This Abuse of the Oil also disposes their Child to knotty hard Tumours,

and at length often proves the first Cause of some Diseases of the Skin,

whose Cure is extremely difficult.

Hence it is evident, this Oil should be used on such Occasions but very

seldom; and that it is always very injudicious to give it in Cholics,

which arise from sharp and sour Humours in the Stomach, or in the

Bowels.

Sec. 382. Infants are commonly most subject to such Cholics during their

earliest Months; after which they abate, in Proportion as their Stomachs

grow stronger. They may be relieved in the Fit by Glysters of a

Decoction of Chamomile Flowers, in which a Bit of Soap of the Size of a

Hazel Nut is dissolved. A Piece of Flanel wrung out of a Decoction of

Chamomile Flowers, with the Addition of some Venice Treacle, and applied

hot over the Stomach and on the Belly, is also very beneficial, and

relieving.

Children cannot always take Glysters, the Continuance of which

Circumstance might be dangerous to them; and every one is acquainted

with the common Method of substituting Suppositories to them, whether

they are formed of the smooth and supple Stalks of Vines, _&c._ of Soap,

or of Honey boiled up to a proper Consistence.

But one of the most certain Means to prevent these Cholics, which are

owing to Children's not digesting their Milk, is to move and exercise

them as much as possible; having a due Regard however to their tender

Time of Life.

Sec. 383. Before I proceed to the third Cause of the Diseases of Children,

which is, the Cutting of their Teeth, I must take Notice of the first

Cares their Birth immediately requires, that is the Washing of them the

first Time, meerly to cleanse, and afterwards, to strengthen them.

_Of washing Children._

Sec. 384. The whole Body of an Infant just born is covered with a gross

Humour, which is occasioned by the Fluids, in which it was suspended in

the Womb. There is a Necessity to cleanse it directly from this, for

which nothing is so proper as a Mixture of one third Wine, and two

thirds Water; Wine alone would be dangerous. This Washing may be

repeated some Days successively; but it is a bad Custom to continue to

wash them thus warm, the Danger of which is augmented by adding some

Butter to the Wine and Water, which is done too often. If this gross

Humour, that covers the Child, seems more thick and glutinous than

ordinary, a Decoction of Chamomile Flowers, with a little Bit of Soap,

may be used to remove it. The Regularity of Perspiration is the great

Foundation of Health; to procure this Regularity the Teguments, the

Skin, must be strengthened; but warm Washing tends to weaken it. When it

is of a proper Strength it always performs its Functions; nor is

Perspiration disordered sensibly by the Alteration of the Weather. For

this Reason nothing should be omitted, that may fix it in this State;

and to attain so important an Advantage, Children should be washed, some

few Days after their Birth, with cold Water, in the State it is brought

from the Spring.

For this Purpose a Spunge is employed, with which they begin, by washing

first the Face, the Ears, the back Part of the Head (carefully avoiding

the [88] _Fontanelle_, or Mould of the Head) the Neck, the Loins, the

Trunck of the Body, the Thighs, Legs and Arms, and in short every Spot.

This Method which has obtained for so many Ages, and which is practised

at present by many People, who prove very healthy, will appear shocking

to several Mothers; they would be afraid of killing their Children by

it; and would particularly fail of Courage enough to endure the Cries,

which Children often make, the first Time they are washed. Yet if their

Mothers truly love them, they cannot give a more substantial Mark of

their Tenderness to them, than by subduing their Fears and their

Repugnance, on this important Head.

[88] That Part of the Head where a Pulsation may be very plainly felt,

where the Bones are less hard, and not as yet firmly joined with

those about them.

Weakly Infants [89] are those who have the greatest Need of being

washed: such as are remarkably strong may be excused from it; and it

seems scarcely credible (before a Person has frequently seen the

Consequences of it) how greatly this Method conduces to give, and to

hasten on, their Strength. I have had the Pleasure to observe, since I

first endeavoured to introduce the Custom among us, that several of the

most affectionate and most sensible Mothers, have used it with the

greatest Success. The Midwives, who have been Witnesses of it; the

Nurses and the Servants of the Children, whom they have washed, publish

it abroad; and should the Custom become as general, as every thing seems

to promise it will, I am fully persuaded, that by preserving the Lives

of a great Number of Children, it will certainly contribute to check the

Progress of Depopulation.

[89] There is however a certain Degree of Weakness, which may very

reasonably deter us from this Washing; as when the Infant

manifestly wants Heat, and needs some Cordial and frequent

Frictions, to prevent its expiring from downright Feebleness; in

which Circumstances Washing must be hurtful to it. _Tissot._

They should be washed very regularly every Day, in every Season, and

every Sort of Weather; and in the fine warm Season they should be

plunged into a large Pail of Water, into the Basins around Fountains, in

a Brook, a River, or a Lake.

After a few Days crying, they grow so well accustomed to this Exercise,

that it becomes one of their Pleasures; so that they laugh all the Time

of their going through it.

The first Benefit of this Practice is, as I have already said, the

keeping up their Perspiration, and rendering them less obnoxious to the

Impressions of the Air and Weather: and it is also in Consequence of

this first Benefit, that they are preserved from a great Number of

Maladies, especially from knotty Tumours, often called Kernels; from

Obstructions; from Diseases of the Skin, and from Convulsions, its

general Consequence being to insure them firm, and even robust Health.

Sec. 385. But Care should be taken not to prevent, or, as it were to undo,

the Benefit this Washing procures them, by the bad Custom of keeping

them too hot. There is not a more pernicious one than this, nor one that

destroys more Children. They should be accustomed to light Cloathing by

Day, and light Covering by Night, to go with their Heads very thinly

covered, and not at all in the Day-time, after their attaining the Age

of two Years. They should avoid sleeping in Chambers that are too hot,

and should live in the open Air, both in Summer and Winter, as much as

possible. Children who have been kept too hot in such Respects, are very

often liable to Colds; they are weakly, pale, languishing, bloated and

melancholy. They are subject to hard knotty Swellings, a Consumption,

all Sorts of languid Disorders, and either die in their Infancy, or only

grow up into a miserable valetudinary Life; while those who are washed

or plunged into cold Water, and habitually exposed to the open Air, are

just in the opposite Circumstances.

Sec. 386. I must further add here, that Infancy is not the only Stage of

Life, in which cold Bathing is advantagious. I have advised it with

remarkable Success to Persons of every Age, even to that of seventy: and

there are two Kinds of Diseases, more frequent indeed in Cities than in

the Country, in which cold Baths succeed very greatly; that is, in

Debility, or Weakness of the Nerves; and when Perspiration is

disordered, when Persons are fearful of every Breath of Air, liable to

Defluxions or Colds, feeble and languishing, the cold Bath

re-establishes Perspiration; restores Strength to the Nerves; and by

that Means dispels all the Disorders, which arise from these two Causes,

in the animal Oeconomy. They should be used before Dinner. But in the

same Proportion that cold Bathing is beneficial, the habitual Use, or

rather Abuse, of warm Bathing is pernicious; they dispose the Persons

addicted to them to the Apoplexy; to the Dropsy; to Vapours, and to the

hypochondriacal Disease: and Cities, in which they are too frequently

used, become, in some Measure, desolate from such Distempers.

_Of the Cutting of the Teeth._

Sec. 387. Cutting of the Teeth is often very tormenting to Children, some

dying under the severe Symptoms attending it. If it proves very painful,

we should during that Period, 1, Keep their Bellies open by Glysters

consisting only of a simple Decoction of Mallows: but Glysters are not

necessary, if the Child, as it sometimes happens then, has a Purging.

2, Their ordinary Quantity of Food should be lessened for two Reasons;

first, because the Stomach is then weaker than usual; and next, because

a small Fever sometimes accompanies the Cutting.

3, Their usual Quantity of Drink should be increased a little; the best

for them certainly is an Infusion of the Leaves or Flowers, of the Lime

or Linden-tree, to which a little Milk may be added.

4, Their Gums should frequently be rubbed with a Mixture of equal Parts

of Honey, and Mucilage of Quince-seeds; and a Root of March-Mallows, or

of Liquorice, may be given them to chew.

It frequently happens, that during Dentition, or the Time of their

toothing, Children prove subject to Knots or Kernels.

_Of Worms._

Sec. 388. The _Meconium_, the Acidity of the Milk, and Cutting of the Teeth

are the three great Causes of the Diseases of Children. There is also a

fourth, Worms, which is likewise very often pernicious to them; but

which, nevertheless, is not, at least not near so much, a general Cause

of their Disorders, as it is generally supposed, when a Child exceeding

two Years of Age proves sick. There are a great Variety of Symptoms,

which dispose People to think a Child has Worms; though there is but one

that demonstrates it, which is discharging them upwards or downwards.

There is great Difference among Children too in this Respect, some

remaining healthy, though having several Worms, and others being really

sick with a few.

They prove hurtful, 1, by obstructing the Guts, and compressing the

neighbouring Bowels by their Size. 2, By sucking up the Chyle intended

to nourish the Patient, and thus depriving him of his very Substance as

well as Subsistence: and, 3, by irritating the Guts and even [90]

gnawing them.

[90] I have seen a Child about three Years old, whose Navel, after

swelling and inflaming, suppurated, and through a small Orifice

(which must have communicated with the Cavity of the Gut or the

Belly) discharged one of these Worms we call _teretes_, about three

Inches long. He had voided several by Stool, after taking some

vermifuge Medicines. The Fact I perfectly remember; and to the best

of my Recollection, the Ulcer healed some Time after, and the

Orifice closed: but the Child died the following Year of a putrid

Fever, which might be caused, or was aggravated, by Worms. _K._

Sec. 389. The Symptoms which make it probable they are infested with Worms,

are slight, frequent and irregular Cholics; a great Quantity of Spittle

running off while they are fasting; a disagreeable Smell of their

Breath, of a particular Kind, especially in the Morning; a frequent

Itchiness of their Noses which makes them scratch or rub them often; a

very irregular Appetite, being sometimes voracious, and at other Times

having none at all: Pains at Stomach and Vomitings: sometimes a costive

Belly; but more frequently loose Stools of indigested Matter; the Belly

rather larger than ordinary, the rest of the Body meagre; a Thirst which

no Drink allays; often great Weakness, and some Degree of Melancholy.

The Countenance has generally an odd unhealthy Look, and varies every

Quarter of an Hour; the Eyes often look dull, and are surrounded with a

Kind of livid Circle: the White of the Eye is sometimes visible while

they sleep, their Sleep being often attended with terrifying Dreams or

_Deliriums_, and with continual Startings, and Grindings of their Teeth.

Some Children find it impossible to be at Rest for a single Moment.

Their Urine is often whitish, I have seen it from some as white as Milk.

They are afflicted with Palpitations, Swoonings, Convulsions, long and

profound Drowsiness; cold Sweats which come on suddenly; Fevers which

have the Appearances of Malignity; Obscurities and even Loss of Sight

and of Speech, which continue for a considerable Time; Palsies either of

their Hands, their Arms, or their Legs, and Numbnesses. Their Gums are

in a bad State, and as though they had been gnawed or corroded: they

have often the Hickup, a small and irregular Pulse, Ravings, and, what

is one of the least doubtful Symptoms, frequently a small dry Cough; and

not seldom a Mucosity or Sliminess in their Stools: sometimes very long

and violent Cholics, which terminate in an Abscess on the Outside of the

Belly, from whence Worms issue. (See Note [90] p. 388.)

Sec. 390. There are a great Multitude of Medicines against Worms. The [91]

_Grenette_ or Worm-seed, which is one of the commonest, is a very good

one. The Prescription No. 62, is also a very successful one; and the

Powder No. 14 is one of the best. Flower of Brimstone, the Juice of

_Nasturtium_, or Cresses, Acids and Honey Water have often been very

serviceable; but the first three I have mentioned, succeeded by a Purge,

are the best. No. 63 is a purging Medicine, that the most averse and

difficult Children may easily take. But when, notwithstanding these

Medicines, the Worms are not expelled, it is necessary to take Advice of

some Person qualified to prescribe more efficacious ones. This is of

considerable Importance, because, notwithstanding a great Proportion of

Children may probably have Worms, and yet many of them continue in good

Health, there are, nevertheless, some who are really killed by Worms,

after having been cruelly tormented by them for several Years.

[91] This Word occurs in none of the common Dictionaries; but suspecting

it for the _Semen Santonici_ of the Shops, I find the learned Dr.

_Bikker_ has rendered it so, in his very well received Translation

of this valuable Work into _Low Dutch_. _K._

A Disposition to breed Worms always shews the Digestions are weak and

imperfect; for which Reason Children liable to Worms should not be

nourished with Food difficult to digest. We should be particularly

careful not to stuff them with Oils, which, admitting such Oils should

immediately kill some of their Worms, do yet increase that Cause, which

disposes them to generate others. A long continued Use of Filings of

Iron is the Remedy, that most effectually destroys this Disposition to

generate Worms.

_Of Convulsions._

Sec. 391. I have already said, Sec. 378, that the Convulsions of Children are

almost constantly the Effect of some other Disease, and especially of

some of the four I have mentioned. Some other, though less frequent

Causes, sometimes occasion them, and these may be reduced to the

following.

The first of them is the corrupted Humours, that often abound in their

Stomachs and Intestines; and which, by their Irritation, produce

irregular Motions throughout the whole System of the Nerves, or at least

through some Parts of them; whence those Convulsions arise, which are

merely involuntary Motions of the Muscles. These putrid Humours are the

Consequence of too great a Load of Aliments, of unsound ones, or of

such, as the Stomachs of Children are incapable of digesting. These

Humours are also sometimes the Effect of a Mixture and Confusion of

different Aliments, and of a bad Distribution of their Nourishment.

It may be known that the Convulsions of a Child are owing to this Cause,

by the Circumstances that have preceded them, by a disgusted loathing

Stomach; by a certain Heaviness and Load at it; by a foul Tongue; a

great Belly; by its bad Complexion, and its disturbed unrefreshing

Sleep.

The Child's proper Diet, that is, a certain Diminution of the Quantity

of its Food; some Glysters of warm Water, and one Purge of No. 63, very

generally remove such Convulsions.

Sec. 392. The second Cause is the bad Quality of their Milk. Whether it be

that the Nurse has fallen into a violent Passion, some considerable

Disgust, great Fright or frequent Fear: whether she has eat unwholesome

Food, drank too much Wine, spirituous Liquors, or any strong Drink:

whether she is seized with a Descent of her monthly Discharges, and that

has greatly disordered her Health; or finally whether she prove really

sick: In all these Cases the Milk is vitiated, and exposes the Infant to

violent Symptoms, which sometimes speedily destroy it.

The Remedies for Convulsions, from this Cause, consist, 1, In letting

the Child abstain from this corrupted Milk, until the Nurse shall have

recovered her State of Health and Tranquillity, the speedy Attainment of

which may be forwarded by a few Glysters; by gentle pacific Medicines;

by an entire Absence of whatever caused or conduced to her bad Health;

and by drawing off all the Milk that had been so vitiated.

2, In giving the Child itself some Glysters: in making it drink

plentifully of a light Infusion of the Lime-tree Flowers, in giving it

no other Nourishment for a Day or two, except Panada and other light

Spoon-meat, without Milk.

3, In purging the Child (supposing what has been just directed to have

been unavailable) with an Ounce, or an Ounce and a Half, of compound

Syrup of Succory, or as much Manna. These lenient gentle Purges carry

off the Remainder of the corrupted Milk, and remove the Disorders

occasioned by it.

Sec. 393. A third Cause which also produces Convulsions, is the feverish

Distempers which attack Children, especially the Small-pocks and the

Measles; but in general such Convulsions require no other Treatment, but

that proper for the Disease, which has introduced them.

Sec. 394. It is evident from what has been said in the Course of this

Chapter, and it deserves to be attended to, that Convulsions are

commonly a Symptom attending some other Disease, rather than an original

Disease themselves: that they depend on many different Causes; that from

this Consideration there can be no general Remedy for removing or

checking them; and that the only Means and Medicines which are suitable

in each Case, are those, which are proper to oppose the particular Cause

producing them, and which I have already pointed out in treating of each

Cause.

The greater Part of the pretended Specifics, which are indiscriminately

and ignorantly employed in all Sorts of Convulsions, are often useless,

and still oftner prejudicial. Of this last Sort and Character are,

1, All sharp and hot Medicines, spirituous Liquors, Oil of Amber,--other

hot Oils and Essences, volatile Salts, and such other Medicines, as, by

the Violence of their Action on the irritable Organs of Children, are

likelier to produce Convulsions, than to allay them.

2, Astringent Medicines, which are highly pernicious, whenever the

Convulsions are caused by any sharp Humour, that ought to be discharged

from the Body by Stool; or when such Convulsions are the Consequences of

an [92] Effort of Nature, in Order to effect a _Crisis_: And as they

almost ever depend on one or the other of these Causes, it follows that

Astringents can very rarely, if ever, be beneficial. Besides that there

is always some Danger in giving them to Children without a mature, a

thorough Consideration of their particular Case and Situation, as they

often dispose them to Obstructions.

[92] This very important Consideration, on which I have treated pretty

largely, in the _Analysis_, seems not to be attended to in

Practice, as frequently as it ought. _K._

3, The over early, and too considerable Use of Opiates, either not

properly indicated, or continued too long, such as Venice Treacle,

Mithridate, Syrup of Poppies (and it is very easy to run upon some of

these Sholes) are also attended with the most embarrassing Events, in

Regard to Convulsions; and it may be affirmed they are improper, for

nine Tenths of those they are advised to. It is true they often produce

an apparent Ease and Tranquillity for some Minutes, and sometimes for

some Hours too; but the Disorder returns even with greater Violence for

this Suspension, by Reason they have augmented all the Causes producing

it; they impair the Stomach; they bind up the Belly; they lessen the

usual Quantity of Urine; and besides, by their abating the Sensibility

of the Nerves, which ought to be considered as one of the chief

Centinels appointed by Nature, for the Discovery of any approaching

Danger, they dispose the Patient insensibly to such Infarctions and

Obstructions, as tend speedily to produce some violent and mortal Event,

or which generate a Disposition to languid and tedious Diseases: and I

do again repeat it, that notwithstanding there are some Cases, in which

they are absolutely necessary, they ought in general to be employed with

great Precaution and and Prudence. To mention the principal Indications

for them in convulsive Cases, they are proper,

1, When the Convulsions still continue, after the original Cause of them

is removed.

2, When they are so extremely violent, as to threaten a great and very

speedy Danger of Life; and when they prove an Obstacle to the taking

Remedies calculated to extinguish their Cause; and,

3, When the Cause producing them is of such a Nature, as is apt to yield

to the Force of Anodynes; as when, for Instance, they have been the

immediate Consequence of a Fright.

Sec. 395. There is a very great Difference in different Children, in

Respect to their being more or less liable to Convulsions. There are

some, in whom very strong and irritating Causes cannot excite them; not

even excruciating Gripes and Cholics; the most painful Cutting of their

Teeth; violent Fevers; the Small Pocks; Measles; and though they are, as

it were, continually corroded by Worms, they have not the slightest

Tendency to be convulsed. On the other Hand, some are so very obnoxious

to Convulsions, or so easily _convulsible_, if that Expression may be

allowed, that they are very often seized with them from such very slight

Causes, that the most attentive Consideration cannot investigate them.

This Sort of Constitution, which is extremely dangerous, and exposes the

unhappy Subject of it, either to a very speedy Death, or to a very low

and languid State of Life, requires some peculiar Considerations; the

Detail of which would be the more foreign to the Design of this

Treatise, as they are pretty common in Cities, but much less so in

Country Places. In general cold Bathing and the Powder No. 14 are

serviceable in such Circumstances.

_General Directions, with Respect to Children._

Sec. 396. I shall conclude this Chapter by such farther Advice, as may

contribute to give Children a more vigorous Constitution and

Temperament, and to preserve them from many Disorders.

First then, we should be careful not to cram them too much, and to

regulate both the Quantity and the set Time of their Meals, which is a

very practicable Thing, even in the very earliest Days of their Life;

when the Woman who nurses them, will be careful to do it regularly.

Perhaps indeed this is the very Age, when such a Regulation may be the

most easily attempted and effected; because it is that Stage, when the

constant Uniformity of their Way of living should incline us to suppose,

that what they have Occasion for is most constantly very much the same.

A Child who has already attained to a few Years, and who is surrendered

up more to his own Exercise and Vivacity, feels other Calls; his Way of

Life is become a little more various and irregular, whence his Appetite

must prove so too. Hence it would be inconvenient to subject him over

exactly to one certain Rule, in the Quantity of his Nourishment, or the

Distance of his Meals. The Dissipation or passing off of his Nutrition

being unequal, the Occasions he has for repairing it cannot be precisely

dated and regular. But with Respect to very little Children in Arms, or

on the Lap, a Uniformity in the first of these Respects, the Quantity of

their Food, very consistently conduces to a useful Regularity with

Respect to the second, the Times of feeding them. Sickness is probably

the only Circumstance, that can warrant any Alteration in the Order and

Intervals of their Meals; and then this Change should consist in a

Diminution of their usual Quantity, notwithstanding a general and fatal

Conduct seems to establish the very Reverse; and this pernicious Fashion

authorizes the Nurses to cram these poor little Creatures the more, in

Proportion as they have real Need of less feeding. They conclude of

Course, that all their Cries are the Effects of Hunger, and the Moment

an Infant begins, then they immediately stop his Mouth with his Food;

without once suspecting, that these Wailings may be occasioned by the

Uneasiness an over-loaded Stomach may have introduced; or by Pains whose

Cause is neither removed nor mitigated, by making the Children eat;

though the meer Action of eating may render them insensible to slight

Pains, for a very few Minutes; in the first Place, by calling off their

Attention; and secondly, by hushing them to sleep, a common Effect of

feeding in Children, being in fact, a very general and constant one, and

depending on the same Causes, which dispose so many grown Persons to

sleep after Meals.

A Detail of the many Evils Children are exposed to, by thus forcing too

much Food upon them, at the very Time when their Complaints are owing to

Causes, very different from Hunger, might appear incredible. They are

however so numerous and certain, that I seriously wish sensible Mothers

would open their Eyes to the Consideration of this Abuse, and agree to

put an End to it.

Those who overload them with Victuals, in Hopes of strengthening them,

are extremely deceived; there being no one Prejudice equally fatal to

such a Number of them. Whatever unnecessary Aliment a Child receives,

weakens, instead of strengthening him. The Stomach, when over-distended,

suffers in its Force and Functions, and becomes less able to digest

thoroughly. The Excess of the Food last received impairs the Concoction

of the Quantity, that was really necessary: which, being badly digested,

is so far from yielding any Nourishment to the Infant, that it weakens

it, and proves a Source of Diseases, and concurs to produce

Obstructions, Rickets, the Evil, slow Fevers, a Consumption and Death.

Another unhappy Custom prevails, with Regard to the Diet of Children,

when they begin to receive any other Food besides their Nurse's Milk,

and that is, to give them such as exceeds the digestive Power of their

Stomachs; and to indulge them in a Mixture of such Things in their

Meals, as are hurtful in themselves, and more particularly so, with

Regard to their feeble and delicate Organs.

To justify this pernicious Indulgence, they affirm it is necessary to

accustom their Stomachs to every Kind of Food; but this Notion is highly

absurd, since their Stomachs should first be strengthened, in Order to

make them capable of digesting every Food; and crouding indigestible, or

very difficultly digestible Materials into it, is not the Way to

strengthen it. To make a Foal sufficiently strong for future Labour, he

is exempted from any, till he is four Years old; which enables him to

submit to considerable Work, without being the worse for it. But if, to

inure him to Fatigue, he should be accustomed, immediately from his

Birth, to submit to Burthens above his Strength, he could never prove

any Thing but an utter Jade, incapable of real Service. The Application

of this to the Stomach of a Child is very obvious.

I shall add another very important Remark, and it is this, that the too

early Work to which the Children of Peasants are forced, becomes of real

Prejudice to the Publick. Hence Families themselves are less numerous,

and the more Children that are removed from their Parents, while they

are very young, those who are left are the more obliged to Work, and

very often even at hard Labour, at an Age when they should exercise

themselves in the usual Diversions and Sports of Children. Hence they

wear out in a Manner, before they attain the ordinary Term of Manhood;

they never arrive at their utmost Strength, nor reach their full

Stature; and it is too common to see a Countenance with the Look of

twenty Years, joined to a Stature of twelve or thirteen. In fact, they

often sink under the Weight of such hard involuntary Labour, and fall

into a mortal Degree of Wasting and Exhaustion.

Sec. 397. Secondly, which indeed is but a Repetition of the Advice I have

already given, and upon which I cannot insist too much, they must be

frequently washed or bathed in cold Water.

Sec. 398. Thirdly, they should be moved about and exercised as much as they

can bear, after they are some Weeks old: the earlier Days of their

tender Life seeming consecrated, by Nature herself, to a nearly total

Repose, and to sleeping, which seems not to determine, until they have

Need of Nourishment: so that, during this very tender Term of Life, too

much Agitation or Exercise might be attended with mortal Consequences.

But as soon as their Organs have attained a little more Solidity and

Firmness, the more they are danced about (provided it is not done about

their usual Time of Repose, which ought still to be very considerable)

they are so much the better for it; and by increasing it gradually, they

may be accustomed to a very quick Movement, and at length very safely to

such, as may be called hard and hearty Exercise. That Sort of Motion

they receive in Go-Carts, or other Vehicles, particularly contrived for

their Use, is more beneficial to them, than what they have from their

Nurses Arms, because they are in a better Attitude in the former; and it

heats them less in Summer, which is a Circumstance of no small

Importance to them; considerable Heat and Sweat disposing them to be

ricketty.

Sec. 399. Fourthly, they should be accustomed to breathe in the free open

Air as much as possible.

If Children have unhappily been less attended to than they ought, whence

they are evidently feeble, thin, languid, obstructed, and liable to

Scirrhosities (which constitute what is termed a ricketty or consumptive

State) these four Directions duly observed retrieve them from that

unhappy State; provided the Execution of them has not been too long

delayed.

Sec. 400. Fifthly, If they have any natural Discharge of a Humour by the

Skin, which is very common with them, or any Eruption, such as Tetters,

white Scurf, a Rashe, or the like, Care must be taken not to check or

repel them, by any greasy or restringent Applications. Not a Year passes

without Numbers of Children having been destroyed by Imprudence in this

Respect; while others have been reduced to a deplorable and weakly

Habit.

I have been a Witness to the most unhappy Consequences of external

Medicines applied for the Rashe and white Scurf; which, however

frightful they may appear, are never dangerous; provided nothing at all

is applied to them, without the Advice and Consideration of a truly

skilful Person.

When such external Disorders prove very obstinate, it is reasonable to

suspect some Fault or Disagreement in the Milk the Child sucks; in which

Case it should immediately be discontinued, corrected, or changed. But I

cannot enter here into a particular Detail of all the Treatment

necessary in such Cases.

__Chapter XXVIII.__

_Directions with Respect to drowned Persons._ [93]

[93] The Misfortune of a young Man drowned in bathing himself, at the

Beginning of the Season, occasioned the Publication of this Chapter

by itself in _June_, 1761. A few Days after, the like Misfortune

happened to a labouring Man; but he was happily taken out of the

water sooner than the first (who had remained about half an Hour

under it) and he was recovered by observing Part of the Advice this

Chapter contains; of which Chapter several Bystanders had

Copies.--This Note seems to be from the Author himself.

__Sect.__ 401.

Whenever a Person who has been drowned, has remained a Quarter of an

Hour under Water, there can be no considerable Hopes of his Recovery:

the Space of two or three Minutes in such a Situation being often

sufficient to kill a Man irrecoverably. Nevertheless, as several

Circumstances may happen to have continued Life, in such an unfortunate

Situation, beyond the ordinary Term, we should always endeavour to

afford them the most effectual Relief, and not give them up as

irrecoverable too soon: since it has often been known, that until the

Expiration of two, and sometimes even of three Hours, such Bodies have

exhibited some apparent Tokens of Life.

Water has sometimes been found in the Stomach of drowned Persons; at

other times none at all. Besides, the greatest Quantity which has ever

been found in it has not exceeded that, which may be drank without any

Inconvenience; whence we may conclude, the meer Quantity was not mortal;

neither is it very easy to conceive how drowned Persons can swallow

Water. What really kills them is meer Suffocation, or the Interception

of Air, of the Action of breathing; and the Water which descends into

the Lungs, and which is determined there, by the Efforts they

necessarily, though involuntarily make, to draw Breath, after they are

under Water: for there absolutely does not any Water descend, either

into the Stomach or the Lungs of Bodies plunged into Water, after they

are dead; a Circumstance, which serves to establish a legal Sentence and

Judgment in some criminal Cases, and Trials: This Water intimately

blending itself with the Air in the Lungs, forms a viscid inactive Kind

of Froth, which entirely destroys the Functions of the Lungs; whence the

miserable Sufferer is not only suffocated, but the Return of the Blood

from the Head being also intercepted, the Blood Vessels of the Brain are

overcharged, and an Apoplexy is combined with the Suffocation. This

second Cause, that is, the Descent of the Water into the Lungs, is far

from being general, it having been evident from the Dissection of

several drowned Bodies, that it really never had existed in them.

Sec. 402. The Intention that should be pursued, is that of unloading the

Lungs and the Brain, and of reviving the extinguished Circulation. For

which Purpose we should, 1, immediately strip the Sufferer of all his

wet Cloaths; rub him strongly with dry coarse Linnen; put him, as soon

as possible, into a well heated Bed, and continue to rub him well a very

considerable Time together.

2, A strong and healthy Person should force his own warm Breath into the

Patient's Lungs; and the Smoke of Tobacco, if some was at Hand, by Means

of some Pipe, Chanel, Funnel or the like, that may be introduced into

the Mouth. This Air or Fume, being forcibly blown in, by stopping the

Sufferer's Nostrils close at the same Time, penetrates into the Lungs,

and there rarifies by its Heat that Air, which blended with the Water,

composed the viscid Spume or Froth. Hence that Air becomes disengaged

from the Water, recovers its Spring, dilates the Lungs; and, if there

still remains within any Principle of Life, the Circulation is renewed

again that Instant.

3, If a moderately expert Surgeon is at Hand, he must open the jugular

Vein, or any large Vein in the Neck, and let out ten or twelve Ounces of

Blood. Such a Bleeding is serviceable on many Accounts. First, merely as

Bleeding, it renews the Circulation, which is the constant Effect of

Bleeding in such Swoonings, as arise from an intercepted or suffocated

Circulation. Secondly, it is that particular Bleeding, which most

suddenly removes, in such Cases, the Infarction or Obstruction of the

Head and Lungs; and, thirdly, it is sometimes the only Vessel, whence

Blood will issue under such Circumstances. The Veins of the Feet then

afford none; and those of the Arms seldom; but the Jugulars almost

constantly furnish it.

Fourthly, the Fume of Tobacco should be thrown up, as speedily and

plentifully as possible, into the Intestines by the Fundament. There are

very commodious Contrivances devised for this Purpose; but as they are

not common, it may be effected by many speedy Means. One, by which a

Woman's Life was preserved, consisted only in introducing the small Tube

of a Tobacco Pipe well lighted up: the Head or Bowl of it was wrapped up

in a Paper, in which several Holes were pricked, and through these the

Breath was strongly forced. At the fifth Blast a considerable Rumbling

was heard in the Woman's Belly; she threw up a little Water, and a

Moment afterwards came to her Senses. Two Pipes may be thus lighted and

applied, with their Bowls covered over; the Extremity of one is to be

introduced into the Fundament; and the other may be blown through into

the Lungs.

Any other Vapour may also be conveyed up, by introducing a _Canula_, or

any other Pipe, with a Bladder firmly fixed to it. This Bladder is

fastened at its other End to a large Tin Funnel, under which Tobacco is

to be lighted. This Contrivance has succeeded with me upon other

Occasions, in which Necessity compelled me to invent and apply it.

Fifthly, the strongest Volatiles should be applied to the Patient's

Nostrils. The Powder of some strong dry Herb should be blown up his

Nose, such as Sage, Rosemary, Rue, Mint, and especially Marjoram, or

very well dried Tobacco; or even the Fume, the Smoke of these Herbs. But

all these Means are most properly employed after Bleeding, when they are

most efficacious and certain.

Sixthly, as long as the Patient shews no Signs of Life, he will be

unable to swallow, and it is then useless, and even dangerous, to pour

much Liquid of any kind into his Mouth, which could do nothing but keep

up, or increase Suffocation. It is sufficient, in such Circumstances, to

instil a few Drops of some irritating Liquor, which might also be

cordial and reviving. But as soon as ever he discovers any Motion, he

should take, within the Space of one Hour, five or six common Spoonfuls

of Oxymel of Squills diluted with warm Water: or if that Medicine was

not to be had very speedily, a strong Infusion of the blessed Thistle,

or _Carduus benedictus_, of Sage, or of Chamomile Flowers sweetened with

Honey, might do instead of it: and supposing nothing else to be had,

some warm Water, with the Addition of a little common Salt, should be

given. Some Persons are bold enough to recommend Vomits in such Cases;

but they are not without their Inconvenience; and it is not as a Vomit

that I recommend the Oxymel of Squills in them.

Seventhly, Notwithstanding the Sick discover some Tokens of Life, we

should not cease to continue our Assistance; since they sometimes

irrecoverably expire, after these first Appearances of recovering.

And lastly, though they should be manifestly re-animated, there

sometimes remains an Oppression, a Coughing and Feverishness, which

effectually constitute a Disease: and then it becomes necessary

sometimes to bleed them in the Arms; to give them Barley Water

plentifully, or Elder-flower Tea.

Sec. 403. Having thus pointed out such Means as are necessary, and truly

effectual, in such unfortunate Accidents, I shall very briefly mention

some others, which it is the general Custom to use and apply in the

first Hurry.

1, These unhappy People are sometimes wrapped up in a Sheep's, or a

Calf's, or a Dog's Skin, immediately flead from the Animal: these

Applications have sometimes indeed revived the Heat of the Drowned; but

their Operations are more slow, and less efficacious, than the Heat of a

well-warmed Bed; with the additional Vapour of burnt Sugar, and long

continued Frictions with hot Flanels.

2, The Method of rolling them in an empty Hogshead is dangerous, and

mispends a deal of important Time.

3, That also of hanging them up by the Feet is attended with Danger, and

ought to be wholly discontinued. The Froth or Foam, which is one of the

Causes of their Death, is too thick and tough to discharge itself, in

Consequence of its own Weight. Nevertheless, this is the only Effect

that can be expected, from this Custom of suspending them by the Feet;

which must also be hurtful, by its tending to increase the Overfulness

of the Head and of the Lungs.

Sec. 404. It is some Years since a Girl of eighteen Years old was recovered

[though it is unknown whether she remained under Water only a little

Time or some Hours] who was motionless, frozen as it were, insensible,

with her Eyes closed, her Mouth wide open, a livid Colour, a swoln

Visage, a Tumour or bloating of the whole Body, which was overladen as

it were, or Water-soaked. This miserable Object was extended on a Kind

of Bed, of hot or very warm Ashes, quickly heated in great Kettles; and

by laying her quite naked on these Ashes; by covering her with others

equally hot; by putting a Bonnet round her Head, with a Stocking round

her Neck stuffed with the same, and heaping Coverings over all this, at

the End of half an Hour her Pulse returned, she recovered her Speech,

and cried out, _I freeze, I freeze_: A little Cherry-Brandy was given

her, and then she remained buried, as it were, eight Hours under the

Ashes; being taken out of them afterwards without any other Complaint,

except that of great Lassitude or Weariness, which went entirely off the

third Day. This Method was undoubtedly so effectual, that it well

deserves Imitation; but it should not make us inattentive to the others.

Heated Gravel or Sand mixed with Salt, or hot Salt alone, would have

been equally efficacious, and they have been found so.

At the very Time of writing this, two young Ducks, who were drowned,

have been revived by a dry Bath of hot Ashes. The Heat of a Dung-heap

may also be beneficial; and I have just been informed, by a very

creditable and sensible Spectator of it, that it effectually contributed

to restore Life to a Man, who had certainly remained six Hours under

Water.

Sec. 405. I shall conclude these Directions with an Article printed in a

little Work at _Paris_, about twenty Years since, by Order of the King,

to which there is not the least Doubt, but that any other Sovereign will

readily accede.

"Notwithstanding the common People are very generally disposed

to be compassionate, and may wish to give all Assistance to

drowned Persons, it frequently happens they do not, only because

they dare not; imagining they expose themselves by it to

Prosecutions. It is therefore necessary, that they should know,

and it cannot be too often repeated, in order to eradicate such

a pernicious Prejudice, that the Magistrates have never

interposed to prevent People from trying every possible Means to

recover such unfortunate Persons, as shall be drowned and taken

out of the Water. It is only in those Cases, when the Persons

are known to be absolutely and irrecoverably dead, that Justice

renders it necessary to seize their Bodies."

__Chapter XXIX.__

_Of Substances stopt between the Mouth and the Stomach._

__Sect.__ 406.

The Food we take in descends from the Mouth through a very strait

Passage or Chanel, called the _Oesophagus_, the Gullet, which, going

parallel with the Spine or Backbone, joins to, or terminates at, the

Stomach.

It happens sometimes that different Bodies are stopt in this Chanel,

without being able either to descend or to return up again; whether this

Difficulty arises from their being too large; or whether it be owing to

their having such Angles or Points, as by penetrating into, and adhering

to the Sides of this membranous Canal, absolutely prevent the usual

Action and Motion of it.

Sec. 407. Very dangerous Symptoms arise from this Stoppage, which are

frequently attended with a most acute Pain in the Part; and at other

Times, with a very incommodious, rather than painful, Sensation;

sometimes a very ineffectual Commotion at, or rising of, the Stomach,

attended with great Anguish; and if the Stoppage be so circumstanced,

that the _Glottis_ is closed, or the Wind-pipe compressed, a dreadful

Suffocation is the Consequence: the Patient cannot breathe, the Lungs

are quite distended; and the Blood being unable to return from the Head,

the Countenance becomes red, then livid; the Neck swells; the Oppression

increases, and the poor Sufferer speedily dies.

When the Patient's Breathing is not stopt, nor greatly oppressed; if the

Passage is not entirely blocked up, and he can swallow something, he

lives very easily for a few Days, and then his Case becomes a particular

Disorder of the _Oesophagus_, or Gullet. But if the Passage is

absolutely closed, and the Obstruction cannot be removed for many Days,

a terrible Death is the Consequence.

Sec. 408. The Danger of such Cases does not depend so much on the Nature of

the obstructing Substance, as on its Size, with Regard to that of the

Passage of the Part where it stops, and of the Manner in which it forms

the Obstruction; and frequently the very Food may occasion Death; while

Substances less adapted to be swallowed are not attended with any

violent Consequences, though swallowed.

A Child of six Days old swallowed a Comfit or Sugar Plumb, which stuck

in the Passage, and instantly killed it.

A grown Person perceived that a Bit of Mutton had stopt in the Passage;

not to alarm any Body he arose from Table; a Moment afterwards, on

looking where he might be gone, he was found dead. Another was choaked

by a Bit of Cake; a third by a Piece of the Skin of a Ham; and a fourth

by an Egg, which he swallowed whole in a Bravo.

A Child was killed by a Chesnut swallowed whole. Another died suddenly,

choaked (which is always the Circumstance, when they die instantly after

such Accidents) by a Pear which he had tossed up, and catched in his

Mouth. A Woman was choaked with another Pear. A Piece of a Sinew

continued eight Days in the Passage, so that it prevented the Patient

from getting down any Thing else; at the Expiration of that Time it fell

into the Stomach, being loosened by its Putridity: The Patient

notwithstanding died soon after, being killed by the Inflammation,

Gangrene and Weakness it had occasioned. Unhappily there occur but too

many Instances of this Sort, of which it is unnecessary to cite more.

Sec. 409. Whenever any Substance is thus detained in the Gullet, there are

two Ways of removing it; that is either by extracting it, or pushing it

down. The safest and most certain Way is always to extract or draw it

out, but this is not always the easiest: and as the Efforts made for

this Purpose greatly fatigue the Patient, and are sometimes attended

with grievous Consequences; and yet if the Occasion is extremely urging,

it may be eligible to thrust it down, if that is easier; and if there is

no Danger from the obstructing Bodies Reception into the Stomach.

The Substances which may be pushed down without Danger, are all common

nourishing ones, as Bread, Meat, Cakes, Fruits, Pulse, Morsels of Tripe,

and even Skin of Bacon. It is only very large Morsels of particular

Aliments, that prove very difficult to digest; yet even such are rarely

attended with any Fatality.

Sec. 410. The Substances we should endeavour to extract or draw out, though

it be more painful and less easy than to push them down, are all those,

whose Consequences might be highly dangerous, or even mortal, if

swallowed. Such are all totally indigestible Bodies, as Cork,

Linen-Rags, large Fruit Stones, Bones, Wood, Glass, Stones, Metals; and

more especially if any further Danger may be superadded to that of its

Indigestibility, from the Shape, whether rough, sharp, pointed, or

angular, of the Substance swallowed. Wherefore we should chiefly

endeavour to extract Pins, Needles, Fish-bones, other pointed Fragments

of Bones, Bits of Glass, Scissars, Rings, or Buckles.

Nevertheless it has happened, that every one of these Substances have at

one Time or another been swallowed, and the most usual Consequences of

them are violent Pains of the Stomach, and in the Guts; Inflammations,

Suppurations, Abscesses, a slow Fever, Gangrene, the _Miserere_ or Iliac

Passion; external Abscesses, through which the Bodies swallowed down

have been discharged; and frequently, after a long Train of Maladies, a

dreadful Death.

Sec. 411. When such Substances have not passed in too deep, we should

endeavour to extract them with our Fingers, which often succeeds. If

they are lower, we should make use of Nippers or a small _Forceps_; of

which Surgeons are provided with different Sorts. Those which some

Smoakers carry about them might be very convenient for such Purposes;

and in Case of Necessity they might be made very readily out of two Bits

of Wood. But this Attempt to extract rarely succeeds, if the Substance

has descended far into the _Oesophagus_, and if the Substance be of a

flexible Nature, which exactly applies itself to, and fills up the

Cavity or Chanel of it.

Sec. 412. If the Fingers and the Nippers fail, or cannot be duly applied,

Crotchets, a Kind of Hooks, must be employed.

These may be made at once with a pretty strong iron Wire, crooked at the

End. It must be introduced in the flat Way, and for the better

conducting of it, there should be another Curve or Hook at the End it is

held by, to serve as a Kind of Handle to it, which has this further Use,

that it may be secured by a String tied to it; a Circumstance not to be

omitted in any Instrument employed on such Occasions, to avoid such ill

Accidents as have sometimes ensued, from these Instruments slipping out

of the Operators Hold. After the Crotchet has passed beyond and below

the Substance, that obstructs the Passage, it is drawn up again, and

hooks up with it and extracts that Impediment to swallowing.

This Crotchet is also very convenient, whenever a Substance somewhat

flexible, as a Pin or a Fishbone stick, as it were, across the Gullet:

the Crotchet in such Cases seizing them about their middle Part, crooks

and thus disengages them. If they are very brittle Substances, it serves

to break them; and if any Fragments still stick within, some other Means

must be used to extract them.

Sec. 413. When the obstructing Bodies are small, and only stop up Part of

the Passage; and which may either easily elude the Hook, or straiten it

by their Resistance, a Kind of Rings may be used, and made either solid

or flexible.

The solid ones are made of iron Wire, or of a String of very fine brass

Wire. For this Purpose the Wire is bent into a Circle about the middle

Part of its Length, the Sides of which Circle do not touch each other,

but leave a Ring, or hollow Cavity, of about an Inch Diameter. Then the

long unbent Sides of the Wire are brought near each other; the circular

Part or Ring is introduced into the Gullet, in order to be conducted

about the obstructing Body, and so to extract it. Very flexible Rings

may be made of Wool, Thread, Silk, or small Packthread, which may be

waxed, for their greater Strength and Consistence. Then they are to be

tied fast to a Handle of Iron-Wire, of Whale-bone, or of any flexible

Wood; after which the Ring is to be introduced to surround the

obstructing Substance, and to draw it out.

Several of these Rings passed through one another are often made use of,

the more certainly to lay hold of the obstructing Body, which may be

involved by one, if another should miss it. This Sort of Rings has one

Advantage, which is, that when the Substance to be extracted is once

laid hold of, it may then, by turning the Handle, be retained so

strongly in the Ring thus twisted, as to be moved every Way; which must

be a considerable Advantage in many such Cases.

Sec. 414. A fourth Material employed on these unhappy Occasions is the

Sponge. Its Property of swelling considerably, on being wet, is the

Foundation of its Usefulness here.

If any Substance is stopt in the Gullet, but without filling up the

whole Passage, a Bit of Sponge is introduced, into that Part that is

unstopt, and beyond the Substance. The Sponge soon dilates, and grows

larger in this moist Situation, and indeed the Enlargement of it may be

forwarded, by making the Patient swallow a few Drops of Water; and then

drawing back the Sponge by the Handle it is fastened to, as it is now

too large to return through the small Cavity, by which it was conveyed

in, it draws out the obstructing Body with it, and thus unplugs, as it

were, and opens the Gullet.

As dry Sponge may shrink or be contracted, this Circumstance has proved

the Means of squeezing a pretty large Piece of it into a very small

Space. It becomes greatly compressed by winding a String or Tape very

closely about it, which Tape may be easily unwound and withdrawn, after

the Sponge has been introduced. It may also be inclosed in a Piece of

Whalebone, split into four Sticks at one End, and which, being endued

with a considerable Spring, contracts upon the Sponge. The Whalebone is

so smoothed and accommodated, as not to wound; and the Sponge is also to

be safely tied to a strong Thread; that after having disengaged the

Whalebone from it, the Surgeon may also draw out the Sponge at Pleasure.

Sponge is also applied on these Occasions in another Manner. When there

is no Room to convey it into the Gullet, because the obstructing

Substance ingrosses its whole Cavity; and supposing it not hooked into

the Part, but solely detained by the Straitness of the Passage, a pretty

large Bit of Sponge is to be introduced towards the Gullet, and close to

the obstructing Subtance: Thus applied, the Sponge swells, and thence

dilates that Part of the Passage that is above this Substance. The

Sponge is then withdrawn a little, and but a very little, and this

Substance being less pressed upon above than below, it sometimes

happens, that the greater Staitness and Contraction of the lower Part of

the Passage, than of its upper Part, causes that Substance to ascend;

and as soon as this first Loosening or Disengagement of it has happened,

the total Disengagement of it easily follows.

Sec. 415. Finally, when all these Methods prove unavailable, there remains

one more, which is to make the Patient vomit; but this can scarcely be

of any Service, but when such obstructing Bodies are simply engaged in,

and not hooked or stuck into the Sides of the _Oesophagus_; since under

this latter Circumstance vomiting might occasion further Mischief.

If the Patient can swallow, a Vomiting may be excited with the

Prescription No. 8, or with No. 34, or 35. By this Operation a Bone was

thrown out, which had stopt in the Passage four and twenty Hours.

When the Patient cannot swallow, an Attempt should be made to excite him

to vomit by introducing into, and twirling about the feathery End of a

Quill in, the Bottom of the Throat, which the Feather however will not

effect, if the obstructing Body strongly compresses the whole

Circumference of the Gullet; and then no other Resource is left, but

giving a Glyster of Tobacco. A certain Person swallowed a large Morsel

of Calf's Lights, which stopt in the Middle of the Gullet, and exactly

filled up the Passage. A Surgeon unsuccessfully attempted various

Methods to extract it; but another seeing how unavailable all of them

were; and the Patient's Visage becoming black and swelled; his Eyes

ready to start, as it were, out of his Head; and falling into frequent

Swoonings, attended with Convulsions too, he caused a Glyster of an

Ounce of Tobacco boiled to be thrown up; the Consequence of which was a

violent Vomiting, which threw up the Substance that was so very near

killing him.

Sec. 416. A sixth Method, which I believe has never hitherto been

attempted, but which may prove very useful in many Cases, when the

Substances in the Passage are not too hard, and are very large, would be

to fix a Worm (used for withdrawing the Charge of Guns that have been

loaded) fast to a flexible Handle, with a waxed Thread fastened to the

Handle, in Order to withdraw it, if the Handle slipt from the Worm; and

by this Contrivance it might be very practicable, if the obstructing

Substance was not too deep in the Passage of the Gullet, to extract

it--It has been known that a Thorn fastened in the Throat, has been

thrown out by laughing.

Sec. 417. In the Circumstances mentioned Sec. 409, when it is more easy and

convenient to push the obstructing Body downwards, it has been usual to

make Use of Leeks, which may generally be had any where (but which

indeed are very subject to break) or of a Wax-candle oiled, and but a

very little heated, so as to make it flexible; or of a Piece of

Whale-bone; or of Iron-Wire; one Extremity of which may be thickened and

blunted in a Minute with a little melted Lead. Small Sticks of some

flexible Wood may be as convenient for the same Use, such as the

Birch-tree, the Hazel, the Ash, the Willow, a flexible Plummet, or a

leaden Ring. All these Substances should be very smooth, that they may

not give the least Irritation; for which Reason they are sometimes

covered over with a thin Bit of Sheep's Gut. Sometimes a Sponge is

fastened to one End of them, which, completely filling up the whole

Passage, pushes down whatever Obstacle it meets with.

In such Cases too, the Patient may be prompted to attempt swallowing

down large Morsels of some unhurtful Substance, such as a Crust of

Bread, a small Turnep, a Lettuce Stalk, or a Bullet, in Hopes of their

carrying down the obstructing Cause with them. It must be acknowledged,

however, that these afford but a feeble Assistance; and if they are

swallowed without being well secured to a Thread, it may be apprehended

they may even increase the Obstruction, by their own Stoppage.

It has sometimes very happily, though rarely, occurred, that those

Substances attempted to be detruded or thrust downwards, have stuck in

the Wax-Candle, or the Leek, and sprung up and out with them: but this

can never happen except in the Case of pointed Substances.

Sec. 418. Should it be impossible to extract the Bodies mentioned Sec. 410,

and all such as it must be dangerous to admit into the Stomach, we must

then prefer the least of two Evils, and rather run the Hazard of pushing

them down, than suffer the Patient to perish dreadfully in a few

Moments. And we ought to scruple this Resolution the less, as a great

many Instances have demonstrated, that notwithstanding several bad

Consequences, and even a tormenting Death, have often followed the

swallowing of such hurtful or indigestible Substances; yet at other

times they have been attended with little or no Disorder.

Sec. 419. One of these four Events is always the Case, after swallowing

such Things. They either, 1, go off by Stool; or, 2, they are not

discharged and kill the Patient. Or else, 3, they are discharged by

Urine; or, 4, are visibly extruded to the Skin. I shall give some

Instances of each of these Events.

Sec. 420. When they are voided by Stool, they are either voided soon after

they have been swallowed, and that without having occasional scarce any

troublesome Symptom; or the voiding of them has not happened till a long

Time after swallowing, and is preceded with very considerable Pain. It

has been seen that a Bone of the Leg of a Fowl, a Peach-stone, the Cover

of a small Box of Venice Treacle, Pins, Needles, and Coins of different

Sorts, have been voided within a few Days after they had slipt down into

the Stomach; and that with little or no Complaint. A small Flute, or

Pipe also, four Inches long, which occasioned acute Pains for three

Days, has been voided happily afterwards, besides, Knives, Razors, and

one Shoe-buckle. I have seen but a few Days since a Child between two

and three Years old, who swallowed a Nail above an Inch long, the Head

of which was more than three Tenths of an Inch broad: it stopt a few

Moments about the Neck, but descended while its Friends were looking for

me; and was voided with a Stool that Night, without any bad Consequence.

And still more lately I have known the entire Bone of a Chicken's Wing

thus swallowed, which only occasioned a slight Pain in the Stomach for

three or four Days.

Sometimes such Substances are retained within for a long Time, not being

voided till after several Months, and even Years, without the least ill

Effect: and some of them have never either appeared, nor been complained

of.

Sec. 421. But the Event is not always so happy; and sometimes though they

are discharged through the natural Passages, the Discharges have been

preceded by very acute Pains in the Stomach, and in the Bowels. A Girl

swallowed down some Pins, which afflicted her with violent Pains for the

Space of six Years; at the Expiration of which Term she voided them and

recovered. Three Needles being swallowed brought on Cholics, Swoonings

and Convulsions for a Year after: and then being voided by Stool, the

Patient recovered. Another Person who swallowed two, was much happier in

suffering but six Hours from them; when they were voided by Stool, and

he did well.

It sometimes happens that such indigestible Substances, after having

past all the Meanders, the whole Course of the Intestines, have been

stopt in the Fundament, and brought on very troublesome Symptoms; but

such however, as an expert Surgeon may very generally remove. If it is

practicable to cut them, as it is when they happen to be thin Bones, the

Jaw-bones of Fish, or Pins, they are then very easily extracted.

Sec. 422. The second Event is, when these fatal Substances are never

voided, but cause very embarrassing Symptoms which finally kill the

Patient; and of these Cases there have been but too many Examples.

A young Girl having swallowed some Pins, which she held in her Mouth,

some of them were voided by Stool; but others of them pricked and

pierced into her Guts, and even into the Muscles of her Belly, with the

severest Pain; and killed her at the End of three Weeks.

A Man swallowed a Needle, which pierced through his Stomach, and into

his Liver, [94] and ended in a mortal Consumption.

[94] I saw a very similar Instance and Event in a Lady's little

favourite Bitch, whole Body she desired to be opened, from

suspecting her to have been poisoned. But it appeared that a small

Needle with fine Thread, which she had swallowed, had passed out of

the Stomach into the _Duodenum_ (one of the Guts) through which the

Point had pierced and pricked and corroded the concave Part of the

Liver, which was all rough and putrid. The whole Carcase was

greatly bloated and extremely offensive, very soon after the poor

Animal's Death, which happened two or three Months after the

Accident, and was preceded by a great Wheezing, Restlessness and

Loss of Appetite. The Needle was rusty, but the Thread entire, and

very little altered. _K._

A Plummet which slipt down, while the Throat of a Patient was searching,

killed him at the End of two Years.

It is very common for different Coins, and of different Metals, to be

swallowed without any fatal or troublesome Effects. Even a hundred

Luidores [95] have been swallowed, and all voided. Nevertheless these

fortunate Escapes ought not to make People too secure and incautious on

such Occasions, since such melancholy Consequences have happened, as may

very justly alarm them. One single Piece of Money that was swallowed,

entirely obstructed the Communication between the Stomach and the

Intestines, and killed the Patient. Whole Nuts have often been

inadvertently swallowed; but there have been some Instances of Persons

in whom a Heap [96] of them has been formed, which proved the Cause of

Death, after producing much Pain and Inquietude.

[95] I knew a Man of the Name of _Poole_, who being taken in the same

Ship with me, 1717 or 18, by Pirates, had swallowed four Ginueas,

and a gold Ring, all which he voided some Days after without any

Injury or Complaint, and saved them. I forget the exact Number of

Days he retained them, but the Pirates staid with us from Saturday

Night to Thursday Noon. _K._

[96] Many fatal Examples of this Kind may be seen in the _Philosophical

Transactions_; and they should caution People against swallowing

Cherry-stones, and still more against those of Prunes, or such as

are pointed, though not very acutely. _K._

Sec. 423. The third Issue or Event is, when these Substances, thus

swallowed down, have been discharged by Urine: but these Cases are very

rare.

A Pin of a middling Size has been discharged by Urine, three Days after

it slipt down; and a little Bone has been expelled the same Way, besides

Cherry-stones, Plumb-stones, and even one Peach-stone.

Sec. 424. Finally, the fourth Consequence or Event is, when the

indigestible Substances thus swallowed, have pierced through the Stomach

or Intestines, and even to the Skin itself; and occasioning an Abscess,

have made an Outlet for themselves, or have been taken out of the

Abscess. A long Time is often required to effect this extraordinary

Trajection and Appearance of them; sometimes the Pains they occasion are

continual; in other Cases the Patient complains for a Time, after which

the Pain ceases, and then returns again. The Imposthume, or Gathering,

is formed in the Stomach, or in some other Part of the Belly: and

sometimes these very Substances, after having pierced through the Guts,

make very singular Routs, and are discharged very remotely from the

Belly. One Needle that had been swallowed found its Way out, at the End

of four Years, through the Leg; another at the Shoulder.

Sec. 425. All these Examples, and many others of cruel Deaths, from

swallowing noxious Substances, demonstrate the great Necessity of an

habitual Caution in this Respect; and give in their Testimony against

the horrid, I had almost said, the criminal Imprudence, of People's

amusing themselves with such Tricks as may lead to such terrible

Accidents; or even holding any such Substance in their Mouths, as by

slipping down through Imprudence or Accident, may prove the Occasion of

their Death. Is it possible that any one, without shuddering, can hold

Pins or Needles in their Mouths, after reflecting on the dreadful

Accidents, and cruel Deaths, that have thus been caused by them.

Sec. 426. It has been shewn already, that Substances obstructing the

Passage of the Gullet sometimes suffocate the Patient; that at other

Times they can neither be extracted nor thrust down; but that they stop

in the Passage, without killing the Patient, at least not immediately

and at once. This is the Case when they are so circumstanced, as not to

compress the _Trachaea_, the Wind-pipe, and not totally to prevent the

swallowing of Food; which last Circumstance can scarcely happen, except

the Obstruction has been formed by angular or pointed Bodies. The

Stoppage of such Bodies is sometimes attended, and that without much

Violence, with a small Suppuration, which loosens them; and then they

are either returned upwards through the Mouth, or descend into the

Stomach. But at other Times an extraordinary Inflammation is produced,

which kills the Patient. Or if the Contents of the Abscess attending the

Inflammation tend outwardly, a Tumour is formed on the external Part of

the Neck, which is to be opened, and through whose Orifice the

obstructing Body is discharged. In other Instances again they take a

different Course, attended with little or no Pain, and are at length

discharged by a Gathering behind the Neck, on the Breast, the Shoulder,

or various other Parts.

Sec. 427. Some Persons, astonished at the extraordinary Course and

Progression of such Substances, which, from their Size, and especially

from their Shape, seem to them incapable of being introduced into, and

in some Sort, circulating through the human Body, without destroying it,

are very desirous of having the Rout and Progression of such intruding

Substances explained to them. To gratify such Inquirers, I may be

indulged in a short Digression, which perhaps is the less foreign to my

Plan; as in dissipating what seems marvelous, and has been thought

supernatural in such Cases, I may demolish that superstitious Prejudice,

which has often ascribed Effects of this Sort to Witchcraft; but which

admit of an easy Explanation. This very Reason is the Motive that has

determined me to give a further Extent to this Chapter.

Wherever an Incision is made through the Skin, a certain Membrane

appears, which consists of two Coats or _Laminae_, separated from each

other by small Cells or Cavities, which all communicate together; and

which are furnished, more or less, with Fat. There is not any Fat

throughout the human Body, which is not inclosed in, or enveloped with,

this Coat, which is called the adipose, fatty, or cellular Membrane.

This Membrane is not only found under the Skin, but further plying and

insinuating itself in various Manners, it is extended throughout the

whole Body. It distinguishes and separates all the Muscles; it

constitutes a Part of the Stomach, of the Guts, of the Bladder, and of

all the _Viscera_ or Bowels. It is this which forms what is called the

Cawl, and which also furnishes a Sheath or Envelopement to the Veins,

Arteries, and Nerves. In some Parts it is very thick, and is abundantly

replenished with Fat; in others it is very thin and unprovided with any;

but wherever it extends, it is wholly insensible, or void of all

Sensation, all Feeling.

It may be compared to a quilted Coverlet, the Cotton, or other Stuffing

of which, is unequally distributed; greatly abounding in some Places,

with none at all in others, so that in these the Stuff above and below

touch each other. Within this Membrane, or Coverlet, as it were, such

extraneous or foreign Substances are moved about; and as there is a

general Communication throughout the whole Extent of the Membrane, it is

no ways surprizing, that they are moved from one Part to another very

distant, in a long Course and Duration of Movement. Officers and

Soldiers very often experience, that Bullets which do not pass through

the Parts where they have entered, are transferred to very different and

remote ones.

The general Communication throughout this Membrane is daily demonstrated

by Facts, which the Law prohibits; this is the Butchers inflating, or

blowing up, the cellular Membrane throughout the whole Carcase of a

Calf, by a small Incision in the Skin, into which they introduce a Pipe

or the Nozzle of a small Bellows; and then, blowing forcibly, the Air

evidently puffs up the whole Body of the Calf into this artificial

Tumour or Swelling.

Some very criminal Impostors have availed themselves of this wicked

Contrivance, thus to bloat up Children into a Kind of Monsters, which

they afterwards expose to View for Money.

In this cellular Membrane the extravasated Waters of hydropic Patients

are commonly diffused; and here they give Way to that Motion, to which

their own Weight disposes them. But here I may be asked--As this

Membrane is crossed and intersected in different Parts of it, by Nerves,

Veins, Arteries, _&c._ the wounding of which unavoidably occasions

grievous Symptoms, how comes it, that such do not ensue upon the

Intrusion of such noxious Substances? To this I answer, 1, that such

Symptoms do sometimes really ensue; and 2, that nevertheless they must

happen but seldom, by Reason that all the aforesaid Parts, which

traverse and intersect this Membrane, being harder than the Fat it

contains; such foreign Substances must almost necessarily, whenever they

rencounter those Parts, be turned aside towards the Fat which surrounds

them, whose Resistance is very considerably less; and this the more

certainly so, as these Nerves, _&c._ are always of a cylindrical

Form.----But to return from this necessary Digression.

Sec. 428. To all these Methods and Expedients I have already recommended on

the important Subject of this Chapter, I shall further add some general

Directions.

1. It is often useful, and even necessary, to take a considerable

Quantity of Blood from the Arm; but especially if the Patient's

Respiration, or Breathing, is extremely oppressed; or when we cannot

speedily succeed in our Efforts to remove the obstructing Substance; as

the Bleeding is adapted to prevent the Inflammation, which the frequent

Irritations from such Substances occasion; and as by its disposing the

whole Body into a State of Relaxation, it might possibly procure an

immediate Discharge of the offending Substance.

2. Whenever it is manifest that all Endeavours, either to extract, or to

push down the Substance stopt in the Passage, are ineffectual, they

should be discontinued; because the Inflammation occasioned by

persisting in them, would be as dangerous as the Obstruction itself; as

there have been Instances of People's dying in Consequence of the

Inflammation; notwithstanding the Body, which caused the Obstruction,

had been entirely removed.

3. While the Means already advised are making Use of, the Patient should

often swallow, or if he cannot, he should frequently receive by

Injection through a crooked Tube or Pipe, that may reach lower down than

the _Glottis_, some very emollient Liquor, as warm Water, either alone

or mixed with Milk, or a Decoction of Barley, of Mallows, or of Bran. A

two-fold Advantage may arise from this; the first is, that these

softening Liquors smooth and sooth the irritated Parts; and secondly, an

Injection, strongly thrown in, has often been more successful in

loosening the obstructing Body, than all Attempts with Instruments.

4. When after all we are obliged to leave this in the Part, the Patient

must be treated as if he had an inflammatory Disease; he must be bled,

ordered to a Regimen, and have his whole Neck surrounded with emollient

Pultices. The like Treatment must also be used, though the obstructing

Substance be removed; if there is Room to suppose any Inflammation left

in the Passage.

5. A proper Degree of Agitation has sometimes loosened the inhering

Body, more effectually than Instruments. It has been experienced that a

Blow with the Fist on the Spine, the Middle of the Back, has often

disengaged such obstructed and obstructing Bodies; and I have known two

Instances of Patients who had Pins stopt in the Passage; and who getting

on Horseback to ride out in Search of Relief at a neighbouring Village,

found each of them the Pin disengaged after an Hour's riding: One spat

it out, and the other swallowed it, without any ill Consequence.

6. When there is an immediate Apprehension of the Patient's being

suffocated; when bleeding him has been of no Service; when all Hope of

freeing the Passage in time is vanished, and Death seems at Hand, if

Respiration be not restored; the Operation of _Bronchotomy_, or opening

of the Wind-pipe, must be directly performed; an Operation neither

difficult to a tolerably knowing and expert Surgeon, nor very painful to

the Patient.

7. When the Substance that was stopt passes into the Stomach, the

Patient must immediately be put into a very mild and smooth Regimen. He

should avoid all sharp, irritating, inflaming Food; Wine, spirituous

Liquors, all strong Drink, and Coffee; taking but little Nourishment at

once, and no Solids, without their having been thoroughly well chewed.

The best Diet would be that of farinaceous mealy Soups, made of various

leguminous Grains, and of Milk and Water, which is much better than the

usual Custom of swallowing different Oils.

Sec. 429. The Author of Nature has provided, that in eating, nothing should

pass by the _Glottis_ into the Wind-pipe. This Misfortune nevertheless

does sometimes happen; at which very Instant there ensues an incessant

and violent Cough, an acute Pain, with Suffocation; all the Blood being

forced up into the Head, the Patient is in extreme Anguish, being

agitated with violent and involuntary Motions, and sometimes dying on

the Spot. A _Hungarian_ Grenadier, by Trade a Shoemaker, was eating and

working at the same time. He tumbled at once from his Seat, without

uttering a single Word. His Comrades called out for Assistance; some

Surgeons speedily arrived, but after all their Endeavours he discovered

no Token of Life. On opening the Body, they found a Lump, or large

Morsel, of Beef, weighing two Ounces, forced into the Windpipe, which it

plugged up so exactly, that not the least Air could pass through it into

the Lungs.

Sec. 430. In a Case so circumstanced, the Patient should be struck often on

the Middle of the Back; some Efforts to vomit should be excited; he

should be prompted to sneeze with Powder of Lilly of the Valley, Sage,

or any cephalic Snuffs, which should be blown strongly up his Nose.

A Pea, pitched into the Mouth in playing, entered into the Wind-pipe,

and sprung out again by vomiting the Patient with Oil. A little Bone was

brought up by making another sneeze, with powdered Lilly of the Valley.

In short, if all these Means of assisting, or saving the Patient are

evidently ineffectual, _Bronchotomy_ must be speedily performed (See No.

6, of the preceding Section.) By this Operation, some Bones, a Bean, and

a Fish-bone have been extracted, and the Patient has been delivered from

approaching Death.

Sec. 431. Nothing should be left untried, when the Preservation of human

Life is the Object. In those Cases, when an obstructing Body can neither

be disengaged from the Throat, the Passage to the Stomach, nor be

suffered to remain there without speedily killing the Patient, it has

been proposed to make an Incision into this Passage, the _Oesophagus_,

through which such a Body is to be extracted; and to employ the like

Means, when a Substance which had slipt even into the Stomach itself,

was of a Nature to excite such Symptoms, as must speedily destroy the

Patient.

When the _Oesophagus_ is so fully and strongly closed, that the Patient

can receive no Food by the Mouth, he is to be nourished by Glysters of

Soup, Gelly, and the like.

__Chapter XXX.__

_Of external Disorders, and such as require chirurgical

Application. Of Burns, Wounds, Contusions or Bruises: Of

Sprains, Ulcers, frostbitten Limbs, Chilblains, Ruptures, Boils.

Of Fellons, Thorns or Splinters in the Fingers or Flesh; of

Warts, and of Corns._

__Sect.__ 432.

Labouring Countrymen are exposed in the Course of their daily Work, to

many outward Accidents, such as Cuts, Contusions, _&c_. which, however

considerable in themselves, very generally end happily; and that chiefly

in Consequence of the pure and simple Nature of their Blood, which is

generally much less acrimonious, or sharp, in the Country, than in great

Towns or Cities. Nevertheless, the very improper Treatment of such

Accidents, in the Country, frequently renders them, however light in

themselves, very troublesome; and indeed, I have seen so many Instances

of this, that I have thought it necessary to mark out here the proper

Treatment of such Accidents, as may not necessarily require the Hand or

Attendance of a Surgeon. I shall also add something very briefly,

concerning some external Disorders, which at the same Time result from

an inward Cause.

_Of Burns._

Sec. 433. When a Burn is very trifling and superficial, and occasions no

Vesication or Blister, it is sufficient to clap a Compress of several

Folds of soft Linen upon it, dipt in cold Water, and to renew it every

Quarter of an Hour, till the Pain is entirely removed. But when the Burn

has blistered, a Compress of very fine Linen, spread over with the

Pomatum, No. 64, should be applied over it, and changed twice a Day.

If the true Skin is burnt, and even the Muscles, the Flesh under it, be

injured, the same Pomatum may be applied; but instead of a Compress, it

should be spread upon a Pledget of soft Lint, to be applied very exactly

over it, and over the Pledget again, a Slip of the simple Plaister No.

65, which every Body may easily prepare; or, if they should prefer it,

the Plaister No. 66.

But, independently of these external Applications, which are the most

effectual ones, when they are directly to be had; whenever the Burn has

been very violent, is highly inflamed, and we are apprehensive of the

Progress and the Consequences of the Inflammation, the same Means and

Remedies must be recurred to, which are used in violent Inflammations:

the Patient should be bled, and, if it is necessary, it should be

repeated more than once, and he should be put into a Regimen; drink

nothing but the Ptisans No. 2 and 4, and receive daily two simple

Glysters.

If the Ingredients for the Ointment, called _Nutritum_, are not at Hand

to make the Pomatum No. 64; one Part of Wax should be melted in eight

such Parts of Oil, to two Ounces of which Mixture the Yolk of an Egg

should be added. A still more simple and sooner prepared Application, is

that of one Egg, both the Yolk and the White, beat up with two common

Spoonfuls of the sweetest Oil, without any Rankness. When the Pain of

the Burn, and all its other Symptoms have very nearly disappeared, it is

sufficient to apply the Sparadrap, or Oil-cloth No. 66.

_Of Wounds._

Sec. 434. If a Wound has penetrated into any of the Cavities, and has

wounded any Part contained in the Breast, or in the Belly: Or if,

without having entered into one of the Cavities, it has opened some

great Blood-vessel; or if it has wounded a considerable Nerve, which

occasions Symptoms much more violent, than would otherwise have

happened; if it has penetrated even to and injured the Bone: in short,

if any great and severe Symptom supervenes, there is an absolute

Necessity for calling in a Surgeon. But whenever the Wound is not

attended with any of these Circumstances; when it affects only the Skin,

the fat Membrane beneath it, the fleshy Parts and the small Vessels, it

may be easily and simply dressed without such Assistance; since, in

general, all that is truly necessary in such Cases is, to defend the

Wound from the Impressions of the Air; and yet not so, as to give any

material Obstruction to the Discharge of the Matter, that is to issue

from the Wound.

Sec. 435. If the Blood does not particularly flow out of any considerable

Vessel, but trickles almost equally from every Spot of the Wound, it may

very safely be permitted to bleed, while some Lint is speedily

preparing. As soon as the Lint is ready, so much of it may be introduced

into the Wound as will nearly fill it, without being forced in; which is

highly improper, and would be attended with the same Inconveniences as

Tents and Dossils. It should be covered over with a Compress dipt in

sweet Oil, or with the Cerecloth No. 65; though I prefer the Compress

for the earliest Dressings: and the whole Dressing should be kept on,

with a Bandage of two Fingers Breadth, and of a Length proportioned to

the Size of the Part it is to surround: This should be rolled on tight

enough to secure the Dressings, and yet so moderately, as to bring on no

Inflammation.

This Bandage with these Dressings are to remain on twenty-four or

forty-eight Hours; Wounds being healed the sooner, for being less

frequently drest. At the second Dressing all the Lint must be removed,

which can be done with Ease, and with reasonable Speed, to the Wounded;

and if any of it should stick close, in Consequence of the clogged and

dried Blood, it should be left behind, adding a little fresh Lint to it;

this Dressing in other Respects exactly resembling the first.

When, from the Continuance of this simple Dressing, the Wound is become

very superficial, it is sufficient to apply the Cerecloth, or Plaister,

without any Lint.

Such as have conceived an extraordinary Opinion of any medical Oils,

impregnated with the Virtues of particular Plants, may, if that will

increase their Satisfaction, make use of the common Oil of Yarrow, of

Trefoil, of Lilies, of Chamomile, of Balsamines, or of red Roses; only

being very careful, that such Oils are not become stale and rank.

Sec. 436. When the Wound is considerable, it must be expected to inflame

before Suppuration (which, in such a Case, advances more slowly) can

ensue; which Inflammation will necessarily be attended with Pain, with a

Fever, and sometimes with a Raving, or Wandering, too. In such a

Situation, a Pultice of Bread and Milk, with the Addition of a little

Oil, that it may not stick too close, must be applied instead of the

Compress or the Plaister: which Pultice is to be changed, but without

uncovering the Wound, thrice and even four times every Day.

Sec. 437. Should some pretty considerable Blood-vessel be opened by the

Wound, there must be applied over it, a Piece of Agaric of the Oak, No.

67, with which no Country place ought to be unprovided. It is to be kept

on, by applying a good deal of Lint over it; covering the whole with a

thick Compress, and then with a Bandage a little tighter than usual. If

this should not be sufficient to prevent the Bleeding from the large

Vessel, and the Wound be in the Leg or Arm, a strong Ligature must be

made above the Wound with a _Turniquet_, which is made in a Moment with

a Skain of Thread, or of Hemp, that is passed round the Arm circularly,

into the Middle of which is inserted a Piece of Wood or Stick of an Inch

Thickness, and four or five Inches long; so that by turning round this

Piece of Wood, any Tightness or Compression may be effected at Pleasure;

exactly as a Country-man secures a Hogshead, or a Piece of Timber on his

Cart, with a Chain and Ring. But Care must be taken, 1, to dispose the

Skain in such a Manner, that it must always be two Inches wider than the

Part it surrounds: and, 2, not to strain it so tight as to bring on an

Inflammation, which might terminate in a Gangrene.

Sec. 438. All the boasted Virtues of a Multitude of Ointments are downright

Nonsense or Quackery. Art, strictly considered, does not in the least

contribute to the healing of Wounds; the utmost we can do amounting only

to our removing those Accidents, which are so many Obstacles to their

Re-union. On this Account, if there is any extraneous Body in the Wound,

such as Iron, Lead, Wood, Glass, Bits of Cloth or Linen, they must be

extracted, if that can be very easily done; but if not, Application must

be made to a good Surgeon, who considers what Measures are to be taken,

and then dresses the Wound, as I have already advised.

Very far from being useful, there are many Ointments that are pernicious

on these Occasions; and the only Cases in which they should be used, are

those in which the Wounds are distinguished with some particular

Appearances, which ought to be removed by particular Applications: But a

simple recent Wound, in a healthy Man, requires no other Treatment but

what I have already directed, besides that of the general Regimen.

Spirituous Applications are commonly hurtful, and can be suitable and

proper but in a few Cases, which Physicians and Surgeons only can

distinguish.

When Wounds occur in the Head, instead of the Compress dipt in Oil, or

of the Cerecloth, the Wound should be covered with a Betony Plaister;

or, when none is to be had in time, with a Compress squeezed out of hot

Wine.

Sec. 439. As the following Symptoms, of which we should be most

apprehensive, are such as attend on Inflammations, the Means we ought to

have Recourse to are those which are most likely to prevent them; such

as Bleeding, the usual Regimen, moderate Coolers and Glysters.

Should the Wound be very inconsiderable in its Degree, and in its

Situation, it may be sufficient to avoid taking any Thing heating; and

above all Things to retrench the Use of any strong Drink, and of

Flesh-meat.

But when it is considerable, and an Inflammation must be expected, there

is a Necessity for Bleeding; the Patient should be kept in the most

quiet and easy Situation; he should be ordered immediately to a Regimen;

and sometimes the Bleeding also must be repeated. Now all these Means

are the more indispensably necessary, when the Wound has penetrated to

some internal Part; in which Situation, no Remedy is more certain than

that of an extremely light Diet. Such wounded Persons as have been

supposed incapable of living many Hours, after Wounds in the Breast, in

the Belly, or in the Kidnies, have been completely recovered, by living

for the Course of several Weeks, on nothing but a Barley, or other

farinaceous mealy, Ptisans, without Salt, without Soup, without any

Medicine; and especially without the Use of any Ointments.

Sec. 440. In the same Proportion that Bleeding, moderately and judiciously

employed, is serviceable, in that very same an Excess of it becomes

pernicious. Great Wounds are generally attended with a considerable Loss

of Blood, which has already exhausted the wounded Person; and the Fever

is often a Consequence of this copious Loss of Blood. Now if under such

a Circumstance, Bleeding should be ordered and performed, the Patient's

Strength is totally sunk; the Humours stagnate and corrupt; a Gangrene

supervenes, and he dies miserably, at the End of two or three Days, of a

_Series_ of repeated Bleedings, but not of the Wound. Notwithstanding

the Certainty of this, the Surgeon frequently boasts of his ten, twelve,

or even his fifteen Bleedings; assuring his Hearers of the insuperable

Mortality of the Wound, since the letting out such a Quantity of Blood

could not recover the Patient; when it really was that excessive

artificial Profusion of it, that downright dispatched him.------The

Pleasures of Love are very mortal ones to the Wounded.

Sec. 441. The Balsams and vulnerary Plants, which have often been so highly

celebrated for the Cure of Wounds, are very noxious, when taken

inwardly; because the Introduction of them gives or heightens the Fever,

which ought to have been abated.

_Of Contusions, or Bruises._

Sec. 442. A Contusion, which is commonly called a Bruise, is the Effect of

the forcible Impression or Stroke of a Substance not sharp or cutting,

on the Body of a Man, or any Animal; whether such an Impression be

violently made on the Man, as when he is struck by a Stick, or by a

Stone thrown at him; or whether the Man be involuntarily forced against

a Post, a Stone, or any hard Substance by a Fall; or whether, in short,

he is squeezed and oppressed betwixt two hard Bodies, as when his Finger

is squeezed betwixt the Door and the Door-Post, or the whole Body jammed

in betwixt any Carriage and the Wall. These Bruises, however, are still

more frequent in the Country than Wounds, and commonly more dangerous

too; and indeed the more so, as we cannot judge so exactly, and so soon,

of the whole Injury that has been incurred; and because all that is

immediately visible of it is often but a small Part of the real Damage

attending it: since it frequently happens that no Hurt appears for a few

successive Days; nor does it become manifest, until it is too late to

admit of an effectual Cure.

Sec. 443. It is but a few Weeks since a Cooper came to ask my Advice. His

Manner of breathing, his Aspect, the Quickness, Smallness, and

Irregularity of his Pulse, made me apprehensive at once, that some

Matter was formed within his Breast. Nevertheless he still kept up, and

went about, working also at some Part of his Trade. He had fallen in

removing some Casks or Hogsheads; and the whole Weight of his Body had

been violently impressed upon the right Side of his Breast.

Notwithstanding this, he was sensible of no Hurt at first; but some Days

afterwards he began to feel a dull heavy Pain in that Part, which

continued and brought on a Difficulty of Breathing, Weakness, broken

Sleep and Loss of Appetite. I ordered him immediately to Stillness and

Repose, and I advised him to drink a Ptisan of Barley sweetened with

Honey, in a plentiful Quantity. He regularly obeyed only the latter Part

of my Directions: yet on meeting him a few Days after, he told me he was

better. The very same Week, however, I was informed he had been found

dead in his Bed. The Imposthume had undoubtedly broke, and suffocated

him.

Sec. 444. A young Man, run away with by his Horse, was forced with Violence

against a Stable-Door, without being sensible of any Damage at the Time.

But at the Expiration of twelve Days, he found himself attacked by some

such Complaints, as generally occur at the Beginning of a Fever. This

Fever was mistaken for a putrid one, and he was very improperly treated,

for the Fever it really was, above a Month. In short, it was agreed at a

Consultation, that Matter was collected in the Breast. In Consequence of

this, he was more properly attended, and at length happily cured by the

Operation for an _Empyema_, after languishing a whole Year. I have

published these two Instances, to demonstrate the great Danger of

neglecting violent Strokes or Bruises; since the first of these Patients

might have escaped Death; and the second a tedious and afflicting

Disorder, if they had taken, immediately after each Accident, the

necessary Precautions against its Consequences.

Sec. 445. Whenever any Part is bruised, one of two Things always ensues,

and commonly both happen together; especially if the Contusion is pretty

considerable: Either the small Blood-vessels of the contused Part are

broken, and the Blood they contained is spread about in the adjoining

Parts; or else, without such an Effusion of it, these Vessels have lost

their Tone, their active Force, and no longer contributing to the

Circulation, their Contents stagnate. In each of these Cases, if Nature,

either without or with the Assistance of Art, does not remove the

Impediment, an Inflammation comes on, attended with an imperfect,

unkindly Suppuration, with Putrefaction and a Gangrene; without

mentioning the Symptoms that arise from the Contusion of some particular

Substance, as a Nerve, a large Vessel, a Bone, _&c._ Hence we may also

conceive the Danger of a Contusion, happening to any inward Part, from

which the Blood is either internally effused, or the Circulation wholly

obstructed in some vital Organ. This is the Cause of the sudden Death of

Persons after a violent Fall; or of those who have received the violent

Force of heavy descending Bodies on their Heads; or of some violent

Strokes, without any evident external Hurt or Mark.

There have been many Instances of sudden Deaths after one Blow on the

Pit of the Stomach, which has occasioned a Rupture of the Spleen.

It is in Consequence of Falls occasioning a general slight Contusion, as

well internal as external, that they are sometimes attended with such

grievous Consequences, especially in old Men, where Nature, already

enfeebled, is less able to redress such Disorders. And thus in Fact has

it been, that many such, who had before enjoyed a firm State of Health,

have immediately lost it after a Fall (which seemed at first to have

affected them little or not at all) and languished soon after to the

Moment of their Death, which such Accidents very generally accelerate.

Sec. 446. Different external and internal Remedies are applicable in

Contusions. When the Accident has occurred in a slight Degree, and there

has been no great nor general Shock, which might produce an internal

Soreness or Contusion, external Applications may be sufficient. They

should consist of such Things as are adapted, first, to attenuate and

resolve the effused and stagnant Blood, which shews itself so

apparently; and which, from its manifest Blackness very soon after the

Contusion, becomes successively brown, yellow, and greyish, in

Proportions as the Magnitude of the Suffusion or Sealing decreases, till

at last it disappears entirely, and the Skin recovers its Colour,

without the Blood's having been discharged through the external Surface,

as it has been insensibly and gradually dissolved, and been taken in

again by the Vessels: And secondly, the Medicines should be such as are

qualified to restore the Tone, and to recover the Strength of the

affected Vessels.

The best Application is Vinegar, diluted, if very sharp, with twice as

much warm Water; in which Mixture Folds of Linnen are to be dipt, within

which the contused Parts are to be involved; and these Folds are to be

remoistened and re-applied every two Hours on the first Day.

Parsley, Chervil, and Houseleek Leaves, lightly pounded, have also been

successfully employed; and these Applications are preferable to Vinegar,

when a Wound is joined to the Bruise. The Pultices, No. 68, may also be

used with Advantage.

Sec. 447. It has been a common Practice immediately to apply spirituous

Liquors, such as Brandy, Arquebussade and [97] Alibour Water, and the

like; but a long Abuse ought not to be established by Prescription.

These Liquids which coagulate the Blood, instead of resolving it, are

truly pernicious; notwithstanding they are sometimes employed without

any visible Disadvantage on very slight Occasions. Frequently by

determining the settled Blood towards the Insterstices of the Muscles,

the fleshy Parts; or sometimes even by preventing the Effusion, or

visible Settling of the Blood, and fixing it, as it were, within the

bruised Vessels, they seem to be well; though this only arises from

their concentring and concealing the Evil, which, at the End of a few

Months, breaks forth again in a very troublesome Shape. Of this I have

seen some miserable Examples, whence it has been abundantly evinced,

that Applications of this Sort should never be admitted; and that

Vinegar should be used instead of them. At the utmost it should only be

allowed, (after there is Reason to suppose all the stagnant Blood

resolved and resorbed into the Circulation) to add a third Part of

Arquebusade Water to the Vinegar; with an Intention to restore some

Strength to the relaxed and weakened Parts.

[97] This, Dr. _Tissot_ informs me, is a Solution of white Vitriol and

some other Drugs in Spirit of Wine, and is never used in regular

Practice now. It has its Name from the Author of the Solution. _K._

Sec. 448. It is still a more pernicious Practice to apply, in Bruises,

Plaisters composed of greasy Substances, Rosins, Gums, Earths, _&c._ The

most boasted of these is always hurtful, and there have been many

Instances of very slight Contusions being aggravated into Gangrenes by

such Plaisters ignorantly applied; which Bruises would have been

entirely subdued by the Oeconomy of Nature, if left to herself, in the

Space of four Days.

Those Sacs or Suffusions of coagulated Blood, which are visible under

the Skin, should never be opened, except for some urgent Reason; since

however large they may be, they insensibly disappear and dissipate;

instead of which Termination, by opening them, they sometimes terminate

in a dangerous Ulceration.

Sec. 449. The internal Treatment of Contusions is exactly the same with

that of Wounds; only that in these Cases the best Drink is the

Prescription, No. 1, to each Pot of which a Drachm of Nitre must be

added.

When any Person has got a violent Fall; has lost his Senses, or is

become very stupid; when the Blood starts out of his Nostrils, or his

Ears; when he is greatly oppressed, or his Belly feels very tight and

tense, which import an Effusion of Blood either into the Head, the

Breast or the Belly, he must, first of all, be bled upon the Spot, and

all the Means must be recurred to, which have been mentioned Sec. 439,

giving the wretched Patient the least possible Disturbance or Motion;

and by all means avoiding to jog or shake him, with a Design to bring

him to his Senses; which would be directly and effectually killing him,

by causing a further Effusion of Blood. Instead of this the whole Body

should be fomented, with some one of the Decoctions already mentioned:

and when the Violence has been chiefly impressed on the Head, Wine and

Water should be prefered to Vinegar.

Falls attended with Wounds, and even a Fracture of the Skull, and with

the most alarming Symptoms, have been cured by these internal Remedies,

and without any other external Assistance, except the Use of the

aromatic Fomentation, No. 68.

A Man from _Pully-petit_ came to consult me some Months ago, concerning

his Father, who had a high Fall out of a Tree. He had been twenty-four

Hours without Feeling or Sense, and without any other Motion than

frequent Efforts to vomit; and Blood had issued both from his Nose and

Ears. He had no visible outward Hurt neither on his Head, nor any other

Part; and, very fortunately for him, they had not as yet exerted the

least Effort to relieve him. I immediately directed a plentiful Bleeding

in the Arm; and a large Quantity of Whey sweetened with Honey to be

drank, and to be also injected by Way of Glyster. This Advice was very

punctually observed; and fifteen Days after the Father came to

_Lausanne_, which is four Leagues from _Pully-petit_, and told me he was

very well. It is proper, in all considerable Bruises, to open the

Patient's Belly with a mild cooling Purge, such as No. 11, 23, 32, 49.

The Prescription No. 24, and the honyed Whey are excellent Remedies,

from the same Reason.

Sec. 450. In these Circumstances, Wine, distiled Spirits, and whatever has

been supposed to revive and to rouse, is mortal. For this Reason People

should not be too impatient, because the Patients remain some Time

without Sense or Feeling. The giving of Turpentine is more likely to do

Mischief than Good; and if it has been sometimes serviceable, it must

have been in Consequence of its purging the Patient, who probably then

needed to be purged. The Fat of a Whale, (_Sperma caeti_) Dragons Blood,

Crabs-Eyes, and Ointments of whatsoever Sort are at least useless and

dangerous Medicine, if the Case be very hazardous; either by the

Mischief they do, or the Good they prevent from being done. The proper

Indication is to dilute the Blood, to render it more fluid and disposed

to circulate; and the Medicines just mentioned produce a very contrary

Effect.

Sec. 451. When an aged Person gets a Fall, which is the more dangerous in

Proportion to his Age and Grossness; notwithstanding he should not seem

in the least incommoded by it, if he is sanguine and still somewhat

vigorous, he should part with three or four Ounces of Blood. He should

take immediately a few successive Cups of a lightly aromatic Drink,

which should be given him hot; such, for Instance, as an Infusion of Tea

sweetened with Honey, and he should be advised to move gently about. He

must retrench a little from the usual Quantity of his Food, and accustom

himself to very gentle, but very frequent, Exercise.

Sec. 452. Sprains or Wrenches, which very often happen, produce a Kind of

Contusion, in the Parts adjoining to the sprained Joint. This Contusion

is caused by the violent Friction of the Bone against the neighbouring

Parts; and as soon as the Bones are immediately returned into their

proper Situation, the Disorder should be treated as a Contusion. Indeed

if the Bones should not of themselves return into their proper natural

Position, Recourse must be had to the Hand of a Surgeon.

The best Remedy in this Case is absolute Rest and Repose, after applying

a Compress moistened in Vinegar and Water, which is to be renewed and

continued, till the Marks of the Contusion entirely disappear; and there

remains not the smallest Apprehension of an Inflammation. Then indeed,

and not before, a little Brandy or Arquebusade Water may be added to the

Vinegar; and the Part (which is almost constantly the Foot) should be

strengthened and secured for a considerable Time with a Bandage; as it

might otherwise be liable to fresh Sprains, which would daily more and

more enfeeble it: and if this Evil is overlooked too much in its

Infancy, the Part never recovers its full Strength; and a small Swelling

often remains to the End of the Patient's Life.

If the Sprain is very slight and moderate, a Plunging of the Part into

cold Water is excellent; but if this is not done at once immediately

after the Sprain, or if the Contusion is violent, it is even hurtful.

The Custom of rolling the naked Foot upon some round Body is

insufficient, when the Bones are not perfectly replaced; and hurtful,

when the Sprain is accompanied with a Contusion.

It happens continually almost that Country People, who encounter such

Accidents, apply themselves either to ignorant or knavish Imposters, who

find, or are determined to find, a Disorder or Dislocation of the Bones,

where there is none; and who, by their violent Manner of handling the

Parts, or by the Plaisters they surround them with, bring on a dangerous

Inflammation, and change the Patient's Dread of a small Disorder, into a

very grievous Malady.

These are the very Persons who have created, or indeed rather imagined,

some impossible Diseases, such as the Opening, the Splitting of the

Stomach, and of the Kidnies. But these big Words terrify the poor

Country People, and dispose them to be more easily and effectually

duped.

_Of Ulcers._

Sec. 453. Whenever Ulcers arise from a general Fault of the Blood, it is

impossible to cure them, without destroying the Cause and Fuel of them.

It is in Fact imprudent to attempt to heal them up by outward Remedies;

and a real Misfortune to the Patient, if his Assistant effectually heals

and closes them.

But, for the greater Part, Ulcers in the Country are the Consequence of

some Wound, Bruise, or Tumour improperly treated; and especially of such

as have been dressed with too sharp, or too spirituous Applications.

Rancid Oils are also one of the Causes, which change the most simple

Wounds into obstinate Ulcers, for which Reason they should be avoided;

and Apothecaries should be careful, when they compound greasy Ointments,

to make but little at a Time, and the oftner, as a very considerable

Quantity of any of them becomes rank before it is all sold;

notwithstanding sweet fresh Oil may have been employed in preparing

them.

Sec. 454. What serves to distinguish Ulcers from Wounds, is the Dryness and

Hardness of the Sides or Borders of Ulcers, and the Quality of the

Humour discharged from them; which, instead of being ripe consistent

Matter, is a Liquid more thin, less white, sometimes yielding a

disagreable Scent, and so very sharp, that if it touch the adjoining

Skin, it produces Redness, Inflammation, or Pustules there; sometimes a

serpiginous, or Ring-worm like Eruption, and even a further Ulceration.

Sec. 455. Such Ulcers as are of a long Duration, which spread wide, and

discharge much, prey upon the Patient, and throw him into a slow Fever,

which melts and consumes him. Besides, when an Ulcer is of a long

Standing, it is dangerous to dry it up; and indeed this never should be

done, but by substituting in the Place of one Discharge that is become

almost natural, some other Evacuation, such as Purging from Time to

Time.

We may daily see sudden Deaths, or very tormenting Diseases, ensue the

sudden drying up such Humours and Drains as have been of a long

Continuance: and whenever any Quack (and as many as promise the speedy

Cure of such, deserve that Title) assures the Patient of his curing an

inveterate Ulcer in a few Days, he demonstrates himself to be a very

dangerous and ignorant Intermeddler, who must kill the Patient, if he

keeps his Word. Some of these impudent Impostors make use of the most

corrosive Applications, and even arsenical ones; notwithstanding the

most violent Death is generally the Consequence of them.

Sec. 456. The utmost that Art can effect, with Regard to Ulcers, which do

not arise from any Fault in the Humours, is to change them into Wounds.

To this End, the Hardness and Dryness of the Edges of the Ulcer, and

indeed of the whole Ulcer, must be diminished, and its Inflammation

removed. But sometimes the Hardness is so obstinate, that this cannot be

mollified any other Way, than by scarifying the Edges with a Lancet. But

when it may be effected by other Means, let a Pledget spread with the

Ointment, No. 69, be applied all over the Ulcer; and this Pledget be

covered again with a Compress of several Folds, moistened in the Liquid,

No. 70, which should be renewed three times daily; though it is

sufficient to apply a fresh Pledget only twice.

As I have already affirmed that Ulcers were often the Consequence of

sharp and spirituous Dressings, it is evident such should be abstained

from, without which Abstinence they will prove incurable.

To forward the Cure, salted Food, Spices, and strong Drink should be

avoided; the Quantity of Flesh-meat should be lessened; and the Body be

kept open by a Regimen of Pulse, of Vegetables, and by the habitual Use

of Whey sweetened with Honey.

If the Ulcers are in the Legs, a very common Situation of them, it is of

great Importance, as well as in Wounds of the same Parts, that the

Patient should walk about but little; and yet never stand up without

walking. This indeed is one of these Cases, in which those, who have

some Credit and Influence in the Estimation of the People, should omit

nothing to make them thoroughly comprehend the Necessity of confining

themselves, some Days, to undisturbed Tranquillity and Rest; and they

should also convince them, that this Term of Rest is so far from being

lost Time, that it is likely to prove their most profitable Time of

Life. Negligence, in this material Point, changes the slightest Wounds

into Ulcers, and the most trifling Ulcers into obstinate and incurable

ones: insomuch that there is scarcely any Man, who may not observe some

Family in his Neighbourhood, reduced to the Hospital, [98] from their

having been too inattentive to the due Care of some Complaint of this

Sort.

[98] This seems just the same as _coming on the Parish_, or being

received into an Alms house here; in Consequence of such an

incurable Disability happening to the poor working Father of a

Family. _K._

I conclude this Article on Ulcers with repeating, that those which are

owing to some internal Cause; or even such as happen from an external

one, in Persons of a bad Habit of Body, frequently require a more

particular Treatment.

_Of Frozen Limbs._

Sec. 457. It is but too common, in very rigorous Winters, for some Persons

to be pierced with so violent a Degree of Cold, that their Hands or

Feet, or sometimes both together are frozen at once, just like a Piece

of Flesh-meat exposed to the Air.

If a Person thus pierced with the Cold, dispose himself to walk about,

which seems so natural and obvious a Means to get warm; and especially,

if he attempts to [99] warm the Parts that have been frozen, his Case

proves irrecoverable. Intolerable Pains are the Consequence, which Pains

are speedily attended with an incurable Gangrene; and there is no Means

left to save the Patient's Life, but by cutting off the gangrened Limbs.

[99] The Reason of the Fatality of Heat, in these Cases, and of the

Success of an opposite Application, (See Sec. 459) seems strictly and

even beautifully analogous to what _Hippocrates_ has observed of

the Danger, and even Fatality, of all great and sudden Changes in

the human Body, whether from the Weather or otherwise. Whence this

truly great Founder of Physick, when he observes elsewhere, that

Diseases are to be cured by something contrary to their Causes,

very consistently advises, not a direct and violent Contrariety,

but a gradual and regulated one, a _Sub-contrariety_. _K._

There was a very late and terrible Example of this, in the Case of an

Inhabitant at _Cossonay_, who had both his Hands frozen. Some greasy

Ointments were applied hot to them, the Consequence of which was, the

Necessity of cutting off six of his Fingers.

Sec. 458. In short, there is but one certain Remedy in such Cases, and this

is to convey the Person affected into some Place where it does not

freeze, but where, however, it is but very moderately hot, and there

continually to apply, to the frozen Parts, Snow, if it be at hand; and

if not, to keep washing them incessantly, but very gently (since all

Friction would at this Juncture prove dangerous) in Ice-water, as the

Ice thaws in the Chamber. By this Application the Patients will be

sensible of their Feeling's returning very gradually to the Part, and

that they begin to recover their Motion. In this State they may Safely

be moved into a Place a little warmer, and drink some Cups of the Potion

No. 13, or of another of the like Quality.

Sec. 459. Every Person may be a competent judge of the manifest Danger of

attempting to relieve such Parts by heating them, and of the Use of

Ice-water, by a common, a daily Experience. Frozen Pears, Apples, and

Radishes, being put into Water just about to freeze, recover their

former State, and prove quickly eatable. But if they are put into warm

Water, or into a hot Place, Rottenness, which is one Sort of Gangrene,

is the immediate Effect. The following Case will make this right Method

of treating them still more intelligible, and demonstrate its Efficacy.

A Man was travelling to the Distance of six Leagues in very cold

Weather; the Road being covered with Snow and Ice. His Shoes, not being

very good, failed him on his March, so that he walked the three last

Leagues bare-footed; and felt, immediately after the first Half League,

sharp Pains in his Legs and Feet, which increased as he proceeded. He

arrived at his Journey's End in a Manner nearly deprived of his lower

Extremities. They set him before a great Fire, heated a Bed well, and

put him into it. His Pains immediately became intolerable: he was

incessantly in the most violent Agitations, and cried out in the most

piercing and affecting Manner. A Physician, being sent for in the Night,

found his Toes of a blackish Colour, and beginning to lose their

Feeling. His Legs and the upper Part of his Feet, which were excessively

swelled, of a purplish Red, and varied with Spots of a violet Colour,

were still sensible of the most excruciating Pains. The Physician

ordered in a Pail of Water from the adjoining River, adding more to it,

and some Ice withal. In this he obliged the Patient to plunge his Legs;

they were kept in near an Hour, and within that Time, the Pains became

less violent. After another Hour he ordered a second cold Bath, from

which the Patient perceiving still further Relief, prolonged it to the

Extent of two Hours. During that Time, some Water was taken out of the

Pail, and some Ice and Snow were put into it. Now his Toes, which had

been black, grew red; the violet Spots in his Legs disappeared; the

Swelling abated; the Pains became moderate, and intermitted. The Bath

was nevertheless repeated six times; after which there remained no other

Complaint, but that of a great Tenderness or extraordinary Sensibility

in the Soles of his Feet, which hindered him from walking. The Parts

were afterwards bathed with some aromatic Fomentations; and he drank a

Ptisan of Sarsaparilla [one of Elder Flowers would have answered the

same Purpose, and have been less expensive.] On the eighth Day from his

Seizure he was perfectly recovered, and returned home on Foot on the

fifteenth.

Sec. 460. When cold Weather is extremely severe, and a Person is exposed to

it for a long Time at once, it proves mortal, in Consequence of its

congealing the Blood, and because it forces too great a Proportion of

Blood up to the Brain; so that the Patient dies of a Kind of Apoplexy,

which is preceded by a Sleepiness. In this Circumstance the Traveller,

who finds himself drowsy, should redouble his Efforts to extricate

himself from the eminent Danger he is exposed to. This Sleep, which he

might consider as some Alleviation of his Sufferings, if indulged, would

prove his last.

Sec. 461. The Remedies in such Cases are the same with those directed in

frozen Limbs. The Patient must be conducted to an Apartment rather cold

than hot, and be rubbed with Snow or with Ice-water. There have been

many well attested Instances of this Method; and as such Cases are still

more frequent in more northern Climates, a Bath of the very coldest

Water has been found the surest Remedy.

Since it is known that many People have been revived, who had remained

in the Snow, or had been exposed to the freezing Air during five, or

even six successive Days, and who had discovered no one Mark of Life for

several Hours, the utmost Endeavours should be used for the Recovery of

Persons in the like Circumstances and Situation.

_Of Kibes, or Chilblains._