
moment the patient rises from the water, injurious consequences
are not so likely to ensue, for the shower gives activity to the
circulation, invigorates the body, and greatly diminishes the
chances of taking cold. I am happy to say that the public baths
in Boston have been so constructed, within the last few years,


PRACTICE OF MEDICINE. 359
-
that an individual may let down a gentle shower of cold water
upon his person, immediately upon rising from the bath-tub.
1461. It will be recollected that I do not object to the warm
bath as a means of promoting health, for if regularly employed
once or twice a week, it will be of eminent service.
WAPOR BATH.
1462. The vapor bath has been extensively used in many of
the European countries for several centuries. It is said that the
Finlanders will remain for half an hour in vapor at 167 degrees
of Fahrenheit, and then pass immediately into the freezing air,
without experiencing the slightest inconvenience. Dr. Bell, in
his work on Baths, observes, that if travellers happen to arrive at
the villages of these people, while they are engaged in bathing,
they will go at once to assist in taking care of the horses, without
any covering whatever, while the strangers, notwithstanding they
are wrapped in furs, sit shivering in the cold.
1463. The Russians make use of the vapor bath at least once
a week, and sometimes much oftener. They vary the tempera-
ture from 120 to 160 degrees; and remain in the bath an hour or
two, when they let down a shower of cold water upon them from
the ceiling by means of a cord and valve. This, says Dr. Traill,
in his account of the Russian vapor bath, is highly exhilarating
and refreshing.
1464. The Russians are in the habit of leaving the vapor bath
while in a profuse perspiration, and rolling in the snow, or if a
river happens to be near, they will plunge into it, entirely re-
gardless of the severity of the weather. Instead of being injured
by this practice, they are rendered more vigorous and healthy,
and it cannot be denied that they are more free from rheumatism,
and consumption, than the people of more highly favored cli-
mates.
1465. The North American Indians are well acquainted with
the effects of the vapor bath. Among the tribes on the Rocky
Mountains, according to Lewis and Clark, it is very uncommon
for a man to bathe alone; he is generally accompanied by one or
sometimes several of his acquaintances; indeed, it is so essentially
a social enjoyment, that to decline going into the bath when in-
vited by a friend, is one of the highest indignities that can be
offered. The frontier Indians construct a bath by bending wil-
lows over at the top, and covering them with skins. The patient
sits in this, until by means of heated stones and water, he has


PRACTICE OF MEDICINE.
perspired sufficiently. These baths are almost universally in the
neighborhood of streams, into which the Indians plunge imme-
diately on coming out of the vapor bath; and sometimes they
subject themselves to a second perspiration. The bath is em-
ployed either for pleasure or health, and is used indiscriminately
as a remedy in all kinds of disease.”
1466. Major Long, who made an expedition to the Rocky
Mountains subsequent to the time of Lewis and Clark, informs
us, also, that the Indian sweating baths, as he terms them, are in
high repute for the cure of many disorders. He remarks, that
they are generally constructed near the edge of a water course,
and formed of pliant branches of trees, stuck into the ground in a
circle, bent over at the top, and covered in every part with bison
ropes. Some of them contain only one person, and others four
or five. The invalid enters with a kettle of water and some
heated stones, on which the water is sprinkled until the requisite
degree of steam is produced. When it is thought that the per-
spiration is sufficiently profuse, the patient is taken out and plunged
into the water, previously breaking the ice, if the stream is frozen.
He is not subjected a second time to the action of the steam, but
covers himself with his robe, and returns home.
1467. Lewis and Clark mention a remarkable cure which was
performed with the vapor bath, during their expedition. One of
their men had so great a weakness in his loins, that he could
not walk, nor even sit upright, without extreme pain. They
exhausted the resources of their art upon him in vain, and at
length, at the suggestion of an Indian hunter, and the request of
the patient himself, they placed him in a vapor bath, with the
steam as hot as it could be borne. In twenty minutes he was
taken out, plunged twice in rapid succession into cold water, and
returned to the bath. During all this time he drank copiously of
horsemint tea. At the end of three quarters of an hour, he was
again withdrawn, carefully wrapped, and suffered to cool gradually.
The morning after the operation, he was able to walk, and was
nearly free from pain. -
146 An Indian chief of considerable rank, who had lost the
use of his limbs, was brought to Lewis and Clark in a canoe, for
the purpose of being cured. They attempted to sweat him, but
he was too weak to sit in the bath; they advised him to go home;
undergo frequent perspirations in a sweating house, and drink
large quantities of horsemint tea. The Indians, however, who
accompanied the chief, were so anxious to have the operation of
* Lewis and Clark's Expedition to the Sources of the Missouri, &c., performed
in 1804–5–6.
























PRACTICE OF MEDICINE. 361
sweating performed under the inspection of Lewis and Clark, that
the latter determined to make a second attempt. This they ac-
cordingly did, and a moderate perspiration was produced. The
next day the chief was able to use his arms, felt better than he had
done for many months, and set up the greater part of the time.
The day following he found himself rapidly recovering, having
strength sufficient to wash his face for the first time during a
twelvemonth. The sweating was not repeated on account of the
rainy weather. The succeeding day, however, a profuse perspi-
ration was induced, and the patient was able to move one of his
legs and thighs, and some of his toes, the fingers and arms having
been nearly restored to their original pliancy. From this period,
he gradually recovered his health, and the use of his limbs. I men-
tion these facts to show that the vapor bath, whether employed
in the wilderness among savage tribes, or in the civilized and
polished circles of society, is a friend to the afflicted, and exer-
cises a renovating and most salutary influence.
1469. Some of the Indian tribes reverse the order of bathing
as it is practised among the whites at the present day, and con-
clude with the warm instead of the cold bath. We are informed
by Lewis and Clark, that their expedition encamped near the
warm springs along the ridges of the Rocky Mountains, and that
the Indians formed one of these into a bath, which was so hot
that Captain Lewis could not remain in it more than nineteen min-
utes. The Indians went into the bath thus constructed, continued
as long as they could bear the heat, and then plunged into a stream,
which was at that time of an icy coldness. They would repeat
the process several times a day, and it is worthy of remark that
they always terminated with the warm bath.
1470. The diplomatised physicians have used their utmost en-
deavors to bring the vapor bath into disrepute; but notwithstand-
ing their gross and flagrant misrepresentations, it has gradually
won its way to public favor, and there is now abundant evi-
dence to satisfy the unprejudiced mind, that it is an invaluable
agent in the treatment of disease. Many distinguished writers,
also, have spoken of it in terms of high commendation. Dr.
Combe, in his work on Physiology, remarks, “The vapor bath is
attended by the very best effects, particularly in chronic ailments,
and there can be no question that its action is chiefly on the
skin, and through that medium on the nervous system. As a
means of determining to the surface, promoting cutaneous exhala-
tion, and equalizing the circulation, it is second to no remedy now
in use; and consequently, in a variety of affections which this

46
362 PRACTICE OF MEDICINE.
process is calculated to relieve, it may be employed with every
prospect of advantage.”
1471. “Of all Turkish remedies,” says Dr. Madden, “the
vapor bath is the first and most efficacious in rheumatic and cu-
ticular diseases. I have seen them removed in one fourth part of
the time in which they are commonly cured with us. * *
As a luxury, I cannot better describe it than in the words of
| Sir John Sinclair. ‘If life be nothing but a brief succession of
our ideas, the rapidity with which they now pass through the mind
would induce one to believe, that, in the few short minutes he has
spent in the bath, he has lived a number of years.”
1472. Major Skinner, in his Adventures in the East, says,
“One of the most pleasing effects of the vapor bath, is the marble-
like polish which it imparts to the skin; there is the conscious-
ness too, that among the many impurities of an Eastern city, you
can bid defiance to them all.”
1473. The Eclectic Journal of Medicine, published in con-
nexion with the Select Medical Library, contains a review of a
work on baths, in which the writer says, “To the war between
Napoleon and Russia is western Europe indebted, if for nothing
else, to the introduction of vapor baths. Russian soldiers having
constructed them in the north of Prussia, some of the Prussian
physicians were induced to observe the effects of this new fashion
of bathing. They soon found that it cured various diseases, such
as rheumatism, and cutaneous and nervous affections, and were
not slow in giving it notoriety throughout Germany, by means of
various publications. The King of Prussia caused a bath to be
constructed at his palace; and in 1818, the Princess Marianne,
sister-in-law of this sovereign, was present at the opening of the
first public vapor bath in Berlin, and allowed it to receive her
name.”
1474. Doctors Reil, Schmidt, and Mangold, Prussian phy-
sicians, are cited by the author of the work in question, in con-
firmation of the safety of vapor baths as a luxury, and of their
efficacy in the removal of disease. Dr. Schmidt says his own
son, not quite six years old, is never happier than in the enjoy-
ment of a vapor bath, and adds that this mode of bathing is
as beneficial to subjects in advanced age, as to those in early
childhood.
1475. The same writer remarks, “The vapor bath may be
used with decided advantage in all seasons, as it is in Russia, an
other countries in Asia. It is a vulgar error, contradicted by
general experience, to suppose that vapor, or warm bathing, in gen-
* Travels in Turkey, Egypt, Nubia, and Palestine. Philadelphia, 1880.

PRACTICE OF MEDICINE. 363
eral, is contra-indicated in winter, as disposing those who bathe to
contract colds.”
1476. The remark of Darwin, that the warm bath is service-
able in retarding the advances of age, (1458) is still more appli-
cable to the vapor bath, the latter having a remarkably invigorating
effect on the old and infirm.
1477. Mungo Park, in allusion to the Mandingoes, says—
“On the first attack of a fever, when the patient complains of
cold, he is frequently placed in a sort of vapor bath, which com-
monly produces a profuse perspiration, and wonderfully relieves
the sufferer. *
1578. Assalina, an Italian physician, published a work on
vapor bathing in 1820, in which he detailed its advantages in the
treatment of many diseases. He introduced portable vapor baths
into common use in Munich, and invented an apparatus by which
he was enabled to apply vapor to the eyes, ears, lungs, the breasts
of females, and other parts that were in a state of inflammation.
The application of vapor to swelled breasts, he found of the most
essential service.
1479. The vapor bath imparts its caloric to the blood, and in
a low or feeble state of the body, renders the circulation more
active and vigorous. The principle upon which it accomplishes
this, has been admirably explained by Magendie. He has quoted
the experiments of an eminent philosopheri to prove that the
movement of a fluid through a tube is rapid in proportion to its
temperature. Cold water was injected into the artery of a dog,
which returned by the corresponding vein in a specified time;
the same quantity of lukewarm water returned eighteen times
quicker; and hot water returned thirty two times quicker than the
lukewarm. The inference of Magendie was, that the circulation
of the blood is feeble in proportion as its temperature sinks below
the natural standard, but when the vapor bath is employed, its
heat or caloric is communicated to the blood, as may be ascer-
tained by placing a thermometer under the tongue, and the circu-
lation becomes active in every part of the body. He ob-
serves that cold damp weather is sure to bring on fits of suffoca-
tion in persons with diseases of the heart, but if the atmospheric
temperature undergoes a trifling rise, the circulation becomes
freer, and the unpleasant symptoms disappear. The sufferers
themselves, he continues, are so perfectly conscious of this, that,
when you prescribe for them, they will tell you that a little sun-
shine would do them infinitely more good than all your drugs.
* Travels into the Interior Districts of Africa, &c.
† Hales.



364 PRACTICE OF MEDICINE.
1480. It is frequently said by the opponents of the vapor
bath, that it occasions debility. There does not appear to be
any ground, however, for this conclusion. The perspirable fluid
consists principally of the serum or watery portion of the blood,
which is incapable of nourishing the body, and which is speedily
replaced either by drinks taken into the stomach, or by cutaneous
absorption of the vapor itself. The loss of this fluid therefore,
abstractly considered, cannot be regarded as a cause of debility,
or we should find the laboring man, who perspires freely from
morning till night, becoming weak and emaciated. We expect
different results from blood-letting, because in this, the rich or
nutritious part of the blood is withdrawn as well as its serous or
watery portion, and the system languishes for the want of its ap-
propriate nourishment. I have yet to learn, however, that debil-
ity will ensue from perspiration produced by the vapor bath, in-
dependent of a diseased or morbid condition of the body. For
example, we know that in ſever, or inflammation, there is a sort of
fictitious strength, which disappears when the disease is subdued,
and leaves the patient in a state of languor or debility. Now
the vapor bath, from its tendency to equalize the circulation, is a
º agent in subduing ſever, or inflammation, and may there-
, in an indirect manner, prove a source of debility. Perspiration
of itself, however, unconnected with disease, does not appear to
exercise a depressing influence, or the Russians, Finlanders,
Turks, and North American Indians, who make such free use of
the bath, would be the most feeble and emaciated people in the
world. Dr. Traill, in his description of the Russian vapor bath,
to which I have already alluded, conveys the impression, that al-
though it may occasion a free perspiration, it does not produce
debility. He went into the bath himself, accompanied by some
friends, and remarks, “In the corner opposite to the ſurnace is a
reservoir of cold water, into which, during our stay in the bath,
the person who manages it, frequently plunged to cool his surface.
a precaution not unnecessary for an individual who is exposed eight
hours daily, stark naked, to a temperature quite oppressive to
the uninitiated. Yet this exposure and alternation cannot be un-
healthy, for I never saw a more athletic man than this person,
who informed me that he had been constantly engaged in his oc-
cupation for sirteen or eighteen months.”
1481. Dr. Combe, the physiologist, in canvassing the subject
of the vapor bath, says, “The prevalent fear of catching cold,
which deters many from using the vapor bath, even more than
from warm bathing, is founded on a false analogy between its
effects and those of profuse perspiration from exercise" or illness.
• The author alludes, undoubtedly, to severe or fatiguing exercise.
PRACTICE OF MEDICINE. 365
- The latter weakens the body, and, by diminishing the power of
reaction, renders it susceptible of injury from sudden changes of
temperature. But the effect of the vapor bath properly admin-
istered is very different. When not too warm, or too long con-
tinued, it increases instead of exhausting the strength, and by ex-
- citing the vital action of the skin, gives rise to a power of reac-
tion which enables it to resist cold better than before.”
1492. Uses or THE WApoR BATH. The fact that two thirds
of our food and drink pass out of the body through the pores, as I
have already stated, (42, 1447) leaving only one third to be dis-
charged through other channels, is sufficient evidence of the value
of the vapor bath as a remedial agent. It determines the blood to
the surface of the body, warms and invigorates the whole system,
and produces a healthy, natural perspiration, which serves to con-
vey from the circulating fluid the various impurities with which it
is loaded. There are many difficult cases in which a cure could
- not be effected without its agency. It should never be omitted,
where the medicines, of themselves, are insufficient to produce a
moist condition of the skin. It communicates a portion of its heat
or caloric to the blood, rendering the circulation more active and
vigorous, as I have previously stated, (1479) and it is on this ac-
count, that it possesses such wonderful efficacy in suspended ani-
mation, stupor, and the low stages of disease.
1483. |. cutaneous affections, and all febrile, or inflammatory
attacks, the vapor bath is particularly serviceable—a few hours
being sufficient, in conjunction with the stimulating medicines, to
break up an ordinary fever. It diminishes swellings, relaxes in-
flamed parts, and allays pain and irritation. In stiffness of the
joints, it cannot be too highly praised. Administered previous to
the cold stage of ague and fever, together with an injection, and a
portion of cayenne and bayberry tea, it will sometimes prevent the
paroxysm, or at least greatly diminish its violence. It has a
soothing influence on the nerves, and is highly useful in restless-
ness, and wandering pains. Administered at bed time, it will
generally procure a good night's rest. Employed in this way, it
is also the best remedy with which I am acquainted, for the cold
and exhausting night sweats which attend consumption. In hys-
teria, colic, cramps of the stomach, convulsions, croup, asthma,
and pains of the bladder, or kidneys, it has been tested too fre-
quently to need any recommendation here. A wiry or feeble
pulse becomes full, soft, and regular under its influence, and hence
* Principles of Physiology. New York, 1838.











































366 PRACTICE OF MEDICINE.
its value in inflammation of the lungs, or of any otherinternal organ;
it invites the blood to the surface of the body, and thereby relieves
the patient of his pains and sufferings. For the same reason, it is
equally beneficial in diarrhoea, and dysentery, and should not be
omitted in these complaints, where the attacks are severe.
1484. The excessive vomiting which takes place in cholera,
and some other diseases, is speedily checked by the vapor bath,
together with a stimulating injection, and two or three doses of
pepper sauce, or cayenne tea. Sydenham observes in one of his
works, that he could not overcome the vomiting in plague, except-
ing by external means applied to produce a sweat or determination
to the surface of the body.
1485. Ulcers are greatly benefited by the local application of
vapor, two or three times a day, as it promotes a healthy action in
the minute vessels, and disposes the parts to heal.
1486. In falls, bruises, and all accidental injuries, the vapor
bath is a sovereign remedy, and should be substituted for blood-
letting, which only weakens the system, and retards the efforts of
nature in repairing the injury. It should be used in conjunction
with stimulating medicines, so as to keep agentle perspiration, until
the pain, soreness, or inflammation abates. Tonics and nourish-
ing food will then be sufficient to complete the cure.
1487. Rheumatism appears to be one of those diseases over
which the vapor bath exercises a sort of magical influence. I
have known a single application of it, with a few doses of cayenne,
or composition, to effect a cure in very obstinate cases, though,
generally speaking, a few courses of medicine are required.
1488. In suspended animation, the bath is a very important
agent. It rarifies or lightens the air with which the patient is sur-
rounded, and promotes a determination to the surface of the body,
without which it would be impossible to revive the dormant pow-
ers of life. Humboldt says, that in ascending mountains the heart
beats violently, and the blood rushes forcibly into the vessels of
the skin, in consequence of the diminished pressure of the atmos-
phere; and it is on this principle that we employ the vapor bath
in suspended animation. The pressure of the atmosphere being
diminished, the heart is enabled to propel the blood to the differ-
ent parts of the body, which it could not do under other circum:
stances, and a restoration to life is the consequence. The usual
mode of applying vapor in suspended animation, is to cover the
patient with º" or blanket, and place a heated stone, wrapped
in a damp cloth, at his feet, administering the antispasmodic tinc-
ture, or some other appropriate medicine. The vapor must be
increased gradually, or the patient will be oppressed, and a recoy-
ery ſail to take place. It is better to commence with a single

PRACTICE OF MEDICINE. 367
stone, as I have directed, and increase the number as circumstan-
ces require.
1489. The bath is an invaluable agent in reducing fractures
and dislocations, and if sufficiently understood, would supersede
the employment of brute force, and murderous pulleys. It re-
laxes the muscles, and produces a wonderful pliancy of the joints.
Dr. Madden says, “I have trembled to see the Turks dislocate
the wrist and shoulder joints, and reduce them in a moment.”
This they were enabled to do by “twisting and kneading” their
limbs in the vapor bath.
1490. Instances occur in which the blood-vessels of the skin
are so completely obstructed, that the bath cannot be used without
considerable preparatory treatment. I was called to a case of
this description, in which the patient, a gentlemen, had been for
several months under the care of the routine physicians. Among
other poisons, he had taken large quantities of digitalis, and so
little blood found its way to the surface, that he felt chilly in the
hottest days of summer. The bath could not be used, because it
produced a violent determination to the head. Heated stones,
wrapped in damp cloths, were placed about the patient, in bed,
and composition tea, with a portion of lobelia, given in small, and
frequently repeated doses. By pursuing this treatment for three
or four days, a free circulation was established, the chilliness dis-
appeared, the skin became warm, and I had no difficulty in ad-
ministering the vapor bath, together with a thorough course of
medicine.
1491. The frequent use of the bath is of great service to those
who are much exposed to a very cold atmosphere. It keeps the
circulation active, and preserves the warmth of the body. In
Captain Parry’s voyage to the north pole, it was used by several
of the crew, and those who employed it previously to taking their
stations on deck, could remain a much longer time than others
who refused to avail themselves of its benefits.
1492. There are many ladies in Philadelphia, and I believe
in other cities, who now use the vapor bath to improve the com-
plexion; and the velvet-like softness and healthful glow which it
imparts to the skin, proves it to be the best cosmetic in the
world.
1493. The perspirable matter which is discharged in the bath,
is sometimes very offensive, and is capable of communicating
disease. The sick room should be well ventilated in such cases,
and the utmost cleanliness observed in every respect. I knew a
* Travels in Turkey, Egypt, Nubia, and Palestine, p. 51. Philadelphia, 1830.

















368 PRACTICE OF MEDICINE,
woman who was salivated by washing the clothes of an infirmary
patient, who had taken considerable quantities of calomel.
1494. In the application of vapor to the body, care should be
observed that it is of a proper temperature. Generally speaking, the
patient's feelings are a sufficient guide in this matter, but in case of
a palsied limb, where there is but little sensibility, the skin is
sometimes blistered by vapor at a comparatively low temperature.
I knew a patient whose foot was badly scalded from the cause
which I have named. So little sensibility was there in the foot,
that he was not conscious of having received any injury. It is
important, therefore, in cases of diminished vitality, as palsy,
frosted limbs, and accidents in which a principal nerve is divided,
to graduate the temperature of the bath according to circum-
stances, wrapping the affected part in a damp or wet cloth, if this
should be deemed necessary.
1495. Application of Vapor in Bed. This is necessary
where the patient is very much debilitated. The mode of doing
it is as follows. Take two or three heated stones or bricks, and
immerse them in cold water until they have done hissing; wrap
them separately in a damp cloth of several thicknesses, and place
them at the feet and sides of the patient, giving him some stimu-
lating tea, as composition, or cayenne and bayberry, and wetting
his face and breast occasionally with cold water, if he is faint. A
piece of oil cloth, or a thick blanket, should be placed beneath
the lower sheet to keep the bed dry, and clean. The steaming
should be continued until a free perspiration ensues, and when the
rocess is completed, the bed clothes and patient’s linen should
|. changed, or the matter that has been thrown out through the
pores will be absorbed.
1496. Semicircular hoops are sometimes placed across the
patient to prevent the bed clothes from coming in contact with his
person, or instead of these, a frame-work may be devised, that
will answer a still better purpose. Those who are furnished with
a boiler, and a lead or tin pipe, may very conveniently introduce
vapor beneath the bed clothes, without the trouble of heating
stones. The pipe should be about three quarters of an inch in
diameter, and terminated with a tin cup four or five inches square.
containing a number of perforations, so that the vapor may issue
beneath the bed clothes in a slow and gradual manner.
1497. Application of Papor with Blankets. This is perform:
ed by placing the patient in a chair, divested of his clothing, and
surrounding him, together with the chair, with one or two clean
blankets, sufficiently large to reach the floor. His face should be

PRACTICE OF MEDICINE. 369
uncovered, that he may breathe the fresh air. If he is cold or
chilly, his feet should rest on a heated stone, or brick. When
these preparations are made, vapor is to be generated by means of
a basin or kettle of water, and four or five red hot stones. The
water is to be placed under the folds of the blanket, behind the
chair, and one of the stones partly immersed in it, supplying its
place with another when it ceases to produce a hissing noise,
and so on until the process is completed. Some stimulating tea
is to be taken in the meantime, as directed in the previous para-
graph, and the patient’s face and breast wetted with cold water, if
he complains of faintness or languor. When he has perspired
sufficiently, which will be in fifteen or twenty minutes, a portion
of cold water should be dashed over him suddenly with a sponge,
or in any other convenient manner, and the blanket drawn around
him to exclude the air, until he is well rubbed from head to foot
with a coarse towel. He may then dress himself, or be placed in
bed, as circumstances require. If the bath is preparatory to a
course of medicine, the cold water is not applied, as will be no-
ticed hereafter, in the directions for a course.
1498. A boiler and pipe, as previously mentioned, (1496)
may be used for the introduction of vapor beneath the blanket,
instead of the plan just recommended.
1499. Bow to enclose a Joint, or Limb. This is intended
for the local application of vapor to swellings, inflammations, and
stiff, or diseased joints. It should be fifteen inches wide, eighteen
inches high, and twenty four inches long. The vapor is introdu-
ced into the box through a tube near the bottom, and made
to pass through a quantity of herbs, or hay. The limb is
placed in the box longitudinally, resting it on pads or cushions, if
necessary, and a blanket thrown over it to prevent the escape of
vapor. In swelling of the labia, or testicles, the patient may sit
over the box very conveniently. The time employed in this
process, may vary from fifteen minutes to two hours, according to
the nature of the case; and if necessary, it may be repeated two
or three times a day. During the process, also, benefit is fre-
quently derived by bathing the affected part with volatile lini-
ment, or some other stimulating wash, and rubbing it briskly with
the hand. This is particularly useful in stiffness of the joints, and
diminished sensibility.
1500. Bow for Vapor Bathing. This is a wooden box,
measuring about two feet in width, two feet and a half in depth,
and six or seven feet in height. It furnishes a very convenient
and economical mode of vapor bathing, and is extensively used
-


47

370 PRACTICE OF MEDICINE.
-
throughout the United States. A sliding board is fitted into it
about eighteen inches from the bottom, which serves the purpose
of a seat. The door is placed in front, and contains two circular
openings, one above the other, which enables the patient to
breathe the external air, either in the erect or sitting posture. A
sliding curtain is suspended over each of these openings, which
can be moved at pleasure. A board or platform, perforated with
half inch auger holes, is fitted loosely into the bottom of the
box, having space enough beneath for the introduction of the pipe
or tube which conveys the vapor. The interior of the box, but
particularly the bottom, should be lined with zinc, to prevent the
absorption of the perspirable matter, which is sometimes very
offensive. The shower bath, by which the vapor bath is generally
concluded, may be administered by pouring water through a piece
of perforated zinc, or tin, at the top of the box; or the water may
be contained in a small vessel, contrived in such a manner that
the patient, by pulling a string, may let down the shower at his
pleasure. The perforations should include a circular space of
about a foot and a half in diameter. A hole should be made in
the bottom of the box to let off the water which collects in it
from the administration of the shower.
1501. The boiler employed to generate the vapor, is made of
tin, sheet iron, or copper, and is sufficiently large to contain a
gallon or more of water. It is furnished with a bale, to suspend it
over the fire. The top, which is soldered on firmly, contains a
hole an inch in diameter, through which water is poured into the
boiler by means of a funnel; a small tin or sheet-iron cup, with a
narrow brim at the top, should be fitted into this hole to prevent
the escape of vapor, during the operation of bathing, without re-
sisting its pressure in case the vessel should be in danger of burst-
ing, as would happen if the water was nearly exhausted. The
vapor is conveyed from the boiler to the box through a lead or
tin pipe, which is three quarters of an inch in diameter, and fur-
nished with a valve to shut off the vapor if occasion requires. If
the pipe is made of tin, it should consist of joints and elbows
neatly fitted together, as it is incapable of being bent or twisted in
the same manner as a lead pipe. -
1502. Portable boilers are now manufactured of sheet iron,
which are very convenient for practitioners, as well as families.
They are made in the form of a cylinder, the upper half being ap-
propriated to the boiler, while the lower half consists of a ſurnace, in
which a fire may be speedily kindled with shavings, or light wood.
1503. Temperature of the Bath. This varies from 105 to
120 degrees, according to the feelings or condition of the patient-

PRACTICE OF MEDICINE. 371
-
If the vapor is too hot, it can be shut off by means of a valve, or
in the absence of this, its heat may be diminished by pouring cold
water into the boiler. It is not necessary, as a general thing, to
employ a thermometer, as it should be an object to render the
bath agreeable to the patient, increasing or diminishing its tem-
perature according to his directions. If, however, he should
become faint or languid during the operation, his face and breast
should be wetted with cold water, as previously directed, or a
tumbler-ful of cold water may be dashed over his person. This
will immediately revive him, and prove refreshing and grateful.
The patient should remain in the bath until a free perspiration.
ensues, which will generally be in fifteen or twenty minutes; and
in the meantime should take one or two draughts of some
stimulating tea, as ginger, composition, or cayenne and bayberry,
which will serve to keep a determination of blood to the surface
of the body.
1504. Cold Shower. The vapor bath should always be ſol-
lowed by the cold shower, excepting where the patient is very
feeble, or chilly. Whatever may be said in opposition to this
practice, it is based upon correct principles, and is productive of
beneficial results. The momentary application of the water does
not occasion a chill, but quickens the circulation, and causes the
blood to flow in an increased quantity into the vessels of the
skin, giving it warmth, fulness, and a bright, glowing color.
Under these circumstances, the patient is much less liable to take
cold, or to be injuriously affected by the atmosphere. The
moment the shower is administered, he is refreshed and invigo-
rated. We have seen that the Russians, and people of other
nations, leave the vapor bath dripping with perspiration, and roll
in the snow, or plunge into a river, previously breaking the ice.
The truth is, the application of cold water would often prove in-
jurious, without preceding it by the vapor bath; and we have
already quoted the assertion of Dr. Bell, that “the best means of
º great cold, is to be previously subjected to high heat.”
1505. Just before the shower strikes the body, the individual
should take in a full inspiration, for the water in its descent, forces
away the air, and causes him to “catch his breath,” as it is term-
ed., The moment he leaves the box, he should be wrapped in a
blanket, and rubbed briskly from head to foot for several minutes
with a coarse towel. He may then dress himself, or return to
bed, according to the state of his health. It is advisable,
however, that invalids remain within doors for some hours after
the bath, unless the weather is sufficiently mild and pleasant
M.
372 PRACTICE OF MEDICINE.
permanent warmth of the skin.
. * of exercise in the open air, without the risk of becoming
chilled. -
1506. The cold shower is move, to be employed, unless there
is sufficient vitality in the system to favor reaction—that is, a
determination of blood to the surface of the body, giving the skin
a ruddy, healthful color. Some persons do not become warm in
the bath until it has been repeated a number of times, and under
these circumstances, the shower would be manifestly improper.
The same remark is applicable to the last stages of disease,
where life is nearly extinct, and it is impossible to establish a
1507. With regard to the quantity of water to be employed,
no precise rules can be given. A quart generally suffices, but in
some instances a much larger quantity is used. If the patient is
of a cold habit, the chill should be taken off; and in some cases
it is better to dispense with the shower altogether, sprinkling a
slight portion of cold water over him with the hand. I have
known the good effects of a course of medicine to be entirely
counteracted by the careless or injudicious use of the shower
bath.
1508. JMedicated Vapor Bath. This is prepared by allowing
the vapor to pass through fragrant herbs, or any medicinal sub-
stance. I am not aware, however, that it possesses any superior-
ity over the vapor of pure water; and if it is necessary to bring
the system under the influence of medicine, it is better to in-
troduce it at once into the stomach, rather than to depend upon its
absorption by the skin, which, in the bath, is somewhat uncertain.
PRE PARATION OF TEAS.
1509. Teas should be prepared in a covered vessel, so as to
procure them in their full strength. This is particularly necessary
in making use of volatile, or aromatic plants. A teapot is very
convenient for the purpose I have named, as the tea can be
poured out without any admixture of the sediment. I am aware
of the prevalent opinion that it is better to swallow “grounds and
all,” but no advantage can arise from this practice, if the medicine
has been steeped a sufficient length of time to obtain its strength;
and experience has satisfied me that the tough, woody, or indiges:
tible matter which constitutes the sediment, is sometimes injuri-
ous, particularly in º ptic affections, and a weak or irritable
condition of the stomach. Volatile plants, such as lobelia inflata,

PRACTICE OF MEDICINE. 373
the mints, golden rod, summer savory, and pennyroyal, should
never be boiled, or their active properties will be dissipated by the
heat.
1510. The terms infusion and decoction are applied to teas ac-
cording to the mode in which they are prepared—that is, either
by steeping or boiling. Common table tea is an example of the
first, and coffee of the second.
1511. CoMposition TEA. Take of the powder a mode-
rately heaped tea-spoonful; sugar double the quantity; mix them
together, and add a tea-cupful of boiling water. Steep until the
tea is cool enough to take. This is the ordinary dose. For
further instructions, see the remarks on composition, under the
head of compounds. (1239, et seq.)
1512. CAYENNE AND BAYBERRY TEA. Take of cayenne
half a tea-spoonful, bayberry double the quantity, and sugar to suit
the taste. Add a tea-cupful of boiling water, and steep as directed
above. This is more active than the composition, and should be
substituted for it in violent or critical cases of disease.
1513. TEA of SPICED BITTERs. Take of the powder a
level tea-spoonful; sugar double or triple the quantity; mix, and
add a tea-cupful of boiling water. Steep a sufficient length of
time, and drink the tea. (1246, et seq.)
1514. NERVINE TEA. Take of scullcap, in powder, two
tea-spoonfuls; cayenne the eighth of a tea-spoonful; sugar three or
four tea-spoonfuls; boiling water a pint. Steep in a covered
vessel until cool enough to use, and #" desirable, add the essence
of cinnamon to give it a flavor. Keep the tea warm by the fire,
and employ it as a drink. It is highly useful in all nervous affec-
tions; and while the patient is using it, he should avoid exposure
to the cold. If the scullcap cannot be procured, the lady’s slipper
may substituted. (923 et seq., and 936, et seq.)
1515. STIMULATING TEA. Take of cayenne, bayberry,
and scullcap, each a tea-spoonful; green lobelia half a tea-spoon-
ful; sugar seven or eight tea-spoonfuls; boiling water a quart.
Steep these in a covered vessel, and keep the tea warm by the
fire. This is highly useful in sudden colds, nervous affections,
pains in any part of the body, cramp, colic, asthma, croup, di-
arrhoea, giddiness, tie douloureux, and hooping cough. I have
found it very beneficial between courses of medicine, in the treat-
ment of scarlet, typhus, and bilious ſevers, as it tends to keep the



374 PRACTICE OF MEDICINE.
skin moist, and of a natural temperature. If the tongue is dry or
parched, the quantity of bayberry should be diminished, and that
of cayenne increased. A tea-cupful of this tea may be given to
an adult every hour or two, or it may be administered in the dose
of a table-spoonful, and repeated more frequently. In the mean-
time it is necessary to avoid exposure to a cold or chilly atmos-
phere, or the tendency to perspiration will be counteracted. The
lobelia is not intended to occasion nausea, and the quantity, there-
fore, may be increased or diminished according to the peculiarities
of the patient. In coughs, and painful affections of the urinary
organs, the tea should be rendered somewhat mucilaginous by the
addition of slippery elm.
1516. DIURET1c TEA. Take of poplar bark a tea-spoonful;
juniper berries, bruised, a table-spoonful; cool wort a handful;
boiling water a quart. Steep in a covered vessel, and sweeten to
suit the taste. This is to be used as a drink, avoiding exposure
to a damp or cold atmosphere. It is useful in strangury, gravel,
and various difficulties of the urinary organs.
1517. TEA For DIARRHGEA, AND Dys ENTERy. Take of
poplar bark a tea-spoonful, bayberry three tea-spoonfuls, boiling
water a pint. Steep, and sweeten to suit the taste. Take a tea-
cupful at a dose, adding to it a table-spoonful of rheumatic drops,
and repeat every hour until a cure is effected. If the drops are
not at hand, half a tea-spoonful of cayenne may be added to each
tea-cupful of the tea. -
1518. Tº A For IMPURITIEs of THE Blood. Take of
cayenne a tea-spoonful and a half; bayberry, poplar bark, and the
dust or powder of sumach berries, each a table-spoonful; meadow
fern burrs, reduced to a powder, a table-spoonful and a half.
Mix thoroughly, and take a tea-spoonful of the powder at a dose,
steeping it in a tea-cupful of boiling water, and adding sugar or
honey to suit the taste. The dose should be repeated two or three
times a day. I have found this to be an excellent medicine in
tetter, itch, jaundice, gout, scald head, scurvy, scrofula, cutaneous
eruptions, ill conditioned sores, and all impurities of the blood.
The quantity of cayenne may be increased, if the patient should
consider it necessary.
1519. TEA For Worms. Take of bayberry half a tea-spoon;
ful; balmony two tea-spoonfuls: boiling water a pint. Steep, and
sweeten to suit the taste. This may be employed as a drink. It
is used for jaundice, as well as worms.
PRACTICE OF MEDICINE.
1520. GINGER TEA. Take of ginger a large table-spoonful,
and steep it in a pint of boiling water. Sweeten with sugar, mo-
lasses, or honey. This is a pleasant and wholesome drink, par-
ticularly if milk be added to it, and is serviceable in flatulency,
cramp in the stomach or bowels, and a cold or feeble state of
the system. (794.)
1521. SLIPPERy ELM TEA. Take of powdered slippery
elm and sugar, each a tea-spoonful; boiling water a pint. Infuse
until the elm is dissolved.
1522. This tea is sometimes prepared by steeping an ounce
of the bark cut into shreds, in a pint of water, as mentioned
above; and in this form is free from sediment.
1523. Elm tea is useful in a great variety of affections, as
diarrhoea, dysentery, sore throat, and inflammation of the stomach,
kidneys, and bladder. It is soothing to the parts with which it
comes in contact, and contains a large amount of nourishment.
(1164, et seq.)
1524, PENNYRoyAL TEA. Take of pennyroyal a handful;
boiling water a pint. Steep in a covered vessel, and sweeten
with sugar. This is useful in slight attacks of disease, and as a
drink during a course of medicine. (1139.)
MISC ELLANE 0 US REMEDIES.
1525. Cough JELLY. Take half a tea-spoonful of cayenne,
a tea-spoonful of powdered elm, and two or three tea-spoonfuls
of loaf sugar ; rub them together, and add a tea-cupful of hot bay-
berry tea; stir until a jelly is formed, and flavor with nutmeg,
cinnamon, or lemon juice. A tea-spoonful may be taken when-
ever the cough is troublesome. It is a very convenient form of
medicine for children. (1165.)
1526. ALTERATIVE MIXTURE. Take of rheumatic drops
and West India molasses, each a table-spoonful; tincture of lobe-
lia half a table-spoonful. Mix. The dose of this is a tea-spoon-
ful, or more, repeated two or three times a day. I have found
this medicine very useful in cutaneous diseases, boils, ill-condi-
tioned sores, and mercurial salivation. It is beneficial in dys-
pepsia also, and generally allays the unpleasant feelings which
are experienced in the stomach after eating. The mixture may
be given with great advantage to children with the rickets, and
• various chronic complaints.




376 PRACTICE OF MEDICINE.
1527. Soot HING DRops. Take of warm water, sweetened,
three tea-spoonfuls; tincture of lobelia, eighteen or twenty drops.
A tea-spoonful of this mixture will generally put a restless infant
to sleep; but the dose may be repeated, if necessary. The med-
icine is also useful in a harsh or dry cough.
1528. CoM Pound For CHILDREN. Take of composition,
spiced bitters, and slippery elm, each a tea-spoonful; cayenne
half a tea-spoonful. Mix with molasses, or honey, and admin-
ister a tea-spoonful at a dose, repeating it three times a day. This
is useful in coughs, loss of appetite, cutaneous diseases, and an
impure state of the blood.
£529. REM Edy For A BURN. Take of fir balsam a table-
spoonful, more or less, and double the quantity of sweet oil.
Spread this on a piece of fine linen, and apply it to a burn or scald,
where the skin is off. It will generally effect a speedy cure.
1530. SUMACH WINE. Make a tea of sumach berries, and
sweeten it with sugar, or honey. It has the color of wine,
and an astringent, and pleasantly acid taste. It is used in the
bowel complaints of children, and as a gargle in sore throat. It
is also employed as a wash for ring-worms, tetters, and similar
eruptions of the skin. (860.)
1531. CAYENNE SIMMERED IN WINEGAR. Take of cay-
enne a tea-spoonful; vinegar a gill. Simmer for four or five
minutes. This is employed for bathing sprains, swellings, rheu-
matic joints, palsied limbs, and parts that have lost their sensi-
bility. It is useful as an external application to the throat, in
quinsy; to the side, in pleuritic affections; and to the abdomen, in
swelling or tenderness of the bowels. A flannel may be saturated
with it, and laid over the affected part, if the disease is severe or
obstinate.
1532. Eye WATERs. These are prepared in various ways,
as will be seen by the subjoined directions. 1. Take of pure cay:
enne a grain; infuse for twenty-four hours in a wine-glassful of
water, and filter. 2. Take of cayenne, lobelia, and bayberry,
each half a grain; infuse as before in half a wine-glassful of water,
and filter. 3. Take of raspberry, or witch hazel tea, free from
sediment, and render it somewhat pungent by the addition of rheu-
matic drops.
1533. These washes may all be used in affections of the eye;
as dimness of vision, inflammation, and a secretion of purulent
PRACTICE OF MEDICINE 377
matter. In approaching blindness, the first and second are deci-
dedly beneficial, as I can assert from my own experience. They
should always be employed milk warm, as cold applications ap-
pear to injure the eye. -
1534. If the eye contains lime dust, there is no better wash
than equal parts of vinegar and water.
POULTICE.S.-
1535. Poultices are external applications intended to soften
and relax the skin, allay pain and inflammation, hasten the dis-
charge of matter from tumors or swellings, and cleanse offensive
or ill-conditioned sores. Some attention must be paid to the
component parts of a poultice, or it will not answer the purpose
designed. Astringents, for instance, have a tendency to dry the
skin, and thereby retard the process of suppuration. (803) In
case of inordinate discharges, however, astringents, combined
with other articles in a due proportion, are highly useful.
1536. In the country, poultices are usually made of bread and
milk, but unless frequently changed, the milk becomes rancid, and
irritating. The poultice also dries in a very short time. If
milk is used at all, it should be perfectly sweet.
1537. There is probably nothing better for the body of a
poultice than powdered slippery elm, as it is not only of a sooth-
ing nature, but continues moist a longer time than almost any
other substance.
1538. A poultice should be renewed as soon as it becomes
dry, which is generally in ten or twelve hours; and iſ much pain
and inflammation are present, it should be wetted occasionally
with cold water, which will allay the pain, and gradually subdue
the inflammatory action. -
1539. Wounds, and raw, or ulcerated surfaces, should be
thoroughly cleansed at each renewal of the poultice. This may
be done by washing them with mild soapsuds, followed by a tea
of bayberry, witch hazel, or pond lily. The two latter are more
soothing than the bayberry, and may be employed where the parts
are very irritable.
1540. A highly inflamed surface is benefited by sprinkling it
slightly with cayenne, finely powdered, previous to the application
of a poultice. -
1541. When the inflammation of a sore, or wound, is subdued,
and the matter all discharged, the poultices are to be discontinued,
and the healing salve employed. -
1542. Poultices containing lobelia, should not be applied to



48

378 PRACTICE OF MEDICINE.
raw surfaces, for they generally occasion distressing nausea, and
vomiting. A gentleman of Boston informed me, that he once
applied a poultice of this description to an ulcer on his breast,
which was followed by severe vomiting; and this continued for
twenty four hours. He did not even suspect that the poultice
was the cause of the difficulty. Where the skin is unbroken,
however, as in hard or painful swellings, lobelia may be added
with advantage. -
1543. ELM AND GINGER Poul.TICE. Take of ginger one
part; powdered slippery elm two parts. Mix with hot water
until of the proper consistence. For boils, carbuncles, felons,
whitlows, and all painful swellings, a portion of cayenne should be
added, as this will frequently allay the pain and soreness, and give
rise to an agreeable sensation of warmth. If the skin is off, the
cayenne must be omitted, and even the ginger, under such cir-
cumstances, must be dispensed with, or used in a very small
quantity. In cases of this description, a simple elm poultice
will be sufficient, mixing it with a tea of raspberry, or pennyroyal.
1544. In the absence of slippery elm, pounded cracker or
the crumb of bread may be used in making a poultice, and some-
times the elm and cracker are employed in equal parts.
1545. INDIAN MEAI, Poultic E. Stir Indian meal into
boiling water, until it is of the desired consistence. This forms an
excellent emollient poultice, and with the addition of cayenne,
lobelia, and rheumatic drops, has been the means, in some instan-
ces, of dispersing cancers and scrofulous tumors. Several weeks
are generally required for this purpose, however, and in the mean-
time, appropriate remedies must be employed to restore the gen-
eral health. The poultice may be applied with advantage to
gouty feet, stiff, swelled, and painful joints, and to the abdomen,
in colic, and some other affections of the bowels. The quantity
of lobelia should not be so large that its absorption will be ſol-
lowed by sickness, or vomiting.
1546. Poultice of the Dregs of RhEUMAtic DRops.
Take of the dregs one part, slippery elm two parts. Make into
a poultice with hot water. This is a useful application to
indolent or offensive sores, and parts that are approaching a state
of mortification. Cayenne, or ginger may be added, if desirable:
It should not be applied to boils, tumors, or swellings in which
the formation of matter has commenced; for it draws the skin into
wrinkles, and greatly retards the suppurative process. -

PRACTICE OF MEDICINE. 379
1547. CARRot Poul.TICE. Boil the carrots until they are
sufficiently soft to form a poultice, and deprive them of their skins.
This is of a soothing nature, and useful in irritable, or badly-con-
ditioned sores. If carrots cannot be obtained, potatoes, or tur-
nips, boiled and mashed into a pulp, may be substituted.
1548. YEAst Poultic E. Take of wheat flour a pound,
and add half a pint of yeast. Expose the mixture to a gentle heat
until it begins to rise. This form of poultice, says the United
States Dispensatory, is gently stimulant, and is sometimes applied
with much benefit to foul and gangrenous ulcers, the fetor of which
it corrects, while it is supposed to hasten the separation of the
slough or dead part.
1549. CHArco Al Poultic E. Take wood charcoal red hot
from the fire, and as soon as it ceases to burn, reduce it to a very
fine powder; mix this with a poultice of slippery elm, or Indian
meal. Charcoal, recently prepared, says Dr. Wood, has the
property of absorbing and neutralizing those principles upon which
the offensive odor of putreſying animal substances depends. The
poultice, therefore, is highly beneficial in correcting the fetor of
wounds and sores that are in an offensive or gangrenous state. It
should be frequently renewed.
INJECTIONS OR ENEMAS.
1550. These are liquid preparations which are thrown into
the rectum with a syringe. They are of great importance in
the management of disease, and if properly prepared, will often
effect a cure without any other treatment. I have known a single
injection to arrest a violent fever, where it depended upon irri-
tating matters in the bowels.
1551. Professor Dewees remarks, “The value of enemas is
only beginning to be appreciated in this country. They have
had to contend against much prejudice to gain their present con-
sideration. An injurious and . delicacy has prevented
their general employment, especially out of our cities; and it is
only within a few years even in our cities, that they have been
looked upon as prompt and efficient remedial applications. For
the good of the afflicted, we hope this prejudice will soon wear
away; and that they will be looked upon as indispensable medical,
as well as domestic remedies.”
* Practice of Physic.

380 PRACTICE OF MEDICINE.
-
1552. Professor Dunglison says, “Injections are invaluable
agents, where the powers of life are so much reduced, that a ra-
tional fear is entertained as regards the administration of cathartics
by the mouth.”
1553. Dr. Thomson, who has done much to render the use
of injections popular in the United States, says they had better be
used ten times unnecessarily, than to be omitted once where they
are absolutely required.
1554. Nutritious injections have been the means of sustaining
life for a considerable time, where the individual was unable to
swallow. Dr. Currie, in his work on Cold Water, relates a case
in which the patient lived sixty days. The injections in such
j. should consist of beef tea, or some other equally nutritious
ulci.
1555. Life is sometimes saved by the use of injections, when
it is impossible to administer medicine by the mouth. An in-
teresting case of this kind was detailed to me by Dr. Wat-
kins of Dover, N. H. A man applied to him with ulcerated
throat, who had not been able to swallow or speak for two
days. An injection composed of cayenne and bayberry tea, with
half a tea-spoonful of green lobelia, was administered, which had
no effect. This was followed by a second and more powerful
one, which occasioned nausea. In fifteen minutes, a third was
given which produced relaxation, and the patient vomited a
considerable quantity of greenish matter, together with pure yel-
low bile. He continued to vomit at intervals for three or four
hours, perspiring freely, but without being able to swallow. His
neck, meanwhile, was bathed repeatedly with strong rheumatic
drops. At length he fell asleep, and on awaking, which was
not until the lapse of five or six hours, had the use of his voice.
He was thirsty, and drank freely of ginger tea, and milk porridge,
from which time he speedily recovered.
1556. Several cases of putrid sore throat have come under
my observation, where the patients were unable to swallow, but by
administering one or two injections containing a tea-spoonful or
more of green lobelia, the difficulty has been speedily removed.
1557. Those who are opposed to depletion in all its forms.
employ injections to evacuate the bowels instead of cathartics:
and that they are entirely adequate to this purpose, I do
* General Therapeutics, p. 251
PRACTICE OF MEDICINE. 381
not entertain a doubt. The innutritious, part of the food, which
is destined to be discharged from the body by stool, passes
through the small intestines in a comparatively fluid state, and is
emptied into the lower or large intestines, where it acquires a
more solid consistence, having been deprived of the greater part of
its moisture by the intestinal absorbents. (958.) The large intes-
times, as I have said, are about six feet in length, (72) and con-
sist of three portions, denominated cºcum, colon, and rectum.
(77, et seq.) The caecum is a kind of sac, about three inches
long, in which the small intestines terminate with a valve. The
colon forms the principal portion of the large intestines, ascend-
ing on the right side toward the liver, passing across the abdo-
men under the stomach, and descending on the left side, where
it forms a convolution similar to the Roman letter S, called by
anatomists the sigmoid flewure. (See Fig. 3, page 20.) Here the
rectum commences, and descends to the anus or fundament, where
it terminates. It will be seen, therefore, that an injection does
not pass beyond the valve of the caecum, nor does it usually
reach higher than the sigmoid flewure. This, however, is
sufficient to evacuate the bowels, for it has been ascertained
that the matter to be voided by stool, accumulates in the sigmoid
flexure, which is always within the reach of injections. The
colon, excepting in rare cases, is not the seat of the accumulation;
and even if it should be distended with alvine matter, from long
continued costiveness, injections would produce the desired effect,
for the forcible contractions which they excite in the lower part of
the intestinal tube, gradually extend to more remote parts, and the
colon becomes at length completely evacuated.
1558. Injections are not only useful in emptying the bowels,
but also make a prompt and decided impression upon the gen-
eral system. They should be employed, therefore, in all danger-
ous or obstinate cases; and should never be dispensed with in
apoplexy, hemorrhage, convulsions, inflammation of the brain,
and low forms of disease. In affections of the bowels, as dysen-
tery, colic, piles, tenesmus, and worms, they afford prompt relief.
In suspended animation, also, they are of great importance in
rousing the dormant energies of life. I have known dogs to be
immersed in water until they were apparently dead, and then re-
vived by the administration of injections composed of an infusion
of cayenne and bayberry, with a portion of the antispasmodic
tincture.
1559. If the stomach is too irritable for the retention of medi-
cine, it may be quieted in most instances by the use of injections,



382 PRACTICE OF MEDICINE.
together with the vapor bath, which have the effect to restore a
balance to the circulation.
1560. Injections into the rectum exercise a powerful influence
on the neighboring parts and organs, and hence they are of great
value in stoppage of the urine, suppression of the menstrual evacu-
ations, and inflammation of the womb, bladder, kidneys, or bowels.
1561. Lobelia added to an injection, in the quantity of a
tea-spoonful of the powdered leaves, or seeds, or a table-spoonful
of the tincture, and repeated once or twice, will excite vomiting,
but is usually followed by more or less prostration. On this ac-
count it is rarely given in this form with a view to its emetic ope-
ration, excepting where it would be obviously useful, as in dislo-
cations, fractures, severe forms of croup, locked jaw, strangulated
hernia, deep seated pains, violent inflammatory affections, and those
cases in which it is desirable to produce general relaxation of the
system. -
1562. Worms in the rectum are effectually dislodged by the
use of stimulating injections.
1563. In diseases accompanied with great debility, tonic in-
jections are sometimes employed with advantage. They may con-
sist of a tea of poplar bark, balmony, golden seal, or any other
approved tonic.
1564. Instances occur in which, from a stricture or closing of
the rectum, it is impossible to administer an injection. A diffi-
culty may also arise from the presence of an abscess in the rectum.
A case of this kind occurred in Philadelphia, in which injections
caused a violent determination of blood to the head, followed by a
loss of consciousness. Ultimately, however, the abscess dis-
charged its contents, and the patient recovered.
1565. syringes. These have been greatly improved of late
years, and admirably adapted to the purpose for which they are in-
tended. They vary in size from one to sixteen ounces. Those
intended for adults are usually accompanied with a straight, and
crooked pipe, the latter of which enables an individual to use the
syringe without an assistant.
1566. Quantity of Fluid for an Injection. This is regu.
lated in some measure by circumstances, but chiefly by the age of
the patient. For an infant a year old, an ounce will be sufficient;
for a child five years old, two ounces; for a youth twelve years
old, three ounces; for an adult, from four to sixteen ounces.
Two table-spoonfuls, I will remark, are about equal to an ounce.
Many practitioners use a pint of fluid for an adult, but half that
PRACTICE OF MEDICINE. 383
quantity will generally answer a better purpose, for it is longer º
tained, and procures a more thorough evacuation. Where a pint
is injected, it is speedily discharged, and produces little or nº
effect. Instances occur, however, in which a pint, or even more,
may be employed with advantage.
1567. Common Injection. Take of bayberry a tea-spoonful;
cayenne, green lobelia, and scullcap, or lady’s slipper, each half a
teå-spoonful; boiling water half a pint. Steep in a covered ves-
sel, and strain, or pour off the liquid. Administer blood warm,
previously smearing the pipe of the syringe, and the external sen-
sitive parts, with lard, tallów, or sweet oil. After the liquid is
drawn into the syringe, the piston should be pushed gently for-
ward until a few drops of it escape, as this will serve to expel any
air which may be contained in the syringe, and which it would be
improper to introduce into the bowels.
1568. In giving an injection, the sediment should be omitted,
at least as a general rule, for it is liable to choke the syringe, an
in dysentery, piles, and other affections of the lower bowels, it
not only increases the irritation already existing, but frequently
gives rise to severe pain and distress. (1252.)
1569. It is proper to retain the injection as long as possible;
and if the muscles of the anus are in a relaxed condition, as
occasionally happens, a folded cloth or towel may be applied to
prevent its immediate escape.
1570. Where the bowels are very sore, or irritable, half a
tea-spoonful of slippery elm, or a tea-spoonful of honey, should be
stirred into the injection, either of which will have a soothing
and beneficial effect. In case of acid in the bowels, great ad-
vantage will be derived by the addition of a tea-spoonful of the
bicarbonate of soda. (1028, et seq.) -
1571. In severe or violent attacks of disease, the quantity of
cayenne and lobelia may be increased, or a table-spoonful of rheu-
matic drops may be added, when the injection is sufficiently cool
to administer. - -
1572. Simple Injections. Where there is no other object in
view than that of merely evacuating the bowels, the injection may
consist of an infusion of catnip, pennyroyal, fleabane, ginger, black
pepper, summer savory, or any of the stimulating herbs. Com-
position tea, or warm water containing a table-spoonful of rheumatic
drops, makes an excellent injection.
1573. Injection for Diarrhoea, or Dysentery. Take of bay- -
berry and cayenne, each a tea-spoonful; slippery elm, and scull-
- -

PRACTICE OF MEDICINE.
cap, or lady's slipper, each half a tea-spoonful; boiling water half a
pint. Steep until the liquid is nearly cool enough for use; strain,
and add two or three tea-spoonfuls of rheumatic drops, or an equal
quantity of the tincture of myrrh, the latter of which is preferable.
In dysentery, the cayenne is a valuable article, and should be freely
employed.
1574. Injection for Immediate Use. Take of warm water half
a pint; antispasmodic tincture one or two table-spoonfuls. Mix.
This is beneficial in apoplexy, convulsions, hydrophobia, locked
jaw, hysteria, and sudden attacks of colic.
1575. Injection for Piles. If the parts are very sore or
irritable, the injection may consist of an infusion of raspberry,
witch hazel, or sumach leaves, rendered somewhat mucilaginous
with slippery elm ; and as soon as it can be borne, ginger, cay-
enne, or rheumatic drops may be added. The liquid should
always be strained, or the sediment will occasion pain, and tenes-
mus, and not unfrequently aggravate the disorder.
1576. Soothing Injection. Take of scullcap a tea-spoonful;
slippery elm half a tea-spoonful; raspberry tea, boiling hot, two
tea-cupfuls. Steep until nearly cool enough to administer, and
strain. If the usual injection is followed by lingering pain, or
uneasiness, this will speedily allay it, and produce a tranquil sen-
sation throughout the whole system. It is beneficial in piles,
recovery from dysentery, and all cases in which there is soreness
or irritability of the lower bowels.
INJECTIONS FOR FEMALES.
1577. These are prepared in various ways, and introduced
into the vagina by means of a female ..". They are useful
in fluor albus, inflammation of the womb, falling of the womb,
menstrual irregularities, and retention of the placenta or after-
birth, accompanied with acrid or offensive discharges. The
manner of preparing them, will be described hereafter, in speaking
the diseases in which they are applicable. -
1578. The syringe most commonly used is five or six inches
long, and three quarters of an inch in diameter. The end is
rounded, and perforated with holes. Dr. Chase's vaginal sy-
ringe, however, is much more convenient and useful than this,
being furnished with a shield which closes the vagina at its orifice.
and prevents the fluid composing the injection from making a
rapid escape. -


PRACTICE OF MEDICINE. 385
GIVING AN EMETIC.
1579. It is necessary, oftentimes, to cleanse the stomach with
an emetic, where it is not convenient to administer a course of
medicine. For this purpose, the patient may either be in bed,
with a heated stone wrapped in a damp cloth at his feet, or seat-
ed by the fire, if the season requires it, covered with a blanket.
A tea of composition, or of cayenne and bayberry, is to be given
in tea-cupful doses, until he begins to perspire. A ...]" of
green lobelia is then to be mixed with another portion of the tea,
and administered at one draught, repeating it every twenty or
twenty five minutes, until the stomach is effectually cleansed.
Two or three doses will generally suffice. If the perspiration dies
away before the lobelia has done operating, an additional quantity
of cayenne must be administered. As soon as vomiting com-
mences, milk porridge should be given freely, (1420) alternating
it occasionally with a tea of pennyroyal, ginger, catnip, or golden
rod.
1580. If the patient is seated by the fire, and does not per-
spire readily, he should immerse his feet in a bucket of warm
water, or rest them on a heated stone, the latter of which is pre-
ferable, as the feet are liable to be chilled by removing them from
the water. If the emetic occasions protracted nausea, without
vomiting, a moderately heaped tea-spoonful of the bicarbonate of
soda (1028) should be given in two-thirds of a tea-cupful of warm
water, or an equal quantity of the tea already mentioned.
1581. Boneset, or blue vervain, will answer very well to
cleanse the stomach, where lobelia cannot be obtained. (705, et
seq. and 711, et seq.)
1582. A change of linen and bed-clothes is important, after the
* of an emetic, particularly if the patient has perspired
reely.
TREATMENT OF CHILDREN.
º -
1583. If children are refractory, and unwilling to take medi-
cine, we should do what we can to render it palateable. The va-
rious teas should be administered without the sediment, and their
unpleasant taste concealed by the addition of sugar, and some
innocent spice, or essence. ... If very young, there is little or no
difficulty in giving them medicine, but this is not the case when
they acquire sufficient strength to make forcible resistance. In
instances of this * will be derived from the use
- 4.

386 PRACTICE OF MEDICINE.
of a newly invented spoon which is represented in the subjoined
cut. It is hollow throughout, and has an orifice at each end,
marked A and B. In order to fill the spoon, the finger is first
placed upon B, and the liquid, whatever it may be, poured into
the orifice at A: the forefinger of the right hand is then placed
upon A, and the first finger removed. By retaining the finger
upon A, the liquid will not escape, and when the spoon is fairly
within the mouth of the child, the finger should be suddenly raised
and replaced, so that only a portion of the liquid may escape at a
time. The first portion swallowed, the finger may be raised a
second time, and so on till the medicine is all administered. It is
important that the finger should not be removed until the child is
observed to take in a breath, as the liquid will then pass down its
throat without difficulty.
1584. In giving an emetic to a child, we should steep a tea-
spoonful of green lobelia in half a tea-cupful of hot raspberry or
bayberry tea, and administer a table-spoonful of the liquid, more or
less, at a dose, according to its age, repeating it every ten or fifteen
minutes, until it operates. The child in the meantime should be
kept in a perspiration, and the action of the emetic assisted by
some pleasant drink, as an infusion of black birch, ginger, or
pennyroyal. Milk porridge should also be given. If the child is
five or six years old, two-thirds of a tea-spoonful of lobelia will be
sufficient, increasing or diminishing the quantity according to its
age.
*iss; It is very convenient, in some instances, to give the
lobelia by injection, a practice which I have sometimes adopted
to my entire satisfaction. Administered in this form, the quantity
requires to be slightly increased. It should be given in some bland
fluid, as milk and water, or raspberry tea, so that it may be retained
as long as possible. If discharged immediately, it produces little
or no effect, and renders it necessary to repeat the injection.
1586. In administering the vapor bath, the child may be tied
in a small arm chair, and surrounded with a blanket, as directed
for an adult, (1497) leaving its head uncovered, that it may breathe


PRACTICE OF MEDICINE. 387
the fresh air. Care must be taken that the vapor is not too hot.
in the meantime, a tea of raspberry, ginger, composition, or
pennyroyal, should be given to aid in promoting perspiration. If
the child appears ſaint, or languid, its face and breast should be
wiped with a cloth or towel wrung out of cold water, or vinegar;
and if there is any manifestation of thirst, special care should be
taken to supply it with drink. This may consist of the teas al-
ready named, or a mouthful or two of cold water, though the
latter should be used sparingly, as it tends to chill the stomach.
1587. The bath may be administered to a very young child,
by placing it on a mattress, covering it loosely with a blanket,
and generating vapor by means of a heated stone, wrapped in a
wet cloth of several thicknesses. -
1588. When the bath is completed, the child may be sponged
with cold water, and rubbed with a cloth or fine towel until its
skin is in a glow, managing it as we would an adult.
COURSE OF MEDICINEs.
1589. In all cases where there is no probability of effecting a
cure by simple treatment, we should administer a course of medi-
cine. This consists in the use of injections to evacuate the bow-
els, astringents to cleanse the mucous membrane of the alimentary
canal, (807) stimulants and the vapor bath to promote perspira-
tion, and an emetic of lobelia to free the stomach from its morbid
or vitiated contents. This is the “one remedy for all diseases”
which the diplomatised physicians have condemned as being un-
º and absurd. I do not hesitate to say, however,
rom what I have seen of the routine practice in our public insti-
tutions, that a course of medicine will do more, in a few hours,
toward the removal of disease, than is often accomplished by the
old school physicians in weeks, or even months. It tends di-
rectly to equalize the circulation, remove obstructions, invigo-
rate the skin, promote appetite and digestion, and restore every
organ and part of the body to a natural and healthy condition. If
these results are produced, it matters not what may be the pecu-
liar type of the disease, for nothing further can be done toward
the perfection of a cure.
1590. A course of medicine does not consist in the adminis-
tration of a single remedy, as many people have been led to sup-
pose, but in a series of remedies, which are admirably adapted to
the removal of disease; and unlike the poisons employed by the
medical faculty, they act in harmony with the laws of the
human system, and do not increase the existing malady. I may


388 PRACTICE OF MEDICINE.
assert, without the fear of contradiction, that there is not a single
prominent agent in the old school materia medica, which does not
produce a disease or irritation peculiar to itself. Blisters, for ex-
ample, excite inflammation; the lancet occasions dyspepsia, ner-
vousness, and a great variety of disorders; digitalis and nitre
weaken the action of the heart, and rapidly diminish the pulse;
opium produces costiveness, and impairs the functions of the brain
and nervous system; and calomel, that fearful scourge of the hu-
man family, destroys the bones, ulcerates the gums, causes the
teeth to drop from their sockets, and diffuses its poison throughout
- every part of the animal machine. Is it reasonable to suppose,
therefore, that substances which are capable of producing disease,
can be of any service in its eradication, excepting on the principle
of substituting one malady for another It is true, we may allay a
severe pain by the use of a stupifying narcotic, but this does not
remove the cause of the complaint. Pleurisy may be relieved in
some instances by copious blood-letting, but it is at the expense of
the patient’s constitution, and perhaps his life. The inflammation
of an internal organ may be transferred to the skin by the external
application of a blister, but the danger of this mode of practice is
apparent to every reflecting mind, and has already been discarded
by some of the most distinguished members of the medical faculty
themselves. -
1591. The charge which is so unceasingly made against the
advocates of the reformed practice, that they use only one remedy,
meaning thereby a course of medicine, is much more applicable to
the diplomatised physicians with whom it originated ; for it is well
known that they profess to cure every form of disease with the
lancet, and a few poisons. It is remarked of Dr. Dudley, one of
- the professors in Transylvania University, that “calomel, tartar
emetic, opium, ipecac, and a few vegetable cathartics, consti-
tute almost his entire materia medica.” Dr. Jackson, formerly
a professor in Harvard University, said to the students in the
Massachusetts General Hospital, “Give me mercury, antimony:
opium, and bark, and I care not for any thing else.” Now i
these medical worthies are not to be censured for confining
themselves to a few pernicious or poisonous drugs, why should the
reformers in medicine be condemned for employing a combination
of innocent vegetable remedies, in what is termed a course of medi-
cine? Admitting, however, for the sake of argument, that we use
only one remedy in all complaints, I am not aware that this would
be any objection to the practice, provided we succeed in curing
our patients. There is surely but little merit in prescribing a
- - * Boston Medical and Surgical Journal for 1839.



PRACTICE OF MEDICINE. 3.89
great variety of drugs, when it is known that their only effect
is to generate disease, and injure or destroy the constitutional
powers.
1592. A course of medicine effectually cleanses the stomach,
which is a very important matter, and one which the routine phy-
sicians generally neglect. For example, a patient applied to me a
few months ago, who had been under a medical man for nearly a
year without receiving any benefit, and during that time no meas-
ures had been taken to restore his stomach to a healthy tone. I
gave him a course of medicine without delay, which caused him
to vomit a large amount of ropy and very offensive matter. From
that moment he felt relieved, and in a short time was restored to
perfect health. I have met with many cases of prolonged disease,
in which a cure was effected by the administration of a few lobelia
emetics to cleanse the stomach. Indeed, this organ, as I have
previously said, may be regarded as the fountain of life; and it is
only through its agency that we can hope to remove disease, or
repair any injury which the system has sustained. It has the con-
trol of every other organ in the body, and disease becomes obsti-
nate or severe in proportion as it loses its power of vital re-
sistance.
1593. The perspiration which ensues from the administration
of a course of medicine, is highly beneficial, and affords more or
less relief in every form of disease. It is well known that ſevers
of every description subside as soon as the patient begins to per-
spire. Dr. Cullen remarks, that “the flowing of the sweat relieves
the difficulty of breathing which occurs during the cold stage of an
intermittent; ” he also says, that “the headach, and the pains of
the back and joints, which usually accompany this affection, grad-
ually go off with the sweating stage.”
1594. Sweating, to be of any service in the treatment of dis-
ease, must be produced by healthy, invigorating stimulants, to-
gether with the vapor bath, and other appropriate remedies. If
it is caused by “hot rooms, and close beds,” as Dr. Denman
remarks, or by cordials and drinks composed of wine, brandy,
or any alcoholic, or narcotic stimulant, it will be more injurious
than beneficial. -
1595. The sweating sickness of Great Britain, which occurred
epidemically about three centuries and a half ago, generally proved
fatal, unless perspiration ensued. This disease, says Dr. Good,
was a malignant fever, and “ran its course in a single paroxysm;
the cold and hot fits were equally fatal; but if the patient reached
the sweating fit, he commonly escaped.” At Shrewsbury, con-


300
PRACTICE OF MEDICINE.
tinues Dr. Good, the disease raged for seven months, and carried
off a thousand victims. After discovering the benefit of the sºul.
ing plan, however, it was far less fatal.
TREATMENT PREVIOUS To A cours E.
1596. Acute Diseases. In these, where it is considered
necessary to administer a course of medicine, it is usually given
without much preparatory treatment, excepting a free use of cay-
enne and bayberry tea. The emetic should be administered as
soon as the system is prepared for its operation—that is, as soon
as the patient begins to perspire, for nothing will afford him more
speedy relief than the thorough evacuation of the stomach.
1597. CHRONic Diseases. In these, particularly if the pa.
tient is of a cold habit, or has been long under the influence of
depletive, or poisonous drugs, the tonic and stimulating medicines
should be used for several days, or perhaps a week, previous to
the administration of a course. A dose of spiced bitters may be
taken before each meal, if the appetite is much impaired; and
during the day, an occasional dose of composition should be used
to warm and invigorate the system. The patient, in the mean-
time, should not i. exposed to a cold or damp atmosphere. At
bed time, a dose of composition, or of cayenne and bayberry, is
to be taken, and if the extremities are cold, or the circulation
feeble, a heated stone, or bottle of hot water, wrapped in a damp
cloth, placed at the feet. At bed time, also, an injection will
be of service, and this should never be omitted, if the bowels
are costive. The lobelia pills, in connexion with the other rem-
edies, are always useful, and in some cases, particularly beneficial.
(1299, et seq.) If the patient is chilly, or possesses but little ani-
mal heat, the vapor bath should be administered once a day, or
once every other day, followed by an application of the stimulating
limiment to the entire surface of the body. (1307.) The most
suitable time for employing the bath is at bed time.
1598. There are some practitioners who administer a course
of medicine in chronic diseases without any preparation of the
system, but it is adviseable to use the warming medicine twenty-
four hours previously, even in the mildest cases. Without this
precaution, the course does not operate so efficiently, and in some
instances, it may occasion the patient considerable distress.
1599. The most suitable time for the administration of a
course is in the morning, an hour or two after breakfast. The



PRACTICE OF MEDICINE. 391
patient should take a light meal, consisting of gruel, or some liquid
nourishment, in preference to solid food, as the latter would not
be fully digested before the operation of the emetic, and in that
case, the emergies of the stomach would have been expended to
no purpose. The administration of a course in the afternoon,
when the patient is fatigued, or languid, is not attended with the
same good results.
1600. Fears are sometimes entertained that a patient is too
much debilitated to admit of vomiting, but I have administered lo-
belia emetics in the last stages of disease, with no other hope than
that of affording mere temporary relief; and vomiting, I have ob-
served, has been performed with perfect ease, accompanied, in
many instances, with an increase of strength. I do not wish
to inculcate the doctrine, that emetics are to be given indiscri-
minately to weak patients, but I do not conceive that debility
alone is a prominent objection, where it is necessary to evacuate
the stomach of its vitiated contents. Professor Ware remarks,
that emetics may be given toward the close of a fever, and says
they are not prostrating, as is supposed, but increase rather than
diminish the strength. We have already quoted Dr. Good, as
saying that “there are few persons so debilitated as not to bear
vomiting.” (631.)
1601. Cases occur now and then, in which it is necessary to
pay particular attention to the treatment preparatory to a course.
I will mention one or two examples.
1602. Mrs. P of Frankford, near Philadelphia, a wealthy
and influential lady, had been indisposed for seventeen years, and
for nine years of that time, had been almost constantly under treat-
ment by Drs. Betton and Lambe. They had cupped her seventy
times, bled her as often, salivated her eleven times, and repeatedly
shaved and blistered her head. I have these statements from her
own mouth, and can vouch for their truth. Among the diseases
with which she was afflicted, according to the testimony of her
physicians, were rheumatism, dyspepsia, tic douloureux, liver
complaint, nervous fever, affection of the kidneys, affection of the
spine, disease of the brain, disease of the heart, and last, though
not least, bilious remitting nervous typhoid ſever, with inflamma-
tion of the sciatic nerve. This last complication baffled the skill
ºf her medical advisers, and they said she could not long survive.
Dr. Taylor was called in, who occupied a day or two in consult-
ing medical authors, and finding no similar case on record, ex-
|. the belief that there was no hope for the patient. Her
usband, Mr. P advised her to take courses of medicine,

392 PRACTICE OF MEDICINE.
but she refused. Ultimately, however, she was induced to try
the experiment, and sent for Dr. Comfort of Philadelphia, as her
physician. He found her in a dangerous situation, and though the
weather was exceedingly warm, and she was wrapped in blankets,
she complained of chilliness. The vapor bath could not be used,
because it produced a violent determination of blood to the head,
and the same effect was caused by immersion of the feet in warm
water. Heated stones, wrapped in damp cloths, were placed
about her person, in bed, and composition tea administered freely,
together with injections, which were repeated four or five times a
day. This treatment was continued for a week, when she began
to perspire, and after that period, there was no trouble in employ-
ing the vapor bath. Several courses of medicine were adminis-
tered, at proper intervals, and in the lapse of six weeks, accord-
ing to Mrs. P 's own statement, she was in the enjoyment of
perfect health, after having been under tolerably active treatment
for nine years, and given up as incurable by her physicians.
1603. Mrs. L of Boston, was troubled with an affection
of the heart, and had been under the care of a medical man for
nearly two years, who considered her case as beyond the reach of
remedies. Her extremities were cold, and she was constantly an-
noyed by a feeling of chilliness, even though seated by a warm
fire. Upon the slightest exertion her heart palpitated violently,
and the blood would rush suddenly to her head. A friend ad-
vised her to take some composition tea, but this increased the pal-
pitation, giving rise to ſaintness, and other distressing symptoms.
My advice was solicited in the case, and finding the blood-vessels
of the skin very much obstructed, I advised her to undergo a
perspiration in bed, which was accomplished by placing heated
stones wrapped in damp cloths at her feet and sides, and giving
her composition tea, which contained about half a tea-spoonful
- of green lobelia to the pint. By this treatment the circulation
became equalized, and the patient ceased to complain either of
palpitation, or a determination of blood to the head. She con-
tinued to take the composition for several days, together with an
injection night and morning, after which a course of medicine was
administered, and with one or two repetitions of it, was entirely
cured of her malady.
-
-
-
DIRECTIONS FOR A COURSE.
1604. Take of powdered bayberry five moderately heaped
tea-spoonſuls; scullcap, or lady's slipper two tea-spoonſuls; cº-
enne two or three tea-spoonfuls; boiling water a quart. Steep in



PRACTICE or MEDICINE. 393
a covered vessel, and set it º the fire to keep warm. If coarse
bayberry is used instead of the powdered, two large table-spoon-
fuls will be required. The scullcap, I will remark, is superior as
a nervine to the lady's slipper, and more agreeable to the taste.
The latter is nauseous to the majority of people, and on that ac-
count is frequently dispensed with in a course of medicine, where
it is important that a nervine should be used. In diseases accom-
panied with nervous symptoms, the scullcap, or lady's slipper
should always be employed, even though it be omitted under
other circumstances.
1605. The course is to be commenced by giving the par
tient a tea-cupful* of the above tea, sweetened to suit the taste.
This is to be followed by an injection, prepared by steeping two
thirds of a tea-spoonful of green lobelia in a tea-cupful and a half
of the tea, while it is hot, straining, or separating it from the sedi-
ment when nearly cool enough to administer, and adding one or
two tea-spoonfuls of rheumatic drops. (See paragraphs 1567,
–8–9–70.) If it is necessary to make a powerful impression on the
system, the quantity of lobelia may be increased, steeping with it half
a tea-spoonful of cayenne, and using a table-spoonful or more of the
drops, instead of the quantity specified. In diarrhoea, or dysen-
tery, a table-spoonful of the tincture of myrrh should be added in-
stead of the drops, though the latter will answer a very good pur-
pose. (1573.) A repetition of the injection is often beneficial, as
in costiveness, pain in the bowels, headach, apoplexy, or any ex-
cessive determination of blood to the head. If uneasiness, or lin-
gering pain follow an injection, the difficulty may be obviated by
administering one composed of slippery elm tea, or a tea of rasp-
berry, scullcap, and elm. (1576.)
1606. As soon as the injection has done operating, the vapor
bath is to be administered in some convenient manner, having
previously made arrangements for that purpose. (See paragraphs
1495, et seq., 1497, et seq., and 1500, et seq.) The temperature
of the bath, as we have already stated, is to be regulated ac-
cording to the feelings or condition of the patient; and if he be-
comes faint or languid, his face and breast should be wetted with
cold water, or a tumbler-ſul of cold water dashed over his person.
(1503.) As soon as the bath is commenced, he should have a
second tea-cupful of the tea, ("") and if he is chilly, or does not
* According to the measure adopted in this work, seven tea-cupfuls are equal
to a quart. See paragraph 605. This hint is requisite, as tea-cups vary greatly
in size.




































50

394 PRACTICE OF MEDICINE.
perspire freely, it may be repeated in five or ten minutes. If
requisite, half a tea-spoonful or more of cayenne may be added to
each cup of the tea. I have observed that where the system has
been well warmed by cayenne, the lobelia operates more efficient-
ly, and produces a more beneficial result.
1607. A free use of the tea in question, produces a twofold
advantage. The bayberry, which is one of its ingredients, cleanses
the inner coat of the stomach of its morbid secretions, (807, 822)
which is a very important object; while the cayenne, in addition
to its general effects upon the system as a pure, healthy stimulant,
acts locally upon the glands of the stomach, and dislodges from
them large quantities of cold, or slimy mucus. By using these
two agents, therefore, previous to the administration of the emetic,
the stomach is cleansed in the most thorough and effectual
manner.
1608. After the patient has remained in the bath until a free
perspiration ensues, which will generally be in fifteen or twenty
minutes, he may wipe himself dry, replace his shirt before leaving
the bath, and go directly to bed, having a blanket thrown around
him to prevent the possibility of his becoming chilled. If he is of
a cold habit, or the season renders it necessary, the bed should
be previously warmed. A heated stone, or bottle of hot water,”
wrapped in several thicknesses of a damp cloth, and that enclosed
in a dry flannel, should always be in readiness to place at his feet,
unless the weather is so warm that there will be no difficulty in
maintaining a perspiration by the use of the medicines alone.
1609. The bedclothes must be regulated according to the
season, using a sufficient quantity to make the patient comfortable,
and keep him in a gentle perspiration. He is sometimes op-
pressed by an undue quantity, and his breathing rendered difficult,
or laborious. This extreme should always be avoided by those
who have charge of the sick.
1610. The Emetic. The first dose of this should be prepared
while the patient is in the vapor bath, so that it may be administer-
ed the moment he is in bed. If the perspiration is suffered to die
away before it is given, it will operate much less favorably. Hence
it is sometimes administered to cold and feeble patients just before
they leave the bath, having the bed previously warmed for their
reception.
* A jug containing about two quarts of water, will retain the heat a much
longer time than a stone, but will not generate so much vapor; the latter, there-
fore, is preferable. A jug, however, is very convenient to place at the feet ºn
going to bed, as it will retain a portion of its heat until morning. A stone jug is
preferable to one of earthen ware.
PRACTICE OF MEDICINE. 395
1611. The emetic is prepared by adding a moderately heaped
tea-spoonful of green lobelia to a tea-cupful of the cayenne, bay-
berry and nervine tea, (1604) sweetening it to suit the taste.
This is to be taken in substance, at one dose. By moistening
the lobelia with equal parts of rheumatic drops and water, before
adding it to the tea, it will mix more thoroughly, and not adhere to
the mouth and throat.
1612. In giving a light course of medicine, which is necessary
in cases of great debility, the lobelia should be administered with-
out the sediment, as it is then more gentle in its effects, and less
liable to be followed by tedious or distressing nausea. It may be
prepared as follows. Take of green lobelia five tea-spoonfuls;
boiling water a tea-cupful and a half; steep fifteen or twenty min-
utes in a covered vessel, and strain. The infusion may be divided
into three portions, and given in the same manner as the powder.
1613. It should be remembered that the brown lobelia is more
strong and active than the green, (695) and consequently should
be used in a diminished quantity. Two thirds of a tea-spoonful of
the former, is about equal to a tea-spoonful of the latter. For my
own part, I prefer the green, particularly in the treatment of chil-
dren, and feeble or delicate patients. Brown lobelia is more apt
to be harsh in its effects, and to occasion prostration. Many
practitioners, nevertheless, use it altogether, and consider it pre-
ferable to the green; while others employ equal parts of the green
and brown in combination. The latter is undoubtedly preferable
where it is necessary to make a prompt and decided impression
on the system, as in apoplexy, delirium tremens, locked jaw, or
any violent febrile, or inflammatory affection.
1614. Repetition of the Emetic. It is a common practice
to administer the second dose of the emetic in fifteen minutes
after the first, but unless there is some urgent necessity, I prefer
waiting at least half an hour, in order that the medicine may diffuse
itself through the system. The second dose may then be admin-
istered, prepared in the same manner as the first ; (1611) and in
fifteen minutes, if vomiting has not ensued, or is not likely to
be effectual, a third dose may be given. Three doses is the
usual number; but sometimes one is sufficient, and at others six
or seven are required. There are many curious extremes in this
respect. I know a lady who never requires more than half a tea-
spoonful of green lobelia to operate as an emetic; while, on the
other hand, I recently met with a case in which nine large tea-
spoonſuls of brown lobelia were given before vomiting ensued.
A similar instance occurred a year or two ago in Nashua,
The patient was afflicted with dyspepsia, and had been dosing with

396 PRACTICE 0F MEDICINE.
Brandreth's pills, but finding no relief, concluded to take a course
of medicine. He commenced at seven o’clock in the morning,
and by noon had swallowed eleven tea-spoonſuls of brown lobelia,
without vomiting, or even experiencing nausea, excepting in a
slight degree. At nine o’clock in the evening, the vapor bath was
administered, after which he dressed himself, and took his seat by
the fire. In about three quarters of an hour, vomiting com-
menced, and he discharged a large quantity of greenish and offen-
sive matter. His stomach soon became quiet, however, and he
ate a hearty supper. He slept soundly during the night; and the
next morning arose at an early hour, prepared for his daily labor
in the factory, in which he was employed. From that time the
dyspepsia left him, and he enjoyed uninterrupted health.
1615. Where the patient is properly managed, it is not neces-
sary, as a general thing, to administer a large quantity of lobelia.
If the stomach is cold and inactive, as often happens in chronic
diseases, the warming medicines should be employed several days
previous to the course. In the present improved state of the veg-
etable practice, it rarely happens that three doses of lobelia are
not sufficient to evacuate the stomach effectually.
1616. The emetic is given in three portions, that it may have
a more thorough operation. The first dose is frequently followed
by vomiting, while the second may leave the stomach quiet, and
vomiting not ensue again until the third is given; or the first and
second doses may both vomit, and yet, if the stomach is very
foul, a third be required; or one dose may operate sufficiently,
producing prostration, frequent vomiting, and a tingling sensation
throughout the whole system; or all three of the doses may be
taken before vomiting occurs; and in that event, the operation is
liable to be tedious, or severe, particularly if considerable time
elapses before the vomiting takes place.
1617. If the contents of the stomach are offensive, they should
be discharged into a basin partly filled with cold water, as this will
prevent the exhalation of unpleasant, or deleterious fumes.
1618. Milk porridge, or unbolted wheat meal gruel (1420,
1424) should be taken freely after vomiting commences, alter-
nating occasionally with a dose of pennyroyal tea, or in the ab-
scence of this, a tea of black birch, catnip, golden rod, summer
savory, or any of the aromatic herbs.
1619. If the perspiration dies away before the emetic is all
given, half a tea-spoonful or more of cayenne should be added to
the subsequent dose, and repeated if necessary.
1620. The patient should not expose i. hands and arms
during the administration of a course; and when he rises to vomit,
the bedclothes should be drawn closely about his neck and shoul-

PRACTICE OF MEDICINE. 397
ders, to prevent his becoming chilled. Wiping his face and
hands with a cloth wrung out of cold water, or vinegar, is refresh-
ing, if he is ſaint or languid from the operation of the lobelia.
The application of vinegar to the nostrils, is useful for the same
purpose. -
I621. In some instances a patient falls asleep after the emetic
has been given, and unless he becomes cold or chilly, should not
be disturbed. While the skin is moist, and of a natural tempera-
ture, we may be assured that the functions of the body are per-
formed in a healthful manner, and sleep under these circumstances
will have an invigorating effect. - -
1622. Within the last year or two, Dr. Thomson has permit-
ted his patients to drink freely of cold water during the operation
of the lobelia, but the practice, I am bound to say, is fraught with
more or less evil. I have known it to give a sudden check to the
vomiting, and produce a severe chill. That a mouthful or two of
cold water may be taken occasionally with advantage, particularly
if the system is well warmed with cayenne, I do not deny ; but
large or frequent draughts of it, I am convinced, are capable of
doing serious injury. The stomach is readily chilled by the use
of cold drinks, and if it falls much below the natural temperature,
while the patient is suffering from disease, the whole system be-
comes sympathetically affected. We have already learned, that a
gill of cold water, administered to St. Martin, reduced the tempe-
rature of his stomach from one hundred to seventy degrees, and
the organ was more than half an hour in regaining the heat which
it had lost. (45.) This fact should teach us the impropriety of
using cold water during a course of medicine, at least in any con-
siderable quantity, particularly if the patient is of a cold or feeble
habit. - -
1623. Lingering .Nausea. If the lobelia has been admin-
istered in the usual number of doses, and the patient is afflicted
with distressing, or long continued nausea, without being able to
yomit, the following dose will generally produce the desired effect.
Take of cayenne and bayberry tea (Íñiz) a tea-cupful, and dis-
solve in it a level tea-spoonful of sal ſeratus, or a moderately
heaped tea-spoonful of the bicarbonate of soda. (1028.) This,
taken at one draught, will rarely ſail to evacuate the stomach.
The alkali is sometimes dissolved in a tea-cupful of warm water,
but is not so efficient. Vomiting may be produced in many in-
stances, by swallowing a bowl-ſul of milk porridge, or an equal
quantity of warm pennyroyal tea; or by pressing firmly with the
hands on the region of the stomach; or by changing suddenly from
one side to the other. If the perspiration has ceased, or the pa-


398 PRACTICE OF MEDICINE.
tient is cold or chilly, the vapor bath, or the application of heated
stones wrapped in damp cloths to the feet and sides, together with
the internal use of cayenne and bayberry tea, will generally excite
the stomach to discharge its contents.
1624. Restlessness. If the patient becomes restless or ner-
vous during the operation of the lobelia, the following prepara-
tion may be given with great advantage. Take of scullcap, or
lady’s slipper, a tea-spoonful; cayenne half a tea-spoonful; su-
gar any desirable quantity; boiling water a tea-cupful. Steep,
and give a table-spoonful of the tea at a dose, repeating it every
five or ten minutes. This will quiet the nerves, and aid the
operation of the emetic.
1625. Pain in the Bowels. Where this is present, relief
may be obtained by an injection of warm water and rheumatic
drops, in the proportion of a tea-cupful of the former, to a table-
spoonful of the latter, repeating it as often as necessary. The
common injection, with the omission of the lobelia, may be used
in its stead. (1567.) Bathing the abdomen with rheumatic drops,
epper-sauce, or a mixture of vinegar and cayenne, simmered,
(1531) will afford more or less relief; and if the pain is obstinate,
a flannel moistened with either of these liquids, and warmed by
the fire, should be laid over the part.
1626. Pain in the Head. This also may be generally re-
lieved by an injection, prepared according to the directions in the
preceding paragraph. If the head is hot or ſeverish, it should be
wrapped in a cloth wrung out of cold water, or vinegar, and the
application renewed as often as the cloth becomes warm. As
soon as the lobelia operates, and the stomach is cleansed, the pain
will generally cease. A heated stone wrapped in a damp cloth,
should be kept constantly at the feet.
1627. Ercessive Vomiting. Where this occurs, as it is liable
to do by giving a course of medicine without any preparation of the
system, or by suffering the patient to become cold during the op:
eration, it it is desirable to afford relief as speedily as possible; and
this is to be accomplished by the use of the vapor bath, or the ap:
plication of heated stones wrapped in damp cloths to the feet and
sides of the patient, administering cayenne tea, or pepper-sauce, in
table-spoonful doses. By this treatment the circulation is equalized.
and the vomiting and irritability of the stomach subside. Cullen
says, “In an attack of the plague, a vomiting happens, which
prevents any medicine from remaining upon the stomach. Dr.
PRACTICE OF MEDICINE. 399
Sydenham tells us, that he could not overcome the vomiting but
by external means, applied to produce a sweat or determination to
the surface of the body.”
1628. I was called to a gentleman who had been vomiting vio-
lently for six or seven hours, in consequence of a lobelia emetic.
He was in a cold room, and had perspired but very little. The
only matter discharged was pure, yellow bile. I steeped half a
tea-spoonful of salt, and a large tea-spoonful of cayenne, in half a
tea-cupful of boiling water, adding, in six or eight minutes, suffi-
cient cider vinegar to fill the cup. A table-spoonful of this was
given every ten minutes, until three doses were taken, and in the
meantime, a heated stone wrapped in a damp cloth, was placed at
the feet. This treatment produced perspiration, and the vomit-
ing ceased.
1629. I find a case of excessive vomiting recorded in my
manuscript notes, which was related to me by Dr. Thomson.
The patient was a Mr. Sherburne of Boston, in whom the diffi-
culty was occasioned by an injection containing an undue portion
of lobelia. When Dr. Thomson first saw the case, the vomiting
had continued for twelve hours, and was accompanied by great
prostration; but by the administration of the vapor bath, it was
speedily and effectually checked. Nothing was given internally,
excepting a tea-cupful of milk porridge soon after the bath, and
some chicken soup in the lapse of an hour.
1630. A cup of table tea, or a tea of spearmint, golden rod,
or black birch, will sometimes allay vomiting, but is not to be de-
pended upon in severe cases.
1631. Ventilation. The importance of ventilating the sick
chamber, particularly during the administration of a course of med-
icine, has not received that attention which it deserves. The air
soon becomes contaminated, and often highly deleterious, and if
ventilation is not resorted to, will have a powerfully depressing
influence on the patient. Dr. Combe observes, “fainting and
hysteries occur in churches much more frequently in the afternoon
than in the forenoon, because the air is then vitiated to the fullest
extent by breathing.” Dr. Reid, who was appointed to ventilate
the English house of Parliament, allotted ten cubic feet of air a
minute to each of the members and officers, and did not consider
this supply any more than adequate to their wants.
1632. “About one hundred years ago, when the pauper in-
fants of London were confined in the work-houses amid impure
air, not more than one in twenty four lived to be a year old, so
that out of two thousand eight hundred received into them, two
thousand six hundred and ninety died yearly; but when the con-

400 PRACTICE OF MEDICINE.
ditions of health came to be better understood, and an act of Par-
liament was obtained compelling the parish officers to send the
infants to nurse in the country, this frightful mortality was reduced
to four hundred and fifty annually.”
1633. The Englishmen who were confined in the Black-Hole
at Calcutta, furnish an example of the horrible effects of a pent
up and vitiated atmosphere. One hundred and forty six of them
were hurried into a dungeon eighteen feet square, which had only
two small windows on one side for the admission of fresh air. In
a few minutes they fell into a profuse perspiration, which was suc-
ceeded by a raging thirst. In less than an hour their respiration
became difficult, and their cries for water were dreadful in the ex-
treme. Within three hours most of them were dead, and those
who survived, were in a raging delirium. At six in the morning,
a period of about twelve hours, when an order came for their re-
lease, only twenty three were found alive, and most of these were
in a putrid fever. -
1634. In giving a course of medicine, the room should be
ventilated during the operation, particularly if the air acquires an
unpleasant smell. A door or window should be opened, so that
the patient will not be exposed to the draught; or he may be pro-
tected from it by throwing a light quilt over his head. In cold
weather, a fire will generally be sufficient for the purpose of ven-
tilation, provided the room is furnished with a fire-place. The
fumes of vinegar are of no service in a sick chamber, for they
conceal the bad air, without purifying or rendering it fit for
respiration. Charcoal should never be burnt in a close apart-
ment, as it evolves carbonic acid gas, which is destructive to life.
The gases from stone coal also, are more or less injurious to
patients.
1635. I have known deplorable consequences to ensue from a
want of ventilation. I was once called to a young man in con-
sumption, whom I found in a small room not more than eight
feet square, into which the fresh air had no access, excepting
when the door was casually opened. On entering the apart-
ment, I was almost suffocated . the closeness of the atmos-
phere. I ordered the patient to be removed to a large room,
where the air could circulate freely, and he soon recovered from
the stupid and almost exhausted condition in which I found him.
1636. Conclusion of the Course. After the emetic has done
operating, a second vapor bath is to be administered, preceded by
an injection similar to the one with which the course was ºom-
menced, (1605) excepting that the lobelia may be omitted, ºr
diminished in quantity. While in the bath, the patient should


PRACTICE OF MEDICINE. 401
drink a tea-cupful of some warming tea, as ginger, composition, or
cayenne. If the latter is employed, it should be taken in divided
portions, unless preceded by a draught of milk porridge, for if
the stomach is empty, it is liable to occasion pain or distress. As
soon as a free perspiration ensues, which will be in from ten to
twenty minutes, the cold shower is to be administered, according
to the directions given under that head. (See paragraphs 1504–
5–6–7.) The patient may now dress himself, if he has sufficient
strength, or return to bed, the sheets having been previously
changed. A tea of composition, or cayenne and bayberry, should
be given occasionally to keep the skin moist—at least for two or
three hours after the course. This is particularly desirable in
severe attacks of disease. If the patient is seated by the fire, he
should be covered with a blanket, and if his feet are cold, he
should place them on a heated stone, or brick. Sitting with the
back to the fire has a beneficial effect, particularly in low chronic
cases, for through the influence of the spinal nerves, a pleasant sen-
sation of warmth is communicated to every part of the body. In
warm weather, the patient should be careful not to expose himself
to a draught or current of air, for the good effects of a course are
sometimes wholly counteracted in this way. He should be con-
tent, also, to remain within doors until the next morning, unless
the weather is mild and pleasant, and other circumstances are
favorable to exercising in the open air.
1637. Bathing the surface with a mixture of cayenne and
vinegar, after the bath, (1531) or rubbing it with stimulating lini-
ment, is useful in many forms of disease, (1306, et seq.) and ren-
ders the patient less susceptible to the effects of cold.
1638. If languor or debility succeeds a course, a tea of spiced
bitters should be used, prepared by steeping three tea-spoonfuls of
the powder in a pint of boiling water, and adding sugar to make it
agreeable. This may be employed as a drink, and is strengthen-
ing to the stomach, and general system. In ſevers and inflamma-
tions, it should not be used until the disease is entirely sub-
dued. (883.) -
1639. Where a patient is restless or nervous, there is no
better remedy than the nervine tea. (1514.)
1640. It is improper to sleep in a cold room after a course,
particularly in low or doubtful cases of disease, and I am con-
vinced that much injury is done by this practice. Breathing the
cold air for several hours through the night, causes, in many in-
stances, an aggravation of the symptoms. Dr. Jackson, formerly
a physician to the Massachusetts General Hospital, remarks, “In
the day; the temperature of our wards is rarely lower than 65 de-
grees of Fahrenheit; and I believe that it is rarely lower than 50
- - -
51

402 PRACTICE OF MEDICINE.
degrees in the most severe nights. When it has been very low
in the night, I have usually discovered it by an increase of disease
in several patients on the next day.”
1641. In asthma, croup, consumption, and various other dis-
orders, it is important that there should be a uniform temperature.
With regard to consumption, some very interesting remarks will
be found in Mr. Slade's Travels in Russia. Speaking of the
climate at Odessa, he says, “it may be supposed that pulmonary
complaints are very common, but this is not the case, owing to
the uniform temperature which is kept up by means of stoves,
throughout halls, stair-cases, saloons, and bed-rooms. Were the
practice introduced into England, of maintaining all the interior of
a house at the same temperature, consumption would, in many
cases, be prevented. A delicate girl in England, whose pale
face, bright eyes, and sensitive frame indicate a predisposition to
consumption, sits all day in winter in a drawing room at a tempe-
rature of 65 or 70 degrees of Fahrenheit, and passes the night in
a room 15 or 20 degrees cooler. Having thus breathed cold air
for seven or eight hours, she descends in the morning to inhale
anew a heated atmosphere, and this action and reaction on the
lungs continue, till the doctor oracularly announces consumption.”
1642. Mr. Slade observes, that “in European Turkey and
Russia, the first question the traveller asks in winter, on arriving
at his night's station, is, ‘Have you a warm room?' If that is an-
swered affirmatively, he is satisfied; and I can speak particularly
of the beneficial effects of sitting and sleeping in rooms of uniform
temperature. Until I arrived at Odessa, I never passed a winter
without having a severe cough; but there I was entirely free from
the malady, though the changes from heat to cold, and vice versa,
were more sudden than had been usually remembered by the in-
habitants.”
1643. In retiring to bed for the night, after a course of medi-
cine, a tea-cupful of composition tea should be administered, and
if necessary, a bottle of hot water wrapped in a damp cloth
(1608–Nöte.) placed at the feet. Where the stimulus of cay-
enne is not required, bayberry tea may be used instead of the
composition; and if the patient is nervous, half a tea-spoonful of
scullcap or lady’s slipper may be added.
1644. Food. In severe acute affections, as bilious, scarlet,
and typhus fevers, the appetite is generally deficient, and the
* Dr. Jackson's Appendix to Dr. Putnam's Translation of Louis on the Effects
of Blood-letting, &c. Boston, 1836.
# London edition, 1840.

PRACTICE OF MEDICINE. 403
stomach incapable of digesting solid food; the strength of the pa:
tient should be sustained, therefore, by the use of bland and nour-
ishing fluids, such as milk porridge, beef tea, and wine whey,
which will not enfeeble or irritate the digestive organs. In the
milder attacks of disease, and in chronic complaints, a course of
medicine is usually succeeded by a good appetite, but it is not
safe to indulge it too freely. It is at best a fallacious guide, and
if a patient should eat until its cravings are satisfied, he will often
overload the stomach, and increase the disorder which he is en-
deavoring to remove. I have invariably observed, that where a
temperate meal is taken after a course, the individual enjoys a
greater degree of bodily comfort, and improves much more rapidly
in health. The kind of food, also, is worthy of a passing no-
tice. Oily substances, such as fat meat, and butter, are difficult
of digestion, (87) and should be avoided. This is particularly
necessary in diseases of the skin, liver complaints, boils, consump-
tion, dyspepsia, gout, heartburn, headach, jaundice, scrofula,
tetter, and chronic ulcers. Stale and rancid butter should never
be eaten under any circumstances. Rich pastry, gravies, mince
pie, tea, coffee, cheese, and so on to the end of the chapter, are
all injurious, and should be discarded by every invalid, however
much he may be disposed to use them while in health. Tea and
coffee are slow poisons, and do immense injury to the human sys-
tem. Of the latter, I can speak from experience, for it injured
my health seriously, before I was fortunate enough to discover the
cause. With regard to tea, Dr. Burdell of New York, has dis-
covered that a few drops of the concentrated decoction, will kill a
rabbit, in a few minutes. I am aware that I am attacking popular
prejudices, in denouncing these two beverages, but no considera-
tion of interest shall deter me from the performance of what I
conceive to be my duty.
y
1645. Among the articles of food which may be eaten after a
course, where solid aliment is not an objection, are sago, rice, tapi-
oca, wheat jelly, the unbolted wheat bread, soft boiled eggs, and the
lean part . meat, provided the individual has been accustomed to
animal food. The plainer each dish is cooked, and the fewer
articles taken at one meal, the better it will be for the patient.
Nothing is more injudicious than the practice of eating every
dainty which the nurse, or kind but inconsiderate friends may be
pleased to furnish. I would particularly recommend the wheat
jelly (1435) as an article of diet, for it is not only nutritious, but
serves to regulate the bowels.

404 PRACTICE OF MEDICINE.
ACCIDENTAL SYMPTOMS.
1646. These I have so termed, because they occasionally
arise during the administration of a course, without being of com.
mon occurrence. Dr. Thomson calls them the “alarming symp-
toms,” and says they indicate a crisis in the disease. He has
known a patient to sob for hours, without being able to liſt his
hand to his head, and yet be on his feet the next day, attending to
his business. He remarks, that persons who have taken a con-
siderable quantity of opium, will sometimes be thrown into a state
of unconsciousness, and appear to be dying, but in a few hours
awake, as if from a refreshing sleep, and speedily regain their
health and vigor.
1647. The “alarming symptoms” do not often occur, says
Dr. Thomson, excepting in chronic diseases, and not until from
three to eight courses have been given. I have met with them in
a few instances, but believe they may be prevented by judicious
management. Where courses follow each other in rapid suc-
cession, with but little attention to the intermediate treatment, they
are almost sure to supervene; but I venture to predict that they
will rarely or never occur, if a course is not administered oftener
than once or twice a week, as is now the practice in chronic dis-
eases, and the warming and invigorating medicines used freely in
the intervals.
1648. Relaration. This is an effect of the lobelia, and is not
owing to actual debility or prostration, but a relaxation of the vol-
untary muscles. (26.) The patient may be unable to turn in bed,
and yet in the lapse of an hour, or even less, be in the full posses-
sion of his strength. The pulse meanwhile is generally regular,
showing that the heart performs its functions in a healthful manner.
In subduing a fever, or inflammation, relaxation, generally occurs;
and this is apt to excite alarm in the minds of those unacquainted
with the medicine, when in fact it is only an evidence that the
remedy has triumphed over the disease. The system recovers
from this relaxation in a very short time. I have myself, in un-
dergoing a course of medicine, been unable to speak above a
whisper, and yet in an hour have regained my original º
and vigor. The relaxation which is produced by lobelia and the
vapor bath, is very different from the debility or prostration which
ensues from blood-letting, and the use of mineral or vegetable
poisons.
PRACTICE of MEdicine. 405:
1649. Delirium. This is usually the result of carelessness,
or improper treatment. If a course of medicine is given without
any preparation of the system, (1596, et seq.) or if the patient is
suffered to become cold or chilly during the operation, slight or
temporary delirium will sometimes be the consequence. Where
opium, or any of its preparations, has been taken in a consider-
able quantity, it is much more apt to occur. The poison no
doubt remains dormant in the system, and is roused into action
by the agents employed in the administration of a course. (495.)
I have witnessed several cases of delirium, caused, as I supposed,
by the previous use of opium, but none more remarkable than that
of Miss Heard, residing at the time in Boston. She was afflicted
with an obstinate nervous complaint, and by the advice of her
physician, had taken freely of opium, and laudanum. Finding no
relief, she adopted the reformed practice, and while undergoing
the second course of medicine, became delirious, talking incohe-
rently, and alternately laughing and crying. Her friends, who
were opposed to the treatment, assembled around her, and de-
clared that she would die. In about three hours, however, she
sunk into a refreshing sleep, from which she awoke without any
recollection of what had past. Delirium occurred during the two
successive courses, which is a very unusual thing, and each time
while she was in the second vapor bath. After the third and final
attack, she began to improve in health, and was ultimately cured
of her malady. During the continuance of the delirium, an occa-
sional dose of nervine tea (1514) was administered, and her feet
kept warm by the application of heated stones wrapped in damp
cloths.
1650. Purging. This arises where purgatives have been
taken in repeated doses, and remain in the bowels without ope-
rating. I will mention a case by way of illustration. A gentle-
man in Boston was attacked with a ſever, and called in a physician,
who gave him a succession of cathartics, but they produced no
effect. The patient became alarmed, and sent for a reformed
practitioner to give him a course of medicine. The course was
commenced without any preparation of the system, and during the
ºperation, the hitherto dormant physic was roused into action.
The purging was severe, and it was found to be almost impossible
to check the discharges. It is important, therefore, where the
bowels are loaded with cathartics, that the warming medicines, to-
gether with injections, be used for a day or two previous to giv-
Ing a course.
1651. Purging takes place in a few instances where cathartics
have not been used, but upon what it depends, I am not able to


406 PRACTICE OF MEDIC INE.
explain. It appears, however, to form a crisis in the disease, and
to terminate without injury to the patient, excepting the debility
which naturally arises from the copious evacuations. The treat-
ment in such cases, should consist in the use of medicines to keep
a determination to the surface of the body. Cayenne and bay.
berry tea, with a portion of scullcap and slippery elm, may be
taken internally, and the same administered by injection. Advan-
tage will be derived also, from bathing the abdomen frequently with
rheumatic drops, or tincture of cayenne.
1652. Coldness of the Body and Extremities. Like many of
the accidental symptoms, this would not probably occur, if the
warming medicines were given a few days in advance of the course.
I will mention a case in point. Mrs. B , a lady of a spare
habit, had been suffering for some weeks with a severe cold, and
her husband, who was an advocate of the reformed practice, pre-
valled upon her to take a course of medicine. Accordingly, the
usual preparations were made, and several doses of lobelia ad-
ministered, but the patient had no disposition to vomit. On
the contrary, she became cold and stupid, manifesting a strong
disposition to sleep, and resembled one who had taken opium.
Heated stones wrapped in damp cloths were placed at her feet
and sides; stimulating injections were administered; the skin was
bathed from head to foot with pepper-sauce, and rubbed briskly
with the hand; and cayenne, composition, and other teas given
internally. Notwithstanding this treatment, however, no improve-
ment took place in her condition until after the lapse of about
eight hours, when her skin became warm, and the distressing
symptoms almost immediately disappeared. She did not vomitat
all, and by the expiration of twenty four hours, was in the enjoy-
ment of her usual health, having been entirely cured of her malady.
1653. Here was an instance in which the system should have
been warmed and invigorated by the use of cayenne, and other
appropriate medicines, (1597) for two or three days before the
course was administered, and then the unfavorable symptoms.
mentioned above, would not have occurred. The practice of
giving courses without any preparatory treatment, where the sys-
tem is in a cold and sluggish condition, is quite too prevalent;
and the evils which follow, are not to be attributed to the reme-
dies themselves, but to the thoughtless and injudicious manner in
which they are employed.
1654. Irregular, or Difficult Breathing. This, I have ob:
served, is usually caused by an undue weight of bedclothes, as
is evident from the relief afforded by sponging the face and

PRACTICE OF MEDICINE. 407
breast of the patient with cold water, or by lifting or anning the
bedclothes, so as to admit the fresh air to his person. I will men-
tion two or three examples. -
1655. Mr. K– of Boston, was attacked with difficult
breathing while undergoing a course, and his friends supposed him
to be dying. Dr. Thomson was sent for, who immediately strip-
ped off the bedclothes, and dashed a quart of cold water over
him. He revived the moment the application was made, and
breathed as freely as ever.
1656. A course of medicine was administered to a child,
whose breathing became difficult. A reformed practitioner was
sent for, who found it wrapped in a heavy blanket, and nearly
smothered in the nurse's arms. It was laid upon a mattress, a
thin quilt thrown over it, and its face and breast bathed with cold
water. Nothing further was required to afford it entire relief.
1657. A young man who had been an invalid for several
months, enteréd an infirmary to take a course of medicine. This
was commenced without preparatory medicines to warm or in-
vigorate the system. The lobelia was administered in the usual
number of doses, and was followed by laborious breathing. I
was invited to examine the patient, and found him with a rapid
pulse, and a moist and warm skin. He was covered by a heavy
weight of bedclothes, which were drawn closely about his neck
and head to prevent the slightest access of air to his person. A
heated stone wrapped in a damp cloth had also been placed at his
feet. I removed the bedclothes, and sponged his face and breast
with cold water, which immediately revived him, and there was
no further difficulty in the case.
1658. Whether difficult breathing is accompanied by a moist
and warm, or a dry and cold skin, the sponging may be employed
with an equal degree of advantage. Dr. Comfort of Philadelphia,
mentioned to me a case in which the skin became cold, and the
face almost livid, and yet the sponging, as previously directed,
afforded prompt and decided relief.
1659. There is a determinate relation between the heat of the
body, and that of the surrounding medium, which should always
be kept in view. Boerhaave supposed that a person could not
live when exposed to a temperature greater than that which is
natural to the body, but this was disproved by some young women
in Germany who went into a heated oven at the temperature of
278 degrees of Fahrenheit, and remained in it about twelve min-
utes.” A person in health is capable of resisting a high degree of
heat, but in some forms of disease, a slight elevation of the sur-
* Bell’s Anatomy and Physiology, 6th American edition.



408 PRACTICE OF MEDICINE.
rounding medium becomes oppressive. Cholera patients, for ex-
ample, who have been debilitated by profuse discharges by stool,
will often ſaint in the vapor bath at a low temperature, unless the
vapor, is introduced slowly, and cold water sprinkled over them
occasionally. In suspended animation, we know that external
warmth must be applied to the surface very gradually, or it will
be impossible to revive the latent spark of life. The external
heat, therefore, must be regulated according to the condition of
the patient, for what is suitable in one case, may have a depressing
influence in another, and perhaps be the means of destroying life.
INTERMEDIATE TREATMENT.
1660. By this term is understood the administration of appro-
priate remedies between the courses of medicine, which is of the
utmost importance, and should never be neglected. In acute
attacks it requires to be active in proportion to the violence of the
disease, administering a tea of composition, or of cayenne and bay-
berry sufficiently often to keep a gentle perspiration, and adding
to it a portion of scullcap, or lady’s slipper, if the patient is ner-
vous. Injections also are of eminent service, independent of
the evacuation of the bowels, and may be repeated two or three
times a day, or every hour, if necessary. In severe attacks of ſever,
whatever may be its type or character, the treatment here specified
must be rigidly pursued, or the skin will become hot and dry almost
immediately after a course. The stimulating tea, (1515) is well
adapted to keep the skin moist, and maintain the equilibrium of the
circulation. In the meantime, a bottle of hot water wrapped in a
damp cloth should be placed at the feet, unless the weather is
so warm as to render it oppressive. In all cases where the skin
is inordinately hot, it may be sponged with cold water. This
application affords prompt and decided relief, and is not a dan-
gerous experiment, as many people have been led to suppose.
1661. If the disease continues unchecked, notwithstand-
ing this treatment, the course of medicine should then be re-
peated. -
1662. In complaints of the bowels, headach, pains in the
back, kidneys, womb, or any other organ or part of the body,
injections may always be employed with advantage.
1663. In ſevers, and inflammations, the tonic medicines should
not be used until the disease is subdued. They are then im:
portant, particularly in debility, loss of appetite, or weakness of
the digestive organs. The best tonic is the spiced bitters.
PRACTICE OF MEDICINE. 409
1664. Thirst may be more effectually relieved by cayenne
tea than by any other remedy. It may be taken in the dose of a
table-spoonful, and repeated every fifteen or twenty minutes, until
the desired effect is produced. It is very beneficial in ſevers
accompanied with a dry or parched mouth.
1665. If the stomach is much disordered, as is usually the
case in severe acute attacks, the patient should be fed with liquid
*", of solid food, for reasons which have been assigned.
1644. -
( 1666. The sick room should be kept perfectly clean and
sweet. The stools, and every thing capable of tainting the air,
should be immediately removed. The apartment should also be
ventilated two or three times a day, particularly in diseases which
have a putrid tendency, taking care not to expose the patient to
the draught. (1634.) The importance of pure, fresh air, in the
treatment of the sick, does not appear to be sufficiently under-
stood or appreciated.
1667. Chronic Diseases. The intermediate treatment in
chronic diseases is necessarily varied according to the nature or
severity of the complaint, but in obstinate cases, it usually con-
sists of a dose of spiced bitters before each meal, a tea-cupful of
cayenne and bayberry tea in the forenoon, another in the middle
of the afternoon, and a third on going to bed. An injection will
also be beneficial at bed time, whether the bowels are costive or
not, for it warms and invigorates the whole system; and if the
weather is cold, or the patient chilly, a bottle of hot water wrap-
ped in a damp cloth should be placed at his feet.
1668. In many cases, no further treatment is required between
the courses, than an occasional dose of spiced bitters and compo-
sition, using the first when the appetite is deficient, and the second
when there is any necessity for a stimulant. If the individual is
obliged to be in the open air, he should take these medicines in
cold or lukewarm water. (1243, 1247.)
1669. Where the feet are habitually cold, advantage will be
derived from sprinkling the soles of the stockings with cayenne
pepper.
1670. In weakness or irritability of the nervous system, the
nervine tea will be beneficial. (1514.)
1671. I have heard practitioners question the propriety of ad-
ministering bayberry to patients with pulmonary difficulties, but
in combination with cayenne, as recommended, I have always
found it to be an invaluable remedy. It acts upon the mucous
membrane of the stomach as a detergent, (807, 822) and removes
or detaches the vitiated secretions, which is an important matter in
-

52
410 PRACTICE OF MEDICINE.
the treatment of all diseases, and particularly affections of the
lungs. In some instances, however, the stomach is irritated by
the indigestible woody matter of the bayberry, and in that case,
the tea should be administered without the sediment. The same
remark is applicable to other medicines. (885.)
1672. The lobelia pills (1298 et seq.) are highly serviceable
as a part of the intermediate treatment. The anti-dyspeptic bread,
wine bitters, vegetable jelly, and other preparations, may also be
used if deemed expedient or necessary.
1673. Patients who have but little animal heat, would do well
to take an extra vapor bath, two or three times a week, following
it with an application of the stimulating liniment. (1306 et seq.)
1674. Particular attention should be paid to the condition of
the bowels, and whether costiveness or diarrhoea prevail, equal
advantage will be derived from the use of injections. These may
be administered once or twice a day, or oftener, as the case
may seem to require. With regard to costiveness, I will add,
that there is no better remedy than the unbolted wheat bread,
(1181, et seq.) or wheat jelly, (1435) for it is not only nourish-
ing, but produces natural evacuations withoutirritating the bowels.
Where there is a tendency to costiveness, the patient should omit
the use of tea, coffee, lean meat, pies or cakes made of super-
fine flour, and all similar articles of food.
1675. Exposure to a damp or cold atmosphere should be
avoided, particularly in the morning before breakfast. The latter
is sometimes injurious even to persons in health. Exposure,
also, to the morning sun in a low or marshy district, while the
stomach is empty, is more or less pernicious. In some parts
of Europe, the officers do not march their troops until they have
breakfasted, and the observance of this rule contributes greatly
to their health, and freedom from malarious and other diseases.
A writer on dietetics remarks, “Where ſever is in a family,
the danger of infection will be much greater to a person going
directly from his own bed to the bed-side of the patient, than
to one who first takes the precaution of drinking, were it only
a cup of coffee.”
1676. If the urine is scanty between the courses, the diuretic
tea (1516) may be used, or a tea of cool wort, cleavers, poplar
bark, or spiced bitters.
1677. Cold might sweats cannot be better treated than by the
administration of a vapor bath at bed time, (1483) followed by an
application of the stimulating liniment, (1306, et seq.) -
1678. The skin should be rubbed night and morning with a
coarse towel, or flesh brush, until it is in a glow. This prºc-
tice is of the utmost importance, as will be acknowledged by

PRACTICE OF MEDICINE. 411
every one acquainted with the functions of the skin, (42-3) and in
obstimate or lingering chronic complaints should never be omitted.
1679. Another valuable remedy in overcoming many forms of
chronic disease, and º: a feeble constitution, is the ap-
plication of cold water to the surface of the body, every morning,
immediately upon rising from bed. For this purpose, either the
shower, sponge, or hand bath may be used, according to the cir:
cumstancés of the case. (See paragraphs 1451–2–3–4–5.) If
the patient is easily chilled, the hand bath will be "..." as it
abstracts but a small portion of the animal heat. I may add, that
the bath is never beneficial, excepting where it is followed by a
warm glow of the skin; and on that account, it is improper
use it, in some instances, without previously invigorating the sys-
tem with courses of medicine. -
1680. Diet. The meals should be taken at regular hours,
and nothing eaten in the intervals. After the stomach has digested
a meal, it requires an interval of repose, or it will soon be worn
out by an excess of labor. It must have rest, as well as the
body after severe or fatiguing exercise. By inattention to this
matter, dyspepsia, heartburn, and a whole host of maladies arise.
“Sir Francis Head, in his humorous book entitled Bubbles from
the Brunnens of Nassau, expresses his astonishment at the enor-
mous quantity of provision’ which the invalids and sojourners at
these watering places ‘so placidly consume; and after noticing
“ the heavy masses which constitute the foundation of the dinner,
and the successive layers of salmon—fowls—puddings—meat
again—stewed fruit—and, lastly, majestic legs of mutton, which
form the lighter superstructure,” he adds, “nothing which this
world affords could induce me to ſeed in this gross manner. The
pig which lives in its sty, would have some excuse; but it is
really quite shocking to see any other animal overpowering him-
self at º with such a mixture and superabundance of food.”
In another page, he remarks, that almost every malady to which
the human frame is subject is, either by high-ways or by-ways,
connected with the stomach; and I must own, I never see a fash-
ionable physician mysteriously counting the pulse of a plethoric
patient; or, with a silver spoon on his tongue, importantly looking
down his red, inflamed ". but I feel a desire to exclaim,
* Why not say to the poor gentleman at once–Sir, you’ve eaten
too much, you've drank too much, and you've not taken exercise
enough.”
1681. Late suppers are particularly injurious, and every inva-
lid should impress this fact indelibly upon his mind.
* Combe on Digestion and Dietetics. Boston, 1836


412 PRACTICE OF MEDICINE.
1682. Moderate exercise after a meal facilitates the digestive
process, as was shown by Dr. Beaumont, in his experiments on
St. Martin. (93.)
1683. The excessive use of meat in this country is a serious
evil, and has no doubt injured or destroyed the health of thou-
sands. Magendie remarks, that the blood of a meat eater, after
it is removed from the circulation, soon becomes putrid, whereas
the blood of a vegetable eater continues sweet for a consider-
able length of time. This proves that animal food has a ten-
dency to render the blood impure, and hence the rapidity with
which it putrefies. I have been long convinced of the truth of
these premises, for I have observed that ſevers, inflammations,
and diseases of every description, are much more difficult to cure
where the patients have been accustomed to indulge freely in ani-
mal food, than where they have confined themselves principally to
vegetable aliment, living temperately, and avoiding the use of spir-
ituous liquors.
1684. There is a prevalent opinion that meat is indispensable
to those who are engaged in active or laborious employments, but
it is forgotten that it contains a less amount of nutriment than
wheat, rye, barley, peas, beans, rice, and other articles which
constitute the food of the vegetable eater. M. M. Percy and
Vauquelin, two celebrated chemists, and members of the French
Institute, made a series of experiments a few years ago to ascer-
tain the relative amount of nutriment contained in different articles
of food, and the following is the result of their labors.
100 lbs. of Bread - contain 80 lbs. of nutriment.
… Meat, the average, “ 35 …
… French beans “ 92 …
… Broad kidney beans “ 89 “
… Lentils ** 94 --
… Potatoes ** 25 --
“ Carrots ** 14 …
… Greens and turnips “ 6 to 8 --
1685. The following table is also derived from chemical ex-
periments, and presents us with the relative proportions of nutri-
ment in substances not mentioned by Messrs. Percy and Vauquelin.
100 lbs. of Wheat contain 85 lbs. of nutriment.
-- e -- 80 --
-- Barley ** 83 --
-- Rice ** 90 --
-- Beets ** 14 --
… Cabbage ** 7 --

PRACTICE OF MEDICINE. 413
1686. We perceive, therefore, that many of the vegetable
substances used as aliment contain more nutriment than meat, and
experience has shown that they are equally well adapted to our
physical wants. I am aware that an individual, in reforming his
habits, and substituting vegetable for animal food, is liable to expe-
rience a sense of languor or debility for a few weeks, but as soon
as his system is adapted to the change, he will soon regain the
strength and vigor which he has lost. Any prominent change in
our habits is followed by more or less inconvenience. I know a
gentleman who lived for three years on vegetable food, and at the
end of that time, from a new arrangement in his family affairs, re-
turned to the use of meat, eating it, as people generally do, two
or three times a day; but he soon experienced a great degree of
debility, and it was several weeks before he acquired his usual
strength. Those who wish to renounce the habit of flesh-eating,
therefore, should either do it gradually, or be prepared to suffer a
temporary inconvenience.
1687. I formerly believed, in common with the generality of
mankind, that meat was an indispensable article of food, particu-
larly to the laboring man, but have had abundant reason to
change my opinion. I have had free intercourse for two or three
years with a large number of physiological reformers, who sub-
sist entirely upon vegetable food, and find they are much more
healthy and vigorous than those who make use of meat. Some of
these reformers are laboring men, who are compelled to work hard
from the rising to the setting of the sun, and they assure me they
possess a greater amount of physical strength, than when in the
habit of flesh-eating. Moreover, they always have a relish for
their meals, without being troubled by a loss of appetite at one
time, or the cravings of hunger at another. They are compara-
tively exempt, also, from attacks of disease, such as colds, diarrhoea,
dysentery, and the prevailing maladies of the seasons; and among
the whole of these reformers, I rarely or never met with a case of
costiveness, or sick-headach–complaints which are so universal
at the present day. -
1688. In my travels in Ireland, I could not but observe the
healthy appearance of the peasantry, and from the high price of
meat in that country, I presume they scarcely taste it once a year.
They live principally upon potatoes. -
1689. Persons who are much in the open air, and enjoy
plenty of exercise, may eat meat, oftentimes, with impunity; but
those of sedentary habits, or feeble digestive powers, are liable to
be injured, particularly if they use it in any considerable quantity.
The fat of meat, however, is much more objectionable than the lean,
for the former, together with all oily or greasy substances, is diffi-
-


414 PRACTICE 0 F MEDICINE.
cult of digestion, and according to Dr. Beaumont, invites a flow
of bile into the stomach to aid in the digestive process.” This
produces a morbid condition of the organ, and is no doubt the
cause of one half the maladies with which mankind are afflicted.
Bile, it will be remembered, was not designed by nature for ad-
mission into the stomach; (73, 74) but by the use of animal
fats, we cause it to flow into that organ, thereby violating one
of the established and most salutary laws of the animal economy.
Of course, we must expect to suffer the penalty attached to the
violation.
1690. “That fat meat contains more nutriment than almost
any thing else,” says Dr. Alcott, “I am not disposed to deny;
but that the stomach can extract a large proportion of this nu-
triment, is more doubtful. My belief is, that where we are
trained to the use of much fat, the stomach acquires the power
of "..."; a small portion of it—enough, at least, to sustain a
measure of health and longevity; but that it is a process so con-
trary to the best intentions of nature respecting us, that it is
done at a very great, and in our climate unnecessary, expendi-
ture of the vital power. The poor Greenlanders and Esquimaux,
though apparently driven to the necessity of subsisting chiefly on
fat, maintain but a miserable existence on it; nor is that existence
very long. In our own more temperate climate, the system finds
great difficulty in digesting oil, even where we have been earl
trained to it; and in tropical climates a greater difficulty still.”
1691. “The use of swine's flesh,” says Dr. Adam Clarke,
“in union with ardent spirits, is, in all likelihood, the grand cause
of scurvy, which is so common in the British nation, and which
would probably assume the form and virulence of a leprosy, were
our climate as hot as that of India.”
1692. Sinclair, in his Code of Health, says, “The late Sir
Edward Barry prevailed with a man to live on partridges with-
out vegetables; but after a trial of eight days he was obliged to
desist, in consequence of strong symptoms of incipient putre-
faction.”
1693. Abstinence from animal food, says Shelly, the poet,
subtilizes and clears the intellectual faculties.
* 1 “India, of all the regions of the earth,” says Ovington,
in his voyage to Surat, “is the only public theatre of justice an
tenderness to brutes and all living creatures; for there, not con-
fining murder to the killing of man, they religiously abstain from
taking the life of the meanest animal.”
* Experiments and observations on the Gastric Juice, p.264. Plattsburgh, 1883.
# Young Housekeeper, p. 85.

PRACTICE OF MEDICINE. 415
1695. St. Pierre, in his Study of Nature, remarks, “The
nations that subsist on vegetable diet are of all men the hand-
somest, the most robust, the least exposed to disease and violent
assions, and attain the greatest longevity. The Brahmins of
º who frequently survive a century, eat nothing but vegeta-
bles.
1696. “Vegetable aliment,” says Dr. Graham of Scotland,
“has no tendency to produce those constitutional disorders which
animal food so frequently occasions; and this is a great advantage,
especially in our country, where the general sedentary mode of
living contributes so powerfully to the formation and establishment
of numerous severe chronic maladies. Any unfavorable effects
vegetable food may have on the body, are almost wholly confined
to the stomach and bowels, rarely injuring the system at large.
This food has also a beneficial influence on the powers of the
mind, and tends to preserve a delicacy of feeling, a liveliness of
imagination, and acuteness of judgment, seldom enjoyed by those
who live principally on flesh.” - -
1697. The same writer says—“It is known that the celebra-
ted Galen was born with an infirm constitution, and afflicted in the
early part of his life with many and severe illnesses; but having
arrived at the twenty eighth year of his age, he was brought after
due observation, and consideration, to believe that there were
sure methods of preserving health and prolonging life; and having
resolved to live thereby, he observed them so carefully, as never
after to have labored under any disorder, excepting occasion-
ally a slight feverishness for a single day, owing to fatigue oc-
casioned by waiting upon his patients. By these means he
attained the age of more than seventy years. We are certain
also, that the noble Venetian, Cornaro, perfectly restored his
health after the age of forty, and prolonged his life to above a
hundred years, by living according to the same rules. Admiral
Henry of Rolvenden, who is, I believe, now living, was, as late
even as his fiftieth or sixtieth year, almost a martyr to various
chronic diseases, had been made a cripple by them, and was
entirely restored by carefully and perseveringly observing a proper
course of living. Some years ago he had reached the age
of ninety one, was then totally without complaint, and could
walk three miles to the neighboring town of Tenderden with-
out stopping. Such are a few of the many examples which
might be produced, proving the extraordinary and almost incred-
ible power of a correct diet and regimen, both in the prevention
and cure of disease, and the prolongation of life.”
*Sure Methods of Improving Health and Prolonging Life.




416 PRACTICE OF MEDICINE.
1698. It is not only in the quality of food that we err, but
also in the quantity. The latter, I am persuaded, is a more fre-
quent source of evil than the former. The stomach is overloaded,
and the food, not being digested, proves a source of irritation to
the organ, which sympathetically affects the whole system. “In-
temperance in eating,” says Professor Caldwell, “is perhaps the
most universal fault we commit. We are all guilty of it, not occa-
sionally, but habitually, and almost uniformly, from the cradle to
the grave. It is the bane alike of our infancy and youth, our
maturity and age. It is infinitely more common than intem-
perance in drinking; and the aggregate of the mischief it does is
greater. For every reeling drunkard that disgraces our country,
it contains one hundred gluttons—persons, I mean, who eat to
excess and suffer by the practice.”
1699. Sir Francis Head, from whom I have already quoted,
very emphatically remarks, “There exists no donkey in creation
so overladen as our stomachs.”
1700. Dr. Abercrombie says, “I believe that every sto-
mach, not actually impaired by organic disease, will perform its
functions if it receive reasonable attention; and when we con-
sider the manner in which diet is generally conducted, both in
regard to quantity and to the variety of articles of food and drink
which are mixed into one heterogeneous mass, instead of being
astonished at the prevalence of indigestion, our wonder must
rather be, that, in such circumstances, any stomach is capable of
digesting at all. In the regulation of diet, much certainly is to be
done in dyspeptic cases by attention to the quality of the articles
that are taken; but I am satisfied that much more depends upon
the quantity, and am even disposed to say, that the dyspeptic
might be almost independent of any attention to the quality of his
diet, if he rigidly observed the necessary restrictions as to quan-
tity.”%
1701. Galen, although he flourished more than sixteen centu-
ries ago, promulgated some excellent ideas on the subject of diet,
which we moderns would do well to regard. “I beseech all
persons,” says he, “who shall read this work, not to degrade
themselves to a level with the brutes or the rabble, by eating and
drinking promiscuously whatever pleases their palates, or by in-
dulging their appetites of every kind. But whether they under-
stand physic or not, let them consult their reason, and observe
what agrees and what does not agree with them; that, like wise
men, they adhere to the use of such things as conduce to their
health, and forbear from every thing which they find, by their own
* Diseases of the Stomach, &c. 1st edition, p. 72.
PRACTICE OF MEDICINE. 417
experience, to do them hurt; and let them be assured, that by a
diligent observation and practice of this rule, they may enjoy a
good share of health, and seldom stand in need of physic or
physicians.”
1702. Mr. Graham, author of the Science of Human Life,
speaking of the quantity of food necessary for man, remarks, “A
very small quantity of good farinaceous food, is sufficient to
supply the alimentary wants of the vital economy, even of the
most robust body of an active laborer; and all that exceeds the
proper supply of these wants, necessarily oppresses the organs,
diminishes the muscular power, and serves to impair, wear out,
and break down all the energies of the system. It is however,
impossible to state any particular quantity of food, which would
be best for every one, of every age, situation, and condition.
The active, vigorous, laboring man of middle age, requires more
food than a child, or an old man, and more than a sedentary, or
studious, or feeble man of the same age; and the same individual
requires more food under some circumstances, than under others.
The only general rule I can give, therefore, in regard to the quan-
tity proper for man, is this: Let every one consider that exces-
sive alimentation is one of the greatest sources of evil to the
human family in civic life; that every member of society has a
continual and powerful tendency to this excess; and therefore,
that every individual should, as a general rule, restrain himself
to the smallest quantity, which he finds from careful investiga-
tion, and enlightened experience and observation, will fully meet
the alimentary wants of the vital economy of his system—know-
ing that whatsoever is more than this is evil! And let every one
remember also, that, as a general rule, there cannot be a blinder
guide, in regard to quantity of food, than appetite; and he who
follows it, will surely be led into excess; for the most active and
vigorous laborer cannot habitually eat artificially prepared food, even
of the simplest and plainest kind, till his appétite is perfectly sat-
isfied, without sooner or later experiencing serious evils from ex-
cessive alimentation; and if this is true of the robust, active labor-
er, to a much greater extent is it true of the inactive, sedentary,
studious and feeble.”
1703. “There is no subject of dietetic economy,” says Dr.
Beaumont, ... about which people err so much, as that relating to
quantity. The medical profession, too, have been accessary to
this error, in giving directions to dyspeptics to eat until a sense of
satiety is felt. Now, this feeling, so essential to be rightly un-
derstood, never supervenes until the invalid has eaten too much, if
he have an appetite, which seldom fails him. Those even who
are not otherwise predisposed to the complaint, frequently induce
º

53

418 PRACTICE OF MEDICINE.
a diseased state of the digestive organs by too free indulgence of
the appetite. . Of this fact, the medical profession are, generally,
not sufficiently aware. Those who lead sedentary lives, and
whose circumstances will permit of what is called free living, are
peculiarly obnoxious to these complaints. By paying particular
attention to their sensations during the ingestion of their meals,
however, they may avoid all difficulty.”
1704. Dr. Pärmly says, “I suffered much in former years
from debility, and other forms of indisposition, induced, I am per-
suaded, by gross and improper diet. For the last year I have
abstained from all exciting drinks, utterly relinquished the use of
tea and coffee, abstained from animal food of every name and
nature, and by this course of conduct have found my health so
much benefited, that I feel it a duty as well as a pleasure to en-
deavor to impress upon the reader the necessity of living more
frugally, if he wish to enjoy that health of body and tranquility of
mind, which none can enjoy, for any great length of time, but
such as live in accordance with the rules prescribed by all sound
philosophers, both of ancient and modern times.”
1705. Attention to diet, both as to quality and quantity, is of
the utmost importance in the treatment of disease, and quite as
necessary as the administration of suitable medicines. Dr. Thom-
son, I regret to say, who has done so much as a reformer in the
healing art, favors the idea that a patient should eat whether his
food is likely to be digested or not; and it has fallen to my lot, in
more than one instance, to notice the evil effects of this practice.
In chronic diarrhoea, for example, I have known death to ensue,
notwithstanding the most energetic treatment, merely because the
patient was permitted to eat “whatever his appetite craved.” I
am further convinced, that a greater number of courses are some-
times administered than would be necessary, if the diet were
properly regulated. Whatever relief a course may afford, the
patient, if he overloads his stomach, or indulges in improper
food, must expect a return of his symptoms; it then becomes ne-
cessary to repeat the course, and thus he goes on, until his patience
is wearied, or he loses all confidence, perhaps, in the treatment.
People must not always expect to be cured of lingering or obsti-
nate complaints, without imposing some little restraint upon their
appetites. Patients frequently call upon me from different parts of
ew England, who have taken repeated courses of medicine with:
out having regained their health; but I have generally found
that they were in the habit of over-taxing their digestive powers:
and using tea, coffee, butter, fat meat, white bread, and other ar;
ticles of food which are calculated to derange the stomach and

PRACTICE OF MEDICINE. 419
bowels. Where I have been successful in inducing them to live
more abstemiously, however, and to pay attention to the quantity as
well as the quality of their food, they have been restored to health
without difficulty.
1706. It affords me pleasure to state, that I have succeeded
in curing many cases of chronic disease by a regulated diet, to-
gether with cold bathing, without resorting to the use of medicine
at all, excepting perhaps an occasional dose of composition, and
spiced bitters. The patient should eat at regular hours, without
indulging his appetite in the intervals, and avoid tea, coffee, and
all oily or greasy substances. The plainer the food is cooked, the
better. Mixtures, such as minced pies, are digested with difficulty,
and produce unpleasant sensations in the stomach. The unbolted
wheat bread (1181, et seq.) should be used instead of the white
bread. A soft boiled egg, now and then, I have not found to be
injurious. Lean meat, also, such as a tender beef steak, or a
piece of roasted mutton, may be taken at dinner time, if the patient
has been accustomed to animal food, and feels that it is indispen-
sable to his wants. It should be eaten, however, without gravy,
butter, or any thing of a greasy nature. With these exceptions,
the patient should confine himself to a vegetable diet, such as peas,
beans, turnips, potatoes, wheat, rye, barley, Indian corn, rice,
tapioca, sago, ripe fruits, and so on, of the infinite variety of vege-
table and farinaceous substances which have been furnished for our
use by a wise and bountiful Creator. The fruits, I will add, should
always be taken as a part of the meal. With regard to the bathing,
cold water may be applied to the surface of the body by means of the
shower, sponge, or hand bath, as the patient may deem the most
appropriate. (1451, 1454, 1455.) If he cannot prevail upon him-
self to use the bath in any form—though I consider it of the ut-
most importance, provided it is followed by a warm glow of the
skin—he should not ſail to rub himself, every night and morning,
from head to foot, with a coarse towel, or flesh brush.
1707. Clothing. But few remarks need be made upon this
subject, for every person of intelligence knows that the dress
should be regulated according to the season and climate. The
grand object of the patient should be, to render himself warm and
comfortable, avoiding both an excess and deficiency of clothing,
for the first enfeebles the system, and the second does not afford
adequate protection, against a damp or cold atmosphere. Lord
Bacon has observed, that a great store of clothes, either upon the
bed, or upon the back, relaxes the body. Flannels, or extra
clothing of any description, should not be laid aside at too early a
period in the spring; and in the autumn, as soon as the atmos-
-
420 PRACTICE OF MEDICINE.
phere becomes sensibly cooler, they should be resumed, for the
- º: is more liable to be attacked by chilliness, and other un-
avorable symptoms, at that period, than in the depths of winter.
1708. With regard to the dress of females, a very great evil
exists in the use of stays; and if ladies would reflect seriously
upon the subject, they would forever cease to mar the symmet
and beauty of their persons by such a monstrous practice. We laug
at the Chinese women for cramping their feet in iron shoes, but how
much more unnatural is it to cramp the waist in stays, and thereby
interfere with the free action of the lungs. Many diseases are
produced in this way, such as cancer, liver complaints, costive-
ness, nervous affections, palpitation of the heart, and consumption.
It should be remembered that the blood undergoes important
changes in the lungs, which adapt it to the various wants of the
animal economy; it is deprived of its impurities, and receives a
bright red color, which is communicated to it by the action of the
air. (125.) But if the chest is contracted by corsets, only a lim-
ited portion of air is received into the lungs, and consequently, the
blood is not sufficiently vitalized for the support of the system.
Curious as the fact may seem, it is estimated that the lining mem-
brane of the lungs is equal to a surface of about twenty two thou-
sand square inches; and it is further estimated, that a healthy per-
son inhales from six to eight hundred cubic inches of air in a
minute. (124.) This quantity is greatly diminished, however,
where the chest is bound in stays; and even the dress, as it is
worn at the present day, serves to lessen the dimensions of the
chest. A German physician ascertained that a young man, di-
vested of his clothing, was capable of taking ninety six cubic in-
ches of air into his lungs at one inspiration; but when his clothing
was adjusted in the usual manner, the quantity at each inspiration
was reduced to fifty cubic inches. I do not make these remarks
with the expectation of rendering corsets and tight dresses unfash-
ionable, but I earnestly beseech those who are laboring under dis-
ease, to throw them aside, for without this precaution, it may be
impossible, in many instances, to effect a cure. It is not suff-
cient to dispense with the use of corsets, but the dress also,
should be worn loosely around the waist. Buchan says, “A
flowing dress, sustained by the shoulders, and gently compressed
by a zone round the middle, with only as much tightness as is
necessary to keep the clothes in contact with the body, ever was,
and ever will be, the most healthy, comfortable, and truly elegant
habit that females can wear, or fancy invent.”
1709. Exercise. Exercise is necessary to invigorate the
body, but in the case of an invalid, should neither be taken in the

PRACTICE OF MEDICINE. 421
damp, cold air, nor to the extent of producing fatigue. In lung
complaints, breathing a cold atmosphere is very injurious, even
though the body is adequately protected by clothing. The feet,
in walking, should be kept warm and dry with thick soled boots
or shoes. Exposure to the night air should be avoided, both in
summer and winter, and the patient should be careful not to stand
for any length of time on the cold ground or pavement. As we
proceed into the air, says Dr. Johnson, while the body is warm,
so we should, by a brisk pace, endeavor to keep up that degree
of animal heat with which we set out, and that determination to
the surface of the body, which is so effectual in preventing affec-
tions of any internal organ.
1710. Exercise quickens the circulation, exhilarates the mind,
creates an appetite, and renovates the whole system. The illus-
trious Cyrus established it as a rule among the Persians, that they
should always labor before eating. Cicero was slender and deli-
cate until he travelled to Athens, where he became robust by
gymnastic exercises. The eccentric Abernethy, who was so fond
of prescribing the blue pill, says that air and exercise are the best
remedies for nervous complaints. Dr. Cheyne thought the weak,
studious, and contemplative, ought to make exercise a part of
their religion. Lord Bacon said that he who wishes to live long,
should change the position of his body at least every half hour.
Cullen acknowledged that exercise and temperance were a certain
remedy, in most instances, for the gout. Plato observed that he
was a cripple who cultivated his mind alone, and suffered his body
to languish through inactivity and sloth. Julius Caesar, it is well
known, was weak and slender until he became inured to the hard-
ships of a military life. “A brisk circulation animates the whole
man; whereas deficient exercise, or continued rest, weakens the
circulation, relaxes the muscles, diminishes the vital heat, checks
perspiration, injures digestion, sickens the whole frame, and there-
by introduces numberless diseases.”
1711. Gymnastic exercises are highly serviceable to the in-
valid, but few have an opportunity of indulging in them, excepting
the inhabitants of our principal cities. Instead of these, however,
running, leaping, climbing a ladder, swinging by the arms, and the
use of the dumb bells may be advantageously substituted. Riding
in a carriage is useful to a weak patient, because it enables him to
breathe the fresh air, but it does not call the different muscles of
the body into action. Horseback riding is probably the best kind
of exercise for an invalid, provided he is not too much debilitated.
Sydenham remarks, “How desperate soever a consumption may,
*Sure Methods of Improving Health and Prolonging Life. London, 1827.

422 PRACTICE OF MEDICINE.
or is esteemed to be, yet I solemnly affirm, that horseback riding
is the most effectual earthly remedy.” Another distinguished
writer says, “The beneficial effects of horseback riding, to those
who are laboring under pulmonary consumption, are often trul
astonishing. I have known invalids afflicted with this dread.
ful disease, who were too feeble to mount a horse without help,
by riding a short distance the first time, and gradually in-
creasing the length of the ride daily, become able, in the course
of two weeks, to ride twenty miles without stopping by the way,
and feel more vigorous at the end of the journey than the begin-
ning ; and I have known instances in which such individuals have
made journies on horseback of several hundred miles, and re-
turned to their homes and friends almost perfectly restored to
health.”
1712. “The great cause why the Europeans appear ruddier
and healthier than we do,” says Mr. Dewey, the American travel-
ler, is, that they exercise more, and live more in the open air.
Parks in England are every thing. In Italy, France, and Ger-
many, the people live much out of doors. Their coffee houses
are in the open air. Families sit as much as possible in gardens,
and public places. Their windows are all tenanted. Not onl
every city, but every town has its public park, adorned wi
trees; and every thing is done that can be done, to make it com-
fortable and refreshing, as well as fashionable. The sons of the
first families in England, are often seen in Switzerland, with their
packs upon their backs, walking amid the mountains, at the rate
of forty miles a day.”
71 “The English girls,” says the same writer, “will
walk five or six miles with ease. They are never afraid of the
air. They do not reason as our girls do, that to be pretty and in-
teresting they must be livid, pale, and consumptive; and in
order to be so, exclude themselves from the open air, from walks
and parks—but they reason naturally, that health is beauty, and
sickness is otherwise. English girls, it is said, are almost the
only girls who climb up the sides of the Alps, or struggle ancle
deep, up the ashes of Vesuvius.”
1714. Exercise should be accompanied by a cheerful mind,
or it will ſail in producing the same beneficial effects. A story
illustrative of this, is related by Dr. Sydenham. It appears that
he had been consulted for a long time by a gentleman, who had
received no benefit from his prescriptions. At length, the doctor
told his patient, he could do no more for him, adding that there
was a Dr. Robinson of Inverness, who was wonderfully skilled
* Science of Human Life. # The Old World and the New.

PRACTICE OF MEDICINE. 423
in such complaints as his, to whom he offered him a letter of
introduction, being confident that he would come back cured.
The patient was a gentleman of fortune, and was soon able
to begin his journey. When he arrived at Inverness, he ſound
there was no physician of that name, nor ever had been
within the memory of any person there. So the gentleman re-
turned vowing every thing that was hostile to the peace of Sy-
denham ; he was in a very ill humor, and told the doctor he
thought he had used him very ill, to send him a journey of so
many hundred miles for nothing. “Well,” said the doctor,
“are you better in health?” “Yes, I am well now, but no
thanks to you,” replied the patient. “No!” said Dr. S: , “but
you may thank Dr. Robinson for curing you. I wanted to send
you a journey with an object in view; I knew it would do you
good; in going, you had Dr. Robinson in contemplation; and in
returning, you were equally busied with the thoughts of scold-
ing me.”
REPETITION OF courses.
1715. In acute diseases, such as dysentery, pleurisy, rheuma-
tism, smallpox, and the various fevers and inflammations, it is
proper to administer the courses in rapid succession, provided the
violence of the symptoms cannot be subdued by the usual intermedi-
ate treatment. (1660, et seq.) It is thought by some that this will
debilitate, but I am persuaded that a much greater degree of de-
bility would ensue, by not making a prompt and decided im-
pression upon the disease at the commencement. In scarlet fever,
for example, which threatens to be obstinate, or severe, if we do
not administer the courses in sufficiently rapid succession to keep
the disease in check, sore throat is liable to supervene, and the
patient’s sufferings will not only be protracted, but there will be
much greater difficulty in effecting a cure. In ſevers and in-
flammations, where the skin becomes hot and dry, notwithstand-
ing the intermediate treatment, I make it an invariable rule of
practice to repeat the course without delay, even though it should
be necessary to administer three courses in twenty four hours.
Where the skin is moist, and of a natural temperature, however, a
repetition of the course is not requisite. - -
1716. In chronic diseases it is improper to administer the
courses in rapid succession, unless required by urgent or peculiar
symptoms. As a general thing, a course once a week will be
sufficient, provided strict attention is paid to the intermediate treat-
* London Practice of Midwifery, 4th edition. London, 1816.


424 PRACTICE OF MEDICINE.
ment. (1667, et seq.) We must be guided in this matter by cir-
cumstances. It may be necessary to administer two courses in a
week, or it may be found that one course in a fortnight will suffice.
While the patient is comfortable, and continues to improve in
health, the course need not be repeated, but if the symptoms as:
sume an unfavorable character, and cannot be subdued by the
remedies usually employed in the intermediate treatment, a rep-
etition of the course becomes indispensable.
1717. Mrs. F of West Cambridge, Mass., informed me
that she was troubled many years since with an obstinate liver com-
plaint, and placed herself under treatment at an infirmary in Bos-
ton, where fourteen courses of medicine were administered to her
in as many days. At the end of that time, she was extremely de-
bilitated, as might be naturally inferred, and the principal of the in-
firmary, who, I am bound to say, was unfit for the responsible
station which he occupied, gave up her case as hopeless. She
was taken home to her friends, with the expectation that she
would soon die, but in this interval of rest, her digestive organs
recovered their tone; she desired some light nourishment, which
had the effect to revive her, and in a short time she was restored
to perfect health. - -
1718. All that human agency can accomplish in the removal
of disease, is, to cleanse the stomach and intestinal canal, invigo-
rate the skin, remove obstructions, and restore a balance to the
circulation; after that, time must be allowed for the digestion and
assimilation of food, or more injury than good will ensue from a
repetition of the courses. If the stomach is nauseated daily with
lobelia, the digestive process is interrupted, and there is no oppor:
tunity for the formation of chyle, without which the blood will
soon become impoverished, and incapable of nourishing or sup-
porting the system.
1719. Those who take a brisk cathartic after a course, as is
sometimes the practice, will find it necessary to repeat the latter
at an earlier period than would be required under other circum-
stances. I will mention a case by way of illustration. A lady
from a neighboring town, placed herself under treatment at an infir-
mary in Washington street, Boston, several years ago, and after
taking several courses of medicine, was so far recovered as to be
able to return home. Before her preparations for the journey
were all completed, however, she was taken suddenly ill, and it
was necessary to repeat the course. It was subsequently ascer-
tained that a portion of mandrake had been given to her in a dose
of spiced bitters, for the avowed purpose of retaining her at the
infirmary, and increasing her expenses. I have only to add, that
such imposition was deserving of the severest punishment.


PRACTICE OF MEDICINE. 425
1720. The appetite does not return, in some instances, until
two or three days after a course, but that, of itself, unaccom-
panied by any urgent symptom, does not warrant an immediate
repetition of the course. I will state, also, that in some cases,
the patient has no relish for food until six or seven courses have
been administered, but this I have generally attributed to improper
aliment, such as butter, meat, oily substances, white bread, and
rich gravies, including tea and coffee as beverages. I have found
where these were dispensed with, and the patient confined to a
wholesome vegetable diet, regulated according to the exigencies of
the case, that the appetite would return in a much shorter time,
and also be more regular and permanent.
NUMBER OF COURSES.
1721. The number of courses requisite to effect a cure, must
necessarily depend upon the nature, or obstimacy of the disease,
and the judgment with which the medicines are administered.
single course is generally sufficient to arrest a simple fever, while
a severe attack of bilious, scarlet, or typhus fever, may require
SIX. Or Seven COurSeS.
1722. In chronic diseases; from three to fifteen or twenty
courses are usually required. We sometimes hear of patients
having taken fifty or a hundred, but I presume so large a number
would not have been required, if proper attention had been paid
to the diet and intermediate treatment.
1723. Miss B of Lynn, Mass., took twenty seven courses
for a malignant disease of the stomach, and was cured, notwith-
standing she had been under treatment by the diplomatised phy-
sicians for seven years. She did not experience much relief until
after the sixteenth course, when she was seized with a peculiar
sensation in the stomach, which she compared to the “crawling
of snakes or eels.” After this, she began to improve, but the
sensation continued, to a greater or less extent, until she had taken
the twenty sixth course, when her health was fully and perma-
nently restored. The courses were administered, at intervals,
during a period of eighteen months. Dr. Patten was the attend-
ing physician.
1724. I knew a gentleman with dropsy, to whom a course
was administered once a week for nine months, before a cure was
accomplished, but he was sedentary in his habits, very fond of an-
imal food, and was obliged, during the day, in consequence of his
business, to breathe an impure air.

54

426 PRACTICE OF MEDICINE.
SYMPTOM'S MARKING THE PROGRESS OF CURE IN CHRONIC
CAS E. S.
1725. A few remarks on this subject may not be unimportant,
as symptoms occasionally arise which are calculated, in some in-
stances, to excite the fears or distrust of the patient.
1726. Pains. These are not uncommon, and are experienced
in various parts of the body, generally occurring after the adminis-
tration of two or three courses. They are not usually of long
duration, and shift from one part of the body to another. They
are prone to arise, where the sensibility of the nerves has been
impaired by narcotics, such as opium, digitalis, and prussic acid.
As soon as the body is renovated, it becomes sensible, if I may
so speak, of the disease which has been preying upon it, and pain-
ful sensations for a limited time are the necessary consequence.
1727. Expectoration. In consumption, and other diseases of
the lungs, this is increased for a time, and then gradually ..
ears. Expectoration is a favorable symptom in a dry cough.
º is nature's method of terminating the disease, as catarrh of the
head is terminated by a discharge of mucus from the nose.
1728. Debility. Chronic diseases are accompanied with more
or less irritation, which may be either local or general, according
to the nature of the complaint, and as soon as this is subdued, the
patient complains of debility, which may continue for a few days,
or for several weeks. He is not to be discouraged, however, for
the symptom is a favorable one, or rather, it must necessarily pre-
cede a restoration to health. While the system is laboring under
a high degree of irritation, the brain is stimulated to increased ac-
tion, and this produces a sort of fictitious strength, which disap-
pears when the irritation is allayed. A patient in the delirium of
fever, for example, may require two or three persons to confine
him in bed, but as soon as the fever subsides, he often sinks into
a state of exhaustion, and becomes entirely helpless.
1729. Despondency. This arises from causes similar to the
above, and so much is the mind depressed, in some instances, that
the patient fancies the medicines are of no avail, and that he can-
not long survive. He often refuses to employ the necessary rem-
edies, but should be encouraged to persevere, for in a week or
two, the spirits will become more buoyant, and the health im-
PRACTICE OF MEDICINE. 427
proved. Despondency does not usually occur, excepting where
the patient has been under a long course of treatment by the
diplomatised physicians.
1730. Ulcers in the Stomach and Bowels. Chronic diseases
sometimes terminate in the formation of little ulcers in the sto-
mach and bowels, which are exceedingly painful, and accom-
panied in many instances with costiveness. In four or five days
they discharge their contents into the stomach and intestinal
canal, and the matter passes off by stool, after which the par
tient speedily recovers. The food, meanwhile, should be of a
light and soothing nature, such as tapioca, sago, wheat jelly,
and preparations of slippery elm. If the patient is costive, in-
jections once or twice a day are indispensable.
1731. Boils. These occasionally make their appearance,
and appear to be the result, in some instances, of that renovating
process which is necessary to free the system from impurities.
1732. False JMembrane. The discharge of this by stool,
is a favorable symptom, and indicates a speedy return to health.
It is a skinny substance, and usually passes from the bowels
in shreds, or patches, but sometimes it assumes the tubular
form, bearing a close resemblance to an intestine. (1393.) It
lines the whole extent of the intestinal tube, as well as the
stomach, and until it is detached, the patient cannot be restored
to permanent health. (1402.) The quantity which is discharged,
in some instances, is almost incredible. In the meantime the
diet should be light, and easy of digestion, consisting of sago,
tapioca, wheat jelly, or similar articles of a soothing nature.
As soon as this membrane makes its appearance in the stools,
the coat usually separates from the tongue, and leaves it clean,
and of a natural appearance.


428 PRACTICE OF MEDICINE.
DisPASEs AND THEIR TREATMENT, WITH
SOME REMARKS ON DISLOCATIONS, FRAC-
TURES, AND WOUNDS.
AGUE AND FEVER.
1733. The cold stage of this disease is preceded for a longer
or shorter time by various symptoms of ill health, such as lassi-
tude, yawning, cold hands and feet, indigestion, restlessness, pains
in the back and limbs, and a peevish or irritable temper. The
blood recedes from the surface, and leaves the skin pale, shrivel-
led, rough, and benumbed, and in some instances the body trem-
bles or shakes so violently as to resemble convulsions. The
breathing is short and laborious, accompanied by a feeling of
tightness or oppression in the chest. The patient may continue
in this state for a few minutes only, or for several hours; and as
the chill goes off, the ſever succeeds, accompanied with thirst,
nausea, vomiting, a full and strong pulse, headach, and pains in the
back and joints. This is termed the hot stage. At length per-
spiration ensues, which terminates the paroxysm. The mouth
becomes moist, the heat of the skin abates, the respiration grows
easy, and the pains in different parts of the body subside.
1734. The chills may return daily, every other day, or every
third day, according to the peculiar type of the disease; but their
recurrence usually takes place every second day. During the in-
tervals, patients sometimes enjoy a tolerable share of health, but
at others, they complain of languor, indigestion, loss of appetite,
and a sensation of ...
1735. Ague and ſever is peculiar to marshy districts, and is
the most prevalent when the days are warm, and the evenings and
mornings damp and chilly. Those who disregard the laws of
health, eating and drinking promiscuously whatever the appetite
may crave, or the fancy dictate, or who indulge in excesses of
any description, which weaken the body, or disorder the digestive
functions, are generally the victims of its attacks.
1736. TREATMENT. During the cold stage, frequent doses
of pepper sauce, composition, or cayenne and bayberry should be
given, together with one or two stimulating injections, and if the
patient is in bed, heated stones wrapped in damp cloths should be
placed at his feet and sides. If the case is obstinate, this should
be followed by a thorough course of medicine, using cayenne, bay-
PRACTICE 0F MEDICINE. 429
berry, and scullcap freely, which will arrest the paroxysm, or
greatly diminish its violence. If the skin is cold and shrivelled,
it should be bathed with a mixture of vinegar and cayenne, (1531)
while the patient is in the bath, as this will aid in recalling the
blood to the surface of the body.
1737. In mild cases, the chill may be arrested by a free use
of the stimulating tea, (1515) or if this is not sufficient, by the
administration of a lobelia emetic. (1579, et seq.)
1738. When a course is given, it is well to follow it by an
application of the stimulating liniment. (1306 et seq.)
1739. The treatment which is requisite in the cold stage, is
equally beneficial in the hot, for the blood is determined to the
internal organs in the first instance, and to the surface of the body
in the second, and in both cases it is equally important to restore
an equilibrium to the circulation.
1740. If the health is much impaired, it may be necessary to
administer several courses of medicine, using spiced bitters sev-
eral times a day in the intervals, together with an occasional dose
of composition, or cayenne and bayberry.
1741. The lobelia pills (1298, et seq.) will be found useful
as a part of the intermediate treatment.
1742. A heated stone wrapped in a damp cloth should be
placed at the feet on retiring to bed.
1743. If the bowels are costive, an injection should be used
once a day; but this will not be necessary, if the patient regulates
his diet, avoiding the use of tea, coffee, fat meat, and butter, and
eating the unbolted wheat bread instead of that made of superfine
flour. He should also rub his skin, night and morning, with a
coarse towel, or flesh brush. Alcoholic drinks should be particu-
larly avoided, and the feet kept warm and dry.
1744. Dr. Louis Frank found black pepper a very useful
remedy in the cure of ague and fever ; (789) and in some parts
of the State of New York, the people employ a tea of blue ver-
vain with great success. (706.)
APO PLE XY.
1745. Apoplexy comes on in some cases with little or no
warning, while in others it is ushered in by premonitory symptoms,
such as headach, dizziness, ringing in the ears, bleeding from the
nose, drowsiness, impaired vision, throbbing in the temples, par-
tial deafness, difficulty of utterance, loss of memory, weakness of
the lower limbs, chilliness, and sometimes nausea. An attack may


430 PRACTICE OF MEDICINE.
occur in a few hours after these symptoms have appeared, or not
for many weeks, or even months.
1746. During the apoplectic fit the patient is wholly insensi-
ble; the breathing is slow, and generally loud or snoring; the
mouth foams, and is occasionally drawn to one side; the face is
sometimes red, or livid, and at others pale, ghastly, and bloated,
with the eyes immovably fixed, or rolling about frightfully in their
sockets. In some instances the lips are puffed out forcibly, and
the saliva scattered in every direction. The extremities are al-
ways cold, and the bowels costive. The fit may subside in a few
minutes, or if relief is not obtained, it may continue for several
days. It is accompanied in some cases with convulsions, and in
others with palsy, which may extend to the whole of one side, or
to a more limited portion of the body.
1747. Deep intoxication is sometimes mistaken for apoplexy,
but the former may be distinguished by the smell of the breath.
1748. Apoplexy generally occurs about the fiftieth year of
age, and seldom much earlier than forty. It is induced by luxu-
rious living, the use of spirituous liquors, severe study, late hours,
venereal excesses, masturbation, and by whatever causes an undue
determination of blood to the head. It is admitted that the free
use of strong coffee is a frequent cause of the disease. It occurs
more frequently just after a hearty meal, than at any other period.
Individuals who are of a full habit, with a short neck, and large
head, are said to be most liable to its attacks.
1749. TREATMENT. The first thing to be done in a case of
apoplexy, is to loosen the garments, remove from the neck what-
ever may compress the veins, and elevate the head and shoulders.
We should then endeavor to equalize the circulation, or in other
words, to recal the blood from the head, where there is an ex-
cess, and distribute it to other parts, where there is a deficiency.
Hence we must administer stimulating injections, containing a por-
tion of the antispasmodic tincture, (1567, 1574) and at the same
time pour some of the tincture (1266, et seq.), down the throat,
which will be far more effectual than the use of the lancet. If the
patientis in bed, a heated stone, or bottle of hot water, wrapped in
a damp cloth should be placed at the feet, and the body and ex-
tremities rubbed briskly with vinegar and cayenne, (1531) or some
other stimulating wash. Cloths wrung out of cold water should be
applied to the head, and renewed as often as they become warm.
As soon as the patient can swallow, cayenne and bayberry tea should
be given, followed by an emetic of lobelia to cleanse the stomach.
The application of external warmth to the body, must be gradual,
commencing with a heated stone, as I have directed, and increas-

- -
-
PRACTICE OF MEDICINE. 431
ing the number in proportion as there is an increase of vitality, until
a free perspiration ensues, not forgetting the usual precaution of
wetting the face and breast with cold water, if there is languor or
faintness.
1750. The prejudice which formerly existed against the use
of emetics in apoplexy, is now disappearing, and even the medical
faculty are beginning to prescribe them without any apprehensions
of evil. Lobelia inflata, however, is the only emetic which
would recommend. Antimony, sulphate of zinc, and other poi-
sonous emetics of that description, would probably do more harm
than good.
1751. After the patient is relieved, he should invigorate his
system with the usual stimulants and tonics, and if necessary, take
one or two courses of medicine.
1752. Persons who are predisposed to apoplexy, should be
very careful with regard to their habits. They should rise early
in the morning, bathe themselves with cold water, (1448, et seq.)
exercise in the open air, take their meals at regular hours, live
upon a plain, simple diet, preferring vegetable to animal food, and
avoiding fat meat, butter, tea, coffee, and all similar articles of
luxury, which, however agreeable to the palate, are known to dis-
order the digestive organs, (1705–6) and thereby injure the whole
system.
ASIATIC CHOLERA.
1753. The Asiatic or spasmodic cholera first made its appear-
ance in Hindostan in 1817, and spread slowly through Arabia,
Persia, Russia, Poland, and Germany, arriving in England in 1831,
and making its way into Canada and the United States the following
year. It is sometimes very sudden in its attacks, the patient
being immediately prostrated by copious, watery evacuations from
the bowels. Usually, however, it is preceded for a few days
or a week by languor, giddiness, pain and rumbling noise in the
bowels, headach, diarrhoea, cramps of the fingers and toes, numb-
ness of the limbs, and sometimes nausea, and vomiting. As soon
as the disease is fairly established, the strength of the patient fails
very rapidly, in consequence of the profuse alvine discharges,
which resemble rice water. These are accompanied with giddi-
ness, ringing in the ears, imperfect vision, violent vomiting, burn-
ing pain at the pit of the stomach, thirst, restlessness, and cramps
or spasms of the legs and thighs, which sometimes extend to the
whole body. The eyes are sunken, and the countenance pale
and cadaverous. The skin becomes cold and clammy, loses its
432 PRACTICE OF MEDICINE.
elasticity, falls into wrinkles upon the hands and feet, and acquires
a livid, or bluish color. The breath is very cold, indicating in
some instances, according to Professor Espy, a temperature of
only 60 degrees. The liver is extremely torpid, so that no bile
makes its *Pººrange in the stools. The urine also is scanty, or
dried up. The mind is rarely affected, and the patient continues
to talk rationally until a short period before his death. In some
cases, the vomiting and spasms do not occur.
1754. Cholera has generally proved most fatal in the neigh-
borhood of low, marshy districts, and in the dirty streets and
alleys of our towns and cities. The intemperate, whether in eat-
ing or drinking, but particularly the latter, and those living in
damp, filthy hovels and cellars, have been most frequently num-
bered among its victims. Want of cleanliness, indigestible food,
unripe fruits, and exposure to the cold or damp night air, are all
exciting causes of the disease.
1755. Those who wish to avoid the cholera, should live tem-
perately, take their meals at regular hours, dispense with those
articles of food which tend to disorder the stomach and bowels,
and use the cold bath every morning as soon as they are out of
bed. (1448, et seq.)
1756. There is no disease, perhaps, in which the medical
faculty have betrayed so gross an ignorance of the healing art as
in cholera. It was a malady with which they were unacquainted,
and this led them to institute a great number of experiments, some
of which were of a barbarous and revolting character. I heard
Professor Hayward state to his class, that he had injected three
pints of a preparation of soda into the veins of a cholera patient
at one time, and three gallons within the space of three hours;
but he acknowledged that this treatment always proved fatal—
or rather, that the patients invariably died.
1757. When the disease prevailed in Boston, the consultin
physicians of the city, having been requested by the Mayor an
Aldermen to prepafe some instructions for the relief of persons
attacked, until medical advice could be obtained, recommended
two hundred drops of laudanum to be taken in hot brandy and
water in the course of an hour, and the application of a mustard
poultice over the whole surface of the bowels. A purgative was
also to be administered. Such was the treatment to be pursued
revious to the arrival of a physician, who, in the language of Dr.
}. generally came in time to “order a coffin” for the unfor-
tunate patient.
1758. Now it is apparent, to every person of reflection, that
the laudanum, brandy, mustard poultice, and purgative, as recom-
mended by the Boston physicians, would be sufficient, in many


PRACTICE OF MEDIC INE. 433
instances, to destroy a person in health, and it need not excite our
wonder, therefore, that these pernicious agents should have proved
fatal to those who were suffering from an attack of cholera.
1759. Magendie, the French Physiologist, entertained a more
rational view of the disease than his medical brethren generally,
and was very successful in its treatment. He says, “The dimin-
ished energy of the circulation, and the blue and cold condition of
the body, in individuals seized with the cholera, were prominent
phenomena. On the arrival of a patient in my wards, he was
placed in a thoroughly heated bed, his limbs rubbed with stimulating
liniments, and bags of hot sand applied along the body; internally
he was given hot drinks.”
1760. By this treatment, which was intended to re-establish
the circulation, “through the artificial restoration of animal heat,”
Magendie frequently witnessed recovery of health.
1761. TREATMENT. To check the rice water discharges, re-
store warmth to the surface, and take off the determination of blood
to the bowels, are important indications of cure in this distressing
malady. Heated stones wrapped in damp cloths should be placed
at the feet and sides, and pepper sauce, or a tea of cayenne and
bayberry, (1512) containing a portion of scullcap, or lady’s slip-
per, given freely, commencing with the dose of a table-spoonful,
if the patient is much prostrated, and repeating it every five or ten
minutes, as the case may seem to demand. The addition of slip-
ery elm to this tea, so as to render it somewhat mucilaginous,
|. been found highly beneficial. Injections are of the utmost im-
portance, and should be administered frequently, as they warm and
invigorate the system, control the diarrhoea, and determine the
blood to the surface. (1567, et seq.) If the patient is in a sink-
ing or collapsed state, two or three tea-spoonfuls of the antispas-
modic tincture may be added to each tea-cupful of the cayenne
and bayberry tea, and if spasms are present, it should never be
omitted. The body and extremities should be rubbed briskly
with pepper sauce, tincture of cayenne, or some other stimulating
wash, as this will have the effect to restore warmth and action to
the skin.
1762. The vapor from the heated stones should be increased
gradually, and in proportion as it can be borne by the patient,
wetting his face and breast occasionally with cold water, if there
are any manifestations of languor, or faintness.
1763. As soon as perspiration ensues, an emetic should be ad-
ministered, followed by all the requisites of a course of medicine,
* Lectures on the Blood, vide Select Medical Library for 1839.

55
434 PRACTICE OF MEDICINE.
and if relief is not thereby afforded, the course may be repeated
according to the circumstances of the case.
1764. When the more violent symptoms are subdued, the
cholerasirup (1262, et seq.) may be usefully employed, and indeed
it may be given with advantage throughout the whole course of the
disease.
1765. During convalescence, spiced bitters should be taken
freely to increase the tone of the digestive organs, together with a
light, soothing, and nourishing diet, such as slippery elm and milk,
(1431) wheat jelly, (1435) and preparations of sago, and tapioca.
Cold water should be avoided until the health is fully restored, as
it is liable to cause a relapse. -
1766. The fleabane is considered an invaluable herb in the
treatment of cholera, and as it abounds in almost every part of the
United States, may be procured when other remedies are not at
hand. (1103–4.)
1767. Pepper sauce (114.1) has cured aggravated cases of
cholera, without the aid of any other medicine. The captain of
a western steamboat was attacked suddenly with the disease, dur-
ing its prevalence in this country in 1832, and in half an hour was
deathly cold, scarcely able to speak, and almost without pulsation
at the wrist. Half a tumbler-ſul of pepper sauce was adminis-
tered, and repeated in a short time. The pulse soon became
perceptible, the extremities manifested a glow of returning warmth,
the haggard visage became placid and serene, and without further
treatment the patient speedily recovered.*
ASTHMA.
1768. Asthma is characterized by difficulty of breathing, tight-
ness across the breast, a short, dry cough, and a sense of approach-
ing suffocation. These symptoms usually increase in violence
during the night, and constitute what is termed an asthmatic fit.
They often seize the patient after the first sleep, and he requires
to be bolstered up in bed, or is compelled, perhaps, to assume
erect position. His breathing is laborious, accompanied with a
wheezing sound, and he feels as if he should die with all the
horrors of suffocation. If he is of a full habit, his face becomes
flushed and bloated, but otherwise, it is somewhat pale and shrunk.
1769. The difficulty of breathing subsides by degrees, and
towards morning, there is usually an expectoration of thick phlegm,
which affords the patient great relief. A similar attack occurs the
* Recorder, Nov. 3, 1832. Columbus, Ohio.

PRACTICE OF MEDICINE. 435
succeeding night, and thus the disease continues for one or two
weeks, or perhaps for months.
1770. An attack of asthma is often preceded by drowsiness,
flatulency, pain in the head, lowness of spirits, and a sluggish or
costive state of the bowels.
1771. The feeling of suffocation which attends this complaint,
is caused by some obstruction in the lungs, which precludes the
free admission of air, but whether this is owing to a spasmodic
contraction of the air passages of the lungs, or whether the mucous
membrane lining these passages is swelled or thickened in conse-
quence of inflammation, has not yet been fully ascertained.
1772. Among the causes of asthma, are, disorder of the di-
gestive functions, a very dry, or very moist atmosphere, violent
exercise, strong mental emotions, breathing poisonous vapors,
checked perspiration, suppression of the menses, and excessive
venereal indulgence.
1773. The wheezing sound which accompanies the breathing,
frequently occurs among children, and in them is known by the
name of phthisic.
1774. TREATMENT. No remedy affords such immediate re-
lief in asthma, as lobelia. Patients laboring under the most violent
paroxysms, are often enabled to breathe freely in a few min-
utes, by the use of this invaluable, and I may say, extraordinary
medicine. One or two tea-spoonfuls of the tincture, either simple
(1274, et seq.) or antispasmodic, (1266, et seq.) may be given
alone, or in a tea of composition, and repeated every five or ten
minutes until relief is obtained. An injection should be adminis-
tered in the meantime, (1567, 1574) and a heated stone wrapped
in a damp cloth placed at the feet.
1775. Lobelia should be employed in a sufficient quantity to
operate as an emetic, for the paroxysm is generally preceded by
an extremely disordered state of the stomach. The vomiting,
moreover, through the action of the diaphragm, serves to expel
the phlegm or mucus from the air passages of the lungs, (645)
which is of great importance in relieving the embarrassed res-
piration.
1776. Where the symptoms are urgent, the best form of the
lobelia is the antispasmodic tincture, but under other circumstan-
ges, I prefer the pulverized leaves, or seeds, administering them
in a tea of composition, or of cayenne and bayberry.
1777. Patients who are fearful of an attack of the asthma,
during the night, should take two or three lobelia pills (1298, et
seq.) on going to bed, together with a dose of composition tea, and
place a bottle of hot water wrapped in a damp cloth at their feet.
|

436 PRACTICE OF MEDICINE.
1778. During the day, the stimulating tea (1515) will be
found of great service, as it keeps the skin moist, and relieves the
cough, and difficulty of breathing. The patient must dress warmly,
exercise in the open air, when it is prudent to do so, and pay par-
ticular attention to his diet. (1680, et seq.) If the health is much
impaired, or the disease has been of long continuance, it will be
necessary to take a few courses of medicine.
BLEED ING FROM THE LUN G.S.
1779. Bleeding from the lungs commences, in some instances,
without any warning, but in others it is ushered in by precursory
symptoms, such as headach, difficulty of breathing, chilliness, las-
situde, cough, flushing of the cheeks, palpitation of the heart,
coldness of the extremities, and tightness across the breast. The
blood is mostly of a bright red color, and sometimes frothy. Its
discharge is accompanied by a saltish taste in the mouth, and a
sense of impending suffocation. The quantity is seldom so great
as to prove fatal at once. The blood may proceed from the mu-
cous membrane which lines the windpipe, and air passages of the
lungs, or from a vessel in the substance of these organs which h
been cut off by the softening of tubercles, as happens occasionally
in pulmonary consumption. In the latter instance, the discharge
of blood is often copious, and requires active and energetic treat-
ment to arrest its flow. -
1780. Among the causes of hemorrhage from the lungs, are
sudden changes of atmosphere, violent exercise, lifting heavy
weights, blowing on wind instruments, irritating substances inhaled
into the lungs, and suppression of the monthly evacuations.
1781. Sometimes a discharge of blood takes place from the
gums, or back part of the mouth, which excites alarm, as it is
supposed to proceed from the lungs, but instead of being florid, it
is of a dark color, and does not excite coughing, or irritation in
the throat. It is also small in quantity.
1782. TREATMENT. If the case is not urgent, a cure may
be effected by giving freely of composition tea, and placing heated
stones "Nº. in damp cloths at the feet and sides of the patient,
in bed. As soon as perspiration ensues, and the circulation be-
comes equalized, the hemorrhage will cease. If the case is ob-
stinate, or the flow of blood considerable, a course of medicine
should be administered, commencing with one or two stimulating
| ". (1567, et seq.) and making free use of cayenne, and
obelia.

PRACTICE OF MEDIC INE. 437
1783. The propriety of this treatment is questioned by the
diplomatised physicians, but the tendency of it is, to restore a
balance to the circulation, and thereby counteract the determina-
tion of blood to the lungs. This gives an opportunity for a co-
agulum to form around the ruptured or bleeding vessel, and the
hemorrhage will then cease. (381.) The stimulants, injections,
vapor bath, and emetic, all tend to recal the blood from the lungs,
and to distribute it to other parts or organs where there is a de-
ficiency, and surely there is nothing hazardous or unphilosophical
in this mode of treatment. At all events, it affords prompt relief
in all curable cases, and that too without the loss of blood by the
lancet, which debilitates the system, and often ruins the constitution.
1784. After hemorrhage is checked, the patient should be
kept in a gentle perspiration for several hours by the use of com-
position tea. He should then adopt the appropriate means of re-
instating his health, such as living temperately, keeping his feet
warm and dry, rubbing his skin night and morning with a coarse
towel, or flesh brush, exercising in the open air, and making use
of the ordinary stimulants and tonics according to the circum-
stances of the case. (1660, et seq.) Where the hemorrhage is
symptomatic of consumption, the case demands very close atten-
tion, and no pains should be spared by the patient to invigorate his
constitution, and restore his lungs to a sound and healthy condition.
BLEEDING FROM THE NO SE.
1785. Bleeding from the nose is most common in young
people of a full habit, and is not attended with danger, excepting
where the discharge is copious, or long continued. It is pre-
ceded, in many cases, by throbbing of the temples, giddiness,
ringing in the ears, heat and itching in the nose, and other symp-
toms indicating a determination of blood to the head. It is pro-
duced by violent exercise, exposure to cold, and the suppres-
sion of any accustomed evacuation. When it occurs in putrid
disorders, it is considered a dangerous symptom.
1786. TREATMENT. The treatment which was recommend-
ed in bleeding from the lungs, is equally applicable in this com-
plaint. A free use of composition, or cayenne tea, so as to
produce a perspiration, will often afford the desired relief. A
stimulating injection, (1567, et seq.) and the immersion of the
eet in warm water, will serve to recal the blood from the head,
and restore an equilibrium to the circulation. In obstinate cases,
it will be necessary to administer a course of medicine.

438 PRACTICE OF MEDICINE.
1787. The introduction of a piece of lint, or raw cotton, into
the nostril, so as to compress the bleeding vessels, or the applica-
tion of cold water to the back of the neck, or along the course of
the spine, will arrest the flow of blood in some cases. At the
same time, the patient should keep in an erect position. Re-
clining over a basin of water, to wash the nose, as is a common
practice, increases rather than diminishes the hemorrhage.
1788. A gentleman in Philadelphia applied to me for advice,
who had been subject to bleeding from the nose for several
months. I advised him to take half a tea-spoonful of cayenne
three times a day, with his food, which, in the course of a week,
relieved him of his malady.
BLEED ING FROM THE STOMACH.
1789. Vomiting of blood, as this disease is termed, is mostly
preceded by chilliness, nausea, and a sense of weight and pain in
the region of the stomach. The breath is offensive, and the hands
and feet cold. The blood is thick or clotted, of a dark color,
mixed with the contents of the stomach, and generally copious.
These signs distinguish it from blood which comes from the lungs.
(1779.) If not discharged by vomiting, it passes off by the
bowels, and renders the stools black and offensive.
1790. This disease may be occasioned by a blow, by the in-
- troduction of a corrosive poison into the stomach, or by any sub-
stance which is capable ...} exciting inflammation. It arises some-
times in the last stage of putrid ſevers, the matter vomited re-
- sembling coffee grounds; and is common to young females who
are irregular in their menstrual discharges. It is seldom so pro-
fuse, says a medical writer, as to destroy the patient suddenly,
and the principal danger seems to arise, either from the great de-
- bility which repeated attacks of the complaint induce, or from the
lodgment of blood in the intestines, which, by becoming putrid,
might occasion some other disagreeable disorder.
1791. TREATMENT. The principles of treatment in this dis-
ease are the same as in hemorrhage from the lungs. The circula-
tion should be equalized, which may be accomplished in mild cases
by the use of cayenne and bayberry tea, but if the symptoms are
urgent, it will be necessary to administer a course of medicine.
The emetic, which constitutes a part of the course, is important
to evacuate the blood which has accumulated in the stomach.
During convalescence, the patient should confine himself to food

PRACTICE OF MEDICINE. 439
of a bland or soothing nature, such as wheat jelly, or preparations
of sago, tapioca, or slippery elm. Spiced bitters should be taken
occasionally to strengthen the digestive organs, and advantage will
be derived by using a tea of evan root, black birch, raspberry, or
any of the mild astringents. If the bowels are costive, an injec-
tion should be administered once or twice a day, particularly if the
stools are dark or offensive.
BLEEDING FROM THE URINARY ORGANS.
1792. This may be caused by external violence; the irritation
of a stone in the bladder, or kidney; lifting heavy weights; severe
exercise; or the internal use of cantharides. In some instances
the quantity of blood discharged is so great as to produce alarm-
ing debility. If the blood is pure, we infer that it is from the
urethra, but if in flakes, or intimately mixed with the urine, we con-
clude that it is from the bladder, or kidney. When it proceeds
from the latter, it is attended by pain or uneasiness in the back,
but if it comes from the bladder, pain is experienced in the lower
part of the abdomen, accompanied with a frequent desire to pass
Water.
1793. TREATMENT. If the bleeding is copious, or if it has
resulted from external injury, a course of medicine should be
administered, as this will not only check the hemorrhage, but pre-
vent the development of inflammation. If the discharge of blood
is moderate, a cure may be effected by drinking freely of a tea of
black birch, purple archangel, cocash, beth root, or composition.
An injection into the rectum, night and morning, will have a
beneficial influence upon the urinary organs. If a stone is
lodged in the kidney, ureter, or bladder, the diuretic tea (1516)
should be employed, rendering it mucilaginous by the addition of
slippery elm. Any of the diuretic articles may be used to advan-
tage. If these do not afford relief, and the pain, or irritation is
severe, the vapor bath, together with a lobelia emetic, should be
administered. (638.)
BILIOUS OR REMITTENT FEVER.
1794. This disease is very common during the summer and
autumn in the Middle and Southern States, prevailing more
particularly in hot weather, and in low and marshy districts. It


440 PRACTICE OF MEDICINE.
commences with languor, drowsiness, bitter taste in the mouth,
º in the head, back, and extremities, followed by chills and
eats, fever, thirst, nausea, and oftentimes a vomiting of bilious
matter. The eyes, skin, and urine, from the wide diffusion of
bile through the system, become of a yellow color. The bowels
are generally costive. The tongue is dry, and covered with a
white, or brown coat. The breathing is oppressed, and a sense
of weight or fulness, is experienced in the right side, and in the
region of the stomach. Delirium is sometimes present. The
abdomen often becomes distended with wind, and sore or tender
on pressure. The stools are sometimes watery and reddish, and
at others black and offensive, somewhat resembling tar.
1795. There is a remission of the ſebrile symptoms in the
morning or forenoon of each day, which lasts for an hour or two,
when the fever returns with its previous violence, and hence the
term remittent fever.
1796. In hot and sickly climates, bilious fever is prone to as-
sume the congestive or malignant form, which runs its course in a
short time, unless checked by efficient remedies. Among its
characteristic symptoms are, great prostration; restlessness; in-
tolerable thirst; violent pains in the head, back, and lower extrem-
ities; red and watery eyes; brown, or black tongue; laborious
breathing; constant retching, or vomiting; great oppression in the
region of the stomach; swelled and purple lips; extreme yellow-
ness of the skin; offensive stools; swelling and soreness of the
abdomen; and frequent, or constant delirium. As death ap-
proaches, purple spots appear on the skin, and bleeding frequently
takes place from the . nose, and other free passages.
1797. Bilious ſever is caused by intemperance in eating and
drinking, irritating substances in the bowels, and exposure in hot
climates, or marshy districts, to the night air. I am convinced
that the use of butter, and all animal fats, from the fact that they
are not digested without recalling the bile into the stomach, is a
frequent cause of the disease. (1689.)
1798. TREATMENT. From the symptoms in bilious ſever,
it will be seen that the liver, stomach, and bowels are prominent
affected, and this will at once suggest the necessity of thoroug
courses of medicine, to restore these organs to a healthy con-
dition. At the commencement of a course, one or two injections
should be administered to evacuate the bowels, and as long as the
stools continue offensive, or unnatural, they may be used several
times a day.
1799. In the congestive form of the disease, in which the par
tient is rapidly sinking, a tea of cayenne, bayberry, and scullcap.

PRActice of Medicine, 441
prepared by steeping a tea-spoonful each of these powders, in a
;" of boiling water, should be given in the dose of a table-spoon-
ul, and repeated every five, ten, or fifteen minutes, and as soon
as the patient revives, and the skin becomes moist, a light course
of medicine should be administered. (1612.)
1800. If the abdomen is swelled, or tender on pressure, it
should be bathed with pepper sauce, rheumatic drops, or tincture
of cayenne, and if this does not afford relief, a flannel moistened
with either of these liquids may be laid over the abdomen, or in-
stead of this, a poultice of wheat bran, or Indian meal, adding
. to give it the necessary degree of pungency, may be
applied.
". After the course is administered, it is very important
to keep the patient in a gentle perspiration, or the fever will re-
turn in all its violence. The stimulating tea (1515) will be
found excellent for this purpose, and if necessary the quantity of
cayenne may be increased. It may be given in table-spoonful
doses every ten or fifteen minutes, or a tea-cupful every hour,
according to the circumstances of the case. A heated stone
wrapped in a damp cloth should be placed at the feet, and
an injection, if necessary, administered every hour. If, notwith-
standing this treatment, the skin becomes hot and dry, and other
unfavorable symptoms return, it will be necessary to repeat the
course without delay.
1802. The scullcap, which is a component part of the stimu-
lating tea, is of great service in allaying the irritability of the ner-
vous system, which may arise in this complaint, and if it canno
be obtained, the lady’s slipper should be substituted. -
1803. If the skin becomes hot or feverish between the courses,
it may be sponged with cold water, which is grateful to the pa-
tient, and often affords surprising relief. (1660.)
1804. From the irritable condition of the stomach and bowels,
solid food should be avoided, and the strength of the patient sus-
tained by nourishing fluids, such as weak milk porridge, wine
whey, and slippery elm tea. As soon as the ſever is entirely
subdued, the restorative medicines are to be freely used. During
convalescence, the unbolted wheat bread, or wheat jelly, should
constitute an article of diet, as this will regulate the bowels. The
patient must be very cautious not to overload the stomach, or ex-
pose himself to damp cold air, or he may suffer a relapse.
56

442 PRACTICE OF MEDICINE.
B O ILS.
1805. These are hard, red, painful tumors, which appear on
various parts of the body, and in a few days or a week, discharge
a quantity of matter, together with a yellow core. In some in-
stances, they continue to appear, one after another, for several
weeks, or even months. Many people suppose that they are an
evidence of health, but this is an erroneous opinion, for they do
not occur excepting in a disordered state of the general system.
1806. TREATMENT. A poultice of slippery elm and ginger,
adding half a tea-spoonful or more of cayenne, (1543) should be
applied, and renewed two or three times a day until the matter is
entirely discharged, after which the healing salve may be used.
The cayenne should not be omitted, as it diminishes the pain and
soreness of the boil. Where it is inconvenient to use a bandage,
the poultice may be confined to the affected part by means of the
adhesive plaster, (1320) melting it in the flame of a candle, in the
same manner as sealing wax, and touching it to the corners of the
cloth upon which the poultice is spread. Immediately before the
application is made, the plaster should be warmed before the fire,
so that it will adhere firmly to the skin.
1807. Boils are sometimes so painful and irritable as to affect
the general health, and in that case a free use should be made of
composition and spiced bitters, to warm and invigorate the system.
The tea mentioned in paragraph 1518, will be found highly ben-
eficial. If the bowels are costive, an injection should be admin-
istered at least once a day. The patient should regulate his diet,
and avoid the use of tea, coffee, ſat meat, and butter; for without
this precaution, he will find it difficult, oftentimes, to effect a cure.
See remarks on diet. (1680, et seq.) In some cases it is neces-
sary to administer a course of medicine.
i808. Boils may be readily dispersed in the forming stage by
keeping them constantly wet with rheumatic drops. This is
best accomplished by the application of a piece of folded linen, or
cotton cloth, confining it with a bandage, or by means of the ad-
hesive plaster, as mentioned above, and moistening it with the
drops as often as it becomes dry. In the meantime the warming
and restorative medicines should be taken internally. Two or
three days are sometimes required to effect the desired object.
1809. Carbuncles are a species of boil, and require to be
treated in the same manner. They are larger in circumference
than boils, but seldom rise above the level of the skin. They are
of a livid or purple color, containing a black core, and sometimes

PRACTICE OF MEDICINE. 443
surmounted by little vesicles or blisters. They mostly occur in
persons of feeble health, and affect the general system to a greater
extent than boils. They are common in warm climates, and
often attend the plague.
BRUISE.
1810. An injury from a blow, or fall, is termed a bruise, and
the dark or purple color which the part assumes, is owing to the
escape of blood from the minute or capillary vessels into the sur-
rounding tissues.
1811. TREATMENT. The part may be bathed with rheu-
matic drops, tincture of myrrh, volatile liniment, or vinegar and
cayenne; (1531) or an application may be made of chamomile,
wormwood, tansy, or featherfew, in the form of a poultice, bruis-
ing the herb and simmering it a few minutes in vinegar, or satu-
rating it with rheumatic drops. This will allay the pain, reduce
the swelling, and frequently prevent discoloration. If there is
much heat or inflammation, the poultice should be wetted fre-
quently with cold water, or the injured part may be wrapped in
cloths, and cold water poured on these. Composition, or cay-
enne and bayberry should be taken in the meantime, if the case
requires it, to keep up a gentle perspiration, and if the stomach
is disordered, it should be cleansed with an emetic of lobelia.
Should the injury be severe, it may be necessary to administer a
course of medicine.
BURNS AND SCALDS.
1812. These are not attended with any particular danger, if pro-
perly managed, unless they are situated on the trunk of the body,
and embrace a considerable extent of surface; for then a portion of
the perspirable matter which should pass off through the pores, is
retained in the circulation, and sooner or later disorders the whole
system. By administering courses of medicine, however, and
paying strict attention to the intermediate treatment, so as to keep
the skin moist, and maintain the equilibrium of the circulation, a
cure may be effected even in very critical cases.
1813. If the skin remains entire, a cloth or towel, several
times folded, should be immediately applied to the part, and wet-
ted frequently with cold water until the pain ceases, giving compo-
sition or cayenne internally to keep up a perspiration. If this
__m =

444 PRACTICE OF MEDICINE.
treatment is adopted in season, it will prevent blistering, and effect
a cure with but little suffering to the patient.
1814. The principle upon which cold water produces such
beneficial effects in burns and scalds, has been admirably explained
by Magendie, whose words I will quote. “If you apply a burn-
ing liquid to your hand,” he says, “it reddens; more blood than is
natural flows into it, and irritation ensues; but if you plunge your
hand into ice-cold water, the quantity of blood rushing to it is di-
minished; the redness decreases in proportion, and you arrest
inflammation at the onset.”
1815. If a blister forms, it is advised by surgeons not to open
it, but to allow the serum or water to remain until a new cuticle is
produced, and then the escape of the serum will not be followed
by any bad consequences.
1816. Where the skin is destroyed, a poultice of slippery
elm should be applied, wetting it with cold water, whenever the
part becomes painful or irritable; and at each renewal of the
poultice, the sore should be washed with soapsuds, followed by
some mild astringent tea, such as pond lily, witch hazel, or su-
mach. A still better application than the elm poultice, however,
and one which I can confidently recommend, is a mixture of fir
balsam and sweet oil, (1529) which generally effects a speedy
and effectual cure.
1817. The raw surfaces of parts, as the fingers and toes,
which have been scalded, or burned, should not be suffered to re-
main in contact, or they will adhere firmly together.
1818. The effect on the skin of an intensely cold body, as
frozen mercury, for example, is the same as that of a hot, or scald-
ing substance. The part reddens, becomes very painful, and at
length blisters. Hence the same plan of treatment is required in
both cases. It is well known that iſ a frozen limb be exposed
suddenly to a warm atmosphere, it will mortify, but this difficulty
may be obviated, where the vitality of the part is not entirely de-
stroyed, by wrapping it in cloths, and wetting it frequently with
cold water, as has been directed for scalds and burns.
CANCER.
1819. Cancer is a highly malignant disease, and attacks the
various structures of the body, but is usually situated in a gland.
In some cases it destroys or eats through important blood-vessels,
and endangers the life of the patient by hemorrhage. It is pro-
* Lectures on the Blood, vide Select Medical Library for 1839.
-


PRACTICE OF MEDIC INE. -
duced by various causes, such as the use of mineral and vegetable
poisons, impure water, unwholesome food, and whatever deranges
the health, or interferes with the circulation of the blood in the
capillary vessels. Chewing tobacco, it is said, has developed it
in the tongue. It is one of the deplorable consequences of vacci-
nation, as I have observed in several instances. In the female
breasts, there is every reason to believe that it is frequently occa-
sioned by the pressure of stays or corsets.
1820. “The disease is not always situated in a gland,” says
a writer on surgery; “it often attacks structures which cannot be
called glandular; and hard glandular swellings are often seen which -
do not partake of the nature of cancer.”
1821. It is sometimes difficult to determine whether a tumor
is cancerous, but among the signs by which it is characterized,
are hardness or induration, shooting or darting pains, which return
at irregular periods, and a puckering and discoloration of the skin
by which it is covered. The superficial veins are generally en-
larged. The tumor has a knotted or uneven surface, and attaches
itself to the skin above and to the muscles beneath, converting the
parts into a solid mass. In the female breast, there is a receding
of the nipple, which is one of the acknowledged signs of cancer.
1822. The diseased skin covering the tumor generally ulcer-
ates before the swelling has attained any considerable size,” and
a sore is produced which discharges a dark colored and lighly
offensive matter. This discharge is so acrid as to corrode or
inflame the parts with which it comes in contact. “The sore
or ulcer becomes irregular in its figure, and unequal on its sur-
face. The edges are thick, hard, and extremely painful, often
exhibiting a ragged or serrated appearance. The ulcer sometimes
spreads with rapidity to a great extent, and its progress produces
frequent hemorrhages, which, joined with the irritation of the dis-
ease, reduce the patient to the lowest state of debility. Granula-
tions generally grow on the ulcerated surface, when the ravages of
the disorder seem to be suspended; but this apparent attempt at
reparation only ends in the formation of an inveterate fungous
substance.”%
1823. Cancer rarely occurs in the female breast previous to
the age of twenty eight, or thirty, and is liable to make its appear-
ance when the monthly evacuations cease, unless particular atten-
tion is paid to the health. -
1824. The course which physicians and surgeons pursue in
the treatment of cancer, is not only inconsistent, but cruel and
arbarous. The knife is their only remedy, and they advise their -
* Practice of Surgery, by Samuel Cooper.

446 PRACTICE OF MEDICINE.
patients to submit to an operation, notwithstanding they admit that
the disease is constitutional, and almost sure to return after the
operation has been performed. Dr. Jackson of Boston, in his
lectures on morbid anatomy, said, “After a cancer has been ope-
rated upon, the disease often returns in a short time with still
greater malignity, and attacks other organs and parts of the body.”
1825. A writer in a foreign medical periodical, in some re-
marks on cancer, says, “Extirpation of the breast was performed
three times, and under circumstances apparently very favorable;
but in all the disease returned. Of ninety eight amputations of the
breast, two ended fatally from exhaustion during the healing of the
wound; and in all the rest, with the exception of thirteen, the dis-
. ºurned after the wound was healed, and terminated in
eath.
1826. With regard to the thirteen, just mentioned, the writer
says he is morally convinced, that in several of the cases, an error
of opinion or diagnosis was committed, and breasts were removed
that were merely affected with scrofulous tumors, or some other
innocent change of structure.
1827. “The above results,” continues the writer, “are wor-
thy of serious attention, and serve unfortunately to confirm the
opinion advanced by many surgeons, that in most cases cancer is
a constitutional and not a local disease.”
1828. Dr. Gibson, Professor of Surgery in the University of
Pennsylvania, said, in one of his introductory lectures, “What
medical man, from any country, would visit London without see-
ing William Lawrence, well known to the whole world as an
anatomist and surgeon. Amidst a crowd of admiring pupils, in
the large and numerous wards of St. Bartholomew's hospital, I
saw him closely question each patient's symptoms, prescribe very
carefully, and take deep interest in each. There were several
long standing cancerous breasts, (one of eleven years) for which
most gentle palliatives only were employed. . . He had “long
known that many such breasts, if let alone, would not prove fatal
for a long time; but if they were extirpated, the disease would
return speedily, and with immense suffering.’”
1829. Patients are not only injured, or destroyed, by the
surgeon's knife, but also by external applications of a poisonous
nature, such for example as arsenic. }. Thatcher, in his Dis-
pensatory, says, “Arsenic has long been known to be the basis of
the celebrated cancer powder. It has been sprinkled in substance
on the ulcer; but this mode of using it is excessively painful, and
* American Journal of Medical Sciences.
+ Boston Medical and Surgical Journal, vol. xxi. p. 278.

PRACTICE OF MEDICINE. 447
extremely dangerous; fatal effects have been produced from its
absorption. This fact I have known in several instances, where
Davidson's agents, and others, have attempted to draw out cancers,
when the patient would absorb enough of the poison to affect the
lungs, and cause him to die of consumption in the course of a
year.” -
1830. TREATMENT. Cancer being a constitutional disease,
it is impossible to cure it without adopting means to restore the
general health. Courses of medicine are indispensable, therefore,
and these should be repeated according to the nature or urgency
of the symptoms, until the difficulty is removed.
1831. If a tumor is discovered which is thought to be cancer-
ous, an effort should be made to disperse it, and for this purpose
a plaster composed of meadow fern ointment, and a portion of
pulverized cayenne and lobelia, may be applied, and constantly
worn, or a poultice prepared as follows, may be used with still
greater prospect of advantage. Take of Indian meal four parts,
cayenne one part, green, or brown lobelia one part; make into a
poultice with equal parts of rheumatic drops and water, and renew
the application as often as it becomes dry. The quantity of cay-
enne may be increased or diminished, according to discretion,
but enough should be used to produce a sensible degree of pun-
gency. These applications promote absorption, and have been
successful, in the course of a few weeks, in removing cancerous
tumors of considerable magnitude. They may be confined to the
affected part by means of the adhesive plaster, as recommended
under the head of boils. (1806.)
1832. In addition to the above treatment, a course of medi-
cine should be administered once a week, or once a fortnight, and
strict attention paid to the diet, and intermediate treatment. The
patient should confine himself as much as possible to vegetable
food, eating temperately, and at regular hours, and avoiding fat
meat, butter, tea, coffee, white bread, and every thing which
tends in the remotest degree to disorder the digestive functions.
(1680, et seq.) A medical writer says, “ The patient should live
abstemiously, avoiding animal food, wines, spirits, and fermented
liquors, as heating, stimulating, and tending to increase pain; a
milk and vegetable diet is the most proper in such cases.” Dr.
Lambe of London, who has quoted this passage in one of his
works, has been successful in curing cancer by a rigid attention to
diet alone, renouncing animal food of every description. He at-
taches great importance, also, to the use of distilled water, which
he considers indispensable in his mode of treatment. For illus-
tration, he says, “In the spring of 1810, I saw Mrs. M , the
-

448 PRACTICE OF MEDICINE.
wife a tradesman, living near Westminster bridge, laboring
under a large ulcerated cancer, with the breathing much oppressed,
as is usual in the last stages of the disease. This woman had lived
almost entirely upon vegetable diet during her whole life. She
had an aversion to animal food. She would take a little fish some-
times, but very rarely. Her own account was to the following
purport. When I lived in the country, I was very healthy; but
as soon as I began to drink the Thames water my health began to
fail, and I have not been in good health since.” I have no
doubt that water, loaded as it is with impurities, particularly in
our principal cities, is a fruitful source of disease, and in treatment
of cancer, I am disposed to agree with Dr. Lambe, that it would
be better, if possible, to use that which has been purified by
distillation.
1833. Besides attention to diet, the patient should exercise
freely in the open air, and use the shower, sponge, or hand bath
every morning, as soon as he is out of bed. (1451, et seq.)
1834. If the cancer has proceeded to ulceration, the cancer
plaster (1321, et seq.) should be applied, and the sore washed
every night and morning with soapsuds, followed by a tea of bay-
berry, pond lily, or any of the astringent articles, to render it per-
fectly clean. The rheumatic drops diluted with water, make a
very excellent wash. The unpleasant or offensive smell may be
easily corrected by a few applications of the yeast, or charcoal
poultice. (1548, 1549.) hen the hard or indurated parts have
been removed, poultices of slippery elm may be used, adding
ginger to them, if it can be borne, and when the sore is suffi-
ciently cleansed, it may be dressed with the healing salve.
During the administration of a course of medicine, also, an elm
poultice should be applied to absorb any matter which may be dis-
charged, or it will inflame or excoriate the neighboring parts.
1835. When the skin which covers a cancer is puckered and
discolored, and it is deemed advisable to promote a discharge
from the tumor, the vegetable caustic may be used as directed
under that head, (1827, et seq.) and followed by the routine of
treatment already recommended for a cancer in a state of ul-
ceration.
chickenpox.
1836. This disease appears to be nothing more than smallpox
in a modified form. It rarely occurs more than once in the same
* Reports on Regimen in Chronic Diseases, p. 406. London, 1815.

PRACTIUE OF MEDICINE, 449
individual. Persons who have been vaccinated are said, by med-
ical writers, to be more liable to it than those who have escaped
the vaccine poison. It commences with chilliness, sickness, head-
ach, pains in the back and extremities, and more or less ſever,
followed by small pimples on various parts of the body, which
show themselves first about the breast and face, and gradually pro-
ceed downward to the feet. They are filled with a whitish fluid,
which gradually changes to a straw color; and in three or four
days, they begin to dry up, leaving small, brown scales. The
precursory symptoms of chickenpox are sometimes so slight as
not to attract attention. When the pimples are large and round,
the disease is distinguished by the name of swinepow.
1837. TREATMENT. If the case is mild, nothing further will
be required than attention to diet, and an occasional dose of com-
position, to keep the skin moist. The patient should not be ex-
posed to the cold, and if the bowels are costive, an injection
should be administered once a day. The stimulating tea (1515)
may be advantageously used in this complaint. If the skin should
become hot and dry, and other unfavorable symptoms arise, an
emetic should be given, or if necessary, a thorough course of med-
icine. The treatment pursued in measles, is equally applicable in
chickenpox.
CHILBLAINS.
1838. These are painful swellings of a red, or bluish color,
and attended with intolerable itching. They appear on the hands,
feet, nose, ears, and lips, in cold weather, and are sometimes pro-
duced by going to the fire when the body is chilled. They are
most common in those of a weak, or cold habit. If neglected,
they may be followed by tedious ulcers.
1839. TREATMENT. When chilblains first appear, they
should be bathed with rheumatic drops, or some other stimulating
wash, followed by an application of fern ointment, healing salve,
the stimulating limiment, or a mixture of fir balsam and sweet oil,
(1529) to shield them from the air. The liniment, and fir balsam
are particularly useful. In case of ulcers, the elm and ginger
poultice should be used, and the affected part washed occasionally
with a warm tea of bayberry, or sumach berries. -

57
450 PRACTICE OF MEDICINE.
CHOLERA MORBU.S.
1840. Cholera morbus, which is another name for vomiting
and purging, is a disease peculiar to the summer and autumn,
arising from the use of unripe fruits, indigestible food, a neglected
state of the bowels, copious draughts of cold water, and a sudden
change from a warm to a cold atmosphere. It comes on with but
little warning, and is extremely rapid in its progress. It com-
mences with nausea, oppression in the region of the stomach,
griping pains in the bowels, followed by copious vomiting and
purging, and a great degree of prostration. The discharges by
stool are mostly thin and watery. In severe attacks, the extremi-
ties become cold, accompanied with great thirst, and violent
cramps of the legs, and muscles of the abdomen. Death takes
place, not unfrequently, in twenty four hours, and sometimes at a
much earlier period.
1841. TREATMENT. This disease being extremely rapid in
its course, we must resort at once to vigorous and active treat-
ment, endeavoring to recal the blood from the internal organs to
the surface of the body, and thereby establish an equilibrium of
the circulation. Cayenne and bayberry tea should be given freely,
together with one or two injections, (1567, et seq.), placing a
heated stone wrapped in a damp cloth at the feet. This should
be followed by the vapor bath and an emetic, or in other words,
a thorough course of medicine, which will not fail to give relief.
The vomiting and purging being checked, a gentle perspiration
should be continued for several hours, and the digestive organs
strengthened by the use of poplar bark, or spiced bitters, with a
dose now and then of cayenne and bayberry. The cholera sirup
may be taken to advantage several times a day. The patient
must avoid the use of solid food, while there is any soreness or
debility of the stomach and bowels, and confine himself to liquid
nourishment, such as oatmeal gruel, (1425) º elm and
milk, (1431) and soothing preparations of a similar kind
1842. I have known a free use of cayenne and bayberry tea
alone to cure severe cases of cholera morbus. An infusion of
black pepper, prepared by steeping a tea-spoonful of the powder
in a tea-cupful of boiling water, will often arrest the vomiting, and
check the diarrhoea. The dose may be repeated every half hour,
or hour.
1843. The cramps of the legs and abdomen may be relieved
by rubbing the affected parts with pepper sauce, rheumatic drops,
or a mixture of cayenne and vinegar. (1531.)


PRACTICE OF MEDICINE. 451
COL.I.C.
1844. This disease commences with an accumulation of wind
in the bowels, attended with a griping or twisting pain, which is
most severe in the region of the navel. Costiveness is generally
present. The pain comes on in paroxysms, followed by transient
intervals of rest. Strong pressure on the abdomen affords more
or less relief, which distinguishes the disease from inflammation of
the bowels. Wind is sometimes forced up from the stomach in
* quantities, and is followed by a momentary cessation
Of pain.
1845. When these symptoms are attended by a vomiting of
bilious matter, headach, bitter taste in the mouth, and yellowness
of the eyes and skin, the disease is called bilious colic.
1846. Colic is usually occasioned by improper food, or excess
in eating and drinking, and if the digestive organs are in a weak or
irritable state, it is frequently excited by very trivial causes.
1847. The dry bellyach or painter’s colic, as it is termed,
is another form of the disease, which is peculiar to those who
work among lead, as house painters, glaziers, and potters. Per-
sons employed in lead mines, and white lead manufactories, are
extremely liable to its attacks. It was at one time prevalent in
England, in consequence of drinking wine and cider into which
a preparation of lead had been put to give it a sweet taste. It
comes on more gradually than the other forms of colic, and is at-
tended with severe and constant pain about the navel, which
sometimes extends to the arms, legs, and other parts of the body.
The abdomen is hard to the touch, and somewhat tender, accom-
panied frequently with severe vomiting.
1848. TREATMENT. Medicines should be given to produce
a perspiration, such as composition, cayenne, or ginger, and as
soon as the skin becomes moist, the pains which characterize the
disease will generally subside. Stimulating injections are of great
importance, particularly in painter’s colic, and may be frequently
repeated. The vapor bath should be administered, or instead of
this, heated stones wrapped in damp cloths may be placed at the
feet and sides, in bed. Flannels wrung out of warm pepper
sauce, or vinegar and cayenne, (1531) and laid upon the abdo-
men, will be serviceable in allaying the pain in the bowels. The
use of nervines is indicated in this complaint, and hence the stim-
ulating tea, (1515) containing, as it does, a portion of scullcap,
may be employed with great advantage. If the stomach is much
disordered, or the case severe or obstinate, either an emetic or a
full course of medicine should be administered. -
452 PRACTICE OF MEDICINE.
- CONSUMPTION. -
1849. Pulmonary consumption is one of the most fatal dis-
eases known, and has been very aptly termed the opprobrium of
the medical faculty. In Europé it carries off one fourth of the
inhabitants, and appears to be equally, if not still more fatal in
the United States. Andral, in a paper which he read before the
French Academy of Science, furnished the following statistics
with regard to the ravages of the disease in different parts of
Europe.
Of 1000 deaths at Stockholm, 63 were by consumption.
… “ Petersburgh, nearly the same number.
115.
… “ Vienna,
… “ Munich, nearly the same number.
… “ Berlin, 150.
… “ London, 236–Dr. Crichton.
… “ Paris, nearly the same number.
1850. Dr. Crichton, in his work on consumption, remarks,
that the disease is much more prevalent in Great Britain than in
Russia; and within the temperate, than in the higher latitudes. In
London and Paris, it destroys nearly a fourth of the population.
There are particular places within the temperate latitudes of Eu-
rope more subject to it than others, owing, it is supposed, to the
cold winds from the Alps and Appenines.
Of 1000 deaths at Marseilles, 250 were by consumption.
-- -- 7.
Genoa,
.. “ Naples, 125
-- “ Rome, 100
-- “ Pisa, 100
1851. In New York, the average deaths by consumption is
243 in 1000, which is nearly one fourth. The city inspector,
in his annual report to the corporation for 1839, says a writer in
the New York American, states the whole number of interments
to be 7953, of which 1315 died of consumption, 460 of inflam-
mation of the lungs, 36 of inflammation of the chest, 28 of bleed-
ing from the lungs, 28 of congestion of the lungs, and 72 of bron-
chitis—total 1939. We perceive, therefore, that 243 in 1000
died of consumption, or of some other disease of the lungs.
1852. “Throughout the Eastern States, the mortality is
probably greater than in New York—while in Lower Canada,

PRACTICE OF MEDICINE. 453
where the winters are as cold as those of Stockholm and St.
Petersburgh, but very dry, and subject to trifling variations,
the disease is much less frequent than with us. The country
bordering upon our great lakes, is not so subject to pulmonary
affections as that upon our seaboard; the native inhabitants are
much less liable to it than we are, and it has been observed
that soldiers sent hence to our garrison, in the vicinity of the
lakes, often recover from incipient consumption. The tempera-
ture of the Island of Michilimacinac, from the 15th of June to
the 15th of August, is almost invariable, and the climate, during
this brief period of summer, is one of the finest in the United
States.”
1853. Women, it has been ascertained, are more frequently
the victims of consumption than men. An English writer attri-
butes this partly to the in-door life which they lead, and partly to
their habit of wearing corsets, which prevents the full expansion
of the chest. “In both ways,” he says, “they are deprived of
free draughts of vital air, and the altered blood deposites tubercu-
lous matter in the lungs. Thirty one thousand English women
died in one year of this incurable malady. Will not this impres-
sive fact induce persons of rank and influence to set their coun-
trywomen right in the article of dress, and lead them to abandon a
practice which disfigures the body, strangles the chest, produces
nervous or other disorders, and has an º tendency to
implant an incurable hectic malady in the frame *
1854. Pulmonary consumption commences with the formation
of tubercles in the lungs, which, in the first instance, are no larger
than the head of a pin, but sooner or later they increase in size,
and if sufficiently numerous, run into each other, forming in-
durated masses of a yellow color. At length they soften, and are
converted into a cream-like substance, which passes through
apertures into the air tubes, and is discharged by coughing. In
this manner, cavities are formed in the lungs, and sometimes
blood-vessels are destroyed, giving rise to copious hemorrhage.
This, however, although a serious, is not necessarily a fatal
Sympton.
1855. Tubercles do not always terminate fatally, but on the
contrary, may exist in the lungs in early life, and yet the indi-
vidual live to an old age, without being aware of their presence.
They may be prevented from enlarging and softening, by a close
attention to the health, but if this is neglected, they usually hurry
the patient to an untimely grave. After tubercles are once form-
* English Annual Report upon Mortality.

454 PRACTICE OF MEDICINE.
ed, they may be further developed by a great variety of causes,
such as blood-letting, the use of mineral and vegetable poisons,
a variable climate, sudden changes from heat to cold, intem-
perance, sedentary habits, improper food, the continued use of
purgatives, excessive venereal indulgence, public speaking, play-
ing on wind instruments, the depressing passions, tight lacing,
neglected colds, improper treatment of cutaneous diseases, inhal-
ing the dust of metallic substances, and in short, whatever de-
ranges the health, or impairs the functions of the vital organs.
1856. The periods which consumptive patients survive, after
the disease is fully developed, and proper means are not taken
to arrest its progress, are variously estimated. Generally, how-
ever, the malady proves fatal within a year, but instances occur,
in which the individual continues to enjoy a tolerable share of
health for ten, twenty, or even fifty years.
1857. It is a remarkable fact, that consumption is usually
suspended during pregnancy, and after the period of delivery, it
often returns with redoubled violence.
1858. Symptoms. Pulmonary consumption generally com-
mences with a dry, hacking cough, which is increased by expo-
sure to a cold or variable atmosphere; and at the same time a
sense of pain or tightness is experienced in some part of the
chest, especially in taking a deep or full inspiration. The breath-
ing is rendered difficult by bodily motion, or unusual exercise.
A deep flush is observed on the cheeks; and the palms of the
hands, and soles of the feet become hot or feverish after eating.
The patient is harrassed by cold sweats during the night, and in
the morning he rises from bed with a feeling of languor, or debil-
ity. The tongue and lips are usually red, accompanied with a
peculiar whiteness of the eye. As the disease advances, the
cough becomes more troublesome, particularly in the evening and
morning, and instead of the frothy, or thin, ropy liquid with which
it was accompanied, there is now a discharge of thick, purulent
matter, of a greenish, or yellow color, and sometimes streaked
with blood. The night sweats are more profuse and exhausting,
and the debility and emaciation greatly increased. Acute pains
are felt in the breast or sides; the eyes are sunken, but remark-
ably bright and expressive; the flush in the cheeks is more vivid;
the breathing more quick and short; and the body wasted almost
to a skeleton. The pulse, in the meantime, is small and frequent,
and varies from a hundred to a hundred and twenty or thirty beats
in a minute.
1859. The last stage of the disease is marked by all the pre-
vious symptoms in a more aggravated form, accompanied by a


PRACTICE OF MIDICINE. 45.5
copious diarrhoea, dropsical swellings of the feet and legs, hoarse-
ness or failure of the voice, sore mouth, ulceration of the throat,
and a peculiar, cadaverous expression of the countenance, which
invariably denotes the consumptive patient.
1860. There is another form of disease, usually regarded as
consumption, which is not dependant upon tubercles, but consists
of a chronic inflammation of the windpipe, and air tubes of the
lungs. In its earlier stages, it may be known by the bluish color
of the lips, the wheezing respiration, pain in the throat, and free
expectoration of matter almost from the commencement of the
disorder. In the latter stages, it bears a close resemblance to
ulmonary consumption, and as the treatment of the two maladies
is essentially the same, they do not require to be distinguished.
1861. Probability of a Cure. The medical faculty acknow-
ledge that they have no efficient remedy for consumption, and
this is sufficiently apparent, for their depletive plan of treatment,
together with the administration of poisons, is much better calcu-
lated to produce, or aggravate the disease, than to have any effect
in its removal. Let any person with tubercles in the lungs, place
himself under active treatment by a diplomatised physician, and
in all probability, pulmonary consumption will be developed in a
very short time. I have met with many such cases in the public
hospitals and alms houses, and would earnestly caution all persons,
who are predisposed to consumption, or whose lungs are in a
weak or irritable state, to avoid the use of all poisonous and deple-
tive agents, as deadly enemies to their health.
1862. Unsuccessful as the medical faculty may be in the
treatment of consumption, however, there are ample proofs that it
is a curable disease. Indeed, I have no doubt that patients would
frequently recover, through the unaided efforts of nature alone, if
they would only keep aloof from the routine physicians. Dr.
Parr remarks, that he has known six cases of decided consump-
tion to recover spontaneously—that is, without medical treatment.
Laennec, in his work on Diseases of the Chest, acknowledges
that it is not beyond the powers of NATURE to effect a cure, al-
though he confesses there are no certain means of accomplishing
it by ART | He made a post mortem examination of five persons,
who died of other diseases than consumption, and “in every in-
stance, cavities or tubercular excavations were found cicatrized,
and for the most part lined by a semi-transparent membrane–
adding testimony to the opinion, that nature does sometimes exert
A curative process in cases of consumption which were apparently
opeless.”
1863. We have conclusive evidence, that tubercles in the

456 PRACTICE OF MEDICINE.
incipient stage, may be removed from the lungs, without passing
into a state of suppuration. Dr. Bellows confined a number of
rabbits in a damp, cold place, and fed them on very coarse food;
in a few weeks some of them were killed, and it was found that
their lungs were studded with tubercles. The remainder of the
rabbits were removed to a more congenial atmosphere, and fed
for a few weeks on richer and better food, after which they were
killed, and it was found that their lungs did not exhibit the slight-
est trace of tubercles.
1864. M. Coster, in a letter addressed to the Royal Acad-
emy of Medicine, in Paris, announced, that from certain exper-
iments which he had made, he hoped to prove that where the
formation of tubercles had commenced, their progress might,
in a great number of cases, be arrested. He shut up a number of
dogs and rabbits in dungeons, without light, where º, could not
exercise, and were exposed to a damp, cold atmosphere by means
of wet sponges placed in the dungeons. Some | these animals
were fed on their ordinary diet, while others were fed on bread
containing half an ounce of carbonate of iron to the pound. All
the former became ill, and the greater part tuberculous, but not
one of the latter, fed on the bread containing iron, presented a
trace of tubercles. *
1865. The removal of tubercles from the lungs, is accom-
plished, undoubtedly, by the process of absorption; and we should
take a hint from nature, and endeavor to aid her in this salutary
operation. The vegetable remedies recommended in this work,
and particularly the courses of medicine, not only restore the
general health, but increase the power of absorption, and hence it
is that the advocates of the new and reformed practice are so suc-
cessful in the cure of consumption. A case of the disease came
under my observation, within the last year, in which the right lung
contained a large tubercular excavation or cavity, and yet the par
tient was restored to perfect health. If the lungs are nearly de-
stroyed, however, and there is not enough remaining for the office
of respiration, it would be fallacious to hope for a cure; but it is
known that respiration may be performed where one lung is en-
tirely gone, and hence a cure is sometimes effected, even where
the disease has committed very extensive ravages.
1866. TREATMENT. Courses of medicine are generally in-
dispensable in this complaint, and if the system is cold, or inactive,
a free use should be made of composition and spiced bitters for
a few days before the first one is administered. (1597, et seq.)
* Bult. de l’ Academy, vide London Lancet, Feb 15th, 1840.




PRACTICE OF MEDICINE, 457
1867. The courses need not be repeated, as a general thing,
oftener than every five, or seven days, (1716, et seq.) and in the
intervals, the warming and invigorating medicines should be em-
ployed, according to the circumstances of the case. (1667, et seq.)
After a course, the patient should not expose himself to a cold or
damp atmosphere, but sit by the fire, if the season requires it,
covered with a cloak or blanket to keep him warm. He should
be careful, also, not to sleep in a cold room, for this is highly
injurious, and not unfrequently causes an aggravation of the symp-
toms. (1640–1–2.)
1868. All that has been said of diet, in a previous place,
(1680, et seq.) is equally applicable here, and it is to be hoped
the subject will receive an attentive and candid consideration. I
would particularly recommend the use of the unbolted wheat bread,
as a means of regulating the bowels. Butter, fat meat, and all
oily or greasy substances should be avoided, as they tend to pro-
duce a morbid condition of the stomach. Tea and coffee should
be excluded from the list of beverages, for they are narcotics,
and cannot be used with any more propriety than an infusion of
digitalis, or any other narcotic poison. (1644.) The skin should
be rubbed every morning with a coarse towel, or the flesh brush,
and as soon as the patient acquires sufficient animal heat to pre-
vent a chill, he should use the hand bath. (1455.)
1869. If night sweats occur, the vapor bath should be admin-
istered just before going to bed, followed by an application of the
stimulating liniment, or in the absence of this, the surface may be
bathed with pepper sauce, or vinegar and cayenne. (1531.)
1870. The various remedies for the cough and diarrhoea, will
be detailed under the appropriate heads.
1871. The patient should exercise regularly in the open air,
when the weather will permit, but not to the extent of producing
fatigue. (1709, et seq.) Horseback riding is particularly bene-
ficial, and was thought by Sydenham to be the most effectual
earthly remedy for consumption. (1711.) The feet should be
kept warm and dry, and the clothing regulated according to the
season and climate. Nor is this all, for it is equally important to
defend the lungs from the cold air. “Is it not strange,” says
Dr. Johnson, in his work on the Liver, “that we should be so
very solicitous about heaping fold over fold on the surface of the
body, while we never dream of the extended surface of the lungs,
which we leave completely exposed Is it not still more strange,
that this should be forgotten, when daily observation shows that
the lungs are the organs which, nine times out of ten, suffer by
this exposure ? We cannot too strongly enforce the necessity,
therefore, of guarding the organs of respiration from the direct
58
458 PRACTICE OF MEDICINE.
influence of the cold air, by such muffling about the face as may
not only detain a portion of the air expired from the lungs each
time, but communicate a degree of warmth to each inhalation of
atmospheric air. A large net, such, for example, as is vulgarly
called a comforter, folded loosely around the face, will receive a
portion of caloric or heat from the breath at each expiration,
which portion will be communicated to the current of air rushing
into the lungs at each inspiration, and thus a frigid atmosphere is,
to a considerable degree, obviated.”
1872. The Respirator. This is a newly invented instrument
of great value, which will enable consumptive patients to exercise
in the open air, even in the depths of winter, without experien-
cing any inconvenience, provided they are warmly clad. Dr.
Bowditch says, “it was devised about four years since by Mr.
Jeffreys of London, and consists of numerous layers of fine me-
tallic wires, so arranged as to form a minute net work. These
are prepared in such a manner that they can be placed over the
mouth, and the person will be able to face the severest cold, or
most violent wind, without difficulty; for, in the first place, the air
is warmed, and in the second, the violence of the current is
wholly checked by the various angles each particle of air meets
with in its passage through the instrument. The theory of its
operation is this; the wire becoming heated by the expired air, in
its turn, warms the external atmosphere that is drawn into the
lungs. There are two kinds, one called the oral, because it
covers merely the mouth, the other orinasal, because it covers
the nostrils, as well as the mouth. As it may be imagined,
the instrument is of great service to all who are #. to cough
on a change of temperature, and it is very extensively used
in England. So far as I can learn, the first one introduced into
Boston, was brought here towards the latter part of the winter of
1838, but even now comparatively few individuals know its value
as a palliative in all diseases of the chest and air passages. Vari-
ous good results have been observed to follow its use. I shall
speak of some of those results, as evinced by thirteen persons
who have used it in Boston.
1873. “All, without exception, speak very warmly in favor of
the instrument. One who was very much troubled with inflamma-
tory affections of the mouth and gums, owing frequently to expo-
sure to cold air, was very much relieved. Every one knows the
pang excited by a current of cold air upon a decayed tooth, but with
the respirator this difficulty is avoided. All, so far as I can learn,
have found that they were prevented from having an access of
coughing from sudden changes of temperature. One told me he


PRACTICE OF MEDICINE. 459
could scarcely believe that so simple a contrivance could be of
any importance, and therefore had recourse to his handkerchief,
as a substitute, and the result was a violent attack of coughing.
One individual had spent the winter of 1838–9 in the South, and
prepared to go again last season, but being persuaded to keep at
exercise in the open air of the country, and with the respirator
constantly in use when out of doors, he was very comfortable
during the winter. Another had been unable to sweep her room
without great fatigue, and frequently an attack of asthma. Upon
using an instrument that I made for her, which was of a less
complicated character than the English, being made of tin instead
of silver or gold, she was able to arrange a number of apartments
without difficulty of respiration, and with much less fatigue than
she had previously experienced in attending to one room merely.
1874. “This brings to my mind another patient, who told
me that before beginning to use the instrument, she was frequent-
ly so exhausted by a short walk, that she found it impossible to
speak or attend to any thing when she arrived at her place of
destination. With the use of the respirator she walks with ease.
Again, a sensation of warmth is diffused over the whole system by
the same means, so that the patient observes instantly when the
respirator is off the mouth, by the sensation of coldness in the
chest, or over the whole frame.
1875. “Another point I will mention which seems to me to
be important, though less so to the physician than to his patient.
One individual informed me that after beginning to use the respi-
rator, his physician’s bill for attendance upon him was much less
than it had been for many years previous, solely, as was believed,
in consequence of being able to go out without having an attack
of bronchitis supervene. The same person now walks instead of
riding, whereby another item of expense is materially dimin-
ished.”%
1876. I fully concur with Dr. Bowditch, in the favorable
opinions he has given of the respirator, and would advise every
consumptive patient, who lives in a cold, or variable climate, to
procure one without delay. I have recommended them in sev-
eral instances, and they have invariably been productive of good
results.
1877. Ramadge’s Tube. This is the invention of Dr. Ram-
adge of London, who has been physician to the London Lung
Infirmary for nearly twenty years, and from all the information I
can gain upon the subject, I am disposed to consider it a very im-
* Dr. Smith’s Medical Almanac for 1841.

460 PRACTICE OF MEDICINE.
portant instrument in the treatment of consumption. I have made
a few trials of it, recently, in my own practice, and was highly
pleased with the results. It is designed for the exercise and ex-
pansion of the lungs, being five or six feet in length, and half an
inch in diameter, prepared with a mouth piece, through which the
patient is enabled to breathe. The Rev. Mr. Howe, formerly
chaplain to the New York City Hospital, has introduced it into
this country, and written a little work descriptive of its beneficial
effects. He says, “The use of this tube for half an hour will
benefit the chest to a greater degree, than an hour's ride on horse-
back, or the vigorous exercise of sawing or chopping wood, and
this without the weariness accompanying these physical exertions,
which invalids are frequently unable to endure.”
1878. The tube is so constructed, says Mr. Howe, that the
air is admitted into the lungs gradually, while it is not permitted to
rush out at once, but is retained, and slowly emitted again, by
which process the lungs are gradually expanded.
1879. “Persons who lead a sedentary life,” continues the
writer, “particularly public speakers, lawyers, and ministers of
the gospel, who have weak voices, or are afflicted with inflam-
mation of the throat, accompanied with hoarseness, and an occa-
sional loss of the voice, or those who are liable to take cold in the
throat, or upper part of the chest, upon every change in the
weather, will find the tube an effective remedy, if they persevere
in its use for a few months. The exercise produced by it, and
the action of the air upon the throat, is such that the changes of
the weather, and exposure to the air, under any circumstances,
will not affect the throat, or bronchial tubes in the least. Deli-
cate females, who have not sufficient exercise, will find the use of
it very pleasant and healthful. Those whose chest or lungs are at
all weak or contracted, will find that the tube will accomplish
great things for them; it will improve the voice, and increase its
power and compass. It will do more towards curing consump-
tion, than a sea voyage, travelling, or a change of climate, and that
too without the necessity of leaving home, or neglecting one’s reg-
ular business.”
1880. It must not be supposed, observes the author, that Dr.
Ramadge “professes to cure all persons in all stages of consump-
tion, but he does assert, that those predisposed to the disease,
who will use the tube for a few months, as directed, will be ren-
dered secure from an attack of consumption. With regard to
those who are laboring under the malady, if there be any possible
human means to save them, and the lungs throughout are not a
mass of corruption, a judicious use of the tube, with proper treat-
ment, will do more than any thing else to restore them to health.”



PRACTICE OF MEDIC INE. 461
1881. Mr. Howe says, “Where the lungs are diseased, the
exercise, expansion, and action of the air, may cause them to be
sorer than they were previously; there may be a great deal of
local irritation for some months, which may excite alarm ; and upon
the softening of the tubercles, there will be a more free expecto-
ration, but this is not to be attributed to any actual increase of the
disease. After the patient has used the tube for two or three
months, all tendency to the formation of fresh tubercles will have
been removed, and whatever irritation, or uneasiness may exist,
and sometimes it is considerable, will be in the part which was
originally diseased.”
1882. Mr. Howe was himself cured of consumption by the
use of Dr. Ramadge’s tube. He says, “While performing my
duties as chaplain in the New York City Hospital, I took a severe
cold, which soon settled into chronic bronchitis, and in a few
months, notwithstanding the best medical aid, it was clearly ascer-
tained that my lungs were tuberculated, and that I was laboring
under pulmonary consumption. The various remedies prescribed
by regular practitioners were resorted to, which rather aggravated
than relieved my complaint, and then recourse was had to the
popular nostrums of the day. These too, were unavailing, and
my physicians agreed that the only possible means of recovery
would be a sea voyage, and travelling. Accordingly I went to
England, where I consulted various physicians, but, so far as I
could judge, the practice pursued was the same as in the United
States, and instead of being benefited, every means only tended
to make me worse. In London I was so indisposed as to be
- confined to my room, and obtained the advice of Dr. D 5 One
f the most celebrated physicians in that city, who advised a blis-
ter, which made me worse, and resulted in great weakness of the
chºs. Aſ length I consulted Dr. Ramadge, who advised me to
use the tube, which gave me relief at once, and I gradually improv-
ed in health, until my chest was quite well.”
1883. “One great advantage arising from the use of the tube,”
tinues Mr. Howe, “is the permanent enlargement of the chest
and lungs. Not only is the whole thorax called into action, the up-
per as well as the lower ribs, but by a few months’ inhalation, the
chest of the invalid will assume a different formation, and undergo
a permanent enlargement of from one to three inches. This is true
in my own case, and has been proved in the case of others under
my immediate observation. The lungs are also thereby enlarged,
so that a person will, at the expiration of two or three months,
be enabled to take in double or threefold the quantity of air that
he did at first. * * *. Where one lung is quite gone with
disease, Dr. Ramadge gives instances in his work, in which inha-

462 PRACTICE OF MEDICINE.
lation has not only kept up the respiration, by forcing the air
through the cells of the lungs, but in which persons have enjoyed
comfortably good health for years.”
1884. Dr. Ramadge gives a particular caution not to use the
tube in the last stages of consumption, for then it would be mani-
festly injurious. He considers its use injudicious, also, in con-
firmed asthma, and diseases of the heart; but in other affec-
tions of the chest, he says it will prove of service.
1885. Patients who cannot afford to purchase a tube, should
practice breathing through the nostrils, as a substitute. This is to be
accomplished by closing the mouth, and inhaling the air through the
nostrils so forcibly as to expand the chest. The individual should
be in a sitting posture, as the enlargement of the chest will then
take place with greater ease. It is sometimes difficult to inflate
the lower lobes of the lungs at the outset, but by practising half an
hour daily, as directed for the tube, the patient will ultimately
. The tube itself, however, is much more agreeable and
effectual.
CONWULSIONS OR FIT.S.
1886. Convulsions result from an irregular action of the mus-
gles, and may be either partial or general, In, St. Vitus's dance,
for instance, the limbs only are effected, while in epilepsy, the
whole body is convulsed. When the muscles contract and re-
main stiff for a longer or shorter time, as in locked jaw, it is called
a spasm, but when the contractions and relaxations succeed each
oved. -
. The causes of this malady are various. It sometimes
ates an affection of the brain, and often accompanies other
diseases. Women are subject to it during pregnancy and labor.
It frequently attacks infants during the irritation of teething. It
often occurs after excessive depletion by the lancet, or otherwise.
If a dog be bled in a small quantity for several days in succession,
he will finally die in convulsions. Indigestible food, worms, in-
temperance in eating and drinking, and external injuries, are among
the familiar causes of this complaint.
1888. TREATMENT. The most effectual remedy in con-
vulsions, is the antispasmodic tincture, (1266, et seq.) which
* The Ramadge tubes may be obtained of Mr. Howe, 209 Grand street, New
York, and at the publication office of this work—price $5,00 each.
other in rapid succession, as in epilepsy, the term




PRACTICE OF MEDICINE. 463
should be given in the dose of two or three tea-spoonfuls, without
delay, and repeated according to the necessity of the case. In the
meantime, one or two strong injections (1567, 1574) should be
administered, as these have a powerful influence in quieting the
irregular action of the muscles. As soon as the spasms, or con-
vulsions abate, cayenne and bayberry tea, containing a portion of
scullcap, or lady’s slipper, should be given to produce a perspira-
tion, and if the symptoms require it, this should be followed by
an emetic, or a course of medicine.
1889. If the jaws are locked or pressed together, the anti-
spasmodic tincture may be poured into the mouth between the
teeth, and as soon as it comes in contact with the parts about the
root of the tongue, the rigidity of the muscles will give way.
1890. If a return of the convulsions is feared, a course of
medicine should be administered, and the usual tonics and stimu-
lants employed to invigorate the system. Attention to diet, ex-
ercise in the open air, and the use of the cold bath every morning,
are important in this complaint, where it has been of long stand-
Ing.
CORN.S.
1891. These chiefly exist on the toes, and about the feet, and
arise as a consequence of wearing tight shoes. They have a
horny appearance, and are formed by a thickening of the cuticle
or outer skin. By pressure on a corn, the nerves beneath are
irritated, and hence the severe pain which they occasion.
1892. TREATMENT. The individual should soak his foot in
warm water, until the corn is softened, and then pare it off with a
sharp knife, taking care not to wound the living flesh. He may
then moisten a strip of bladder, or suet skin, with nerve ointment,
rubbing it between the hands until it is soft and pliable, and wrap
it round the toe, or part affected, suffering it to remain until worn
away by the shoe. The application may be repeated, if neces-
sary. Dr. Thomson says he has seldom known this to ſail in
effecting a cure.
COSTIVENESS.
1893. An evacuation by stool every twenty four hours, is an
indispensable requisite of health, but if an individual goes longer
than this, he often feels heavy, dull, and feverish, and if he be-
comes habitually costive, a long train of symptoms generally ensue,



464 PRACTICE OF MEDICINE.
-
such as headach, sickness, flatulency, swelling of the abdomen,
dry or parched tongue, bad taste in the mouth, offensive breath,
and a partial or total failure of the appetite. The sick-headach,
piles, and a variety of nervous and convulsive affections, are often
dependent on a confined state of the bowels.
1894. Costiveness is owing to a deficient vermicular or peris-
taltic motion of the intestines, (71) and along with this, the
mucous membrane by which they are lined, does not secrete the
necessary amount of fluid, so that the fecal matter becomes dry,
and hard. The liver is also frequently torpid, and does not
furnish bile in sufficient quantity, which has been aptly termed
“ the natural physic of the body.” Medical authors inform us of
cases in which patients were without a stool for many months. I
was consulted by a young man of extremely sedentary habits,
within the past year, who had been without an evacuation from
the bowels for twenty three days.
1895. Errors in diet, and want of exercise, are frequen
causes of the malady. The use of bread made of superfine flour,
especially if adulterated with alum, as is a common practice with
the bakers, is one of the most unſailing sources of cosſiveness with
which I am acquainted. Should this not confine the bowels, how-
ever, the patient has only to overload his stomach, drink freely
of strong tea, or coffee, and remain at home by the fireside,
instead of exercising in the open air, and he will soon find it ne-
cessary to call in a physician, or apply to Brandreth for a box of
pills. -
1896. TREATMENT. Individuals who have resorted to the
use of physic in costiveness, need not be told that although it may
afford temporary relief, it leaves the bowels more """ or inac-
tive than they were at first. Dr. Marshall Hall, whom I have
previously º on this subject, remarks, “The habitual use of
active cathartics, although attended with temporary relief, seldom
fails to bring on or aggravate a permanent state of costiveness.”
(951) Besides, purgatives act upon the principle of depletion,
weakening or debilitating the patient, and cannot be used with any
more propriety than the lancet.
1897. Fai meat, butter, and all oily or greasy substances have
a purgative effect, and are therefore calculated to do harm. Dr.
Cullen found that four ounces of fresh butter, taken in the morn-
ing, would produce one or two extra stools during the day.
Hence, an individual might as well take a dose of castor oil, at
breakfast time, as to eat freely of butter, for the effect is much
the same. -
1898. The best remedy I have found for costiveness, is the


PRACTICE OF ME DIC INE. 465
unbolted wheat bread, (1181, et seq.) which regulates the bowels,
without producing any of the evil effects of physic. The meal of
which the bread is made, may be manufactured into cakes, crack-
ers, hasty pudding, or gruel, and used for the same purpose; or
the wheat itself, in its natural state, may be formed into a jelly, by
boiling it a sufficient time in water, (1435) and eaten with sugar,
or molasses. The latter is excellent to regulate the bowels of a
convalescent.
1899. Persons who are predisposed to costiveness, should
subsist principally upon vegetable food, take their meals at regular
hours, eat moderately, dispense with the use of tea and coffee,
exercise in the open air, and rub the skin from head to foot every
night and morning with a flesh brush, or coarse towel. The cold
bath (1448, et seq.) is also an important remedy. Dr. Good
mentions the case of a female who had no evacuation from the
bowels for four months, and was cured in eight days by the use
of the cold bath alone.
1900. Injections may always be used successfully to give ini-
mediate, or temporary relief.
1901. If a costive state of the bowels is accompanied with
feeble health, a few courses of medicine should be administered.
1902. Among the various medicines which may be used
beneficially in this complaint, are boneset tea, (713) cayenne and
molasses, (767) pepper sauce, (114.1) the bird peppers swallow-
ed whole, (755, 767) golden seal, (897) spiced bitters, (1246)
and lobelia pills, (1299.) -
1903. Powdered charcoal is thought by some people to be
an innocent and useful remedy in costiveness, but it irritates the
bowels, and like magnesia, often collects in a mass, and forms an
obstruction in the intestinal tube. - -
COUGH.
1904. A cough may be the effect of a cold, or a symptom of
some more serious complaint. Sometimes it is dry, and at others
accompanied with an expectoration of matter. It does not often
excite alarm, unless it has been of long continuance. Though
generally regarded as an enemy to health, Dr. Good justly ob-
serves, that it is to the lungs, what vomiting is to the stomach,
causing a discharge of matter from the air passages, which would
otherwise prove injurious. The common practice, therefore, of
checking a cough by the use of opiates, without removing the
cause, is a serious, and sometimes a fatal error. Mrs. of
Philadelphia, who had been troubled for a long time with a hack-



59

466 PRACTICE OF MEDICINE.
ing cough, informed me that in the course of six months, she had
taken at least a quart of brown mixture, which is a preparation of
opium. At the end of that time the cough left her, but the cure,
as she termed it, was purchased at a dear rate, for the opium had
constipated her bowels, destroyed her appetite, rendered her skin
sallow, and impaired the sensibility of her whole nervous system.
1905. TREATMENT. If the cough is symptomatic of con-
sumption, or any other disease of an obstinate or dangerous char-
acter, we should cleanse and invigorate the system with courses
of medicine, or endeavor to restore the health by proper attention
to diet, exercise, and cold bathing. A cough which results from
a sudden cold, may be cured, oftentimes, by taking a dose of
composition on going to bed, and placing a bottle of hot water
wrapped in a damp cloth at the feet. If necessary, the dose
may be repeated for several nights in succession, and if the appe-
tite is impaired, the spiced bitters may be taken two or three
times a day. -
1906. Inhaling the fumes of vinegar, or even the vapor of
water, is useful in coughs. Among other important remedies, are
cayenne and molasses; (773) anti-dyspeptic bread; the tincture
of lobelia dropped on loaf sugar; (1283) lobelia pills; vervain, and
boneset teas; (708, 714) and the cough powder, sirup, balsam,
and jelly. See index. -
1907. If the cough is dry and harsh, it may be greatly reliev-
ed by covering the patient with a blanket, so that he may breathe
the smoke of a piece of burning paper, in which cayenne has been
wrapped. White paper should be used instead of the colored, as
the latter is frequently poisonous; or instead of the paper, a small
portion of cayenne may be sprinkled on a red hot shovel, beneath
the folds of the blanket. This will cause perspiration, loosen the
cough, and produce free expectoration. The operation should
be performed at bed time, and repeated two or three times a week,
until the desired relief is obtained. As soon as the patient is in
bed, he should take a dose of composition tea, and have a bottle of
hot water wrapped in a damp cloth placed at his feet. I have
known two or three applications of this remedy to break up a
cough of six or eight weeks' standing.
croup.
1908. This is an inflammatory affection of the windpipe or
trachea, which extends, in most instances, to the air passages o
the lungs. It is chiefly confined to children under twelve years
PRACTICE OF MEDIC INE. 467
of age, but occasionally attacks adults, and even persons in ad-
vanced life. It is most prevalent in damp and changeable weath-
er, and hence its frequent occurrence in the spring and autumn.
1909. Croup is sometimes very sudden in its attacks, usually
coming on in the night, but is generally ushered in by a harsh,
dry cough, impeded respiration, quick pulse, and slight febrile
symptoms. When the disease assumes its ordinary violence, the
cough is loud and ringing, and the breathing much oppressed,
accompanied with a wheezing sound. The face is flushed, and
the skin hot. The cough, in some cases, is dry at the com-
mencement of the disease, and in others is accompanied by a
free expectoration of matter. The inner or mucous coat of the
windpipe, as well as that of the air passages, is sometimes covered
with false membrane, (1397) which serves still further to embar-
rass the respiration, unless it is detached and coughed up.
1910. Croup is a dangerous disease, and if not faithfully
watched, may proceed rapidly to a fatal issue. Dr. Marshall
Hall says, “it terminates in some cases within twenty four hours,
more commonly it lasts two or three days, and in rare instances it
continues for a week and upwards. In favorable cases the cough
becomes more loose, and less frequent, the breathing easy, and
the heat and pulse less. But we cannot account the patient safe,
until he has passed a night without a return of the symptoms.”
1911. TREATMENT. In mild cases of croup, nothing further
will be required than an occasional dose of composition to keep
the skin moist; and at night, on retiring to bed, a bottle of hot
water wrapped in a damp cloth should be placed at the feet. If
the bowels are irregular, an injection should be administered once
or twice a day. The diet should be light, and easy of digestion,
and the skin well rubbed night and morning with a coarse towel,
or flesh brush. One very important precaution is, to keep up a
uniform temperature in the sick room, for those who have had the
management of croup, know that as soon as the fire is neglected,
or the air in the apartment becomes chilly, there is a return, or
increase of the malady.
1912. The stimulating tea (1515) is an excellent medicine in
group, particularly if there is much cough, or difficulty of breath-
ing. The lobelia and scullcap, of which it is partly composed,
are well adapted to remove these two symptoms. It should be
given to the extent of producing perspiration.
1913. If the disease comes on suddenly, and the symptoms
are violent, a tea-spoonful or more of the tincture of lobelia should
be given, either alone, or in composition tea, repeating it in five or
ten minutes, if necessary, and administering one or two injections.


468 PRACTICE OF MEDICINE.
As soon as relief is afforded, a full and thorough course of medi-
cine should be given, so that the disease may be effectually re-
moved.
1914. In severe cases, the throat should be rubbed for ten or
fifteen minutes with a mixture of vinegar and cayenne, (1531) and
a flannel wrung out of this liquid, tied round the neck, renewing
the application every two or three hours.
1915. Emetics are important in croup, because they not only
equalize the circulation, but serve to expel the phlegm or mucus
from the air passages of the lungs. (645.)
DEArness.
1916. Deafness may proceed from various causes, such as
a defect in the structure of the ear; inflammation; debility or
relaxation; the presence of some foreign body; a deficiency of
wax; or what is more common, a hardening of the wax, which
sometimes closes or obliterates the passage leading into the ear.
1917. TREATMENT. I have known this malady to be cured
'" administration of courses for some other disease, but that
} only in particular cases, for if the deafness is owing to a de-
ect in the structure of the ear, a cure is out of the question. In
case of hardened wax, the ear should be syringed every night "
morning with an infusion of lobelia, about milk warm, or instea
of this, an infusion of raspberry leaves, rendered slightly pungent
by the addition of rheumatic drops. The ear should be closed
with a piece of raw cotton, saturated with the drops, so as to ex-
clude the air. This treatment has cured a great many cases of
deafness. If a foreign substance is lodged in the ear, warm water
should be injected into it with considerable force, so that the
offending body may be washed away.
DELIRIUM TREMENs.
1918. Delirium tremens, mania a potu, or craziness from
drink, as the disease is variously called, is characterized by de-
- lirium, and a tremor of the hands, and other parts of the body.
It is principally confined to persons addicted to the use of ardent
spirits, who have been deprived, for some time, of their accus-
tomed stimulus. It commences with lassitude, giddiness, loath-
ing of food, and nausea, or vomiting. The eyes have a wild or
glaring expression, the hands become tremulous, and the patient


PRACTICE OF MEDICINE. 469
is restless, fretful, very talkative, and wholly unable to sleep.
The bowels are torpid, the thirst urgent, and the tongue red, or
coated. When the disease is fully developed, the patient talks
and raves violently, thinks he is about to be attacked by robbers,
flies to the window or door to make his escape, fancies that he
hears strange noises, and declares that his bed is surrounded by
furious beasts, which are ready to devour him. Indeed, it would
be impossible to give an adequate description of the wild and
horrible conceits which are constantly passing through his brain.
In some cases, fatal convulsions, or apoplexy ensue. The par-
oxysm of madness has been known to continue a week, and in
some instances a month, terminating at last in permanent insanity.
1919. A tendency to sleep, in this disease, is a favorable
symptom, but if the delirium continues, accompanied with stu-
por, cold extremities, and a twitching of the hands and muscles
of the face, there is every reason to apprehend a fatal issue.
1920. Opium eaters are subject to delirium tremens, as well
as those addicted to the use of ardent spirits.
1921. TREATMENT. I know of no medicine that will so
speedily and effectually quiet the delirium in this disease, as lobelia
inflata; and in some instances, the patient will sink into a calm
and refreshing sleep as soon as he is put under its influence. A
tea-cupful of cayenne and bayberry tea, (512) to which two or
three tea-spoonfuls of rheumatic drops, and a tea-spoonful of the
tincture of lobelia have been added, should be given, repeating it
in ten, fifteen, or twenty minutes, and administering a stimulating
injection, containing a table-spoonful or more of the anti-spasmodic
tincture, or a heaped tea-spoonful of the green, or brown lobelia.
(1567, et seq.) Two or three repetitions of the injection will be
found useful, where the delirium is furious. Brandy, in a small
quantity, is a beneficial agent, and in this disease, arising, as it
usually does, from an absence of the wonted stimulus, should
always be employed. I have given it in the dose of a table-
spoonful, repeating it once or twice, with the most decided ad-
vantage. Heated stones wrapped in damp cloths should be placed
at the feet and sides, and a course of medicine administered,
giving lobelia in a sufficient quantity to cleanse the stomach effec-
tually. After the course, the patient should be careful to guard
against a relapse, which is liable to occur. He may take an oc-
casional dose of the stimulating tea, (1515) or a strong tea of
scullcap, (924) either of which is very useful in checking a ten-
dency to delirium, and nervous tremors. If the disease returns,
the course must be repeated.
1922. It is worthy of remark, that in some cases of delirium



470 PRACTICE OF MEDICINE.
tremens, the morbid craving for alcoholic drinks entirely subsides,
after two or three courses have been administered.
1923. Violence should not be used in restraining the patient,
during the prevalence of delirium, unless it is absolutely necessary,
for the more kindly he is dealt with, the more tractable will he
generally prove.
DIARRIICEA.
1924. This disease consists of watery, slimy, or perhaps
frothy evacuations by stool, which are of a yellow, green, or
brown color, and very offensive. In some instances they are mixed
with particles of undigested food, and are generally accompanied
by tenesmus, and griping pains in the bowels. If copious, they
soon reduce the strength of the patient, for they drain away the
serous or watery part of the blood. The vermicular or peristaltic
motion of the bowels (71) is greatly increased. The disease is
produced by a variety of causes, such as intemperance in eating
and drinking, vitiated bile, worms, acidity arising from imperfect
digestion, and exposure to a damp or variable atmosphere.
1925. TREATMENT. In ordinary cases, a cure may be
effected by the use of bayberry tea and rheumatic drops, adding a
table-spoonful or more of the latter to a tea-cupful of the former,
and repeating the dose every hour until the diarrhoea is checked.
The dysentery or cholera sirup is also an excellent remedy. Ex-
posure to cold should be avoided, and the feet kept warm and dry.
1926. If the disease assumes a chronic form, it will be neces-
sary, where the case is obstinate, to administer courses of medicine,
repeating them once or twice a week, as circumstances may re-
quire. Between the courses, if the stools are frequent or copious,
injections should be administered two or three times a day, and a
free use made of composition and spiced bitters. The following
preparation will be found beneficial. Take of poplar bark a tea-
spoonful, cayenne one or two tea-spoonfuls, bayberry three tea-
spoonſuls, boiling water a pint; steep, and sweeten to suit the
taste. This tea should be kept warm, and two thirds of a tea-
cupful taken several times a day. The addition of slippery elm,
to render it somewhat mucilaginous, will increase its good effects.
The dysentery sirup is useful in the chronic, as well as the acute
form of the disease. A tea of prickly ash is also a valuable rem-
edy. The patient must keep his skin moist, and by all means
avoid exposure to a damp or chilly atmosphere. A rigid atten:
tion to diet is also indispensable. If food of an improper kind

PRACTICE OF MEDIC INE. 471
passes from the stomach into the bowels in an undigested state,
it keeps up the irritation upon which the disease depends, and
under these circumstances, it is impossible to effect a cure,
notwithstanding the most active and thorough treatment. Hence,
the patient should avoid the use of meat, butter, gravies, pastry,
rich or unwholesome mixtures, and every thing which tends to
impair the digestive functions, and subsist principally upon bland
and nourishing fluids, such as the unbolted wheat meal gruel, or
slippery elm boiled in milk. (1431.) The wheat jelly, (1435)
eaten moderately, is an excellent article of diet. The skin should
be rubbed night and morning with a coarse towel, or flesh brush,
and if the weather is cold, an occasional vapor bath, followed by
an application of the stimulating liniment, (1307) will prove of
service. On retiring to bed, a bottle of hot water wrapped in a
damp cloth should be placed at the feet.
DISLOCATIONS.
1927. In dislocations, says a writer on surgery, the limb or
part is either shortened, lengthened, or distorted, according to the
nature of the accident, accompanied with pain, swelling, and a
partial or total loss of motion. The head of the dislocated bone
is frequently felt in its new position, while the soft parts about the
joint lose their peculiar shape, or fulness. Any movement of
the limb causes an increase of pain; and sometimes a grating or
crackling noise is heard, as in fractures. Mr. Castle remarks,
“When dislocations have only occurred a day or two, there will
sometimes be found a slight crepitation, which is owing to the
escape of synovia from the joint into the surrounding cellular
membrane; this becomes thickened by the absorption of the more
fluid part, and crackles under motion—a circumstance which every
F.'" should be aware of, as the case may be mistaken for
acture; but there is not that peculiar grating felt which the ex-
tremities of a fractured bone produce.”
1928. “Dislocations,” says Mr. Castle, “generally arise
from violence, and are accompanied by laceration of the ligament
of the joint, but sometimes they happen from relaxation of the
ligaments only. If muscles are kept long upon the stretch, their
power of contraction is in a great measure lost; or if from paral-
ysis, they lose their action, a bone may be easily dislocated, and
reduced as quickly. Dislocations frequently arise from ulceration
of the joints, by which the ligaments are detached, and the bones
become altered in their relation to each other; this frequently
happens in the hip. Dislocations are sometimes accompanied


472 PRACTICE OF MEDICINE.
with fracture. At the ankle joint, a dislocation seldom occurs
without fracture of the fibula; and sometimes the acetabulumº is
broken in dislocations of the hip joint. When a bone is both
fractured and dislocated, it is best to reduce the dislocation with-
out loss of time, taking care that the fractured part be strongly
bandaged in splints, to prevent any injury being done to the mus-
cles; for if this is not attended to at first, it cannot be afterwards,
without, in all probability, disuniting the fracture.”
1929. Dislocations are divided into the simple and compound,
the first consisting of a dislocation merely, while in the second,
there is an external wound communicating with the cavity of the
dislocated joint. The latter are frequently attended with danger,
from the fact that inflammation is apt to arise.
1930. In compound dislocations, says Dr. Cooper, it is a
most important point to obtain a prompt union of the wound, as
the injury can afterwards only be regarded as one of a simple kind.
The lips of the wound are, therefore, to be brought accurately
together with sticking plaster, and the joint kept perfectly quiet in
splints.
"...i. The hip and shoulder joints are the most frequently
dislocated, because they are loose in their sockets, and admit of
motion in every direction.
1932. There is but little difficulty, as a general thing, in re-
turning a dislocated bone to its place, if we succeed in overcom-
ing the rigid, involuntary contractions of the muscles. In accom-
plishing this, physicians and surgeons often employ the strength of
three or four men, assisted perhaps by a pair of pulleys, and such
is the force which they sometimes exert, that they fracture bones,
and lacerate muscles, blood-vessels, and nerves. An accident of
this kind happened to the late Professor Physic of Philadelphia,
who is styled the Father of American Surgery, and the same
dreadful results frequently occur in the hands of his less distin-
guished followers.
1933. A more speedy and effectual method of relaxing the
muscles, and that too without increasing the sufferings of the
patient, is to administer a tea of cayenne, or composition, until
perspiration ensues, and wrap the injured part, for some distance
above and below the joint, in cloths or napkins of several thick-
messes, and pour water upon them, as hot as it can be borne, for
ten or fifteen minutes. If however, this treatment is insufficient,
it is only necessary to administer a vapor bath, followed by an
emetic of lobelia, which will completely relax the whole muscular
system. As soon as the reduction is accomplished, the cloths
* The cup-like cavity or socket which receives the head of the thigh bone.

PRACTICE OF ME DIC INE. 473
should be reapplied, and cold water poured upon them, which
will favor the contraction of the muscles, and enable them to keep
the bone in its place. The lobelia, I will remark, administered in
the form of injections, has a more relaxing influence than when
introduced into the stomach. (1561.)
934. “Difficulties in the reduction may arise,” says Mr.
Castle, “from the head of the bone catching against the opposite
surface, and then the former requires to be raised before it can be
returned. The peculiar ligaments of the joints may also interfere
with the reduction. This is particularly to be noticed in the
knee, where the bone should be moved in such a direction as to
relieve the ligament which remains entire. The ligaments of the
ankle joint are of extraordinary strength, and the bones of this
joint will often break, rather than the ligaments give way.”
1935. When a round headed bone is dislocated, it should be
drawn out of the place in which it is lodged, by an extension of
the limb, and then by the necessary rotation, it will readily slip
into its socket.
1936. With regard to the efficacy of lobelia and the vapor
bath, in relaxing the muscles, no one will entertain a doubt who
gives them a trial. Dr. W. R. Griffin, a physician of the old
school, in some remarks upon the subject, says, “I will cite a
case which tends to illustrate the remarkable degree to which the
muscular fibres may be relaxed by the use of lobelia, and its con-
comitant remedies. A Miss Merchant of my acquaintance, met
with an accident which occasioned a complete dislocation of the
thigh bone. The most eminent surgeons were immediately sent
for, who, owing to the powerful contraction which existed in the
muscles of the limb, were unable to effect a reduction. After
every means had been employed which are generally resorted to
on such occasions, the case was abandoned as incurable, and the
young lady, anticipating herself a cripple for life, was left to hob-
ble about upon crutches, a pitiable spectacle of professional igno-
rance. In this situation she continued for more than a year, when
in consequence of some temporary indisposition, she applied to
Dr. Cornell of Clinton. While she was under his care, the remedy
above mentioned was administered with a liberal hand. Upon
one occasion, when the system was completely under the influ-
ence of this medicine, the dislocated limb, by an accidental move-
- ment, became fixed in its natural socket, so that the young lady
was immediately enabled to walk with as great facility as though
the accident had never occurred. The relation of this case may
afford a profitable hint to surgeons.”
1937. The vapor bath, independently of the lobelia, is an inval-
uable agent in producing muscular relaxation. Dr. Madden says

60
474 PRACTICE OF ME dic in E.
he has trembled to see the Turks dislocate the wrist and shoulder
joints, and reduce them in a moment, which they were enabled to
do by “twisting and kneading” their limbs in the vapor bath.
He adds, the most rigid joints are rendered pliant by this practice.*
1938. A blacksmith residing near Philadelphia, bad his shoul-
der dislocated downward into the armpit, and called in two diplo-
matised physicians, who exerted all the strength of which they
were capable, to no purpose. They left the patient and went to
Philadelphia in search of pulleys. The blacksmith in the mean-
time, not willing to undergo any additional tortures, unless it was
indispensably necessary, sent for one of his neighbors, who gave
him some composition, and made an application of cloths and hot
water, as previously described, with a view of relaxing the mus-
cles. As soon as this was accomplished, he drew the patient's
arm over his shoulder, giving the head of the dislocated bone an
upward movement, and without any difficulty, it slipped into its
socket. Presently the physicians returned with the pulleys, but
was very much surprised to find that there was no occasion for
their use.
1939. A dislocation should be reduced as speedily as possible,
for after a few weeks, the bone forms adhesions to the parts with
which it is in contact, and the muscles also become accommo-
dated to their new position, so that it is difficult, or perhaps im-
possible, to restore the bone to its place. “In recent cases,”
says Mr. Castle, “reduction is easily effected, but aſter a few
weeks, or even days, it is accomplished with difficulty. In
these cases, where it has been said the dislocations have been
reduced a long time after the accident, the patient has never been
able to use the joint extensively. In muscular persons, the re-
duction of the shoulder ought never to be attempted after three
months; but if the patient be less muscular, four months should
be the utmost limit. In dislocation of the thigh, two months may
be fixed on as the time, beyond which it would be wrong to make
any attempt, excepting in a person of very relaxed fibre, when a
little more time may be allowed.”
1940. A female correspondent of the Botanic Luminary,
published in Michigan, states that she was called to a woman
whose hip had been dislocated by a fall, and that three diploma-
tised physicians and one bonesetter had endeavored ineffectually
to restore the bone to its place. The common means of exten-
sion had been resorted to, and the patient abandoned to the re-
sources of nature. When the writer first saw her, it had been
six weeks since the accident, and eleven days since the physicians
*Travels in Turkey, Egypt, Nubia, and Palestine. Philadelphia, 1820.

PRACTICE OF MEDICINE. 475
had deserted her as a hopeless case. Cayenne and nerve pow-
der were administered freely, and the hip, and adjacent parts
wrapped in cloths, upon which water was poured as hot as it
could be borne, for about fifteen minutes, when the muscles were
so relaxed, that the dislocated bone was returned to its socket
without difficulty. In this case, there had been no º
for adhesions to form, or the reduction could not have been ac-
complished so easily, even though the muscles had been com-
pletely relaxed. - -
1941. If the soft parts are wounded in a dislocation, the bone
should be replaced, the wound cleansed from dirt, its lips brought
together with adhesive plaster, and the usual applications made to
exclude the air. The limb should then be placed in that position
in which there is the greatest relaxation of the muscles, and the
joint suffered to rest until the lips of the wound have united. If
a bone protrudes, and is covered with dirt or dust, it should be
washed clean with a sponge and warm water, before it is replaced.
“It is an exceedingly bad practice,” says Dr. Cooper, “to saw
off the protruding end of a dislocated bone in compound cases.
The bone may always be replaced; and what good the proposers of
this plan have in view is difficult to conceive.” If there is dan-
ger of the joint becoming stiff, it should be moved gently at the
end of four or five days, or as soon as the lips of the wound are
sufficiently united to admit of this motion.
1942. If the wound becomes hot, or painful, cloths should
be applied, and wetted occasionally with cold water, as directed
for burns and scalds, (1813–14) and cayenne, or composition ad-
ministered internally to keep a perspiration. This is necessary in
injuries of every description, for while the skin is moist, and the
equilibrium of the circulation maintained, there is no danger of
febrile or inflammatory symptoms ensuing. If the stomach is
disordered, it should be cleansed with an emetic of lobelia; or if
the general system is much affected, it will be necessary to ad-
minister a course of medicine.
1943. If the wound suppurates, or becomes offensive, it must
be poulticed.
1944. The two joints most frequently dislocated, as I have
said, are the shoulder and hip. The first may be thrown out
of place in three directions, downward into the arm-pit, back-
ward toward the spine, and forward upon the clavicle or collar
bone. In the downward dislocation, the head of the bone presses
on important nerves, and generally causes a great degree of pain.
The head of the thigh bone may pass out of its socket in every
direction, but the usual dislocation is upwards, in which case the
limb is shortened, turned inwards, and not easily separated from
the other.

476 PRACTICE OF MEDICINE.
T
- DROP.SY.
1945. Dropsy is a collection of watery fluid in the cellular
membrane,” or any of the cavities of the body, as the chest and
abdomen. It is caused by a weakness of the absorbent vessels,
which are unable to take up the fluid and discharge it from the
system through the natural channels. It is a frequent result of
blood-letting, and the internal use of mercury, arsenic, and other
poisons. Measles and scarlet fever, treated on the antiphlogistic
plan, are often followed by dropsy. The skin in this disease,
is hot and dry, accompanied with loss of appetite, thirst, scanty
urine, and an inactive state of the bowels.
1946. In dropsy of the abdomen; the breathing is short and
difficult, and if the accumulation of water is considerable, the
patient is obliged to limit his food and drink to the smallest pos-
sible quantity. If pressure be made upon the abdomen, pain or
soreness is experienced. In the latter stages of the disease, a
short, dry cough, and swelling of the feet and legs are liable to
ensue.
1947. Dropsy of the chest commences with a feeling of tight-
ness at the lower part of the sternum or breast bone, with a diffi-
culty of breathing while in an erect position, which is greatly in-
creased by exercise. While in bed, the patient is most easy with
his head and shoulders somewhat elevated. He complains of thirst,
and is troubled with a hacking cough. His sleep is often inter-
rupted by sudden starts. His feet swell, his countenance has
an anxious expression, and his extremities are often cold and be-
numbed. Pressure upon the abdomen just below the ribs, so as
to force its contents upward against the diaphragm, is followed by
coughing, and a feeling of suffocation.
1948. Dropsy of the cellular membrane is termed anasarca,
and at the commencement, says a medical writer, shows itself by
“a swelling of the feet and ankles towards the evening, which, for
a time, disappears again in the morning. The tumefaction is soft
and inelastic, and when pressed upon by the finger, retains its
mark for some time, the skin becoming much paler than usual.
By degrees the swelling ascends, and occupies |. trunk of the
body; and at last even the face and eyelids appear full and bloat-
ed; the breathing then becomes difficult, | urine is small in
quantity, high colored, and deposites a reddish sediment; the
bowels are costive, the perspiration is much obstructed, the coun-
* This is the spongy texture between the skin and the muscles.
+Ascites. + Hydrothorax.

PRACTICE OF ME DICINE. 477
tenance yellow, and the thirst considerable. To these symptoms
succeed torpor, heaviness, a troublesome cough, and a slow fever.
In some cases the water oozes through the pores of the cuticle;
in others it raises the cuticle in small blisters; and sometimes the
skin, not allowing the water to escape through it, is compressed
and hardened, and at the same time so much distended as to
give the tumor a considerable degree of firmness.”
1949. Patients who have been bled copiously, or salivated
with mercury, are liable to this form of disease. The cells com-
posing the cellular membrane become debilitated, and lose their
elasticity, so that the water passes through them by the force of
gravity, and descends to the inferior parts of the body, where it
first accumulates. Hence the swelling of the feet and ankles,
as mentioned in the preceding paragraph.
1950. TREATMENT. In a severe case of dropsy, it is ne-
cessary to administer courses of medicine, repeating them once or
twice a week, as circumstances may require. This will invig-
orate the system, and increase the action of the absorbents, where-
by the dropsical fluid will be discharged from the system through
the appropriate channels, and its further accumulation prevented.
The perspiration during each course, should be as profuse as
possible; and the patient may advantageously remain for half an
hour or an hour in the vapor bath, taking some stimulating tea
internally, to keep a determination of blood to the surface of the
body, and dashing a tumbler-full of cold water over his person
occasionally, to prevent languor or ſaintness. Between the courses,
the spiced bitters should be taken before each meal, with one or
two doses of composition, or cayenne and bayberry, during the
day. (1667.) Injections should be employed as long as costive-
ness prevails; and the skin should be rubbed briskly every night
and morning with a coarse towel, or flesh brush. The diet
should be light and nourishing, avoiding those articles of food
which tend to constipate the bowels, or weaken the digestive
organs. (1680, et seq.)
1951. Diuretics are useful in dropsy, because they increase
the secretion of urine, and thereby diminish the amount of fluid in
the system. Among these, are cleavers, juniper berries, and
wild lettuce. (1227.) Dr. Thomson says he cured a patient by
giving a tea of the wild lettuce, without any other remedy. Cool
wort, though a good general diuretic, is of no service, I am told,
in dropsy. I have found the following preparation to answer a
very good purpose. Take of juniper berries, bruised or pounded,
a table-spoonful; poplar bark, cayenne, bayberry, and sculleap,
each a tea-spoonful; green lobelia, half a tea-spoonful, more or

478 PRACTICE OF MEDICINE.
less; boiling water a pint and a half. Steep, and sweeten to suit
the taste. This tea may be kept warm by the fire, and the whole
of it taken in the course of twenty four hours. Diuretics are
uncertain in their effects, however, and unless they produce a
free discharge of urine, should not be used.
1952. Four or five cayenne pills after each meal, will be
found beneficial. (1801.) Advantage is also derived from the
daily use of the vapor bath, between the courses, remaining in it
for half an hour, or an hour, as previously mentioned, so that the
!". may perspire freely. º. the bath, the surface should
e well rubbed with pepper sauce, vinegar and cayenne, (1531) or
the stimulating liniment. In dropsy of the abdomen, it should be
swathed with flannel, and moistened two or three times a day
with pepper sauce, or some other stimulating wash. -
1953. During convalescence, the hand bath (1455) should be
employed, to prevent a relapse.
1954. If the abdomen is greatly distended with fluid, and
there is no prospect of its removal through the medium of absorp-
tion, it is advisable, after two or three courses of medicine, to
perform the operation of tapping.” Before this is determined
upon, however, it should be ascertained whether there is any fluc-
tuation, for if the enlargement of the abdomen is owing to any
other cause than an accumulation of water, serious injury might be
done to the intestines, or some other organ in the abdominal
cavity. The usual mode of performing the operation, says Mr.
Castle, is to place the patient in a high chair, with a pail between
the knees, the operator sitting in a lower chair. A sheet is cross-
ed round the abdomen, the ends of which are held by an assist-
ant, who presses the sheet tightly on the abdomen. A puncture
is now made with a lancet two or three inches below the navel,
followed by the introduction of an instrument called a canula, to
evacuate the fluid. There is no danger of wounding the intes-
times, because they are attached to the spine by the mysentery,
(70) which confines them within certain limits. As soon as
the lancet meets with no further resistance, however, remarks
Dr. Cooper, it is not to be ". more deeply, without any
object, and with a possibility of injuring the viscera. If a canula
is not at hand, a female bougie may be employed. The puncture
is usually made with what is termed a trocar, but many surgeons
prefer an ordinary lancet. As the fluid escapes, the abdomen
should be tightly compressed with the sheet, or swooning and
convulsions may arise. The canula should be moved about in
* Paracentesis abdominis.

#: RACTICE OF MEDIC IN E. 479
various directions, to favor the escape of the fluid, and if the
current suddenly stops, a blunt instrument should be introduced
into the canula, to remove the obstruction. When the water is
completely evacuated, the lips of the wound should be pressed
together with the fingers, and retained in that position by strips of
adhesive plaster, applied transversely. The abdomen should then
be rubbed with pepper sauce, or rheumatic drops, and swaſhed
rather tightly with flannel. This done, a course of medicine
should be administered, to prevent the re-accumulation of fluid,
and repeated as often as occasion may require.
1955. If the operation of tapping is performed a second time,
the puncture should not be made in the same place, as the intes-
times sometimes form an adhesion at this point, and are in danger
of being wounded.
py's ENTERy.
1956. This disease is dependent on an acute inflammation of the
mucous membrane of the colon and rectum, and is known by the
name of fluº. It is often ushered in by a sense of lassitude, want
of appetite, sickness at the stomach, and slight chills alternating
with flushes of heat. These symptoms are succeeded by griping
stools, which consist of mucus, or of mucus streaked with blood,
and sometimes pure blood is discharged. The natural feces are
either retained, or evacuated in small, round masses, denominated
scybala. In some cases the stools resemble the washings of meat,
and are highly fetid. The patient has a constant desire to go to
stool, and is harrassed with an inclination to strain, which does
not afford any relief. The skin is hot and dry, and the tongue
covered with a white, or brown coat. As the disease advances,
a fixed pain or soreness is felt in the bowels, which is increased
by pressure. The thirst is more urgent, the ſever more violent,
the urine scanty and high colored, and the evacuations extremely
offensive. There is also great diminution of strength. The
liver is torpid or inactive, as is evinced by the absence of bile
from the stools. The bowels are frequently distended with wind,
so that on striking the abdomen, it sounds like a drum. Shreds
or patches of false membrane are sometimes passed in the alvine
discharges. -
1957. “In protracted and unsubdued cases,” says Dr. Eb-
erle, “great prostration ensues; the pulse becomes small, corded,
and very frequent; the countenance cadaverous; the abdomen
tender, elastic, and sometimes flat; the skin harsh and shrunk;
the breath offensive; the gums tender and swollen; the stools


480 PRACTICE OF MEDICINE.
liquid and dark colored; the extremities cold; and the surface of
the body moist and clammy.”
1958. Dysentery occurs most commonly in summer and
autumn, and is produced by unripe fruits, indigestible food, ob-
structed perspiration, vitiated bile, and a variety of similar causes.
In some instances it appears to depend on a peculiar state of the
atmosphere, for we find it prevailing to a great extent in particular
neighborhoods, without any other assignable cause. A medical
writer says, “The disease is much more prevalent in warm cli-
mates than in cold ones; and in the months of August, Septem-
ber, and October, which is the rainy season of the year in the
West Indies, it is apt to break out and become very general
among the negroes on the different plantations in the colonies.
The body having been rendered irritable by the great heat of
the summer, and being exposed suddenly to much moisture, with
open pores, the blood is thereby thrown from the exterior vessels
upon the interior, so as to give rise to dysentery.” -
1959. TREATMENT. In the forming stage of the disease, it
may be removed by the use of the dysentery sirup, or bayberry
tea and rheumatic drops, as recommended in the treatment of
diarrhºea. (1925.) If the disorder is fully established, however,
and threatens to be severe, or obstinate, courses of medicine
should be administered, repeating them every twelve, twenty four,
or forty eight hours, according to the violence of the symptoms.
This will counteract the undue determination of blood to the
bowels, rouse the liver into action, and enable the skin to perform
its functions in a healthy manner.
1960. Injections afford very great relief in this malady, and
as there is a constant accumulation of acrid or offending matter in
the bowels, they should be administered several times a day.
They should be carefully strained, however, or the sediment may
occasion tenesmus. (1568, 1573.) Where the bowels are cold
or torpid, as frequently happens, each injection should contain a
large tea-spoonful of cayenne. -
I The vapor bath is also an important remedy, as it recals
the blood to the surface, and tends to equalize the circulation.
1962. If the bowels are swelled, or tender on pressure, they
should be bathed with rheumatic drops, or vinegar and cayenne;
(1531) or a flannel moistened with either of these liquids, may be
spread over the abdomen.
1963. The patient should be kept in a gentle perspiration
between the courses, and for this purpose a heated stone wrappe
in a damp cloth may be placed at the feet, and a free use made
of the stimulating tea, (1515) rendering it mucilaginous with slip-

PRACTICE OF MEDIC INE. 481
pery elm. The latter is particularly useful where the bowels are
in a high state of irritation.
1964. The diet should be strictly guarded, or it may be diffi-
cult to effect a cure. (See remarks on chronic diarrhoea in par-
agraph 1926.) The patient should confine himself entirely to
fluid nourishment, such as milk porridge, or the unbolted wheat
meal gruel. (1424.) During convalescence, the dysentery sirup
may be employed, together with the usual restorative medicines,
taking care not to overload the stomach, or eat indigestible food.
1965. Among the simple remedies which are beneficial in
dysentery, I would particularly mention the fleabane. (1104.)
It has cured obstinate cases, even after they have been abandoned
by the diplomatised physicians.
DYSPEPSIA OR INDIGESTION.
1966. This disease was scarcely known to our forefathers,
but owing to our luxurious habits, and the evil tendency of the
old school practice of physic, it is now one of the most fashion-
able maladies of the day. It usually commences in a slow and
gradual manner, giving the first warning of its approach by an
uneasy sensation in the stomach, especially after eating, accom-
panied with costiveness, thirst, cold hands and feet, and some-
times nausea and vomiting. These are succeeded by a long train
of symptoms, such as nervousness, flatulency, heartburn, water
brash, tenderness in the region of the stomach, chilliness, flushes
of heat, difficult breathing, rising of wind in the throat, flatulent
distention of the bowels, languor, despondency, palpitation of the
heart, dizziness, headach, imperfect vision, and burning sensation
in the hands and feet. The patient becomes restless, feeble, and
emaciated. The slightest morsel of food often causes him severe
distress, and he complains, not unfrequently, of pains darting from
the stomach to the spine or back bone. The bowels are some-
times costive, and at others loose. The tongue is red in some
cases, at others pale and glossy, and sometimes it is covered with
a white, or yellow coat.
1967. Among the various causes of dyspepsia, bloodletting
stands conspicuous. This fact is acknowledged by Professor
Chapman of the Pennsylvania University, and by some others of
the medical faculty. The food, it is well known, cannot be
digested without the requisite supply of gastric juice, (85) and as
this is a secretion from the blood, it must be diminished in pro-
H. as the material is diminished from which it is derived.
ence the frequent occurrence of dyspepsia in those who have




61 -
482 PRACTICE Of MEDICINE.
been copiously bled. Among other causes of the malady, I may
mention intemperance in eating, the use of spirituous liquors,
very hot or very cold drinks, despondency, sedentary habits,
and the use of medical poisons, particularly arsenic, antimony,
aqua ſortis, and the oil of vitriol, all of which are frequently em-
ployed by the diplomatised physicians.
1968. TREATMENT. Most cases of dyspepsia may be cured
by close attention to diet, (1680, et seq.) exercise in the open air,
(1709, et seq.) and the use of the hand bath every morning upon
rising from bed. (1455.) The fine wheat bread should be
entirely discarded as an article of food, and that made of the unbolt-
ed wheat meal used in its stead. (1181, et seq.) This will regu-
late the bowels, and procure natural stools, which is of the utmost
importance in dyspeptic affections. For further information on
this subject, see paragraph 1898, and those which follow, under
the head of costiveness.
1969. No more food should be taken at a meal than will
digest, no matter how small the quantity; or it will excite unpleas-
ant sensations, and protract the period of recovery. Butter, and
animal fats of every description, are injurious, and should be
avoided. If the patient is not disposed to use the hand bath, as
recommended above, he should not fail to rub himself every night
and morning with a coarse towel, or flesh brush, until his skin is
in a glow. The feet should be kept warm and dry, and the
clothing regulated according to the season and climate. If food
has been incautiously eaten which occasions distress, it should be
immediately followed by a dose of spiced bitters, cayenne pills,
or a tea-spoonful or more of rheumatic drops, in half a wine-
glassful of sweetened water.
1970. In acidity of the stomach, it is a common practice to
use alkalies, such as pearlash, and sal aeratus, but these irritate
the organ, and at best afford only temporary relief. The bicar-
bonate of soda, however, is less objectionable as an alkali, being
free from irritating properties, and may be taken in the dose of a
level tea-spoonful, dissolving it in a tea-cupful of warm water,
or composition tea, when the stomach is extremely sour. The
i. object should be, however, to restore the stomach to a
ealthy tone, so that it will cease to generate acid.
1971. The spiced bitters may be taken two or three times a
day, and a dose of composition, or cayenne and bayberry, at bed
time. If the patient is not confined to the house, the bitters should
be mixed with cold water, and taken in substance, (1247) unless
the powder irritates the stomach. Composition prepared in the
same way is also beneficial. (1243.) I have found the alter-

PRACTICE OF MEDICINE. 483
-
ative mixture (1526) to answer an excellent purpose in dyspeptic
complaints.
1972. If the case is obstinate, or the health very much im-
paired, a few courses of medicine should be administered.
1973. The daily use of Ramadge’s tube, as directed for con-
sumptive patients, (1877, et seq.) has accomplished wonders in
the treatment of dyspepsia. I am informed that a certain medical
man, who professes to cure this malady, places his sole reliance
upon the use of this tube, and charges twenty dollars for his ad-
vice, which he requires his patients not to reveal. However
much I may be disposed to condemn this secresy, it is but just
to say that his patients are generally cured.
E.A.R.A.C.H.
1974. This is usually caused by inflammation in the ear, arising
from exposure to cold; as a sequel of the measles, scarlet fever, or
putrid sore throat, treated upon the antiphlogistic plan; or from
the introduction of some foreign body into the ear, such as an
insect, or a piece of stone, or glass. The pain is usually intense,
and in some cases, convulsions have ensued. If the inflammation
is not subdued, ulceration follows, succeeded by a discharge of
yellowish, somewhat bloody, and very offensive matter. The
small bones of the ear are sometimes involved in the ulceration,
and fragments of them occasionally come away. This is more
particularly the case where the system has been poisoned with
mercury.
1975. TREATMENT. A dose or two of composition, and
the application of heated stones wrapped in damp cloths to the
feet and sides, so as to produce a perspiration, will often afford
relief. Half a tea-spoonful of the warm infusion of lobelia, or an
infusion of raspberry leaves, rendered slightly pungent with rheu-
matic drops, may be poured into the ear. The stimulating tea,
(1515) containing, as it does, a small portion of "..." gen-
erally allay the pain, if taken in the dose of a table-spoonful every
five, ten, or fifteen minutes. Relief is often obtained by covering
the head with a blanket, and holding it over a basin of water, into
which heated stones are partially immersed to generate vapor;
or a heated stone wrapped in a damp cloth, and wetted with vin-
egar, may be placed at the side of the head, in bed. The ear
should be closed with a piece of raw cotton, moistened with rheu-
matic drops, or antispasmodic tincture, to exclude the air.
1976. Worms sometimes breed in the ear, causing a great


484 * 0 F MEDICINE.
deal of distress, and in such case the ear should be syringed sev-
eral times a day with a tea of raspberry, witch hazel, or any other
mild astringent, adding rheumatic drops as they can be borne.
1977. In severe or obstinate cases of earach, it is advisable
to administer a course of medicine.
EPILEPSY OR FALLING SICKNESS.
1978. In this disease, the individual falls down suddenly, and
becomes convulsed, and insensible. In somes cases the attack
occurs without any warning, but in others it is ushered in by pre-
monitory symptoms, such as giddiness, ringing noise in the ears,
dimness of sight, and confusion of ideas. Sometimes an attack is
denoted by a creeping sensation in the feet and legs, resembling a
stream or current of cold air, which rises suddenly to the brain, and
is followed by a loss of sense and voluntary motion. I knew an
epileptic patient who always experienced this sensation in his foot,
just before being seized with the convulsions. By distending the
affected limb, however, and pressing down forcibly upon the
knee, he often succeeded in preventing a paroxysm.
1979. The fit may last only a few minutes, or it may be pro-
longed for an hour. In the meantime the body is convulsed, the
face frightfully distorted, the breathing hurried and laborious, the
tongue protruded, and a quantity of frothy saliva collected about
the mouth. The eyes roll about wildly in their sockets, and at
length become permanently fixed. The face is sometimes pale,
and at others of a purple or livid color. The body is alternately
stiff and relaxed. The tongue is often caught between the teeth,
and severely wounded. In some cases, several fits succeed each
other in rapid succession, and after the final paroxysm, the patient
may return at once to consciousness, or he may continue in a
drowsy or stupid state for several hours. In some instances,
where the disease has been of long continuance, the convulsions
are so violent as to terminate in death.
1980. The attacks usually occur at night, during sleep. The
intervals at which they return, are various. The patient may
have two or three paroxysms in a day, or he may not have more
than that number in a year. If frequent, they injure or destroy
the mental powers, terminating in some cases in complete idiocy.
1981. Among the causes of epilepsy, are, injuries about the
head, use of alcoholic drinks, excessive venereal indulgence, vehe-
ment emotions, terror, dropsy of the brain, repelled cutaneous
eruptions, worms, irritating substances in the bowels, painful teeth-
ing, and suppression of the monthly evacuations.
PRACTICE OF MEDICINE. 485
1952. TREATMENT. During the epileptic fit, the patient
should be prevented from injuring himself by his struggles; and
if his tongue is protruded, a piece of wood, or roll of cotton,
should be placed between the teeth, to prevent it from being
wounded. The head and shoulders should be elevated, as in apo-
plexy, and every thing removed from the neck which is liable to
compress the veins. If the patient is a female, her dress should be
loosened about the waist. If the fit does not immediately subside,
the antispasmodic tincture may be given in the dose of two or three
tea-spoonfuls, and the same treatment pursued which is recom-
mended under the head of convulsions. (1888, et seq.) Frictions
of the skin with pepper sauce, or vinegar and cayenne, (1531)
will also be beneficial.
1983. Epilepsy generally requires the administration of thor-
ough courses, and these may be administered once a week, or
oftener, attending meanwhile to the diet, (1680, et seq.) and other
intermediate treatment. (1667, et seq.) The patient should eat
the unbolted wheat bread, and subsist principally upon vegetable
food, avoiding the use of fat meat, butter, pastry, and all unwhole-
some mixtures. (1706.) The stomach should never be over-
loaded, as this, alone, is sometimes the cause of an epileptic at-
tack. If the bowels are costive, it will be necessary to administer
an injection once a day. The cold bath, in some form or other,
(1448, et seq.) should be used every morning, as this will serve
to invigorate the constitution. The lobelia pills, scullcap, or
alterative mixture, may be beneficially employed between the
courses, as a part of the intermediate treatment. Wormwood tea,
also, though disagreeable to people generally, is recommended by
those who have tried it, as a valuable remedy.
ERYSIPELAS.
1984. Erysipelas or St. Anthony’s fire consists of an inflam-
mation of the skin, which appears in a blotch of a deep red or
copper color, attended with more or less swelling, and a º:
or burning pain. These symptoms are usually preceded by lassi-
tude, chills and heats, loss of appetite, sickness at the stomach,
and pains in the head, neck, and back. The disease attacks all
parts of the body, but is most common on the face, and extremi-
ties. The inflammation is at first confined to a small spot, but it
gradually spreads to a greater or less extent over the surrounding
surface; and cases are mentioned by medical authors in which it
has covered the whole body. When the face is the seat of the
malady, the symptoms are mostly violent. The features are often

486 *RAºtice 0F MEDICINE.
much distorted, and the swelling so great as to close the eyelids.
Drowsiness, and a tendency to delirium, not unfrequently arise.
On the fourth or fifth day, blisters of different sizes make their
appearance on the inflamed surface, containing a clear and watery
fluid, which afterwards becomes of a straw color, and more or less
glutinous. In twenty four or forty eight hours the blisters break,
when the redness and swelling begin to subside, and the adjacent
cuticle peels off in the form of scales.
1985. In unfavorable cases, the inflamed surface assumes a
livid color, and the blisters are followed by obstinate ulcers. In
some instances collections of matter take place between the skin
and the muscles, which render the swelling soft and puffy, and
when the matter is discharged, it has the appearance of small
pieces of wet tow.
1986. Children and old people are more subject to erysipelas
than individuals in the middle period of life. It attacks females
more frequently than males. Sometimes it assumes the chronic
form, and returns every few weeks, or months. It is produced
by intemperance, living in damp places, sudden changes from heat
to cold, and irritating substances applied to the skin. Dr. Hall
says it is often the immediate effect of indigestible food. It fre-
quently prevails epidemically, especially in hot seasons, and in a
bad habit of body, is apt to terminate in gangrene.
1987. Tre ATMENT. In this, as in all diseases of the skin,
we should keep a determination to the surface of the body. The
bowels should be regulated with injections, and a tea of composi-
tion, or of cayenne and bayberry, administered to promote a gen-
tle perspiration. The stimulating tea (1515) will answer a still
better purpose. This, with a light vegetable diet, will be suffi-
cient to cure mild cases of the disease; but if the symptoms are
violent, it will be necessary to give a course of medicine, re-
peating it, at proper intervals, until the disorder is removed. . .
1988. The inflamed surface may be bathed º with
equal parts of sweet oil and the antispasmodic tincture, shaking
º together before the application is made; or a piece of
linen moistened with the liquid, may be laid upon the affected
art, extending somewhat beyond the margin of the inflammation.
his prevents the disease from diffusing itself over the adjoining
surface. If the part is very hot and painful, it may be sponged
occasionally with cold water, or cloths may be applied to it, as
recommended for burns and scalds, (1813) and frequently wetted
with cold water.
1989. If the blisters degenerate into ulcers, they should be
poulticed with slippery elm, adding a portion of ginger, if it can be


PRACTICE OF MEDICINE, 487
- be borne, and washing the sores at each renewal of the poultice
with soapsuds, followed by a tea of witch hazel, pond lily, or
some other mild astringent. If gangrene ensues, the yeast poul-
tice (1548) may be advantageously applied, using, at the same
time, the most active medicines internally.
ExCEssive, FLow of URINE.”
1990. The urine discharged in this disease generally has a
sweetish taste, and amounts in some cases to several quarts in a
day. The thirst is urgent, the appetite voracious, the skin dry,
and the stomach and bowels disordered. The tongue is sometimes
red, and at others covered with a white coat. The patient is fre-
quently troubled with heartburn, flatulency, oppression at the sto-
mach after eating, cold extremities, headach, and pain and weakness
in the loins. The copious discharges of urine are soon followed by
great debility, and emaciation. The memory is sometimes im-
paired. In the latter stages of the complaint the gums become
spongy, and the breath offensive, accompanied by difficulty of
breathing, and swelling of the feet and legs. The malady has
been known to continue for many years, although it frequently
destroys the patient in a few weeks. It is chiefly confined to
cold, damp climates, and is produced by gravel, venereal ex-
cesses, checked perspiration, and the use of cantharides, and
digitalis. -
1991. It is an admirable law of the animal economy, that
where one organ ceases to perform its function, another imme-
diately takes its place. For example, an individual may pass two
or three hours at an evening party, without any desire to evacuate
the bladder, because during that time, the skin is warm and active,
but as soon as he goes into the cold air, a check is given to the
perspiration, and he experiences an urgent desire to pass water.
Thus it is with the disease under consideration. The skin be-
- comes inactive, and the perspirable matter which should pass off
through the pores, is retained in the circulation, but by an increas-
ed action of the kidneys, it is discharged from the system. In
warm climates, such as the West Indies, the disease is scarcely
known, because the skin is not so liable to obstruction as in cold-
er climates.
1992. TREATMENT. Medicines should be given to produce
a perspiration, as this is the most effectual mode of controlling the
* Called in medical language, diabetes.


488 PRACTICE OF MEDICINE.
flow of urine. A tea of cayenne and bayberry, injections, the
vapor bath, and emetics, may all be used according to the urgency
of the case. If the disease is obstinate, courses of medicine will
be required, and in the interval the spiced bitters, or some other
tonic, should be freely employed to strengthen the digestive organs
and invigorate the general system. Diuretics (1227) are also
indispensable, as they serve to increase the tone of the kidneys.
I would particularly recommend the diuretic tea. (1516.) The
diet should be regulated, (1680, et seq.) and the skin well rubbed
every night and morning with a coarse towel, or flesh brush.
FAINTING.
1993. Fainting or swooning mostly comes on suddenly, and
is occasioned by loss of blood, violent emotions, severe pain,
disorder of the stomach and bowels, tight lacing, impure or con-
fined air, poisonous gases, and a variety of other causes. The
heart is weakened in its action, and does not propel the blood to
the surface; hence, the countenance becomes pale, and the ex-
tremities cold. The attack is often preceded by giddiness, and
confusion of ideas, and occasionally terminates in vomiting.
1994. TREATMENT. The individual should be placed in a
recumbent position, so as to favor the return of blood to the brain,
and in most cases he will regain his consciousness in two or three
minutes. His face may be sprinkled with cold water, a free
current of air admitted to his person, and strong vinegar, tincture
of camphor, or smelling salts applied to his nostrils. If the patient
is a female, the dress should be loosened about the waist. If the
recovery is protracted, the same routine of treatment may be
employed which is recommended for suspended animation. See
index.
FALLING OF THE FUNDAMENT.
1995. This is a protrusion or falling of the inner membrane
of the rectum, from debility or relaxation of the parts. It is more
troublesome than dangerous, and has become very common since
the introduction of Brandreth's pills. It is often to be met within
children. The use of purgatives greatly increases the difficulty,
so that the slightest straining will cause a protrusion; and iſ the
part is not returned in due season, it will become painful, swollen,
and inflamed.



PRACTICE 0 F MEDICINE. 489
1996. TREATMENT. The loose membrane will sometimes
return without artificial assistance; but if this is not the case, it
should be pushed up gently with the fingers, previously smearing
them with lard, or sweet oil. Washing the part with a warm tea
of raspberry, witch hazel, or sumach leaves, will prove of service.
In severe cases, it may be necessary to administer the vapor bath
and an emetic, before the membrane can be replaced.
1997. Injections two or three times a day will be found useful
in this complaint, as they strengthen the debilitated parts; and
special care should be taken to obviate costiveness. (1896, et seq.)
FEL ON AND WHITLOW.
1998. A felon has its seat in the periosteum or membrane which
covers the bones, and usually makes its appearance about the
finger joints. A whitlow is similar to a felon, but is not so deeply
seated. It is formed under the skin, but does not extend to the
bone. It is often situated at the root of the finger nail, and is
familiarly termed a run-round.
1999. TREATMENT. Felons and whitlows are both very
painful, inasmuch as the skin does not readily yield to the swel-
ling. It is necessary therefore, to give vent to the pus or matter
by an incision with a lancet, cutting down to the part affected;
and this is particularly desirable in felons, as the bone may be-
come diseased, and the finger joint be destroyed. Instead of an
incision with a lancet, Dr. Thomson recommends the following
plan of treatment, a knowledge of which he derived from the In-
dians. Take a piece of punk the size of a pea, and burn it on
the affected part, covering the other portions of the finger with a
cloth or napkin wetted with cold water. The burning may be
repeated, if necessary; and the pain, it is said, is very slight. As
soon as the vitality of the skin is destroyed, it is to be punctured
with a needle, slightly elevated, and a small portion of it cut away,
so that the pus may escape. This accomplished, the elm and
ginger poultice (1543) may be applied as in any other sore.
2000. Those who prefer that a felon or whitlow should take
its course, without having either of the above trivial operations
performed, may subdue the pain in some measure by the applica-
tion of poultices, containing a portion of cayenne and lobelia,
which will soften and relax the skin, and enable it to yield more
readily to the swelling. At the same time the stimulating tea
(1515) should be taken internally, to quiet the nerves, and keep
up a gentle perspiration.
62
490 PRACTICE OF MEDICINE.
FRACTURES.
2001. When a bone is broken, it is termed a fracture, and it
may be either simple or compound, according to the nature of the
accident. “If the bone is broken in two or more pieces,” says
Sir Astley Cooper, “and there is not an external wound com-
municating with the fractured ends of the bone, the fracture is
still called simple; on the other hand, if the bone is broken in
but one place, and there is an outward wound, the accident is
called a compound fracture. Large wounds may occur at the
same time with fractures, but unless these communicate with the
bone, they are not called compound fractures.
2002. “Fractures are, likewise, said to be complicated,
when they are attended with diseases, or accidents, which render
the indications in the treatment more numerous, and require sun-
dry operations for the accomplishment of the cure. Thus, frac-
tures may be complicated with severe degrees of contusion,
wounds of the soft parts, injury of large blood-vessels, a disloca-
tion, or diseases, and particular states of the constitution, as the
scurvy, and rickets, which are said to retard the formation of
callus, and render the cure more backward.”
2003. Fractures are also distinguished into longitudinal,
transverse, and oblique, according to the direction in which they
n.
2004. Bones sometimes break without any assignable cause,
as happens now and then in particular diseases, and when they
become brittle or rotten from the effects of mercury. I saw a
patient in the Massachusetts General Hospital, who broke his
thigh bone by simply turning in bed. -
2005. When a bone is fractured, it is indicated by pain,
swelling, more or less distortion, and a grating sound when the
broken ends are rubbed together. This crepitus or grating how-
ever, is sometimes heard in dislocations, as mentioned heretofore.
(1927.) If the accident happens to one of the extremities, the
individual loses his control over the limb. If the thigh bone is
broken, the contraction of the muscles is so great that the limb
becomes almost immediately shortened, but in the leg, or forearm,
where there are two bones, and only one of them fractured,
shortening does not take place, because the sound bone keeps up
the necessary degree of extension.
2006. “The symptoms of fractures,” says Dr. Samuel
Cooper, “are exceedingly various, according to the bones which
are broken; and though most writers have indiscriminately men-
tioned loss of motion in the injured limb, deformity, swelling,

PRACTICE OF MEDICINE. 491
tension, pain, etc., as forming the distinguishing marks, yet it is
apparent to any one acquainted with the structure of the body,
that fractures cannot always prevent the motion of the part,
or occasion outward deformity; and every surgeon must know,
that though at first there may be pain in the situation of a fracture,
no swelling and tension take place till after a certain period.
When therefore a limb is broken, and the event is not manifest
from the distortion of the part, it is proper to trace with the fin-
gers the outlines of the suspected bone, and whenever any unu-
sual pain occurs, or any unnatural irregularity appears, to try if
no grating or crepitus can be felt on endeavoring to make one end
of the bone rub against the other. When the thigh, or arm bone
is the subject of injury, a crepitus is felt almost as soon as the
limb is touched, and in case of the thigh, there is considerable
shortening of the extremity, unless the fracture be of the trans-
verse kind. But when there are two bones, as in the leg, and
forearm, and any one is broken, the other continues to prevent
the limb from being shortened and thrown out of its natural shape,
so that a crepitus can only be felt by a proper examination with
the fingers. I am aware that considerable harm, and great un-
necessary pain, have been occasioned in the practice of surgery
by an over-officious care to feel the grating of fractured bones,
and whenever the case is sufficiently evident to the eyes, I cannot
refrain from censuring those practitioners who indulge their ill-
judged habits at the expense of torture to the unfortunate patient.
A fracture is an injury which is necessarily attended with consid-
erable pain, and followed by a great deal of tension, and to in-
crease these evils by rough handling of the part, is above all things
cruel.
2007. “In cases of fractures, the muscles of the limb are
often affected with involuntary spasms, which put the patient in
great pain, and when the thigh bone, arm bone, or both bones of
the leg, or forearm are broken, occasion great distortion while
the violence of the spasm continues.”
2008. The plan which nature adopts in repairing a broken
bone is this. In four or five days after the accident, matter is
thrown out from the fractured ends, which is soft and of a jelly-
like consistence at first, but gradually hardens into bone, and
unites the two ends firmly together. The new bone forms an
enlargement at the point of union, and is termed a callus. The
time required for bones to unite, is influenced by circumstances.
In children the union is more speedy than in adults. The usual
period, however, is from three to five weeks. If the health is
much impaired, the process is retarded, and in the practice of the
diplomatised physicians, a year has elapsed without any union


492 PRACTICE OF MEDICINE.
taking place. The limb must be kept perfectly still, especially
after the expiration of four or five days, or the matter which is
thrown out, will fail to cement the fractured ends.
2009. The method of relaxing the muscles previous to set-
ting a bone, or in other words, bringing its fractured ends into
contact, is precisely the same as that recommended in the treat-
ment of dislocations, to which the reader is referred. (1993.)
By pursuing this plan, the bone may be restored to its natural
position with comparative ease, and with but little pain or suffer-
ing to the patient.
2010. The ends of the broken bone being restored to their
natural situation, the limb, as I have said, should be kept at rest
until a union takes place, selecting that position in which there is
the greatest relaxation of the muscles which would be most likely
to displace the bone. “The position which relaxes the flew or
muscles, however,” says Dr. S. Cooper, “has quite an opposite
effect upon the extensors. * The answer is, that no posture will
completely relax every set of muscles, in every instance; and
in this case, the joints must be placed in the middle state, be-
tween perfect flexion and perfect extension, as in this manner,
though complete relaxation is not effected, most of the muscles
will not be in the state of tension. When, however, every mus-
cle having the power to displace a fracture can be relaxed, the
others, which have no power over the progress of the case, may
be neglected, and the posture determined accordingly. Thus,
in fracture of the thigh, where we cannot perfectly relax every
muscle capable of disturbing the fracture, we place the hip and
knee joints in the mid state between perfect flexion and extension;
in the fracture of the patella, where we can relax every muscle
which can resist the .. of the surgeon, we regulate the pos-
ture without any regard to muscles which have no influence over
the fracture.”
2011. The fractured limb is usually encased in thin, narrow
pieces of wood or splints, extending beyond the two joints nearest
the fracture, and fastened with tape, or strips of linen, interposing
some soft substance between the wood and the skin, to prevent the
latter from being chaſed. Raw cotton, or soft padding of any de-
scription, will answer the purpose. The number of splints must
vary according to the size of the limb. Two are generally suffi-
cient for the arm, and three or four for the thigh. Thick paste-
board softened in water, is sometimes used, and when it becomes
dry, forms a very solid casing. It has the advantage of being easi-
* The flexor muscles bend a limb, and the extensors straighten it. See
paragraph 24.
PRACTICE OF MEDICINE, 493
- -
ly moulded to the limb. A box open on one side is sometimes
employed to keep the limb in its requisite position.
2012. In an oblique fracture, the two surfaces of the broken
bone should be kept closely in contact, or the ends may overlap
in consequence of the contraction of the muscles, and produce
a permanent shortening of the limb.
2013. “Oblique fractures,” says Sir Astley Cooper, “are
more troublesome, and difficult of cure, than transverse ones, be-
cause an oblique surface does not resist the retraction of the lower
portion of the broken bone; and consequently, it is very difficult to
keep the ends of the fracture duly applied to each other. When
the callus has acquired some firmness, the patient should still keep
the part or limb quiet, until the union is perfectly consolidated.
In fractures of the lower extremities, even after the union has pro-
ceeded so far that the splints admit of being left off, the patient
ought not to venture out of bed, or bear upon the limb, till several
more days have elapsed.”
2014. The treatment of a compound fracture, says Dr S.
Cooper, is similar to that of a simple one, excepting that a more
rigorous attention to quietude is necessary on the part of the pa-
tient, and more vigilant care on the part of the surgeon. The
limb must, as in the simple fracture, be placed in a relaxed posi-
tion ; the fracture, if displaced, must be reduced as speedily as
possible, the lips of the wound brought into contact with adhesive
plaster, and the limb secured with splints, as already directed. If
pieces of bone are discovered, they should be carefully removed.
If the wound becomes hot and painful, it should be wetted occa-
sionally with cold water, which will prevent an undue flow of blood
into the vessels of the injured part. (1942.) The rheumatic drops,
or tincture of balm of Gilead buds, (1039) either pure, or di-
luted with water, may be applied several times a day with great
advantage. In the event of suppuration—that is, the formation of
matter—poultices must be employed, as in any other wound or
sore, taking care not to disturb the fracture any more than can be
avoided.
2015. If an important artery is wounded, it must be secured
with a ligature, which cannot be accomplished very well excepting
by those who are acquainted with the anatomy of the parts, and
possess an adequate degree of surgical knowledge. Sir Astley
Cooper says, “it was formerly the practice to amputate in com-
pound fractures, whenever any vessel of importance was wounded,
under the supposition that the injury could not be repaired, and
that gangrené would in all probability happen ; but I have seen
so many limbs saved, even when the principal artery going to the


494 PRACTICE OF MEDICINE.
limb has been torn, that I am induced by experience to adopt a dif-
ferent plan.”
2016. If a bone protrudes through the soft parts, and is covered
with dirt or gravel, it should be washed clean before it is replaced.
2017. While the bone is uniting, the process should be aided
by a careful attention to the health, for if the body is diseased, re-
covery from the injury will be more or less retarded. The diet
should be light, and easy of digestion, and medicines employed
according to the nature or urgency of the symptoms. If proper
treatment was resorted to in cases of fracture, many a limb would
be saved which is now amputated by the surgeon. Composition
tea should be given sufficiently often to keep the skin moist, and
maintain the equilibrium of the circulation. This will allay the
pain in the injured part, and prevent the developement of inflamma-
tion; or if it should be insufficient, the stimulating tea (1515)
may be employed. The latter is also particularly beneficial in case
of any spasmodic action of the muscles. If the stomach is disor-
dered, it should be cleansed with an emetic of lobelia; or it may
be necessary to administer a thorough course of medicine. If the
bowels are confined, injections should be given. I would advise
the patient to make use of the unbolted wheat bread, or wheat
jelly, (1435) as an article of diet.
2018. With regard to amputation, it is frequently resorted to
unnecessarily, and almost as frequently contributes to a fatal termi-
nation. Dr. Warren, professor of surgery in Harvard University,
remarked, in one of his lectures, “it has been frequently stated,
that out of fifty amputations in one of the greatest hospitals in Paris,
forty eight proved fatal. I doubted this assertion, and took occa-
sion when in Paris, to make enquiry of persons connected with
the hospital, on the subject, and every one told me the same story.”
Amputation, therefore, appears to be a dangerous experiment;
whereas if proper treatment were instituted, so as to prevent any
sinking or prostration of the vital powers, the life of the patient, as
well as the injured limb, would generally be saved.
GIDDIN ESS OR WERTIGO.
2019. Whatever disturbs the balance of the circulation, has a
tendency to produce giddiness; hence it may result from too great
a quantity of blood in the head, as in inflammation; or from a de-
ficiency, as in hemorrhage, or depletion by the lancet. Among
its exciting causes may be enumerated intemperance in eating,
drunkenness, a costive state of the bowels, and excessive indul-
gence in sexual intercourse. It is likewise produced by looking
-
PRACTICE OF MEDICINE. 495
down from a great height; by the motion of a ship at sea; by
running round for some time in a circle; and in some instances,
by suddenly rising out of a recumbent posture.
2020. TREATMENT. Relief may be generally obtained by
the use of composition to equalize the circulation, and spiced bit-
ters, or some other tonic, to invigorate the digestive organs. If
the stomach is much disordered, an emetic of lobelia will be ne-
cessary. If the malady is connected with a costive state of the
bowels, as is generally the case, an injection once or twice a day
will be particularly serviceable. (See treatment in costiveness—
1896, et seq.) The skin should be rubbed night and morning
with a coarse towel, or flesh brush, the diet regulated, (1680, et
seq.) and tea, coffee, rich gravies, superfine flour bread, butter,
and all animal fats, scrupulously avoided.
G0NO RRHCEA.
2021. Gomorrhoea or clap is an inflammation of the urethra,
which arises in from one to fifteen days after impure sexual inter-
course. It commences with an itching or tingling sensation in the
part, followed by burning or scalding pain on passing water, and a
discharge of thin, whitish matter, which gradually increases in
quantity, becomes more thick, and assumes a yellow, or greenish
color, being occasionally streaked with blood. -
2022. The individual is tormented with painful erections, es-
pecially at night, while in bed, and the penis is sometimes drawn
into the form of a curve, which surgeons distinguish by the name
of chordee. The pain in such case is very severe, and is occa-
sionally attended by a discharge of blood.
2023. The disease is generally local, being limited to an inch,
or an inch and a half of the urethra, but sometimes it extends to
the bladder, which becomes very sore or irritable, and the water
is passed in a small stream, or perhaps in drops, causing the most
acute pain and suffering. The testicles and groins are liable to
swell, and become inflamed, attended by an uneasy or burning
sensation in the rectum.
2024. In consequence of inflammation, the prepuce or fore-
skin often becomes so swelled that it cannot be drawn back; or if
drawn back, may become constricted so that it cannot be returned,
forming a tight ligature round the penis.
2025. The disease is generally much less severe in females
than in males. Indeed, the former often experience no other than
a slight inconvenience. A woman afflicted with fluor albus, is


496 PRACTICE OF MEDICINE.
sometimes supposed to have gonorrhoea, and instances occur in
which she communicates a similar disease to her husband, who
may entertain an unjust suspicion of her virtue. “The surest
way,” says a medical writer, “ of forming a correct conclusion,
in instances of this nature, will be to draw it from an accurate in-
vestigation, both of the symptoms which are present and those
which have preceded the discharge; as likewise from the concur-
ring circumstances, such as the character and mode of life of the
person, and the probability there may be of her having had vene-
real infection conveyed to her by an illicit connexion.”
2026. When gonorrhoea is treated in an improper manner, it
is often followed by a thin, slimy discharge from the urethra, which
has received the name of gleet. The discharge may continue for
months, and even years. It does not only arise as a sequel of
gonorrhoea, but is excited by injuries, and a too free indulgence in
sexual intercourse.
2027. THEATMENT. Gonorrhoea, in the forming stage, may
often be cured by taking a dose of spiced bitters three or four times
a day, and a tea-cupful of strong bayberry tea at bed time. A tea-
spoon-ſul of rheumatic drops should be added to each dose of the
medicine. The diet should be light, and easy of digestion, con-
sisting principally of vegetable food. Beer, wine, and alcohol in
all its forms, must be avoided. If the bowels are confined, they
should be regulated according to the directions under the head of
costiveness. (1896, et seq.) -
2028. Dr. Comfort of Philadelphia, recommends the following
plan of treatment, which, he informs me, will usually effect a cure
in six or eight days. Take of bayberry four table-spoonfuls ; the
dust or powder of sumach berries one table-spoonful; cayenne a
tea-spoonful and a half; mix, and take a large tea-spoonful of the
powder three or four times a day, steeping it in a tea-cupful of
boiling water, and adding sugar to suit the taste. Ten, fifteen, or
twenty drops of the tincture of lobelia should also be taken every
hour or two during the day, on loaf sugar.
2029. The alterative mixture (1526) is useful in gonorrhoea,
and will sometimes effect a cure without any other remedy. As
much of it should be taken as possible, without producing an
unpleasant degree of nausea.
2030. Injections into the urethra before the inflammation be:
comes very active, or after it has been subdued, will be found of
signal benefit. They may consist of an infusion of raspberry,
witch hazel, sumach, or any of the astringents, rendered pungent
by the addition of rheumatic drops. They should be milk warm,
and administered immediately after passing urine. (813.)
PRACTICE OF MEDICINE. 497
2031. The parts should be washed once or twice a day, so
as to keep them perfectly clean, and care must be taken that the
matter discharged does not come in contact with the eyes.
2032. The chordee, as it is termed, may be greatly relieved
by drinking freely of scullcap tea, or a tea of composition con-
taining a small portion of lobelia.
2033. In swelling and inflammation of the penis, testicles, or
groins, a local application of vapor should be made in some con-
venient manner, and the parts, excepting those which are partic-
ularly sensitive, bathed with the volatile liniment, or other stimu-
lating wash. (1499.)
2034. It is not necessary to administer a course of medicine
in this disease, unless the health is very much impaired.
2035. In the treatment of females, injections per vaginam
should be employed three or four times a day. They may be
prepared as already directed, or consist exclusively of bayberry
tea. The latter answers an excellent purpose.
2036. The treatment recommended in gonorrhoea, is equally
applicable in gleet. In the latter disease, injections into the
urethra are particularly demanded.
GOUT.
2037. This disease comes on in fits or paroxysms, and some-
times without any warning, but in most cases its approach is de-
noted by precursory symptoms, such as imperfect digestion,
acidity of the stomach, heartburn, flatulency, a confined state of the
bowels, drowsiness, numbness of the limbs, feverishness, debility,
and lowness of spirits. The attack generally commences with a
º in the ball of the great toe, or some other part of the foot,
ollowed by a hot and dry skin. The pain increases in severity, and
in a few hours the foot and lower part of the limb become swollen
and red, with considerable distention of the veins. The tender-
ness is so great that the patient can scarcely bear the weight of the
bed-clothes. There is high fever, loss of appetite, pain and
disorder of the bowels, burning sensation in the stomach, and
sometimes nausea and vomiting. The tongue is either red, or
covered with a white, or yellow coat.
2038. The attacks usually occur in the spring, or beginning of
the winter, and at first are generally a year or more apart, but as
the disease advances, and the constitution becomes impaired, they
are much more frequent.
2039. When a paroxysm terminates, the skin covering the
affected part occasionally peels off. In some instances the dis-

63

498 PRACTICE 0F MEDICINE.
ease disappears from one foot and is suddenly transferred to
the other.
2040. The gout may also attack the knee, hand, wrist, elbow,
and shoulders, and in some cases it recedes from the foot, and
fixes itself upon some internal organ, such as the brain, heart,
stomach, bowels, or kidneys, giving rise to various, and oftentimes
alarming symptoms.
2041. The gout rarely attacks the young. Tr. Hall says,
“it affects the male sex, and the intemperate principally, but by
no means exclusively. It is generally dependent on a deranged
state of the system, and especially of the stomach and bowels;
and frequently attends acute or protracted dyspepsia.” Indolent
habits, luxurious living, and a free indulgence in wine and other
fermented liquors, are fruitful sources of the malady.
2042. Chronic gout, as it is termed, is usually the result of
injudicious medical treatment. It consists, says Dr. Hall, who
should be regarded as very good authority in this matter, “of
permanent pain, swelling, weakness, deformity, and distortion of
the parts which have been repeatedly the seat of the acute dis-
ease, and especially of the hands and feet. There is great de-
rangement of the digestive organs, accompanied with a dry and
sallow skin, irritable temper, and more or less debility and emacia-
tion.
2043. Sydenham, speaking of the gout, remarked, “What is
a consolation to me, and may be to other gouty persons of small
fortunes and slender abilities, is, that kings, princes, generals,
admirals, philosophers, and several other great men, have thus
lived and died. In short, it may, in a more especial manner, be
affirmed of this disease, that it destroys more rich than poor
persons, and more wise men than fools.”
2044. TREATMENT. In a paroxysm of the gout—as it is
generally preceded by an affection of the stomach, and more or less
disorder of the general system—we should administer a course of
medicine, which will seldom fail to subdue the urgent symptoms,
and relieve the patient of his sufferings. The affected part may
be bathed frequently with rheumatic drops, antispasmodic tincture,
or a mixture of vinegar and cayenne; (1531) or a flannel moist-
ened with either of these liquids may be applied to the part.
After the course, the composition and spiced bitters may be used
several times a day, according to the necessity of the case, and
an injection given every twelve or twenty-four hours, to regu-
* Marshall Hall’s Practice of Medicine.
PRACTICE OF MEDICINE. 499
late the bowels. If the patient is nervous or irritable, a tea of
scullcap, or lady's slipper, containing a small portion of cayenne,
will be beneficial. Wine, brandy, and all alcoholic drinks, must
be scrupulously avoided. The diet should be light and chiefly
vegetable, always including the unbolted wheat bread as an article
of food. (See diet 1680, et seq.) The skin should be rubbed
every night and morning with a flesh brush, or coarse towel; and
the hand bath should also be used. (1455.) It may be necessary
to repeat the course several times, before a cure is effected.
2045. In mild cases of gout, relief may be often obtained by
the use of the stimulating tea, (1515) giving it until perspiration
enSues.
2046. The alterative mixture is beneficial in the intermediate
treatment of this disease.
2047. If the feet or hands are swelled, the Indian meal
poultice, or a fomentation of burdock, or mullein leaves, (1061,
1135) may be applied. The local application of vapor, rubbing
the part afterwards with rheumatic drops, or vinegar and cayenne,
as mentioned above, and wrapping it in a flannel moistened with
the same, will aid essentially in reducing the swelling and inflam-
mation.
GRAVEL AND STONE.
2048. By gravel is understood those small, sand-like concre-
tions, which form in the kidneys, and pass through the ureters
into the bladder, causing acute pain in the loins, numbness of the
thighs, and a retraction or drawing up of the testicles. The pain
is increased by exercise. Fainting and vomiting are sometimes
present. There is a frequent desire to pass water, which is small
in quantity, and generally of a red color. It * deposites a
brown or red sediment on standing. The gravel at length makes
its way into the bladder, and is discharged with the urine, which,
for the time, terminates the patient’s sufferings.
2049. The gravel sometimes lodges in the urethra, which
may be known by acute pain in the part, and retention of urine.
Previous to the swelling and inflammation which are apt to arise,
the stone may be felt by compressing the penis.
2050. Gall stones are hard bodies of various sizes which form
in the gall bladder. It does not appear that they cause any trouble
or uneasiness, as a general thing, unless they pass into the duct
leading from the gall bladder to the duodenum, (see Fig. 1, page
15,) and then they occasion the most excrutiating pain.
2051. By stone is understood a concretion in the kidneys, or


500 PRACTICE OF MEDICINE.
bladder, identical with gravel, but so large that it cannot be dis-
charged from the body without very great difficulty; and some-
times its dimensions are such as to put this entirely out of the
question.
2052. When a stone exists in the bladder, it is attended with
tenesmus, a frequent desire to pass water, an uneasy sensation in
the head of the penis, and severe pain in the lower part of the
abdomen. The urine is sometimes mixed with blood, and mucus.
It often comes away in drops, but if it flows in a full stream, it is
apt to be suddenly checked. The greatest pain is always expe-
rienced immediately after the discharge of urine.
2053. It is remarked by medical writers, that the gravel rare-
ly terminates in stone. -
2054. These painful maladies usually attack individuals in the
decline of life, and are intimately connected with disorder of the
digestive functions. They rarely prevail in warm climates, and
do not often trouble those who exercise in the open air, and avoid
a luxurious and sedentary life. This is remarkably exemplified
in the case of a merchant of one of the Hanseatic towns, related
by Magendie. The merchant in question “was possessed of a
considerable fortune, and in 1814 lived in an appropriate style,
keeping a very good table, of which he himself made no sparing
use. He was at this time troubled with the gravel. Some polit-
ical measures unexpectedly took place, which caused him the loss
of his whole fortune, and obliged him to take refuge in England,
where he passed nearly a year in a state bordering upon extreme
poverty, which obliged him to submit to numberless privations;
but his gravel disappeared. By degrees he succeeded in estab-
lishing his affairs; he resumed his old habits, and the gravel very
shortly began to return. A second reverse occasioned him once
more the loss of all he had acquired. He went to France almost
without the means of subsistence, when his diet being in propor-
tion to his exhausted resources, the gravel a second time van-
ished. Again his industry restored him to comfortable circum-
stances; again he indulged in the pleasures of the table, and had
to pay the tax of his old complaint.”
2055. Gravel and stone are formed from the impurities or
sediment of the urine, which, like the blood, and other fluids of
the body, becomes unhealthy in consequence of a disordered state
of the general system. -
2056. TREATMENT. TXiuretics and mucilages may be freely -
and usefully employed in these complaints. Of the former, I
would particularly recommend cool wort. The tincture of fir
balsam may be taken in the dose of a tea-spoonful three times a day,
PRACTICE OF MEDICINE. 501
with more or less benefit. I have found the following preparation
to be one of great value. Take of poplar bark, scullcap, and the
dust or powder of sumach berries each a tea-spoonful; green lo-
belia half a tea-spoonful; cool wort a handful; boiling water a
quart. Steep in a covered vessel, strain, add two tea-spoonfuls of
powdered slippery elm, and sweeten to suit the taste. This tea
may be drank freely during the day, keeping it warm by the fire.
It allays the pain which is experienced in passing water, and has a
soothing influence upon the whole system. The patient, in the
meantime, should not expose himself to a cold or damp atmos-
here.
p 2057. The excessive pain which is caused by the passage of
gravel from the kidney to the bladder, may be relieved by the
vapor bath, and an emetic of lobelia. Injections containing lobe-
lia are also important. If the case is urgent, a full course of
medicine should be given. Flannels wrung out of hot rheumatic
drops, or a mixture of vinegar and cayenne, (1531) may be ap-
plied externally to the region of the pain, together with a heated
stone or bottle of hot water wrapped in a damp cloth. The
lobelia is particularly useful, because, by its relaxing influence, it
diminishes the pain, and facilitates the passage of the gravel.
The same treatment is requisite in case a gall stone is lodged in
the gall duct; and the mechanical action of vomiting aids essen-
tially in promoting its discharge into the intestines.
2058. The practice of injecting fluids into the bladder to dis-
solve the stone, is now generally abandoned, for it was found,
with a few exceptions, to be unsuccessful, and often occasioned
irritation, or inflammation of the organ. The stone may attain a
large size without necessarily proving fatal, or even causing any
inconvenience, provided the individual is careful of his diet, and
adopts the necessary precautions to keep his system in a healthy
and vigorous state.
HEAD ACH.
2059. Headach is produced by a variety of causes, such as
severe study, menstrual irregularities, disorders of the womb, a
determination of blood to the head, and a deranged condition of
the stomach and bowels. Persons often complain of it after a
profuse diarrhoea, or excessive depletion by the lancet. In fe-
males, it is frequently occasioned by costiveness. If headach
arises a short time after eating, we usually refer it to disorder of
the stomach, but if not until an hour or two has elapsed, we infer
that it is caused by an affection of the bowels. The pain may be


either dull, vehement, or throbbing. Sometimes every part of the
head is affected, while at others the pain is confined to the fore-
head, side of the head, or perhaps to a still more circumscribed
portion. The most distressing form of the disease, is what is
termed sick headach, which not unfrequently harrasses the patient
for many years, and at last terminates in death. It comes on in
paroxysms, which last from two to twenty four hours, and are
sometimes accompanied with vomiting.
2060. TREATMENT: Relieſ may be often obtained by sitting
near the fire, covered with a blanket, and taking composition suffi-
cient to produce a perspiration. If the bowels are costive, an in-
jection is indispensable. The digestive organs should be strength-
ened by spiced bitters, or some other tonic, taken two or three
times a day; and if the system is cold, chilly, or inactive, cayenne
and bayberry should be employed, particularly at bed time.
2061. One of the best remedies, however, is an emetic of lo-
belia, which will generally afford entire relief, unless the disease
is obstinate, or of long standing, and then a few courses of medi-
cine will be required.
2062. The headach snuff is serviceable in many instances.
2063. Where headach is the result of costiveness, the reme-
dies should be employed which are recommended under that head.
(1896, et seq.)
2064. Sick headach may generally be cured by a regulated
diet, and the use of the hand bath every morning. (1680, et seq.)
I have adopted this treatment in a great many cases, and never
knew it to fail in producing the desired results. I may further
add, that I never knew an individual who subsisted entirely upon
vegetable food, and bathed himself every morning in cold water,
to be troubled with the malady.
HEARTBURN.
2065. This consists of a distressing and gnawing pain in the
stomach, accompanied with sour eructations, nausea, and some-
times fainting. It is a common symptom of dyspepsia. The
food being imperfectly digested, it gives rise to a superabundance
of acid in the stomach, together with an accumulation of wind.
Some women suffer almost constantly with the heartburn during
pregnancy, but it generally disappears soon after delivery. It is
caused by improper food, overeating, very hot or very cold drinks,
fat meat, butter, cheese, wine, ardent spirits, and whatever produ-
ces weakness or disorder of the digestive organs.

PRACTICE OF MEDICINE. 503
2066. TREATMENT. Besides temperance in eating and drink-
ing, regularity in meals, and the selection of food that will not
oppress or irritate the stomach, all of which are highly important,
a cure is to be effected by the use of spiced bitters, or some
other tonic, two or three times a day, and a dose of composition,
or cayenne and bayberry, on going to bed. Slippery elm, or any
other mucilage, is soothing to the stomach, and may be used freely.
The alterative mixture may be employed with great advantage in
heartburn. Alkalies are sometimes used to give temporary relief,
º they do nothing towards accomplishing a permanent cure.
1970.)
HIP DISEASE.
2067. The seat of this painful affection is in the cup-like
cavity or socket which receives the head of the thigh bone. It is
caused by local injuries, the use of mercury, and exposure to
cold. It is common to children under fourteen years of age, and
often arises in persons of a scrofulous habit. It usually comes on
very gradually, beginning with slight debility and soreness in the
joint, especially after a long walk. Considerable pain, or uneasi-
ness is felt in the knee, even before an affection of the hip is
suspected. As the disease advances, the hip becomes exces-
sively painful, and the pain is increased by the slightest movement
of the limb, or by pressure over the affected joint. The leg and
thigh begin to waste away, and the buttocks lose their rounded
form, becoming more or less flattened. At first there is a re-
markable lengthening of the limb, but after awhile it becomes
shorter than the other, having the toes turned inward. Sometimes
there is a painful twitching of the muscles, but this is not a com-
mon symptom. If the inflammation is not arrested in season,
suppuration may ensue, causing a destruction of the bones and
cartilages, and terminating in distortion and incurable lameness.
2068. It is said of the late Professor Physic, that he would
never undertake to treat a child with hip disease, unless he could
º obtain the consent of its parents to keep the limb per-
ectly still in splints until a cure was effected, which generally re-
quired, according to his own acknowledgment, from a year to
eighteen months. Comment is unnecessary.
2069. TREATMENT. Where the disease has not been aggra-
Wated by improper management, such as leeching, blistering, cup-
ping, and the use of mineral, or vegetable poisons, it may generally
be cured by one or two courses of medicine, together with appro-



504 PRACTICE OF MEDICINE.
priate intermediate treatment. (1660, et seq.). Composition, spiced
bitters, and the alterative mixture, may all be usefully employed.
In an obstinate form of the malady, a succession of courses will
be required, repeating them once or twice a week, according to
the exigencies of the case. Where the limb is much wasted,
it should be bathed several times a day with the stimulating lini-
ment, pepper sauce, or tincture of cayenne, and kept warm by the
application of heated stones or bottles of hot water wrapped in
damp cloths. If the pain is severe, the hip should be rubbed
frequently with either of the preparations just named; or a flannel
wrung out of hot rheumatic drops, or a mixture of vinegar and
cayenne (1531) may be laid over the affected joint. If there is
painful twitching of the muscles, relief may be obtained by using
scullcap tea, containing a small portion of cayenne. The daily
application of vapor to the hip and lower extremities, by means
of a blanket passed round the waist, will be highly serviceable,
and after the operation, each time, the affected hip and extremity
should be well rubbed with the stimulating limiment.
HYDROPHOBIA.
2070. This dreadful disease is usually communicated by the
bite of a rabid dog, and usually manifests itself in from fifteen to
sixty days after the accident, though a much longer time may
elapse before it is developed.
2071. An individual may be bitten by a rabid dog without suſ-
fering any bad consequences. Mr. Hunter mentions twenty per-
sons who were bitten, and only one of them was in the least aſ-
fected.
2072. Hydrophobia may be caused by the poisonous saliva
coming in contact with a wound, or a raw surface, or by handling
the garments of a person who died of the malady...
2073. The disease, in some cases, attacks the individual sudden-
ly, but in others it is preceded by chilliness, flushes of heat, languor;
depression of spirits, restlessness, disturbed sleep, thirst, costive-
ness, nausea, and sometimes vomiting. The patientis reserved, sus-
picious, gloomy, and silent. The wound or bite is apt to be pain-
ful, and often assumes a livid, or inflamed appearance. At length
a sense of tightness is felt in the chest, with difficult swallowing,
slight tremors of the body, and a considerable collection of saliva
in the mouth. An intolerable dread of liquids is soon expe-
rienced, and even the sight or mention of them is often sufficient
to bring on the most violent spasms. The thirst is excessive, and
the respiration short and hurried. The spasms occur at irreg-


PRACTICE OF MEDICINE. 505
ular periods, and continue from a quarter to half an hour. In the
intervals the patient talks calmly and rationally, and cautions his
friends to be on their guard lest he should injure them in his fits of
madness. During the paroxysms, the countenance assumes a wild
and furious aspect; the eyes are blood shot and sparkling; the
body and limbs are thrown into violent spasms; the fists are
clenched; the mouth foams; and the unfortunate sufferer attempts
to bite every one who falls in his way.
2074. Magendie, in some remarks on hydrophobia, says,
“Formerly, when an individual was seized with this terrific affec-
tion, the mode of treatment was as follows—and indeed, these
charitable plans were employed at no very distant period from
our own. The wretched sufferer was either stifled between two
mattresses, or bled from the four extremities, and allowed to
perish from the loss of blood; or he was put into a sack, and
thrown, sack and all, into a river. These methods of treatment,
originally adopted from ignorance, were continued up to our own
time, with the most culpable indifference.”
2075. Dr. Good observes, “There is no disease for which
so many remedies have been devised, and none in which the mor-
tifying character of vanity of vanities, has been so strikingly writ-
ten upon all of them.”
2076. TREATMENT. If a patient is attacked suddenly with a
paroxysm, a table-spoonful of the antispasmodic tincture should be
given without delay, and an equal or double the quantity of the
same, added to half a pint of warm water, administered by injec-
tion. This will produce an immediate and powerful effect upon
the system, and generally allay the convulsive tremors. The in-
jection may be repeated, if necessary, and in the meantime heated
stones or bottles of hot water wrapped in damp cloths should be
placed at the feet and sides, and preparations made to administer
the vapor bath. This should be followed by an emetic of lobelia,
and all the requisites of a full and thorough course of medicine.
2077. If the wound puts on a livid, or inflamed appearance,
it should be washed with rheumatic drops, or tincture of myrrh,
and poultices applied, as in any other sore.
2078. The mouth should be frequently washed and the throat
gargled with bayberry tea, in order to remove the poisonous saliva,
and vitiated secretions.
2079. The courses may be administered every twelve, or
twenty four hours, until the disease is completely removed, and
in the intervals, cayenne, bayberry, and scullcap tea should be
freely employed. The stimulating tea (1515) will answer an
excellent purpose.
506 PRACTICE OF MEDIC INE.
2080. Some physicians regard scullcap as a specific in hydro-
phobia, (927) but I should be disposed to use it merely as an
auxiliary remedy.
2081. The vapor bath of itself is said to be an invaluable
agent in the treatment of hydrophobia. M. Buisson read an in-
teresting paper on the subject before the Paris Academy of Arts
and Sciences, in which he gives the particulars of his own case.
He was called to a woman who was laboring under hydrophobia,
and some of the poisonous saliva coming in contact with an ulcer-
ated sore on one of his fingers, he contracted the disease himself.
He says, “ The ninth day after the accident, I suddenly felt a
pain in my throat, and a still greater pain in my eyes; my bod
seemed to have become so light, that I fancied I could leap an im-
mense height; and the skin on my ulcerated hand became so acute
in feeling, that I thought I could have counted every hair on my
head with it without seeing. The saliva was continually rising in
my mouth, and not only the sight of shining objects, but the very
contact of the atmosphere, became painful to me. I felt a desire
to run about and bite every animate and inanimate object but my
own fellow creatures; in fine, I experienced great difficulty of
breathing, and the sight of water was more distressing to me than
the pains in my throat. These effects returned at intervals of
five minutes from each other, and it appeared to me that the pains
originated in the diseased finger, and extended as high as the
shoulder.” -
2082. “M. Buisson,” says a London medical journal, “con-
cluding from these various symptoms that he was suffering under
hydrophobia, resolved to make an end of himself by suffocating
himself in a vapor bath. With this view he raised the heat to
140 degrees of Fahrenheit, but was delighted no less than sur-
prised, to find that all his pains disappeared. He went out of
the bath completely cured, made a hearty dinner, and drank more
freely than was usual with him. He adds that he has treated
more than fourscore persons, who had been bitten by mad dogs,
in a similar manner, and that they had all recovered, with the ex-
ception of a child seven years old, who died in the vapor bath
he was administering. The writer prescribes for all persons
who have the misfortune to suffer from the bite of rabid animals, a
certain number of vapor baths, and violent perspiration every
night, produced by covering themselves with blankets, with a
feather bed above them; this perspiration to be aided by drink-
ing copiously of a hot decoction of sarsaparilla. He concludes by
remarking, that those animals in whose case madness most fre-
quently exhibits itself, as if spontaneously, such as dogs, wolves,
and foxes, are never liable to transpiration.”

PRACTICE OF MEDICINE. 507
HYSTERIA.
2083. Hysteria is principally confined to the female sex, and
is most common about the period of menstruation. It seldom
occurs before the age of puberty, or after the final cessation of the
menstrual discharges. The attack is characterised by alternate
fits of weeping, sobbing, and convulsive laughter, and sometimes
the patient utters loud and piercing shrieks. The countenance
has a wild expression, accompanied, in severe cases, with inco-
herent talking, grinding of the teeth, and tearing of the hair. The
eyes roll about frightfully, the fists are clenched, and sometimes
the whole body is convulsed.
2084. Cases occur in which the above symptoms are not
manifested, and the patient sinks at once into a state of insensi-
bility, with her eyes closed, her teeth pressed firmly together, and
her breathing slow, but not laborious. She may remain in this
situation for several hours, or perhaps a day, unless roused to
consciousness by a proper application of remedies.
2085. Among the various symptoms which characterize hys-
teria in its different forms and grades of violence, are palpitation
of the heart, difficulty of breathing, fear of impending suffocation,
hiccough, sickness at the stomach, vomiting, despondency, cold-
ness of the extremities, intolerance of light and sound, sighing,
hoarseness, loss of voice, sudden fits of coughing, pains in the
abdomen and left side, a sense of tightness in the region of the
stomach, and a feeling as if a ball was rising in the throat. The
countenance is sometimes pale, and at others red and swollen.
The paroxysm is generally of short duration.
2086. Hysteria is occasioned by menstrual irregularities, indo-
lence, luxurious living, irregular hours, crowded and heated apart-
ments, severe mental emotions, fright, costiveness, worms, indi-
gestible food, vitiated bile, suppressed perspiration, and exposure
to cold during the menstrual period. It is frequently connected,
also, with disease of the spine, and womb.
2087. TREATMENT. In a violent paroxysm of this malady,
the dress is to be loosened about the waist, and one or two tea-
spoonfuls of the antispasmodic tincture administered, as directed in
the treatment for convulsions. (1888, et seq.) This should be
followed by a tea of cayenne, bayberry, and scullcap, containing a
small portion of green lobelia, (1515) administering a tea-cupful
every ten or fifteen minutes until perspiration ensues. In the
meantime, heated stones wrapped in }. cloths should be placed
at the feet and sides. If this does not afford the desired relief, it


508 PRACTICE OF MEDICINE.
will be necessary to give a course of medicine; and if convulsions
are present, or if there is a violent determination of blood to the
head, the course should be preceded by two or three stimulating
injections. (1567, 1574.)
2088. If the patient falls into a state of insensibility, the same
treatment may be pursued which is recommended in suspended
animation, to which the reader is referred.
2089. Mild cases of hysteria may be relieved by a tea of com-
position, cayenne, pennyroyal, catnip, summer savory, yarrow, or
any of the warming and stimulating herbs, giving it in frequent
draughts so as to produce perspiration.
2090. If the disease depends on an affection of the spine, or
womb, or if the general health is very much impaired, the most
speedy and effectual means of affording relief will be to admin-
ister a few courses of medicine, and in the intervals, making use
of the ordinary stimulants and tonics, according to the circum-
stances of the case. (1660, et seq.) Attention to diet, (1680, et
seq.) exercise in the open air, (1709, et seq.) a cheerful temper,
and an avoidance of every thing which predisposes to an attack,
should be rigidly observed. If the spine is affected, it may be
rubbed five or ten minutes every night and morning with pepper
sauce, vinegar and cayenne, (1531) rheumatic drops, or the vola-
tile, or stimulating liniment. The use of the hand bath every
morning will also be of service. (1455.)
IN FLAMMATION OF THE BLADDER.
2091. In this disease, there is a burning pain in the region of
the bladder, which is increased by pressure on the lower part of
the abdomen. The abdomen is also more or less swelled. The
urine is scanty, and of a deep red color, and when passed occa-
sions intense pain. Sometimes it is mixed with blood. The
skin is hot and dry, the thirst urgent, and the bowels torpid. Nau-
sea and vomiting frequently occur, accompanied, in some instances,
by troublesome bearing down pains in the rectum. When the
inflammation is seated in the neck of the bladder, a retention of
urine is a common symptom, and the bladder consequently be-
comes very much distended. A sudden cessation of pain, cold-
ness of the extremities, a clammy sweat, and great prostration, are
extremely unfavorable symptoms, and indicate a state of gangrene.
The disease is caused by blisters, the internal use of cantharides,
the introduction of instruments into the bladder, obstructed per-
spiration, and exposure to a cold or variable atmosphere. It is
liable to attack persons with gout and dyspepsia.



PRACTICE OF MEDIC INE. 509
2092. The chronic as well as the acute form of the malady,
frequently results from injudicious medical treatment. The former
is a tedious as well as distressing complaint, being accompanied
with febrile symptoms, derangement of the stomach and bowels,
burning pain in the bladder, and a frequent desire to pass water,
which is mixed with ropy or stringy mucus, and sometimes a
considerable portion of blood. -
2093. TREATMENT. If the symptoms are violent, a course
of medicine should be given, repeating it at proper intervals until
the disease is subdued.
2094. Between the courses, the stimulating tea, (1515) or a
tea of composition, rendered mucilaginous by the addition of slip-
pery elm, may be drank freely, keeping the skin warm and moist
in the meantime, as this will counteract any distress which might
be occasioned by the cayenne.
2095. The abdomen in the region of the bladder should be
frequently bathed with rheumatic drops, volatile liniment, or vine-
gar and cayenne; (1531) or if the pain is extremely severe, flan-
nels wrung out of either of these liquids, and warmed by the fire,
may be applied, together with a heated stone wrapped in a damp
cloth; or an application may be made of the Indian meal poultice,
or a poultice of burdock, or mullein leaves. (1061, 1135.)
2096. Diuretics are beneficial, and may be given freely. I
would particularly recommend the cool wort, and sumach berries.
Where there is a discharge of mucus from the bladder, this class
of remedies is very important.
2097. Injections into the rectum exercise a powerful influence
over the bladder, and should be repeated every hour during the
violence of the disease. They allay the pain, and tend in an es-
pecial manner to subdue the inflammatory action. Each injection
should contain half a tea-spoonful of green lobelia, more or less,
regulating the quantity so as not to occasion distressing nausea.
(1567, et seq.)
IN FLAMMATION OF THE BOWELS.
2098. The inflammation, in this disease, may be seated either
in the internal or external coat of the bowels, constituting two dif-
ferent affections. In the former, diarrhoea or dysentery ensues,
which have been described under the appropriate heads, and di-
rections given for the treatment. Sometimes the inflammation is
confined exclusively to the mucous membrane of the duodenum,
and in that case there is often an obstruction of the biliary duct,

510 PRACTICE OF MEDICINE.
(see Fig. 1–page 15) followed by a bitter taste in the mouth,
and a yellow or jaundiced hue of the skin.
2099. Inflammation of the external coat of the intestines, is
termed peritonitis. Sometimes it is ushered in by a severe chill,
and at others commences with an uneasy sensation in the bow-
els, followed by a fixed and burning pain, which is increased by
pressure on the abdomen. There is more or less thirst, accom-
panied by a dry and hot skin, short and laborious breathing, and
sometimes nausea and vomiting. The tongue is mostly red along
the edges, with a dry, brownish coat in the centre. The patient
“generally lies still upon the back, every motion being attended
by augmented pain; and the knees are frequently raised so as to
remove the pressure of the bed clothes.” In most cases the
bowels are obstinately costive. In seven or eight days, if the dis-
ease is not checked, gangrene is liable to ensue, which is an-
nounced by a sudden remission of pain, sinking of the pulse, ca-
daverous expression of countenance, and cold, clammy sweats.
2100. Among the causes of this malady, are injuries about
the abdomen, a neglected state of the bowels, and sudden changes
from heat to cold.
2101. TREATMENT. Inflammation of the external coat of
the bowels, particularly if extensive, is a disease of considerable
danger, and should be met at the outset with prompt and energetic
treatment. A thorough course of medicine should be given, com-
mencing with one or two strong injections, (1567, et seq.) and if
this does not afford the desired relief, the course should be re-
peated as soon as the symptoms become unfavorable.
2102. Applications should be made to the abdomen, such
as are directed for inflammation of the bladder. (2095.)
2103. Between the courses, the patient should be kept in a
gentle perspiration with the stimulating tea, (1515) increasing or
diminishing the quantity of cayenne and lobelia according to cir-
cumstances. Composition tea alone may suffice, in some cases,
to keep the skin moist. Injections are important in this disease,
and should be administered four or five times a day; or even every
hour if the case is severe, or critical. Each one should contain a
portion of lobelia.
2104. If symptoms of gangrene occur, the patient is not to be
abandoned, for a cure may be effected even then, provided the
treatment is sufficiently ". and emergetic. Our chief reliance
must be upon courses of medicine, and the frequent use of strong
injections. - - --
2105. During convalescence, the patient should restrict him-


PRACTICE OF MEDICINE. 511
self to a light, nourishing diet, and avoid exposure to the cold, as,
without adequate precaution in this respect, he may experience a
relapse.
IN FLAMMATION OF THE BRAIN.
2106. The membranes which surround or cover the brain,
may be the seat of the inflammation, or it may attack the substance
of the brain itself. It usually commences with a sense of fulness
in the head, and flushing of the face, followed by severe headach,
throbbing in the temples, redness and sparkling of the eyes, florid
countenance, heat and dryness of the skin, extreme thirst, intol-
erance of light and sound, watchfulness, and violent delirium.
The pain is dull, or shooting, according as the substance of the
brain, or its membranes are affected; and in some cases it occu-
pies the whole of the head, while in others it is confined to a par-
ticular portion. The tongue is sometimes red, and at others of a
yellow, or dark color. The stomach and bowels are more or
less disordered, and the liver often in a torpid or inactive state, as
is indicated by the whitish color of the stools.
2107. As the disease advances, the delirium increases in vio-
lence; the eyes are prominent, the countenance assumes an ex-
pression of ferocity, and the patient talks in a wild and incoherent
strain. The breathing is generally deep, slow, and often laborious.
Among the symptoms which frequently accompany the malady,
are morbid and acute hearing, followed by deafness, imperfect
vision, difficulty of swallowing, yellowness of the skin, and con-
vulsive movements of the limbs, or of the whole body.
2108. Where the head is shaved and blistered, and the patient
leeched, cupped, bled, and dosed with poisons, the malady often
proves fatal in five or six days.
2109. The disease is caused by mechanical injuries of the
head, suppression of the catamenia, changes from heat to cold,
checked perspiration, disorder of the stomach and bowels, drunk-
enness, intemperance in eating, and severe or protracted study.
It is also frequently a sequel of other affections.
2110. Among the symptoms indicating an unfavorable termi-
nation, are weak pulse, cold and clammy skin, grinding of the
teeth, stupor, loud breathing, hemorrhage from the bowels, and
a red, yellow, or dark colored urine.
2111. TREATMENT. In violent attacks, the most energetic
treatment is necessary, for unless we recall the blood from the
brain, and restore an equilibrium to the circulation, the inflamma-


512 PRACTICE OF MEDICINE.
- -
tion may go on increasing until it is impossible to effect a cure.
Hence, a full course of medicine should be given, preceded by
two or three injections to evacuate the bowels; and the course
may be immediately repeated, if the unfavorable symptoms return.
The head should be kept in an elevated position, to prevent the
accumulation of blood in the organ, and heated stones wrapped
in damp cloths placed at the feet and sides.
2112. Between the courses, the stimulating tea (1515) may
be used to keep up a gentle perspiration, increasing the quantity
of cayenne and lobelia, if desirable. Injections should be given
four or five times a day, (1567, et seq.) or oſtener if neces-
sary, as these have a powerful effect in counteracting the deter-
mination of blood to the brain. While the head continues hot,
cloths wrung out of cold water should be applied to it, and re-
newed as often as they become warm. After the inflammation is
checked, the health is to be restored by a light, nourishing diet,
and the usual strengthening or restorative medicines.
IN FLAMMATION OF THE RIDNEY.
2113. This affection commences with chills, succeeded by a hot
and dry skin, and a shooting, or dull pain in the small of the back.
This pain often extends to the bladder and thighs, and is increased
by pressure over the region of the kidney, or by any violent
motion, or contortion of the body. Sometimes there is a drawing
up of the testicle on the affected side. The bowels are generally
costive. There is a frequent desire to pass water, which is scanty,
and often red. If both kidneys are inflamed, the urine is entirely
suppressed, in which case the perspiration soon acquires a urinous
smell. This symptom is a bad one, and requires active treatment,
for if the urine is suffered to remain in the blood, it will give rise
to drowsiness, and stupor, from which the patient may never
recover. Sickness at the stomach, and vomiting, are not unu-
sual symptoms.
2114. The causes which give rise to inflammation of the kid-
ney, are external injuries, strains of the back, lifting heavy weights;
the presence of gravel in the kidney, the use of cantharides, and
other animal, mineral, and vegetable poisons.
2115. TREATMENT. In a mild attack of this disease, relief
may be obtained by keeping the patient in a perspiration with com-
position tea, and the application of heated stones wrapped in damp
cloths to his feet. Injections, diuretics, mucilaginous drinks,
and stimulating applications to the small of the back, where the


PRACTICE OF MEDICINE. 513
pain is seated, are all beneficial, if not indispensable, and may be
used as directed for inflammation of the bladder. If both kidneys
are inflamed, or the disease assumes a threatening aspect, one or
more courses of medicine are to be administered.
IN FLAMMATION OF THE LIVE R. *
2116. This disease may be developed gradually, or it may be
sudden in its attack, commencing with chilliness, and pain in the
right side, followed by fever, difficulty of breathing, cough, thirst,
yellowness of the skin and eyes, clay colored stools, and gen-
erally nausea, and vomiting. The patient experiences a difficulty
in lying on the left side. The urine is scanty, and of a yellow, or
dark color. The pain in the side is sometimes acute, and at
others dull or obtuse, and is increased by pressure. Pain in the -
right shoulder is also a common symptom. The tongue is some-
times smooth and glossy, but is generally covered with a white, or
yellow coat.
2117. Inflammation of the liver is caused by injuries about the
right side, exposure to wet and cold, errors in diet, drinking cold
water when the body is heated, luxurious living, sedentary habits,
a neglected state of the bowels, and especially the use of mercury,
which acts specifically upon the liver as a powerful poison. “In
warm climates,” says a medical writer, “this organ is more apt
to be affected with inflammation than perhaps any other part of
the body, probably from the increased secretion of bile which
takes place when the blood, by exposure to cold, is thrown on
the internal parts; or from the bile becoming acrid, and thereby
exciting an irritation in the liver.”
2118. Chronic inflammation of the liver, says the same
writer, “is usually accompanied by a morbid complexion; loss
of appetite and flesh; costiveness; indigestion; ſlatulency; clay
colored stools; pains in the stomach; a yellow tinge of the skin
and eyes; high colored urine, which deposites a red sediment, -
and ropy mucus; an obtuse pain in the region of the liver, ex-
tending to the shoulder, and not unfrequently with a considerable
degree of asthma.”
2119. Inflammation of the liver may terminate in one or more
abscesses, the contents of which may be discharged externally, or
into the abdomen or chest, or may issue by an opening into the
intestines, stomach, or lungs, in case the liver should previously
form an adhesion to either of these organs.
* Hepatitis.
65 -
514 PRACTICE OF MEDICINE.
2120. TREATMENT. The principles of treatment are the
same in this disease, as in inflammation of any other internal part.
We must endeavor to restore an equilibrium to the circulation,
and when this is accomplished, the affected organ will be relieved.
A tea of composition, or of cayenne and bayberry, may be taken
sufficiently often to keep the skin moist; and if green lobelia be
added to it in a small quantity, so as not to excite an unpleasant
degree of nausea, it will be still more beneficial. Injections should
be given several times a day, whether the bowels are costive or not;
and if the side is very painful, applications should be made to it as
directed for the abdomen, in inflammation of the bladder. (2095.)
If nervous symptoms arise, a portion of scullcap, or lady’s slipper,
may be added to the other medicines. The strength of the
patient should be sustained by some nourishing liquids, such as the
oat meal, Indian meal, or unbolted wheat meal gruel. If the case
is obstinate, a course of medicine should be administered, repeat-
ing it according to the degree and urgency of the symptoms.
2121. If the inflammation should terminate in an abscess of
the liver, which is often indicated by chills, succeeded by flushes
of heat, (1363) tonics should be given several times a day, in ad-
dition to the other treatment, to keep up the strength and vigor of
the system; and if the abscess points externally, the elm and gin-
ger poultice should be applied to promote the discharge of its con-
tents, as in any other tumor or swelling which has proceeded to
suppuration. (1361, et seq.)
21 During convalescence, the feet should be kept warm
and dry, and exposure to a cold or damp atmosphere avoided.
Butter, and all ſat or oily substances should be excluded from the
diet, as they tend to derange the stomach, and thereby injuriously
affect the liver.
2123. In the chronic form of the disease, courses of medicine
are generally required, together with thorough intermediate treat-
ment. (1667, et seq.)
IN FLAMMAtion of THE LUNgs. *
2124. Inflammation of the lungs, or lung fever, as it is com-
monly termed, is usually ushered in by cold chills, followed by a
hot and dry skin, hurried and laborious breathing, tightness of the
breast, distressing cough, scanty and high colored urine, and dull
pain in some part of the chest, which is increased by coughing,
or taking a long breath. The tongue is often dry, and of a dar
* Pneumonia.

PRACTICE 0 F MEDICINE, 515
color. The most easy position for the patient is upon his back.
“In the beginning, the cough is frequently without expectora-
tion; but in some instances it is moist, even from the first, and
the matter is various both in color and consistence, and is often
streaked with blood.” In some cases it resembles a bright red
jelly. It is usually glutinous, however, and adheres to the sides
of the vessel in which it is contained.
2125. In severe or violent attacks, the countenance becomes
livid, and the lips blue, or purple, accompanied with a dry, harass-
ing cough, a sense of suffocation, delirium, and sometimes stupor.
2126. The disease, if improperly treated, often proves fatal
in from three to seven days. It is most prevalent in cold and
changeable weather, and in the practice of the diplomatised phy-
sicians, is frequently a sequel of other maladies. It is mostly
confined to one lung, but if both lungs are involved, the danger is
proportionably increased. The inflammation may terminate in
suppuration, (1361, et seq.) “which event is to be known by
frequent slight shiverings, an abatement of the pain and sense of
fulness in the part, and by the patient being unable to lie on the
side which was affected, without experiencing great uneasiness.”
Gangrene arises occasionally, and is indicated by an offensive
breath, and expectoration of a dark colored and highly fetid
matter.
2127. TREATMENT. When the disease has made any con-
siderable progress, the sufferings of the patient are so acute as to
require the most active treatment to afford him relief. Heated
stones wrapped in damp cloths are to be placed at the feet and
sides, and the stimulating tea administered in the dose of half a
tea-cupful every five, ten, or fifteen minutes, until the difficulty of
breathing is relieved; and in the meantime one or two injections
(1567) must be given to evacuate the bowels thoroughly. The
quantity of cayenne in the stimulating tea may be increased, if
considered necessary. As soon as the patient begins to perspire,
lobelia should be given to cleanse the stomach, followed by all the
requisites of a course of medicine, and this may be repeated ac-
cording to circumstances until the malady is removed.
2128. Between the courses, a tea of composition, or of cay-
enne and bayberry, should be given to keep the skin moist, adding
a small portion of lobelia, if the cough is troublesome or the
breathing difficult. The cough may also be benefited by the use
of slippery elm tea, the cough jelly, (1525) or by inhaling the
fumes of vinegar, or even the vapor of water.
2129. Injections may be advantageously given several times
a day, and if the symptoms are violent, should not be omitted.
__

516 PRACTICE OF MEDICINE.
2130. External applications should be made to the seat of the
pain, as directed for the abdomen, in inflammation of the bladder.
(2095.)
2131. The patient should be nourished with some light gruel,
which will not oppress the stomach, and make free use of the
restorative medicine during convalescence.
INFLAMMATION of THE stom Ach.*
2132. This disease is characterized by a constant burning
pain in the stomach, accompanied by fever, restlessness, de-
pression of spirits, a confined state of the bowels, and frequent
retching, or vomiting, especially after eating, or drinking. The
tongue is mostly red, but is sometimes covered with a white, or
dark coat. The pain in the stomach is sometimes increased by
pressure in the region of that organ. If the disease is not subdued,
other symptoms arise, such as difficulty of swallowing, hurried and
oppressed breathing, sore throat, hiccough, great prostration of
strength, a short and painful cough, cold, clammy sweats, and
sometimes delirium.
2133. The disease is caused by indigestible food, draughts of
cold water when the body is heated, the use of corrosive poisons,
and exposure to a damp or chilly atmosphere. It also follows in
the train of other affections.
21:34. TREATMENT. As the welfare of the whole vital
economy depends, in a great measure, upon the healthy condition
of the stomach, we should resort to active and thorough treat-
ment, in order to check the disease as speedily as possible.
Hence it is proper to administer a course of medicine, which will
not only cleanse the stomach, but counteract the morbid determi-
nation of blood to the organ, and thereby subdue the inflamma-
tory action. The different teas which are employed during the
course, should be strained, and the lobelia also should be admin-
istered without the sediment, as the latter, by adhering to the mu-
cous coat of the stomach, may occasion tedious and distressing
nausea. (1612. - -
2135. After the course, the patient should be kept in a gentle
perspiration, and for this purpose, a heated stone wrapped in a
damp cloth may be placed at his feet, and composition tea, or
any similar preparation, rendered mucilaginous by the addition of
slippery elm, given in small and frequently repeated doses.
* Gastritis.



PRACTICE OF MEDICINE. 517
Injections several times a day, will be attended with decided ben-
efit. The region of the stomach should be rubbed frequently
with rheumatic drops, or pepper sauce; and flannels, or poultices
applied to it, if necessary, as directed for the abdomen, in inflam-
mation of the bladder. (2095.)
2136. While the stomach is inflamed, the digestive process
is partially if not wholly arrested, and it is important, therefore,
that the patient should refrain from the use of solid food, until
permanent recovery has taken place. Sago gruel, slippery elm
and milk, or any mucilaginous preparation, may be used mode-
rately with advantage.
INFLUENZA. -
21:37. There is but little difference between a common cold
or catarrh, as it is termed, and the influenza, excepting that the
latter prevails as an epidemic, and is much more severe and sud-
den in its attacks. Chilliness, followed by sneezing, hoarseness,
fever, difficulty of breathing, pain in the breast, side, and other
parts of the body, more or less cough, and a thin discharge from
the nostrils, are its common characteristics. It produces a great
degree of debility, and is often complicated with inflammation of
the lungs.
2138. TREATMENT. A mild case of influenza may often be
cured by sitting near the fire, covered with a cloak, or blanket,
and taking composition, or cayenne and bayberry tea, to keep up a
moderate perspiration. Where the breathing is difficult, a small
portion of lobelia may be added to the tea. An occasional injec-
tion will accelerate the progress of the cure, and if the bowels are
costive, should not be omitted. The cough may be alleviated by
any of the remedies enumerated under that head. (1905, et seq.)
If there is severe pain in the chest, flannels moistened with rheu-
matic drops, or volatile liniment, may be applied, together with a
heated stone wrapped in a damp cloth. (2095.) If the disease
does not yield, a course of medicine will be requisite, repeating
it according to the circumstances of the case.
ITCH.
2139. The itch is generated by personal filthiness, and is -
highly contagious. Impure air, and a coarse or meagre diet ren-
ders the system more susceptible of its influence. The disease is

518 PRACTICE OF MEDICINE.
readily contracted by sleeping in a bed which has been occupied
by a person infected. It has its origin in the skin, and commences
with an itching between the fingers and about the joints, gradually
extending to other parts of the body. When the patient is warm
in bed the itching is increased, which becomes at length almost in-
tolerable. In the meantime small pimples, filled with a watery,
or yellowish fluid, make their appearance; and from the disposi-
tion of the individual to scratch himself, the disease is not only
communicated to other parts, but the skin is often broken, and
converted into a sore.
2140. TREATMENT. An occasional dose of composition,
especially at bed time, is all the medicine that is generally required
internally, unless the health is very much impaired, and then either
an emetic, or a full course of medicine may be administered.
the appetite is impaired, the spiced bitters, or some other tonic
may be used. The diet should be light, and chiefly vegetable,
avoiding butter, and all animal ſats. If costiveness prevails, any
of the remedies mentioned under that head may be employed.
(1896, et seq.)
2141. There are many external applications which may be
made with advantage. Among these are tincture of lobelia,
meadow fern ointment, an ointment of yellow dock, (1218) and
rheumatic drops combined with one fourth part of the spirits of
turpentine. An application of the rheumatic drops alone, follow-
ed by one of the meadow fern ointment, as soon as the skin has
had time to dry, has been found very effectual. The patient
should be washed thoroughly clean every day with warm water
and soap; or the vapor bath may be administered, and the surface
sponged with a tepid solution of sal aeratus, or bicarbonate of
soda. (1029.) One or the other of the above ointments, or
washes, should be applied every night and morning.
2142. If the skin is brokén and irritable, it may be washed
with a tea of sumach, or witch hazel leaves, and healing salve or a
poultice applied, according to the nature of the case.
JAUNDICE.
2143. This disease is occasioned by a diffusion of bile through
the system, giving rise to a yellow color of the skin, eyes, urine,
and even the perspiration. It comes on occasionally without any
warning, but is usually preceded by languor, costiveness, flatu-
lency, pain in the bowels, drowsiness, chills and heats, loss of ap-
petite, bitter taste in the mouth, disagreeable itching over the


PRACTICE OF MEDICINE. 519
whole body, and in some instances a dull or heavy pain in the right
side. The stools are whitish or clay colored, and the tongue is
covered with a dense yellow coat. Objects frequently appear
discolored, having a yellow, or greenish aspect. In severe cases,
the skin becomes very dark, which has given rise to the name of
black jaundice. It is a curious fact, that while the urine and per-
spiration, in females, communicates a yellow tinge to linen, the
milk is unaffected either in taste, or color.
2144. If the disease is not arrested, emaciation ensues, ac-
companied with night sweats, and difficulty of breathing -
2145. Jaundice is caused by whatever interferes with the flow
of bile from the liver into the intestines. Hence it may be pro-
duced by disease of the liver, by inflammation of the biliary ducts,
or the presence of gall stones in these passages, or the bile may
become too thick to be discharged through its natural channels.
Inflammation of the inner coat of the duodenum, also, by obstruct-
ing the mouth or orifice of the biliary duct, may give rise to the
malady. (See Fig. 1, page 15.)
2146. TREATMENT. In the treatment of jaundice, we must
warm and invigorate the system with cayenne and bayberry, and
keep the bowels thoroughly evacuated with injections. The latter
may be administered several times a day, and are particularly ben-
eficial, inasmuch as they cause the bile to flow again into the in-
testines, where it belongs. If the stomach is much disordered,
it must be cleansed with an emetic, after which the spiced bitters,
or some other tonic may be employed, to strengthen the digestive
organs. In the meantime free use should be made of cayenne.
If there is severe pain in the bowels, or side, flannels wrung out of
rheumatic drops, or other stimulating liquid, may be laid over the
affected part. (2095.) An occasional dose of lobelia pills (1298,
et seq.) may be employed with advantage. If the case is obsti-
nate, or the symptoms alarming, a course of medicine should be
given, repeating it at proper intervals, until the disorder is re-
moved. -
2147. If the breathing is difficult, lobelia in small doses will
be serviceable. -
2148. Mild cases of jaundice have been cured by a prepara-
º of bayberry, American aspen, and wild cherry tree bark.
995.)
L0 CKED JAW.
2149. This is a disease in which the jaws become locked
from spasm or rigidity of the muscles. It is occasioned by

PRACTICE OF MEDIC INE.
wounds, bruises, mineral and vegetable poisons, sudden changes
from heat to cold, surgical operations, drinking cold water when
the body is heated, and a variety of other causes. Punctured and
lacerated wounds produce it more frequently than injuries of any
other description. It usually commences with stiffness of the
neck and shoulders, which ultimately extends to the jaws, accom-
panied by painful and difficult swallowing. At length the jaws
become permanently closed or pressed together. Sometimes the
whole body is affected with the spasms, being drawn forward,
backward, or sideways, according to the convulsive action of the
muscles. There is a tightness of the breast, with a severe pain
in the region of the stomach, darting backward to the spine. The
countenance is hideously distorted, and the respiration labored
and difficult. The jaws usually remain fixed, but in other parts
of the body, there is usually a succession of spasms, until the
whole frame becomes rigid and motionless.
2150. The disease occasionally attacks new born infants, but
is of rare occurrence among old people.
2151. The diplomatised physicians acknowledge that they
have no remedy for this dreadful malady. Dr. Mackintosh says,
“After a careful review of the cases recorded in the annals of
physic, no plan of treatment hitherto employed seems to have
been attended with benefit. Bleeding, purging, cold and warm
bathing, all the most powerful narcotics, and mercury, have each
had its warm supporters, but with little success.”
2152. TREATMENT. Patients attacked with the locked jaw,
may be speedily relieved by the use of the antispasmodic tincture,
which may be poured into the mouth between the teeth, and as
soon as it comes in contact with the parts about the throat, the
rigidity of the muscles will give way, and the mouth open. The
tincture may be given in the dose of one, two, or three tea-spoon-
fuls, and repeated every five minutes until the desired effect is pro-
duced; and in the meantime, heated stones wrapped in damp
cloths should be placed about the patient, and two or three
injections administered. These should contain rather more than
the usual quantity of lobelia, (1567, 1574) as this medicine tends
in a powerful manner to subdue the spasms. As soon as the
patient is relieved, so that he can swallow without difficulty, a
thorough course of medicine should be given, making free use of a
tea of cayenne, bayberry, and scullcap, the latter of which is partic-
ularly beneficial in diseases of this description. If the health is
* Practice of Physic, 2d American edition, vol. ii. p. 139.


PRACTICE OF MEDICINE. 521
feeble, it may be necessary to give a succession of courses, at-
tending strictly to the diet, (1680, et seq.) and intermediate treat-
ment. (1660, et seq.)
- MEASLES.
2153. This disease is ushered in by headach, and slight
creeping chills, which are followed by feverish symptoms, hoarse-
ness, difficult breathing, vomiting, swelling and redness of the
eyes, a hoarse, dry cough, drowsiness, sneezing, and a thin,
watery discharge from the eyes and nose. The eruption is some-
times preceded by delirium, or convulsions. The tongue is
covered with a white coat, and the breath is very offensive. On
the third or fourth day, but sometimes considerably later, the rash
makes its appearance about the face and forehead, and then suc-
cessively on the body and extremities, reaching the feet in the
course of twenty four, or forty eight hours. It consists of small
red spots, resembling fleabites, which run into each other and
form patches, leaving the intermediate skin of a natural color.
The rash begins to fade in about three days, and from that time grad-
ually disappears, accompanied with a separation of the cuticle or
outer skin, in the form of scales. The febrile and other symptoms
are liable to continue while the eruption is out, unless subdued by
proper treatment. In severe cases, the face and eyes are much
swollen, the tongue brownish, and the rash of a dark or livid
color, which has given rise to the name of black measles.
2154. This disease rarely occurs more than once in the same
individual. Children are more liable to it than grown persons.
It is contagious, and occurs at all seasons, but is most prevalent
in the winter.
2155. The measles and scarlet fever bear a close resemblance
to each other, but the former may be distinguished by the hoarse,
dry cough, the sneezing, the inflamed and watery eyes, the thin
discharge from the nostrils, and the natural color of the skin be-
tween the patches of eruption.
2156. Among the unfavorable symptoms, are delirium, copi-
ous diarrhoea, a tendency of the eruption to recede, and a pallid,
or livid color of the skin.
2157. In the old school practice, the measles are apt to be
followed by consumption, dropsy, inflammation of the lungs, and
other equally dangerous disorders.
2158. TREATMENT. In the milder form of the disease,
nothing more is required than an occasional dose of composition

66

522 PRACTICE OF MEDICINE.
to keep the skin moist; and if the bowels are confined, an injec-
tion may be administered once or twice a day. Exposure to a
damp or cold atmosphere must be avoided. A dose of composi-
tion should be administered at bed time, and a jug of hot water
wrapped in a damp cloth, placed at the feet. The diet is to be
light, and easy of digestion, consisting of wheat jelly, the unbolted
wheat meal gruel, or any similar preparation which is not likely
to oppress or irritate the stomach.
159. If the eruption is slow in making its appearance, ac-
companied by fever, and difficulty of breathing, an emetic of lo-
belia should be administered, or if necessary, a full course of
medicine. This, with a free use of cayenne, will bring out the
eruption, and after that, by keeping up a gentle perspiration, all
unfavorable symptoms will be obviated. If there is a tendency of
the skin to become hot and dry, the stimulating tea (1515) may
be employed, and an injection administered every hour or two.
The same treatment is requisite in case the eruption suddenly dis-
appears, or the skin assumes a pallid, or livid color.
2160. The cough and difficulty of breathing may be alleviated
by any of the remedies usually employed for that purpose, such as
the tincture of lobelia dropped on sugar, (1283) or the cough bal- -
sam, or jelly. (1295, 1525.) If the eyes are sore, or inflamed,
they should be washed occasionally with a warm tea of raspberry,
witch hazel, or sumach leaves, rendered slightly pungent with rheu-
matic drops.
MILK SICKNESS OR PUKING COMPLAINT.
2161. This disease is peculiar to certain portions of the
Western country, and commences with lassitude, debility, and
tremors, succeeded by a burning sensation in the stomach, offen-
sive breath, constant retching or vomiting, and a confined state of
the bowels, particularly in the latter stages of the complaint.
2162. Milk sickness is said to be caused indirectly by a poi-
sonous vine or shrub, which is eaten by cattle, producing in them
what is called the trembles. They frequently die of this malady
in twenty four hours, and dogs are killed by eating the flesh of
their carcasses. The milk of cows is poisoned by the plant, and
persons using it, are liable to be attacked with the symptoms
above enumerated. Even butter and cheese made in the districts
where the plant is found, cannot be eaten without the risk of de-
stroying life. Dr. Fansher of Connecticut, has published a letter
on the subject, in which he says, “I understand that the family
of Mr. Simsbury have been poisoned by eating cheese which
- —l
PRACTICE OF MEDICINE. 523
came from New Orleans, and every member of it perished;
and having recently returned from a tour to the West, I have
thought it my duty to state what I heard relative to the milk sick-
mess districts, viz.:-that the beef, butter, and cheese, as well as
the milk of the cows which feed in the woods, was deadly poison
to those who partook of them, and that persons in that region dare
not make use of either; but that they are in the habit of sending
what they dare not eat to New Orleans, where it is sold to mer-
chants, who are not aware of the criminal fraud, and suspect not
that they are dealing in a deadly poison.”
2163. The vine is found in various parts of Ohio, Kentucky,
Indiana, Illinois, and some other States; and it is usually in these
localities, I am informed, that the milk sickness prevails. I do
not know the botanical, or even common name of the plant.
2164. TREATMENT, Courses of medicine to cleanse the
system, and stimulating injections, frequently repeated, to evacu-
ate the bowels, are both important in this disease, as it is one of
considerable obstimacy and danger. Perspiration should be pro-
duced as speedily as possible, as this will tend to check the ex-
cessive vomiting. A tea of cayenne and lady’s slipper, with a
small portion of lobelia, is said to answer an excellent purpose.
It may be given in the dose of a table-spoonful, and repeated
every five minutes until the stomach becomes quiet. A gentle-
man in the West writes me thus: “I was called a few days
ago to a case of milk sickness, which I treated as follows.
I commenced by giving pepper sauce in table-spoonful doses,
placing heated stones wrapped in damp cloths at the feet and sides
of the patient, bathing the region of the stomach with warm rheu-
matic drops, and administering a number of very strong injections
in rapid succession, each one containing a tea-spoonful of cay-
enne, and a table-spoonful of antispasmodic tincture. By this
time the circulation was somewhat equalized, a moderate perspira-
tion ensued, and the vomiting ceased. I then gave a full course
of medicine, and the emetic brought up a large quantity of offen-
sive matter from the stomach. I followed this with composition
tea, to keep the skin moist, administering an injection every two
hours; and the next day I repeated the course, which removed
every vestige of the disease. The patient was left in a very de-
bilitated state, but by the use of tonics, and a light, nourishing
diet, he soon recovered his strength.”


524 PRACTICE OF MEDICINE.
MORTIFICATION.
2165. In mortification, the blood becomes stagnant, ceasing
entirely to circulate, and the part loses its sensibility and natural
warmth, assuming a dark or livid color. It is soft or doughy to
the touch, and the skin is frequently raised in blisters. At length,
if the case does not terminate fatally, a line of demarcation is
drawn between the dead and the living flesh, and the former sepa-
rates from the latter. Previous to this, however, nature guards
against the possibility of hemorrhage, by plugging up the vessels
leading to the affected part, with coagulated blood.
2166. The commencement of mortification is indicated by a
sudden cessation of pain, and if it is extensive, or involves an im-
portant part or organ, the countenance assumes a cadaverous ex-
pression; the pulse becomes small and quick; cold clammy
sweats ensue; and the patient is often affected with delirium.
2167. Mortification is caused by whatever impedes the circu-
lation of the blood. Thus, when an intestine is protruded from
the cavity of the abdomen, as in hernia or rupture, so as to cut off
the supply of blood, the part will soon lose its vitality, and mor-
tify. Mortification of the face in children is often produced by
the use of mercury, and corrosive sublimate, and it also frequently
follows the application of blisters, and mustard poultices. If we
prevent the entrance of arterial blood into a limb it will soon mor-
tify. “Palsy, conjoined with pressure, old age, or ossification of
the arteries,” says a medical writer, “may produce mortification;
also cold, particularly if followed by the sudden application of
warmth; and likewise excessive heat applied to a part.”
2168. When a part is only partially destroyed—that is, while
there is still a feeble circulation, and some sensibility—it is termed
gangrene or the first stage of mortification; but when the blood
ceases to move, and the part becomes cold, black, and destitute
of all feeling, it is called sphacelus or mortification in the second
Stage.
ãº. “Hiccough,” says Sir Astley Cooper, “is the cha-
racteristic sign of gangrene, in whatever part of the body it is sit-
- uated. The fact is, when gangrene arises from a diseased state
of the constitution, the stomach is extremely deranged, and this
- derangement is followed by a spasmodic contraction of the dia-
phragm, producing hiccough.” -
2170. TREATMENT. When mortification is threatened, it
can only be prevented by keeping up the circulation in the part
affected; and for this purpose the system must be invigorated by
—i.
PRACTICE OF MEDICINE. 525
courses of medicine, making free use, in the intervals, of cayenne,
bayberry, nervines, tonics, and injections. The courses may be
repeated every twelve, twenty four, or forty eight hours, accord-
ing to the circumstances of the case. As long as the patient is in
a gentle perspiration, he may be considered as doing well, but if
the skin becomes cold and clammy, or any other unfavorable
symptom arises, either an emetic, or course of medicine should
be administered without delay. The strength should be sustained
by a light, nourishing diet.
2171. A poultice of Indian meal, or wheat bran, mixed with
equal parts of vinegar and water, and containing a portion of gin-
ger, or cayenne, may be applied externally, and renewed several
times a day. This will prevent the gangrene from extending to
the neighboring parts. The rheumatic drops, or tincture of myrrh
may be added to the poultice with advantage. When the separa-
tion between the dead and living flesh takes place, the yeast poul-
tice is an excellent application, as it not only hastens the separa-
tion, but corrects the offensive smell. (1548.) The charcoal
poultice (1549) may also be used; or a poultice of equal parts of
slippery elm and pounded cracker, mixed with raspberry or bay-
berry tea. At each renewal of the poultice, the part should be
washed clean with warm soapsuds, followed by some mild astrin-
gent tea, such as pond lily, or witch hazel, or with the tincture of
myrrh, diluted, if necessary, with water. If the part is hot and
painful, the poultice should be wetted frequently with cold water.
An occasional dose of composition tea will also serve to allay the
pain; or if this is insufficient, lobelia may be added to the tea, but
not in a sufficient quantity to excite unpleasant nausea. After the
dead flesh is entirely removed, and the part assumes a healthy
appearance, the healing salve may be applied.
MUMPS.
2172. This disease is principally confined to children, and
prevails sometimes epidemically. It rarely occurs more than
once in the same individual. It commences with a stiffness of
the jaws, attended oftentimes by a feeling of restlessness, and a
slight degree of fever. This is succeeded by a swelling of one
or both sides of the neck, about the angles of the jaw, which fre-
". occasions difficulty of swallowing, and sometimes inter-
eres with the respiration. The swelling is moveable at first, but
soon becomes hard and firm. It increases until about the fourth
day, when it begins to decline. The breasts in females and the

526 PRACTICE OF MEDICINE.
testicles in males are liable to become affected, and sometimes
swell to an enormous degree.
2173. TrEATMENT. The mumps is usually a very mild com-
|..." provided the patient avoids exposure to the cold. The swel-
ing should be covered with a flannel, and bathed frequently with pep-
er sauce, rheumatic drops, or the antispasmodic tincture. The
ace should be washed in warm instead of cold water, as the latter is
apt to cause a transfer of the swelling to the parts already named.
Injections to free the bowels, if they are confined, and composition
enough to keep the skin moist and of a natural temperature, is all
the treatment that is generally required. If a violent fever should
arise, however, or the testicles or breasts should swell, a course
of medicine is to be given, or at least an emetic to cleanse the
stomach. The breasts, or testicles, as the case may be, should
be bathed several times a day with rheumatic drops, or volatile
limiment, and a heated stone wrapped in several thicknesses of a
damp cloth applied to them.
NETTLE RASH.
2174. This is an eruption of the skin, manifesting itself in
blotches or elevations of a red color. It is attended by heat and
itching of the parts, resembling the sting of an insect. In children
it is called hives. It is most common in the spring and autumn,
and is apt to appear when the body is overheated by exercise, or
the skin irritated by scratching. In some instances, the patient
complains of drowsiness, loss of appetite, nausea, and headach.
It is caused by the use of wine, and ardent spirits; by particular
kinds of food; by irritating applications to the skin; and more
especially by overheating the system, and allowing it to cool sud-
denly.
#5. No part of the body is exempt from the disease, and
where many of the blotches “rise together, and continue an hour
or two, the parts are often considerably swelled, which particularly
happens in the arms, face, and hands. The eruption infects the
skin, sometimes in one place and sometimes in another, for one or
two hours together, two or three times a day, or perhaps for the
greatest part of twenty four hours. In some constitutions it lasts
only a few days, in others many months.”
2176. TREATMENT. Relief is afforded by giving cayenne
or composition to produce a ". aiding the medicine, if
n case of drowsiness, or nausea,
necessary, with the vapor bath.


PRACTICE OF MEDICINE. 527
an emetic should be given to cleanse the stomach. The patient
should be particular about his diet, eating moderately, and avoid-
ing the use of fat meat, butter, pastry, gravies, and all unwhole-
some mixtures. If there is nervous irritation, a tea of scullcap
may be employed with advantage. Those predisposed to the
complaint, should rub the skin every night and morning with a
coarse towel, or flesh brush; and the hand bath would also be
highly serviceable. (1455.)
NIGHTMARE.
2177. Nightmare occurs during sleep, and consists of an
anxious or fearful dream. The individual fancies that some mon-
ster is pressing on his chest; or that he is endeavoring to escape
from an assassin, or a furious wild beast, without the ability to
speak, or move ; or that he is about to be dashed to pieces by
falling from a great height; or some other equally wild and horri-
ble conceit. The respiration is impeded, and sometimes the
patient is threatened with suffocation. The frightful sensations
which are experienced, “generally originate in a large quantity of
wind, or indigestible matter in the stomach, which, pressing the
stomach against the diaphragm, interferes with the respiration, or
renders it short and convulsed. Flatulent distention of the intes-
times may likewise produce similar results.” The individual on
awaking, often finds himself bathed in perspiration.
2178. TREATMENT. If an attack is feared, a tea-cupful of
cayenne and scullcap tea, or from three to five lobelia pills, may
be taken at bed time, and a jug of hot water wrapped in a damp
cloth placed at the feet. This will keep the circulation active
during the night, and generally prevent an occurrence of the
malady. The individual should be particular, however, to avoid
intemperance in eating, and particularly late or full suppers, and
he will cease to be annoyed by the midnight intruder.
PALPITATION OF THE HEART.
2179. This disease is more common in the old than the young,
and consists of a strong and irregular action of the heart, which is
sometimes called throbbing, and when the action is more feeble,
it is termed fluttering of the heart. During the attack, there is
often difficulty of breathing, giddiness, nausea, ſainting, and some-
times blueness of the lips. The palpitation is occasionally so
528 PRACTICE OF MEDICINE.
strong as to be heard by the bystanders. It occurs in nervous
affections, such for example as hysteria, and is a symptom also of
enlargement of the heart, and other diseases of this organ. It is a
common result of blood-letting, and the use of digitalis. It often
accompanies a disordered state of the stomach and bowels, espe-
cially in pregnant women, and is mostly brought on by severe
exercise, and strong mental emotions. Injuries of the heart by
violence, also give rise to palpitation. Dr. Good mentions the case
of a French soldier, who was wounded by a musket ball passing
into his breast, which was followed by troublesome palpitation of
three years' continuance. In six years after the accident, he died
of a complaint totally unconnected with the wound, and upon
examination it was found that the ball which entered his breast
was lodging in the right side of his heart.
2180. TREATMENT. The diplomatised physicians frequent-
ly pronounce the disease incurable, when, in fact, if they would
cease to administer their drugs, the patient would speedily re-
cover through the sanative operations ºnature alone. Dr. Good,
from whom I have just quoted, remarks, “It frequently happens,
that a palpitation of long standing, and which has been regarded as
of a dangerous kind, has gradually gone away of its own accord, and
left us altogether in the dark.” Dr. Cullen also mentions the
case of a gentleman who suffered two or three years with violent
palpitation of the heart, which was pronounced by many physi-
cians absolutely incurable, but the disease gradually abated, and at
length wholly disappeared.*
218.1. In ordinary cases of palpitation, it will be sufficient to
take a dose of spiced bitters before each meal, and one of compo-
sition, or cayenne and bayberry, containing a slight portion of
lobelia, on going to bed at night. If the stomach is much dis-
ordered, it is to be cleansed with an emetic ; and if the bowels are
costive, an injection should be administered at least once a day.
Where there is much nervous excitement, the lobelia pills, or a
tea of scullcap, may be used advantageously. The food must be
light and easy of digestion, and every thing avoided which has the
slightest tendency to derange or oppress the stomach. (See re-
marks on diet, 1680, et seq.) Exercise in the open air will be
beneficial, provided it is not severe, or fatiguing; and the patient
should be careful not to indulge in fits of anger, or violent emo-
tions of any description. Cold bathing, also, in some form or
other, (1448, et seq.) is of great service, as it tends to invigorate
the system, and thereby to remove the disease.
* Cullen’s Materia Medica.

PRACTICE OF MEDIC INE. 529
2182. If the patient is suffering under a severe attack of the
disease, it may be relieved by the use of the stimulating tea,
(1515) giving it in small and frequently repeated doses until per-
spiration ensues, and in the meantime placing heated stones wrap-
ped in damp cloths at the feet and sides. The latter, or the
vapor bath in its stead, are indispensable, in order to invite the
blood to the surface of the body; otherwise the use of stimulants in-
ternally may increase rather than diminish the palpitation. So long
as the skin is moist, and there is an equilibrium of the circulation,
the patient will be free from suffering. In affections of the heart,
I would particularly recommend the application of external
warmth, and the use of lobelia in doses just short of producing
nausea.
2183. If the palpitation is owing to an affection of the heart, or
is dependent on some obstinate nervous disorder, a few courses of
medicine will be required, repeating them according to the vio-
lence or urgency of the symptoms.
PALSY OR PARALYSIS.
2184, Palsy is characterised by a loss of motion and sensi-
bility, and usually attacks one entire side of the body, but is some-
times confined to a particular part, as a hand, an arm, or a leg.
Particular nerves are occasionally palsied, so that the patient is
deprived of one or more of the senses. When the lower part of
the body is the seat of the disease, the individual is apt to lose
the control of the bladder and rectum.
2185. Palsy is often occasioned by apoplexy, inflammation
of the brain, disease of the spinal marrow, and compression of the
nerves in dislocations, fractures, or injuries of any description.
Among the causes of the malady, are masturbation, excessive
venereal indulgence, severe study, want of exercise, and intem-
perance in eating and drinking. The long continued application
of sedatives, says a medical writer, will likewise produce palsy,
as we find those whose occupations subject them to the constant
handling of white lead, and those who are much exposed to the
poisonous fumes of metals or minerals, are more or less subject to
its attacks.
2186. “Palsy usually comes on with a sudden and immediate
loss of the motion and sensibility of the parts; but in a few instan-
ces, it is preceded by a numbness, coldness, and paleness, and
sometimes by slight convulsive twitches. When the head is much
affected, the eye and mouth are drawn to one side, the memory
and judgment are much impaired, and the speech is indistinct and


67
530 PRACTICE OF MEDICINE.
incoherent. If the disease affects the extremities, and has been
of long duration, it not only produces a loss of motion and sensi-
bility; but likewise a considerable flaccidity and wasting in the
muscles of the parts affected.”
2187. TREATMENT. Courses of medicine, repeated at
proper intervals, will cure most cases of palsy—at least I have
never known them to fail.
2188. The vapor bath of itself is a valuable remedy, and
may be administered every other day, followed by an application
of the stimulating liniment to the entire surface of the body. Care
must be taken that the vapor is not too hot, however, for if there
is a great loss of sensibility in the affected parts, it will sometimes
do serious injury, even at a temperature that would be agreeable
and pleasant under other circumstances. (1494.) I have known
patients to be badly scalded through carelessness in this respect.
The same remarks are equally applicable to heated stones, or
bottles of hot water.
2189. Between the courses, cayenne, bayberry, and spiced
bitters may be freely employed, to keep up an action in the sys-
tem, and invigorate the digestive organs. Injections may be used
advantageously two or three times a day, whether the bowels are
costive or not. The lobelia pills, or alterative mixture, will be
found of essential service as a part of the intermediate treatment.
The diet must be regulated, eating those articles of food which
are light, and easy of digestion, and taking care not to overload
the stomach. (See remarks on diet—1680, et seq.)
2190. The affected parts should be rubbed frequently with
pepper sauce, volatile liniment, or tincture of cayenne, the latter
of which is preferable where there is great coldness, or loss of
sensibility. Flannels wrung out of either of these liquids, and
warmed by the fire, may also be applied, together with heated
stones wrapped in damp cloths. The flannels may be renewed
two or three times a day until the sensibility is restored.
2191. The surface of the body should be rubbed every night
and morning with a coarse towel, or flesh brush, until the skin is
in a warm and pleasant glow. Friction up and down the course
of the spine, is, in many instances, particularly beneficial.
2192. If the paralytic shock has been caused by apoplexy,
the same treatment should be pursued which is recommended
under that head. (1749, et seq.)


*RACTICE OF MEDICINE. 531
PIH.E.S.
219.3. These are tumors of various sizes, which are situated
either within or at the verge of the anus, and consist of an enlarge-
ment or distention of what are termed the haemorrhoidal vessels. *
They usually commence with a tingling sensation in the anus, or
perhaps a feeling of uneasiness or oppression, and if the individual
is much upon his feet, or exercises severely, they speedily en-
large, and become excessively painful. They are known as blind
piles when no blood is discharged, but otherwise, they take the
name of bleeding piles. Sometimes they form a ring or cluster
round the internal surface of the rectum, and interfere with the
passage of the feces, causing severe pain and suffering. They
are often forced down at stool, and in some instances are returned
with difficulty. The mucous or lining membrane of the rectum,
being in a relaxed or debilitated state, is also apt to protrude.
The local irritation generally extends to the bladder, and causes a
frequent desire to pass water. -
2194, Piles are most common to persons in the middle pe-
riod of life, and rarely occur in youth, or after the age of fifty.
Pregnant women are very liable to them, and also persons of
weak and relaxed habits of body, Purgatives are a fruitful source
of them, and hence their prevalence since the introduction of
Brandreth's pills. They are also caused by a sedentary life, the
frequent use of strong coffee, liſting or carrying heavy burthens,
and above all, by long continued costiveness.
2.195. In some instances the piles become inflamed, and the
inflammation terminates in an abscess, which arises in the middle
of the tumor, and degenerates into a fistulous sore. In other
cases, the inflammation terminates in a hardened or indurated
mass, which sometimes ulcerates, and discharges a thin, acrid
matter,
2196. The piles are so large in some instances, as to fill the
rectum, and the excrements, if they are at all hard, cannot pass.
Under these circumstances, the piles are forced out of the anus,
at stool, in order to procure a free passage, and the internal coat
of the rectum, as I have said, is naturally protruded with them.
If the bleeding piles come down in this manner, they discharge a
considerable quantity of blood, because the anus, by the contrac-
tion of its muscles, forms a kind of ligature above them.
2197. TREATMENT. Particular attention must be paid to
* For this reason, the piles, in medical language, are termed hamorrhoids.
532 PRACTICE OF MEDICINE.
the bowels in this complaint, for if costiveness ensues, it will be
rendered much more violent. Injections may be used once or
twice a day, or any of the remedies may be employed to keep
the bowels open which are recommended under the head of cos-
tiveness. (1896, et seq.) Food should be selected that will digest
easily, and not oppress the stomach, such as preparations of In-
dian meal, ripe fruits, and especially the unbolted wheat bread.
Apples are particularly beneficial, and may be eaten at each meal.
2198. If the piles are sore or irritable, a tea of raspberry,
sumach, or witch hazel leaves, may be administered by way of in-
jection, and as soon as the smarting ceases, a portion of ginger,
cayenne, or rheumatic drops, may be added to the tea. The in-
jections must, in all cases, be strained, or the sediment may oc-
casion pain, and tenesmus. (1575.) -
2199. The pile ointment (1313, et seq.) may be used exter-
nally with great advantage, spreading it on a piece of folded linen,
and confining it to the part by means of a bandage in the * of
the letter T. Where the piles are situated at the verge of the
anus, however, there is no one thing which gives such immediate
relief as the application of a piece of cotton wool, previously
moistened with the essence of spearmint. It causes a pungent or
smarting sensation, and if the pain is severe, may be removed in
the course of ten or fifteen minutes. The application may be re-
peated, if necessary. I have prescribed this remedy in numerous
instances, and scarcely ever knew it to fail in producing the de-
sired effect.
2200. From two to five lobelia pills, taken at bed time, with
a dose of composition tea, are highly useful, as they are generally
followed by an easy stool the next morning. -
2201. If the piles have been neglected for a long time, and
the general health is much impaired, it will be necessary to ad-
minister courses of medicine, repeating them according to the cir-
cumstances of the case. Injections should be employed two or
three times a day between the courses, particularly if there is an
acrid discharge from the rectum.
PLEURISY.
2202. Pleurisy consists of an inflammation in the membrane
which covers the lungs, and lines the cavity of the chest. An
acute pain arises in one or both sides, which is increased by
coughing, or upon taking a full breath. The skin is usually, hot
and dry, the pulse hard and frequent, the tongue covered with a
thick, white coat, the countenance flushed, and the urine scanty

PRACTICE OF MEDICINE. 533
and of a deep red color. The patient does not lie upon the
affected side, but generally throws himself upon his back, as
the most easy and comfortable position. Cough is not an in-
variable symptom, but when present, is either dry, or accom-
panied with a slight discharge of nearly transparent matter. In
case the inflammation attacks the substance of the lungs, however,
the matter expectorated is generally mixed with blood.
2203. Pleurisy mostly occurs in persons of a full and ro-
bust habit, and is generally caused by exposure to cold, whereby
the blood is thrown in an undue quantity upon the internal organs.
2204. The lungs, in consequence of the inflammation, some-
times adhere to the sides of the chest, but this is not considered
a serious accident, for it does not interfere with the respiration.
2205. TREATMENT. The treatment which was recommend-
ed for inflammation of the lungs, is equally applicable in pleurisy.
(2127, et seq.) Medicines are to be given to produce a deter-
mination to the surface of the body, and as soon as the patient
begins to perspire freely, he will generally experience relief.
Cayenne and bayberry tea, lobelia in small doses, injections,
and the application of heated stones wrapped in damp cloths to
the feet and sides, are each important. In violent attacks, our
chief dependence must be upon full and thorough courses.
2206. As an application to the side, I have found the follow-
ing extremely beneficial. Take equal parts of cayenne and brown
lobelia, and make them into a paste with healing salve, meadow
fern ointment, or lard. Spread this on a piece of linen of the
priate bandages. The stimulating liniment will also answer a
good purpose; or flannels wrung out of warm rheumatic drops,
volatile liniment, or vinegar and cayenne, (1531) may be applied,
together with a heated stone, as already directed. The stone
itself will frequently suffice to allay the pain.
2207. After the disease is removed, the patient should not
expose himself to a cold or damp atmosphere, until his lungs be-
come strong and vigorous, or he will be in danger of a relapse.
PO ISONING.
2208. This is occasioned by a variety of mineral and vegetable
substances, such as arsenic, corrosive sublimate, calomel, sulphate
of zinc, tartar emetic, sulphuric and nitric acids, antimony, sugar of
lead, nitre, prussic acid, opium, laudanum, digitalis, poison hem-
lock, belladonna, and so on to the end of the chapter. They act
proper size, and confine it to the region of the pain with appro-


534 PRACTICE OF MEDIC INE.
either by irritating, or corroding the stomach and bowels, or by
stupifying the brain and nervous system, giving rise to drowsiness,
stupor, and frequently convulsions.
2209. Persons are often killed through the carelessness of the
apothecaries, who give them some deadly poison instead of the
article for which they enquire. Mistakes of this kind are of fre-
quent Occurrence.
2210. Arsenic is a well known poison, and is more frequent-
ly employed than any other for criminal purposes. In a large
dose it is apt to excite vomiting, and may be discharged from the
stomach without doing material injury. When not thus ejected,
it frequently destroys life in a few hours. Among the symptoms
which mark its progress, are a burning sensation in the throat,
excessive vomiting, dizziness, griping pains in the stomach and
bowels, purging of blood, hiccough, º of breathing and
swallowing, livid and bloated countenance, great debility, ſainting,
insensibility, cold sweats, palsy of the limbs, and convulsions.
2211. The narcotic poisons, such as opium, give rise to
drowsiness, stupor, a loud or snoring respiration, pale or livid
countenance, great relaxation, insensibility of the eye to light,
and sometimes vomiting and convulsions. Death often takes place
very speedily.
2212. TREATMENT. Vomiting should be produced without
delay, so that the poison may be ejected from the stomach, and
there is no emetic, with which I am acquainted, that will operate
more speedily and effectually than lobeſia. It may be employed
in any of its forms, and should be given in full and frequent doses
until the desired effect is produced. During the operation, warm
teas should be given freely to wash out the stomach, Slippery
elm tea may also be employed with great advantage, both during
the continuance of the vomiting, and for several hours after it has
ceased. If the poison is followed by soreness or inflammation of
the stomach, it will be advisable to administer a course of med-
ICine.
2213. About a year ago, a gentleman of Boston staggered into
one of the infirmaries in that city, and said that he had injured
himself by a fall. He was slightly delirious. His face was swell-
ed, and of a livid color. In a short time he became insensible.
A tea-cupful of composition tea, containing a tea-spoonful of brown
lobelia, was poured down his throat in table-spoonful doses. In
five minutes he vomited, and discharged a large quantity of dark
colored matter. He then stated his suspicions that his wife had
given him arsenic, which she had attempted to do once before.
During the night, he frequently became drowsy, or stupid, but

PRACTICE OF MEDICINE. 535
was as often revived by the composition and lobelia, as mentioned
above. In the morning, a thorough course of medicine was
administered, which afforded almost entire relief. The patient
complained of difficulty of breathing for two or three days, after
which he recovered his usual health.
2214. If poisoning is produced by an alkali, it may be neutral-
ized by an acid, as vinegar, or lemon juice and water, and thereby
rendered inert.
2215. If an essential oil has been swallowed, it may be ren-
dered comparatively harmless by taking a portion of brandy, or
other spirit. These antidotes should be immediately followed by
an emetic to cleanse the stomach.
QUINSY. AND PUTRID SORE THROAT.
2216. Quinsy or inflammatory sore throat is very common in
the spring and autumn, when the weather is changeable. It com-
mences with chilliness, which is succeeded by fever, and pain in
swallowing. As the disease advances, the swallowing becomes
exceedingly difficult, if not impracticable, and the throat and
tongue are often so much swelled as to destroy the voice, and
render the breathing laborious. The pain in the throat is severe
and darting, and frequently extends to the ears. The mouth is
dry, and the tongue covered with a white, or dark coat. Some-
times the eyes are inflamed, and the face red and bloated. Where
the inflammation is not checked in season, little ulcers form in the
throat, which increase the sufferings of the patient, and render the
case tedious and distressing.
2217. The complaint is caused by exposure to a damp or
chilly atmosphere, wet feet, standing on the cold ground, wearing
damp clothes, and by the irritation of indigestible food in the
stomach. Persons who have had one attack, are extremely liable
to a second. Salivation, says Dr. Eberle, appears to create an
increased aptitude to the disease.
2218. Putrid sore throat prevails sometimes as an epidemic,
and is often an attendant upon scarlet fever. It commences with
chilliness, and sometimes nausea and vomiting, with the usual
symptoms of a sore and inflamed throat. The breath becomes
offensive, the neck is occasionally stiff, and dark looking ulcers
are seen in the mouth and throat. The tongue is covered with a
brown, or black coat. The inflammation often extends to the
ears, producing deafness, and sometimes to the brain, causing
delirium, or stupor. Dark colored spots make their appearance,
in some cases, about the face, neck, and other parts of the body.

536 PRACTICE OF MEDICINE.
-
The ſever is violent, and generally increases towards evening. If
the disease is not arrested, it tends rapidly to putrefaction. Co-
pious diarrhoea ensues, accompanied by great prostration, and not
unfrequently a discharge of blood from the mouth, nose, and other
free passages.
2219. TREATMENT. In violent attacks of these complaints,
courses of medicine should be given, repeating them according to
the urgency of the case. It is sometimes necessary to administer
two or three courses in twenty four hours. The treatment in
quinsy, however, does not require to be so active as that in putrid
sore throat. In mild cases of the former disease, a free use of com-
position, or cayenne and bayberry, with an occasional injection to
keep the bowels open, will often effect a cure. Slightly nauseating
doses of lobelia are highly serviceable in allaying the inflammation.
The best form of this medicine is the stimulating tea. (1515.)
2220. If the patient is unable to swallow, an injection con-
taining a tea-spoonful of green lobelia (1567) may be adminis-
tered, repeating it once or twice until it produces the requisite
degree of relaxation. Cayenne and bayberry tea should then be
given, followed by the vapor bath, and all the requisites of a full
and thorough course of medicine. It is sometimes necessary to
adminster all the medicines by way of injection. A case of this
kind is detailed in paragraph 1555. º
2221. The various teas should be administered without the
sediment, straining them through a cloth, or fine seive.
2222. The throat should be frequently gargled with bayberry
tea, followed by a weak infusion of cayenne. This will detach
large quantities of offensive matter, and afford great relief.
2223. Breathing the fumes of vinegar, or the vapor of water,
is productive of benefit.
2224. Pepper sauce is a useful medicine in affections of the
throat; or in the absence of this, the following preparation may be
used. Take of cayenne a tea-spoonful and a half; fine salt half a
tea-spoonful; boiling water a tea-cupful. Steep fifteen minutes,
and add a tea-cupful of good cider vinegar. A table-spoonful of
this may be given every fifteen minutes or half an hour, as the
case may seem to demand. It is pleasant to the taste, and
highly salutary in its effects. In some instances, the salt may act
as a purgative, and if so, it should be omitted from the prepara-
tion.
2225. External applications to the throat are important, and
among these, I know of none better than a mixture of vinegar and
cayenne, simmered for a few minutes over the fire. The throat
should be rubbed with this liquid for ten or fifteen minutes, and

—i.
PRACTICE G F MEDICINE. 537
|
a flannel moistened with it, tied round the neck. The application
may be renewed several times a day. It is a valuable remedy in all
cases of sore throat. In some instances it produces severe smart-
ing, while in others it only causes a pleasant sensation of warmth.
2226. Raspberry, or barberry jelly, (852, 997) dissolved in
water, makes a refreshing and cleansing drink in inflammatory, or
putrid sore throat, and is particularly useful during convalescence.
2227. A case of putrid sore throat came under my observa-
tion in Boston, in which courses of medicine afforded little or no
relief, the breathing being difficult, and the patient complaining of
great fulness in the throat. The tincture of lobelia was given
in the dose of a tea-spoonful, every few minutes, and in this
way he swallowed at least three wine-glassfuls without vomiting.
He expectorated more than a quart of yellow and offensive matter,
however, which relieved the urgent symptoms, and then, by the
administration of another course, he was restored to the full en-
joyment of health.
RHEUMATISM.
2228. Rheumatism is generally produced by the influence
of cold, and consequently is most prevalent when the weather is
damp and variable. It commences with chilliness, followed by
flushes of heat, and a quick and strong pulse, which varies from
one hundred and twenty to one hundred and forty beats in a min-
ute. The pain is very acute, and mostly confined to the larger
joints. The parts are frequently red, swollen, inflamed, and
extremely tender to the touch. The skin is hot and dry, the
appetite impaired, the thirst excessive, the urine scanty and high
colored, and the tongue covered with a white, or brown coat.
The bowels are generally costive. Sometimes there is headach
and redness of the eyes, and in some instances a vomiting of bilious
matter. The muscles about the ribs are occasionally affected,
so that the patient imagines himself to be laboring under an attack
of pleurisy. The pains are sometimes fixed, and at others wan-
dering, changing from one part of the body to another within
twenty four hours, and if the disease is improperly treated, they
are not unfrequently transferred to vital organs, such as the brain,
heart, stomach, bladder, and womb, producing serious, and even
fatal consequences. -
2229. Rheumatism is frequently caused by the use of mercury,
which deranges the whole system, and renders it extremely sus-
ceptible to the *... cold. In the Southern States, where
8



538 PRACTICE OF MEDICINE.
T-
calomel is employed freely in ſevers, mercurial rheumatism, as it
is termed, is a very common complaint.
2230. TREATMENT. The medical faculty, according to their
own confessions, appear to be entirely ignorant of the proper
treatment to be pursued in rheumatism. Dr. Mackintosh, in his
Practice of Physic, remarks, “One set of practitioners depend
entirely upon blood-letting; another upon purging; a third upon
exciting long-continued profuse perspirations; a fourth upon the
exhibition of bark alone; and a fifth upon a course of mercury to
produce salivation. It is no wonder, therefore, under such
empirical treatment, that an attack of the disease used formerly to
continue violent for such a long period of time. Formerly an
attack of acute rheumatism, with its consequences, generally con-
fined the patient for twelve months, that is to say, before he
regained his ordinary state of health, and few got off with less than
six months’ confinement to bed.” -
2231. Dr. Mackintosh also condemns “the calomel and
opium treatment” in rheumatism, which is so fashionable at the
present day, observing that he has “often seen the tongue of
patients swollen and ulcerated, and profuse salivation produced,
without the least signs of amendment.”
2232. With regard to the “perspirations” which are objected
to in the above paragraph, we are informed by Dr. Mackintosh,
that they were produced by “a load of bedclothes,” and “large
and repeated doses of Dover's powder.” Now as this powder is
a poisonous preparation, being composed of ipecac, opium, and
sulphate of potassa, it need not excite our surprise that the “per-
spirations” proved injurious, and indeed it is fortunate that the
patients even survived the treatment. Perspiration which results
from the use of pure, healthy stimulants, however, together with
the vapor bath, will always have a beneficial effect.
2233. There is no disease, perhaps, in which the reformed
ractice produces such extraordinary results as in rheumatism.
º relieves the most excruciating pains in a few hours; and I have
known patients who had been crippled for years, to be restored to
the use of their limbs, as well as the enjoyment of health, by two
or three courses of medicine.
2234. A mild attack of the complaint may often be cured by
rubbing the affected part two or three times a day with the rheu-
matic drops; or by giving a tea of composition, or cayenne and
bayberry, until perspiration ensues; or by the administration of a
vapor bath, together with one or two injections to evacuate the
bowels. In an obstimate, or chronic case, however, particularly if
it has been caused by mercury, it is usually necessary to administer

PRACTICE 0F MEDICINE. 539
courses of medicine, repeating them at proper intervals, until the
disease is removed. Between the courses, the patient must avoid
exposure to cold, keep his feet warm and dry, dress according to
the season and climate, and make use of the ordinary stimulants
and tonics, according to the circumstances of the case. (1660,
et seq.) If the bowels are costive, an injection should be ad-
ministered once or twice a day. Lobelia pills, both during the
day, and at night on going to bed, will be beneficial. The
affected parts may be bathed frequently with vinegar and cay-
enne, (1531) antispasmodic tincture, volatile liniment, or, if
there is a loss of sensibility, with the strongest tincture of cay-
enne; and if this does not afford the desired relief, flannels wrung
out of either of these liquids, and warmed by the fire, may be
applied, together with a heated stone, or bottle of hot water,
wrapped in a damp cloth.
2235. If the weather is chilly, or if the individual possesses
but little animal heat, the entire surface of the body may be rubbed
after each course of medicine with the stimulating liniment. (1306,
et seq.)
2236. The diet should be nourishing and easy of digestion.
Many an attack of rheumatism has been prolonged by overloading
the stomach, and eating gross and improper food, notwithstanding
tolerably efficient treatment.
RIC KETS.
2237. This disease is characterized by softening and distor-
tion of the bones, and seldom appears before the ninth month of
infancy, or later than the third year. The flesh becomes soft, the
head enlarges, the breast bone protrudes, and the limbs waste
away. The spine is distorted, having a curve like the letter S.
The countenance is pale, and the cheeks sallow, accompanied
by emaciation, debility, cough, disinclination to motion, difficulty
of breathing, and swelling of the abdomen.
2238. TREATMENT. The disease is one of extreme debility,
and is dependent, no doubt, on a highly disordered state of the
digestive organs. Hence the bones are imperfectly nourished, and
losing the earthy matter which gives them strength and hardness,
(17) they easily bend under the weight of the body. No time should
be lost, therefore, in adopting the necessary treatment to restore
the health, and invigorate the general system, for, although the life
of the child may be saved, it may, from the soft and yielding state
of the bones, become hopelessly deformed. Besides, if the patient

540 PRACTICE of MEDICINE.
is a female, malformation of the pelvis may ensue, which is no
uncommon thing in rickety children, and in the event of pregnancy,
her life may become a sacrifice from the difficulty attending pār-
turition.
2239. The system must be invigorated with the bitter or
restorative medicines, pure air, and a wholesome, nourishing diet.
Tea, coffee, butter, rich cakes, pastry, white bread, oily or
greasy substances, and many similar articles with which children
are surfeited by their fond and anxious parents, should be sedu-
lously withheld from the patient. Milk, ripe fruits, the un-
bolted wheat bread, wheat jelly, slippery elm boiled in milk,
(1431) and preparations of oatmeal, }. meal, sago, rice, and
tapioca, may all be used to advantage. The child must be kept
clean, and proper means taken to give it plenty of exercise in the
open air. Its skin should be rubbed every night and morning
with a coarse towel, or flesh brush. The bowels are generally
disordered, and should be evacuated once or twice a day with in-
jections. The alterative mixture, (1526) and compound for chil-
dren, (1528) will both be found very useful internal remedies.
Equal parts of composition and spiced bitters, also, is an excel-
lent form of medicine. Half a tea-spoonful of this powder, and
double the quantity of sugar, mixed with half a wine-glassful of
cold, or lukewarm water, may be taken in substance, three times
a day. In addition to this treatment, the stomach, if it is much
disordered, should be cleansed once or twice a week with an
emetic of lobelia, preceded by an injection, and the vapor bath.
2240. Care must be taken to prevent curvature of the spine.
“For this purpose,” says Sir Astley Cooper, “it has been the
practice to keep children in the recumbent posture for a great
length of time. This is a plan which I by no means advise; ex-
ercise should be freely allowed, taking care only that it be not pro-
tracted so as to occasion fatigue. At the same time that exercise
is taken, you must preserve the spine in a straight position by giv-
ing it artificial support. This may be effected by two springs of
steel added to the stays, one on each side of the spine, which
may be worn by the patient in any position. In the use of me-
chanical means, however, the great object should be, not to force
the child into a constrained position, but merely to prevent incli-
nation on one side or the other.”
2241. Whatever advantage may be derived from giving arti-
ficial support to the spine, I suspect, after all, that the best mode
of treatment, is, to increase the tone and vigor of the muscles,
which will be far more effectual in preventing deformity, than
steel springs, or any other mechanical contrivance. Nevertheless,
I am persuaded that cases occur, in which artificial support is pro-
PRActice of MEDICINE. -- 541
ductive of beneficial results, yet it can avail but little, unless the
general system is strengthened and invigorated by attention to diet,
and correct medical treatment.
2242. The body should be prevented from pressing upon the
lower extremities, until the bones have acquired sufficient solidity
and firmness to support the weight. This remark is applicable to
infants generally, and not to those only affected with the rickets.
Mr. Combe says that parents generally delight to see their infants
“run alone” at as early an age as possible, and use many methods
to induce them to stand and walk. “The bones,” he adds,
“which are the frame-work of the body, do not become perſectly
solid till near twenty years after birth. In very young children,
bones are but pliable gristle, and by pressure, or the support of
weight, are bent from their natural shape. When the child stands,
its whole weight is thrown on the bones of its legs, which at too
early an age are not firm enough for its support, and they are thus
liable to be bent. If let alone, nature will prompt the infant when
to rise up. It will not continue to creep till the age of four-
score, as some seem to imagine.”
RINGWORM.
2243. This is an eruption of the skin, appearing in circular
patches of a deep red color, having a number of very minute pim-
ples or blisters around the circumference. It is most frequent
in children, occurring usually about the face, neck, and shoulders,
and is attended with a troublesome itching. When the circles
are large, the skin in the centre has a healthy appearance, but
otherwise it is reddened, somewhat elevated, and roughish. The
pimples break in four or five days, followed by thin brownish
crusts, which finally scale off. In many cases, however, there are
frequent renewals of the eruption, which protract the disease for
many weeks, and even months.
2244. TREATMENT. Keeping the part clean with soap and
water, bathing with rheumatic drops, or the antispasmodic tincture,
and applying healing salve, or meadow fern ointment, to exclude
the air, is probably, the best treatment that can be pursued.
Rheumatic drops and the red powder or dust of sumach berries,
form a superior wash in this complaint. It may be applied several
times a day, followed by the ointment as already directed. The
root of yellow dock, simmered in cream, as recommended for the
itch, is also an excellent remedy.

542 PRACTICE OF MEDICINE.
RUPTURE OR HERNIA.
224.5. When a portion of the intestines is protruded from the
abdomen, forming a tumor or sac under the skin, it is called a
rupture.
2246. This protrusion may take place at various parts, but it
generally occurs at the groin, and inner part of the thigh.
2247. There is an opening through the muscles at the lower
part of the abdomen for the passage of certain vessels which go to
the testicles in the male, and to the genital organs in the female ;
and if this aperture is unusually large, or the parts are in a weak
or relaxed condition, a portion of intestine may escape through
it, and form an enlargement, swelling, or otherwise a hernia.
Sometimes the protruded portion descends into the scrotum, and
then it takes the name of scrotal hernia. If it does not descend
thus low, it is known as inguinal hernia.
2248. Rupture in females most commonly takes place at the
inner part of the bend of the thigh, the intestine forcing itself
through the aperture which gives passage to the blood-vessels
leading to and from the lower extremity. This, both in the male
and female, is called femoral or crural hernia.
2249. When the bowels protrude at the navel, it is designated
umbilical hernia, and when from any other promiscuous point in
front of the abdomen, ventral hernia.
2250. The membrane which lines the cavity of the abdomen
always makes a part of the hermial sac, because it is necessarily
pushed before the intestine, as the latter escapes from the abdom-
inal cavity.
2251. The rupture is increased in size by coughing, but is
diminished by pressing upon it with the fingers. In lying down it
almost entirely disappears. If long neglected, it may form ad-
hesions to the parts with which it is in contact, so that it cannot
be returned; or it may become inflamed and swollen, so as to in-
terrupt the circulation of the blood, as well as the passage of the
feces. In the latter case there is more or less danger, the patient
experiencing severe pain, and being attacked, in most instances,
with nausea and vomiting. If the intestine is not returned, mor-
tification ensues, accompanied with cold, clammy sweats, and a
sudden abatement of the pain and swelling.
2252. Among the causes of rupture, besides general weak-
ness or debility of the system, are running, jumping, lifting heavy
weights, wearing tight apparel, straining at stool, and parturition.
2253. A hernia or rupture is said, in medical language, to be
either reducible, irreducible, or strangulated. These terms are

PRACTICE OF MEDICINE. 543
thus explained by Sir Astley Cooper. It is reducible, when the
protruded bowels lie quietly in the sac, and admit of being readily
put back into the abdomen; irreducible, when the protruded bow-
els suffer no constriction, yet cannot be put back, owing to ad-
hesions, or their large size in relation to the aperture through
which they have to pass; and strangulated, when the hernia not
only cannot be reduced, but suffers constriction also ; so that, if a
iece of intestine be protruded, the pressure to which it is sub-
jected, stops the passage of its contents towards the anus, excites
inflammation of the bowels, and brings on a train of alarming and
often fatal consequences.
2254. TREATMENT. When a rupture is first discovered, it
should be returned gently with the fingers, and the intestine pre-
vented from protruding again, by applying a roll of cotton, or
something of like nature, to the part, and maintaining it there with
a bandage. This can be easily done by a person of common in-
genuity, and at very little expense. Those who can afford a
truss, however, had better procure one, as this, if properly ad-
justed, is in every respect convenient and comfortable to the
wearer. Among the various trusses which have been invented of
late years, I know of none that I am disposed to recommend more
highly than those of Dr. Fletcher of Boston.
2255. If the health is much impaired, it must be reinstated by
the use of composition, spiced bitters, injections, and other appro-
priate remedies; or if necessary, by the administration of a few
courses of medicine.
2256. It may be impossible to reduce a hernia, on account
of an adhesion, and yet it is not to be considered dangerous, so
long as inflammation and swelling do not arise. Every precaution
should be taken, however, not to increase the difficulty, either by
injuries, violent exercise, or inattention to the health.
2257. A strangulated hernia cannot be returned until the in-
flammation and swelling are subdued, and this may be speedily
and effectually accomplished by the administration of a course
of medicine. When the system is sufficiently relaxed by the
lobelia, the protruded bowel is to be returned very gradually,
taking care to do it gently, and without using force, for it
would be better to occupy an hour or two in the operation,
than to perform it with undue haste, or violence. After the re-
duction is accomplished, the patient should wear a truss, or com-
press and bandage, as previously directed, to prevent a repetition of
the accident. In replacing the protruded intestine, the patient
should lie upon his back, with his thighs bent upon his body, and
his head and shoulders elevated with pillows. This position is
avorable to a relaxation of the muscles of the abdomen.


544 PRACTICE OF MEDICINE.
2258. Surgical operations should not be tolerated in this
complaint, for patients are frequently destroyed by the unhallowed
knife of the surgeon, who might have been readily cured by judi-
cious medical treatment. There is not only danger of severing
an important artery, but also of cutting into the intestines, in which
case the patient’s life becomes a sacrifice. Death frequently
ensues also from inflammation which arises as a consequence of
the operation.
2259. In infants, the bowels not unfrequently protrude at the
navel, and in that case, the difficulty is to be obviated by the
application of a compress and bandage, as directed above.
SALIVATION OR MERCURIAL DISEASE.
2260. Salivation is produced by mercury, and its preparations,
and is one of the most fearful maladies to which the human system
is liable. Sometimes it is speedy in the work of destruction,
and at others, dooms the patient to slow and lingering torments.
The symptoms cannot be better described than in the language of
Dr. Good, who says, “There is not only a high degree of irrita-
tion of the mouth, but of the system generally; great debility;
emaciation; stiff, incurvated limbs; total loss of teeth; failure of
the appetite; sore throat; sleeplessness; swollen tongue; offensive
breath; eruptions of the skin; and fetid ulcers in the mouth.” I
may add, that the gums often become putrid; the soft parts about
the mouth frequently mortify; and even the bones, particularly
those of the jaws, are frequently destroyed. Terrible cases of
salivation occur in infants at the breast, in consequence of the
mother having taken mercury by the direction of her physician.
For further information with regard to the dreadful effects of this
poison, the reader is referred to the remarks on mercury, in
another place. (423, et seq.)
2261. TREATMENT. Courses of medicine are requisite in
this complaint, for in no other way can the mercury be expelled
from the system. They may be repeated daily, or only once a
week, according to the symptoms, until a cure is effected. The
mouth should be washed frequently with bayberry tea, followed by
a weak infusion of cayenne, in order to detach and remove the
unhealthy secretions. Injections once or twice a day are neces-
sary to regulate the bowels; and spiced bitters, or some other
tonic, should be given freely to invigorate the digestive organs.
2262. Hoarhound tea has been highly recommended as a
remedy in salivation. Dr. Withering cured a young man with it
_

PRACTICE OF MEDICINE. 545
in a short time who had been suffering from the effects of saliva-
tion for a year. (1122.)
2263. Where mercury has been taken, the face is liable to
swell during the administration of a course; and to afford relief, a
heated stone wrapped in a damp cloth, and wetted with vinegar,
should be placed near the face under the bedclothes, and as soon
as the skin becomes moist, the swelling will abate.
SCALD OR SCALLED HEAD.
2264. This is a peculiar eruption of the head, which extends
in some instances to the face. It is accompanied by troublesome
itching, and a thick, offensive discharge, which glues or mats
together the hair, and forms into yellowish, or greenish scabs. It
is mostly confined to children, but now and then makes its ap-
pearance in adults. The matter is sometimes so acrid as to
excoriate the skin, and if it comes in contact with the eyes,
produces redness and inflammation. There is sometimes a fetid
discharge from the ears, and occasionally an enlargement of the
glands on the sides of the neck, giving rise to tumors or kernels
beneath the skin.
2265. TREATMENT. It is advisable to administer one or two
courses of medicine, for although the disease manifests itself locally,
it is dependent on a disordered state of the general system; and
unless the fountain is purified, it will continue to send forth streams of
muddy water. Between the courses, composition, spiced bitters,
and enemas, may be used according to the necessity of the case.
Among the preparations which may be beneficially employed, are
the alterative mixture, (1526) the compound for children, (1528)
and the tea for impurities of the blood. (1518.) The diet must re-
ceive attention, avoiding butter, meat, tea, coffee, and the fine
flour bread. (See remarks on diet—1680, et seq.)
2266. The head should be thoroughly washed every night and
morning with a sponge and warm soapsuds, followed by a tea of
bayberry, pond lily, witch hazel leaves, or any other of the
astringents. The bayberry is preferable, if its pungency is not an
objection. An application is then to be made of meadow fern
ointment, and if the parts are not too sensitive, it may be mixed
with a small portion of rheumatic drops. The head is next to be
bound in a cloth, or covered with a bladder, or cap, to favor
perspiration, and keep the skin moist, using the warming medi-
cine internally to produce a determination to the surface of the
body. Before the head is dressed, a dose of composition should
- 69

546 PRACTICE OF MEDICINE.
be given. If the meadow fern ointment cannot be obtained, the
nerve ointment will answer a very good purpose, or equal parts of
pulverized gum myrrh and the red powder of sumach berries,
with lard sufficient to make an ointment, may be employed.
2267. Turing the administration of a course of medicine, a
poultice of sliperry elm should be confined to the affected parts,
if possible, so as to absorb the discharge, which might otherwise
inflame the healthy skin, and cause an extension of the disease.
SCARLET FEVER,
2268. Scarlet fever is a contagious disease, and attacks chil-
dren more frequently than adults. It occurs at all seasons, but is
most prevalent in the autumn, and early part of winter, rarely
appearing in the same individual a second time. It commences
with languor, chilliness, depression of spirits, and pains in the
head and back, which are soon followed by a hot and dry skin,
and sometimes nausea and vomiting. In about two days, a scarlet
eruption makes its appearance on the face and neck, and in the
course of twenty-four hours, diffuses itself over the whole body.
It gives to the skin a peculiar red appearance, which has been
compared to the shell of a boiled lobster. Sometimes it is uni-
versal, while at others, it is only to be seen in patches, leaving
the intermediate skin of a natural color. It acquires a more florid
hue in the evening, but diminishes in redness toward the morning.
The face is usually swelled, and sometimes the throat is sore.
The tongue is covered with a thick, white coat in the middle,
but is of a deep red color at the point, and along the edges. De-
lirium is not unfrequent in the evening. In five or six days the
eruption begins to fade, and mostly disappears in the space of
forty eight hours, accompanied by a separation of the cuticle or
outer skin, in the form of scales.
2269. In the more aggravated form of scarlet fever, the throat
becomes red and very much inflamed. The voice is hoarse, and
the swallowing painful and difficult. The patient sometimes
cannot speak above a whisper. The thirst is urgent, the skin
excessively hot, and the tongue red and dry. The eruption
comes out irregularly, and not until the third or fourth day from
the commencement of the disease. Sometimes it suddenly dis-
appears, and then returns after a limited time. The neck is apt
to be stiff, painful and swollen. If the fever and inflammation are
not checked, little ulcers form in the throat, which assume a gray-
ish color, and render the breath offensive. Among other symp-

PRACTICE OF MEDICINE. 547
toms which frequently arise, are diarrhoea, vomiting, soreness of
the bowels, and sometimes delirium, or stupor.
2270. The disease occasionally puts on a malignant type, and
tends rapidly to putrefaction. The eruption assumes a dark or
livid color, accompanied with dull and inflamed eyes, small and
feeble pulse, dark and fetid ulcers in the throat, offensive breath,
rattling and oppressed breathing, great prostration, copious dis-
charges from the bowels, deafness, bleeding from the nose, mouth,
or other free passages, and delirium, or stupor almost from the
commencement of the attack.
2271. Scarlet fever is sometimes confounded with the measles,
but it may be distinguished by the eruption, which is different in
color and appearance from that of the measles, and by other
characteristić signs. (See paragraph 2155.) The distinction,
however, is of no practical importance, for the indications of cure
are the same in both diseases, each requiring to be treated on the
same general principles.
2272. Among the symptoms indicating an unfavorable termi-
nation in scarlet fever, are involuntary discharges from the bowels,
a copious flow of urine, cold extremities, purple spots on any part
of the body, great prostration, stupor, and constant delirium;
whereas, a moist, clean tongue, a more full and regular pulse, and
a scaling off of the cuticle, are evidences of a return to health. It
is a more favorable symptom, also, when the eruption is of a bright
red color, and uniformly diffused over the surface, than when it is
in patches, and very faint, or of a purple or livid aspect, appear-
ing first on one part and then upon another.
2273. TREATMENT. If the symptoms are mild, the treat-
ment recommended for measles, in paragraph 21.58, will be suffi-
cient, aiming to keep a constant determination to the surface of
the body. If the skin becomes hot and dry, however, it will be
necessary to administer a course of medicine, followed by a free
use of cayenne and bayberry tea, and an injection every half hour,
or hour. If, notwithstanding this treatment, it is impossible to
keep up a perspiration, and the ſever returns, the course must be
repeated without delay, and so on until the disorder is removed.
By keeping the fever in subjection from the commencement of
the attack, soreness of the throat may be obviated, or if it be-
comes inflamed, it may be prevented from passing into a state of
ulceration. Hence it is always better, if the symptoms are at all
unfavorable, to resort to active treatment at the very outset of the
disease. The stimulating tea, increasing the quantity of cayenne
and lobelia, if necessary, is an excellent medicine to keep up the
moisture of the skin.
–

548 PRACTICE OF MEDICINE.
2274. Where the surface of the body is inordinately hot,
sponging it with cold water will have a highly beneficial influence.
Professor Eberle remarks, that this is the only sudorific and ano-
dyne which will not disappoint the practitioner. It is often fol-
lowed by a free perspiration, and renders the patient easy and
comfortable. It should never be employed, however, excepting
where the skin is very hot and dry. Cayenne or composition
should be given in the meantime, to keep a determination to the
surface.
2275. If the throat is sore, or the swallowing difficult, the
same treatment may be pursued which is recommended under the
head of quinsy (2220, et seq.)
2276. If the disease assumes a malignant type, relief can only
be obtained by thorough courses of medicine, repeating them as
often as the symptoms become alarming, and making free use of
the stimulating tea in the intervals to keep up a perspiration. In-
jections are also important.
2277. Where the bowels are sore, or very much distended
with wind, applications are to be made to the abdomen as directed
in paragraph 2095.
2278. The sick chamber should be frequently ventilated.
(1631, et seq.)
2279. During convalescence, the patient must avoid exposure
to cold, and recruit his energies by the use of the bitter or resto-
rative medicines, and a light, nourishing diet. The wheat jelly,
or unbolted wheat meal gruel should be eaten, to regulate the
bowels. Advantage will be derived from rubbing the skin every
night and morning with a coarse towel, or flesh brush, until it is
in a warm glow. Gentle exercise in the open air, provided the
weather is mild and pleasant, will have an invigorating effect.
(1709, et seq.)
2280. Deafness of one or both ears occasionally follows scar-
let fever, but is not generally of long continuance. The ears
should be filled with wool, or cotton, moistened with rheumatic
drops, or the antispasmodic tincture, to exclude the air. Syring-
ing the ear once or twice a day with warm raspberry tea, is also
beneficial. (1917.) -
2281. In the old school practice, a failure of the voice is
often a sequel of scarlet ſever, but I have never known it to occur
in the reformed practice. In some instances it continues during
life. The difficulty may be easily remedied at the commence-
ment, however, by one or two courses of medicine.
PRACTICE Orº MEDICINE, 549
scroFULA or king’s Evil.
2282. In scrofula, there is great derangement of the sto-
mach and bowels, and the whole system is more or less affected.
Small moveable tumors or kernels are felt under the skin, in vari-
ous parts of the body, but particularly along the neck. The
upper lip, and sides of the nose, are swelled. In children of a
scrofulous habit, sores, and scaly eruptions are often observed
about the face, and behind the ears. It is asserted that the dis-
ease is principally confined to those with a delicate skin, and light
hair and eyes, but there does not appear to be any adequate foun-
dation for this opinion.
2283. When the tumors first make their appearance, they are
free from pain, and the skin covering them is of a natural
color. They may remain in this condition for two or three
years, without causing the patient any inconvenience, or they
may enlarge and suppurate in a much shorter time, acquiring a
reddish, or purple color, and finally discharging matter, which
is sometimes extremely acrid or corroding.
2284. The eyes are often inflamed in scrofula, and the in-
ternal organs, such as the heart, liver, kidneys, brain, and lungs,
become the seat of the scrofulous humor. The joints, also,
especially those of the elbows and ancies, are liable to swell and
suppurate.
2285. Whatever deranges the health, or causes debility of
the general system, has a tendency to produce the disease.
Hence it is of frequent occurrence in the old school practice,
in which mercury, and other poisons are freely employed. It
is common among the poor, arising from unwholesome food,
want of cleanliness, and deficiency of clothing. Medical writers
assert that pigs, rabbits, and other animals may be rendered
scrofulous in a short time by giving them very coarse food.
A cold, damp, and changeable atmosphere, predisposes to the
disease. It also frequently attacks persons working in factories,
where the air is pent up and unwholesome.
2286. The medical faculty are very unsuccessful in the treat-
ment of scrofula, as one may well imagine, who takes into consid-
eration the agents which they employ. Dr. Cullen says, “We
have not yet learned any practice which is certainly or even gener-
ally successful in its cure.” Dr. Mackintosh, in his Practice of
Physic, remarks, “We are told by almost every author, to cor-
rect the bad habit of body,” and improve the state of the constitu-
tion; but, as far as I am aware, we have never yet been told a
proper method to bring about this desirable event, or indeed, in



550 PRACTICE OF MEDICINE.
what the bad habit of body consists.” Professor Hayward of
Harvard University, after observing to his class, that “the exces-
sive use of mercury is supposed to develope scrofula,” remarked,
“Almost every article of the materia medica has been tried in the
disease, and abandoned; and sometimes patients recover their
health under any mode of treatment, provided it be not too severe
or violent.”
2287. TREATMENT. Thorough courses of medicine are re-
quired in this affection, for while the bowels are torpid, the diges-
tion imperfect, the skin and liver inactive, and the circulation
feeble or languid, it is impossible that there can be a permanent
change for the better; but in proportion as these difficulties are
removed, so will the general system recover its tone, and the
disease gradually disappear.
2288. The courses may be repeated once or twice a week,
according to the urgency of the symptoms, and cayenne, bayberry,
restoratives, and enemas, used freely in the intervals. Lobelia
pills, the alterative mixture, or the tea for impurities of the blood,
(1518) may be employed with more or less advantage. Clean-
liness, pure air, exercise, and clothing adapted to the season and
climate, are each important. The skin should be rubbed briskly
every night and morning with a coarse towel, or flesh brush.
The meals should be taken at regular hours, and nothing eaten
that will derange, or oppress the stomach. (1680, et seq.) Butter,
fat meat, tea, coffee, gravies, minced pies, and all mixtures
of a similar kind, are more or less injurious. The unbolted
wheat bread, rice, hominy, mush and milk, tapioca, sago, ripe
fruits, soft boiled eggs, and the lean part of a tender beef steak,
provided the patient has been accustomed to animal food, may be
used with benefit.
2289. The hand bath (1455) is an invigorating agent, where
there is no objection to its employment.
2290. The scrofulous tumors, if not too far advanced, may
often be dispersed by applications of the Indian meal poul-
tice, or a plaster composed of meadow fern ointment, cayenne,
and lobelia, as directed for the incipient stage of cancer. (1831.)
The tumors may sometimes be removed, also, by keeping them
constantly wet with rheumatic drops, as mentioned in the treat-
ment for boils. (1808.) If suppuration has commenced, however,
they must be poulticed until the matter is discharged, when an
application may be made of the healing salve. If the joints are
affected, and have proceeded to suppuration, they must be treated
in a similar manner.
2291. Sometimes a scrofulous ulcer leaves a considerable
PRACTICE OF MEDICINE. 551
cavity, particularly in the breasts of females, and in that case it
should be syringed gently with an infusion of sumach, witch hazel,
or raspberry leaves, rendered slightly pungent with rheumatic
drops, if the sore is not too irritable; and when the cavity is suſ-
ficiently cleansed, its surfaces should be brought into contact by a
compress and bandage, so that they may form the necessary union.
Without this precaution, it is sometimes impossible to cure an
ulcer, however active or judicious the treatment may be in other
respects.
SCURWY.
2292. Scurvy originates in a highly disordered state of the
general system, and has a tendency to putrefaction. The blood
is dark and liquid, the countenance sallow and bloated, the pulse
feeble, the skin dry and inactive, the breath offensive, and the
respiration hurried by the slightest motion. The teeth are loose,
and the gums spongy, and disposed to bleed. Wounds that have
been healed, break out afresh; the feet and legs swell; and livid
or purple spots appear on different parts of the body, usually com-
mencing on the lower extremities, and proceeding upward to the
abdomen, and arms. The disorder comes on with lassitude, de-
bility, dejection of spirits, an unwillingness to move about, and a
feeling of stiffness in the knees and feet. In the latter stages,
hemorrhage takes place from the nose, mouth, bladder, and rec-
tum. The stools are very offensive. Great emaciation ensues,
accompanied by stiff and swollen joints, and wandering pains in
different parts of the body. In some cases, indolent ulcers form
on the thighs and legs. -
2293. The disease appears in its most aggravated form among
seamen during long voyages, and is usually attributed to the use of
salt provisions, but whatever influence these may have, it no
doubt originates in a depraved condition of the digestive organs,
brought on by fatiguing labor, alcoholic drinks, impure water,
want of cleanliness, exposure to damp and unwholesome air, or
whatever has a tendency to weaken or disorder the general system.
The land scurvy, as it is termed, is milder in its symptoms,
excepting when it breaks out in camps and garrisons.
2294. TREATMENT. Courses of medicine are necessary to
strengthen the digestive organs, increase the activity of the skin,
free the blood from impurities, and invigorate the general system.
They may be administered once or twice a week, according to
the necessity of the case. Injections must be used several


552 PRACTICE OF MEDICINE.
times a day, until the stools cease to be offensive. Tonics, and
a free use of cayenne and bayberry, are indispensable. The diet
and intermediate treatment, may be the same as in scrofula.
(2288.) If meat is eaten, it should consist of a lean and tender
beefsteak, or piece of roasted lamb, without any gravy. The
fashionable remedies prescribed by the diplomatised physicians,
such as lemon juice, garlic, horseradish, and scurvy grass, and re-
garded by them as specifics, possess but little value, excepting per-
haps to amuse the patient in the absence of some more efficient
remedy.
2295. If the joints are stiff, they should be rubbed frequently
with pepper sauce, or vinegar and cayenne, (1531) and wrapped
in flannels to keep them warm. The local application of steam,
also, is particularly beneficial. (1499.) In the event of ulcers,
they must be treated as will be directed hereafter, under that
head. If the gums are spongy, the mouth should be frequently
washed with cayenne and bayberry tea, or rheumatic drops diluted
with water.
SHINGLE.S.
2296. This disease commences with a number of vividly red
patches, a short distance from each other, which pass round the
waist in the form of a girdle, without, however, entirely encircling
the body. Sometimes they take a direction over the shoulder,
or down to the groin. They are preceded by an itching and
burning sensation, and sometimes sickness and headach. The
patches or clusters are one or two inches in diameter, and soon
become covered with a number of small blisters, which burst in
four or five days, and discharge a thick, glutinous matter, which
forms into crusts or scales of a brownish color. The blisters dry
up in some cases without the formation of scales, and in others
they are followed by tedious ulcers.
3297. This affection mostly occurs in persons between twelve
and twenty five years of age. It is caused by intemperance in
eating, the use of spirituous liquors, and sudden changes from
heat to cold.
2298. TREATMENT. If the health is much impaired, or the
stomach in a disordered state, an emetic should be administered,
or if adviseable, a course of medicine. This should be followed
by the use of spiced bitters, or some other tonic, and an occa-
sional dose of composition, or cayenne and bayberry. If the
bowels are confined, an injection should be administered once a
day until they become regular. The diet, as in all cutaneous dis-
PRACTICE OF MEDICINE. 553
eases, must be regulated, avoiding the use of butter, and every oily
or greasy substance. (1680, et seq.) The external applications
may be the same as directed for ringworm, to which the reader is
referred. I am told that equal parts of the tincture of bayberry
and rheumatic drops make an excellent wash, but cannot speak
of its virtues from experience. The blood root steeped in vin-
egar is also an approved remedy. If ulcers should form, they
must be managed as directed under that head.
SMALLPOX.
2299. Smallpox prevails at all seasons of the year, and attacks
persons of every age and sex. It does not often occur more than
once in the same individual. Many people appear to be exempt
from the disease, notwithstanding their exposure to it in its worst
forms, while others, who think they have used every precaution
to guard against its contagious influence, contract it without any
apparent cause. The American editor of Good's Study of
Medicine, says, “In that loathsome receptacle, the well remem-
bered Jersey prison ship, which was specially appropriated for
the confinement of American prisoners, more than one hundred
and twenty men were imprisoned, who had never been affected
with smallpox either naturally or by inoculation, and yet of that
number, less than two thirds were attacked with the disease,
which, however, proved extremely fatal. One would naturally
expect, that in such a place the specific virus of smallpox would
act with much more violence. This fact was communicated to
Dr. Francis by the late Philip Freneau, of New Jersey, one of
the prisoners.”
2300. It has been suggested that those who live in strict obe-
dience to the laws of health, are exempt from the disease; and a
case in illustration has been cited by Dr. Alcott, in his Library
of Health. “A sea captain in Virginia,” he says, “desirous of
having the smallpox by inoculation, made application to a phy-
sician for the purpose. On being repeatedly inoculated, without
success, and on being questioned by the physician in regard to his
habits, it was found that he had, for some months or years, ab-
stained from all fermented and alcoholic liquors, and from the use
of animal food. By the advice of the physician, he resumed the
use of flesh and wine, and after some time, was inoculated again,
and had the small pox in the usual manner.”
* Good’s Study of Medicine, 6th American edition, vol. i. pp. 624–5.
t Health Library, vol. iv. No. 1.

70
554 PRACTICE OF MEDIC INE.
2301. Symptoms. Smallpox commences with a cold stage,
which is soon succeeded by ſever, accompanied by pains in the
head, back, and region of the stomach; sóreness of the throat;
great thirst; vomiting; inactive state of the bowels; cold hands and
feet; drowsiness; and in adults a tendency to perspiration. The
fever is usually the most intense just before the eruption makes its
appearance; and in children, the latter is sometimes preceded by
convulsions. The tongue, at first, is covered with a white coat,
but gradually assumes a bright red color. The eruption usually
makes its appearance the third or fourth day, and is first seen on
the face, neck, and breast, from which it passes down, in the
course of twenty four hours, to the lower extremities. The ſever
then abates, and leaves the patient comparatively free from dis-
tress. The eruption consists of small, red spots, which, on the
first and second days, says Dr. Hall, are hard, globular, painful,
and distinct from each other, with the intervening spaces nearly
colorless. They enlarge gradually, and on the third, fourth, and
fifth days, contain a little yellowish fluid, the intervening spaces
becoming red. On the sixth and seventh days, they are distin-
guished by a central indentation. On the ninth and tenth days
the indentation ceases to be observed, and the pustules, as they
are termed, present a full and rounded appearance. On the
eleventh, twelfth, and thirteenth days, they begin to dry up, and
are followed by hardened crusts or scabs, which fall off at length,
leaving the skin of a brown, or red color. “In those cases
where the pustules are large, and are late in becoming dry and
falling off, they are very apt to leave pits behind them; but where
they are small, suppurate quickly, and are few in number, they
neither leave any marks behind them, nor do they occasion much
affection of the system.” -
2302. About the eighth day from the commencement of the
disease, the face usually begins to swell, and if the pustules are
numerous, the swelling increases to such an extent as to close the
eyelids. At the same time there is an increased flow of saliva,
accompanied, in some instances, with hoarseness, difficulty of
swallowing, and deafness. On the tenth or eleventh day, the
swelling of the face subsides, together with the flow of saliva, and
affection of the throat, and the feet and hands become tumid and
uffy. -
p º, Smallpox is divided into two kinds, the distinct and
confluent. In the first the eruptions are separate from each other,
and in the second they run together, forming large or continuous
patches, particularly on the face. The confluent smallpox is the
most aggravated form of the disease. The eruption is not unfre-
quently preceded by a copious diarrhoea; and the tongue is cov-

PRACTICE OF MEDICINE. 555
ered with a dark, or black coat. The saliva is so viscid as to be
discharged from the mouth with difficulty. The ſever, unless
subdued by appropriate remedies, continues violent throughout
the malady, accompanied sometimes with delirium, stupor, or
convulsions. The matter contained in the pustules is of a dark
color, and oftentimes so acrid as to excoriate the parts with which
it comes in contact. “Sometimes it happens that a putrescency
of the fluids takes place at an early period of the disease, and
shows itself in livid spots interspersed among the pustules, and by
discharge of blood by urine, stool, and from various parts of the -
ody.” -
2304. Inoculation, and Vaccination. Inoculation was practised
extensively before the time of Dr. Jenner, who introduced vaccina-
tion, and was performed by puncturing the skin with some conven-
ient instrument, and inserting the matter of a smallpox pustule, so
that it might be absorbed, and carried into the system. The poison
taking effect, the smallpox was produced with all its characteristic
symptoms, but in a milder form, as it was said, and this was re-
garded for a time as preferable to the old plan of taking it by
chance. It was soon discovered, however, that inoculation was
productive of greater evil than good, because, by inducing the
smallpox in this artificial manner, it was communicated to others
who would not consent to be inoculated, and consequently the
mortality was increased rather than diminished.
2305. In 1798, Dr. Jenner came before the English public
with his discovery of vaccination, which consisted of the intro-
duction of matter into the system, which he obtained from erup-
tions on the teats and udders of cows, and the disease it produced
was called kine or cow pow. This was said to prevent, or modify
the smallpox, without any of the objections which had been urged
against inoculation; and Dr. Jenner received twenty thousand
pounds from the English government for his discovery. Vac-
cination, however, notwithstanding all that was said in its favor,
was regarded by many people with abhorrence, and among
these, was the ingenious and well known Mr. Cobbett, who,
in giving his views upon the subject, said—“There are some
things, surely, more hideous than death, and more resolutely to
be avoided; at any rate, more to be avoided than the mere risk
of suffering death.” He also observes, “that in hundreds of in-
stances, persons vaccinated by Jenner himself, have taken the
smallpox afterwards, and have either died from the disorder, or
narrowly escaped with their lives.” He further states, that the
* Cobbett’s Advice to Young Men.

556 PRACTICE OF MEDICINE,
smallpox broke out in the town of Ringwood, England, in its
worst form, and carried off more than a hundred persons, young
and old, every one of whom had been vaccinated. “I may here
add,” continues Mr. Cobbett, “ that I was vaccinated myself in
1800 by Dr. Mead of Alstead, N. H., and that too in both arms,
but in six months after, I was seized with the smallpox, notwith-
standing the care-taking pains of the doctor to poison the disease
out of me.”
2306. From England, vaccination was introduced into the
United States, where it has been made subservient to the pecuni-
ary interests of the medical profession, regardless altogether of the
health and lives of the people. In the city of Boston, the diplo-
matised physicians receive from one to five dollars for every per-
son they vaccinate, according to his or her ability to pay; and to
add to their emoluments, they have procured the passage of a law
which imposes upon parents the necessity of having their children
vaccinated, before they can send them to school. Nor are they
satisfied with vaccinating each individual once, but have announced
that after a certain number of years, it is necessary to be re-vacci-
nated, or there is still danger of contracting the disease. All this,
to me, appears more like a scheme to obtain the people's money,
than to confer upon them any real, or even supposed advantage.
I am not alone in this opinion, for it was openly and fearlessly
proclaimed a year or two ago in the Massachusetts House of Rep-
resentatives, by Col. Thayer of Braintree, a member of that body.
A bill was before the House in relation to the removal of smallpox
patients from Boston to a neighboring island, in order to prevent,
as it was supposed, the spread of the disease, and Col. Thayer,
in the course of an animated speech on the subject, remarked,
“It has been said by the worthy doctor on my right, that there is
an epidemic in the air. But there is always an epidemic some-
where, and I believe it is in the pockets of certain gentlemen, who
say there is no danger—no excitement—and that we must vacci-
nate and re-vaccinate. Why do physicians, generally—not all of
them, I confess—wish to enforce vaccination, and oppose the
other means intended to prevent the spread of the smallpox? Do
they lose money by it? Do they vaccinate any one gratuitously
of whom they can obtain their pay No, sir; I am told that they
receive one, two, three, or five dollars, for each person they vacci-
nate. I was told by a very respectable physician in this city, that
one doctor has received ten thousand dollars for vaccinating and
attending on smallpox patients. It is no wonder, then, that they
recommend vaccination, and re-vaccination—it is no wonder that
they endeavor to keep up the excitement in the public mind.
What has been the practice of some of the doctors in this city


PRACTICE OF MEDIC INE. 557
- T-
Have they not done all in their power to spread the disease ?
Have they not inoculated with the smallpox matter and did not
one of them inoculate a whole family of young children with the
smallpox, at the north part of the city ?”
2307. Mr. M. another member of the Massachusetts Le-
gislature, and a gentleman in whom I can repose every confidence,
informed me that in 1800 he resided in Marblehead, a small sea-
port town within fifteen or twenty miles of Boston, and during
that period, a physician in the place introduced the smallpox
among the inhabitants for the purpose of increasing his practice.
2308. Medical writers, with all their prepossessions in favor of
vaccination, do not apppear to place much confidence in it as a
preventive of the smallpox. Dr. Eberle says, “From whatever
cause it may proceed, it is beyond a doubt, that the failures of
vaccination in preventing secondary smallpox, have been steadily
and progressively on the increase for some years past.” He
further remarks, “Dr. Gregory has given a table of the total
number of admissions into a smallpox hospital in ten different
years, and from this statement it appears that in the year 1810, -
the proportion of cases of smallpox after vaccination, to the whole
number of admissions, was as 1 to 30; while in 1815, it was as 1
to 17; in 1819, as 1 to 6; in 1821, as 1 to 4; and during the
year 1823, as 1 to 3 1-2.”
2309. During the prevalence of the smallpox in Boston, in
the winter of 1839, the Boston Medical Association appointed a
committee to enquire into the character and extent of the small-
pox and varioloid, then existing in the city, and the committee
reported, that in the execution of their commission, they addressed
a circular letter to every practitioner of medicine known to them
in Boston, inclusive of South and East Boston, presenting to
them certain enquiries in a printed tabular form, to which enquiries
immediate answers were solicited. These enquiries related to
the name and residence of all patients affected with the disease,
who had come under the care of each physician respectively,
together with their age, occupation, the question of previous
smallpox or vaccination in the individual, and the character and
event of the disease. To obtain answers to these enquiries,
personal application was made, when necessary, so that a return
was probably obtained from every medical practitioner in the city,
From these returns it appears that the disease had been seen and
attended by somewhat less than half of the physicians then prac-
tising in the city, the majority having met with no cases in their
practice. The committee then proceeded to analyze the returns,
* Eberle’s Practice of Medicine, 4th edition,

55S PRACTICE OF MEDICINE.
and found that the whole number of cases known to the physi-
eians of Boston up to the 9th of December, was two hundréd and
forty eight. Of these, 115 were males, and 121 females. Of
the remaining 12 the sex was not stated.
2310. The ages were as follows. Under two years, 10;
between two and ten years, 44; between ten and twenty years, 49;
between twenty and forty years, 101; over forty years, 34; un-
2311. The occupations and condition are stated as follows.
Laborers, 27; mechanics, 32; merchants, traders, and those
- devoted to professions, 22; domestics, 28; others, including chil-
dren, 114; unknown, 25.
2312. The causes to which the patients attributed their dis-
ease, were, direct connection with the sick, 127; supposed con-
veyance of contagion by another, 1; unknown, 120. It would
seem, from this part of the report, that persons may be attacked
with smallpox, without being exposed to the disease.
2313. With regard to the protective power of smallpow and
vaccination, which is the most interesting part of the report,
it is stated that 13 had been previously attacked with the smallpox;
149 had been vaccinated once; 18 had been vaccinated twice;
and 55 had neither had the smallpox, nor been vaccinated. Now
it would seem that vaccination, instead of exercising any protective
influence, predisposes an individual to the smallpox, for out of
two hundred and forty eight cases of the disease included in the
above report, the astounding fact must be kept in view, that more
than Two THIRDs of THEM HAD BEEN VAccINATED once,
AND NINETEEN of THEM MoRE THAN once We have con-
clusive evidence, therefore, that vaccination is no protection what-
ever against smallpox, while in addition to the expense and loss of
time attending the process, it is liable to be followed by obstinate
diseases, such as boils, cancers, and affections of the skin. Cases
of this kind are exceedingly numerous, and should excite the
alarm of every friend to the human family. Dr. Eberle, in his
Practice of Medicine, very honestly remarks, “I have several
times known obstinate and alarming cutaneous affections commu-
nicated to children, by vaccinating with matter taken from un-
healthy subjects.” He also adds, “It is a common belief among
persons out of the profession, that the vaccine disease is apt to
give rise to disagreeable eruptive affections, and such occurrences
are in fact not very unfrequent.”
2314. A young woman by the name of Blatchford, mentioned
in a preceding part of this work, (288, et seq.) was under treat-
ment at the Massachusetts General Hospital a long time for a se-
were cutaneous disease, which was said by ...; and friends to




-
-
PRACTICE OF MED10 INE. 559
have been produced by vaccination, and after having been made
the victim in that institution to a series of the most revolting ex-
periments, was dismissed in a worse condition than when she
came. The vaccination was performed by an eminent physician
of Boston, who, of course, observed the usual precautions with
regard to the vaccine matter, and yet he inflicted a dreadful and
perhaps incurable malady upon his patient. Such facts cannot
fail to excite the deepest regret and sympathy in every exalted
and benevolent mind, even though the medical faculty should pass
them by as unworthy of notice or attention.
2315. “We are informed,” says Dr. Alcott, “that syphilis
has been communicated by vaccination; and that several cases of
this sort occurred quite recently in a family near Boston. The
story is almost incredible, and yet we received it from a source
on which we are accustomed to rely.”
2316. A Mr. Benson of Boston, was attacked about two
years ago with boils, which, he informed me, made their ap-
pearance soon after he was vaccinated, and they continued to fol-
low each other in such rapid succession, that his life became a bur-
then. He was cured in four or five weeks, however, by the re-
formed practice, and since that time has enjoyed excellent health.
2317. Joseph A. Whitmarsh of Boston, told me that he was
vaccinated by a physician in Providence, R. I., several years
ago, and that it was followed by a painful and troublesome ulcer,
which continued the whole of one winter.
2318. A child of Mr. and Mrs. Robbins, residing in Middle-
sex street, Boston, was vaccinated in the right arm, in December,
1839, by a diplomatised physician, but the vaccine poison not -
taking effect, the operation was performed a second time, which
proved effectual. The original puncture, however, now became
inflamed, and the inflammation extended to the elbow, where a
large and painful ulcer formed, succeeded in a short time by ulcers
over the whole of its body. Dr. Perry, a physician of the old
school, was called in, who stated that the disease was not the
effect of vaccination, but was owing to a scrofulous humor. The
mother, however, asserted that the child had been perfectly healthy
until the period of vaccination, and had never manifested the
slightest symptom of a scrofulous disposition. I called to see the
child, in company with Dr. Osgood, and found the ulcers lining
its mouth, and extending down its throat. Appropriate remedies
were ordered, which were followed by a sensible improvement in -
the child; but Dr. Perry called in accidentally, and assured the
parents that it must inevitably die. Disheartened at this intelli-
* Library of Health, February, 1840.

560 PRACTICE OF MEDICINE.
gence, they discontinued the treatment, and as was to be expect-
ed, it soon expired.
2319. One fact worthy of being noted, in relation to the above
case, is, that after the child was vaccinated the second time, and
before the arm became inflamed, as has been described, the phy-
sician who performed the operation, filled about forty quills with
the matter of the pustule, which were intended for the vaccination
of other persons, and thus the disease with which the little sufferer
was afflicted, was no doubt extensively propagated.
2320. A child of Mr. and Mrs. #. residing at 7, Suf-
folk street, Boston, was vaccinated about two years ago by Dr.
Storer of that city, a gentleman of some distinction as a physician
of the old school, and when the vaccine virus took effect, the
child broke out with ulcers, similar to the one already mentioned,
and after lingering for a period of four months, death put an end to
its sufferings.
2321. I might fill a volume with cases of this description, but
the above will suffice to show the danger of vaccination; and
must be permitted to express the fervent hope, that the people
will ultimately open their eyes to the enormity of the practice.
There is still another objection to vaccination, which
is, that the smallpox is not a fatal or even dangerous disease when
properly treated, although in the hands of the diplomatised
physicians, it is truly a scourge of the human race. There is no
disease which yields more readily to the medicines employed in the
reformed practice, than this; but on the other hand, if patients are
bled, blistered, and dosed with poison, it must be expected that
many of them will perish, for the treatment itself is sufficient, in
many instances, to destroy life, independent of any co-operation
of the original disorder. -
2323. Vaccination, I may add, is often followed by a disease
which physicians have been pleased to term varioloid, but which,
says Dr. Eberle, is “a modified form of smallpox;” and he observes
that this malady is becoming “more and more common,” having
“appeared in various countries within the last fifteen years in fre-
quent and extensive epidemics.” No longer ago than Febru-
ary last, according to the New York Evening Post, it prevailed
extensively in that city. “Persons are attacked by it,” remarked
the editor, “without having to their knowledge, been exposed to
the contagion. We have heard of several cases in which it has
been fatal, and the remark has been made, with what truth we
cannot say, that it appears to be more virulent than usual.” Now
if varioloid is nothing but smallpox, why do not physicians hon-
estly call it by that name The answer is obvious, that inasmuch
as varioloid prevails epidemically, and is often very fatal, it must



PRACTICE OF MEDICINE. 561
be designated by some other title, or the people would perceive
at once, that vaccination neither has any tendency to prevent
smallpox, nor to modify its effects; and they would cease to en-
courage the imposition which has been practised upon them to such
an alarming extent. -
2324. TREATMENT. By giving medicine to promote a
gentle perspiration, no difficulty will be experienced in the treat-
ment of smallpox. Severe cases are often cured by the use of
composition, or cayenne and bayberry, giving a dose every one,
two, or three hours, as long as the symptoms render it necessary.
Pennyroyal, or catnip tea, is also an excellent medicine, and may
be employed freely as a drink. It is important that the bowels
should be regularly evacuated, and if there is any tendency to cos-
tiveness, an injection may be administered every night and morn-
ing. Benefit will be derived from taking a dose of composition at
bed-time, and placing a bottle of hot water wrapped in a damp
cloth at the feet. I would recommend the patient to abstain from
animal food, and subsist principally upon a nourishing vegetable
diet, such as hominy, wheat jelly, and preparations of sago, rice,
tapioca, and the unbolted wheat meal. My objection to animal
food, is, that it tends to render the blood impure, (1683) and in
this disease we must be particular to guard against putrescency of
the fluids.
2325. If any unfavorable symptom should arise, such as flat-
tening of the pustules, tendency of the eruption to recede, intense
fever, copious diarrhoea, black tongue, delirium, stupor, or great
prostration of the vital powers, we must administer a thorough
course of medicine, and repeat it at proper intervals as long as
there is any apprehension of danger. Between the courses, appro-
priate remedies are to be employed to preserve the moisture of
the skin, (1660) for unless we keep a constant determination to
the surface of the body, the whole force of the disease will be
expended upon the internal organs, and produce an alarming, or
perhaps fatal train of symptoms.
2326. Where the patient is restless or nervous, a portion of
scullcap, or lady's slipper, may be added to the other medicines,
or the nervine tea may be employed. (1514.)
2327. If convulsions ensué, the same treatment may be
adopted which is recommended under that head. (1888, et seq.)
2328. The patient should be sponged during the administra-
tion of each vapor bath with a solution of sal aeratus, or bicar-
bonate of soda, giving preference to the latter, if it can be obtained.
(1029.) This cleanses the skin, and has a highly salutary effect.
The solution may be warm or cold, as may be most agreeable.
71
562 PRACTICE OF MEDICINE.
After it has been applied, the surface may be washed with pure
water, or a tea of raspberry, witch hazel, or sumach leaves.
2329. The temperature of the sick chamber is to be regu-
lated according to the season. A cold atmosphere, which is fre-
quently recommended by physicians, is as injurious as an undue
degree of warmth. Extremes are to be avoided. The patient
should neither be loaded with clothes, as was the practice fifty or
sixty years ago, nor denied a sufficient quantity to render him
comfortably warm, and keep the skin moist. A peculiar and un-
pleasant odor rises from the body during the latter stages of the
disease, and hence the utmost degree of cleanliness should be
observed, and the apartment ventilated several times a day, with-
out exposing the patient to draughts of air. (1634.) Ventilation,
let it be borne in mind, is of paramount importance.
2330. Medical writers recommend that the face should not
be heated by exposure to the fire, and the precaution is worthy of
attention. -
2331. One particular advantage attending the reformed vege-
table practice in smallpox, is, that the face is rarely or never
pitted. -
SORE OR IN FLAMED EYE S.
2332. This complaint commences with soreness, heat, red-
ness, and a copious flow of tears. There is also a sensation
resembling that of sand in the eye. The pain is sometimes in-
tense, darting, as it were, into the brain, and extending, in some
instances, to the teeth, lower jaw, and ear. The light cannot be
borne. The eyelids swell, and become glued together by the
discharge of matter. Constitutional symptoms frequently arise, as
chills, flushes of heat, headach, and fever. The discharge is
sometimes so acrid as to inflame the adjacent parts.
2333. TREATMENT. Sore eyes are often regarded as a local
disease, when in fact they are dependent upon a disordered state of
the stomach; and external applications are made for months in suc-
cession, without benefit, where an emetic or course of medicine
would in all probability effect a speedy and radical cure.
2334. The eyes may be washed several times a day with
either of the preparations recommended under the head of eye
waters. (1532, et seq.) In the meantime the bowels should be
regulated by injections, and the usual tonics and stimulants em-
ployed to invigorate the digestive organs, and keep up a healthy
action in the system. If there is a discharge of matter from the

- PRACTICE OF MEDICINE. 563
eyes, they should be kept perfectly clean by washing them fre-
quently with warm water and milk, or a tea of raspberry, or witch
hazel leaves; and if the lids are sealed together, they should be
slowly and cautiously opened, so as not to injure the parts. If
there is a collection of matter under the lids, it should be carefully
washed away. A poultice of slippery elm, containing a small
portion of ginger, and covered with a piece of gauze, may be ap-
plied with advantage; and if the eye becomes very hot, the poul-
tice may be wetted occasionally with moderately cold water.
2335. Sore eyes are sometimes caused by the irritation of
wild hairs, as they are termed, which should be immediately
plucked out with some convenient instrument.
SPRAINS.
2336. These are the result of accidents, and mostly occur in
the ancles, and wrists. They are followed by pain, heat, red-
ness, swelling, and sometimes discoloration of the skin. If the
ligaments which bind the joints together are seriously injured, the
case may linger for several weeks before a cure is effected, unless
the patient consents to keep the joint at rest. External applica-
tions are to be made, as recommended for bruises; (1811) and if
the health is impaired, it must be reinstated by attention to diet,
and the use of appropriate medicines.
st. Vitus’s DANCE.
2337. In St. Vitus's dance, the voluntary muscles (26) are
thrown into irregular action, producing convulsive movements in
various parts of the body. The disease is usually preceded by
prominent derangement of the stomach, bowels, and nervous sys-
tem. Females are more subject to it than males. It usually
makes its attack between the ages of eight and fifteen, though it
may occur at an earlier or later period. It mostly commences
with an occasional twitching of the fingers, and muscles of the
face, and after a time, other parts of the body become affected,
especially the lower extremities, producing awkwardness in
walking, and a jerking and unsteady gait. The hands are fre-
quently unmanageable, so that the patient finds great difficulty in
conveying food to the mouth. The face is often hideously dis-
torted. In severe cases, the swallowing and respiration are ren-
dered difficult, and the voice is more or less impaired. The
twitches subside during sleep. The disease may disappear in a



























564 PRACTICE OF MEDICINE.
few weeks, or it may be protracted for many years. It is in-
creased in violence by exposure to cold, and by strong mental
emotions. It is caused by fright, intemperance in eating and
drinking, suppression of the catamenial discharges, and the use of
mineral and vegetable poisons.
2338. TREATMENT. If the complaint has been of ſong con-
tinuance, a few courses of medicine should be given, administer-
ing spiced bitters and composition several times a day, in the in-
tervals. If the bowels are torpid, an injection once a day will be
indispensable. Nervines are useful in this complaint, and particu-
larly the scullcap, the infusion of which may be taken freely as
a drink. The lobelia pills, or alterative mixture, may be ad-
vantageously employed as a part of the intermediate treatment.
The patient should subsist upon a plain, simple diet, eating tem-
perately, and avoiding the use of tea, coffee, butter, and all oily
or greasy substances. The unbolted wheat bread will be found
very wholesome.
2339. If the bowels are obstimately costive, a decoction of
boneset may be employed with advantage; (713) or half a tea-
º of cayenne mixed with molasses may be taken three times
a Clay.
2340. I have found the following preparation to answer a
very good purpose. Take equal parts of scullcap and compo-
sition, and steep a large table-spoonful of the powder in a pint of
boiling water. Keep the tea warm by the fire, and take a tea-
cupful at a dose, repeating it three or four times a day, and avoid-
ing exposure to a damp or chilly atmosphere. The value of the
remedy may be increased by adding ten, fifteen, or twenty drops
of the tincture of lobelia to each tea-cupful of the tea. In addition
to this treatment, the skin should be rubbed briskly every night
and morning with a coarse towel, or flesh brush.
SUPPRESSION, AND RETENTION OF URINE-
2341. In suppression of urine, the kidneys, either from in-
flammation, weakness, or some mechanical obstruction, lose their
secreting power, so that there is little or no urine conveyed to the
bladder. Among the symptoms which characterize the malady,
are restlessness, headach, thirst, nausea, vomiting, fever, pains in the
back, and lower part of the abdomen, and a constant desire to pass
water. If any urine is discharged, it is accompanied by a violent
burning or scalding sensation. The perspiration sometimes ac-
PRACTICE OF MEDICINE. 565
quires a urinous smell. The kidneys ſailing to perform their ac-
customed office, the urine is retained in the circulation, and unless
discharged through the pores, it causes drowsiness, stupor, and
sometimes delirium, or convulsions.
2342. The disease is produced by the use of mercury, and
cantharides, and by the irritation of gravel in the kidneys. In fe-
males it is sometimes caused by exposure to cold during the cata-
menial discharge.
2343. Retention of urine is owing to weakness or paralysis of
the bladder, whereby it loses its expulsive power ; or to an ob-
struction in the urethra, or neck of the bladder, arising from in
flammation. The disease is more frequent in advanced than early
life. The bladder is sometimes so much distended as to enlarge
the abdomen, causing an appearance of dropsy. There is a fre-
quent desire to pass water, accompanied with the most excruci-
ating pains, and the lower part of the abdomen in the region of
the bladder is tender on pressure. The skin is usually hot and
dry, and the patient complains of nausea and headach.
2344. The disease is caused by venereal excesses, gravel,
the use of acrid poisons, the introduction of surgical instruments
into the urethra, and injuries inflicted by improper treatment
during childbirth. A wound of the spine is sometimes followed
by paralysis of the bladder, and under these circumstances, little
or no pain is experienced in the latter organ until it is consider-
ably distended with urine. If relief is not afforded, the bladder
finally bursts, and its contents escape into the abdomen, which
is a fatal accident.
2345. In connexion with these diseases, I may mention
strangury, which consists of a difficulty and pain in passing
water, without implying an obstinate retention. The urine is
sometimes voided in drops, and at others in a small, or perhaps
divided stream. Children whose health is neglected during
teething, are subject to the complaint. It is frequently produced
by the external application of blisters.
2346. TREATMENT. If suppression of urine is owing to
inflammation of the kidneys, the patient should be treated as
directed under that head, (2115) making free use of enemas,
diuretics, and mucilaginous drinks. If the patient is restless or
nervous, the scullcap, or lady's slipper may be added to the
other medicines. If drowsiness, or stupor should occur, or if
the perspiration acquires a urinous smell, we must resort to active
treatment, administering full and thorough courses of medicine,
for unless we keep a constant determination to the surface of the
body, it may be impossible to save the life of the patient. Stim-


566 PRACTICE OF MEDICINE.
ulating injections every half hour or hour, are particularly beneficial,
adding a small portion of lobelia to each, but not enough to excite
unpleasant nausea.
2347. In retention of urine also, courses of medicine are in-
dispensable, provided the case is obstinate, and I have never yet
heard of an instance in which they did not afford entire relief.
The vapor bath, cayenne tea, and frequent stimulating injections
are particularly serviceable. Local applications should be made to
the region of the bladder, as directed in paragraph 2095. Heated
stones wrapped in damp cloths should be placed at the feet and
sides of the patient, in bed, so as to keep up a free perspiration,
or the cure will be protracted, and his sufferings rendered much
more intense.
2348. Dr. Watkins of New Hampshire, informed me that a
laboring man applied at his infirmary, about two years ago, who
had not passed any urine for thirty six hours, and of course his
agonies can be better imagined than described. A tea of cay-
enne, bayberry, and lady’s slipper, containing a small portion of
lobelia, was administered in frequent doses, together with two or
three strong injections. The patient experienced no relief, how-
ever, for the pain was so urgent that he could not be kept in bed,
nor was it possible, under these circumstances, to administer the
vapor bath. The perspiration was so profuse as to leave the
F. of the footsteps on the floor. After the lapse of about three
ours, during which time the patient suffered the greatest imagin-
able torments, he was told that unless he consented to remain in
bed, death would be inevitable; and his fears becoming excited,
he concluded to obey the injunction of his medical attendant.
Accordingly, he returned to bed, and heated stones wrapped in
damp cloths were placed about him, and a large tea-cupful of the
above tea administered. In less than ten minutes the pain ceased,
accompanied by a copious discharge of urine. The patient now
experienced a slight degree of nausea, from the effects of the lo-
belia, and after slight vomiting, slept soundly for several hours.
The next day a course of medicine was given, which restored the
individual to his usual health.
2349. In strangury, relief may generally be obtained by the
use of diuretic and mucilaginous drinks. The diuretic tea,
(1516) with the addition of slippery elm, may be employed with
great advantage.
2350. Suppression of urine is frequently mistaken by medical
men for retention, and they attempt a surgical operation, which
often proves fatal to the patient. Dr. Warren of Harvard Uni-
versity remarked, in a lecture, that a gentleman residing in South
Boston, was attacked, many years ago, with suppression of urine.

PRACTICE OF MEDICINE. 567
and was attended by a physician, who, after administering the
usual remedies, plunged a trocar through the rectum into the
bladder, but no urine followed the withdrawal of the instrument.
The operation was repeated a second, and even a third time, but
without any other effect than that of producing a copious discharge
of blood. The patient died, and it was found upon a post mortem
examination, that the bladder did not contain a drop of urine.
There was violent inflammation of the kidneys, however, which
prevented the secretion of urine.
SUSPENDED ANIMATION.
2351. This may arise from various causes, such as hanging,
drowning, falling from a height, a severe blow, long exposure to
cold, a stroke of lightning, or inhaling noxious gases.
2352. In drowning, all signs of life disappear in a few min-
utes, and the face assumes a livid and swollen appearance. The
eyes are staring and glassy, and the limbs more or less stiffened.
A considerable portion of water makes its way into the stomach,
but by a contraction of the windpipe, it is excluded from the
lungs, until life entirely ceases. In a few instances, persons have
been restored to life after having been immersed in the water for
half an hour, so that we should always be on the side of human-
ity, and make every possible effort at resuscitation, even though
we have but slight hopes of success.
2353. Persons are often destroyed by carbonic acid gas,
which abounds in wells, cellars, and caverns, and which also
accumulates in a large quantity by burning charcoal in a tight
room. In the concentrated form, it destroys life almost instantly,
but if mixed with atmospheric air, it produces giddiness, faintness,
insensibility, and eventually death. The face is swollen, the lips
blue, and the veins of the neck and head distended with blood.
Persons who are about to descend into a well, where they have
reason to suspect the presence of this destructive gas, should use
the precaution to let down a lighted candle, and if it is extinguish-
ed, they may be assured that their descent will be followed by
immediate death. -
2354. When an individual is struck by lightning, small blotch-
es are often observed on different parts of the body, and some-
times red streaks are seen on the breast and arms. If life still
continues, the breathing is slow and difficult, and the face gen-
erally red and swollen. -
2355. In long exposure to cold, the skin becomes pale, rough


568 PRACTICE OF MEDICINE.
and shrivelled, followed by drowsiness, benumbed limbs, and an
urgent desire to sleep.
2356. TREATMENT. One, two, or three tea-spoonfuls of
the antispasmodic tincture (1266) should be poured down the
throat, and the dose repeated, if necessary, in five minutes. In
the meantime, stimulating enemas will be found of great advantage,
for the impression which they make on the bowels may be trans-
mitted through the nerves to the heart, and thereby rouse this
organ into action, or in other words, renew its contraction. Fur-
thermore, it must be borne in mind, that the pressure of the
atmosphere upon the surface of the body interferes with the
return of the blood to the skin, (1488) and to obviate this difficulty,
the air immediately around the patient should be lightened or
rarified by the application of vapor. For this purpose, he may
be covered with a blanket, and heated stones wrapped in damp
cloths placed about his person, and particularly at his feet. The
artificial warmth must be introduced very gradually, however, or
the patient may be destroyed even after signs of life have been
manifested. To use the beautiful language of Armstrong, in his
work on Health,
* While the vital fire
Burns feebly, heap not the green fuel on ;
But prudently foment the wandering spark,
With what the soonest feels the kindred touch ;
Be frugal even of that; a little give
At first; that kindled, add a little more,
Till, by deliberate nourishing, the flame
Revived, with all its wonted vigor glows.”
2357. The antispasmodic tincture may be given in tea-spoonful
doses, as the case may seem to require; or if that cannot be ob-
tained, a strong tea of cayenne, bayberry, and rheumatic drops,
containing a portion of green, or brown lobelia, may be employed.
The surface of the body should be rubbed briskly with the tinc-
ture of cayenne, or some other stimulating wash. If convenient,
vapor may be generated by means of a boiler, (1501-2) and ap-
plied directly to the body as mentioned in paragraph 1496. If
the room is cold, a fire should be immediately kindled with some
light materials. The first symptoms of returning life will be man-
ifested by a muscular motion of the lips, eyes, or extremities, and
by degrees the skin will become soft and warm. Cayenne, or
composition, may then be given internally, and the external heat
also increased, but in the same gradual manner as already di-
rected.
PRACTICE OF MEDICINE. 569
-
2358. After recovery, the patient should be kept in a mod-
erate perspiration for ten or twelve hours, and if requisite, an
emetic, or course of medicine administered.
2359. In case of drowning, the individual should be stripped
of his wet clothes, wrapped in a blanket, and carried to some con-
venient place for the administration of the necessary remedies.
His head should be kept in its natural position. The practice of
shaking the patient, or rolling him upon the ground, is not produc-
tive of any good, and may result in serious injury.
2360. Where an individual has been benumbed by exposure
to cold, external warmth should be introduced still more gradually
than in the case of drowning, or suspended animation from any
other cause. If the limbs are frosted, they should be wrapped in
cloths, and wetted frequently with cold water, as directed in par-
agraph 1813. -
sy Philis. *
2361. A person is said to have the syphilis, observes a med-
ical writer, when the venereal poison has been received into, or
is diffused through the system, and there produces its peculiar
effects, such as ulcers in the mouth, tetters, ulcers of the skin,
pains, swellings, and caries or mortification of the bones. As
long as the effects of the poison are local and confined to or near
the genital organs, the disorder is not called syphilis, but is dis-
tinguished by some particular name, according to its seat or ap-
pearance, such as gonorrhoea, chancre, or bubo.
2362. Syphilis, as well as gonorrhoea, the latter of which has
been described under the appropriate head, is generally contracted
by impure sexual intercourse, and is sometimes transmitted from
parent to child. It is so contagious, in some instances, as to be
communicated by the breath. This, however, is very rare.
Cardinal Wolsey was indicted for whispering in the king's ear,
while supposed to be affected with venereal. -
2363. Chancres are sores of a peculiar character, which arise
in a few days, or weeks after the venereal poison has been
imbibed. They are properly termed syphilitic ulcers. In the
male, they usually make their appearance on the head of the penis,
or under the foreskin; but in the female, they are generally found
on the external or internal labia, or within the vagina. They ap-
pear also on the thighs, and indeed, on every part of the body
with which the venereal poison comes in contact. They are di-
* This disease is also called venereal, lues venerea, and pox.
- *-

570 PRACTICE OF MEDICINE.
vided by Dr. Marshall Hall into four kinds, the simple, the indu-
rated, the phagadenic, and the gangrenous.
2364. The simple syphilitic ulcer usually begins about the
head of the penis, “with a small red spot, followed by a yellow-
ish-white point, gradually changing to a small, slightly excavated
ulcer, having its bottom covered with a yellowish-white, very
adherent substance.” -
2365. The indurated ulcer “is circular, excavated, without
granulations, covered with a whitish adherent matter, and having
a callous base, with hard, thick edges. When it appears on the
body of the penis, it spreads to a considerable size, and retains its
characteristic hardness, but without excavation.”
2366. The phagadenic or eating ulcer “ has an eroded as-
pect, is without granulations, and the soft parts which surround it
are not callous nor indurated. It sometimes spreads with great
rapidity, committing much havoc in the course of a few days; at
other times it creeps slowly, but does not stop until it has de-
stroyed a considerable portion of the head of the penis. It is
sometimes attended with hemorrhage.”
2367. The gangrenous ulcer “is the most terrific of all the
primary syphilitic affections. It begins with a small blackish spot,
attended with little pain, but which on examination is found to be
a gangrenous eschar. This goes on increasing until a slough sep-
arates, leaving a highly corrosive sore, attended with acute pain,
and soon covered with a new eschar. In this manner a succes-
sion of erosive |''. and eschars go on, until a large part,
and sometimes the whole of the genital organs, in both sexes, are
destroyed.”
2368. The matter discharged from these sores is capable of
ulcerating the healthy skin, and hence the utmost cleanliness
should be observed.
2369. Buboes, as they are termed, are an enlargement or
swelling of the glands, very much resembling a boil, and have re-
ceived their name from a Greek word signifying groin, in which
they most frequently appear. They are found occasionally in the
armpits, and in other glandular parts. They frequently suppurate,
and break, discharging a large quantity of matter.
2370. The health of the patient becomes seriously affected in
this complaint. He complains of headach, severe pains in the
joints, sore throat, distressing cough, and disorder of the stomach,
and bowels. He expectorates considerable quantities of thick
phlegm. The skin breaks out with red pimples, and copper-
colored spots or blotches also make their appearance, covered at
first with whitish scales, and passing at length into offensive sores:
As the disease advances, ulceration seizes upon the throat, and


PRACTICE OF MEDICINE. 57.1
extends to the neighboring parts, gradually eating away the palate
and nose. The voice becomes hoarse, and is at last entirely
destroyed. The bones in different parts of the body increase in
size, presenting large tumors, and at length become rotten and ex-
foliate. It is a question with me, however, whether these dread-
ful symptoms, together with the formation of buboes, are not fre-
quently produced by mercury, for it is well known that the med-
ical faculty invariably administer that poison in syphilis, believing
that nothing else will remove the disorder. The effect of mer-
cury in rotting the bones, also, is equally well known to those
who are acquainted with its nature.
2371. “When the disease is suffered to take its own
course,” says a writer on the subject, “ and is not counteracted
by proper remedies, the patient will, in the course of time, be
afflicted with severe pains, particularly in the night time; his
countenance will become sallow, and his hair fall off; he will lose
his appetite, strength, and flesh; his rest will be much disturbed
by night, and a slight hectic fever will arise. The ulcers in the
mouth and throat being likewise suffered to spread, and to occa-
sion a caries of the bones of the palate, an opening will be made
from the mouth to the nose; and the cartilages and bones of the
nose being at length eaten away, they will sink on a level with the
face. Some constitutions will bear up a considerable time against
the disease, while others again will soon sink under the general
weakness and irritation which it produces.”
2372. TREATMENT. The disease, in its early stages, where
the symptoms are not urgent, may usually be cured by very simple
treatment. The diet should be sparing, and chiefly vegetable ;
the skin rubbed every night and morning with a coarse towel, or
flesh brush; and the bowels regulated, if necessary, with injec-
tions. If the appetite is impaired, the spiced bitters, or some
other tonic, may be taken before each meal; and at night, on
going to bed, benefit will be derived from a dose of composition,
or cayenne and bayberry. For further directions, see paragraph
1706. If the disease does not readily yield to this treatment, a
course or two of medicine should be administered.
2373. The syphilitic ulcers should be washed every night and
morning with warm soapsuds, followed by a tea of witch hazel,
bayberry, or any other of the astringents, and touched with a
feather which has been dipped into rheumatic drops, or tincture
of myrrh. The latter application should never be omitted, where
the ulcers are gangrenous. A poultice of slippery elm, prepared
with raspberry, or witch hazel tea, may now be applied, renewing
it every twelve hours, or oftener if necessary, and adding a por-

572 PRACTICE OF MEDICINE.
tion of ginger to it, where the sore is not too irritable. After the
ulcers assume a healthy appearance, the healing salve may be
applied.
2374. If buboes arise, an attempt may be made to scatter
them, according to the directions in paragraph 1808, or 1831,
taking a dose of cayenne or composition several times a day, to
keep up a healthy action in the system. If, however, they are
very much inflamed, and there is every appearance of suppuration
having commenced, they should be poulticed as ..". boils,
(1806), so that the matter or pus may be discharged as speedily
as possible.
2375. Both in buboes and syphilitic ulcers, the local applica-
tion of vapor is found to be highly efficacious. (1499.)
2376. If severe constitutional symptoms arise, or if the sys-
tem has been poisoned with mercury, a cure can only be effected
by thorough courses of medicine, repeating them once or twice a
week, according to the necessity of the case, and paying partic-
ular attention to the intermediate treatment. In this way the
blood will be purified, and the system restored to a healthy con-
dition. The alterative mixture may be used with advantage
between the courses. If the throat is affected, it should be
gargled frequently with some astringent tea, rendered slightly
pungent with rheumatic drops.
TETTER.
2377. Tetter is an eruption of the skin, manifesting itself in
patches of various sizes, and of a red color. It is accompanied
with heat, and itching, and is followed by pimples or blisters
similar to those in ringworm and shingles.
2378. Dry tetter, as it is termed, arises most commonly on
the face, neck, arms, and wrists, disappearing after a certain time
in the form of bran-like scales. The disease returns at uncertain
periods. The eruption is not always in patches or clusters, but is
sometimes continuous over a large extent of surface.
2379. The moist or running tetter is most frequent on the
extremities. The blisters are larger than in the preceding species,
and ultimately discharge a thick, glutinous matter, which dries into
scabs or crusts. These fall off in a fortnight or more, and in
some instances disclose ulcerated surfaces beneath.
2380. The attacks of this disease are often renewed by over;
heating the system, by improper indulgence of the appetite, and
by sudden changes from a warm to a cold atmosphere.
PRACTICE OF MEDICINE. 573
2381. TREATMENT: I have cured several cases of tetter by
making frequent applications of meadow fern ointment, and giving
either the alterative mixture, or the tea for impurities of the blood,
(1518) two or three times a day. The affected part should be
washed every night and morning with warm water and Castile soap,
and rinsed with pure water, or a tea of bayberry, pond lily, or su-
mach berries. The ointment, as mentioned above, is then to be
applied, and if the skin is not too irritable, it may be preceded by a
wash of the tincture of lobelia. The bowels must be kept regular,
(1896, et seq.) and if there is a loss of appetite, a dose of spiced
bitters may be taken before each meal. Attention to diet, and
cold bathing, are highly efficacious in this complaint. (1706.)
The patient must forego the use of butter, fat meat, tea, coffee,
and the superfine flour bread; and if he is not disposed to em-
ploy the cold bath, should rub himself every night and morning
with a coarse towel, or flesh brush.
2382. The different external applications recommended for
ringworm and shingles, may be employed with equal advantage in
tetter. The vapor bath is a valuable remedial agent, inasmuch as
it cleanses and softens the skin, which is of paramount importance.
2383. In tetter of long standing, it is necessary to administer
two or three courses of medicine.
23S4. When the scabs fall off and leave raw or ulcerated
surfaces beneath, the parts should be washed with soapsuds, fol-
lowed by some mild astringent tea, such as witch hazel, or sumach
leaves, and poultices of slippery elm applied. In the event of an
acrid discharge, poultices should be applied during the admin-
istration of the vapor bath, to absorb it, lest by coming in con-
tact with the healthly skin, it should cause an extension of the
disease.
THIRST.
2385. This is owing to a dryness of the glands of the mouth
and throat. It is one of the characteristic symptoms of fever, and
occurs also in diarrhoea, dysentery, and all profuse discharges
from the body. It rarely troubles those who confine themselves
to an exclusively vegetable diet. -
2386. Drinking large and frequent draughts of cold water, in
consequence of thirst, is a pernicious practice, for it chills the
stomach, and lays the foundation for many obstinate diseases.
2387. TREATMENT. I know of no better remedy for thirst,
where it has become habitual, than cayenne tea, which may be
-


574 PRACTICE OF MEDICINE.
taken in the dose of half a tea-cupful, or more, three or four times
a day. The thirst in ſevers, however urgent, may generally be
relieved by a few doses of this tea.
TIC DOULOUREUX.
2388. Tic douloureux consists of a severe and darting pain
along the course of the nerves in various parts of the body, but
chiefly in the face. The sensation is felt in the forehead, temples,
cheeks, mouth, lips, tongue, and ball of the eye, according to the
particular nerve which is affected. The same kind of pain is felt
in the upper and lower extremities, and in the internal organs, as
the bladder, stomach, bowels, and womb. It occurs in par-
oxysms of longer or shorter duration, and sometimes makes its
attack with the suddenness of an electric shock. The slightest
touch or movement of the body will often produce a paroxysm.
In some instances the disease continues for many years. The
part affected is tender to the touch, and sometimes there is a
twitching or convulsive action of the adjacent muscles.
2389. Some physicians are in the habit, in this affection, of
dividing the nerve by a surgical operation, forgetting that the pain
is almost sure to return very soon in a neighboring part; while
others not only bleed, blister, leech, cup, and dose with calomel,
but destroy the sensibility of the nervous system by the adminis-
tration of opium, prussic acid, and other deadly narcotics.
2390. An eminent medical writer observes—“Routine prac-
titioners are too much in the habit of bleeding whenever the pain
is severe, and of giving calomel or the blue pill when the pain is
referred to the region of the liver. I have been consulted by
individuals whose constitutions were injured by the frequent repe-
tition of powerful remedies, and by some who never can regain the
loss of blood, or recover from complaints thereby produced, and
the too frequent use of mercurial preparations.”
2391. TREATMENT. In tic douloureux, there is generally
more or less disorder of the digestive organs, and hence the sto-
mach should be cleansed with an emetic, followed by the use of
spiced bitters, and an occasional dose of cayenne, bayberry, and
nerve powder, especially on going to bed. In chronic cases, it
is adviseable to administer a few courses of medicine.
2392. The affected part should be bathed frequently with the
strongest tincture of cayenne, and if this does not afford relief, a
cloth or flannel moistened with the tincture may be applied, to-
gether with a heated stone wrapped in a damp cloth.

PRACTICE OF MEDICINE. 575
2393. Particular attention must be paid to the bowels, using
enemas, or some other appropriate remedies, if they are confined.
2394. Lobelia pills, or an infusion of scullcap, will be found
an excellent medicine in this complaint. The stimulating tea, ad-
ministered to the extent of producing perspiration, will also afford
relief in many instances.
2395. The stimulating limiment is a valuable external appli-
Catlon.
2396. Tic douloureux is frequently dependent on a decayed
tooth, and in that case the tooth should be extracted by some
skilful dentist. -
TOOTHACH.
2397. When a tooth decays, and the nerve becomes exposed,
it is usually followed by severe pain, which is increased by taking
cold. The face and gums frequently become sore and swollen,
and hence the term ague in the face. Pain in the teeth may
arise from other causes than decay, however, and on this account,
the individual should not be too eager to have them extracted.
Toothach is often peculiar to pregnancy, and is occasioned also
by many nervous disorders. Persons who have taken mercury,
are extremely liable to it, even before the teeth have begun to
decay.
2398. TREATMENT. Composition, cayenne, rheumatic drops,
or any of the warming medicines, will often afford relief; and if
the individual is in bed, a heated stone wrapped in a damp cloth
may be placed at his feet. If the tooth is hollow, a piece of lint
moistened with rheumatic drops, or summer savory oil,” may be
introduced into it with advantage.
2399. A flannel moistened with hot rheumatic drops, or vin-
egar and cayenne, (1531) and applied to the face, will often ease
the pain.
2400. Composition tea, with a small portion of lobelia, is a
valuable remedy, provided the patient sits near the fire so as to
favor perspiration. The lobelia need not be employed to the
extent of producing nausea.
2401. A small bag of cayenne placed between the cheek
and teeth, has often been used with success; or the cayenne may
be confined between two thin layers of cotton wool, about the
size of a penny, and the whole wetted with rheumatic drops.
* Any of the essential oils may be employed.


576 PRACTICE OF MEDICINE.
This application is followed by a free discharge of saliva and cold
ropy mucus, and in fifteen or twenty minutes the pain will generally
subside.
2402. The local application of vapor to the face, will some-
times afford almost instantaneous relief. To accomplish this, a
blanket may be thrown over the head, and vapor generated by im-
mersing a heated stone in a basin of water, which the individual
may conveniently hold in his lap; or a heated stone wrapped in a
damp cloth, and wetted with vinegar, may be applied to the face,
under the bedclothes.
TYPHUS FEWER.
2403. This disease was formerly known as nervous, or putrid
fever, and is thought by some to be contagious, but it is probably
owing to impure air, unwholesome food, a general neglect of
the health, and other causes which tend to depress or impair the
vital energies. It is most prevalent in jails, camps, hospitals, and
the crowded and filthy hovels of the poor.
2404. Typhus fever commences with a feeling of lassitude,
want of appetite, debility, restlessness, dull and heavy eyes, gid-
diness, and confusion of ideas. These symptoms continue a few
days, or perhaps a week, when the patient is attacked with chills,
succeeded by flushes of heat; great depression of spirits; disgust
for all kinds of food; white, and clammy tongue; and pains in
the head, back, and sometimes extremities. Vomiting also occa-
sionally takes place. Fever now ensues, with the train of symp-
toms peculiar to the disease, such as dryness of the lips, thirst,
giddy sensation on rising to walk, heavy feeling of the head, dis-
inclination to motion, disturbed and unrefreshing sleep, and a ten-
dency during the night to delirium. The skin is usually dry, but
in some instances perspiration is observed on the upper portion of
the body. Diarrhoea is sometimes an early symptom, though the
bowels are generally torpid. Cough, difficulty of swallowing, and
red and watery eyes, are liable to occur. Bleeding at the nose is
not uncommon, and arises in various stages of the complaint.
Blood is also discharged now and then from the mouth, nose, and
bowels. Rose spots on the abdomen are frequently observed,
after the disease is fairly established. The memory now becomes
imperfect, the hearing obtuse, the utterance slow and hesitating,
and the delirium more wild and frequent.
2405. The sinking stage next ensues, which is marked by
great prostration, black incrustations about the lips and teeth, in-
difference to surrounding objects, pungent heat of the skin, swelling
-

PRACTICE OF MEDICINE. 57.7
and tenderness of the bowels, rapid pulse, livid, or sunken coun-
tenance, rough and black tongue, dark spots upon the surface,
watery and offensive stools, picking at the bedclothes, catching at
imaginary objects, twitching of the lips, jaws, eyelids, and hands,
hiccough, low muttering delirium, and a death-like stupor.
2406. A natural warmth and moisture of the skin, abatement
of the delirium, moist clean tongue, and a return of the appetite,
are favorable symptoms; but if the delirium is continued, with an
unnatural expression of the countenance, pain and swelling of the
bowels, cough, difficulty of swallowing and breathing, loss of
sight, purple spots on the body or extremities, red, swollen, or
black tongue, black incrustations about the lips and teeth, cold,
clammy sweats, picking at the bedclothes, and offensive, or invol-
untary stools, we infer that there is great danger, though the pa-
tient is not to be abandoned as incurable.
2407. TREATMENT. In the early stage of typhus fever, we
should administer two or three thorough courses of medicine, if
so many are requisite, to remove the disease before the constitu-
tional powers have been seriously impaired.
2408. The courses may be repeated every twelve, twenty
four, or thirty six hours, according to the degree and urgency of
the symptoms; and in the intervals, we must endeavor to keep
up a gentle and equal perspiration over the whole body, as in
fevers of every description. For this purpose I have been in the
habit of using the following preparation. Take of green lobelia
from a half to a whole tea-spoonful; bayberry and scullcap each a
tea-spoonful; cayenne two tea-spoonfuls; boiling water two tea-
cupfuls. Steep in a covered vessel, strain, and sweeten to suit
the taste. Keep the tea warm by the fire, and administer a
table-spoonful of it every ten, fifteen, or twenty minutes, until the
skin becomes moist. It is not necessary that the lobelia should
be used in a sufficient quantity to produce any considerable de-
gree of nausea. During the administration of the tea, a stimu-
lating injection (1567) should be given every hour or two, which
will have a special influence in keeping up a healthy action in the
system, and maintaining the equilibrium of the circulation. A
heated stone wrapped in a damp cloth should also be placed at
the feet. If, notwithstanding this treatment, the skin becomes
hot and dry, lobelia should be given to cleanse or evacuate the
stomach, and if the patient is much enfeebled or prostrated, the
infusion should be used without the sediment, as directed in para-
graph 1612.
2409. A tea of composition, or of cayenne and bayberry, will
often suffice to keep up the perspiration after a course, without
-
73

578 PRACTICE 0 F MEDICINE.
the aid of lobelia, but if there is a tendency of the ſever to return,
this medicine should always be employed in small and frequently
repeated doses. Injections, let it be borne in mind, are of the
utmost importance, and if the stools are offensive, or the bowels
swollen, or painful, they should be employed frequently.
2410. Thirst may be speedily allayed by the use of cay-
enne tea.
2411. The diarrhoea which often occurs in typhus fever, may
be checked, in many instances, by a tea of black pepper, steeping
a tea-spoonful of the powder in a tea-cupful of boiling water, and
adding sugar to suit the taste. If the first dose is not effectual, it
may be repeated in one or two hours.
2412. If the bowels are painful, or distended with wind, ap-
plications may be made to the abdomen, as directed in paragraph
2095
2413. The sick chamber should be ventilated frequently,
without exposing the patient to currents of air. (1634.) The
chamber should also be kept perfectly clean and sweet in other
respects, and the bedclothes, as well as the patient’s linen,
changed at least once a day.
2414. If the skin is very hot, great advantage will accrue
from sponging it with cold water, previously administering a dose
of cayenne, or composition, to keep a determination to the sur-
face. (2274.)
2415. Purgatives must be avoided in typhus fever, particu-
larly the latter stages of it, for there is a tendency of certain
glands in the small intestines to become inflamed, or ulcerated,
and under these circumstances, a cathartic can only be employed
at the risk of the patient’s life.
2416. If the brain is affected, as is the case where delirium,
or stupor occurs, the medicines are more or less tardy in their
operation, and require to be given in an increased quantity.
24 The food, throughout the disease, should be liquid,
consisting of wine whey, slippery elm tea, or any similar prepara-
tion, which will not irritate the stomach; and even during conva-
lescence, the diet should be light, and easy of digestion, as inat-
tention to this matter is not unfrequently a cause of relapse. As
soon as the ſever is entirely subdued, the bitter or restorative
medicines are to be employed, to increase the tone of the stomach,
alternating them occasionally with cayenne, so as to keep up the
requisite degree of action in the system.
PRACTICE OF MEDIC INE. 579
ULCERS.
2418. These are formed by a process termed ulceration,
(1365, et seq.) and result from a variety of causes, such as
wounds, burns, setons, issues, and the external application of
caustic, blisters, and mustard poultices. If the blood is impure,
the slightest scratch or bruise is liable to degenerate into an ill-
conditioned sore or ulcer, especially in cold weather. Scrofulous
and syphilitic ulcers have already been described under the ap-
propriate heads.
2419. When an ulcer is in a healthy state, says Dr. S. Coop-
er, it discharges a whitish matter resembling cream, and the gran-
ulations are small, red, and pointed at the top. When the gran-
ulations have risen to the level of the surrounding skin, those next
the old skin become smooth, and covered with a thin semi-trans-
parent film, which afterwards becomes opaque, and forms cuticle.
An ulcer answering this description, is in a healing state, and the
parts should be kept perfectly clean. The florid color of the
granulations, says Sir Astley Cooper, is produced by the blood-
vessels having a considerable quantity of arterial blood, and a free
circulation.
2420. In indolent ulcers, says Dr. S. Cooper, “the edges
of the surrounding skin are thick, prominent, smooth, and rounded.
The granulations are smooth and glossy, the pus or matter is im-
perfectly formed, and adheres so firmly to the surface of the ulcer
that it can scarcely be wiped away. The bottom of the sore
forms almost a level, and its general aspect gives the idea of a
portion of the skin and parts underneath having been for some
time removed, and the exposed surface not having commenced
any new action to fill up the cavity. Indolent ulcers form the
majority of those which are to be seen in the large hospitals of
London. Their granulations are endued with a weak living
principle, and are very apt to be suddenly absorbed without any
assignable cause.” -
2421. Irritable ulcers are extremely tender, bleed very easily,
and have jagged or uneven edges. There is no distinct appear-
ance of granulations, but only of a whitish, spongy substance,
which discharges a thin acrid fluid. -
2422. In malignant ulcers the surrounding skin is of a livid
color, and covered with small vesicles or blisters, as in mortifi-
cation. They sometimes corrode or destroy the bones. Among
the causes of this species of ulcer, is the use of mercury.
2423. Ulcers frequently form on the legs, in consequence of
an impeded circulation in the veins. They are more frequent in


580 PRACTICE OF MEDICINE.
men than in women, particularly those who are much upon their
feet. The diseased veins are enlarged, and irregular in their
course, and the “surface covering them is formed into a crust,
under which a quantity of serum is secreted.” Weins in this
state are said to be varicose, and surgeons, in order to effect a
cure, are in the habit of tying and dividing them, but the prac-
tice, says Sir Astley Cooper, is replete with danger. He adds,
“ another overwhelming objection to the operation is, that when
it does not prove fatal, its ultimate effects are perfectly useless.”
2424. An ulcer occasionally extends to a considerable depth,
so “that the discharge has to travel through a channel before it
arrives at the surface,” and is known by the name of fistula. It
arises in different parts of the body, but is most common about
the anus, and hence the term fistula in ano.
2425. TREATMENT. In the local treatment of ulcers, they
should be washed clean with warm soapsuds, followed by a tea of
witch hazel, bayberry, or some other appropriate astringent, and a
poultice of slippery elm applied, repeating the application every
twelve or twenty four hours, according to the necessity of the
case. If the sore is hot and painful, the poultice should be wetted
occasionally with cold water.
2426. Bayberry tea is an excellent cleansing wash for sores,
unless they are very irritable, and then a tea of witch hazel, pond
lily, or sumach is preferable, inasmuch as it is devoid of pungency,
and of a mild and soothing nature.
2427. Ulcers of an indolent character require to be stimu-
lated, and after they have been washed, as directed above, they
may be wetted with rheumatic drops, or tincture of myrrh. This
is particularly adviseable where the sore is malignant, or gangre-
nous. A portion of ginger, or rheumatic drops, may be added to
the poultices, if it can be borne by the patient.
2428. Ulcers are sometimes signally benefited by sprinkling
them with pulverized loaf sugar, previous to the application of the
oultice.
p 2429. Fistulas, and ulcers of every description, which extend
for any distance beneath the surface, should be syringed every
night and morning, as directed inº 2291, particularly if
they are offensive, or the seat of an acrid discharge. By this
means the sore is thoroughly cleansed, and brought into a healing
condition. A small syringe should be employed, and the fluid
injected with as little force as possible, especially if the part is very
sensitive. Nevertheless, we should always be certain that we
reach the bottom of the ulcer, or the treatment will ſail in produ-
Pita CTICE OF MEDICINE. 581
cing the desired effect. The tincture of myrrh has been injected
into fistulas, and ulcerated cavities, with great advantage. (906.)
2430. If a sore is irritable, the carrot poultice will be found
highly useful; or if it is extremely fetid, an application may be
made of the yeast, or charcoal poultice.
2431. Ulcers on the lower extremities, which are dependent
on an enlarged state of the veins, cannot be cured, as a general
thing, unless the patient avoids an erect position. If he is much
upon his feet, there is no opportunity for the veins to diminish in
size, and the ulcers become extremely obstinate. It is a very
good practice to bandage the limb, commencing at the foot, pre-
viously laying a plaster of the stimulating liniment on the diseased
surface.
2432. In the event of proud flesh, as it is termed, which is
nothing more than a prominent or unhealthy state of the granula-
tions, the sore may be washed with an infusion of sumach berries,
or rheumatic drops diluted with water; and a poultice of slip-
pery elm, prepared with a tea of witch hazel, or bayberry, ap-
plied. Lint moistened with sweet oil, nerve ointment, or the
green salve, is frequently applied to keep down granulations, and
as more or less pressure is necessary, it must be confined to the
sore with an appropriate bandage. The poultice or lint may be
employed, according to the circumstances of the case.
2 Besides external applications, medicines are to be used
internally to restore the general health, for while the blood is
impure, and the whole system disordered, it is impossible that an
obstinate ulcer can be healed. This is verified at the public
hospitals and alms houses, where patients remain for months, and
even years, with what are termed incurable ulcers, merely because
adequate means are not taken to improve the health, and invigorate
the constitution. Tonics, stimulants, enemas, and the vapor bath
are to be employed, as the case may seem to demand; and if the
ulcer has been of long standing, it will be necessary to administer
a few courses of medicine. Attention to diet is indispensable.
(See remarks on that subject in paragraph 1706.) I have known
chronic ulcers of ten or fifteen years’ standing, to be cured in five
or six weeks by a regulated diet, and an occasional course of med-
icine. The wife of Mr. Wilson of Philadelphia, who is well
known in that city, was afflicted for fifteen years with an ulcer,
which her medical attendants, after exhausting all the resources of
their art, told her would speedily prove fatal, but by taking sev-
eral courses of medicine, she was restored to health in six weeks.
Dr. Comfort was the attending physician.
-



582 PRACTICE OF MEDICINE.
-
WHITE SWELLING.
2434. White swelling is an inflammation of a joint, but without
redness or discoloration of the skin, as the name implies. It is gen-
erally seated in the knee, ankle, wrist, or elbow, and is a common,
as well as a distressing malady. It is caused by sprains, bruises,
exposure to wet and cold, and particularly by the use of mercury.
If the knee is the part affected, it becomes incapable, sooner or
later, of supporting the full weight of the body, and is forced into
a curved or bent position. In the early stage of the complaint,
the swelling is usually inconsiderable, but ultimately the joint be-
comes very large, while the other parts of the limb are emaciated.
If the disease is not arrested, suppuration ensues, and troublesome
ulcers are formed about the joint. The health in the meantime is
much impaired, and at last the patient is exhausted by copious
diarrhoea and night sweats.
2435. TREATMENT. The general health requires particular
attention in this complaint, and if much impaired, it should be re-
instated by the administration of a few courses of medicine. Be-
tween the courses, composition, cayenne, spiced bitters, enemas,
and the vapor bath, may be employed as circumstances require.
The alterative mixture is also a useful medicine. Attention to
diet, and cold bathing, provided the latter is admissible, should
not be neglected. (1706.)
2436. The local application of vapor to the affected joint once
or twice a day, as directed in paragraph 1499, will be found
highly efficacious in removing the pain and inflammation, and
establishing a healthy action in the part. After the process has
been completed, the joint may be rubbed briskly with warm vin-
egar and cayenne, (1531) or the stimulating liniment, and wrap-
ped in a flannel to keep the skin moist. If there is much pain,
a flannel wrung out of the vinegar and cayenne may be applied,
together with a heated stone, or bottle of hot water, wrapped in a
damp cloth.
2437. During the administration of a course of medicine, the
following poultice may be confined to the swelling with advantage.
Stir Indian meal into boiling water until it is of the desired consis-
tence, and mix with it a tea-spoonſul or more of cayenne, and two
table-spoonfuls of brown lobelia. When the course is finished,
the poultice may be removed, and the joint wrapped in flannel, as
directed above.
2438. If suppuration takes place, the elm and ginger poultice
must be applied until the inflammation is subdued, and the matter
PRACTICE OF MEDICINE. 583
all discharged. The ulcer may then be dressed with healing
salve.
2439. Dr. Thomson informs me that previous to suppuration,
he has used the following poultice with particular benefit. Take
of the green root of comfrey, and scrape it until you have a suffi-
cient quantity of the pulp or mucilage; add the white of one or
two eggs, and a glass or more of fourth proof brandy; beat these
together in a mortar, until you have a poultice of the proper con-
sistence. Spread the mixture upon a piece of linen, or fine soft
leather, sufficiently large to surround the joint, and confine it with
appropriate bandages. The poultice is to be renewed as often as
it becomes dry. The particular advantage of this application is,
that it gradually contracts upon the swollen joint, and diminishes
the swelling, without increasing the pain, or irritation.
WHOO PING COUGH. -
2440. This is a disease peculiar to children, though it occa-
sionally attacks adults. It frequently prevails as an epidemic, and
is most common in the spring and autumn, commencing with
the symptoms of a common cold. It does not usually occur in
the same individual a second time. The cough is moderate at
first, but in the course of a week or fortnight, increases in vio-
lence, and acquires a peculiar shrill and whooping sound. It
makes its attacks in fits or paroxysms, which continue for a longer
or shorter time, and terminate in an expectoration of phlegm or
mucus. In some instances vomiting occurs. During the exer-
tion of coughing, the eyes become prominent, and the counte-
nance red, or livid. The bowels are mostly disordered, accom-
panied, not unfrequently, with loss of appetite, headach, ſever, and
a coated tongue. Oftentimes, however, the patient does not expe-
rience any particular indisposition. The malady seems to depend
upon an inflammation of the air passages of the lungs, and is ren-
dered more violent by exposure to cold. If not seasonably ar-
rested, it may continue for six or eight weeks, or perhaps as many
months, and terminate at last in some obstinate or dangerous
malady.
2341. During the paroxysms of coughing, the patient is some-
times in danger of suffocation, inasmuch as the coughing is con-
tinued a considerable time before taking a breath.
2442. TREATMENT. Courses of medicine are not necessary
in this complaint, excepting where the symptoms are urgent, or
the general health is very much impaired. If the bowels are


584 PRACTICE OF MEDICINE.
--- -
irregular, an injection should be administered once or twice a day,
and exposure to wet and cold avoided. The feet, in particular,
must be kept warm and dry. The diet should be light and nour-
ishing, dispensing with the use of fat meat, butter, and all the
grosser articles of food. The wheat jelly, or the unbolted wheat
meal gruel, will be of essential service in regulating the bowels.
2443. If the air passages of the lungs are loaded with phlegm,
so as to oppress the breathing, an emetic of lobelia will afford
immediate relief.
2444. Where the appetite is impaired, the spiced bitters may
be taken before each meal; and if the symptoms are violent, the
patient should be kept in a gentle perspiration with composition
tea; or if this is insufficient, with an infusion of cayenne, bayberry,
scullcap, and green lobelia. (1515.) The latter preparation is
highly serviceable in allaying the cough. Among other useful
remedies which may be employed for this purpose, are the cough
jelly, cough powder, alterative mixture, and the tincture of lobelia
dropped on loaf sugar. (1283.)
WORMS.
2445. “Worms, says Cuvier, can only propagate them-
selves in the interior of the bodies of other animals. There is
hardly any animal which does not give support to several kinds of
them, and frequently the same species of them does not inhabit
more kinds of animal than one. They are not only found in the
intestinal tube, and the ducts communicating with it, but also in
the cellular tissue, and the substance of the brain, liver, and other
organs. The difficulty of conceiving how they arrive in these
situations, together with the observation that they are never met
with out of the living body, has caused some naturalists to believe
in their spontaneous generation. But it is now sufficiently settled,
not only that the greater part of them produce either eggs or
living young, but that they have distinct sexes, which copulate
like other animals. We are therefore obliged, says Cuvier, to
believe that they are propagated by germs sufficiently minute to
enter the smallest passages, and that animals sometimes contain
these germs at the time of birth.”
2446. Among the different species of worms which infest the
intestinal canal, the most common is the long round worm, which
is tapering at both ends, and measures from six inches to a foot in
length. It inhabits the small intestines, says the work from
* American editors of Dr. Marshall Hall’s Practice of Medicine.

PRACTICE OF MEDICINE. 585
which I have already quoted, and is supposed to ſeed upon the
chyme. It sometimes creeps upward to the stomach, and in rare
instances to the mouth. “ The symptoms indicating its presence
are equivocal; but are commonly considered to be, starting in the
sleep, itching of the nose, irregular or excessive appetite, and
more or less emaciation. Nevertheless these worms are often
suspected of being present when they do not exist, and often
exist in healthy persons without doing any harm. They are ex-
pelled in acute diseases, of which they are not the cause.”
2447. The maw or pin worm, as it is termed, is not more
than half an inch in length, with a sharp tail, and is found prin-
cipally in the rectum, where it causes an itching and distressing
sensation, particularly after having retired to rest. “Many indi-
viduals,” say Drs. Bigelow and Holmes, in their edition of Mar-
shall Hall's Practice, “are infested with them from childhood,
but get rid of them as they advance in years. Some, however,
are troubled with them during the whole of a long life, though
they are represented as less annoying after middle age, than
before. They most commonly appear periodically, both in chil-
dren and adults, after intervals of from three to six weeks. Dur-
ing the intervals they are neither felt, nor seen in the discharges.
Their periodical return is announced by a sense of itching and burn-
ing at the extremity of the rectum, felt principally in the evening,
sometimes producing tumefaction, and eruption of the neighboring
skin. This irritation continues to recur every evening for a week,
or more, and then ceases. During this time the worms are dis-
charged alive and active in every alvine evacuation. Cathartics
and enemeta bring away vast numbers of them, but without dimin-
ishing the annoyance occasioned by those which remain behind.
At length they spontaneously cease to appear, the irritation sub-
sides, cathartics no longer bring them to light, and the inex-
perienced practitioner flatters himself that the evil is remedied.
Nevertheless, after a few weeks, they again return in undiminished
numbers, attended by the same phenomena as before. Whether
the new race are cotemporaries of the old, or descendants from
them, is not easy to tell. They have been found in other parts of
the alimentary tube, as well as the rectum. The food of these
animals appears to be the mucus which lines the intestinal canal.
Buried in this substance, they resist the effect of the most violent
cathartics and vermifuges, oil of turpentine, and croton not ex-
cepted. If we may be permitted to indulge in an hypothesis, it is,
that during a greater part of the time, they remain quietly im-
bedded in this mucus, deriving from it their habitation and nour-
ishment, being at the same time secured from the effects of the
peristaltic motion ; but at certain periods, perhaps at their gene-
74
586 PRACTICE OF MEDICINE.
rating seasons, they issue forth from this covert, and mingle them-
selves in the contents of the alimentary canal, in consequence of
which they are liable to be expelled with the common mass.”
2448. The tape worm is well known for its peculiar and ex-
traordinary character. It is sometimes forty or fifty feet in length,
consisting of a series of joints, which are about a quarter of an
inch square. It inhabits the small intestines, and is sometimes
found in the stomach. It is flat, like a piece of tape, and hence
its name. “It is capable,” say Drs. Bigelow and Holmes,
“of subsisting in the intestimes for an indefinite number of years,
continually casting off joints, which appear in the stools. Whether
these |. are reproduced, and, if so, in what manner, is a sub-
ject of hypothesis, upon which different opinions are entertained.
The symptoms indicating the presence of this worm are slight, so
much so as not to attract notice, until the joints are observed in
the discharges, or are found in the clothes or bed, having crawled
away from the rectum. But generally, if the worm has attained
considerable size, there is more or less pain, sense of weight and
uneasiness in the abdomen, voracious appetite, nausea, itching of
the anus, and nose, and sometimes emaciation. M. Guilbert
thinks it unnecessary to use any remedies for the tape worm, hav-
ing observed that it may exist for a long time without any disturb-
ance in the economy, provided the patient be plentifully sup-
plied with nourishing food. In the end it will disappear spon-
taneously.”
2449. TREATMENT. Equal parts of composition and spiced
bitters is an excellent medicine for worms. A tea-spoonful of the
powder, steeped in two thirds of a tea-cupful of boiling water,
and sweetened to suit the taste, may be given two, three, or four
times a day. This will generally effect a cure in a mild attack of
the complaint.
2450. Injections are highly efficacious, particularly in case of
the maw or pin worm, which is usually confined to the rectum.
They may be administered with advantage several times a day,
and if the patient is costive, should always constitute a part of the
treatment.
2451. Bayberry is an important remedy, because it detaches
the vitiated mucus which lines the intestinal canal, (807, 822)
and which, I have no doubt, is invariably present during the ex-
istence of worms. It may be given in the form of composition,
as directed above, or the tea may be administered, with a portion
of cayenne. -
2452. Where the symptoms are urgent, or the health seri-
ously impaired, one or two courses of medicine will be necessary.

PRACTICE OF MEDICINE. 587
2453. Purgatives are generally regarded as indispensable in
worm complaints, but although they may afford temporary relief,
they rarely fail to produce a morbid condition of the bowels,
which serves to prolong the disease.
2454. If children were properly managed with respect to diet,
I suspect they would rarely or never be troubled with worms.
The manner in which they are pampered at the present day, by
inconsiderate parents, can scarcely fail to derange the stomach and
bowels, and an attack of worms is almost a necessary conse-
quence. If children were confined to a vegetable diet, which, in
fact, is more nutritious than animal food, (1684, et seq.) allowing
them ripe fruit at their meals, and milk, or pure soft water for
drink, they would cease to be afflicted with the malady. Exer-
cise in the open air, also, when the weather permits, is indispen-
sable to a healthy and vigorous state of the general system.
WOUNDS.
2455. Wounds consist of cuts, lacerations, bruises, and punc-
tures. Added to these, we have what surgeons term gun-shot
wounds, which are produced by bullets, and other hard bodies
projected from fire-arms.
2456. A cut, in surgical language, is an incised wound, and is
made with a knife, or any other cutting instrument. It will heal
very readily by bringing the divided surfaces into contact with
stitches, or adhesive plaster. Fibrine or adhesive matter (117)
is thrown out by the wounded vessels, which unites or glues the
parts together, in the course of forty eight hours. This is called
healing by the first intention, which is one of the unmeaning
phrases in surgery, signifying that a cure takes place without sup-
puration. “ The vessels of the wounded surface,” says Dr. S.
Cooper, “ cease to bleed, and their extremities become imper-
vious to the blood itself, but not to the fibrine or coagulating
lymph which forms the general bond of union between living parts.
This uniting medium is the primitive and most simple connexion
that takes place between the two sides of a wound. In many
cases, however, where the wound is put into a state of apposition,
before the hemorrhage has had time to cease, no doubt a coagulum
of blood itself constitutes the first bond of union, and, as wounds
must thus be frequently united through the medium of red blood,
the propriety of cleansing a wound from it so exactly as some sur-
geons do may be called in question. The simple union of the
sides of a wound is what may be considered as taking place di-
rectly after they have been brought into contact. The next step



588 PRACTICE OF MEDICINE.
in the process of union by the first intention, is the generation of
yessels in the lymph, or blood, and this is soon followed by an
intercourse between the vessels of the two sides of the wound.
2457. “The celerity with which the process of union by the
first intention is completed, must excite the admiration of the phi-
losophical surgeon. In the short space of seventy two hours, the
wound produced by amputation of the thigh is often securely
united throughout its whole extent, without any suppuration, ex-
cepting just where the ligatures are situated. Incised wounds of
a moderate size, may in general be completely healed by this
method in forty eight hours.”
2458. Lacerations are wounds in which the parts have been
violently torn asunder. They differ from incised wounds, in-
asmuch as they bleed but little, even though the largest blood-
vessels have been injured. Limbs have been torn from the body
without the occurrence of dangerous hemorrhage. Lacerated
wounds are more disposed to inflame than the incised, and also
more frequently affect the general system.
2459. Bruises or contusions have been described under the
appropriate head.
2460. A punctured wound is made with a pointed instrument,
such as a bayonet, a needle, or a shoemaker’s awl. It is far more
dangerous than a cut, and is often followed by severe inflamma-
tion, and sometimes an extensive collection of matter. Great
agitation of the nervous system frequently ensues, “and this has
been attributed to the injury of tendons, or nerves. This doc-
trine is now almost quite exploded, as surgeons often see nerves
and tendons wounded without the occurrence of great constitu-
tional disorder. The explanation of the fact, that great derange-
ment of the system is very apt to follow punctured wounds, is not
yet unfolded in a satisfactory manner; but the fact itself is fully
established in the surgical records of all ages, and the firm basis
of daily experience.” --
2461. In the treatment of a wound, where it is necessary to
bring the divided surfaces into contact, it should be washed with
a sponge and lukewarm water; and if the hemorrhage does not
readily subside, it may be checked by making steady and contin-
ued pressure with the sponge upon the wounded vessels. This
accomplished, the coagulated blood is to be washed away, and the
lips of the wound brought together with stitches, or strips of ad-
hesive plaster, or both, allowing spaces between the latter for the
escape of blood and serum.
2462. Fine white sewing silk should be employed for the
stitches or sutures, taking care that it is sufficiently strong for the
purpose required. The stitches may be half an inch or an inch

PRACTICE OF MEDIC IN E. 589
apart, according to the extent or character of the wound, and after
the expiration of five or six days, they should be removed, lest
they excite inflammation. In making a suture, the needle is to
be passed through the skin on both sides of the wound, at oppo-
site points, and the thread tied in a knot, so as to bring the two
surfaces into apposition. In addition to the sutures, adhesive
plaster may also be applied, as mentioned above, to give still
firmer support to the parts.
2463. If a wound becomes hot and painful, cloths should be
applied, and wetted occasionally with cold water. This will gen-
erally afford prompt relief, and prevent the development of in-
flammation. Composition, or cayenne and bayberry, should be
taken internally at the same time, to keep up a healthy action in
the system. If the general health is much affected, it will be
necessary to administer a course of medicine. After the course,
the patient should be kept in a gentle perspiration, for while the
skin is moist, and the equilibrium of the circulation maintained,
unfavorable or alarming symptoms will not arise.
2464. In the event of suppuration, poultices must be applied,
as directed under the head of ulcers.
2465. Fresh wounds are signally benefited by wetting them
two or three times a day with rheumatic drops, or the tincture of
balm of Gilead buds. (1039.)
2466. If the pain is severe, it may be allayed by giving com-
position tea, until perspiration ensues; or if this does not produce
the desired effect, the stimulating tea may be employed, or any
other tea containing a small portion of lobelia.
2467. “If the wound be in a muscular part, more especially
in transverse wounds of muscles, it is required that the position of
the limb be carefully attended to, that the wounded muscle be re-
laxed as much as possible, and its separated portions kept in
contact.” -
2468. Parts which are nearly separated, as a finger, or the
nose, will readily unite by keeping the two surfaces in appo-
sition with sutures, or adhesive plaster. “Mr. Hunter removed
the spur of a cock, and placed it in the comb by incision, where
it not only adhered, but grew. A tooth extracted from the
human subject and placed in the comb of a cock, will also
adhere.” -
2469. If a bullet is lodged in the soft parts, it should be ex-
tracted, if this can be accomplished without too much difficulty;
but otherwise, it need not excite any alarm, for it may remain
imbedded in the flesh for a life time without doing any injury.
Splinters of bones, and other bodies of a similar character, fre-
quently work themselves out by a natural process.

590 PRACTICE OF MEDICINE.
2470. The air must be excluded from wounds, or it will ren-
der them painful, and interfere with the healing process.
2471. Wounds of flrteries and Veins. If an artery is wound-
ed, the blood flows rapidly in jets, corresponding with the con-
tractions of the heart, and is of a red or florid color; if a vein, the
bleeding is slow, gradually filling the wound, and the blood is
dark or purple.
2472. In checking the flow of blood from an artery, pressure
is to be made on the vessel between the wound and the heart;
but if the hemorrhage is from a vein, pressure is to be made on
the side of the wound furthest from the heart, for in the arteries,
the blood has an outward direction, while in the veins, it always
moves inward towards the heart.
2473. Pressure is always sufficient to arrest the bleeding
from a vein, but in a large artery, it is only of service until the
vessel can be secured with a ligature. This is to be done by
drawing the artery out of its sheath with a hook or tenaculum, and
tying it with a piece of catgut, or two or three strands of white
sewing silk. Both ends of the wounded artery should be secured,
and if the vessel is deeply seated, the ligature cannot be passed
round it excepting with a curved or crooked needle.
2474. In modern surgery, it has been found that twisting an
artery ten or a dozen times with some convenient instrument, will
answer instead of a ligature, but it is generally considered advise-
able to apply the latter, in case the vessel is large. In the smaller
arteries, twisting no doubt answers an excellent purpose.
2475. The plan by which nature arrests the bleeding of a
small artery, is as simple as it is admirable. As soon as the
vessel is divided, it draws up within its sheath, and contracts at
the mouth, so that the blood is enabled to coagulate, and fill up
the artery adjacent to the wound with a solid plug. In a large
artery, however, the force or impulse of the blood from the heart
is so strong, as not to admit of coagulation, and hence the neces-
sity of a ligature.
YELLOW Fever.
2476. This disease is characterized by high fever, yellow
color of the skin, and vomiting of black ropy matter, resem-
bling coffee grounds. It is peculiar to warm climates, break-
ing out in the hot weather of summer, and particularly in the
neighborhood of low and marshy districts. It is no doubt caused
PRACTICE OF MEDIC in E. 591
by the decomposition of vegetable and animal substances, which
fills the whole atmosphere with impurities. Under these circum-
stances, persons who are intemperate in their habits, or indulge in
any excesses which weaken the body, are very liable to be at-
tacked. Individuals who reside where the disease is prevalent,
should avoid exposure to the rays of the sun, as well as the cool
damp air of the night.
2477. Previous to an attack, the patient generally complains
of headach, giddiness, pains in the back and limbs, chilliness,
loss of appetite, nausea, debility, costiveness, and a sense of
weight or oppression at the stomach. These symptoms, in the
ordinary course of the disease, are succeeded by a hot and dry
skin, great thirst, retching, flushing of the face, anxious expression
of countenance, shooting pains in the head, back, and extremities,
vomiting of yellow or greenish matter, restlessness, hurried breath-
ing, intolerance of light, delirium, and a severe, burning pain in
the stomach. The vomiting becomes more frequent and distres-
sing as the disease advances, and the skin and eyes assume a yel-
low color. The latter symptoms, however, may not occur for
four or five days from the commencement of the attack. The
tongue which was red at first, or covered with a white, or yellow
coat, becomes dark colored, or black. In the last stage of the
complaint, the pulse sinks, the black vomit commences, and the
extremities become icy-cold. Profuse diarrhoea is a common
symptom, accompanied, oftentimes, with delirium, hiccough,
stupor, convulsions, swelling of the abdomen, and hemorrhage
from the bowels, and other free passages.
2478. The black vomit consists of blood almost in a putrid
state, which escapes from the vessels of the stomach. Magendie
has produced it in dogs, by injecting a small portion of putrid
water into their veins.
2479. TREATMENT. The force of this disease seems to be
expended principally on the stomach and liver, and hence we must
resort to active treatment to relieve these organs, or it will be
impossible to effect a cure. A thorough course of medicine
should be administered without delay, and if this does not afford
the desired relief, it should be repeated as soon as the skin be-
comes hot and dry, or other unfavorable symptoms return.
2480. Between the courses, the patient should be kept in a
gentle perspiration by the use of enemas, and cayenne and bay-
berry tea, containing a small portion of lobelia.
2481. Cayenne is a highly efficacious remedy, and should be
freely employed. Dr. Thatcher, in his Dispensatory, states that
where the stomach was too irritable for calomel in the yellow fever


592 - PRACTICE OF ME DIC INE.
of the West Indies, cayenne made into pills was administered, and
it cured even after the black vomit had commenced. (747.)
2482. After the first day or two, there is sometimes a re-
mission of the symptoms, which leads the patient to suppose that
he is regaining his health, but this is often a deceitful calm, and
unless the stomach has been thoroughly cleansed, and the skin is
moist, and of a natural temperature, the medicine should be given
in full and frequent doses.
2483. The treatment which has been recommended for ty-
phus ſever, may be adopted with equal propriety in this, and the
reader is therefore referred to the remarks on that subject. (2408,
et seq.)
END OF WOLUME FIRST.
- -
- - -
- -
-
- - -
- -
- -
G L Q S S A R Y.
ABDoMEN, the belly.
Alvine, relating to the intestines.
ANEMIA, flatulence.
ANTIPHLogistic, any mode of treat-
ment which weakens the system, or exhausts
the vital powers.
ANus, the fundament or extremity of the
great intestine, through which the excre-
ments or feces are discharged.
CANULA, a small tube.
CAPILLARIEs, the small blood-vessels
which connect the arteries and veins.
CAR Bos, a name applied by chemists to
charcoal.
CARBoxic Acid GAs, fixed air; a com-
pound of carbon and oxygen. It is emitted
from burning charcoal, and is found in
mines, caverns, and at the bottom of wells.
CATAMEN1A, the monthly discharges
- from the womb.
CATAPLAsm, a poultice.
CELLULAR, having little cells.
CHRoN1c, a term applied to diseases of
long standing; the opposite of acute.
HyLE, the milky fluid produced by di-
gestion, from which the blood is formed.
Clyst ERs, injections.
CoMA, stupor; drowsiness.
CoMAtosk, having an irresistible pro-
pensity to sleep.
CoNGEstion,
blood.
ConstipATION, costiveness.
CRANIUM, the skull.
CREP1tus, a crackling noise.
CUTANEous, relating to the skin.
undue accumulation of
Decoction, a medicine prepared by
boiling.
Diagnostic, distinguishing; character-
istic; the sign or symptom by which one
disease is distinguished from another.
Diaphoretic, a medicine which pro-
motes perspiration.
A.
The technicalities employed in the first volume of this work, are either referred to in
the index, or explained in the subjoined glossary.
DIETEtic, relating to diet.
Diu Resis, increased discharge of urine.
DRAstic, violent, powerful.
Dyspnoea, oppressed breathing.
EMEsis, vomiting.
EMMENogogue, a medicine which is
said to promote the monthly discharge of
females.
ENDEMic, a disease peculiar to certain
localities or districts.
ENEMATA, injections.
ERYTHEMA, a slight inflammation of the
skin.
Esch AR, the dead substance produced
by applying caustic.
Et seq., a contraction of the Latin words
et sequitur, signifying that which follows.
FARINAcEous, mealy; pertaining to
meal.
FAuces, the cavity behind the tongue.
FEBRILE, feverish.
FEcEs, the discharges by stool.
Function, the action or office performed
by an organ.
GAst Ric, relating to the stomach.
GEstation, pregnancy.
HEctic, a slow, habitual ſever, with
sweats and emaciation.
HeMoRRhAGE, bleeding from any part
of the body.
HEPATic, relating to the liver.
HERPEric, having the character of
tetter.
-
Idiosyncrasy, any peculiar habit.
LEsion, a wound; injury.
Loins, the small of the back.
Lymph, a fluid contained in the lym-
phatic vessels.
-
















11 G.L.O.S.S.A. R.Y.
MARAsmus, a wasting of the body with-
out apparent disease.
Modus oper AND1, the method of ope-
rating.
Morbid, diseased.
Mucus, one of the fluids of the body, as
the mucus of the nose.
NARcotic, a poison which impairs or
destroys the sensibility of the nerves.
NEURALGIA, disease of the nerves.
Nosology, a systematic arrangement of
diseases into classes, orders, genera, and
species.
CEsop HAgus, the gullet or meatpipe.
OPP Rob RIA MEdicorum, the disgrace
of the physicians.
Ossified, changed into bone.
Oxygen, one of the constituents of the
air, without which we could not exist.
PARoxysM, a name applied to a periodi-
cal attack of a disease which lasts for a
limited time and then declines.
PATHology, the doctrine of diseases.
PER ANUM, by the anus.
PERIost EUM, the membrane which cov-
ers the bones.
PER v AGINAM, by the vagina.
PHARMAcopoei A, a dispensatory.
Physiology, the science which teaches
the knowledge of living bodies.
Post MoRTEM, after death.
PRIAPIsM, a continual erection of the
penis.
PURULENT, consisting of pus or matter.
PyLoRus, the intestinal orifice of the
stomach.
REMIt TENT, ceasing for a limited time.
RETCHING, straining to vomit.
Rigor, a sudden coldness, attended by
shivering.
SALIVA, spittle.
SANGUINEous, relating to the blood.
SciRRHus, a hardening or induration of
a gland.
Scy BALA, dry, hard excrements, rounded
like nuts or marbles.
SEcRETIon, a substance derived from the
blood, as the saliva, bile, and gastric juice.
SERUM, the watery part of the blood.
SLough, a separation of dead from liv-
ing flesh.
SPUTA, any kind of expectoration.
Sudokirić, that which produces perspi-
ration.
Syncop E, fainting.
SYNovi A, a fluid peculiar to the joints,
by which they are lubricated.
TENESMUs, a painful desire to go to
stool.
TESTEs, the testicles.
THERAPEuſtic, relating to the employ-
ment of remedies.
Topic AL, confined to a particular part.
TRoca R, the name of an instrument
used for tapping, in dropsy.
WEsicle, a blister.
WiscERA, the contents of the abdomen
and chest, as the lungs, stomach and intes-
times.
ViscID, sticky, glutinous.
Wis conservat Rix NATURAE, that pow-
er by which the body, in a state of dis-
ease, is enabled to regain its healthy func-
tions.


I N D E X.
The figures refer to the paragraphs, excepting where they are preceded by the
word page.
Et seq. is a contraction of the Latin words et sequitur, signifying that which
follows. -
Abercrombie, remark by, 198.
Abscess, 1361.
case of 342, et seq.
of liver, 2119.
Abortion, caused by ergot, 560.
Absorbent system, 64.
Absorbents, 62, et seq.
trunk of the, 61.
Absorption, 63, et seq.
Acetic acid, 594, 1193.
fermentation, 594.
Achillea millefolium, page 298.
Achilles tendon, 27.
Acids, 593, et seq.
mineral, 504, et seq.
Adhesive plaster, 1319.
Ague and fever, 1733.
in the face, 2397.
Alcohol, 1018.
how obtained, 1019.
produces disease, 1022.
is narcotic, 1023.
diminishes strength, 1024.
Alarming symptoms, 1446–7.
Aletris farinosa, 915.
Alkalies, 1025.
enumeration of 1229.
Alterative mixture, 1526.
Althaea rosea, page 272.
American aspen, 888.
Amputation, 2015, 2018.
Amygdalus Persica, page 217.
Anasarca, 1948.
Anatomy, page 1. -
comparative, 2.
may be taught to children,
5, 6.
Hippocrates ignorant of, 7.
Aneurisms, 105.
Animal food, 1683, et seq.
Angelica tree, 1146.
Animal heat, 134, et seq.
source of 135.
Antacids, see alkalies.
Anthemis nobilis, 1074.
cotula, page 275.
Anti-dyspeptic bread, 1323.
Antimony, 473, et seq.
preparation of 476.
Antispasmodic tincture, 1266.
dose of 1273.
Antispasmodics, enumeration of 1226.
Antiseptics, 1233.
enumeration of, ib.
remarks on, 1234, et seq.
Apocynum androsaemifolium, page 246.
Apoplexy, 1745.
Aqua fortis, see nitric acid.
used in inflammation of the
liver, 234.
Aralia spinosa, 1146.
Archangel, 1030.



iv.
IND Ex.
-
Arctium lappa, page 257.
Aromatics, 1237.
enumeration of, ib.
Arrow root jelly, 1433.
Arsenic, 484, et seq.
used by physicians, 486.
produces disease, ib.
preparations of 488, 1829.
Artemisia absinthium, page 297.
Arteries, 102, et seq.
subject to enlargement, 105.
wounds of, 2471.
Arum triphyllum, page 294.
Asarum Canadense, page 259.
Ascites, 1946.
Asiatic cholera, 1753.
experiments of physi-
cians in, 1756–7.
how treated by Magen-
die, 1759.
- Aspen, large, 889.
American, 888.
Aster Puniceus, page 264.
Asthma, 1768.
Astringents, 801.
not used in poultices, 803.
are detergent, 807.
are cleansing medicines,
ib.
to be used previous to an
emetic, 810.
use of, in various diseases,
811, et seq.
different kinds of, 1222.
Balm of Gilead, 1036.
tinct. of the buds, 1039.
Balmony, 899.
Balsam poplar, 1037.
tincture of the buds,
- 1039.
Balsams, 590.
Barks, when to collect, 609.
Barberry, 993.
preparation of, 995.
jelly, 997.
Bathing, 1443.
vapor, 1462.
cold, 1448.
warm, 1456.
salutary, 1457.
recommended by Frank-
lin, 1458.
inferior to vapor bath-
ing, 1459, 1460.
Bath, sponge, 1454.
hand, 1455.
Bayberry, 816.
wax, 818.
coarse, 820.
cleanses inner coat of stom-
ach, 822.
not purgative, 823.
sometimes an emetic, 824.
a dentifrice, 827.
snuff, 828.
Beaumont’s work on digestion, 81.
Beef tea, 1421.
Belladonna, 526, et seq.
dilates pupil of the eye,
528.
used by imposters, ib.
Bellyache, dry, 1847.
Benzoic acid, 598.
Berberis vulgaris, page 243.
Beth root, 865.
tastes like unicorn, 866.
used after parturition, ib.
Betula lenta, page 202.
Bicarbonate of soda, 1027–8.
Bile, passes into the duodenum, 58, 74.
in the stomach, 1689.
Biles, see boils.
Biliary organs, 53, et. seq.
ducts, 58.
Bilious colic, 1845.
fever, 1794.
congestive form of 1796.
Bird pepper, 731.
Bitter herb, see balmony.
Bitter medicines, see tonics.
Bitter root, 1009.
action of, on the liver, 1017.
Bitter sweet, 1041.
thistle, 1045.
Black birch, 838.
drop, 500.
jaundice, 2143.
measles, 2153.
pepper, 783.
root, 998.
vomit, 2477–8.
Bladder, 51.
Blanc mange, 1437.
Blatchford, Miss, case of 288, et seq.
Bleeding, see hemorrhage.
from the lungs, 1779.
nose, 1785.
stomach, 1789.
urinary organs, 1792.




-
-
-
| N. D. Ex- w
Blisters, 409, et seq.
excite inflammation, 411.
induce mortification, 415–6.
boiling water a substitute for,
417.
Blood, 113, et seq.
quantity of, in the body of an
adult, 113.
temperature of, ib.
pabulum of life, ib.
furnishes the secretions, 115.
composition of, i.17.
venous, 125.
arterial, ib.
circulation of, when discovered,
128.
Blood-letting, 346, et seq.
remarks on, by Dr. Jack-
son, 171.
practised by Hippocrates,
346.
learned dispute concern-
ing, 347.
cross bleeding, 348.
effects of 349.
opinions of, by M. Louis,
350, et seq.
does not arrest pain, 354.
does not arrest inflam-
mation, 356.
opinions of, by Dr. Hall,
358, et seq.
convulsions produced by,
359, 360–1.
causes delirium, stupor,
and death, 36.2–3–4–5.
occasions inflammation,
366–7, 388.
causes hemorrhage, 369.
occasions ulceration,371,
372.
occasions dropsy, 380.
cases of, 374–6–7.
prohibited by Erasistra-
tus, 378.
hazardous, 379.
hemorrhage from lungs,
381.
in suspended animation,
382–3.
authors, 384, et seq.
in ague and ſever, 389.
condemned by medical
Lobstein's remarks on,
390, et seq.
| Blood-letting, accidents accompanying,
391.
Blood root, 1048. -
remedy for polypus, 1050,
1051.
Blue pill, 471.
scullcap, 921.
vervain, 703.
vitriol, see sulphate of copper.
Boiler, steam, 1496, 1501.
portable, 1502.
Boils, 1731, 1805.
Bolingbroke, killed by quackery, 155.
Bones, 14.
colored by madder, 15.
insensible when sound, 16.
painful when diseased, ib.
composition of 17.
broken, see fractures.
of an infant, 2242.
Boneset, 709.
Box for vapor bathing, 1500.
to enclose a joint, 1499.
| Brain, 139.
surrounded by membranes, ib.
seat of sensation, ib.
nerves of 147.
dropsy of, 213
| Bread of life, see anti-dyspeptic bread.
Broken hones, see fractures.
Bronchia, 124.
Broussais, and his doctrines, 184, et
seq.
pupils of 186.
practice of 188.
his opinion of physicians, 190.
Brown, Dr., opinions of, 176, et seq.
studies of, 176.
rival of Cullen, 178.
denounces Cullen, and oth-
ers, ib.
Brown lobelia, 695, 1613.
mixture, 1904.
Bruise, 1810.
Buboes, 2369.
how treated, 2374.
Buck horn brake, 1053.
Burdock, 1058.
Burns and scalds, 1812.
Butternut, 987.
extract, 989.
sirup, 990.
Byron, death of 269, et seq.
was opposed to bloodletting,
274.
-
-
-
- -






vi
Ex.
IND
Byron, called his physicians butchers,
278.
Caecum, 78.
Callus, 2008.
Calomel, 437–8–9, 467.
given in the autumn, 154.
modus operandi of 440.
enormous use of, 446.
direful effects of 453.
action of, upon the liver, 454.
names of, 467.
Caloric, see heat.
Camphor, 591.
a narcotic, 1066.
Canada snake root, 1068.
balsam, 1107.
Cancer, 1819.
marsh rosemary used in,
877.
operations for, useless, 1825,
et seq.
balsam, see cancer plaster.
Canker, 808.
rash, see scarlet fever.
Cantharides, 536.
effects of 537.
Capillaries, 106, et seq.
Capsicum, page 180.
annuum, 270.
baccatum, 731.
frutescens, 733.
Carbonic acid gas, 2353.
Carbuncles, 1809.
Caries, 1368.
Carrageen, 1123.
Cartilages, 29.
Cassia, 1078.
Catarrh, 2137.
Cathartics, see purgatives.
Catnip, 1071.
Caustic, vegetable, 1327–8.
Cavities in the lungs, 1862.
Cayenne, 727, 731.
African, 732–6, 764.
West India, 732–4–5.
East India, 733.
an old remedy, 737, et seq.
not heating, 741.
medical authorities, 744, et
seq.
not narcotic, 745.
does not blister, 745, 760.
a pure stimulant, 746.
obviates thirst, 751–2.
Cayenne, recommended in hemorrhage,
753.
recommended in
754.
adulteration of 761–2–3.
purest stimulant known, 765.
effects of, ib.
precaution in the use of 766.
burning sensation of, how
remedied, 780–1.
dose of 782.
tincture of, 1284.
pills, 1301.
and bayberry tea, 1512.
simmered in vinegar, 1531.
Celastrus scandens, page 253.
Centaurea benedicta, page 254.
Cerebellum, 139.
Cerebrum, ib.
Chamomile, 1073.
garden, ib.
flowers, 1074.
European, ib.
Chancres, 2363.
Chapman, Dr., remarks by, 179, et seq.
Chelone glabra, page 215.
Chemical analysis, 563.
Chequer berry, see spicy wintergreen.
Cherry spirit, 1205.
Cheyne, Dr., anecdote of 162.
Chicken pox, 1836.
remarks on, 227.
tea, 1422.
Chilblains, 1838.
Children, compound for, 1528.
treatment of 1583.
Chilly pepper, 733.
Chimaphila umbellata, page 279.
Chocolate root, see Evan root.
Cholera morbus, 1840.
Asiatic, 1753.
sirup, see dysentery sirup.
Chordee, 2022.
remedy for, 2032.
Chronic diseases, symptoms indicating
the cure of 1725, et seq.
Chrysanthemum parthenium, page 267.
Chyle, 73.
Cinnamon, 1078. "
Circulation of the blood, 128, et seq.
remarks on, 132.
flooding,
Citric acid, 596.
Clap, 2021.
Cleansing medicines, 807.
Cleavers, pointed, 1079.
IND EX. vii
-
Cleavers, common, 1080.
small, 1082.
Clothing, 1707.
Cloves, 1087.
Coagulable lymph, see fibrine.
Cocash, 1088.
Cochlearia armoracia, page 272.
Colchicum, 501, et seq.
woman poisoned with, 503.
Cold air, injurious to weak lungs, 1709,
1871.
effect of, similar to that of a burn,
1818.
feet, remedy for, 1669.
water, useful in burns, 1813–14.
shower, 1504, et seq.
Coldness of body and extremities, 1652.
Colic, 1844.
bilious, 1845.
painter’s, 1847.
remarks on, 973.
Colon, 79.
Colton, Rev. C. C., 11.
Comfrey, 1091.
Common salve, 1318.
Composition, 1238.
how to give, 1243.
mixed with cold water,
ib.
tea, 1511.
Compound for children, 1528.
Compounds, list of, page 305.
Congestive fever, 1796.
Conserve of hollyhock, see anti-dyspep-
tic bread.
Consumption, 1849.
remarks on, by Magen-
die, 207.
quackery in the treat-
ment of 208, et seq.
weed, 1207.
symptoms of, 1858.
probability of a cure,
1861, et seq.
- night sweats in, 1869.
respirator, useful in,
1872.
Ramadge’s tube useful
in, 1877.
Contusions, see bruises.
Convulsions, 1886.
Cool wort, 1093.
Copperas, see sulphate of iron.
Coptis trifolia, page 271.
-
Costiveness, 1893.
Costiveness, remarks on, 970.
Cornaro, 1697.
Corns, 1891.
Corrosive sublimate, 468.
Corsets, 1708.
Cough, 1904. -
powder, 1253.
sirup, 1264.
balsam, 1295.
Counter irritation, 405, et seq.
Course of medicine, remarks on, 1589,
et seq.
treatment previous
to, 1596, et seq.
directions for, 1604.
light, 1612.
conclusion of 1636.
food after, 1644.
accidental symp-
toms during, page
404.
repetition of, 1715,
et seq.
number of, 1721, et
seq.
Cow pox, 2305.
Croup, 1908.
Cupping, 404.
Curvature of the spine, 2244.
Cut, 2456.
Cuticle, 37.
Cutis or true skin, 39.
Cypripedium humile or acaule, 929.
parviflorum or pubescens,
931.
candidum, 933.
spectabile, 934.
Cystic duct, 58.
Deadly nightshade, see belladonna.
Deafness, 1916.
Debility, 1728.
Decoction, 1510.
Delirium, 1649.
tremens, 1918.
remarks on, by Dr.
Eberle, 222.
antimony in, 223.
opium in, 224-5.
Demulcents, see mucilages.
Dentifrice, 828.
Despondency, 1729.5-
Detergents, 807.
Diabetes, see excessive flow of urine.
Diaphragm, 120, et seq.





























































viii
IND Ex. -
Diarrhoea, 1924.
remedies for, 790, 840, 869,
1034.
tea for, 1517.
chronic, 1926.
Diet, 1680.
important in the treatment of dis-
ease, 1706.
use of meat, 1683, et seq.
quality and quantity of food, 1698,
et seq., 1705.
remarks on, by Abercrombie,
1700.
by Galen, 1701.
Graham, 1702.
Beaumont, 1703.
Parmly, 1704.
Difficult breathing, 1554.
cases of 1655, et seq.
Digestion, 81, et seq.
motions of stomach in, 82.
gastric juice indispensable to,
85.
medium time required for,
94–6.
Digitalis, 539, et seq.
direful effects of 540.
Directions for a course of medicine,
page 392.
Disease a unit, 196.
what is it 3 1376.
Diseases, and their treatment, page 428.
Dislocations,simple and compound, 1929.
how to relax the muscles
in, 1933.
of hip and shoulder, 1944.
Diuretics, 1227.
Diuretic tea, 1516.
Dose of medicines, 1438.
Dover’s powder, 499, 2232.
Dress, see clothing.
of females, 1708.
Dropsy, 1945.
of abdomen, 1946.
chest, 1947.
cellular membrane, 1948.
Drowning, 2352, 23.59.
Dry bellyache, 1847.
Duchess D’Abrantes, mother of, cured
by a milk-man, 7.
Duodenum, 73.
bile received into, 74.
Dura mater, 32, 139.
Dysentery, 1956.
tea for, 1517.
Dysentery sirup, 1262.
Dyspepsia, 1966.
caused by
1967.
remarks on, 214, et seq.
blood-letting,
Earach, 1947.
Elecampane, 1097.
Emetic, how to administer, 1579, et seq.
for a child, 1584.
by injection, 1585.
in a course, 1610.
Emetics, 617.
modus operandi of 618.
importance of, 619, 620.
useful in fevers, 631.
-- apoplexy, 646, 1750.
favor absorption, 633.
assist the passage of gall-
stones, 638.
increase the action of the dia-
phragm, 645.
are expectorant, ib.
not all poisonous, 675.
remarks on, 1600.
different kinds of, 1220.
Enemas, see injections.
Epilepsy, 1984.
Epitaph of Italian count, 180.
Ergot, 555, et seq.
causes gangrene, 556–7.
used in parturition, 558.
causes abortion, 560.
Erigeron Canadense, page 268.
Philadelphicum, 1105.
Erysipelas, 1984.
Essences, 1297.
Eugenia caryophyllata, page 263.
Eupatorium perfoliatum, 175.
Evan root, 853.
used instead of tea and coffee,
854.
Excessive flow of urine, 1990.
Exercise, 1709.
its effects, 1710.
anecdote relating to, 1714.
indulged in by English girls,
1713.
Exercises, gymnastic, 1711.
Expectorants, 1230.
Expectoration, 1727.
Expiration, 121.
Eye waters, 1532.
Falling of the fundament, 1995.


IND EX. ix
-
Falling sickness, see epilepsy.
False membrane, 1393, et seq., 1732.
opinion of the an-
cients, 1394.
remarks on, by Bi-
chat, 1394.
by Professor
Thomson,
1395.
by Dr. Good,
1398,1406.
not a part of the intes-
times, 1394–6.
coughed up in croup,
1397.
not organized, 1398.
a knowledge of im–
portant, 1399.
produced by mitric
acid, 1400.
by purgatives,
1407.
prevents the action
of poisons, 1400.
necessity of its detach-
ment, 1402.
non-appearance after
death, 1403–4.
medical men ignorant
of 1405.
Fainting, 1993.
Fat meat injurious, 1689, 1690.
Featherfew, 1100.
Felon, 1998.
Female restorative, 1248.
Fever, 1329.
yellow, 201, 2476.
scarlet, 218, 2268.
typhus, 642–3, 2403.
bilious or remittent, 1794.
congestive, 1796.
remarks on, by Jackson, 1329.
by Good, 1330.
by S. Smith, 1331.
by Eberle, 1322.
by Hosack, 1333.
opprobrium of the faculty, 1333.
theories of, 1335–6–7–8–9.
preceded by debility of capilla-
ries, 1340, et seq. -
symptoms of 1343–4.
condition of the skin in, 134–5–6.
temperature of the skin in, 1347.
-- of the bloodin, 1348.
how treated by physicians, 1350.
B
-
Fever is salutary in design, 1352.
Fir balsam, 1106.
tincture of, 1290.
Fistula, 2424.
in amo, 2424.
Fits, 1886.
Fitzgerald, Miss, case of, 345.
Fleabane, 1103.
Flowering fern, 1055.
Flowers, when to collect, 613.
Fluttering of the heart, 2179.
Food, see diet.
a stimulant, 718.
for the sick, 1419.
after a course, 1644–5.
Fowler’s solution, 488.
Foxglove, see digitalis.
Fractures, 2001.
simple, or compound, 2001.
complicated, 2002.
longitudinal, transverse, or
oblique, 2003.
how to relax the muscles in,
2009.
Frosted limbs, 2360.
Galen, 1697.
Gall bladder, 57.
stones, 2050.
Gallic acid, 600.
Galium asprellum, 1079.
aparine, 1080.
verum, 1081.
trifidum, 1082.
Gangrene, 2.168.
Garden pepper, 1111.
Gastric juice, 85.
Gastritis, see inflammation of stomach.
Gaultheria procumbens, page 286.
Geum rivale, page 205.
Giddiness, 2019.
Ginger, 792.
black, ib.
white, ib.
West India, ib.
East India, ib.
preserved, 796.
sirup, 797.
beer, 7.98.
powders, 799.
wine, 800.
wild, 1068.
tea, 1520.
Ginseng, 939.
esteemed by the Chinese,940,




X IND EX.
Giving an emetic, 1579, et seq.
Glands, 44, et seq.
sebaceous, 41—Note.
mucous, 45.
salivary, 46.
lymphatic, 47.
Gleet, 2026.
treatment of 2036.
Gnaphalium polycephalum, page 275.
Golden rod, 1112.
seal, 894.
Goldthread, 1115.
Gonorrhoea, 2021.
Good, Dr., remark by, 193.
Gout, 2037.
chronic, 2042.
Graduated measure, 606.
Gravel, 2048.
Great sympathetic nerve, 148.
Green lobelia, 695, 1613.
salve, 1317.
Gristle, 29.
Gruel, unbolted wheat meal, 1424.
oatmeal, 1425.
Indian meal, 1426.
sago, 1427.
Gum, 581.
myrrh, 902.
resin, 588.
Haemorrhoids, see piles.
Hamamelis Virginica, page 200.
Hand bath, 1455.
Hardhack, 868.
Harvey’s doctrine of the circulation,132.
Headach, 2059.
sick, ib.
snuff, 1325.
treatment of, 2064.
Healing by the first intention, 2456–7.
salve, 1316.
Heart, 98, et seq.
number of its contractions, 99.
figure of, page 37.
valves of, 130.
ball lodged in, 2179.
heartburn, 2065.
Heat, animal, 134, et seq.
source of, 135–7.
Hedeoma pulegioides, page 278.
Helonias dioicia, page 218.
Hemlock gum, 871.
spruce, 870.
oil of 872.
Hepatic duct, 58.
Herbs, collecting and drying,607, et seq.
Hernia, 22.45.
scrotal, 2247.
inguinal, ib.
femoral or crural, 2248.
umbilical, 2249.
ventral, ib.
reducible, 2253.
irreducible, ib.
strangulated, ib.
of infants, 2259.
Hip disease, 2067.
Hives, 2.174.
Hoarhound, 1121.
Hollyhock, 1118.
Hooping cough, see whooping cough.
Horseradish, 1120.
Hospital cases, 287, et seq.
Hot drops, see rheumatic drops.
Hunter, John, obstimacy of, 1334.
Hydrastis Canadensis, page 214.
Hydrocyanic acid, see prussic acid.
Hydrophobia, 2070.
how treated by physi-
cians, 2074.
cured by the vapor bath,
2081–2.
Hydrothorax, 1947.
Hypotheses, medical, 183.
Hysteria, 2083.
Hysterics, see hysteria.
Ictodes fetidus, page 283.
Iliac passion, 974.
Ilium, 75.
Indigestion, 1966.
Inflammation, 1354.
of the liver, 232, et seq.
theory of 1354–6.
signs of 1358.
terminations of,1361-5-9.
cases of, 1370, et seq.
produced by loss of blood,
1372, et seq.
of the bladder, 2091.
“ chronic,2092.
bowels, 2088.
brain, 2106.
kidney, 2113.
liver, 2116.
“ chronic, 2118.
lungs, 2124.
stomach, 2132.
is accompanied by debil-
ity of capillaries, 1857.
IND EX. xi
Inflammatory sore throat, 2216.
Inflamed eyes, 2332.
Influenza, 2137.
Infusion, 1510.
Injection, quanity of fluid for, 1566.
common, 1567.
powder, 1251.
for diarrhoea and dysentery,
1573.
for immediate use, 1574.
for piles, 1575.
soothing, 1576.
for females, 1577.
Injections, remarks on, 1550, et seq.
simple, 1572.
astringent, per vaginam, 814.
per anum, why effectual,
958.
Dr. Dewee's opinion of,
1551.
nutricious, 1554.
life saved by, 1555.
substitutes for cathartics,
1557.
act upon the whole system,
1558.
cannot always be used, 1564.
Innoculation, 2304.
Innula helenium, page 266.
Inspiration, 121–4.
Intermediate treatment, 1660.
in chronic dis-
eases, 1667.
Intestines, 70, et seq.
their structure, 71.
vermicular or peristaltic mo–
tion of, 71.
divided into small and large,
72.
small, function of, 76.
large, 77.
Iodine, 531, et seq.
leading effects of, 534.
Ipecacuanha, 529.
Irregular or difficult breathing, 1654.
Issues, 420.
Itch, 2139.
Jaundice, 2143.
remedies for, 901, 995.
black, 2143.
Jefferson, Thomas, opposed to physi-
cians, 159.
Jejunum, 75.
Jelly, raspberry, 850.
Jelly, tapioca, 1432.
arrow-root, 1433.
rice, 1434.
wheat, 1435.
cough, 1525.
Juglans cinerea, page 241.
Juniper, 1124.
berries, 1125–6.
leaves, diuretic, 1126.
Juniperus communis, page 274.
Kidneys, 49.
Kine pox, 2305.
King’s evil, see scrofula.
Lacerations, 2458.
Lacteals, 63.
Lady’s slipper, red or purple, 929.
yellow, 931.
white, 933.
gay or tall, 934.
Lancet, substitute for, 1270.
Large aspen, 889.
Late suppers, 1681.
Laudanum, 497.
Laurus camphora, 1062.
cinnamomum, page 261.
Laxatives, defined, 978, 1232.
enumeration of, 1232.
Leaves, when to collect, 6.12.
Leeches, 392, et seq.
destroy life, 393.
children killed by, 395.
syphilis, communicated by,
399.
Leptandra Virginica, page 244.
Life everlasting, 1127.
Ligaments, 28.
capsular, 28.
Lingering nausea, 1623.
Liniment, volatile, 1304.
stimulating, 1306.
Liver, 54.
becomes enlarged, 55.
fatty, ib.
abscess of, 2119.
inflammation of, how treated by
physicians, 233–4.
Lizars, John, condemns the old school
practice, 191–2.
Lobelia, green, 695.
brown, ib.
tincture of 1274.
pills, 1298.
inflata, 648, et seq.


xii INDEX.
Lobelia inflata, named after M. de Lo-
bel, 648.
used by Penobscot In-
pians, 653.
Thomson not the dis-
cover of, 650.
early history of, 660,
et seq.
patented in 1812, 664.
old school authorities,
666, et seq.
remarks on, by Cutler,
667.
Good, 668.
Eberle, 669,
670.
Tully, 671.
Waterhouse,
672.
Thomson,673.
properties and uses of,
674, et seq.
does not inflame the
stomach, 674.
is not cathartic, 674,
684.
- does not operate in
health, 676, et seq.
analysis of, 683.
not narcotic, 685.
quiets nervous irritabil-
ity, 686.
acts promptly in cases
of poison, 689.
valuable in small does,
690.
a powerful antispasmo-
dic, 691.
relaxes the muscular
system, 693, 1648,
1936.
valuable expectorant,
694.
evacuates the stomach
thoroughly, 696.
rules for its administra-
tion, 698.
collecting and preserv-
ing, 699, et seq.
Locked jaw, 2149.
Louis, researches by, 170, et seq.
Lovely thistle, 1045.
Lues venerea, see syphilis.
Lung fever, 2124.
Lungs, 122, et seq.
Lungs, air passages of, 124.
air cells of, ib.
circulation of blood through,
125.
cavities in, 1862.
Lycopus virginicus, 1031.
- europaeus, 1032.
Lymphatics, 64–5.
Magendie, opinions of, 164, et seq.
lectures of, on the blood, 164.
ridicules medical theories,
166.
objects to medical technicali-
ties, 168.
Malic acid, 595.
Mandrake, 1002.
Mania a potu, 1918.
Marsh rosemary, 873.
Martin, Alexis St., 81.
Marubium vulgare, page 273.
Materia medica, vegetable, page 143.
Mayweed, 1129.
Meadow fern, 1131.
ointment, 1308.
saffron, 501.
Measles, 2153.
black, ib.
Measures, 603.
scale of, 605.
Meat, 1683, et seq.
nutriment in, 1684.
not indispensable as food, 1687.
fat, objectionable, 1689.
Medical poisons, 199.
skepticism, 237, et seq.
quackery, 570, et seq., 1602.
Medicine, not a poison, 564.
spoon, page 386.
term defined, 562.
mill for grinding, 616.
Medicines, dose of, 1438.
Membrane, 30–1.
serous, 32.
mucous, 33.
cellular, 34,
adipose, 35.
Mentha piperita, page 282.
viridis, page 268.
Mercurial erethismus, 431–3.
rheumatism, 2229.
disease, 2260.
Mercury, 423, et seq.
effects of 204–5, 218, 424,
441, 450.



IND EX. xiii
Mercury produces a new disease, 428,
452. -
salivation by, 427.
remarks on, by Dr. Water-
house, 430.
secondary effect of 431.
Dr. Bateman killed by, 432.
sudden deaths from, 434–5.
produces mortification, 449,
451.
lays dormant in the system,
455, et seq.
enters the circulation, 459, et
seq.
preparations of, 467–8–9, 471.
Mesentery, 70.
Metricaria chamomilla, page 260.
Midrif, see diaphragm,
Milk sickness, 2161.
porridge, 1420.
Mineral acids, 504 et seq.
Mitchella repens, 1171.
Mithridates, 1400.
Miscellaneous remedies, page 375.
Montaigne, anecdote by, 153.
Morphia, 496.
Mortar for preparing medicines, 615.
Mortification, 1369, 2165.
produced by mercury,
2167.
Moxas, 422.
Mucilages, 1228.
Mullein, 277.
Mumps, 2172.
Murders, secundem artem, 255, et seq.,
269, et seq., 284, 345, 443.
Muscles, 22, et seq.
flexors and extensors, 24.
voluntary and involuntary, 26.
Mustard, 277.
poultices, 418–9, 1137,
Myrica cerifera, page 198.
gale, page 276.
Myrrh, see gum myrrh.
tincture of, useful for a weak
back, 906.
Napoleon, opposed to physicians, 157.
abstained from food in sick-
mess, 158.
Narcotics, rejected by our Saviour, 239.
Narrow dock, 1216.
Nausea, lingering, 1623.
Necrosis, 1368.
Nepeta cataria, page 260.
Nerve, great sympathetic, 148.
ointment, 1310.
Nerves, 142.
sensible and insensible, 145. A
voluntary and involuntary, ib.
spinal, 146.
of the brain, 147.
olfactory, ib.
optic, ib.
different pairs of, ib.
Nervine tea, 1514.
Nervines, 918.
differ from narcotics, 919.
enumeration of, 1224.
Nervous system, 138, et seq.
Nettle rash, 2.174.
New Zealanders, history of, 150.
untainted by disease, 151.
Nichols, Nancy, case of 318, et seq.
Night sweats, 1869.
mare, 2177.
Nitrate of potassa, see nitre.
Nitre, 547, et seq.
sweet spirits of 548.
a narcotic, 550.
cases of poisoning by, 551–2.
Nitric acid, effects of, 505, et seq.
used by physicians, 511.
North American Indians, 152.
Number of courses, 1721, et seq.
six, see rheumatic drops.
Nux vomica, 543.
Nymphaea odorata, page 201.
Oatmeal gruel, 1425.
Oil of vitriol, see sulphuric acid.
Oils, vegetable, 583.
fixed or expressed, 584.
volatile or essential, 585.
Ointment, meadow fern, 1308.
nerve, 1310.
pile, 1313.
gall, 1315.
Old school practice, 149, et seq.
fruits of 253, et seq.
One remedy, 1591.
Opium, 489, et seq;
effects of 490–1–2.
diminishes sensibility, 493.
lies dormant in the system,
495. -
preparations of, 496, et seq.
Osmunda regalis, page 256.
cinnamomea, 1055.
Ossification of arteries, 105.
-

viv
IND EX.
Oxalic acid, 597.
Oxygen, 137.
Palpitation of the heart, 2179.
Palsy, 2184.
case of 335, et seq.
Pain in the bowels, 1625.
head, 1626.
Pains, 1726.
Panax quinquefolium, page 224.
Pancreas, 60.
Paracentesis abdominis, 1954.
Paralysis, see palsy.
Paregoric, 498.
Parotid gland, 46.
Peach tree, 910.
meats or kernels, 910–11.
jam, 912.
Pearlash, 1027.
Pennyroyal, 1138.
tea, 1524.
Peppermint, 1152.
Pepper sauce, 1140.
Pericardium, 100.
Pericranium, 14.
Periosteum, ib.
Peristaltic motion of intestines, 71.
Peritoneum, 32.
Peritomitis, 2099.
Perspiration, 1593, et seq.
sensible and insensible, 41.
amount of discharged, 42.
checked, a cause of dis-
ease, 42, 719.
Phthisic, 1773.
Physic, Dr., how treated, 375.
Physicians, do they ever cure, 285.
Pia mater, 139.
Pile ointment, 1313.
Piles, 2.193.
blind, ib.
bleeding, ib.
Pills, lobelia, 1298.
cayenne, 1301.
sumach, 1303.
Pinus balsamea, page 268.
canadensis, page 209.
Piper nigrum, page 192.
Pipsissewa, 1142.
Plants, collecting and drying, 607,
et seq.
Plaster, adhesive, 1319.
strengthening, ib.
cancer, 1321. -
Pleura, 82.
Pleura costalis, 123.
pulmonalis, ib.
Pleurisy, 2202.
Pneumonia, see inflammation of the
lungs.
Podophyllum peltatum, page 245.
Polypus, remedy for, 1050–1.
Poison, external, remedy for, 1201,
1218.
Poisons, medical, 199.
remain dormant in the system,
466.
Poisomous drugs,
150.
Poisoning, 2280.
case of, 2213.
Poplar, 888.
Populus tremuloides, ib.
grandidentata, 889.
candicans, page 251.
balsamifera, 1037.
Potash, 1027.
Poultice, elm and ginger, 1543.
Indian meal, 1545.
of the dregs of rheumatic
drops, 1546.
carrot, 1547.
yeast, 1548.
charcoal, 1549.
Poultices, remarks on, 1535, et seq.
Pox, see syphilis.
Practice of medicine, pages, 325, 349.
Prickly ash, 1145.
mentioned by Carver, 1151.
used by the Indians, ib.
Proud flesh, 2432.
Proximate vegetable principles, 580.
Prunus virginiana, page 295.
Prussic acid, 513, et seq.
Miss Landon killed by,517.
Puking complaint, 2.161.
Pulmonary consumption, see consump-
tion.
Pulse, 1381.
varieties of, 1385–6.
no guide in disease, 1387, et
seq.
Napoleon’s, 1382.
Punctured wounds, 2460.
Purgatives, 942.
are depletive, 943.
compared with blood-let-
ting, ib.
irritate the stomach and
bowels, 94.4–6.
a cause of disease,

INDEX. xv. -
Purgatives produce inflammation of
bowels, 945.
weaken the system, 947.
hurry off the chyle, ib.
Cullen’s opinion of, 948.
impair digestion, 949.
remarks on, 951–2–3.
not efficient, 955–6–7.
occasion fetid stools, 959,
960.
relieve pain temporarily,
962.
action of cannot always be
controlled, 964. -
condemned by medical men,
965, et seq.
dangerous in typhus fever,
971.
useless in colic, 973.
unsafe in the hands of the
people, 977.
different from laxatives,
978.
renounced by many prac-
titioners, 979, et seq.
discarded by Dr. Thom-
son, 985.
enumeration of 1225.
Purging, 1650, 1651.
Pus, 1361–2.
Pustules, smallpox, 2301.
Putrid sore throat, 2218.
case of, how treated,
2227.
Pyrola umbellata, page 279.
rotundifolia, page 296.
Quackery, learned, 200, et seq., 570,
et seq.
case of 1602.
Quicksilver, see mercury.
mines, 426.
Quinsy, 2216.
Ramadge’s tube, 1877.
Raspberry cordial, 848.
vinegar, 848, 851.
jelly, 850.
jam, 852.
Recapitulation of the materia medica,
page 299.
Rectum, 80.
Red clover, 1155.
precipitate, 469. - -
Relaxation, an effect of lobelia, 1648.
Remittent fever, 1794.
Repetition of courses, 1715–16.
Resins, 588.
Respirator, 1872.
Restlessness, 1624.
Restoratives, see tonics.
Rete mucosum, 38.
Retention of urine, 2343.
Revere, Professor, remarks by, 185.
Rheumatic drops, 1255.
Rheumatism, 2228.
mercurial, 2229.
how treated by physi-
cians, 2230.
Rhus, page 206.
Rice coffee, 1430.
jelly, 1434. -
Rickets, 2237.
Ringworm, 2243.
Rome banished her physicians, 253.
Roots, when to collect, 608.
Rosin, 588.
Rubus strigosus, page 203.
Rumex crispus, page 293.
Run-round, 1998.
Rupture, see hernia.
Rush, Dr., quackery of 201, et seq.
purges of 204.
condemned by Dr. Currie,
205.
Russell, J. P., case of 338, et seq.
Sago gruel, 1427.
Sal aeratus, 1027. -
Salivation, 430–7, 2260. -
cases of, 317, 44.2–3–4–5.
Saltpetre, see nitre.
Salve, healing, 1306.
green, 1307.
common, 1308.
Sanguinaria Canadensis, page 254.
Sarsparilla, 1156.
Satureja hortensis, page 287.
Scaevola, 648.
Scald or scalled head, 2264.
Scalds, 1812.
Scarification, 401, et seq. |
Scarlet fever, 2268.
remarks on, by Drs.
Francis and Fuller, -
218–9, 220.
Scrofula, 2282.
how treated by medical men,
2286.
remarks on, 226.


xvi.
IND EX.
-
-
Scrofulous tumors, 2283, 2290.
ulcers, 2283, 2291.
Scullcap, 921.
used in hydrophobia, 927.
Scurvy, 2292.
land, 2293.
specifics in, 2294.
Scutellaria lateriflora, page 220.
hyssopifolia, 928.
integrifolia, ib.
Seeds, when to collect, 614.
Serum, 117, et seq.
Setons, 421.
Shingles, 2296.
Shower bath, 1451, 1504, et seq.
how administered, 1452.
effects of 1453.
Sigmoid flexure, 79.
Sinapis migra, page 277.
Sirup, dysentery or cholera, 1262.
- cough, 1264.
- Skeleton, page 4.
skin, 36, et seq.
oily fluid secreted by, 40.
remarks on, by Mr. Bell, 43.
functions of, 1447.
neglected, 1456.
Skunk cabbage, 1158.
Slippery elm, 1162.
used in making bread,
1164.
nourishing for infants,
- 1166.
and milk, 1431.
custard, 1436.
tea, 1521.
Smallpox, 22.99.
remarks on, 227.
symptoms of, 2301.
pustules, ib.
distinct, 23.03.
confluent, ib.
Smelling salts, 1326.
Snake head, see balmony.
root, Canada, 1068.
Snuff, aromatic, 1069.
headach, 1325.
Sore, ulcerating, 1366.
eyes, 2332.
lips, remedy for, 1309.
mouth, remedy for, 875, 1117.
throat, 2216, et seq.
Sores, see ulcers.
Solanum dulcamara, 1043.
Solidago odora, page 270.
Soothing drops, 1527.
Spanish flies, see cantharides.
Spasm, 1886.
Spearmint, 1168.
Specifics, doctrine of 916.
Sphacelus, 2.168.
Spiced bitters, 1245.
tea of 1513.
Spicy wintergreen, 1171.
berries of 1172–3.
oil of 1174.
Spinal marrow, 141.
nerves, 146.
irritation, case of 235.
Spine, curvature of 2240.
Spiraea tomentosa, page 209.
Spirit of wine, see alcohol.
Spleen, 59.
use of, unknown, ib.
enlarged, in typhus fever, ib.
Sponge bath, 1454.
Sprains, 2336.
remedies for, 1057, 1077.
Spurred rye, see ergot.
Squaw weed, 1088.
Squill, 522, et seq.
woman killed by, 523.
sirup of 524. -
St. Anthony’s fire, 1984.
Vitus's dance, 2337.
Star grass, 915. -
Statice limonium, page 210.
Steam-boiler, 1496, 1501–2.
Stimulants, 716, et seq.
defined, 716.
effects of, 717, 728.
indispensable in disease.
720.
different kinds of, 721,
1221.
alcoholic, 724–7.
Dr. Lamb’s remarks on,
726–7.
pure and impure, 726.
in hemorrhage from lungs,
729.
in diarrhoea and dysentery,
730.
Stimulating liniment, 319.
tea, 1515.
Stitches, see sutures.
Stomach, 66, et seq.
situation of, 66.
orifices of, 67.
has three coats, 68.


INDEX. xvii
Stomach, temperature of 95.
controls other organs, 622–7.
diseased when not suspected,
623–4–5–6.
indigestible substances in,628,
–9, 630.
Stone, 2051, et seq.
Stoppage of the bowels, see colic, and
ileus, or iliac passion.
Stramonium, 525.
Strangury, 2345.
Strengthening plaster, 1319.
Strychnia, 544.
Sublingual gland, 46.
Submaxillary gland, ib.
Sulphate of zinc, 519.
copper, 520.
iron, 521.
Sulphuric acid, 509, et seq.
used by physicians, 511.
Sumach, 855.
smooth or upland, ib.
stag-horn or velvet, 856.
mountain or dwarf, 857.
dust of the berries, 858.
pills, 1303.
wine, 1530.
Sumatrans, botanical knowledge of 568.
Summer savory, 1175.
oil of 1177.
Suppression of urine, 2341.
Suppuration, 1361.
Suspended animation, 2351.
Sutures, 2462.
Swaim, Mr., 156.
Sweat, see perspiration.
Sweating baths, 1466.
sickness, 1595.
Swine pox, 1836.
Swooning, 1993.
Sympathetic nerve, 148.
Symphytum officinale, page 265.
Syringes, 1565.
female, 1578.
Syphilis, 2361.
Syphilitic ulcers, 2363, et seq.
how treated, 2373–5.
Tacamahaca, iO37.
Tanacetum vulgare, page 288.
Tannin, 592, 801.
Tansy, 1178.
Tape worm, 2448.
Tapioca jelly, 1432.
Tapping, 1954.
Tartar emetic, 476, et seq., 725.
ointment, 478.
dangerous agent, 480–1.
patient killed by, 482.
causes convulsions, 483.
Tartaric acid, 599.
Tartarized antimony, 476.
Tea, composition, 1511.
cayenne and bayberry, 1512.
of spiced bitters, 1513.
nervine, 1514.
stimulating, 1515.
diuretic, 1516.
for diarrhºea and dysentery, 1517.
for impurities of the blood, 1518.
for worms, 1519.
ginger, 1520.
slippery elm, 1521.
pennyroyal, 1524.
Teas, preparation of, 1509.
Temperature of the body, 134.
Tendons, 27.
Tetter, 2377.
dry, 2378.
moist or running, 2379.
Theory, abortions of, 182.
Thirst, 2385.
Thoracic duct, 61.
Thorn apple, see stramonium.
Thoroughwort, see boneset.
Throbbing, 2179.
Tiarella cordifolia, page 265.
Tic douloureux, 2388.
Tight lacing, 1708.
Tincture, antispasmodic, 1266.
lobelia, 1274, et seq.
cayenne, 1284.
scullcap, 1286.
myrrh, 1288,
fir balsam, 1290.
balm of Gilead buds, 1039.
opium, 497.
Tongue, appearance of, in disease, 1408,
et seq.
tremulous, or pointed, 1416.
soft and flat, ib.
inclined to one side, 1417.
Tonics, 880.
not used in ſevers and inflam-
mations, 883.
lose their effect, 887.
different kinds of, 1223.
Toothach, 2397.
bush, 1150.
Treatment of children, 1583.




xviii
IND Ex-
Treatment previous to a course, page
390.
Trembles, 2162.
Trifolium pratense, page 282.
Trillium pendulum, page 208.
Truss, 2254.
Tubercles, 1854–5.
may be removed, 1863, et
Seq,
absorption of 1865.
Tumors, scrofulous, 2283.
Tunica arachnoides, 139.
Typhus fever, 2403.
favorable symptoms in,
2406.
how treated by physi-
cians, 242–3, 723.
Ulceration, 1356.
increased action of absorb-
ents, 1365.
Ulcerating sore, 1366.
Ulcers, 2418.
indolent, 2420.
irritable, 2421.
malignant, 2422.
varicose, 2423.
syphilitic, 2363, et seq.
in stomach and bowels, 1730.
Ulmus fulva, page 284.
Americana, page 285.
Unbolted wheat bread, 1181.
meal gruel, 1424.
Unicorn, 913.
false, ib.
confounded with star grass,
915.
Ureters, 50.
Urethra, 52.
Urine, 49.
excessive flow of 1990.
suppression of 2341.
retention of 2343.
Vaccination, 2304.
objections to, 2305, 2322.
no protection against small-
pox, 2308, et seq.
horrible cases of 2318,
2320.
Vaccine poison, 2318.
Vaginal syringe, 1578.
Vapor applied in bed, 1495.
with blankets, 1497.
with a box, 1499, 1500.
Vapor bath, 1462.
temperature of 1503.
followed by cold shower,
1504.
medicated, 1508.
for children, 1586–7–8.
relaxes the muscles, 1937,
1938.
used by the N. A. Indians,
1465, et seq., 1467–8.
erected by the king of
Prussia, 1473.
named after the Princess
Marianne, 1473.
warms the blood, 1479.
does it debilitate 2 1480.
effects of 1482.
how used in suspended an-
imation, 1488.
used by Captain Parry’s
men, 1491.
improves the complexion,
1492.
employed in hydrophobia,
2081.
cautions respecting, 1494.
Varicose veins, 2423.
Varioloid, 2323.
Vegetable caustic, 1327.
jelly, 1292.
food, conduces to health,
1696.
Vegetables, nutriment in, 1684, et seq.
Veins, 109, et seq.
varicose, 2423.
wounds of 2471.
Venereal, see syphilis.
Ventilation, importance of 1631.
black-hole of Calcutta,
1633.
Verbascum thapsus, page 277.
Verbena hastata, page 174.
urticifolia, 704.
Vertigo, 2019.
Wervain, blue, 703.
white, 704.
Vinegar, 1193.
and cayenne, 1531.
Virginian thyme, 1196.
Vomiting, excessive, 1627.
how treated, 1628, et seq.
wakerobin, 1198.
Walpole, killed by quackery, 155.
Wash for sores, 815,827, 835, 847, 854.

INDEx. xix
Warm bathing, 1456.
salutary, 1457.
recommended by Frank-
lin, 1458.
inferior to vapor bath-
ing, 1459, 1460.
Washington’s death, 255, et seq.
Waterhouse, Dr., admission of, 200.
Weights, 601.
Wesley, Rev. John, opposed to physi-
cians, 160, et seq.
Wheat jelly, 1435.
White swelling, 2434.
vervain, 704.
pepper, 787.
pond lily, 833.
vitriol, see sulphate of zinc.
elm, 1163.
bread, injurious, 1183–4.
Whitlow, 1998.
Whooping cough, 2440.
blisters in, 231.
Wild ginger, 1068.
hairs, 2335.
cherries, 1205.
lettuce, 1206.
red raspberry, 841.
cherry tree, 1202.
bark of, devoid of
prussic acid, 1203.
Windpipe, 124. ,
Wine bitters, 1260.
whey, 1423.
Witch hazel, 830–2.
Woman’s friend, see female restorative.
Woody night shade, 1043.
|Worms, 2445.
tea for, 1519.
different species of 2446, et
seq.
Wormwood, 1209.
Wounds, 2455.
gun-shot, ib.
incised, 2456.
lacerated, 2458.
punctured, 2460.
transverse, 2467.
treatment of, ib.
of arteries and veins, 2471, et
Seq.
Yarrow, 1213.
Yellow fever, 2476.
how treated by Dr. Rush,
201.
bed straw, 1081.
water lily, 837.
dock, 1216.
ointment of, 1218.
Zanthoxylum fraxineum, page 280.
Zingiber, page 193.



G U I D E F O R W O M E N .


AMERICAN WEGETABLE PRACTICE.
NEW AND IMPROVED
G UI DE TO H E A L T H ,
DESIGNED
FOR THE USE OF FAMILIES.
in six PART's.
Part I. Concise View of the Human Body, with engraved and wood-cut illustrations.
Part II. Glance at the Old School Practice of Physic. Part III. Vegetable Materia
Medica, with colored illustrations. Part IV. Compounds. Part V. Practice of Med-
icine, based upon what are deemed correct Physiological and Pathological Principles.
Part VI. Guide for Women, containing a simplified treatise on Childbirth, with a
description of the Diseases peculiar to Females and Infants.
BY MORRIS MATTSON,
PHYSICIAN TO THE REFORMED BOSTON DISPENSARY, LECTURER ON PHYS-
IOLOGY, THE PRACTICE OF MEDICINE, ETC. ETC.
Do not counteract the living principle.—Napoleon.
“It is contrary to the dictates of common sense, to suppose that a Poison, either
mineral or vegetable, can be a MEDICINE.”
I N T W O WO L U M E S.
VOL. II.
B O S T O N :
PUBLISHED BY DANIEL L. H.A.L.E., -
Blackstone St....Seven doors W. of Hanover St.

1841.
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Entered according to act of Congress, in the year 1841, by
MORRIS MATTSON, -
in the Clerk’s Office of the District Court of Massachusetts.
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P A R T S I X T H .
G U I D E F O R. W. O. M. E. N.
MENSTRUATION, AND FEMALE COMPLAINTS.
MENSTRUATION.
2484. Menstruation is the discharge of a fluid from the womb
resembling blood, which takes place monthly, and continues until
forty five or fifty years of age, unless suspended by pregnancy, or
disease. It commences at the period of life termed puberty,
which, in the United States is about the age of fourteen; but in
other countries, where the climate is different, it varies consider-
ably from this standard. In some parts of India, for example,
females become mothers at from ten to twelve years of age, and
cease to menstruate at from twenty five to thirty; while in the
high northern regions, as Iceland, twenty five is the average age
at which they begin to menstruate.
2485. The first menstrual discharge is usually destitute of
color, and makes its appearance sometimes without indisposition,
but is usually preceded by headach, feverishness, and pains in
the back, breasts, and lower extremities. After this, it returns
at uncertain periods, until its regular monthly evacuations are es-
tablished. The continuance of the discharge varies from a few
hours to a week or fortnight, but the usual period in this country
is three or four days. The quantity is generally five or six
Ounces.
598 GUIDE FOR WOMEN.
2486. A female does not conceive until after she has men-
struated. Some women do not menstruate at all, and are barren.
2487. With a few exceptions, the menstrual discharge ceases
in pregnancy, nor does it generally appear during the nursing
period, unless the child remains at the breast an unusual length of
time.
2488. The final cessation of the menses is called the turn of
life, or the critical period of life, and generally takes place in this
climate between forty five and fifty years of age. There are some
curious exceptions to this rule, however, for women have been
known to menstruate at a very advanced period of life. Dr. Wil-
liams, in a letter published in the Boston Medical and Surgical
Journal, speaks of a lady residing in Northfield, Mass., who began
to menstruate a second time at ninety eight years of age. Similar
instances are mentioned by Haller and Rush. The celebrated
Madame de Stael furnishes an example of a woman menstruating
after the age of sixty.
2489. When menstruation is about to decline, the discharge
is sometimes scanty and colorless, and at others profuse and
exhausting ; but it generally returns at irregular periods, and di-
minishes gradually in quantity until it finally disappears. The
breasts diminish in size at this period, and the woman becomes
incapable of bearing children. In many instances, the health re-
mains good, notwithstanding this change in life, but in others there
are attacks of fever, headach, eruptions of the skin, shooting pains
in various parts of the body, and other unfavorable symptoms.
RETENTION OF THE MENSES.*
2490. The non-appearance of the monthly evacuation at the
natural period, is called retention of the menses, and is followed
sooner or later by serious ill health. Among the symptoms which
characterize the malady, are debility; great disorder of the sto-
mach and bowels; sallow countenance; pains in the back and
loins; swelling of the ankles at night, and of the face in the
morning; palpitation of the heart; hurried, or laborious breathing;
disturbed sleep; colorless urine; derangement of the nervous
system; and sometimes a harassing cough. The skin is pale and
cold, and in some instances acquires a greenish tinge, which has
given to the disease the name of green sickness. The blood, says
Dr. Gooch, has been found to be of a pale red color, and watery,
like the juice of a cherry. The malady not unfrequently termi-
* Chlorosis.


GUIDE FOR WOMEN. 599
nates in dropsy, or consumption. Females are most subject to it
who live an idle and luxurious life, and do not enjoy the advan-
tages of exercise in the open air. Hence it is far more prevalent
in cities than in the country.
2491. TREATMENT. In an obstinate case, a few courses of
medicine should be administered, repeating them once or twice a
week, until the disease is removed. Between the courses, free
use should be made of the usual stimulants and tonics, such as
composition, cayenne, and spiced bitters, to keep up an action in
the system, and invigorate the digestive organs. Pennyroyal tea,
containing a small portion of cayenne, may be employed advanta-
geously as a drink. The alterative mixture will be found an effi-
cacious medicine. If the bowels are costive, half a tea-spoonful
or more of cayenne, mixed with molasses, may be taken three
times a day. If the nervous system is in a deranged or irritable
condition, the nervine tea should be employed. (1514.)
2492. Injections into the rectum every night and morning,
will accomplish much in procuring a flow of the menses, as they
exercise a highly salutary influence over the uterine organs.
They may be prepared as directed in paragraph 1567. Injec-
tions into the vagina are also serviceable, and may be employed
two or three times a day, administering them with an appropriate
syringe. (1578.) They may be prepared as any other injection;
or may consist of composition tea; or a tea of bayberry, with a
tea-spoonful or more of rheumatic drops; or of an infusion of cat-
nip, summer savory, fleabane, yarrow, or any other of the stimu-
lating herbs.
2493. Another important remedy in promoting the menstrual
discharge, is the hip bath, which consists of the application of
vapor to the hips and lower extremities. To accomplish this, a
blanket is fastened around the waist, which hangs in folds upon
the floor, and the vaporis introduced beneath the folds as directed
in paragraph 1497, or 1501. The bath may be continued for an
hour, or more, and repeated every day between the courses of
medicine.
2494. The patient should keep her feet warm and dry, and
avoid exposure to a cold or damp atmosphere. If the weather is
mild, exercise in the open air will be beneficial. The skin should
be rubbed night and morning with a coarse towel, or flesh brush,
until it is in a glow. The food should be light and nourishing,
avoiding the use of tea, coffee, fat meat, and all oily substances.
(See remarks on diet, 1680, et seq.) -




600 GUIDE FOR WOMEN.
suppression of THE MENSEs. *
2495. Apart from pregnancy, the menses are frequently in-
terrupted by exposure to cold, mental agitation, and other causes
which derange the health. The discharge is sometimes suddenly
checked by remaining in a damp place until the body is chilled,
and in that case there is usually headach, a dry and hot skin,
thirst, tenderness in the region of the womb, and pains of the
back and lower extremities. Sometimes the patient is attacked
with shiverings. If the suppression continues beyond two or
three periods, the health becomes more or less impaired, as in re-
tention of the menses; and hemorrhage from the lungs, or some
other organ, is liable to occur.
2496. TREATMENT. If the suppression is owing to a sud-
den cold, a cure may be effected by taking composition until per-
spiration ensues, and if the patient is in bed, a heated stone wrap-
ped in a damp cloth, may be placed at her feet. If she perspires
with difficulty, an injection should be administered, followed by
the vapor bath, and if necessary, an emetic of lobelia to cleanse
the stomach. If the disease is obstinate, or of long standing, the
treatment directed for retention of the menses will be equally ap-
plicable in this.
PAINFUL MENSTRUATION.f
2497. This complaint is often caused by cold, and is liable
to occur after abortion, particularly if the woman be of a nervous
or irritable temperament. It is more frequent in cities than in the
country, and is principally confined to those who take but little
exercise, or are indolent or luxurious in their habits. The dis-
charge is scanty at first, and accompanied with grinding or bear-
ing down pains, which are often more severe than those of labor.
Pains also occur in the back, loins, and breasts, with headach,
fever, and tenderness in the region of the womb. As the dis-
charge increases, these symptoms gradually abate, until finally
they disappear altogether. False membrane, and little flakes or
masses resembling clots of blood, are frequently discharged from
the womb, and are followed by partial, if not entire relief. In-
stead of ſeverish symptoms, the patient is sometimes attacked
with chilliness. The stomach and bowels are always more or less
* Amenorrhaea. # Dysmenorrhaea.
GUIDE Fort Wom EN. 601
deranged. The discharge, though deficient at first, may become
so profuse as to cause considerable debility.
2498. A woman laboring under this complaint, very rarely
conceives.
2499. TREATMENT. The most effectual means of curing
painful menstruation, is by the administration of a few courses of
medicine, repeating them at proper intervals, and adopting appro-
priate intermediate treatment. (1660, et seq.) Exercise in the
open air, friction of the surface night and morning with a flesh
brush, or coarse towel, and a plain, wholesome, and nourishing
diet, using the precaution not to overload the stomach, or eat at
irregular hours, will each have an influence in improving the
health, and strengthening the constitution.
2500. When the menses are about to appear, or after the
painful discharge has commenced, relief may be obtained by taking
composition, or cayenne and bayberry, to produce a perspiration,
aided, if necessary, with the vapor bath; or if the patient is in
bed, heated stones wrapped in damp cloths may be placed at her
feet and sides. The stimulating tea will answer an excellent pur-
pose in allaying the pains, and quieting the nervous system, if that
should be in a state of irritability. Injections into the rectum and
vagina, as directed in paragraph 2492, will be found highly ser-
viceable. With regard to the latter, an infusion of yarrow may be
employed with great advantage. If severe pain is experienced in
the region of the womb, a flannel wrung out of hot rheumatic
drops, or vinegar and cayenne, (1531) may be laid over the
affected part.
2501. The female restorative should be taken two or three
times a day between the menstrual periods, particularly if the ap-
petite is impaired; and if the circulation is feeble, or the patient
complains of chilliness, it may be combined with a portion of
Cayenne.
2502. The unbolted wheat bread should constitute a part of
the diet, as it will serve to regulate the bowels.
2503. Painful menstruation frequently disappears after marriage.
PROFUSE MENSTRUATION, *
2504. We have seen that the amount of fluid discharged at
each menstrual period, is generally five or six ounces, but in an
* Menorrhagia.
-


76

602 GUIDE FOR WOMEN.
T
unhealthy state of the system, the quantity may be increased to
such an extent as to occasion extreme debility.
2505. There are two classes of females, says Dr. Gooch,
who are peculiarly disposed to this complaint. In the robust and
plethoric, it is characterized by inflammatory symptoms, as per-
manent pain, sense of fulness, weight, and tenderness in the re-
gion of the womb, together with a hot skin, and a full, hard,
febrile pulse. In the other class, it is without pain in the region
of the womb, and accompanied by a pale countenance, languid
circulation, and a small weak pulse. Dr. Gooch designates the
latter as the chronic form of the malady.
2506. If the discharge is long continued, extreme debility
ensues, with headach, giddiness, noise in the ears, feeble pulse,
pale, or cadaverous countenance, chilliness, cold hands and feet,
and a tendency oftentimes to dropsy.
2507. The discharge may be profuse, and of short duration;
or it may continue moderately for ten or twelve days, gradually
exhausting the patient; or it may return every two or three weeks,
instead of at the established monthly periods. In either case, the
loss of blood proves highly injurious to the constitution.
2508. The complaint is caused by unwholesome food, impure
air, want of exercise, intemperance in eating and drinking, and too
much sexual intercourse. It often follows abortion.
2509. In the practice of the old school physicians, these ir-
regular discharges not unfrequently continue for years, until at last
the patient sinks into the welcome embrace of death.
2510. TREATMENT. The undue determination of blood to
the womb must be counteracted by treatment which will restore a
balance to the circulation. If the discharge is moderate, it may
be checked by taking composition, or cayenne and bayberry, until
perspiration ensues; but if it is copious, or has continued for a
considerable time, it will be necessary to administer a full course
of medicine, as in any other dangerous or obstinate hemorrhage.
Injections per anum are of great value in equalizing the circula-
tion. After the urgent symptoms are subdued, the female resto:
rative, together with cayenne, or composition, may be employed
to invigorate the digestive organs, and strengthen the general
system.
2511. Filling the vagina with ice to stop the flow of blood,
as is practised by the diplomatised physicians, is replete with dan-
ger, and should never be attempted. It weakens the blood-vessels
with which it comes in contact, and consequently, as soon as the
ice is removed, the blood flows into them in an increased quan-
tity, and increases rather than diminishes the hemorrhage. The

GUIDE FOR WOMEN. 603
author of the London Practice of Midwifery acknowledges that
ice has been in the vagina all day without doing any good; and it
is to be presumed he would be equally willing to acknowledge
that it has sometimes done an infinite deal of harm.
FLU or ALBUs or whites.*
2512. Fluor albus consists of a discharge from the vagina of
a white or milky color. It is most common among married
women, especially if they have frequently miscarried, and occurs
during pregnancy, as well as at other periods. Women of a deli-
cate constitution, who have removed from a cold to a warm cli-
mate, are said to be particularly liable to its attacks. As the
disease advances, the discharge assumes a yellow, green, or
brownish color, becoming more or less offensive, and occasion-
ally it is so acrimonious, that the wife communicates a similar dis-
order to her husband. (2025.) The complaint is sometimes
merely local, and at others constitutional symptoms arise, such
as loss of appetite, costiveness, depression of spirits, pains in the
back and loins, paleness of the countenance, diminution of strength,
chilliness, and a burning sensation in passing water.
2513. Fluor albus is caused by unwholesome diet, strong tea
and coffee, the frequent use of purgatives, the irritation of pes-
saries, injuries inflicted by instruments during childbirth, and too
frequent indulgence in sexual communication.
2514. TREATMENT. Injections into the vagina two or three
times a day are of primary importance, particularly if the discharge
is acrid or offensive. (2492.) They should be employed about
milk warm. I have frequently prescribed an infusion of yarrow
for this purpose, and, as I have thought, with particular advantage.
2515. If the appetite is impaired, a dose of spiced bitters
may be taken before each meal, and if the patient complains of
chilliness, or pains in the back and loins, composition may be
used occasionally through the day, and also at night on retiring
to bed, placing a heated stone wrapped in a damp cloth at the feet.
2516. If costiveness prevails, it is to be removed as directed
under that head, (1896, et seq.) remembering that the bowels
should be evacuated once or twice daily.
2517. The female restorative is a useful medicine in this
complaint, and may be employed to strengthen the digestive
organs, instead of the spiced bitters.
* Leucorrhoea.
604 GUIDE FOR WOMEN.
2518. Where there is scalding of urine, an infusion of clea-
vers, cool wort, or some other appropriate diuretic, will afford
relief.
2519. If the disease is obstinate, a few courses of medicine
should be given, repeating them once a week, or oftener, until a
cure is effected.
FALLING OF THE WOMB, *
2520. This arises from a relaxed or debiliated condition of
the vagina, which allows the womb or uterus to descend by
the force of gravity. It occurs both in married and unmarried
females, but is most common soon after childbirth, because the
womb at that period is large and heavy, and the parts by which it
is supported are feeble and relaxed. Sometimes the organ de-
scends only a short distance into the vagina, accompanied with a
sensation of fulness and bearing down; and at others it protrudes
beyond the external organs, forming, in some instances, a large
tumor or bag. The patient complains of dragging pains in the
lower part of the back, uneasiness about the hips, and severe pains
also in the thighs and groins. The whole system is more or less
affected, and a train of nervous symptoms ensue. The pains are
increased by walking, but after remaining for some time in bed,
or in a horizontal position, they partially or wholly subside. A
discharge resembling that in fluor albus is commonly present, and
sometimes it is very copious. A difficulty is experienced in
passing urine and feces, because the womb presses both upon the
rectum and neck of the bladder, between which it is situated like
a wedge.
2521. TREATMENT. In addition to courses of medicine, which
must be repeated according to the degree and urgency of the symp-
toms, injections per vaginam should be employed several times a
day. (2492.) These will remove the acrid or offensive matter,
allay the pain, and impart tone and vigor to the debilitated parts.
They should consist of a tea of bayberry, pond lily, witch hazel,
or some other prominent astringent, adding a portion of rheumatic
drops. Between the courses, an injection should be administered
once a day to evacuate the bowels, provided costiveness prevails,
* Prolapsus uteri, or procidentia uteri. By prolapsus, says Denman, is meant
a descent of the uterus into the vagina, lower than its natural situation, but
when it protrudes beyond the external organs of generation, it is then called pro-
cidentia.


GUIDE FOR WOMEN. 605
and cayenne, composition, and the female restorative employed
- according to circumstances, to keep up a healthy action in the
system, and promote appetite and digestion. I am in the habit of
prescribing the alterative mixture, which I have found to be very
useful in this complaint, particularly where the stomach is much
deranged, or the food occasions distress. If the patient suffers
severe pain, she should be kept in a gentle perspiration with the
stimulating tea, which is particularly serviceable where there is
much irritability of the nervous system.
2522. Pessaries are frequently used as a mechanical support
for the womb, but they appear to do more harm than good.*
They not only irritate the parts with which they are in contact,
and occasion an offensive discharge, but by keeping up a constant
distention, they increase the debility of the vagina, and thereby
aggravate and prolong the malady.
2523. “A lady who suffered from procidentia uteri,” says
the author of the Practical Compendium of Midwifery, “devised
- a pessary for herself, which was thus made. Melt four ounces of
beeswax, together with a piece of mutton suet the size of a wal-
nut, and pour it into a box of the requisite size, which has a pillar
in its centre; turn it out when cold, and you have a thin cake
with a hole in the middle. Thus a pessary is formed, which the
lady herself has found a very effectual one, and it has also afforded
relief to many poor women whom she has supplied with it.
The pessary should be taken out every night. The circular
hole should not be very large, lest the neck of the womb should
descend into it and become strangulated ; yet it must be so large
as to admit the passage of the menstrual fluid.”
2524. Whether this form of pessary is preferable to those
made of wood, or metal, I am not prepared to say, but women suſ-
fering with displacement of the womb, may make a trial of it for
themselves. The organ should be returned as nearly as possible
to its original position, and the pessary introduced gently into the
vagina, so that the mouth of the womb may rest upon its upper
surface. The great objection to the wax, as well as other similar
pessaries, however, is, that if they are not so large as to be intro-
duced with some difficulty, they are liable to drop out, and hence
injure the vagina by the distention which they occasion.
2525. A pessary prepared as follows, I have recommended in
several instances with decided advantage. Take a piece of sponge
the size and shape of an egg, and enclose it in a bag made of silk,
or very fine linen, introducing between it and the sponge a layer
-
* Pessaries generally consist of a piece of flat, circular wood, with a hole in
the centre. They are sometimes made of ivory, metal, or India rubber.

606 GUIDE FOR WOMEN.
of pulverized bayberry and poplar bark, in the proportion of two
thirds of the former, to one third of the latter, and moisten the
bag with port wine, a decoction of bayberry, or a solution of rheu-
matic drops, as strong as it can be borne. The bag is to be
introduced into the vagina after the manner of a pessary, and
when it is ultimately adjusted, the ends should be from side to side
of the patient. It affords a soft and easy cushion for the womb;
and the vagina, instead of being rigidly distended, as is the case
with the common pessary, gradually contracts upon the bag, and
soon acquires sufficient tone or strength to maintain the uterus in
its place. A piece of tape should be attached to the bag, so that
it may be withdrawn occasionally, in order that the vagina may be
cleansed with injections, as already recommended. It need not
be worn at night, and when it becomes offensive, a new one is to
be substituted, remembering that as the vagina contracts, each
successive bag is to be diminished in size.
2526. If the womb protrudes beyond the external organs, and
is swelled and inflamed, it cannot be returned into the vagina
until the swelling and inflammation are subdued, and to accom-
plish this, a thorough course of medicine should be administered.
The displaced organ should then be washed with a warm infusion
of raspberry, witch hazel, or sumach leaves, and returned in a
gentle manner with the fingers, previously smearing them with
sweet oil, lard, or what is preferable, the mucilage of slippery
elm. The descent of the womb is now to be prevented by me-
chanical means, as recommended in the preceding paragraph, and
astringent injections should be employed several times a day to
aid the contraction of the vagina. It is important, also, that the,
body should be as much as possible in a horizontal posture, as long
as there is any tendency of the uterus to escape from its natural
position.
2527. Where the womb has been displaced so long that a
cure is out of the question, the patient may pass through life very
comfortably by regulating her diet, (1680, et seq.) and using
appropriaté medicines, when they are required, to strengthen and
invigorate the system. A lady of Boston consulted me some
months ago, with prolapsus uteri, who, after suffering indescribable
tortures for many years under treatment by the medical faculty;
was given up to die at the Massachusetts General Hospital, and
yet, by the administration of a few courses of medicine, and
proper intermediate treatment, she has been enabled to superin-
tend her household affairs, and travel a long distance every
Sabbath to church. The uterus, I may add, has descended to
within one inch of the external organs.
2528. Pregnancy is sometimes a means of curing this malady.
GUIDE FOR WOMEN. 607
During the third month of gestation, the womb ascends spon-
taneously from the pelvis into the cavity of the abdomen, and if
roper care be taken after delivery, a cure may be effected. The
. must be kept in a horizontal posture, until the uterus has
returned to its natural dimensions, and astringent injections fre-
quently employed, as recommended heretofore.
2529. “The imperfect procidentia uteri is often overlooked,”
says Dr. Gooch, “and the case treated merely as a stomach
complaint. Two very eminent physicians were consulted by a
lady; they treated her as one of disordered stomach; after a lapse
of time, another physician was consulted, who, from the uneasy
sensation and weight experienced about the pelvis, in conjunction
with other symptoms, concluded that there might be an imperfect
procidentia uteri. He examined, and found it to be so. He
returned the uterus, and introduced a globular pessary, after which
the stomach complaint ceased in about a week. The physicians
who were first consulted were both men of ability, (!) and of high
rank in their profession; but they declared that they never heard
of a procidentia uteri, in which the organ did not protrude exter-
nally l’”
POLYP U.S.
2530. This is a tumor or excrescence which grows from some
part of the womb, or vagina, supported generally by a very narrow
neck, although, in some instances, it is broad and flat at the base.
If very large, it produces many unpleasant as well as unſavorable
symptoms, such as bearing down pains, copious bleeding, diffi-
culty in passing urine and feces, and acrid or offensive discharges
from the vagina. The hemorrhage is increased at each men-
strual period, and finally the patient sinks into a state of great
debility or exhaustion. The excrescence frequently originates
within the cavity of the womb, and gradually descends into the
vagina. The neck is sometimes so slight that it may be separa-
ted with but little hemorrhage. The tumor may enlarge so as to
protrude beyond the external organs of generation, and in that
case might be mistaken for the uterus, only that it possesses but a
limited share of sensibility.
*The reader is referred to the note at bottom of page 604 for an explanation
of the term procidentia uteri, as given by Dr. Denman, an English writer of
eminence, whose work on obstetrics is received by the medical profession as
standard authority, both in England and the United States.


608 GUIDE FOR WOMEN.
2531, TREATMENT. A polypus may be removed in a week
or ten days by passing a ligature around its neck, so as to cut off
the supply of blood by which it is nourished. The operation is
attended with but little pain. At first the polypus swells, but it
soon begins to soften and diminish in size. The ligature or
thread should be drawn gently at first, and tightened every two or
three days until the tumor separates. There is always an offensive
discharge, which should be removed by injections into the vagina.
(2492.)
2532. The tumor decomposes in some instances, instead of
coming away in a mass, and in such case the discharge is ex-
tremely fetid. A polypus thus removed does not grow again,
unless it happens to be of a malignant character. There may be a
difficulty sometimes, from the situation of the excrescence, in
securing it with a ligature, and when this occurs, the thread must be
passed around it with some convenient instrument. Care must be
taken not to enclose any of the living parts with the excrescence,
or it will produce excessive pain, and seriously injure, if not de-
stroy the patient.
2533. “Dr. Hunter,” says Dr. Gooch, “applied a ligature
to a polypus, and drew it tight; violent pain was produced; he
slackened it, the pain ceased; he pulled it again, and agonizing
pain was occasioned; he told the patient she must bear it; he gave
her an opiate, and thus left her. The next day he found her with
a thready and almost imperceptible pulse, bathed in cold sweats,
with a cadaverous countenance. She soon died; and he found on
examination, that he had included a portion of the womb in the
ligature.”
PARTS CONCERNED IN GENERATION.
PEL WIS OR BASIN.
2534. The pelvis is a bony structure or cavity, at the lower
part of the abdomen, forming the base of the spine, and is sº
named from a Greek word signifying basin, because it is shaped
like a basin used in former times.
GUIDE FOR WOMEN. 609
-
2535. The accompanying figure will give some idea of its
formation. The prominences at A, A, may be felt at the right
.Adult Female Pelvis.
and left sides of the abdomen, about three inches above the bend
of the thigh, constituting portions of the hip bones. The ter-
mination of the spine, which consists of a small moveable bone,
is seen at B, and may be felt an inch or an inch and a half
behind the anus. It is pushed back in time of labor by the head
of the child, which increases the diameter of the pelvis from
before backward, and facilitates the progress of delivery. C, C,
are the cup-like cavities or sockets which receive the heads of the
thigh bones. D, is the pubis or front bone, which is placed at
the upper and fore part of the pelvis, just above the external organs
of generation. It consists, in fact, of two bones, which meet at
D, and are united to each other by a very strong cartilage, and
otherwise secured by ligaments. An opinion is entertained by
some people, who know nothing of the anatomy of the human
frame, that these bones separate during labor, but nature has
bound them together so firmly as to prevent the possibility of
such an occurrence. In a diseased or morbid condition of the
bones, however, a separation has been known to take place, but
the accident is a serious one, and in some instances disables the
"woman for life.
25.36. The pelvis contains the bladder, rectum, and womb.
The first of these organs is situated just behind the pubis, the
second is in contact with the spine, on the opposite side, and be-




77 -
610 GUIDE FOR WOMEN.
tween these we have the uterus or womb. Above the brim or
edge of the pelvis, of which the top of the pubis forms a part, the
intestines, and other organs of the abdomen are situated.
2537. With regard to the diameters of the pelvis, it will be
seen that the distance from side to side is greater than from the
top of the pubis to the spine, as designated at the letter E. The
diameters are reversed, however, at the outlet of the passage, the
shortest one being from side to side, and the longest from before
backward, measuring from the lower edge or arch of the pubis, to
the termination of the spine, as figured at B. In all easy and
natural labors, therefore, the head of the child, which measures
more from the forehead to the crown, than from one side to the
other, must be accommodated to these diameters, and such a
provision nature has actually made, for as the head enters the
cavity of the pelvis at its brim, the face is either to the right or
left side of the mother, but as it descends in the passage, and
approaches the outlet, the face turns either to the arch of the
pubis, or the spine or back bone, but generally to the latter. In
the process of delivery, therefore, the head moves in a curved
direction, sliding backward, in the first instance, towards the
spine, and then moving forwards in the direction of the outlet.
2538. The short diameter of the pelvis is estimated at about
four inches, and the long diameter at five inches; while the short
diameter of the child's head is three inches, and the long one four
inches; so that in ordinary cases, labor is accomplished with
perfect ease. A diminution in the size of the pelvis, however, or
an increase in the size of the head, will have some influence on the
result, though the rule which medical men have endeavored to
establish, that “a child at full time cannot pass when the short
diameter of the pelvis is less than two inches and a half,” appears
to be without foundation. Baudelocque, the distinguished French
accoucheur, says, “A few years ago, I preserved a woman from
the Caesarean operation,” the diameter of whose pelvis had been
estimated at only one inch and a quarter by her physician; we
waited four hours for the favorable moment to operate; the ap-
paratus was prepared; the woman was ready to place herself on
the couch; twelve or fifteen persons, as well physicians as sur-
geons, were going to be witnesses of this afflicting scene; when
touching the woman for the first time, I declared strenuously that
she would be delivered naturally, and without difficulty; as actually
happened two hours afterwards, and the child was strong and
healthy.”
* Cutting through the abdomen into the uterus, and extracting the child. The
operation is so called because Julius Cæsar is said to have been extracted in this
manner.


GUIDE FOR WOMEN. 611
2539. The bones of a child's head are soft and yielding at the
time of birth, and capable of great compression, so that delivery
may take place although the head is larger than the cavity of the
pelvis. Such was undoubtedly the case in the instance mentioned
by Baudelocque.
2540. Labors are sometimes rendered tedious by deformity
of the pelvis, which is produced by the rickets during childhood,
(2237, et seq.) or which may occur in adult age from the soften-
ing of the bones. The pelvis may be so much distorted, as to
render delivery impossible, but this is a rare occurrence; and
where there is extensive deformity, the female is generally aware
of the fact, or at least has every reason to suspect it, and will
therefore prudently refrain from matrimony. It often happens,
however, that a woman is deformed in the back and limbs, and
yet is perfect with regard to the pelvis, so that this should be
taken into the account when a question arises as to the propriety
of entering the married state.
EXTERNAL PARTS OF GENERATION.
2541. These, in the language of anatomists, are the mons
veneris; the labia or lips; the nymphae; the clitoris; the meatus
urinarius, and urethra; the perineum; and, when it exists, the
men.
2542. JMons Veneris. This is the prominence over the
pubis.
2543. Labia. These are two in number, uniting in an angle
below the mons veneris, and running towards the anus, near which
they terminate in a second or lower angle. They are subject to
inflammation and enlargements.
2544. Nymphº. The nymphae are small folds of skin, of a
vermilion red, situated within the superior half of the labia, form-
ing a junction near their upper angle. They are very large at
birth, but of a moderate size in the adult. They serve to direct
the water downward, and are called the internal labia. In some
subjects, they enlarge to such an extent as to become a source of
inconvenience. If they adhere in consequence of inflammation,
they may be separated by gradual pressure with the thumbs, after
which they should be kept apart with a ſold of linen, moistened
with sweet oil, or nerve ointment, until they are healed.
2545. Clitoris. This is a small body within the nymphae,
similar in structure to the male penis. In some instances it has
acquired the size of the penis, and hence the term hermaphrodite.
2546. JMeatus urinarius, and urethra. The meatus urinarius
612 GUIDE For women.
is the opening of the urethra, consisting of a little bulb or eleva-
tion, and is situated within the nymphae at the entrance of the
vagina—that is, if a female were to pass her finger downward be-
tween the nymphae or internal labia, it would strike upon the
meatus urinarius just before entering the vagina. A knowledge of
this part is important, in case it becomes necessary to use the
catheter. The urethra is the canal leading from the meatus urina-
rius into the bladder, and is an inch or an inch and a half long.
During the latter months of pregnancy, it rises almost perpendicu-
larly behind the pubis or front bone, but at other periods, when
the bladder is in its natural position, its direction is obliquely
backwards.
2547. Perineum. The perineum is the space between the
lower angle of the labia and the anus, and varies in extent in
different females, but is usually about two fingers in breadth. In
the old school practice of midwifery, where every thing is accom-
plished by force, instead of waiting for the quiet operations of
nature, it is frequently torn or lacerated by the head of the child,
particularly during a first confinement.
2548. Hymen. The hymen is a ſold of membrane which
forms a line of separation between the external and internal parts
of generation, being situated at the mouth of the vagina, just be-
hind the meatus urinarius. It is generally ruptured at the first
connexion between the sexes, though, in a few instances, it is so
thick and strong as to prevent all sexual intercourse. When there
is an opening through it, however small, the menses are allowed
to escape, so that the female experiences no difficulty on this
account, but if the membrane is entire, thereby sealing up the
vagina, the menses collect from time to time, ultimately producing
an enlargement of the abdomen, resembling pregnancy. Tºr.
Denman was called to a young woman under such circumstances,
who was suspected to be pregnant, though she asserted to the
contrary, and had never menstruated. On examination, it was
found that the hymen was entire. An incision was made through
it, and four pounds of blood of the color and consistence of tar
were discharged. The swelling of the abdomen abated, and the
patient menstruated regularly after that period, without suffering
any difficulty or inconvenience.
2549. It is a curious fact, related by medical writers, that
women become pregnant with the hymen entire, so that its pres-
ence is not a decisive proof of virginity, nor should the absence of
it, without other circumstances, lead to suspicions unfavorable to
the unmarried female, for it may be destroyed early in life by
disease, or otherwise, and is frequently wanting, says Dr. Francis
of New York, in a natural and health state of the parts. In-


GUIDE FOR WOMEN. 6.13
deed, there are some eminent writers who have denied its exist-
ence altogether. -
2550. If the hymen continues entire beyond the age of
puberty, when the menses are expected to flow, it should be care-
fully divided with a knife or lancet, to allow the menstrual fluid to
escape. For this purpose it need not be laid entirely open; but
to favor sexual intercourse, as in case of matrimony, two incisions
should be made, one from above downward, and the other from
side to side, crossing each other in the centre of the membrane.
Another plan is, to cut out the hymen by a circular incision—
that is, by passing the knife around the circumference of the mem-
brane, taking care not to wound the adjacent parts. After the
operation is performed, and the hemorrhage has ceased, a roll of
lint moistened with nerve ointment should be introduced into the
vagina, and continued there a sufficient length of time to prevent
the wounded parts from adhering together.
INTERNAL PARTS OF GENERATION.
2551. These are the vagina and womb, with the appendages
of the latter, which consist of the ligaments, Fallopian tubes, and
ovaries.
2552. Vagina. The vagina is the canal which leads from
the external parts of generation to the womb, and in the adult
female is about two inches wide, and five or six inches long. In
young females its length does not exceed three or four inches.
Its upper extremity is terminated by the womb, the neck of which
it encircles. Its lining membrane is thrown into folds or wrinkles,
which allow of its distention in the time of labor. These folds are
lessened however by frequent child-bearing. The lower part of
the vagina is connected with the rectum behind, and the bladder
and urethra in front. -
2553. The vagina is so short, in some instances, that the
mouth of the womb may be felt just within the labia, but this is a
deformity which very rarely occurs. “There is no remedy for
this malformation,” says Dr. Gooch, “and the female who is the
subject of it must be an unhappy companion for life. Dr. Hunter
was consulted by a lady in a mask, who had a short vagina. He
told her she was the most unfortunate wife a man could have,
there being no cure for her.”
2554. The vagina, continues the same writer, may be of the
proper length, and yet “so small as scarcely to admit a goose
quill. The consequences of this contraction are similar to those
of the unyielding hymen. In this dilemma a medical man is con-


614 GUIDE FOR WOMEN.
sulted. Inflammation has perhaps been produced in the vagina,
by the efforts to overcome the obstruction; there is a burning
sensation in the vagina, accompanied by a discharge, and the
bride and her relatives think that her husband has communicated
to her some disease. On examination, it is found that the con-
tracted portion of the vagina will not admit the finger. The diffi-
culty is to be overcome by dilating the canal with bougies,” intro-
ducing one previously oiled, which passes with some difficulty.
Do this at bed time, and the next morning enquire if it produces
pain; if not, let it remain twenty four hours. If however it pro-
duces much pain, you must remove it, and introduce a smaller
one. At the end of twenty four hours, withdraw the first bougie,
and pass up a second of a larger size; and thus proceed until the
vagina is sufficiently dilated. Before the bougies are introduced,
you must reduce the inflammation which may have been previously
excited.”
2555. Womb. The womb, as we have already seen, is at
the top of the vagina, between the bladder and rectum. Its shape
has been compared to that of a compressed or flattened pear; and
for the sake of convenience, it has been divided into three parts,
the fundus, the body, and the cervix or neck. The upper part is
called the fundus, the lower the cervix or neck, and the interme-
diate portion the body. The womb is about three inches long.
Its width, at the neck, is one inch, and at the fundus two inches.
Its cavity is small, and scarcely large enough to admit a bean, or
an almond. The neck, which protrudes into the vagina, is usu-
ally half an inch long. The organ is plentifully supplied with
nerves, and hence the intimate sympathy which exists between
that and the stomach, breasts, and other parts of the body, when
it is in a morbid or diseased condition. Small as are its dimen-
sions in the natural state, it increases to a wonderful size during
pregnancy, measuring twelve inches or more in length, at the full
term, and nine inches from side to side at the fundus. It also
preserves its thickness. The cavity, which was only large enough
to hold an almond, now contains the child, invested in its mem-
branes, which, of themselves, form a large mass, and two or
three quarts of fluid termed the waters or liquor amnii.
2556. After delivery, the womb is two or three weeks in re-
turning to its natural size, and if there is much debility of the
parts, it may descend into the vagina, as already stated, constitu-
ting prolapsus or falling of the womb. -
* A bougie is an instrument made of India rubber, which surgeons introduce
into the urethra, qºsophagus, and rectum. It is round, pliable, and of various
sizes, according to the purpose for which it is to be used.

GUIDE FOR WOMEN. 615
2557. Until the third month of pregnancy the womb remains
within the pelvis, but after that period, it ascends into the cavity
of the abdomen.
2558. Appendages. Broad ligaments or folds of membrane
are given off from the fundus of the womb, at its sides, which
confine the organ within the pelvis. The Fallopian tubes are en-
closed in the upper edge of the broad ligaments, and are three or
four inches long, terminating in fringe-like extremities, which
float loosely in the pelvis. They open into the womb by ex-
tremely minute orifices. The ovaries are also situated in the broad
ligaments, one in each, being below the Fallopian tubes, and
about an inch from the womb. They are described as whitish
bodies, resembling a large bean in size and figure. Animals de-
prived of them cease to bring forth young. It is supposed that
they contain the embryo or germ of life, in the form of an egg,
which is carried from the ovary by the Fallopian tube at the pe-
riod of conception, and deposited in the womb, where it is grad-
ually quickened into life. What influence the semen of the male
exercises over this mysterious process is not known, excepting
that without it, impregnation could not take place.
2559. The ovaries, though small in their natural state, are
sometimes distended with fluid to an extraordinary degree, consti-
tuting what is termed ovarian dropsy. A small tumor is at first
discovered on one side of the abdomen, which gradually extends to
the whole of the abdominal cavity. “The patient keeps upon her
feet, and looks healthy at first, but the constitution begins at length
to suffer, the abdomen becomes more distended, the patient loses
flesh, emaciation ensues, and death finally takes place.” The dis-
ease is to be treated by courses of medicine; and the abdomen
should be frequently rubbed with the stimulating liniment.
2560. Below the Fallopian tubes, the round ligaments, as
they are termed, are given off, which pass out of the pelvis, and
are distributed to the groin, mons veneris, and neighboring parts.
This will explain the cause of severe pain being felt in these
regions, when the womb is diseased.
PARTS WITH IN THE PEL WIS.
2561. The pelvis contains the bladder, womb, vagina, and
rectum, as we have seen; and in order to show how these parts
are connected, I have procured the following imperfect wood-cut
illustration, which represents a vertical division of the pelvis from
before backwards, cutting through the middle of the vagina, but
leaving the bladder and rectum entire.
616 GUIDE FOR WOMEN.
FIG, 10. -
Piew of the organs within the Pelvis.
A, the pubis or front bone, at the point of division; B, the spine or back bone
cut directly down; C, portion of the right thigh; D, the right buttock; E, the
bladder partly distended with urine, rising behind the pubis; F, the urethra of
canal leading into the bladder; G, the rectum; H, the anus; K, the vagina; L,
the womb, with its mouth projecting into the vagina.
2562. By reference to the cut, it will be seen how falling of
the womb produces bearing down pains, and interferes with the dis-
charge of the urine and feces. Attention to the connexion of the
parts, also, will explain the nature of what is termed retroversion
of the womb, which will be treated of hereafter.
PREGNANCY, AND ITS DISEASES.
SIGNS OF PREGINANCY.
2563. Suspension of the menses is one of the first signs of
º: but is not to be relied upon, for it may be produced
y other causes than the pregnant condition; and on the other


GUIDE FOR WOMEN. 617
hand, a woman may become pregnant, and have a continuance of
the menstrual discharge for two or three months, or perhaps for
the whole term.
2564. Morning sickness often occurs soon after pregnancy,
accompanied with heartburn, costiveness, and other symptoms in-
dicating a disordered state of the stomach and bowels.
2565. In three or four months the breasts begin to swell, and
are affected with shooting or darting pains. The circle around
the nipple changes to a deeper hue, and the skin within this cir-
cumference is rougher than ordinary. -
2566. After the third month, the womb rises out of the pel-
vis, followed by an enlargement of the abdomen, just above the
pubis. The motion of the child is then felt, which is termed
quickening. This is regarded as one of the more infallible signs
of pregnancy, but is also liable to deceive, for a similar sensation
may be produced by an accumulation of wind in the bowels.
The ascent of the womb into the abdomen is sometimes so sud-
den that the woman ſaints. The usual period of quickening is
the sixteenth week. Some women, however, do not feel the
motion of the child until the sixth or seventh month; and others
do not experience any sensation of the kind during the whole term
of pregnancy.
2567. By the expiration of six months, the fundus of the
womb is found as high as the navel, which, instead of being de-
pressed, is now raised to a level with the skin, or is perhaps pro-
truded, in consequence of the pressure from within. This, I
may add, is considered an unerring sign of pregnancy. The ab-
domen, moreover, at its most prominent part, is firm and hard to
the touch, which is not the case in dropsy, and some other en-
largements. The motion of the child may also be felt at this
period, if the hand be placed on the abdomen, and continued with
a gentle pressure for a few minutes, especially if it be previously
dipped into cold water. This motion is sometimes feeble, and at
others violent.
2568. During the eighth month, the fundus of the womb oc-
cupies the region of the stomach; but towards the close of the
ninth month, it gradually subsides, until it is nearly on a level
with the navel.
2569. The predictions in regard to pregnancy, however, are
often uncertain, and those who pretend to be best acquainted
with the subject, often make the most deplorable blunders. Pro-
fessor Dewees, in his edition of Baudelocque, says—“I was sev-
eral times in consultation concerning a woman, whose pregnancy
appeared to be doubtful to her till the last moment, as well as to the
physician who had the care of her health, because the motions of

78

618 GUIDE FOR WOMEN.
the child could not in any way be perceived, and nothing we could
do, even at eight months and a half, could excite them; the child,
which was as strong as usual, was nevertheless born healthy.”
2570. Professor Channing of Harvard University, mentioned
the following ludicrous circumstance in one of his lectures. “A
few years ago,” said he, “there was a young woman at the Mas-
sachusetts General Hospital with all the symptoms of dropsy.
She bore a good character, was of a religious turn of mind, and
was not suspected, therefore, of any improper conduct. She
was treated with digitalis, blood-letting, and all the remedies (!)
for dropsy, and was at last discharged as an incurable patient.
In a short time after this, however, I heard that she had been put
to bed with twins. I do not know how I could have been so de-
ceived, but such are the errors which are sometimes committed
in the medical profession.”
2571. Pregnancy is occasionally mistaken for dropsy of the
abdomen, and the deplorable consequences which are likely to
ensue from such an error, have been vividly portrayed by Dr.
Denman, in his Practice of Midwifery. He says—“If any ac-
tive remedies are used on the presumption of dropsy, the child
will, of necessity, be often destroyed, and an abortion or prema-
ture labor occasioned; and when the operation of tapping has
been performed, it has been known to prove fatal to the mother
and child, always reflecting great discredit both upon the operator
and profession.”
DISEASES OF PREGNANCY.
2572. It would be questioning the goodness of the Creator
to suppose that pregnancy is incompatible with a healthy condition
of the system, but such are the luxuries and abuses of society at
the present day, that we find many unpleasant and even alarming
symptoms growing out of the pregnant state. I am convinced,
however, that if females would confine themselves to a simple,
wholesome diet, eating moderately, avoiding excesses of every
description, and exercising frequently in the open air, they would
experience no derangement of health during pregnancy, and be
partially if not wholly exempted from suffering in childbed.
2573. Among the prominent diseases incident to the preg-
mant state, are piles, heartburn, giddiness, headach, cough, diar-
rhoea, jaundice, toothach, fluor albus, retention of urine, hysteria,
palpitation of the heart, and sometimes convulsions, all of which
* American edition of Denman, by Dr. Francis of New York, 1825.
GUIDE FOR WOMEN. 619
are described under their appropriate heads, and do not require
any further notice here. There are some other diseases, how-
. of which it may be necessary to speak rather more at
ength.
2574. , Sickness and Vomiting. Sickness is a common
symptom during the first few months of pregnancy. It generally
occurs in the morning immediately after rising from bed, and for
that reason has been termed the morning sickness. A dose of
spiced bitters, or a tea-spoonful of rheumatic drops in a wine-
glassful of warm water, sweetened, with a portion of powdered
cinnamon, may be taken to advantage. If vomiting ensues, or if
the stomach is very irritable, an emetic of lobelia may be admin-
istered. The patient should confine herself to very plain food,
and pay attention to the quantity as well as the quality. (1698,
et seq.) She should also avoid the use of tea, coffee, butter, and
all oily or greasy substances, for these almost invariably produce
a deranged or morbid condition of the stomach. (1689, et seq.)
Perhaps it is rarely suspected that sexual intercourse is frequently
a cause of sickness, vomiting, and other distressing symptoms
during the pregnant period *
2575. Costiveness. This is a common attendant on preg-
nancy, and should never be allowed to continue for any length
of time. The bowels may be kept free by regulating the diet,
eating ripe fruits, and the unbolted wheat bread. If the case is
obstinate, injections will be necessary, and perhaps a course of
medicine. Further directions will be found under the appropri-
ate head.
2576. Swollen and Painful Breasts. These should be rub-
bed two or three times a day with volatile liniment, or a mixture
of cayenne and vinegar, (1531) covering them with flannels to
keep the skin moist. The stimulating liniment is, perhaps, a still
better application—at least it is highly recommended by ladies
who have given it a trial. Where the pain is severe, compo-
sition should be taken internally to maintain a gentle perspiration ;
or if the skin is harsh and dry, the stimulating tea may be em-
ployed. Swollen breasts are signally benefited by steaming them
once or twice a day for a quarter or half an hour; and for this
purpose, a blanket may be thrown over the shoulders, fastened
around the neck, and vapor generated by immersing heated stones
in a basin of water. The patient should recline over the basin,
in some convenient position, so that the vapor may come in con-
tact with the breasts.


620 GUIDE FOR WOMEN.
2577. Swelling of the Labia. This takes place, in some
instances, to an enormous degree. Heated stones wrapped in
damp cloths, should be placed at the feet and sides, and compo-
sition tea, or some similar medicine, administered freely, to keep
up a perspiration. In addition to this treatment, vapor should be
applied locally, as directed in paragraph 1499, and the parts
bathed occasionally with nerve ointment. If suppuration ensues,
poultices are to be employed, as in any other swelling accompanied
by the formation of matter.
2578. Restlessness and Want of Sleep. The nervine tea,
employed as a drink, will be found highly efficacious. The addi-
tion of a small portion of lobelia, but not enough to occasion
nausea, will increase its good effects. An injection and vapor
º on going to bed, will generally predispose the patient to
Sleep.
2579. Itching. An itching of the external parts of genera-
tion is sometimes so troublesome, that the woman is obliged to
avoid society, and shut herself up in her room. The parts should
be kept perfectly clean, and if the vagina is in a morbid condition,
it should be cleansed with injections. (2492.) Injections per
anum are also indispensable, in case the rectum is irritated by
worms, or a collection of hardened feces. -
2580. Cramps and Pains. These frequently attack the
lower extremities, and pains are also experienced in the back,
sides, hips, and bowels. Composition, enemas, the vapor bath,
and scullcap, or some other nervine, are to be used according to
the circumstances of the case. If the stomach is much disor-
dered, an emetic will be indispensable. The part in which the
pain is seated, may be rubbed with the volatile liniment, rheu-
matic drops, or vinegar and cayenne, (1531) and if this does not
afford relief, a flannel moistened with either of these liquids may
be applied. Lobelia in doses just short of producing nausea, is
very efficacious in allaying cramps, and obstinate pains.
2581. Swelling of the Legs. This occasionally occurs, and
is sometimes accompanied by enlargement of the veins. The
swelling may extend to the whole body, and the woman acquire
enormous dimensions, even before the sixth month of pregnancy.
In these cases thorough courses of medicine are required, using
cayenne, bayberry, and spiced bitters freely in the intervals. The
skin should be rubbed briskly every night and morning, with a
GUIDE FOR WOMEN. 621
eoarse towel, or flesh brush, and every effort made to strengthen
and invigorate the system. Frictions of the swollen limbs with
the stimulating liniment will have a beneficial effect.
RETROVERSION OF THE WOMB.
2582. This accident generally happens between the third and
fourth months of pregnancy; but it occurs sometimes soon after
delivery, before the womb has had time to return to its natural
size. It may also take place from enlargement of the organ by
disease.
2583. The top or fundus of the womb is thrown backwards
upon the rectum, while the mouth is forced against the pubis,
compressing the urethra and neck of the bladder, and preventing
the escape of urine. A tolerably accurate idea may be formed of
the relative state of the parts by referring to Fig. 10, page 616.
2584. Retroversion of the womb is caused by falls, blows on
the abdomen, straining at stool, and by neglecting to evacuate the
bladder until it is over-distended with urine. The organ being
thus enlarged, forces the top of the womb against the rectum, as
already described. Among the symptoms which characterize the
accident, are bearing down pains, uneasiness about the neck of the
bladder and rectum, retention of urine and feces, and dragging
pains in the groins and fore part of the thighs. If the blad-
der is not seasonably evacuated, it may burst, and discharge its
contents into the abdomen; or it may become inflamed and
speedily mortify.
2585. TREATMENT. There is no difficulty in restoring the
womb to its natural position soon after the retroversion takes
place, but if it is neglected for a week or fortnight, it is not so easily
accomplished. As soon as the accident is discovered, therefore,
the woman should be placed on her hands and knees, previously
evacuating the bowels with injections, and a finger introduced
either into the vagina between the womb and the rectum, or into
the rectum itself, making gentle and continued pressure upon the
displaced organ until it is restored to its natural situation. “If
the uterus is once felt to move from its preternatural position, it
rises easily into its appropriate place.” The operation perform-
ed, the patient should remain in bed a few days, to prevent a
recurrence of the accident.
2586. If retroversion takes place during pregnancy, and relief
is not afforded, the difficulty is overcome as soon as the womb

622 GUIDE FOR WOMEN.
ascends from the pelvis into the cavity of the abdomen, which, as
we have stated, is after the third month. -
2587. Use of the Catheter. If the mouth of the womb
presses firmly upon the urethra, it is evident that the urine will
be retained, and if the bladder is over-distended, it must be
evacuated before any thing further can be accomplished for the
relief of the patient. The pressure may sometimes be removed
from the urethra by gently inserting the finger between it and the
womb, thereby allowing the urine to escape, but if this cannot be
effected, it will be necessary to resort to the use of a catheter,
which is a small India rubber tube, slightly curved, and four or
five inches long. If this is not to be obtained, a small goose quill
will answer the purpose, cutting a hole in its side near the end,
and another at the top of the barrel, without separating it from the
feather, making every part of it perfectly smooth. This, although
straight, may be readily introduced into the bladder, by a gentle
motion backwards and upwards, following the course of the
urethra, as delineated in the figure on page 616. Force must not
be employed, lest it occasion inflammation. A little patience is
all that is necessary, and the woman may either perform the ope-
ration herself, or entrust it to the hands of a female friend. Care
must be taken that the catheter is of sufficient length, for the neck
of the bladder is upon the stretch, and therefore longer than
natural.
2588. After the bladder is emptied of its contents, the dis-
placed womb is to be restored, as already directed ; and as a gen-
eral rule, the organ should be pushed toward either the right or
left side of the patient, before moving it in the direction of the
pnbis, for, by this precaution, we avoid the projection of the
spine, as seen at E. in Fig. 9, page 609, which would be likely to
interfere with the success of the operation.
2589. With regard to the introduction of the catheter, Dr.
Bard very truly and emphatically observes, “From motives of
delicacy alone, this easy operation ought to be in the hands of the
women.” Nevertheless, there are physicians who have been in
the habit of visiting female patients daily, for weeks in succession,
to evacuate the bladder, when the patients themselves could have
complished it without the slightest difficulty, had they been
º instructed. Dr. Ewell, in his Family Physician, applies
elash of censure to this indelicate but fashionable practice, and
asks, “What is the operation of introducing the catheter the
bladder containing the urine, is immediately behind the pubis or
front bone, and the canal to it not three inches long. The instru-
ment is adapted to the size of the canal, and the woman lying on

guide for women. 623
her back, finding the entrance into which the end of the catheter
is introduced, and pushing it gently backwards and upwards, in
the direction where the least resistance is made, can readily intro-
duce it herself, to draw off the urine. If the woman be too sick
to perform the operation, it can be accomplished by her associate,
or nurse.”
ABORTION.
2590. Most cases of abortion occur between the eighth and
twelfth weeks of pregnancy, and are usually preceded by intermit-
ting pains in the back, and lower part of the abdomen, with a
sense of weight in the region of the womb. These symptoms
may continue only a few days, or for several weeks. In the
meantime the breasts become soft, and diminish in size, accom-
panied, in many instances, by sickness, vomiting, nervous, and
hysterical symptoms, and a frequent desire to evacuate the blad-
der and rectum. A still more prominent sign of abortion, is a
discharge of blood from the vagina, which, when profuse, is
called flooding. This arises from the detachment of the placenta
from the internal surface of the womb. The discharge of blood
is sometimes small, and at others copious. Bearing down pains
at length ensue, and the embryo child is sooner or later expelled.
The pains vary in intensity, being, in some cases, as severe as
those of labor, while in others they cause little or no suffering.
A discharge of blood from the vagina should not necessarily
create alarm, however, for it frequently takes place without being
followed by abortion.
2591. Women who reside in cities, and are indolent or luxu-
rious in their habits, keeping late hours, and frequenting crowded
apartments, are far more subject to abortion than those who pass
their lives in the country, enjoying the advantage of exercise in
the pure, fresh air, and avoiding those excesses and improprieties
which tend to impair the health, and weaken the constitution. A
useful lesson might be learned, with regard to this matter, from
the domestic animals, which are said to miscarry much more fre-
quently than those existing in their native wilds.
2592. Abortion is produced by a great variety of causes,
such as blows on the abdomen, dancing, jumping, straining at
stool, the irritation of piles, strong mental emotion, fright, blood-
letting, purgatives, long continued diarrhoea, indulgence in sexual
intercourse, and the internal use of mercury, and other poisons.
Women who menstruate with difficulty, and happen to conceive;
are very apt to miscarry. Aloes, by irritating the rectum, and


624 GUIDE FOR WOMEN.
thereby sympathetically affecting the womb, is often a cause of
abortion. Indeed the whole routine of purgatives is pernicious.
A writer in the Boston Medical and Surgical Journal for 1839,
says he was called to a delicate married lady who had symptoms of
being in labor, and in a short time was delivered of a small, feeble
child, weighing about four pounds, although her time was not up
by two months. Copious flooding took place after the expulsion
of the placenta. The cause of the difficulty was a dose of Bran-
dreth's pills, six in number, which the patient had taken the day
previously, being somewhat costive. The pills operated violent-
ly, and the woman was tormented with a constant desire to go to
stool, until the labor pains commenced.
2593. The teeth frequently ache during pregnancy without
being in the least decayed, but should not be thoughtlessly extract-
ed, for the operation has frequently proved a cause of abortion.
2594. TREATMENT. By the employment of suitable reme-
dies, abortion may generally be prevented. If the symptoms are
severe, a course of medicine should be administered, which will
check the flooding, and quiet the irregular action of the womb.
In milder cases, a tea of composition, with one or two injections
per anum, will usually suffice to produce the desired effect. If
the patient is in bed, heated stones wrapped in damp cloths
should be placed at the feet and sides to favor perspiration. If
there is much irritability of the nervous system, scullcap, or some
other nervine, may be added to the composition tea.
2595. If abortion is apprehended, the woman should avoid
all sexual intercourse with her husband until after the period of
quickening, which takes place, as we have stated, about the six-
teenth week of pregnancy. This is considered indispensable by
all writers on midwifery. -
2596. A woman who has miscarried once, is liable to do so
again, and hence she should employ every means in her power to
break up the habit, as soon as any of the symptoms of abortion
are manifested. This object cannot be accomplished more effect-
ually than by the administration of one or two courses of medi-
ciné, for by renovating the general system, they enable the con-
stitution to bear the additional demand which is made upon its
powers.
2597. If abortion actually occurs, and the embryo child is
expelled without the placenta, the latter should be suffered to re-
main until discharged by the efforts of nature. The introduction
of the hand into the womb with the view of forcing it away, as is
practised by some of the diplomatised physicians, is attended with
more or less hazard, and may terminate in fatal consequences.
guide for women. 625
The celebrated Denman remarks, “It has been imagined that the
safety of the patient very much depended upon the complete and
speedy expulsion of the afterbirth, in cases of abortion; and when
it was retained, very active deobstruent medicines, as they are
called, were supposed to be necessary, and strenuously given for
the purpose of expelling it, lest it should become putrid, and
some of the putrified particles be absorbed into the constitution.
I believe the whole of this supposition is groundless, having seen
many instances of its being expelled in a very putrid state at
different periods of pregnancy, when the patient was in perfect
health; and if she had any disease, the putridity of the placenta
clearly seemed the consequence, not the cause, of the disease.
At all events, much less mischief may be expected from the re-
tention of a putrid placenta at this period of pregnancy, than from
attempts to force it away by the medicines usually given for that
purpose, or by manual assistance.”
2598. No evil consequences need be apprehended from the
retention of the placenta, if medicines be given to keep the patient
in a perspiration; and if flooding, or any other unfavorable symp-
tom should occur, all difficulty may be obviated by giving a
thorough course of medicine. Injections per anum, prepared in
the usual manner, (1567) have the effect to stimulate the womb
into action, and rarely ſail to bring away a retained placenta.
-
HINTS ON TREATMENT DURING PREGNANCY.
2599. Every woman should be impressed with the importance
of attending strictly to her health during the pregnant period, for
upon this depends the welfare of herself and embryo child. If
her system is diseased, the child will be diseased also, and in-
stances are on record of children having been born with syphilis,
and other horrible disorders, which they inherited from their
mothers. The maternal blood furnishes the exclusive nourish-
ment of the inſant, previous to its birth, and if that fluid is ren-
dered impure by disease, or otherwise, it is easy to perceive that
it must exercise a highly pernicious influence.
2600. Poisonous drugs should be particularly avoided during
pregnancy. Haller states that the use of saffron at this period
will change the waters or liquor amnii to a saffron color; and
Baudelocque quotes Levret as saying, that this fluid, where the
woman has taken mercury, has the property of whitening copper.
These are startling facts for the consideration of mothers, who do
not wish to inflict injury upon their offspring. With regard to
the effects of mercury, Dr. Denman says, “Instances sometimes

79
626 GUIDE FOR WOMEN.
occur of pregnant women being affected with the venereal disease;
and we have generally been advised to follow a mode of treat-
ment, by which the disease was not intended to be perfectly cured,
but moderated and restrained from further progress; leaving the
absolute cure to be completed, when the patient was recovered
from the state of childbed. This method of proceeding has been
recommended on the presumption that dangerous consequences
would result either to the mother or child, if a quantity of mercury
was used, during pregnancy, sufficient to root out the disease
effectually from the constitution.”
2601. Blood-letting should not be tolerated during pregnancy,
because it deprives the child of a portion of its nourishment,
which is the blood, enfeebles the constitutional powers of the
mother, and thereby lays the foundation for a tedious, or difficult
labor.
2602. A woman should be in possession of all her physical
powers in the time of labor, and therefore, if her health is impair-
ed previous to the expiration of her term, it should be reinstated
by courses of medicine and proper intermediate treatment, not
forgetting to regulate the diet. She will then, in most cases,
have an easy labor. I have known courses to be administered to
women during the seventh or eighth month of pregnancy, with a
view of invigorating the general system, and they have assured me
that their situation was more comfortable a few hours after deliv-
ery, than it had been formerly, under the old practice, in as many
weeks.
2603. A woman with her first child, particularly if she be
somewhat advanced in years, is more apt to have a tedious labor
than at subsequent periods, and it is adviseable, therefore, that she
should take a course of medicine a few days or a week previous
to delivery, and sit over the vapor of water for a quarter or half
an hour every night before retiring to bed. (1499.) This will
produce a softening or relaxation of the external parts, and when
labor commences, they will readily undergo the necessary dis-
tention.
EMETICS.
2604. Since lobelia inflata has acquired so much popularity
as an emetic, during pregnancy, and has been discovered to be
perfectly safe and harmless, some of the medical profession have
engaged in a bitter crusade against its use, denouncing those who
employ it in their practice, and declaring that emetics of every
description, and particularly lobelia, are almost certain to produce


GUIDE FOR WOMEN. 627
abortion, or some other equally deplorable consequence. As
specimens of this professional cant, for Iknow of no other term by
which it can be designated, I will quote briefly from the testimony
of some of the leading physicians of New York, in the trial of Dr.
Frost, who were summoned by the government with no other
view than to crush, if possible, a growing and rival system of
medical practice.
2605. Dr. Cheeseman said he should consider it highly im-
proper to give emetics to women during pregnancy, unless ur-
gently called for, and there were many emetics which he would
prefer to lobelia.
2606. Dr. A. G. Smith, who is a professor in the New
York Medical College, said, “I do not consider lobelia proper
in any case of midwifery. Emetics may sometimes be adminis-
tered to a lady near, or actually in her confinement, but lobelia
would be decidedly an improper article.” -
2607. Dr. Gilbert Smith was called upon the stand, and the
following lucid and interesting dialogue took place between him
and the Recorder, who, I add with regret, was leagued with the
medical profession to destroy the reformed practice.
2608. Recorder. Do you consider it proper, doctor, to give
a lady emetics during pregnancy *
2609. Doctor. Not unless it would be more dangerous to
omit than to use them.
2610. Recorder. Would it be proper to puke a lady in that
delicate situation, provided she had a fever ?
2611. Doctor. By no means.
2612. Recorder. Would there not be danger of the emetic
producing miscarriage 3
2613. Doctor. If it was lobelia, I think there would.
2614. When Dr. Smith was interrogated by the counsel for
the defence, with regard to his knowledge of lobelia, he said he
had never used it, although he had been in practice for forty years,
nor had he ever known it to be used by any of his brother physi-
cians. He had derived his knowledge of it from medical books,
and the titles of those books he could not even name. Now what
are we to think of the candor of an individual, who will condemn
a plant with which he is wholly unacquainted, and endeavor to
convey the impression that it is capable of producing miscarriage 2
2615. Dr. Cheeseman, also, who declared in his testimony
* Dr. Frost was charged with having caused the death of Tiberius G. French,
by the administration of lobelia, and other medicines employed in the reformed
practice, when it was shown in evidence, that the patient died under the mal:
treatment of the diplomatised physicians. See the report of the trial, published
in Philadelphia, soon after the official proceedings took place.

628 GUIDE FOR WOMEN.
that lobelia was as poisonous as prussic acid, acknowledged that
he had never used it, and of course could have known nothing of
its properties.
2616. The question arises, whether these physicians were
sincere in their condemnation of the use of emetics in pregnancy,
or whether they were actuated by selfish and wicked motives.
On this point, I appeal with confidence to the work of the cele-
brated Denman, which was republished in New York in 1825, by
Dr. Francis, a leading and distinguished member of the medical
profession in that city. Denman, speaking in reference to preg-
nant women, says, “When there are signs of disturbance in the
stomach, from offensive humors, or preceding complaints arising
from intemperance in eating or drinking, gentle emetics may be
given, and the repetition, if necessary, may be unlimited.”
Again, he says—“When there is nausea or inclination to vomit,
without any evacuation, a gentle emetic is the best remedy: and
this may be repeated, whenever the urgency of any symptom re-
quires it; experience having fully proved, that emetics may be
given to pregnant women with perfect safety.”
2617. Lobelia, however, is the only active emetic which
I would use in pregnancy, or which appears to be entirely free
from objection. It does not leave behind it the lingering nausea,
or debility, which follows the administration of other emetics, but
on the contrary, it is no sooner done operating, than the patient
feels strengthened and refreshed, having, in most instances, a keen
relish for food. It exercises a soothing influence upon the
whole system, equalizes excitement, restores a balance to the
circulation, and while it evacuates the stomach, does not lay the
foundation for a diseased or morbid condition of that, or any
other organ. But it is not thus with tartar emetic, and other sim-
ilar poisons employed in the old school practice, for they often
occasion purging, horrible retching, and violent inflammation of
the stomach, leaving the patient in a weak, feeble condition, from
which she may be several days in recovering. These agents are
also a frequent cause of abortion.
* Francis's edition of Denman, p. 235.
GUIDE FOR WOMEN. 629
LABOR OR CHILDBIRTH.
GENERAL REMARKS.
2618. Why has the practice of midwifery been snatched from
the hands of women, to whom it was at one time confided by
public consent Do they not possess all the requisites for so
delicate and sacred an office Are they deficient in intellect,
that their rights should be usurped by the medical profession, who
are determined to make the healing art, in all its branches, an
odious monopoly Look for a moment at Madame Boivin, the
celebrated lecturer on midwifery in Paris, who superintended the
delivery of more than twenty thousand women, and wrote a work
on midwifery which is now quoted as authority by the medical
faculty in Europe and America. If a woman is capable of teach-
ing the principles of midwifery to large classes of students in the
capital of France, surely those of her sex are competent to admin-
ister to each other’s wants and necessities in the hour of travail.
2619. Apart from these considerations, however, why should a
medical man wish to intrude himself into the chamber of parturition,
urging upon the poor, deluded woman, the necessity of his attend-
ance, unless he is lost to common decency and propriety During
the latter part of the sixteenth century, popular feeling in Europe
was so much opposed to this practice, that a “physician in Ham-
burgh was publicly branded, because he was induced by curiosity
to be present at a delivery, in female attire.” But society has now
changed, and the refined and delicate sensibility which character-
ized a by-gone age, has lost its influence upon the people of the pre-
sent day. We have shown a disposition to go backward in morals,
and make a sacrifice of all that is dear to female delicacy.
2620. The iron hand of medical despotism has not only exer-
cised its influence in the United States, but also in other countries.
The Athenians, actuated by a low and grovelling spirit, enacted a
law that women should not practice midwifery, but from the de-
termination of those who were resolved to die rather than submit
to exposure, the law was speedily repealed.
2621. The Danish government, on the other hand, affords
a bright example of moral excellence and purity in this respect,
for it viewed the employment of men midwives, as they are termed,
as highly improper, and established schools for the instruction of
women in the principles of midwifery.f
* Francis's Denman. # Dr. Ewell.


630 GUIDE FOR WOMEN.
2622. Two centuries ago, or thereabouts, the practice of
midwifery was chiefly confided to women, and was character-
ized by a great deal of simplicity. To give some idea upon
this subject, I will make a few extracts from a work which was
written about that time, by a physician in London, and intended
for the use of midwives. The writer says, “I have read many
books, with all the late writers on midwifery, and I perceive that
they all follow one common road, taking their several schemes
and figures one from another. * * *. In several of these
schemes various things may be perceived which will be trouble-
some to the woman in labor, which a judicious practitioner will
not follow.” The writer then observes—“From mine and their
directions, let midwives choose the best and easiest ways of re-
lieving women in affliction; and to decide all disputes, let reason
be the judge, let experience argue the dubious points of practice;
and after a full debate, let unspotted truth record to succeeding
times what is most fit to be followed and used.”
2623. The same writer makes the following appropriate obser-
vation. “Let midwives observe the ways and proceedings of
nature for the production of her fruit on trees, or the ripening of
walnuts and almonds, from their first knotting to the opening of the
husks and falling of the nut; the green husks sticking so close
that it is not possible to separate the husk from the shell, whilst it
is unripe; but as the fruit ripeneth the husk droppeth and with a
fissure openeth, and by degrees separateth the fruit without any
enforcement.”
2624. Again, he says—“An egg representeth the womb; the
hen by keeping the egg warm, doth breed the chicken, which,
when it comes to maturity, doth break the shell, and is hatched
without injury. These signatures may teach midwives patience,
and persuade them to let nature alone to perform her own work,
and not to disquiet women by their struggling, for such enforce-
ments rather hinder the birth than any way promote it, and often
ruins the mother, and usually the child. Let midwives know that
they are nature's servants.”
2625. The rules which were so beautifully inculcated by this
writer two centuries ago, have been wholly disregarded in modern
times; for now, instead of rendering nature the desired assistance,
her efforts are paralyzed by the use of the lancet, and a host of
mineral or vegetable poisons, and when the strength of the patient
is exhausted, her child is dragged away by the murderous forceps,
or delivered by means of some dreadful operation. The fruit is
not allowed to separate naturally from the husk, but is violently
detached, and often withers and dies in common with the parent
tree.

GUIDE FOR WOMEN. 631
2626. The medical faculty inculcate the doctrine, that it is
extremely hazardous for a woman to pass through labor without
being attended by a physician, but this is very far from the truth.
Baudelocque exhibits a table of 17,308 pregnant women who
were admitted into the Lying-in Hospital at Paris, and out of the
whole number, 17,078 were delivered without the assistance of
art. In 49 cases, the forceps were employed, and in 13 others
the children were killed by the perforator.
2627. Merriman, in his Synopsis, enumerates 2,947 labors,
which produced 2,988 children, some of them being twins, and
in only 30 instances were instruments employed. In 2,810 of
the cases the head presented, which is always desirable.
2628. From these statements it will be seen that out of
20,255 women, 19,995 were delivered without artificial assist-
ance, leaving only 260 that were doomed to instrumental tortures.
Why then should a fee be paid to the physician, when he is
merely an idle spectator of the birth of the child Is it to be
supposed that the operations of nature are performed with more
certainty or precision, because a gentleman with a diploma hap-
}. to be leaning against a bed-post in the parturient chamber 2
ndeed, so useless is the attendance of a physician, that Dr.
Gooch remarks, “Whoever engages in the practice of midwifery,
must make up his mind to spend many a useless hour in the house
of his patients; for if he is absent when the child is born, it will
be thought he should have been present ; at all events, the pa-
tients are assured that he has been of no service, and will grudge
him his fee, or perhaps not pay it at all.”
2629. But what is to be done, some one inquires, where it is
necessary to make use of instruments The answer is obvious,
that if a woman is properly managed, there will be no occasion
for instruments. Nature, if properly assisted, will be able to sur-
mount every difficulty. This has been abundantly and satisfac-
torily tested in the reformed practice, for the last ten or fifteen
years. It is very easy to render a labor tedious or difficult by
mal-treatment of the patient. Let her be bled, physicked, and
dosed with poison, and her constitutional powers will soon be so
much enfeebled, that the womb has not sufficient energy to expel
the child, and then its skull is either perforated, so as to extract
its brains, or it is seized by the physician with a pair of forceps,
and dragged forcibly into the world. Copious flooding generally
ensues, and the mother, as well as the child, is frequently de-
stroyed. I wish I could say that instances of this kind are rare,
but such is not the fact, and it is time that the public should take
this momentous subject into consideration, for of all the depart-

632 GUIDE FOR WOMEN.
ments of medicine, there is no one which calls so loudly for re-
form as that of midwifery.
2630. Let a woman observe common prudence with regard
to her health, and avoid the use of the lancet, and all poisonous
or pernicious drugs, and she will experience no difficulty in child-
birth. This fact has been clearly demonstrated. The native
women of Africa and America, for example, do not even employ
midwives, so easy are their labors. Mr. Lawrence, in his Lec-
tures on Physiology and the Natural History of Man, observes,
“The very easy labors of negresses, native Americans, and other
women in the savage state, have been often noticed by travellers.
This point is not explicable by any prerogative of physical form-
ation; for the pelvis is rather smaller in these dark colored races
than in the European and other white people. Simple diet, and
constant and laborious exertion, give to these children of nature a
hardiness of constitution, and exempt them from the ills which
afflict the indolent and luxurious females of civilized societies. In
the latter, however, the hard-working women of the lower classes
in the country, often suffer as little from childbirth as those of any
other race. Analogous differences, from like causes, may be
seen in the animal kingdom. Cows kept in towns, and other ani-
mals deprived of healthful exercise, and accustomed to unnatural
food and habits, often have difficult labors, and suffer much in
- - xx
2631. In Lapland, and other northern countries, where they
do not interfere with the process of labor, the women enjoy a
similar immunity from suffering.
2632. Among the Araucanian Indians, says Stevenson, in his
Twenty Years Residence in South America, a mother, immedi-
ately on her delivery, takes her child, and going down to the
nearest stream, washes herself and it, and returns to the usual la-
bor of her station.
2633. “The wonderful facility with which the Indian women
bring forth their children,” say Lewis and Clark, in their well-
known journal, “seems rather some benevolent gift of nature, in
exempting them from pains which their savage state would render
doubly grievous, than any result of habit. One of the women
who had been leading two of our pack horses, halted at a rivulet
about a mile behind, and sent on the two horses by a female
friend. On inquiring of one of the Indian men the cause of her
detention, he answered with great appearance of unconcern, that
she had just stopped to lie in, and would soon overtake us. In
fact, we were astonished to see her in about an hour's time come
on with her new born infant and pass us on her way to the camp,
apparently in perfect health.”

GUIDE FOR WOMEN. 633
2634. Washington Irving, in his work entitled Astoria, re-
lates a similar incident in the following language. “The squaw
of Pierre Dorion, (who, with her husband, was attached to a party
travelling over the Rocky Mountains, in winter time, the ground
being covered with several feet of snow,) was suddenly taken
in labor, and enriched her husband with another child. As the
fortitude and good conduct of the woman had gained for her the
good will of the party, her situation caused concern and per-
plexity. Pierre, however, treated the matter as an occurrence
that could soon be arranged, and need cause no delay. He re-
mained by his wife in the camp, with his other children and his
horse, and promised soon to rejoin the main body on their march.
In the course of the following morning the Dorion family made
its appearance. Pierre came trudging in advance, followed by
his valued, though skeleton steed, on which was mounted his
squaw with the new born infant in her arms, and her boy of two
years old, wrapped in a blanket, and slung on her side. The
mother looked as unconcerned as if nothing had happened to her;
so easy is nature in her operations in the wilderness, when free
from the enfeebling refinements of luxury, and the tampering ap-
pliances of art.”
2635. Among the hardy countrywomen of Scotland, child-
birth is equally devoid of danger, or difficulty. Alison, in his
Principles of the Criminal Law of Scotland, cites the case of
Catherine Butler, who in the spring of 1829, two or three days
after her delivery, walked from Inverary to Huntley, a distance of
twenty eight miles, in a single day, with her child on her back.
He says—“It is not unusual to find women engaged in reaping,
retire to a little distance, effect their delivery by themselves, re-
turn to their fellow laborers, and go on with their work during the
remainder of the day, without any other change of appearance than
looking a little paler and thinner.” He further adds, that “in-
stances have occurred in which women have walked six or eight
miles on the very day of their delivery, without any sensible in-
convenience.”
INSTRUMENT'S AND OPERATIONS.
2636. The diplomatised physicians, who practice midwifery;
are furnished with a great variety of murderous instruments, to aid
them in their vocation, such as the perforator, vectis, blunt hook,
and forceps, each of which I propose briefly to describe for the
information of my female readers.
SO

634 GUIDE For WOMEN.
2637. Perforator. This is a pointed instrument which is
thrust into the head of a child, with the view of extracting its
brains; the latter are scooped out through the orifice with the
handle of a spoon, or in any other convenient manner. The
head is thereby diminished in size, and can be dragged from the
pelvis more easily. Any tyro can perform the operation, who
has the good fortune to pass a year at some medical college.
Professor Channing recommends that the work be well done, de-
stroying not only the brain, but the upper portion of the spinal
marrow, lest there should be some remnants of vitality remaining.
He informed his class that he performed this operation in one in-
stance when the child cried after its brains were out. He said
the sound was the most appalling one he ever heard, and no one
was disposed to question his veracity.
2638. Vectis. This is a sort of lever, resembling the blade
of a single pair of forceps, and is used by the diplomatised phy-
sicians “to assist the delivery of the child’s head.” The author
of the London Practice of Midwifery, speaking of its application,
says—“It is obvious that the force applied by the instrument
must be equal to the resistance, if not superior to it; and then
mischief may arise to the parts of the child's head so acted upon,
producing much injury; the ear may be injured; the lower jaw,
or process of the temporal bone may be broken; or any part of
the surface, in consequence of the pressure, may slough off or
mortify : these evils are by no means imaginary; there are various
instances recorded of each of them, and that under the hands of
the most careful and deaterous men.”
Dr. Gooch, in his Practical Compendium of Mid-
wifery, says, “Not long since a practitioner of great professional
accomplishments sent for me to consult with him on a most dis-
tressing case: the head during the labor (which had been over
four days) had rested a long time on the perineum; he applied
the vectis, using it with great care and attention. He succeeded
in delivering the woman, and believed the labor to be well over;
but within twenty four hours afterwards, a violent burning pain
came on in the vagina, with a fetid discharge, and shiverings, fol-
lowed by a hot skin, and rapid pulse; the teeth and tongue soon
became covered with black incrustations; there was low delirium;
and death soon terminated the scene. The death of this patient
was occasioned by inflammation, gangrene, and sloughing of the
vagina, º by the pressure of the instrument against the soft
parts. Even by men who possess more than an average share
of skill, instruments are never used without risk of injury to the
soft parts.”

GUIDE FOR WOMEN. 635
2640. Blunt hook. The name of this instrument implies
its office. It is used to drag the child out of the pelvis, when
other means have failed. “It is to be placed over the thighs,”
says the author of the London Practice, “which will certainly
command the delivery, and where a small equally applied force is
sufficient, it will be both successful and safe; but as it is self evi-
dent that iron is always stronger than bone, there will be a great
risk of breaking the thigh bone by this instrument.” The author
concludes by saying, “But the woman is not to die to save the
child’s bones from the risk of being broken; and it is certainly
better to have to treat a child with its thigh broke, than one whose
brains have all been scooped out.”
2641. Forceps. This instrument is made of two very strong
pieces of iron or steel, opening and shutting like a pair of pincers,
with two long blades to seize the head of the child. It is some-
times armed, says Denman, with teeth or sharp protuberances
on the internal surface of the blades which grasp the head. It is
intended, he adds, to extract the child without regard to the in-
jury it may sustain. He also observes, that forceps have been
made with hinges or joints between the handle and blade of each,
answering no other purpose than that of concealing them, that an
operation may be performed with them in a clandestine manner!
2642. The history of this instrument should be sufficient to
deter any humane or sensible man from its use. It was invented
by Dr. Chamberlen of London, whose son “took it to Paris, and
offered it to Louis XIV. This monarch proposed giving him
two thousand pounds for the discovery, provided it was success-
ful. Mr. Chamberlen accordingly applied it in the first case of
- difficult labor which occurred in Paris. The pelvis was deform-
ed; yet he persisted in applying the instrument with great diffi-
culty and no effect. The woman died; and the body being
opened, it was found that in forcing the blades up, he had forced
them through the sides of the womb. The moment he found that
this was the case, he took to his heels without waiting for a mes-
senger.””
2643. Dr. Gooch says, “The first time I ever saw the for-
ceps applied, it was done with great care by a gentleman as skil-
ful as any in this metropolis; (London) but he lacerated the pe—
rineum quite into the anus, and the opening remains to this day.
The first time I used them in the Westminster Lying-in Hospi-
tal, I lacerated the perineum, and could not avoid it, though I
took special care.”f
* London Practice of Midwifery. Practical Compendium of Midwifery.

636 GUIDE FOR WOMEN.
2644. Professor Channing of Harvard University, recently
exhibited, an instrument to his class in the shape of forceps, which
he described as the invention of Baudelocque the younger, present
teacher of midwifery in Paris. The professor said he received it
direct from that city, having purchased it for twenty five dollars.
It was of huge dimensions, rough in its construction, and was
made of solid iron, weighing not less than thirty pounds. Its en-
tire length was two feet and a half. The parts intended to clasp
the head of the child, were heavy clumps of iron, very thick, and
about two inches long. They were almost sufficient of them-
selves to fill the vagina independently of the child. The instru-
ment was made to open by a screw an inch in diameter, and a
foot in length, being turned by a handle like an ordinary windlass.
It is but justice to Professor Channing to say, that he did not
recommend its employment.
2645. Operations. The principal of these is the Casarean,
which is performed by cutting through the abdomen into the
womb, and extracting the child. It is so termed, because Julius
Caesar is said to have been brought into existence in this manner.
It is frequently performed by inconsiderate physicians and sur-
geons at the present day, notwithstanding it is almost invariably
fatal. “Every woman,” says Denman, “for whom the Caesarean
operation can be proposed, will probably die; and should any one
survive, her recovery may rather be considered as an escape, than
as a recovery to be expected, though there is always a probable
chance of saving the life of the child.”
2646. Merriman saw the operation performed twenty three
times in England, and in every instance it proved fatal.
2647. The author of the London Practice says—“We find
that the operation has uniformly been fatal in our own country-
it has been performed in London, Leicester, Edinburgh, and Man-
chester, by the best surgeons of these places, and there are none
better in the world, but all the patients have died.”
2648. In France, the bones forming the pubis are frequently
divided at their point of union, (D, Fig. 9, page 609) as a means
of enlarging the pelvis, and facilitating the birth of the child. The
operation, however, is attended with a great deal of hazard, and
generally fails in producing the desired result. “The objections
against it,” says Dr. Gooch, “are decisive. If you divide the
bones by an incision through them, you will find that you do not
increase the diameter of the pelvis in the direction in which it is
contracted, which is generally from before backwards. The room
which this operation gives is in the lateral direction; you there-
fore gain no increase of the capacity of the pelvis, where it is

GUIDE FOR WOMEN. 637
chiefly required. Further, the bones after being thus divided
may not unite; and the bladder is liable to be injured. The op-
eration has been performed in this country (England) but once;
and in that case, strange to say, it succeeded; but in ten days
afterwards, the woman died, not from the operation, but from
drinking porter and brandy.”
SIGNS OF LAB 0 R.
2649. Dating a fortnight after the cessation of the menses,
labor generally commences at the expiration of about nine calender
months, but there are material deviations from this standard, for it
may *" at the seventh month, or not until the tenth or eleventh
month.
2650. A child born at seven months may live and do well,
but earlier than this, it very rarely survives. George III. was a
seven months child, and he enjoyed as long a reign perhaps as
any of the English kings. Indeed, a child at seven months is
more likely to live than one at eight.
2651. A week or two before labor commences, the womb
gradually sinks in the abdomen, as stated in paragraph 2268, and
“ the motions and weight of the child are felt to be lower than
formerly.” A few days previous to delivery, a whitish, slimy
discharge takes place from the vagina, and the external organs of
generation become soft and full. In some instances this discharge
is small until labor actually commences. It is intended by nature
to lubricate the parts, and facilitate the passage of the child. It
is usually tinged with blood, which is familiarly termed the show,
and this is one of the surest evidences we have of the commence-
ment of labor, for it indicates a detachment of the placenta or
afterbirth from the internal surface of the womb. In a few in-
stances the show is wanting, while in others it is tolerably copious,
and occasionally a considerable quantity of pure blood is dis-
charged.
2652. As labor approaches, the woman complains of tenesmus,
and has a frequent desire to pass water. I may here remark, that
the bladder should be kept as empty as possible, and the bowels
thoroughly evacuated by injections, as this will increase the
dimensions of the pelvis, and facilitate the progress of delivery.
(See Fig. 10, page 616.)
2653. “The symptoms indicating the commencement of
labor,” says the author of the Practical Compendium of Mid- -
wifery, “are pains in the back and loins extending down the front

638 GUIDE FOR WOMEN.
of the thighs; these at first continue but a few seconds, and recur
every fifteen or twenty minutes; the patient rarely gives evidence
of the pain at this period by exclamation; but if you notice her
countenance you can easily tell when the pain is on. If she is
working or reading, she lays her work or book aside, distorts her
mouth, lays hold of the chair, and there is a general appearance of
uneasiness, but as soon as the pain is gone, she resumes her work,
or takes up her book, and speaks as if nothing had happened.”
2654. The pains are divided into true and false, but in some
instances they so closely resemble each other, that it is impossible
to distinguish them apart. False pains, however, come and go
irregularly, occurring sometimes two or three weeks previous to
delivery, and are often seated in the abdomen, producing an un-
pleasant griping sensation. The true pains, on the other hand,
mostly begin in the back and loins, and return at regular intervals,
varying from five minutes to half an hour. They recur more fre-
quently and are of longer duration, in proportion as the labor
advances; and in the meantime the membranes, distended with the
waters or liquor amnii, protrude through the mouth of the womb
into the vagina. In some instances they descend so low as to be
felt at the external orifice of the vagina.
2655. The pains are cutting or grinding at first, succeeded by
what are termed the bearing down pains. At length the mem-
branes break, and “the waters escape with a gush, deluging the
bed. There is now a longer interval between the pains, but sooner
or later they recur, and the patient becomes boisterous in the ex-
pression of her sufferings; she lays hold of a towel which is com-
monly fastened to the bed-post for this purpose, and bears down
with all her might; her pulse is rapid, and the pains more frequent,
strong, and lasting; a degree of impatience is now manifested, and
the head of the child descends lower and lower in the vagina,
till it presses firmly on the perineum. In this stage of the labor;
an inexperienced person would think that a few pains would expel
the child, but though the head rests on the perineum,” and pre-
sents at the external orifice, yet it may be some hours before it is
expelled, more especially if it is the first labor; but if the second
or third, half a dozen pains will generally be sufficient to complete
the process.”
2656. Labor commences with the slow and gradual opening
or dilatation of the mouth of the womb, which causes the grinding
or cutting pains previously mentioned; and the diplomatised phy-
sician, instead of leaving this process entirely to nature, thrusts
* This term has already been explained, and signifies the space between the
anus and lower angle of the labia. (2577.)
GUIDE FOR WOMEN. 639
his hand into the vagina, and endeavors to bore his clumsy fingers
into the orifice of the womb, under the pretext of aiding in its
dilatation. This barbarous practice, I am happy to say, is con-
demned by some of the medical profession themselves. Profes-
sor Channing, in one of his lectures, said, “According to Dr.
Hamilton of Edinburgh, it is a fixed rule never to allow the mouth
of the womb to be over twelve hours in dilating, before attempting
to render artificial assistance, but Dr. Collins of Dublin, who has
superintended fourteen thousand cases of labor, says that this prac-
tice is founded in error; that we should never interfere with the
natural process under any circumstances; and he strengthens him-
self in his position, by saying, that he has been far more successful
in practice than Dr. Hamilton. Indeed, a sharp controversy has
been carried on between these able writers, and you have author-
ity therefore, for any kind of treatment which you may be dis-
posed to pursue.”
EXAMINATIONS, AND RUPTURE OF MEMB RANES.
2657. If there is any one feature of the old school practice
more objectionable or revolting than another, it is that of making
frequent examinations during labor. It is not only indecent, and
immoral in its tendency, but is often attended with serious or fatal
consequences to the patient. In expressing my disapprobation on
this subject, however, I shall confine myself principally to the
remarks of eminent medical writers, lest it should be thought that
I am unnecessarily fastidious in a matter which has received the
almost universal sanction and approval of society.
2658. Dr. Denman remarks, “In every thing which relates
to the act of parturition, nature, not disturbed by disease, or
molested by interruption, is fully competent to accomplish her
own purpose. She may be truly said to disdain and abhor assist-
ance.”
2659. He says in another place, “From a retrospective view
of the practice of midwifery, in all former times, and in all coun-
tries, every intelligent person sees, and is ready to acknowledge,
that there has been too officious an interposition, and too great a
readiness to give assistance in various ways, for the relief of many
difficulties attending parturition; which are not only fully proved
to require no assistance, but which are also now allowed to be
surmounted in a safer and more effectual way by the resources of
the constitution.”
2660. Here is another paragraph from the same source:
“The native powers of the constitution, when not interrupted,
- =

640 GUIDE FOR WOMEN.
are not only superior to the common obstructions of the process,
but in general, to the various kinds and degrees of deviation from
the natural course of labors.”
2661. In enumerating some of the causes of difficult labor, the
same distinguished writer remarks, “There is one much more
frequent than the rest, which is, the derangement of the order of
the labor by an officious interposition, or by improper manage-
ment. Upon this subject it would be unpardonable to make an
assertion, which is not supported by experience; but I am not
fully convinced, that the far greater number of really difficult la-
bors to which I have been called, (and I must not conceal the
truth, many of those which have been originally under my own
care) were not of that denomination from unavoidable necessity,
but were rendered such by improper management, in the com-
mencement or course of the labor.”
2662. Dr. Bard, speaking of examinations, says—“What
terms shall I use to condemn, as it deserves, the abominable prac-
tice of boring, scooping, and stretching the soft parts of the
mother, under the preposterous idea of making room for the child
to pass. It is impossible to censure this dangerous practice too
severely; it is always wrong; nor can there be any one period in
labor, the most easy and natural, the most tedious and difficult,
the most regular, or preternatural, in which it can be of the least
use—in which it will not unavoidably do great mischief: it will
render an easy labor painful—one which would be short, tedious—
and one which, if left to nature, would terminate happily, highly
dangerous.”
2663. “ Unfortunately for the interest of humanity,” says Dr.
Dewees, formerly Professor of Midwifery in the Pennsylvania
University, “it requires more knowledge not to be officious, than
falls to the share of many of those who pretend to practice mid-
wifery. It is a vulgar prejudice, that great and constant benefit
can be derived from the agency of the accoucheur, especially
during the active state of pain; and this feeling is but too often
encouraged by the ignorant and designing, to the injury of the par
tient, and disgrace of the profession.”
2664. Baudelocque is very severe in his remarks upon the
French midwives for undertaking to dilate the parts concerned in
delivery, as soon as any symptoms of labor are manifested, and
says that these “manoeuvres,” as he terms them, “often produce
an effect quite contrary to what the midwives expect; for by
depriving the organs which they handle so incautiously, of the
micus which nature furnishes at that time abundantly, for no other
purpose than to relax them, they irritate and dry them so much,
that they seldom fail to inflame and become extremely painful.”

GUIDE FOR WOMEN. 641
2665. The French midwives are no doubt deserving of all
the censure which Baudelocque has bestowed upon them, but it
must be remembered, in extenuation, that they have borrowed
their ideas of practice from the French physicians themselves,
who are notorious for their love of making examinations. The
medical faculty in France should endeavor to reform themselves,
before they undertake to reform the midwives.
2666. Gooch furnishes a very good argument against examina-
tions, and one which should be constantly borne in mind. “The
changes of the womb succeeding conception,” he says, “are not
those of size only, but also of structure. The parietes or coats
become so soft and pulpy, that it is easy to thrust the finger
through them; and I warn you that if you have your hand in the
womb, and should, during a labor-pain, push your finger against
it, nothing is more likely than that your finger will pass through its
coats.” -
2667. “One cause of difficult labor,” says the author of the
London Practice of Midwifery, “is the irregular contraction of
the muscular fibres of the womb; and this always arises from irri-
tation of the mouth of the womb in needless examinations.”
2668. Much stress is here laid upon “needless examina-
tions,” but the intelligent and unprejudiced reader will probably
conclude, after perusing the foregoing extracts, that they are all
needless.
2669. The diplomatised physicians, as much as they may feel
disposed to boast of their acquirements, make some ludicrous
blunders in their examinations. Some of my readers will prob-
ably recollect the anecdote of a professor of midwifery in Paris,
who, in one of the Lying-in Hospitals, made an examination of a
woman in labor, and declared that the head presented, while, in
truth, it was the breech, the students in the meantime amusing
themselves with the mistake of their distinguished teacher! be-
cause they saw the meconium * on his fingers.
2670. As much as the practice of making examinations de-
serves to be reprobated, I have no wish to condemn them indis-
criminately, for in some instances they are requisite. I will give
an example. A lady of Boston had symptoms of labor at the
natural period, and slight pains were experienced for several days.
Abhorring the idea of exposure to a physician, she solicited the
advice of an intelligent female friend, who suspected thickening of
the membranes. An examination was made by the latter, and the
membranes were found protruding beyond the external organs of
generation. Being unusually thick and strong, they were care-
* The excrements which are first evacuated by the child after its birth.

81

642 GUIDE FOR WOMEN.
fully clipped with a pair of scissors, and delivery took place im-
mediately. Such an examination by such a person was appropri-
ate and necessary, and the patient had not the mortification of
being exposed to the rude or perhaps unhallowed gaze of a phy-
Slclan.
2671. Excepting in a case like the preceding, the membranes,
as a general thing, should not be ruptured, for nature will perform
this part of her work as she performs every other, with perfect
order and regularity. Besides, the waters contained within the
membranes, serve as a protection to the child, and if they are pre-
maturely discharged, the infant is frequently destroyed by the con-
tractions of the womb. This led Denman to remark, that “the
untimely rupture of the membranes, whether natural or artificial,
has been often mentioned as the cause of much mischief, and of
many tedious or difficult labors.” He also says—“We will
agree in establishing it as a general rule for our own conduct, that
the membranes should never be ruptured artificially, at least be-
fore the mouth of the womb is fully dilated, and be persuaded that
it is afterwards unnecessary, unless there should be some cause
more important than the mere delay of a labor, or some reason of
more weight than those which have been commonly assigned.”
He also observes, in his flphorisms, that “the premature rupture
of the membranes, is the most general cause of difficulties in par-
turition.”
2672. The author of the London Practice, says, “Rigidity
of the membranes has been stated to produce difficult labor. It
has sometimes, though rarely, happened, that labor has been
quicker when the membranes were ruptured easily; but though
the labor be slower, it is safer, where the membranes remain
entire. Where they are to be opened, there have been a great
number of pretty looking instruments invented for doing it—long
tubes, at the end of which blades or points were projected ; but
it requires more skill in telling where they should be let alone,
than where they should be used.”
2673. Women should be aware of the fact, that they are
sometimes grossly and wickedly imposed upon by the medical
faculty, during labor, and if they have any doubts on this subject,
I respectfully submit to their perusal the following paragraph from
the London Practice of Midwifery, from which I have already
frequently quoted. “A patient, after the waters are discharged.”
says the author, “requires a little management; it is not just to
stay with her at the time; and yet it is necessary, if we leave her;
to leave her in confidence; therefore we may give her the idea of
making provision for whatever may happen in our absence; we
GUIDE FOR WOMEN. 643
may pass our finger up the vagina, and make a moderate degree
of pressure for a few seconds on any part of it, so that she may
just feel it, after which we may say to her, “There, ma'am, I
have done something that will be of great use to you in your la-
bor.” This she trusts to ; and if, when she sends for us, we get
there in time, it is well; if later than we should be, we easily sat-
isfy her : ‘Yes, you know I told you I did something which
would be of great service to you in your labor.” If the placenta
is not yet come away, ‘Ah! I am quite in time for the afterbirth,
and that you know is of the greatest consequence in labor.” And
if the whole is come away, ‘We are glad the afterbirth is all come
away, in consequence of what we did before we last left the pa-
tient, and the labor terminated just as we intended it should.”
POSITIONS OF WOMEN.
2674. These vary in different countries, according to fashion
or custom. In Holland, Germany, and Spain, women are de-
livered in a chair, constructed for the purpose. In France, they
lie upon the back; in some other parts of Europe, they kneel on
a cushion, and rest their elbows on a chair or sofa. Many women
prefer to be delivered while sitting on the lap of a friend. In
England and the United States, it is common for a woman to lie
on her left side near the edge of the bed, with her knees drawn
toward the abdomen, and separated by a pillow.
2675. “The situation of the woman,” says Baudelocque,
“must be varied according to circumstances, and the period of
labor. When it is but just begun, and is not complicated with any
accident, and every thing relative to delivery is in good order, the
woman may choose the situation which appears most convenient
to herself.”
2676. Professor Dewees, in his edition of Baudelocque, says,
“The mode usually pursued in this country, is to have the pa.
tient’s bed made in the common way, with the addition of a folded
blanket in the middle of it, and under the lower sheet; then we
separate the sheets by rolling the bedclothes from one side nearly
to the other. The foot of the bed is then well beaten to make it
firm, over which part another folded blanket is spread; the patient
is then for the most part placed on her left side, her knees a little
bent, her hips placed near the edge of the bed, while her feet are
firmly pressed against the bed post. A pillow, rolled tight and
tied, is placed between her knees in the advanced period of labor;
a sheet or blanket, according to the weather, is thrown over her;
her head is raised by pillows. The advantage arising from this


644 GUIDE FOR WOMEN.
mode, is that when labor is finished, the patient, after having the
wet things taken from about her, is easily drawn up in the bed,
without fatigue or even disturbance.”
2677. The following position possesses peculiar advantages
in some cases of difficult labor. The woman sits on the foot of a
bed, with her feet resting upon a trunk, box, or stool, having the
knees some distance apart, while a sheet, twisted lengthwise into a
soft roll, is stretched across the small of her back, and supported
at each end by an assistant. When a pain comes on, she leans
with her back against the sheet, which is now held firmly by the
assistants, and braces her body by pressing with her feet upon the
box, or stool, which must be of the requisite height for this pur-
pose. She may derive still further support by grasping the sheet
with her hands, or seizing a towel attached to the bed-post, on
either side. By this arrangement, she has full command of her
physical powers, and the partially erect position of her body, fa-
vors the descent of the child in the pelvis. In the absence of a
pain, unless delivery is close at hand, the woman may repose upon
the bed, or walk about the room, according to her wish or incli-
nation. In regard to position, however, no positive rules can be
given, for this must be varied, as Baudelocque observes, according
to circumstances. Indeed, we often find a woman in labor, un-
consciously seeking that position which is the most natural, and
the best adapted to the expulsion of the child.
CATHE TER.
2678. If the head of the child is low in the pelvis, and presses
for a sufficient length of time against the urethra, or neck of the
bladder, (see Fig. 10, page 616) it will occasion retention of
urine, as mentioned in retroversion of the womb, (2582, et seq.)
and the bladder will be in danger of bursting, unless its contents
are drawn off with a catheter. The mode of using this instru-
ment has been described in paragraphs 2587–89. I have never
known of a case in the reformed practice in which it was neces-
sary to employ a catheter, but as instances of the kind may occur,
particularly where the labor has been protracted by mal-treatment,
such as blood-letting, or the use of poisons, it is adviseable to be
prepared with the means of affording relief.
DIFFERENT PRESENTATIONS.
2679. The position of the child or foetus in the womb, is
such as to occupy the least possible space. The thighs are
GUIDE FOR WOMEN. 645
doubled upon the abdomen, and the legs upon the thighs. The
feet necessarily lie close to the breech, and are mostly crossed.
The chin rests upon the breast. “The elbows are in contact
with the sides, and the hands turned up to the head, one of which is
often placed upon the cheek or ear.” This position varies, how-
ever, in a great variety of ways. The head, nevertheless, is gen-
erally downward, and is therefore almost invariably the presenting
art. In 17,499 births which occurred in one of the Paris Lying-
in Hospitals, 16,286 of them were presentations of the vertex or
crown of the head. It will be seen therefore, that the deviations
from the established laws of parturition are not very numerous;
other parts, however, as well as the head, occasionally present, as
I shall proceed to notice. By the examination of women who
have died previous to, or in the act of childbirth, says a writer on
the subject, it has been ascertained, that whatever may be the sit-
uation of the child in the early part of pregnancy, such it will be
at the time of labor, unless, indeed, the position be altered by
some accidental violence, which very rarely happens.
2680. HEAD. The first stage of labor consists in the dilata-
tion or opening of the mouth of the womb, which allows the
membranes investing the child to protrude into the vagina. This
is called the gathering of the waters. At length, from the forcible
contractions of the womb, the membranes break, followed by a
gushing or discharge of the waters or liquor amnii. Sooner or
later, according to the strength or frequency of the pains, the
head makes its appearance externally, and with one or two addi-
tional pains, the body is usually expelled. The labor is always
the most easy and natural, when the vertex or crown of the head
presents, and passes under the arch of the pubis or front bone.
(See Fig. 9, page 609.) There are deviations from this order,
however, for occasionally the face presents; or the face may
incline toward the pubis, and the vertex toward the spine or back
bone; or one or both arms may come down with the head; but in
neither case have we any reason to anticipate difficulty. Denman
says, “Experience has fully proved that in either of these posi-
tions, the head may be expelled by the natural efforts with perfect
safety to the mother and child, though not generally with such
ease and expedition as if the hind-head or crown was turned to-
wards the pubis; unless the head be very small.”
2681. As soon as the head is expelled, it should be observed
whether the umbilical cord is around the neck of the child, and if
so, it is to be drawn down carefully and removed. Sometimes it
is passed two or three times round the neck, and if the removal
- =


646 GUIDE FOR WOMEN.
is attended with difficulty, care must be taken not to break the
cord by undue force or violence.
2682. The perineum, which is the space between the lower
angle of the labia and the anus, (2577) is sometimes pushed for-
ward by the head of the child during the process of labor ; and in
the old school practice is frequently lacerated, but I am satisfied
that the accident would never occur if proper treatment was
pursued, and the rigidity of the external parts overcome by the
local application of vapor, (1499) or cloths wrung out of water as
hot as it can be borne by the patient. Supporting the perineum
with the hand, as is generally practised by the diplomatised phy-
sicians, does not appear to be of any avail, and is thought by some
to be injudicious. Denman says, it may be very much doubted,
whether some of the methods practised to prevent laceration of
the perineum, may not in fact be the cause of the accident; and
he adds, that “when women were delivered without assistance,
he has not in any instance observed any very considerable lace-
ration.”
2683. Dr. Warren of Harvard University, in some remarks
on this subject, in one of his lectures, said, “According to my
experience no benefit is derived from attempting to support the
perineum ; if it is in a condition to be ruptured, the rupture will
take place under any circumstances; it cannot be prevented by
an application of the hand; I have known the perineum to be
ruptured when it was supported by the hand.”
2684. BREEch. The breech may be distinguished from the
face or head, by the absence of the nose, ears, and other familiar
parts. When it presents, the child is born double, and mostly
without difficulty, though the labor is apt to be somewhat more
tedious than in ordinary cases. If delivery does not take place
soon after the body is expelled as far as the navel, the child may
die from compression of the umbilical cord, through which its life
is exclusively maintained until respiration is established. Hence
it is recommended by some writers to hasten the delivery; and
this is to be accomplished by passing one or more fingers into the
groin, using a gentle degree of force, and operating during the
continuance of a pain. If the cord is upon the stretch, it must
be pulled somewhat lower down, or the circulation of the blood
through it will be arrested as effectually as though it were com-
pressed. There are other writers and teachers of midwifery,
who are not in favor of hastening the delivery until the shoulders
are expelled, and among these is Professor Hodge of the Penn-
sylvania University, who assigns as a reason, that the chin may be
thrown from the breast, and the head thereby locked in the pelvis.
GUIDE FOR WOMEN. 647
Whatever danger there may be from compression of the cord, he
thinks there is still greater danger in attempting to force the
delivery; and there are many eminent physicians who concur with
him in this opinion. After the shoulders are expelled, however,
and the head is in the lower strait of the pelvis, delivery must
be accomplished in a few minutes, or the child will die. A
napkin or towel may be passed round the breech, and the head
worked gently from hip to hip, so as to favor the extraction, but
too much force must not be employed, or dangerous consequences
may ensue.
2685. “When the child is brought down as low as the shoul-
ders,” says Dr. Denman, “it has been esteemed by some a very
injudicious practice to bring down the arms; while others have
considered this step absolutely necessary in all cases, the arms,
according to them, occupying a portion of that space which should
be filled by the head only. If the extraction of the head with the
arms turned up, be on trial found tolerably easy, there is clearly
no occasion to bring them down; but if the head should remain
fixed in such a manner as to resist the force which we think can
be safely or prudently exerted, then the arms ought to be succes-
sively brought down, but very cautiously, lest they should be
fractured or dislocated, or be forced down so suddenly as to
lacerate the perineum.
2686. “When the arms are down, should there be much
difficulty or delay in the extraction of the head, it will be of great
service to pass the fore finger of the left hand into the mouth of
the child, and to press down the jaw towards the breast—but not
to pull by it—in order to change the position of the head, which
may be easily done, and the extraction thereby greatly facilita-
ted.”
2687. Dr. Francis, the editor of Denman, follows the above
paragraph with a note, in which he says, “By placing one or two
of the fingers upon the face of the child, just below the orbits of
the eyes, we have a much greater, and probably safer purchase,
to enable us to change the position of the head. Accoucheurs do
not seem to reflect upon the condition of the lower jaw; and that
it may at this early state, be easily broken or dislocated.”
2688. If there is sufficient evidence of the death of the child,
it may be left to be expelled by the natural efforts, for there is no
necessity, under these circumstances, of forcing the delivery.
2689. The practice of bringing down the feet, in a breech
presentation, is unnecessary, and is said by some experienced
accoucheurs, to be productive of more harm than good.
2690. FEET AND KNEEs. A presentation of either of these,


648 GUIDE FOR WOMEN.
does not require any special notice, for as soon as the limbs are
expelled as far as the breech, the case is to be managed precisely
as though it was an original breech presentation.
2691. ARM. When the arm or shoulder presents, the body
lies across the pelvis, which renders the labor more or less
tedious. By pushing the arm back, when this can be done with-
out difficulty, the head will sometimes come down, and the deliv-
ery take place naturally; but if the arm cannot be easily returned,
it has been advised that the midwife pass her hand into the womb,
and bring down the feet. There is but little to be said in favor
of this operation, however, though it may in some instances
answer a good purpose. The hand should be smeared with lard,
or the mucilage of slippery elm, and carried up in the direction of
the feet, which are to be brought down so as to allow of a natural
movement of the joints—that is, the limbs are not to be twisted
across the back, or they will be broken, or the joints dislocated. “If
both feet cannot be readily grasped and brought down together,”
says Dr. Gooch, “bring down one first, and then the other;” or
if one foot should remain, delivery will take place with the limb
doubled upon the body, as in presentation of the breech. It is
important that a hand should not be mistaken for a foot, as this
might lead to serious consequences in attempting to perform the
operation of turning. As the feet are brought down, the arm will
recede, until it finally disappears. The effort to turn should
never be made during a pain, as the womb is then contracting on
the child, and would render the operation impracticable. The
turning accomplished, let the labor proceed as though it were an
original case of the breech. If the presence of the hand causes
the womb to contract, which it frequently does, and that too in the
most violent manner, the hand should be laid perfectly flat until the
contraction ceases, or there will be danger of rupturing the organ.
Indeed, this is a strong objection to the operation, unless it be
performed with exceeding care; and moreover, it is sometimes
found impossible to turn the child under any circumstances what-
ever.
2692. Dr. Gooch says, “In some instances when the hand
or shoulder presents, the head rests on the edge of the brim of the
pelvis; and if you return the presenting part, the uterus is so stim-
ulated to a vigorous action, by the introduction of the hand, that
the head is thrown off the brim of the pelvis, and descends as in a
natural presentation. I have succeeded in this way in many cases,
and in some to which I was called for the express purpose of
turning; while apparently only making a common examination, I
have returned the presenting part, and then waited for a pain,
GUIDE for women. 649
which has brought down the head. I have then desired the at-
tending practitioner to examine; and he has been surprised to find
that the arm was converted into a head presentation. On one
occasion when the arm presented I pushed it up, and down came
the umbilical cord, which I carefully replaced; the uterus imme-
diately contracting forced down the head, which of course contin-
ued to be the presenting part until it was expelled. In arm pre-
sentations when the body of the child is completely across the
pelvis, you must turn and deliver; but if the head is only a little
removed from its natural position, then return the hand, in the
hope that the head at the next pain will assume its place.”
2693. Cases have frequently occurred in which turning was
altogether out of the question, and yet the woman has been deliv-
ered by the natural efforts with comparative ease. Denman,
speaking of presentations of the arm and shoulder, says, “In some
cases, when we are first called, the shoulder is so far advanced
into the pelvis, and the action of the womb is at the same time so
strong, that it is impossible to raise or move the child, which is so
forcibly impelled by the pains as to overcome all the power we
are able to evert. This impossibility of turning the child had, to
the apprehension of writers and practitioners, left the woman with-
out any hope of relief. But in a case of this kind which occurred
to me about twenty years ago, I was so fortunate as to observe,
though it was not in my power to pass my hand into the womb to
turn the child, that by the mere effect of the action of the womb,
an evolution took place, and the child was expelled by the breech.”
2694. If, then, where it is impossible to turn the child, nature
is competent to effect its delivery, why should we ever call in the
assistance of art It may be said, however, that the above is
only a solitary case, and is not sufficient to establish a rule of
practice. Very true, but it happens that instances of this kind
are very frequent. Denman observes, that “the cases in which
this evolution has occurred, are now so numerous, and supported
not only by many examples in his own practice, but established
by such umerceptionable authority in the practice of others, that
there is no longer any room to doubt of the possibility of its hap-
pening, more than there is of the most acknowledged fact in mid-
wifery.” Denman, I may add, is not entirely opposed to turn:
ing, when it can be performed with safety to the mother, or afford
a better chance of saving the child, but he observes, “when we
are called to a patient with a preternatural labor, in which there is
little or no reason to hope for the presentation of the child, or in
which we are assured of its death, or when the operation of turn-
ing cannot be performed without violence, and some danger to
the mother; then the knowledge of the spontaneous evolution

82

650 GUIDE FOR WOMEN.
will set our minds at ease, and disengage us from the consideration
of making any hasty attempts to perform a hazardous operation,
from which no possible good can be derived, except that of ex-
tracting a dead child, and which, at all events, might be effected
by a method far more safe to the mother.”
2693. Among the many cases of spontaneous evolution, as it
is termed, in which turning was formerly thought to be indispen-
sable, an interesting one is mentioned by Gooch in the Medical
Transactions of the London College of Physicians. The patient
was a young woman with her first child. The membranes broke,
and an arm descended, protruding its whole length, while the
shoulder pressed forward under the arch of the pubis. Dr.
Gooch says—“I abstained from turning, and sat down by the
bedside, fully expecting what actually took place, the spontaneous
expulsion. Resolved to know what became of the arm if this
should happen, and thus fit myself for a witness on the disputed
point, I laid hold of it with a napkin, and watched its movements;
but so far from going up into the womb when a pain came on, it
advanced so rapidly, that in two pains, with a good deal of mus-
cular exertion on the part of the patient, but apparently with less
suffering than the birth of the head in a common first labor, the
side of the chest, the abdomen, and the breech, passed one after
the other in an enormous sweep over the perineum, until the but-
tocks and legs were completely expelled. The head and remain-
ing arm were still to be extricated, but this was effected with the
greatest ease. The child was dead. The mother had not felt
it move since the previous day, at noon. The cord was without
pulsation, and empty and shrunk, looking as if the blood had not
circulated through it for some time. The side of the chest which
came foremost, was of a green color, having the skin peeled off.”
2696. Here we have ample evidence of what may be accom-
plished by nature, if left to her own resources; and if physicians
would learn to repose more confidence in her powers, and cease
to paralyze her efforts by their deleterious mode of practice, they
would be less amenable to the charges of ignorance and barbarity
which are now so frequently preferred against them.
2697. With regard to turning, if it is resorted to at all, let it
be performed with the utmost caution, and under circumstances
which promise a positive advantage to the mother or child. Dr.
Collins, an eminent writer on midwifery, in commenting upon this
subject, observes, “I know of no operation more truly dangerous,
both to mother and child, than the artificial dilatation of the mouth
of the womb and turning the child; and confident I am, that the
practitioner who adopts such a line of practice, except from strict
hecessity, will often have abundant cause to regret his proceedings.”
GUIDE FOR WOMEN. 651
2698. UMBILICAL CoRD. The umbilical cord, which is usu-
ally about twenty inches long, though sometimes more than double
that length, occasionally comes down in advance of the child, and
if it suffers compression, so as to stop the circulation of blood
through it, the child must inevitably die. It is necessary there-
fore to return it beyond the presenting part, and support it in that
situation until a pain comes on, when, if the child ..., there
is a chance of its being retained. The operation may be per-
formed with the hand, or we may employ a very thin, narrow slip
of whalebone, notched at the end to receive the cord, and covered
with a piece of fine linen or silk, to prevent it from injuring or
irritating the parts with which it comes in contact. It is some-
times necessary to return the cord a number of times before it
will remain. In some instances it may be conveniently suspended
on a leg or an arm of the child, and retained in that manner. If
the cord is flaccid and without pulsation, it is an evidence that the
child is dead, and the labor under these circumstances, may be
allowed to proceed without interruption. The pulsation may
cease during a pain, however, in consequence of the compression
which necessarily takes place, and be resumed after the pain is
Over.
2699, PLACENTA. When the placenta or afterbirth presents,
there is often considerable flooding. This is to be checked by
the usual course of treatment in such cases, which will also have
a tendency to increase the labor pains, and expedite the delivery.
If the flooding is copious, a course of medicine should be given
without delay, but if the discharge of blood is so slight as not to
excite any apprehension, it will be sufficient to keep the patient in a
perspiration by the free use of some stimulating tea, such as com-
position, catnip, ginger, pennyroyal, or raspberry, adding cayenne
and nerve powder as circumstances may seem to require. In-
jections per anum and the vapor bath may also be employed, if
they are requisite, in order to maintain the equilibrium of the
circulation, which is the grand object to be attained in all cases of
flooding or hemorrhage.
DURATION OF LABOR.
2700. This varies according to circumstances. In some
instances it is completed in less than ten minutes, by two or three
brisk pains, while in others it may continue for several hours, or
even days. In the old school practice, twelve hours is consider-
ed a very short period. In the Lying-in Hospital in the Uni-




652 GUIDE FOR WOMEN.
versity of Berlin, a woman was in labor six days and six hours,
and was then delivered without artificial assistance.
2701. A lady of Boston, an advocate of the reformed
practice, not being disposed to employ the necessary reme-
dies, was taken in labor about six months ago, and lingered for
three days in great distress, without delivery taking place. I was
consulted in the case, and directed a tea-cupful of composi-
tion and scullcap tea to be given, succeeded by an injection per-
anum, and the vapor bath. After the bath, the patient was placed
in bed, and a dose of medicine prepared as follows. To a tea-
cupful of composition tea, boiling hot, a tea-spoonful each of
scullcap and green lobelia, and half a tea-spoonful of cayenne were
added. After steeping until sufficiently cool to administer, the
liquid was poured from the sediment, sweetened with sugar, and
given at a single draught. Labor pains succeeded almost im-
mediately, and in five minutes the delivery was accomplished.
2702. If the child is unusually large, and the pelvis small, the
labor will be proportionably tedious, because a greater length of
time is required for the complete dilatation of the parts. Among
the causes of tedious labor, are depression of spirits, fear, a
loaded state of the bowels, weakening the action of the womb by
blood-letting, and giving the patient mineral or vegetable poisons.
A first labor, especially if the woman be somewhat advanced in
life, is generally more tedious than subsequent ones.
TREATMENT DURING LABOR.
2703. If there is any period in a woman’s life when she re-
quires the full possession of her physical powers, it is in the hour
of travail. Hence, instead of depriving her of blood, and destroy-
ing her constitutional energies by the administration of poisons,
her health and strength should be maintained by the use of med-
icines which act in harmony with the laws of the human system.
Such are the agents employed in the reformed practice, and those
who have tested them in cases of midwifery, will bear testimony
to their superior value and efficacy. Dr. Robinson, in some
remarks on this subject, says, “In child-bed delivery, a matter
never to be forgotten, this practice has very nearly removed the
pain and punishment from the daughters of Eve, threatened to
our progenitor, and entailed upon her offspring. A lady of good
sense, and without the least coloring of imagination, said it was
easier to have five children under the operation and influence of
this new practice, than one by the other management and medi-
cine; and she had had experience in both cases, and has been
|

GUIDE FOR WOMEN. 653
supported in the evidence by every one who has followed her
example.” -
2704. I have spoken in a previous place of the necessity of
keeping the bladder as empty as possible, and evacuating the
bowels thoroughly with injections. (2652.)
2705. When labor commences, a tea of raspberry leaves,
adding one or two tea-spoonfuls of cayenne to the pint, may be
given occasionally as a drink, to keep up a gentle perspiration.
The stimulating tea may be employed with still greater advantage,
as it tends to quiet any irritability of the nerves which may exist,
and produces a gentle relaxation of the muscular system, which is
necessary in order to procure an easy delivery. If nausea or
vomiting is present, an emetic should be given to cleanse the
stomach, administering the infusion of lobelia without the sediment.
(1612.) The patient's room should be ventilated before she goes
into it, and the temperature regulated according to the climate or
season. Many a labor has been rendered tedious, by allowing
the woman to become chilled for the want of a fire. If the
patient has an appetite for food, let her partake of some oat meal,
or Indian meal gruel, or any other preparation that will digest
easily, and not oppress the stomach.
2706. Dr. Burns, in his well known work on obstetrics,
remarks, “A fundamental principle in midwifery is, that relaxa-
tion or dimunition of resistance is essential to an easy delivery;
and could we discover any agent capable of effecting this rapidly
and safely, we should have no tedious labors except from the
state of the pelvis or position of the child. This agent has not
yet been discovered. Blood-letting does often produce salutary
relaxation; but is not always to be depended on, neither is it
always safe.”
2707. The agent so earnestly desired by Dr. Burns, is to be
found in the lobelia inflata, which will “rapidly and safely” relax
the muscular system, without laying a foundation for protracted
debility, which must necessarily accrue from blood-letting, par-
ticularly if it be copious. Some remarks on lobelia, with regard
to its relaxing influence, will be found in paragraph 1648.
2708. FALSE PAINs. The character of these have already
been described. (2654.) They may be quieted by an injection
or two (1567) per anum, and a free use of either of the teas
mentioned in the above paragraph, taking it in a sufficient quantity
to produce perspiration. The parts in which the pains are seated,
may be rubbed briskly with vinegar and cayenne, (1531) or the
* Lectures on Medical Botany. Boston, 1838.


654 GUIDE FOR WOMEN.
stimulating liniment, the latter of which is preferable. If the
pains are accompanied with ſever, or other symptoms of severe
indisposition, an emetic, or course of medicine should be admin-
istered.
2709. Rigidity of the ExtERNAL PARTs. If the exter-
nal parts of generation are closely contracted, and void of all dis-
position to dilate, they may be relaxed by the application of cloths
wrung out of water as hot as it can be borne; or the patient may
sit for a quarter or half an hour over the vapor of water; (1499)
or if it is more convenient, she may employ the hip bath, as direc-
ted in paragraph 2493. In the meantime some appropriate tea
should be taken internally, to maintain a gentle moisture of the skin.
By this mode of treatment the parts will become relaxed and soft,
and when the head of the child is expelled, it will not tear or lace-
rate the perineum. If, also, the parts are dry and heated, as fre-
quently happens where they have been irritated by the rude hand
of an officious attendant, the vapor has an equally good effect in
restoring to them their natural secretion or mucus, with which na-
ture intended they should be furnished during the period of la-
bor. (2651.)
2710. LINGERING PAINs. If the labor is tedious, and the
pains have died away, the following may be given with the most
beneficial effect. Take of composition and green lobelia, each a
tea-spoonful; cayenne half a tea-spoonful; sugar any desirable
quantity; boiling water a tea-cupful. Steep in a covered vessel
until sufficiently cool to administer, and pour the liquid from the
sediment, adding one or two tea-spoonfuls of rheumatic drops, or
an equal quantity of the tincture of scullcap. This may be taken
at one dose, and repeated in fifteen minutes, if necessary. I have
never known it to ſail in producing efficient labor pains, and bring-
ing the labor to a speedy and favorable issue.
2711. Where the löbelia is employed in the form of powder,
the infusion only should be administered, for the sediment is liable
to adhere to the mucous coat of the stomach, and thereby keep
up lingering nausea, or vomiting, after the child has been expelled.
2712. The vapor bath is a valuable agent in renewing labor
pains, when they have died away; and in connexion with it, the
following tea may be administered. Take of composition and scull-
cap, each a tea-spoonful; boiling water a tea-cupful. Steep in a
covered vessel, as directed above, strain, sweeten to suit the taste,
and add a table-spoonful of the antispasmodic tincture. This is to
be administered to the patient as she is leaving the bath, or imme-
diately after she is in bed.

GUIDE FOR WOMEN. 655
2713. Dr. Thomson was called to a woman in Greenfield,
Saratoga county, N. Y., who had been in labor ten days, and
whose life was despaired of by her husband and friends. He took
of composition, cayenne, lady’s slipper, and brown lobelia, each a
tea-spoonful; sugar a large table-spoonful; boiling water a tea-cup-
ful. After steeping a sufficient length of time, he poured the
liquid from the sediment, and administered it at a single dose. In
less than fifteen minutes the child was born, contrary to the ex-
pectations of all present, and in a short time the woman was able
to be upon her feet.
2714. FLooDING. This is a discharge of blood from the womb,
caused by a partial or complete detachment of the placenta or aſ-
terbirth, and may occur either before, during, or after labor. When
it is profuse, it is manifested by chilliness, ſainting, pallid counte-
nance, hurried breathing, and great prostration of strength. These
symptoms may occur without any appearance of flooding, and if
there is also a sudden enlargement of the abdomen, we have
every reason to suspect an accumulation of blood in the womb, in
consequence of the mouth or orifice of that organ being closed.
2715. If flooding occurs after the birth of the child, and be-
fore the placenta has been expelled, it is an established rule with
the diplomatised physicians to bring it away by force—that is, by
thrusting the hand into the womb, and scooping or tearing it out
by violent means. This practice greatly enhances the difficulty,
however, for bloodvessels are torn or lacerated which, otherwise,
might have remained uninjured, and the flooding is necessarily in-
creased. Besides, the womb may fail to contract at all, in conse-
quence of the injury which it has received, and under these cir-
cumstances the patient may ultimately bleed to death. If, how-
ever, the placenta was left to be expelled by the natural efforts,
instead of employing force, the womb would contract upon the
bleeding vessels, and thereby arrest the hemorrhage.
2716. Treatment. The principles of treatment in flooding
are the same as in bleeding or hemorrhage from the lungs, (1782,
et seq.) or any other internal organ. The circulation must be
equalized, and then the difficulty will be overcome. If the dis-
charge of blood is but slightly increased beyond what we naturally
expect in cases of labor, we may generally check it by giving
composition, or cayenne and bayberry, until perspiration ensues,
assisting the operation of the medicine by an injection per anum,
and the application of heated stones wrapped in damp cloths to the
feet and sides. If however the flooding is copious, the treatment
656 GUIDE FOR WOMEN.
must be active, or the patient will soon become exhausted, and
probably die. One or two stimulating injections (1567, 1574)
should be given, and lobelia administered in full doses as an
emetic, steeping it in strong cayenne and bayberry tea. The
antispasmodic tincture is the best form of the medicine, as it is
more immediate in its effects. It may be given in the dose of
three or four tea-spoonfuls, and repeated as often as circumstances
require. Heated stones, as already mentioned, must be placed
about the patient, to favor perspiration, and keep up a determina-
tion of blood to the surface of the body. It is also important to
remain in bed, avoiding an erect position, until the flooding
ceases.
2717. FAINTING. This may occur from loss of blood, or
from mere fatigue or exhaustion. In the latter instance, cool air,
sprinkling the . and breast with cold water, the horizontal pos-
ture, and the application of vinegar, camphor, or smelling salts to
the nostrils, are useful remedies. If it is owing to loss of blood,
and the recovery of the patient is protracted, the same treat-
ment may be pursued which is recommended for suspended ani-
mation. (2356, et seq.)
2718. FIT's or CoNvulsions. These, like flooding, may
occur before, or after labor. They resemble those of epilepsy, and
are sometimes extremely violent. The eyes have a glaring aspect,
the mouth foams, the tongue is thrust out, the breathing is laborious,
the skin becomes purple, and the countenance is frightfully distorted.
The fits come on in paroxysms, the intervals between them vary-
ing from a few minutes to two or three hours. They are usually
preceded by symptoms which indicate their approach, such as a
determination of blood to the head, giddiness, ringing in the ears,
headach, cramp or pain at the pit of the stomach, slow pulse,
imperfect vision, or perhaps a total loss of sight. A paroxysm
may last only a few minutes, or it may continue for a quarter or
half an hour. When the patient recovers, she is wholly uncon-
scious of what has passed, and is sometimes left in a stupid or
insensible condition. Convulsions are frequently caused by eating
indigestible food, and taking frequent draughts of cold water, or
any other cold drink, while the general system is in a weak or
feeble condition.
2719. Treatment. The treatment to be pursued in con-
vulsions, has already been detailed under that head, in the alpha-
betical list of diseases, to which the reader is referred. (1888,


GUIDE FOR WOMEN. 657
et seq.) I may add, that if symptoms indicating a paroxysm are
observed, the attack may be prevented by taking an emetic of lo-
belia, or if necessary, a full course of medicine.
TYING AND CUTTING THE NAVEL STRING.
2720. “Perhaps the changes,” says Dr. Denman, “which
take place in the body of the child, immediately after its birth, are
not perfectly understood at this time. We know, however, if the
child is in a healthy state, that it usually cries lustily and continu-
ally when the air rushes into its lungs, which are thereby expand-
ed. This cry, which does not seem to be occasioned by pain,
but surprise, is in its consequences extremely important, as it is
the cause of an exertion of all the powers of the child, and ena-
bles it to acquire a new manner of living, inconsistent with, and
very different from, that which it possessed before it was born.
But the change from uterine life, as it may be called, to breathing
life, is not instantaneous, but gradual; and the uterine life contin-
ues till the breathing life is perfected, as is proved by the continu-
ance of the circulation between the child and the placenta for some
time after it has cried. As the breathing life becomes perfected,
the uterine life gradually declines, and the manner of its declension
may be proved by attending to the pulsation of the navel string,
which first ceases at the part nearest the placenta, and then, by
slow degrees, nearer and nearer to the child, till at length it en-
tirely ceases; so that the whole of the circulating blood ultimately
resides in the body of the child; and the navel string, which was
before turgid, becomes quite flaccid. It seems reasonable to be-
lieve, that the continuance of uterine life after the birth of the
child was designed for its preservation from the accidents of its
state at that time, should the acquisition of its breathing life be by
any course retarded or hindered. If, then, the practice of tying or
dividing the navel string the instant the child is born be followed,
though it were before vigorous, it will in some cases immediately
decline, and never acquiring its perfect breathing life, may in a
short time die; or if the child were in a feeble or dubious state,
possessing only that life which it had during its residence in the
uterus, as by tying and dividing the navel string that life is de-
stroyed before the breathing life is acquired, it must inevitably
perish. We may therefore safely conclude, that the navel string
of a new-born infant ought not to be tied or divided till the circu-
lation in it has ceased spontaneously; nor would the child suffer,
though the cord was never tied, if it was not divided.”
2721. The pulsation in the navel string usually ceases in ten

83

658 GUIDE FOR WOMEN.
or fifteen minutes, when it is to be tied with two ligatures, one of
which is to be placed an inch and a half from the body of the
child, and the other about three inches, severing or cutting the
cord midway between the ligatures with a pair of sharp scissors.
The child is then to be given to the nurse to be washed and
dressed. Denman says, “It was formerly the custom to divide
the umbilical cord under the bedclothes; but having once known
a very deplorable accident from this cause, I make it a general
rule decently to withdraw the child, that I may have an oppor-
tunity of seeing how I perform the operation.” With regard to
the ligatures, they may consist of eight or ten strands of thread,
or sewing silk, and the one nearest the child should be drawn
tolerably tight, to prevent accidental hemorrhage. Nevertheless,
this has been known to occur, from shrinking of the cord, and
then a new ligature must be applied, or the old one tightened. I
will add, that when the ligature is applied in the first instance,
care should be taken not to include the intestines, for they some-
times protrude into the cord, constituting a hernia, and the liga-
ture, if suffered to remain, may produce fatal consequences.
TWINS.
2722. It is estimated that twins occur once in about every
hundred labors; and in a very few instances, a woman gives birth
to three, four, or even five children. If, after delivery has taken
place, the abdomen still continues hard, and nearly of its usual
size, we generally conclude that there is another child; but on the
other hand, if the abdomen is soft or flaccid, excepting, perhaps,
just above the pubis, where the hard, contracted womb may be
felt, we infer that there is nothing to be expelled but the placenta
or afterbirth.
2723. In the event of twins, we are to superintend the deliv-
ery of the second child, precisely as though the first had not been
born, leaving it to be expelled by the natural efforts, and making
use of composition, enemas, emetics, and the vapor bath, as they
may be needed, to prevent flooding, fainting, convulsions, and all
other alarming symptoms. Dr. Gooch says, “I have compared
notes with those who make it a rule to extract the second child
immediately after the birth of the first, and I find that they are
often embarrassed by irregular contraction of the womb and hem-
orrhage; neither of which will happen if the womb is left to expel
every part of the child. With respect to the position of the sec-
ond child, if the presentation is not natural, the same mode of
treatment will be required as if there were only one.”

GUIDE FOR WOMEN. 659
2724. The placenta is not to be disturbed after the birth of
the first child, for it will not interfere with the delivery of the
second; and any attempt to remove it may endanger the life of
the mother by hemorrhage.
MANAGEMENT OF THE CHILD.
2725. As soon as the infant is born, its mouth is to be cleans-
ed from the mucus or slime with which it is often obstructed, so
that the air may have free access to its lungs. Many children
may be saved, says Dr. Dewees, by a proper attention to this cir-
cumstance. If the mucus is very thick or tenacious, it may be
withdrawn by means of a fine dry rag, introducing it into the back
part of the mouth with the finger.
2726. The body of the infant also, is sometimes covered with
a slimy substance, which cannot be more effectually removed than
by rubbing a little sweet oil or butter over the surface, and wash-
ing it with warm water and Castile soap until it is perfectly clean.
2727. The proper manner of dressing a new-born child, is
º too familiar with every nurse to require any directions
rom me. Its clothes must be in proportion to the season, and
sufficiently loose to allow of a free circulation of blood in every
part of the body. It should not be wrapped up so as to smother
it, nor should the clothes be insufficient to keep it warm and com-
fortable. Many a child has perished from the carelessness of the
nurse in allowing it to become chilled.
27.28. Pure air is very important, not only to the child, but
the mother. Hence the necessity of occasionally ventilating the
room which they occupy. An infant frequently dwindles away in
consequence of a vitiated atmosphere, without the cause of the diff-
culty being suspected. About fifty years ago, according to the Phi-
ladelphia Journal of Health, 2944 infants out of 7650 died within
a fortnight after their birth, in the Lying-in Hospital at Dublin, in
consequence of an insufficiency of pure air. A majority of them
expired in convulsions, and in many instances the jaws were locked,
and the face livid and bloated. The rooms were ultimately en-
larged and more fully ventilated, and the mortality diminished in
the proportion of one to three.
2729. It is recommended not to admit a strong light to the
face of an infant, lest it should acquire the habit of squinting.
2730. The sooner the child is put to the breast the better,
even though it should be within an hour after its birth; for this
will excite the secretion of milk, and lessen the danger of sore
nipples, and other complaints of the breast. Besides, the first

660 GUIDE FOR WOMEN.
T-
milk of the mother seems to have been designed by nature to
cleanse the bowels of the inſant of the mecomium or greenish
matter which they contain at birth. If this substance remains an
undue length of time, it causes irritation and disease. Neverthe-
less, it is improper to give castor oil, or any other purgative, with
a view to its removal. If there is no evacuation from the bowels
in the course of twenty four hours, an injection of raspberry tea,
milk warm, may be administered with a small syringe. A tea-cup
one third full will be sufficient, and if necessary, the injection may
be repeated. An occasional tea-spoonful of poplar bark tea,
sweetened, may be given by the mouth, which will have a ten-
dency to move the bowels in a gentle and natural manner.
2731. If there is a retention of urine, which occasionally
happens, an infusion of cool wort, or of water melon seeds, may
be given with advantage. A cloth wrung out of warm water, and
laid over the abdomen, will often produce a discharge of urine.
2732. Raspberry tea, sweetened, with the addition of one
third part milk, which has been previously boiled, may be given
with benefit to infants soon after their birth. It improves the
health, and appears to counteract any tendency which there may
be to sore mouth.
2733. In giving either medicine or food to an infant, however,
it should be remembered that its stomach, at birth, is no larger
than a hen's egg, and is therefore easily overloaded.
2734. If the child is in a diseased or morbid state, it should
have an emetic of lobelia, and this may be given with the happiest
effect, even though it is not a day old. The emetic may be
prepared by steeping half a tea-spoonful of green lobelia, and a
tea-spoonful of sugar, in one third of a tea-cupful of hot raspberry
tea. The infusion, when of a proper temperature, may be given
in the dose of a tea-spoonful, and repeated every fifteen minutes
until it operates.
MANAGEMENT OF THE PLACENTA.
2735. Soon after the delivery of the child, the labor pains are
renewed, and the placenta or afterbirth" is expelled. This usually
takes place in fifteen or twenty minutes, and is rarely deferred
beyond half an hour. If the pains are feeble, they may be quick-
ened, in many instances, by grasping the abdomen, in the region
of the womb, repeatedly in the hand, and if pains are induced, the
womb will be felt beneath the hand contracting into a hard mass
* Called also secundines.
Guide for women. 661
or tumor. The placenta, as a general thing, will then be ex-
pelled, together, in some cases, with a considerable quantity of
blood, which has been retained in the womb, but this need not
excite any alarm.
2736. Medical men not only injure or destroy their patients
by forcing the delivery of the child, but also by violently extract-
ing the placenta. They tear or rupture numerous blood-vessels,
occasioning dangerous or fatal hemorrhage, and not unfrequently
produce inversion of the womb, which is one of the most deplorable
and melancholy accidents which could befal the unfortunate woman.
Nay, they sometimes tear away the womb itself, under an impres-
sion that it is the afterbirth. A case of this kind occurred about
two years ago in New York, in the person of a Mrs. Cozzens,
who was attended in her labor by Dr. Septimus Hunter, a regular
bred, diplomatised physician. After the birth of the child, which
took place without any difficulty, he proceeded to extract the
placenta by force, “pulling with both his hands,” the woman in
the meantime screaming in the greatest agony, and declaring that
he “was tearing out her heart.” After laboring diligently for
nearly half an hour, he brought away what he termed a “false
conception,” but which in reality was the womb. The patient
died several minutes before he had finished the brutal operation.
It cannot be said, in extenuation, that he was ignorant of the prac-
tice of midwifery—at least, not more so than his professional
brethren, generally—for he studied medicine with his father, who
was an English surgeon of some eminence, went to London at the
age of manhood, to practice in one of the hospitals, engaged after
that in the practice of surgery, to which he devoted himself for
four or five years, and then emigrated to New York, where he
had been employed seven or eight years as a physician, previous
to being called to the case of Mrs. Cozzens.
2737. Dr. Hunter was arrested and put upon trial for the
murder of his patient. The jury brought in a verdict of “gross
ignorance,” but on being told by the Court that such a verdict
was not a legal one, they returned a verdict of manslaughter in
the fourth degree, strongly recommending the prisoner to mercy.
He was then sentenced to one year’s imprisonment in the pen-
itentiary, without any fine being imposed. Thus it will be seen
to what an extent our juries and Courts of justice are disposed to
favor those who commit murder under the sanction of a diploma.
2738. Dr. Denman observes, that “the introduction of the
hand into the womb for the purpose of bringing away a retained
placenta, is often mentioned in writings and conversation as a
slight thing; but I am persuaded that every person, who attends to


662 GUIDE FOR WOMEN.
the consequences of the practice, will think it of importance, and
that, if possible, it ought to be avoided.”
2739. Professor Channing told his class, that some physicians,
when hurried with business, would tear the placenta away, causing
the patient, as he had often seen, a great deal of suffering and
misery. -
2740. An English writer on obstetrics forcibly observes,
“When we have seen a child safely expelled by a process regu.
lated by the greatest wisdom, there seems to be no reason why
we should be apprehensive of error or inability in those powers for
the separation or exclusion of the placenta, which is but an in-
ſerior or secondary part of the same process.”
2741. No danger need be apprehended from retention of the
placenta. A physician of Dublin, whose name I now forget,
published the report of a case in which the placentas of twins
remained undelivered for six weeks, and then came away in a
natural manner. Denman says, “I once saw an instance of a
whole placenta retained till the fifteenth day after the birth of the
child, and then expelled with little signs of putrefaction.” Some-
times the placenta adheres so firmly to the womb as to prevent its
separation, even by a great degree of force, but by waiting a few
days, or perhaps a week, its detachment will take place without
trouble or difficulty.
2742. The reason assigned by medical men for the removal
of the placenta by force, is, that if suffered to remain beyond a
certain time, it may occasion inflammation, flooding, convulsions,
or some other dangerous or alarming symptom; but it is well
known to every person sufficiently acquainted with the reformed
practice, that these evils, which the diplomatised physician has
so much reason to dread, may be prevented by appropriate treat-
ment, always remembering, in doubtful or critical cases, to admin-
ister a thorough course of medicine. . . .
2743. Stimulating injections (1567) per anum, by the indirect
influence which they exercise over the womb, are of great value
in bringing away a retained placenta. I have known a single
injection to produce the desired effect in one or two minutes, even
in very obstinate cases. Sometimes the placenta is low down in
the vagina, and may be withdrawn by a gentle movement of the
umbilical cord. Unless it is completely separated from the
womb, however, and may be felt with the fingers within the vagina,
it is hazardous to pull at the cord, particularly in the absence of a
pain, for there is danger of inverting the womb, which, as I have
said, is one of the most lamentable accidents that could befal the
patient. -
2744. Dr. Gooch says, “Do not separate the placenta from
T
GUIDE FOR WOMEN. 663
its attachment to the uterus, but remove it with as little force as
possible when already separated and almost expelled by the ac-
tion of the uterus. By acting thus, you will in most cases prevent
those perilous circumstances which may attend the separation of
the aſterbirth. But if you deviate from this rule, you hazard two
principal dangers; one, the inversion of the uterus; the other,
hemorrhage; either of which may terminate in death. On passing
your finger up the vagina after the birth of the child, you may feel
nothing but the bare cord; the placenta is then high up, and at-
tached to the fundus uterior top of the womb : if you now pull it
away by force, you will leave the mouths of the vessels of that
part of the uterus open, to which the placenta was attached, and a
frightful hemorrhage will ensue; or you will invert the uterus.
When the uterus is contracted you cannot invert it; but if it is
flaccid and soft, it is as easily inverted as the finger of a glove;
and if while in this state you extract the placenta with force, you
may cause the death of the patient.”
2745. If the health becomes impaired during the retention of
the placenta, medicines are to be employed according to the cir-
cumstances of the case.
2746. If symptoms indicating internal hemorrhage should oc-
cur, (2715) active and energetic treatment must be adopted, ad-
ministering a thorough course of medicine, and making free use
of lobelia, cayenne, and enemas. The writer from whom I quo-
ted in the preceding paragraph, says, “Not long since I was
requested to attend at the examination of a female who had died
soon after delivery. The labor appeared to have terminated fa-
vorably, and the accoucheur had left her. Soon afterwards she
became pale and ſainted. He was immediately sent for, but just
as he arrived she expired. There was no external discharge of
blood; he knew not to what so fatal a change could be imputed.
As soon as we entered the bed-room to make the examination,
we perceived that the abdomen was much above the level of the
body, and appeared as prominent as that of a woman seven months
gone with child. The uterus, on exposure, was seen to be enor-
mously distended ; and though there was no external evidence of
hemorrhage, on cutting into it we found a mass of coagulated blood,
amounting to a gallon. The hemorrhage in this case occurred aſ-
ter the extraction of the placenta; but it most frequently happens
when this body is lodged in the mouth of the uterus and upper
part of the vagina, where it acts like a plug, by which the effused
blood is confined within the cavity of the uterus.”
2747. It occasionally happens that a portion of the placenta
remains in the womb, giving rise, as soon as it begins to decom-
pose, to offensive discharges; and in that case, injections per vagi-



664 GUIDE FOR WOMEN.
nam should be used several times a day, to keep it perfectly clean.
(2492.)
2748. In case of twins, both placentas are usually discharged
together, after the birth of the second child.
MANAGEMENT OF THE MOTHER.
2749. It is not necessary to say much upon this subject, for
every sensible woman who has made herself acquainted with the
new practice, will know how to manage her own case. For a
disordered stomach, she will take an emetic ; for serious ill health,
a course of medicine; for costiveness, an injection daily, or some
other appropriate remedy; for loss of appetite, or imperfect di-
gestion, a dose of poplar bark, spiced bitters, or some other tonic,
before each meal; and for chilliness or shiverings, composition
and the vapor bath. -
2750. If there is soreness of the abdomen, back, or hips, the
affected part may be rubbed with the volatile, or stimulating lini-
ment, and a heated stone wrapped in a damp cloth applied.
2751. If the breasts are hard and painful, they may be treated
according to the directions in paragraph 2576.
2752. After pains, as they are termed, may be either prevent-
ed or greatly mitigated by keeping the patient in a gentle perspira-
tion for several hours after delivery. The stimulating tea may be
used with great advantage for this purpose.
2753. Watery or greenish discharges frequently take place
from the vagina for three or four days after the birth of the child,
and in some instances they are not only offensive, but so acrid
as to excoriate the skin with which they may come in contact.
The difficulty may be obviated by injections per vaginam, which
should be administered several times a day. (2492.)
2754. For a day or two after delivery, particularly if the
digestive organs are in a weak or feeble condition, the patient
should confine herself to liquid nourishment, such as the unbolted
wheat meal gruel, or any similar preparation mentioned under the
head of food for the sick. Solid aliment should be avoided, until
the stomach has acquired sufficient tone to digest it without ex-
citing unpleasant sensations in that organ. A lady of New York
ate freely of a lobster six days after confinement, and though her
health was tolerably good at the time, she was a corpse in less
than three hours. -
2755. It is a fact well worthy of notice, that fluid nourish-
ment, such for example as mush and milk, will increase the secre-
tion of milk much more rapidly than solid food. “If the woman

GUIDE FOR WOMEN. 665
goes to bed taking a cold supper only,” says a writer on the
subject, “little or no milk will be secreted; but if she has taken
a supper of two thirds milk and one third barley water, constitu-
ting what is called barley gruel, the milk will spout from the
breasts during the night. If therefore, the secretion of milk is
slow and scanty, give her sufficient fluid nourishment.”
2756. As soon as the patient begins to make use of solid
food, the wheat jelly, or unbolted wheat bread, should constitute
* part of her diet, as this will serve to regulate the bowels.
1898).
2757. The patient should beware of blood-letting and the use
of purgatives, for they very soon diminish the secretion of milk.
Let a woman be purged briskly every other day, and it will not
be long before her breasts are almost emptied of milk. This fluid,
also, which nature no doubt intended for the exclusive nourishment
of the child, is rendered impure or unwholesome by poisonous
drugs. It is well known that an infant may be salivated, by putting
the mother under the influence of mercury during the nursing
period. Disease also has an influence upon the milk, as medical
authors have abundantly proved. Dr. Eberle, in his work on the
Nourishment of Infants, says, “It is manifestly the design of
nature, that the infant should draw its food from the mother's
breasts; it is reasonable to presume that this design cannot be
contravened, without subjecting both mother and infant to an
increased liability to injurious consequences. It can scarcely be
doubted that the mother's milk is, in general, better adapted to the
constitutional temperament of her offspring, than that furnished by
others. Besides, when the suckling of the infant is submitted to
a nurse, it is liable to various sources of injury and disorder which
are in a great degree, if not entirely obviated, when this important
duty is performed by the mother. . . . * * The child, also,
runs much more risk of receiving bad and unwholesome milk,
when suckled by a hired nurse, than when the office is performed
by the mother herself. I have known several instances of most
serious injury inflicted on the child’s health and constitution in
this way. That syphilis may be, and has been communicated
through the milk of the nurse, I have not the smallest doubt; and
the communication of other loathsome diseases by nurses to their
nursling, such as itch, and tetter, is by no means uncommon.
But even where no specific disease of the kind is contracted, the
general health and constitution are often permanently injured by
the unwholesome or uncongenial character of the milk furnished
by the nurse. When the milk of the nurse is of a bad quality, it
usually produces very obvious disturbance in the digestive organs
of the infant. The stomach and bowels become weak and irri-
84
666 GUIDE FOR women.
table. The child vomits frequently, or is harrassed by painful
and watery diarrhoea. It becomes restless, fretful, and peewish;
its flesh wastes and becomes flabby; its countenance assumes a
distressed, pale, sickly aspect; its sleep is disturbed by sudden
starts; it often cries out suddenly, as if in violent pain; and in
most instances, fatal irritation, and effusion in the brain, finally
ensue, and terminate the infant’s sufferings.”
STILL-BORN chi L.D.
2758. When a child is still-born, the first thing to be done
is to introduce a dry rag into the back part of its mouth, (2725)
and remove any slime or collection of matter with which it may
be blocked up, so that the air may pass freely into its lungs.
2759. Applying vinegar, camphor, or smelling salts to the
nostrils of the infant; slapping it gently on the buttocks and soles
of the feet with the open hand; or sprinkling it with a little cold
water, and blowing strongly into its face, have each been recom-
mended as a means of awakening the dormant powers of life.
2760. A tea-spoonful of weak composition tea may be poured
down its throat, and three or four ... of the same
administered by injection, with a small syringe adapted to the
purpose. Raspberry tea, milk warm, with five or six drops of
the antispasmodic tincture, makes a very good injection; and by
repeating it several times, and wrapping the child in warm flannels,
. may be ultimately restored. The particular advantage of
injections, is, that the impression which they make upon the
bowels, may be communicated through the nerves to the heart,
and thereby rouse this organ into action.
2761. When the placenta comes away with the child, it has
sometimes been the practice to place the former upon embers,
and as it became heated, to strip the umbilical cord towards the
body of the child, until it was supplied with a sufficient degree of
heat to expand its lungs. Dr. Thomson mentions a case of this
kind, in his Guide, in which he leaves his readers to infer that he
was the original discoverer of this mode of pratice, but like many
other of his reputed discoveries, it was known long before he
was born. Dr. Denman says, “It seems to have been a
practice with the ancients, to wait for a certain time after the
birth of the child for the exclusion of the placenta, before the
navel string was tied or divided; and if the child was born appar-
ently dead, or in a very feeble state, the placenta, when expelled,
was laid upon its belly, as a restoring or comforting applicatiºn:
When the child revived but slowly, or when the signs of life


GUIDE FOR WOMEN. 667
declined, it became a custom to lay the placenta on hot embers,
or to immerse it in hot wine; and the heat thereby conveyed was
supposed to stimulate the weak or decaying powers of life to more
vigorous action.”
3762. If the skin is pale and cold, the child should be wrap-
ped in warm cloths or flannels, so that it may not lose the little
animal heat which it possesses, and rubbed briskly from head to
foot with the hand. Injections should also be administered, as
directed in a preceding paragraph. Immersing the child up to
the neck in water about blood warm, has been tried in many in-
stances with success. A still better mode of applying external
heat, however, is to lay the infant upon a soft mattress, or pillow,
cover it with a light quilt or flannel of sufficient dimensions, ex-
cepting its face, and place a heated stone wrapped in a damp cloth
near the child, beneath this covering. The warmth which is thus
generated, will rarify the surrounding atmosphere, and tend to re-
cal the blood to the surface of the body. (See paragraph 2356.)
The external heat must be increased gradually, or it may interfere
with the success of the experiment.
2763. “When respiration is not commenced immediately on
the birth of the child,” says Dr. Gooch, “you must excite the
action of the respiratory muscles, taking care in the meantime that
the child’s animal heat be not lost. These intentions are fulfilled
by inflating the lungs, and by putting the child into a warm bath.
During the first five minutes after its birth, the heat of the child is
not likely to be much diminished, therefore first inflate the lungs.
This may be done either by placing the mouth to that of the in-
fant, and blowing into it, or by blowing through a tube, or by
means of a small pair of bellows. If you attempt the inflation of
the lungs through the mouth, you first stop both nostrils, and press
the thyroid cartilage gently back against the oesophagus, to pre-
vent the passage of air into the stomach. If you employ the bel-
lows, the proceeding is the same, with the exception that the pipe
of the bellows is to be adapted to one nostril, while the other, as
well as the mouth, is closed. The lungs are to be inflated slowly,
and then press the chest, in order to expel the air. These ope-
rations are to be performed alternately, so as to imitate, as nearly
as possible, the natural inspiration and expiration. If in three
or four minutes the child does not exhibit the customary signs
of animation, immerse it in a warm bath of ninety six degrees,
* The first edition of Denman's work, be it known, was published before
Thomson ever wrote.
# This is a projection of the throat, and is known, in common language, as
.Adam’s apple. It is more prominent in men than in women.

668 GUIDE FOR WOMEN.
and go on stimulating the powers of respiration in the manner
just described. In five or ten minutes the child will generally be
restored by this proceeding; but if your exertions are not suc-
cessful within this period, you must persevere for half an hour, or
longer.”
2764. I should not be disposed to use the bellows to inflate
the lungs, as the introduction of cold air into these organs may
render the experiment unsuccessful; but there does not appear to
be the same objection to blowing through a tube with the mouth,
for the breath of the operator possesses a certain degree of
warmth.
2765. In attempting to recover a still-born child, we should
not relax our efforts too soon, as infants are sometimes lost, which,
by a little more perseverance, might be saved. A physician in
London was endeavoring to restore a still-born child, and after
a long and fruitless effort, gave up the task, and the child, wrap-
ped in a flannel, was laid in a basket, and placed in a closet. In
the evening he called to see the mother, and saw the nurse with
a young child in her arms, which, he was surprised to hear, was
the one which he had laid away so carefully as dead. The
nurse told him that a noise was heard in the closet about an hour
after he had left, and opening the closet door, she saw the child,
greatly to her astonishment, kicking about in the flannel.
DIFFICULT LABOR.
2766. The diplomatised physicians, in their works on mid-
wifery, have divided labors into the “difficult,” the “preternatu-
ral,” the “anomalous or complex,” and so on to the end of the
chapter; but the difficulties which they encounter are no doubt
principally owing to their own mismanagement. If a woman is
taken in labor, they commence their operations by thrusting the
hand into the vagina, and boring their fingers into the mouth of the
womb; this produces local irritation, and sooner or later the
whole system becomes affected. Fever, or inflammation is now
developed, and as a remedy for this newly created disorder, the
woman is purged, bled copiously, and dosed with a variety of poi-
sons. In the course of the treatment, also, she is frequently stu-
ified with narcotics. She becomes weak and exhausted, and
er pains die away. The ergot or spurred rye (555, et seq.) is
then given, which throws the womb into violent spasmodic action,
threatening the organ with laceration, and causing the patient to
it London Practice of Midwifery.
GUIDE FOR WOMEN. 669
scream in the agony of her pains. Professor Bigelow says, “It
is impossible for a woman to rest, or sometimes even to breathe,
under the influence of this potent drug.” Professor Channing, in
some remarks on the same subject, said, “We often fear the womb
will be torn by the violence of the contractions which we our-
selves have occasioned.” The child, under these circumstances, -
is almost invariably killed ; and if it is not expelled during the
continuance of the pains which have been excited by the ergot,
the womb becomes insensible to the effects of the poison, and the
woman is told that she cannot be delivered without the aid of in-
struments. Force is then employed, or some horrid operation
performed, and in too many instances she ultimately pays the
forfeit of her life. Here, then, is the origin of “ difficult”
labors, and the wonder only is, considering the subject in all its
bearings and ramifications, that they are not multiplied in a ten-fold
degree.
2767. Denman lays down the principle, that “all the difficul-
ties attending labor may be reduced to two kinds; first, those -
which arise from the imperfect action of the womb ; second, those
which are occasioned by the resistance made to that action when
duly exerted.” Now the principal difficulty is without doubt a
feeble action of the uterus, and this is to be obviated by the use of
medicines which will sustain and invigorate the patient, and not by
the abstraction of blood, or the administration of poisons, which
can have no other effect than to weaken or paralyze the constitu-
tional powers. The womb acts with almost incredible power in
time of labor, and if not injured by an officious examination, or
weakened by maltreatment of the patient, will be found entirely
adequate to the delivery of the child. Nay, we are told of instan-
ces in which the child has been expelled by its contractions several
hours after the death of the mother. Professor Gallup mentions
the case of a woman, in whom the action of the womb “expelled
a full-grown child eight hours after she was laid away as dead.”
2768. A story is related by Dr. Channing, which proves that
a woman, if left to herself, may often be delivered naturally, not-
withstanding she has suffered the greatest agony at the hands of
her medical attendants. “I was called,” said he, “to a case of
arm presentation, in the country. Three physicians had succes-
sively abandoned the woman, but the fourth, poor fellow was
still in attendance, and almost worn out. One of the physicians,
as I was informed, had cut away the right shoulder; another the
left shoulder; and a third had removed the collar bone. The
woman expressed a wish not to be handled any further, and said
* Gallup’s Institutes.
—


670 - GUIDE FOR WOMEN.
she was anxious to die. I found that the womb was quiet, because
it had been worn out, and knew that after a sufficient interval of
rest, it would begin to contract. This very soon took place, and
in a short time after my arrival, the child was delivered.”
2769. Another story of a similar character is related by Dr.
Channing. “An old physician whose name I forget,” said he,
“used to speak in his conversation of a lady whom he had attend-
ed successfully in a number of labors; but at length she saw fit to
engage the services of her nephew, a young physician, whom she was
desirous of patronizing. When the time arrived for his attendance,
he officiated to the best of his knowledge, but not succeeding as
the lady desired, she despatched a messenger in great haste for
her old physician. When he arrived, he found the young man
with his coat off, his sleeves rolled up, and his hands bloody,
holding in them a pair of forceps. The old gentleman told him
very calmly to wash his hands, and put on his coat; that it was
not best to hurry matters; and in a short time the woman had two
or three brisk pains, and was delivered by the natural efforts.”
2770. With regard to the mutilation of children in utero,
there now appears to be a disposition to punish such atrocities.
A man in France, whose arm had been cut off previous to his
birth, instituted an action against the physician who performed the
operation, claiming heavy damages, and succeeded in procuring a
pension adequate to his support during life.
2771. Professor Dewees mentions the case of a woman, in
whom the mouth of the womb could not be discovered by her
physicians, and “it was agreed in consultation, that as there was no
outlet to the organ, one should and must be made.” Accordingly,
a knife was plunged into the womb, and the child extracted through
the orifice. The woman recovered from the wound, and was sub-
sequently delivered naturally—a clear proof, says Dr. Dewees,
how unnecessarily the operation was performed !”
2772. Dr. Francis of New York records the case of a woman
in that city, who was married when she was fourteen years old,
and at the age of fifteen, or thereabouts, gave birth to a living child,
weighing seven pounds, by the natural pains. There is nothing
extraordinary in this however, excepting as a part of her general
history. In the course of the following seven years, she became
pregnant seven times, and with one exception, when she miscarried,
was delivered by murderous instruments—three of her children
having been killed. At her last delivery, she complained that
some injury was done her; yet, notwithstanding, within little more
than two years, she bore a healthy child by the natural pains;
* Dewees’s Baudelocque.
GUIDE FOR WOMEN. 67.1
and on the 28th of June, 1815, she was again delivered of a
healthy, well formed infant, in a natural manner. “ This wo—
man,” says Dr. Francis, “in her first and two last labors, bore
healthy children of the common size, by the natural pains, a man-
ifest proof of a well formed pelvis, and affording the strongest pre-
sumption that the same management might have conducted her with
equal success through the labors of the intermediate period, during
which, from causes not necessary to be assigned, instruments
were unnecessarily made use of in sia, successive births, and THREE
HUMAN BEINGS DESTROYED !”*
DISEASES SUBSEQUENT TO LABOR.
CHILDBED FEVER.f
2773. This malady usually makes its appearance four or five
days after delivery, commencing with chilliness or shivering, suc-
ceeded by a hot skin, thirst, and other symptoms of fever.
There is a fixed pain in the abdomen, with swelling and great
tenderness on pressure, indicating a high degree of inflammation in
the bowels. Sometimes the patient cannot even bear the weight of
the bed-clothes on the abdomen. The inflammation may be con-
fined to a small portion of the bowels only, or it may be extensive,
involving the womb, and other adjacent parts. The tongue is
mostly dry, and covered with a white, or brown coat. Short
and hurried breathing, nausea, vomiting, anxious expression of
countenance, and pains in the back, hip, and lower extremities, are
common symptoms. The milk is altered in taste and appearance,
and either diminished in quantity, or entirely dried up.
2774, Childbed ſever is rarely to be met with in the reformed
practice, but is both frequent and fatal in the ranks of the med-
ical faculty. Indeed, they acknowledge that it often destroys two
thirds of their lying-in patients; and Gooch says, “ some years
ago, at the Westminster Hospital, its ravages were such that they
buried two in a coffin, in order to conceal from the public as fai
as possible, THE EXTENT OF THE MoRTALITY'
* Francis's Appendix to Deuman. # Puerperal fever.




672 GUIDE FOR WOMEN.
2775. The diplomatised physicians assert, that the disease is
propagated by some contagious influence, and that “the infection
may be carried from one patient to another on the clothes, not-
withstanding a journey in the rough wind of six or eight miles.”
Gooch, who was a convert to this doctrine, acknowledged that he
“kept a suit of clothes expressly for visiting his contaminated
patients.” A much better mode of obviating the difficulty, how-
ever, would be to treat childbed women as though they were
human beings, avoiding the abstraction of blood, or the adminis-
tration of poisons; and above all, never to interfere with the pro-
cess of labor, either by thrusting the hand into the vagina, or
womb; dragging away the child with instruments; or extracting
the afterbirth by force. If Dr. Gooch, and his adherents, will
adopt these precautions, they may rest assured that they will
never have occasion to change their clothes when they visit a
patient with this malady.
2776. TREATMENT. If the attack is slight, the bowels may
be evacuated once or twice a day with injections; and composi-
tion tea administered sufficiently often to keep up a gentle perspi-
ration, placing a bottle of hot water wrapped in a damp cloth at
the feet. If the case is violent, a course of medicine will be re-
quired, and this is to be repeated as often as the unfavorable symp-
toms return. An injection once an hour between the courses,
will be of essential service in counteracting the undue determina-
tion of blood to the bowels, and maintaining the equilibrium of the
circulation. If the abdomen is painful and swollen, applications
may be made to it as directed in paragraph 2095. As soon as
the disease is subdued, the bitter or restorative medicines are to
be employed.
swell ED or Milk leg. *
2777. If the patient has neglected her health, or has been
improperly treated during confinement, this complaint is liable
to occur within a week or fortnight after delivery, commencing
with a slight degree of swelling in the limb, some increase of heat,
and general ſeverishness. In some instances the disease is usher-
ed in by chilliness or shiverings. The .."; generally in-
creases rapidly, so that in the course of twenty four hours, the
entire limb from the toe to the groin, is greatly enlarged. It is of
a white and polished appearance, painful on being moved, hard to
*Phlegmasia dolens.
guide for women. 673
the touch, and when pressed with the finger, leaves no indentation,
as in the case of dropsy, and some other swellings. Improperly
managed, the disease is apt to be protracted, the limb remaining
in a stiff, weak, painful and somewhat swollen condition for months,
and even years.
2778. TREATMENT. If the attack is violent, a course of
medicine should be administered, repeating it according to the
severity of the symptoms; and when the fever is entirely subdued,
the patient is to be strengthened by the use of spiced bitters, or
some other tonic, with an occasional dose of composition. If
the bowels are costive, they should be evacuated once or twice a
day with injections. The limb should be steamed for half an
hour or an hour every night and morning, by means of the hip
bath, (2493) or in any other convenient manner, and rubbed
briskly afterwards with the stimulating liniment, or a mixture of
vinegar and cayenne. (1521.) It is then to be swathed in flan-
nels to keep it warm, and a bottle of hot water wrapped in a
damp cloth placed at the foot. By this treatment, in addition to
courses, provided they are necessary, the swelling will soon sub-
side, and the patient recover her health.
2779. The disease is sometimes accompanied by an offen-
sive discharge from the vagina, and in that case it should be
cleansed with injections, which may consist of raspberry, bay-
berry, or witch hazel tea, adding half a tea-spoonful or more of
rheumatic drops.
SO RE NIPPL ES.
2780. The nipples become extremely sore in some instances,
and bleed whenever the child is applied to the breast. They are
to be protected from the air, and washed after nursing with an
infusion of some vegetable astringent, such as raspberry, witch
hazel, sumach, or bayberry. An infusion of the latter, with an
equal part of the tincture of balm of Gilead buds, (1039) is an
excellent wash. A rag several times folded and spread over
with meadow fern ointment, or moistened with the tincture of fir
balsam, may be applied to the nipple with great advantage.
While the child continues to nurse, however, there is more or less
difficulty in effecting a cure, unless the woman should employ
nipple shields. These are made of wood, glass, ivory, and metal,
and are placed over the nipple so that the child may suck without
doing it any further injury. Employed with jūdgment, they
answer an excellent purpose. They may be purchased in any of
the principal towns or cities.

85

674 - GUIDE FOR WOMEN.
SWELLED BREAST.S.
2781. This complaint is produced by a variety of causes,
such as exposure to cold, local injuries, pressure from tight
clothes, and checking the flow of milk at too early a period.
The breasts are exceedingly painful, and sometimes they feel
rough or knotted. The little canals or ducts which convey the
milk from different parts of the breast to the nipple, become
obstructed, giving rise to inflammation, and if relief is not afforded,
a tedious and painful abscess may form, accompanied by disorder
of the general system.
2782. TREATMENT. The breasts should be relaxed and
softened by the local application of vapor, two or three times a
day, and emptied of their contents either by the child, or some
female friend. They are also to be rubbed frequently with vola-
tile liniment, or some similar preparation, as recommended in par-
agraph 2576, and covered with flannel to keep the skin moist.
Composition may be taken to maintain a gentle perspiration, and
if the bowels are costive, they are to be evacuated once or twice
a day with injections. If there is much disorder of the general
system, it will be necessary to cleanse the stomach with an emetic
of lobelia, or to administer a full course of medicine.
2783. If an abscess forms, it is to be poulticed as though it
were a boil, (1806, et seq.) until the matter is all discharged. If
the abscess leaves a considerable cavity, and shows no disposi-
tion to heal, it is to be treated as directed in paragraph 2291.
-
INVERTED WOMB.
2784. This accident is generally caused by taking away the
placenta or afterbirth by force, whereby the top or fundus of the
womb is forced within its own cavity. It is a serious evil, and if
not speedily remedied, may cause the death of the woman, or
render her an object of disgust to herself and husband for life.
2785. If the womb is in a relaxed or feeble state, and does
not contract after the delivery of the child, it may be inverted by
pulling very slightly upon the umbilical cord. Hence, it would
be a safer practice always to leave the placenta to be expelled by
the uterus itself, unless it is low down in the vagina, and then it
may be removed without any hazard to the patient. (2743, et seq.)
2786. There are different degrees of inversion. The top of
the womb may be merely dipped into its own cavity, as it were:

GUIDE FOR WOMEN. 675
*
or it may descend through the neck and mouth of the organ,
and protrude, in some instances, beyond the external parts of
generation, forming a bag or tumor between the thighs. The
accident is generally accompanied by profuse and continued flood-
ing, with distressing pains, a sense of bearing down, and some-
times ſainting, and convulsions.
2787. The womb should be restored to its proper situation
with as little delay as possible, or it may become inflamed, and
mortify. If this does not occur, however, and the womb contin-
ues inverted, it becomes the seat of a continued and highly of.
fensive discharge, and the patient is also liable to copious hemorr-
hages. -
2788. TREATMENT. There is not much difficulty in restor-
ing the womb to its natural situation immediately after the inversion
takes place, but if two or three hours are suffered to elapse, the
operation becomes more difficult, and in a few days it is generally
considered altogether impracticable. Dr. Denman has found it
impossible to reduce the inversion even a few hours after the acci-
dent occurred. In performing the operation, the hand is to be
passed into the vagina, previously smearing it with lard, or the
mucilage of slippery elm, and the protruded portion returned in a
slow and gentle manner. If the placenta is adherent to the womb,
it should be returned also, leaving it to be expelled by the pains,
for if it is detached, blood-vessels will be ruptured, and profuse
hemorrhage will ensue. There is no danger of hemorrhage, how-
ever, so long as the whole surface of the placenta adheres to the
womb. When the reduction is accomplished, the hand should
not be withdrawn from the organ until it begins to contract, or
there may be a repetition of the accident. If the womb is sore
or inflamed, lobelia should be given in emetic doses, preceded by
an injection per anum and the vapor bath, as in a course of medi-
cine, and as soon as the system is relaxed, and the soreness aba-
ted, the womb is to be returned to its proper situation, as already
directed. -
2789. In a chronic or long standing case of inversion, the par
tient may pass through life comfortably by taking a course of med-
icine whenever her health is much impaired, and employing injec-
tions per vaginam, (2492) whenever there is an acrid or offensive
discharge. Attention to diet, also, (1680, et seq.) will do much
to strengthen and invigorate the constitutional powers.

676 GUIDE FOR WOMEN.
T}ISEASES OF INFANTS.
DIRECTIONS FOR GIVING MEDICINE.”
2790. Some hints on this subject have already been given in
speaking of the “management of the child” after delivery. In-
fants, I may remark, are to be treated on the same general princi-
ples as adults, though the rules for the administration of medicines
require to be somewhat varied.
2791. Many of the complaints of children, such as worms,
croup, whooping cough, and rickets, will not be mentioned in this
part of the work, as they have already been described among the
general diseases.
2792. Application of Vapor. Where the infant is young or
helpless, it may be steamed very conveniently by laying it on a
mattress, or pillow, covering it up to the neck with a thin quilt,
and placing a heated stone wrapped in a damp or wet cloth near it
beneath the quilt, taking care that the vapor thus generated is not
too hot to be oppressive. Perspiration may be promoted by giv-
ing an occasional tea-spoonful of warm raspberry, or black birch
tea, sweetened. If the infant has the appearance of being faint or
languid, its face and breast should be wiped with a cloth or napkin
wetted with cold water, or vinegar. If the child is three or four
years old, it may be tied in a chair, and the bath administered as
directed in paragraph 1586.
2793. Injections. These are equally as beneficial in the treat-
ment of children as adults, and are to be administered with a small
syringe adapted to the purpose. The quantity of fluid to be em-
ployed, is specified in paragraph 1566. They may consist of
raspberry, black birch, catnip, or pennyroyal tea, and if the case
requires it, each injection may contain from five to ten drops
of the antispasmodic tincture, or an equal quantity of rheumatic
drops.
2794. Emetics. These should never be withheld where the
stomach is much disordered, or the health seriously impaired.
* These directions have reference to infants within the first or second year of
their age. If they are older, the reader is referred to remarks on the “treatment
of children,” commencing on page 385.
GUIDE FOR Wom EN. 677
The lobelia is to be prepared by steeping half a tea-spoonful or
more of the powdered leaves in a third or half a tea-cupful of hot
raspberry tea, straining the infusion, or pouring it carefully from
the sediment, and adding sugar to render it more agreeable to the
taste. A tea-spoonful of the liquid is to be given at a dose, and
repeated every ten or fifteen minutes until it operates sufficiently.
The infant should be wrapped in a light quilt or flannel, to shield
it from the air, and keep it in a perspiration. After vomiting
has commenced, it should have an occasional tea-spoonful of milk
porridge, or an infusion of raspberry.
W 0MITING OF MILK.
2795. This, perhaps, can scarcely be termed a disease, as it
frequently takes place when the infant is apparently healthy.
Nevertheless, if it seems to be dependent on a disordered state of
the stomach, and the milk is ejected in coagulated masses, an
infusion of raspberry leaves, poplar bark, or sumach berries,
sweetened, may be given occasionally in the dose of a tea-spoon-
ful. Sometimes the mother’s milk does not agree with the infant,
and when that is ascertained, it should be fed for a few days on
weak milk porridge, or a preparation of slippery elm and milk,
(1431) the latter of which is particularly beneficial. I have re-
marked that the stomach of an infant at birth, is no larger than a
hen's egg, and it is therefore very easily overloaded. Mothers
should be careful on this point, for overſeeding infants, or giving
them improper food, is the principal cause of all their maladies.
SORE MOUTH,
2796. A tea of raspberry and poplar bark, equal parts, sweet-
ened; or weak composition tea, rendered palateable with milk and
sugar, and administered several times a day, will generally effect
a cure. If the stomach is much disordered, it is to be cleansed
with an emetic of lobelia. The infant must not be overſed. The
dust or powder of sumach berries, mixed with honey, and laid on
the tongue so as to dissolve gradually, will have a good effect. If
the mouth is filled with canker, it should be washed with a rag
moistened with raspberry tea.
SORES BE HIND THE EARS.
2797. Infants are sometimes affected with sores behind the
ears, which, if neglected, become very troublesome. They should

678 GUIDE FOR WOMEN.
be washed clean every night and morning with warm soapsuds, fol-
lowed by an infusion of some mild astringent, such as black birch
bark, or sumach leaves, and an application made of the meadow
fern ointment. If the scabs are hard, or the parts sore or irrita-
ble, poultices of slippery elm will be essential. If the bowels
are costive, injections should be administered two or three times
a day, and weak composition tea employed as a drink.
TEETHING.
2798. The child begins to cut its teeth in about six months.
after birth, and until this process is completed, it is liable to be
attacked by a variety of symptoms, such as swollen and painful
gums, driveling of saliva, feverishness, loss of appetite, restless-
ness, diarrhoea, and sometimes convulsions. If an occasional dose
of composition is not sufficient to afford relief, it should have a
course of medicine, commencing with an enema of pennyroyal,
catnip, or composition tea, and followed by the vapor bath,
(27.91) and an emetic of lobelia. (2794.) If a tooth is unusually
slow in making its way through the gum, producing great irri-
tation and distress, relief may be obtained by cutting through
the skin across the head of the tooth with a sharp penknife or
lancet. The precaution must be used to cut entirely down upon
the tooth, or the operation will not succeed. The pain lasts only
for a moment, and is nothing in comparison with what the child
might otherwise suffer. -
2799. Scullcap tea is an excellent medicine for children
whose health is impaired by the irritation of teething, particularly
if they are restless, or unable to sleep.
ERUPTIONS OF THE Skin.
2800. Where the skin becomes the seat of an eruption, the
bowels should be regulated, and composition tea given to keep up
a healthy action in the system. If the appetite is impaired, a tea
of poplar bark may be administered. The child should be kept
perfectly clean by washing it every morning with water and Castile
soap. If the infant is very feeble, the water should be warm, but
if its constitution is tolerably firm, and it has a sufficiency of
animal heat, cold water will have a more invigorating effect.
DIARRHCEA, AND GRIPING PAINS.
2801. Diarrhoea is very often produced by improper food,
which occasions flatulency, an acid stomach, griping pains in the

GUIDE FOR WOMEN. 679
bowels, and greenish discharges by stool. If the disease is not
arrested, the infant soon becomes extremely emaciated. Some-
times the discharges are so profuse and exhausting, that death takes
place in forty eight hours from the commencement of the attack.
2802. There are a variety of remedies which may be used
with advantage in this complaint, such as an infusion of raspberry
leaves, black birch bark, golden rod, or composition. The
dysentery sirup in the dose of a tea-spoonful, and repeated every
hour or two, will generally arrest the discharges. Weak com-
position tea should be given by injection several times a day; and
the same administered by the mouth, so as to keep the infant in
a gentle perspiration, as this will counteract the undue determina-
tion of blood to the bowels.
2803. The griping pains are frequently allayed by giving four
or five drops .# the essence of spearmint, in a tea-spoonful of
warm raspberry tea. This medicine will also serve to check the
diarrhoea.
2804. If the case is obstinate, an emetic of lobelia should be
given. (27.94.
2805. The vapor bath (27.91) is a valuable remedy, and may
be administered twice a day until the disease is checked. It has
a soothing effect upon the nervous system, so much so, that the
infant not unfrequently goes to sleep under its influence. It
should never be dispensed with if the skin is cold, or the patient
chilly.
ºn. If the abdomen is swollen and tender, it should be rub-
bed with the stimulating liniment, or a weak solution of vinegar
and cayenne, (1571) followed by an application of warm flannels.
2807. A decoction of the bark of fir balsam (1110) has cured
the diarrhoea of infants when other remedies, upon which we are
accustomed to rely, have failed. Rice coffee is also an excellent
medicine. (1430.
2808. The mother’s milk is sometimes rendered impure or
unwholesome by inattention to diet, or the use of deleterious drugs,
and where that is the case, it is sometimes impossible to arrest the
diarrhoea without taking the infant from the breast, and feeding it
for a few days on milk porridge, or slippery elm and milk. (1431.)
2809. Cholera. º as it is termed, is only an aggravated
form of diarrhoea, and requires the same treatment, excepting, per-
haps, that it should be a little more active.
CONVULSIONS.
2810. These are often connected with other diseases, and not
unfrequently arise during the irritation of teething. The stomach




680 GUIDE FOR WOMEN.
and bowels are generally in a very disordered condition. An ene-
ma of bayberry tea, containing fifteen or twenty drops of the anti-
spasmodic tincture, may be administered, and repeated every five
or ten minutes until relief is obtained. The vapor bath will have
an excellent effect in allaying the convulsive action of the body
and limbs; or if more convenient, the child may be immersed up
to its chin in warm water. If the jaws are locked, five or ten
drops of antispasmodic tincture, mixed with a little raspberry tea,
should be poured into its mouth, if possible, and when the liquid
comes in contact with the parts about the throat, the rigidity of the
jaws will usually give way. When the convulsions subside, ap-
propriate medicines are to be employed to restore the general
health.
TONGUE-TIED CHILDREN.
2811. The tongue is sometimes tied down by a string or thin
whitish membrane, which prevents the infant from protruding the
tongue from its mouth, and interferes also with its nursing. The
membrane should be divided with a pair of sharp scissors, taking
care not to cut into the substance of the tongue, as there would
be danger of hemorrhage. The operation is simple, but still it
should be performed with care.
WATER IN THE SCROTUM.
2812. This is a collection of water in the bag containing the
testicles, and in order to effect a cure, the parts should be rubbed
two or three times a day with the volatile, or stimulating liniment.
A bandage should also be applied so as to compress the scrotum
slightly, which will favor the absorption of the fluid. If the health
is impaired, it is to be reinstated by appropriate medicines. When
the disease occurs in an adult, it is sometimes necessary to draw
off the fluid by the operation of tapping, which can only be per-
formed with safety by a surgeon who is acquainted with the anat-
omy of the parts. I need scarcely suggest, that this malady should
not be confounded with scrotal hernia. (2247.)
THE END.
G. L. O S S A. R. Y .
The technical terms employed in the second volume of this work, are either referred to
in the index, or explained in the following glossary.
ABDoMEN, the belly.
Accouch EUR, one who assists women
in childbirth.
ANUs, the fundament or extremity of the
great intestine, through which the excre-
ments or feces are discharged.
CATAMEN1A, the monthly discharges
from the womb.
DEcoction, a medicine prepared by
boiling.
DIEATATIon, the act of expanding or
enlarging.
DIURET1c, a medicine which promotes
the discharge of urine. -
ENEMA, an injection. -
ET seq., a contraction of the Latin words
et sequitur, signifying that which follows.
FEcEs, the discharges by stool,
Foetus, the child in the womb.
GEstation, pregnancy.
HEMoRRHAGE, bleeding from any part
of the body.
In UTERo, in the womb.
Loins, the small of the back.
86
LIQUQR AMN11, the water contained
within the membranes which surround the
child previous to birth.
MENSTRUAL, pertaining to the menses.
CEsoph Agus, the gullet or meatpipe.
Os TINCE, the mouth of the womb.
PARTURITIon, the act of bringing forth
young.
PER ANUM, by the anus.
PER v AGINAM, by the vagina.
RECTUM, the lower part of the greatin-
testine which terminates at the anus.
RETCHING, straining to vomit.
RIgor, a sudden coldness, attended by
shivering.
SExual, pertaining to the sexes.
STUpoR, insensibility.
Syncopf, fainting.
TENESMUs, a painful desire to go to
stool.
UMBilical cond, the navel string.
UTERus, the womb.
VERTEX, the crown of the head.




| N D F X .
The figures refer to the paragraphs, excepting where they are preceded by the
word page.
Et seq. is a contraction of the Latin words et sequitur, signifying that which
follows.
Abortion, 2590.
caused by purgatives, 2592.
placenta retained in, 2597,
2598.
Abscess of the breast, 2781.
how treated, 2783.
Adam’s apple, page 667.
Afterbirth, see placenta.
After pains, 2752.
Air, pure, important to infants, 2278.
Amenorrhoea, page 600.
Arm presentation, 2691.
case of, 2768.
Bearing down pains, 2655.
Blood-letting, 2601.
Blunt hook, 2640.
Boivan, Madame, 2618.
Bougie, page 614.
Breast, abscess of 2781.
how treated, 2783.
Breasts, swollen and painful, 2576,
2781. - º
Breech presentation, 2684.
Brim of the pelvis, 2536.
Broad ligaments, 2558.
Caesarean operation, 2645.
fatal, 2645, et seq.
Catheter, 2546, 2678.
use of 2587, et seq.
w
Childbirth, see labor.
Child, position of, in the womb, 2679.
management of, after birth, 2725,
et seq.
pure air important to, 27.28.
stomach of, at birth, 2733.
still-born, 2758.
Childbed fever, 2773.
fatal in London, 2774.
said to be contagious,
2775.
how to prevent, ib.
Children, mutilation of 2770.
directions for giving medicine
to, 2790, et seq.
how to steam, 2792.
injections for, 2793.
emetics for, 2794.
sore mouth of 2796.
tongue-tied, 2811.
water in scrotum of, 28.12.
Chlorosis, page 598.
Cholera infantum, 2809.
Clitoris, 2545.
Convulsions, 2718.
of infants, 2810.
Costiveness, 2575.
Cough, 2573.
Cozzens, Mrs., murder of 2736.
Cramps and pains, 2580.
Critical period of life, 2488.

684
index.
Diarrhoea, 2577.
Different presentations, page 644.
Diseases subsequent to labor, page 671.
of infants, page 676.
- vomiting of milk,
2795.
- sore mouth, 2796.
sores behind the
ears, 2797.
teething, 2798.
eruptions of the
skin, 2800.
diarrhoea, 2801.
griping pains, ib.
convulsions, 2810.
Dropsy, ovarian, 2559.
Duration of labor, 2700, et seq.
Dysmenorrhoea, page 600.
Emetics, during pregnancy, 2604, et seq.
recommended by Denman,
2616.
Examinations and rupture of membranes,
page 639.
indecent, 2657.
denounced by Dr. Bard,
2662.
- argument against, 2666.
- needless, 2667–8.
- sometimes necessary,2670.
Eruptions of skin, in children, 2800.
Fainting, 2717.
Falling of the womb, 2520, 2556, 2562.
case of 2527.
sometimes cured
by pregnancy,
2528.
Fallopian tubes, 2558.
False pains, 2654.
remedy for, 2708.
Feet, or knees, presentation of 2690.
Fever, childbed, 2773.
First child, labor apt to be tedious,
2603.
Fits, see convulsions.
Flooding, 2714.
Fluor albus, 2510.
Forceps, 2641.
invented by Dr. Chamberlen,
2642.
offered to Louis, XIV., ib.
first experiment with, in
France, ib.
pair of, described, 2644.
French midwives, 2664–5.
Frost's, Dr., trial, 2604.
Gathering of the waters, 2680.
George III., a seven month’s child,
2650.
Giddiness, 2573.
Green sickness, 2490.
Headach, 2573.
Head presentation, 2680.
Heartburn, 2573.
Hermaphrodite, 2545.
Hints on treatment during pregnancy,
page 625.
Hip bath, 2493.
bones, 2535.
Hymen, 2548.
entire, 2548–9, 2550.
division of 2550.
Hysteria, 2573.
Infant, see child.
Injections, useful in bringing away a
retained placenta, 2743.
for children, 2793.
Instruments and operations, page 633.
lives destroyed by, 2772.
Internal bleeding or hemorrhage, 2714,
2746.
labia, 2544.
parts of generation, page 613.
Inverted womb, 2784.
chronic inversion,2789.
Itching, 2579.
Jaundice, 2573.
Knees, presentation of 2690.
Labia, 2543.
swelling of 2577.
adhesion of, in infants, 2544.
Labor, page 629.
a natural process, 2630, et seq.,
2658, et seq.
signs of 2649, et seq.
pains, 2654.
difficult, 2766.
causes of, 2661–7, 2767.
duration of, 2700, et seq.
treatment during, 2703, et seq.
discharges from vagina, after,
2753.
diseases subsequent to, page
671.

- -
-
-
-
INDEX. 685
Lingering pains, 2710, et seq.
Liquor amnii, 2555.
Lobelia, learned opinions respecting,
2605, et seq.
relaxing power of, 2706–7.
Management of the child, 2725, et seq.
mother, 2749, et seq.
Meatus urinarius, 2546.
Meconium, 2730.
Membranes, rupture of, 2655, 2671–2.
Men-midwives, 261.
Menorrhagia, page 601.
Menses, cessation of 2488.
retention of, 2490.
suppression of 2495.
Menstruation, page 597.
painful, 2497.
profuse, 2504.
Mercury, 2600.
Midwifery, 2618, et seq.
confided to women, 2622.
cases of, 2701, 2713.
Milk, secretion of, influenced by diet,
2755.
rendered impure by drugging,
2757.
leg, 2777.
Mons veneris, 2542.
Morning sickness, 2574.
Navel string, tying and cutting, 2720.
pulsation in, 2721.
Nipple shields, 2780.
Nymphae, 2544.
Ovarian dropsy, 2559.
Ovaries, 2558.
Operation, clandestine, 2641.
Operations, 2636, 2645, et seq.
cases of, 2770–1.
Pains, 2580.
of labor, 2654.
bearing down, 2655.
lingering, 2710, et seq.
Palpitation of the heart, 2573.
Parts concerned in generation, page 608.
Pelvis, or basin, 2534.
figure of, page 609.
brim of, 2536.
diameters of, 2537–8.
deformity of 2540.
parts within, 2561.
Perforator, 2637.
... ºn
Perineum, 2548.
laceration of, 2682.
should it be supported
2682–3.
Pessaries, 2522–3–4.
Pessary, 2525.
Phlegmasia dolens, page 672.
Piles, 2573.
Placenta, retained in abortion, 2597–8.
presentation of, 2699.
management of, 2735.
portion of, retained, 2747.
not to be forced away, 2736.
should be expelled by womb,
2785.
retained fifteen days, 2741.
Placentas of twins, 2748.
Polypus of the womb, 2530.
case of, treated by
Hunter, 2533.
Positions of women, 2674, et seq.
Pregnancy, and its diseases, page 616.
signs of 2563, et seq.
predictions of, uncertain,
2569, 2570.
mistaken for dropsy, 2571.
diseases of, 2572, et seq.
hints on treatment during,
page 625.
emetics during, 2604, et
seq.
Presentation of the head, 2680.
breech, 2684.
feet and knees,2690.
arm, 2691.
umbilical cord,2698.
placenta, 2699.
Procidentia uteri, page 604.
imperfect, 2529.
Prolapsus uteri, see falling of the womb.
Pubis, bones of, divided 2648.
Puerperal fever, see childbed fever.
-
Quickening, 2566.
Restlessness, 2578.
Retention of the menses, 2490.
urine, in an infant, 2731.
Retroversion of the womb, 2562, 2582.
Rickets, 2540.
Rigidity of the external parts, 2709.
Round ligaments, 2560.
Rupture of membranes, 2671–2.
Scrotal hernia, 28.12.



87

686
INDEX.
-
Semen, 2558.
Show, 2651.
Sickness and vomiting, 2574.
Skin, eruptions of, in children, 2800.
Sore nipples, 2780.
mouth of infants, 2796.
Sores behind the ears, 2797.
Sponge pessary, 2525.
Spontaneous evolution, 2694–5.
Squinting, 2729.
Still-born child, 275S, et seq.
how to recover, 2759,
et seq.
Swelled or milk leg, 2777.
Swelling of the labia, 2577.
legs, 2581.
Teething, 2798.
Toothach, 2573.
Treatment during labor, 2703.
True pains, 2654.
Turning, remarks on, by Collins, 2697.
when to be attempted, 2691.
sometimes impossible, 2693.
Turn of life, 2488.
Twins, 2722.
signs of, ib.
placentas of, how managed,
2724, 2748.
-
Tying and cutting the navel string, 2720.
Umbilical cord, 2698.
pulling at, dangerous,
2885.
Urethra, 2546.
Uterus, see womb.
Urine, retention of, in an infant, 2731.
Vagina, 2552.
deformity of, 2553–4.
dilatation of, 2554.
discharges from, after labor,
2753.
Vapor, application of, 2792.
Vectis, 2638.
patient killed by, 2639.
Vomiting, 2574.
of milk, 2795.
Water in the scrotum, 28.12.
Waters, see liquor amnii.
Whites, see fluor albus.
Women, imposed upon, 2673.
positions of, 2674, et seq.
Womb, 2555.
neck of, ib.
appendages of 2558, et seq.
inversion of, 2744, 2784.
ERRATA.
Page 5, seventh line from the bottom, vertebra should read vertebrae. The same
error occurs in the fourth and fifth lines from the bottom of the same page.
Page 16, second line from the bottom, 62 should be 63.
Page 58, sixth line from the bottom, 192 should be 191.
Page 102, tenth line from the bottom, 396 should be 395.
Page 147, fifth line from the bottom, were should be was.
Page 151, twelfth line from the top, are should be is.
Page 160, fifth line from the bottom, 448 should be 648.
Page 161, ninth line from the top, 648 should be 649.
* “ eighteenth line from the top, the number 649 is a duplicate.
Page 187, fifth line from the bottom, changed should be substituted for modified.
Page 200, third line from the top, dentrifice should read dentifrice.
Page 35, eighteenth line from the top, heaping should be heaped.
Page 434, eighth and ninth lines from the bottom, “to assume erect position,” should
read, to assume an erect position. -
Page 440, twelfth line from the bottom, “without recalling the bile into,” should read,
without eausing a flow of bile into, &c.
Page 478, eleventh line from the bottom, mysentery should read mesentery.



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