degree. Generous diet, the cold bath, exercise, and amusements, are the
most likely means to remove this complaint. It is greatly increased by
solitude and indulging gloomy ideas; but may often be relieved by
cheerful company and sprightly amusements.
When low spirits are owing to a weak relaxed state of the stomach and
bowels, an infusion of the Peruvian bark with cinnamon or nutmeg will be
proper. Steel joined with aromatics may likewise in this case be used
with advantage; but riding, and a proper diet, are most to be depended
on.
When they arise from a foulness of the stomach and intestines, or
obstruction in the hypochondriac viscera, aloetic purges will be proper.
I have sometimes known the Harrowgate sulphur-water of service in this
case.
When low spirits proceed from a suppression of the menstrual or of the
hæmorrhoidal flux, these evacuations may either be restored, or some
others substituted in their place, as issues, setons, or the like. Dr.
Whytt observes, that nothing has such sudden good effects in this case
as bleeding.
When low spirits have been brought on by long-continued grief, anxiety,
or other distress of mind, agreeable company, variety of amusements, and
change of place, especially travelling into foreign countries, will
afford the most certain relief.
Persons afflicted with low spirits should avoid all kinds of excess,
especially of venery and strong liquors. The moderate use of wine and
other strong liquors is by no means hurtful; but when taken to excess
they weaken the stomach, vitiate the humours, and depress the spirits.
This caution is the more necessary, as the unfortunate and melancholy
often fly to strong liquors for relief, by which means they never fail
to precipitate their own destruction.
OF HYSTERIC AFFECTIONS.
These likewise belong to the numerous tribe of nervous diseases, which
may be justly reckoned the reproach of medicine. Women of a delicate
habit, whose stomach and intestines are relaxed, and whose nervous
system is extremely sensible, are most subject to hysteric complaints.
In such persons a hysteric fit, as it is called, may be brought on by an
irritation of the nerves of the stomach or intestines, by wind, acrid
humour, or the like. A sudden suppression of the _menses_ often gives
rise to hysteric fits. They may likewise be excited by violent passions
or affections of the mind, as fear, grief, anger, or great
disappointments.
Sometimes the hysteric fit resembles a swoon or fainting fit, during
which the patient lies as in a sleep, only the breathing is so low as
scarce to be perceived. At other times the patient is affected with
catchings and strong convulsions. The symptoms which precede hysteric
fits are likewise various in different persons. Sometimes the fits come
on with coldness of the extremities, yawning and stretching, lowness of
spirits, oppression and anxiety. At other times the approach of the fit
is foretold by a feeling, as if there were a ball at the lower part of
the belly, which gradually rises towards the stomach, where it occasions
inflation, sickness, and sometimes vomiting; afterwards it rises into
the gullet, and occasions a degree of suffocation, to which quick
breathing, palpitation of the heart, giddiness of the head, dimness of
the sight, loss of hearing, with convulsive motions of the extremities
and other parts of the body, succeed. The hysteric paroxysm is often
introduced by an immoderate fit of laughter, and sometimes it goes off
by crying. Indeed there is not much difference between the laughing and
crying of an highly hysteric lady.
Our aim in the treatment of this disease must be to shorten the fit or
paroxysm when present, and to prevent its return. The longer the fits
continue, and the more frequently they return, the disease becomes the
more obstinate. Their strength is increased by habit, and they induce so
great a relaxation of the system, that it is with difficulty removed.
It is customary, during the hysteric fit or paroxysm, to bleed the
patient. In strong persons of a plethoric habit, and where the pulse is
full, this may be proper; but in weak and delicate constitutions, or
where the disease has been of long standing, or arises from inanition,
it is not safe. The best course in such cases is to rouse the patient by
strong smells, as burnt feathers, asafœtida, or spirits of hartshorn,
held to the nose. Hot bricks may also be applied to the soles of the
feet, and the legs, arms, and belly may be strongly rubbed with a warm
cloth. But the best application is to put the feet and legs into warm
water. This is peculiarly proper when the fits precede the flow of the
menses. In case of costiveness, a laxative clyster with asafœtida will
be proper; and as soon as the patient can swallow, two table-spoonfuls
of a solution of asafœtida, or of some cordial julep, may be given[151].
The radical cure of this disorder will be best attempted at a time when
the patient is most free from the fits. It will be greatly promoted by a
proper attention to diet. A milk and vegetable diet, when duly persisted
in, will often perform a cure. If however the patient has been
accustomed to a more generous diet, it will not be safe to leave it off
all at once, but by degrees. The most proper drink is water with a small
quantity of spirits. A cool dry air is the best. Cold bathing and every
thing that braces the nerves, and invigorates the system, is beneficial;
but lying too long in bed, or whatever relaxes the body, is hurtful. It
is of the greatest importance to have the mind kept constantly easy and
cheerful, and, if possible, to have it always engaged in some agreeable
and interesting pursuit.
The proper medicines are those which strengthen the alimentary canal and
the whole nervous system, as the preparations of iron, the Peruvian
bark, and other bitters. Twenty drops of the elixir of vitriol, in a cup
of the infusion of the bark, may be taken twice or thrice a day. The
bark and iron may likewise be taken in substance, provided the stomach
can bear them; but they are generally given in too small doses to have
any effect. The chalybeate waters generally prove beneficial in this
disorder.
If the stomach is loaded with phlegm, vomits will be of use; but they
should not be too strong, nor frequently repeated, as they tend to relax
and weaken the stomach. If there be a tendency to costiveness, it must
be removed either by diet, or by taking an opening pill as often as it
shall be found necessary.
To lessen the irritability of the system, antispasmodic medicines will
be of use. The best antispasmodic medicines are musk, opium, and castor.
When opium disagrees with the stomach, it may either be applied
externally, or given in clysters. It is often successful in removing
those periodical head-achs to which hysteric and hypochondriac patients
are subject. Castor has in some cases been found to procure sleep where
opium failed; for which reason Dr. Whytt advises, that they should be
joined together. He likewise recommends the anti-hysteric plaster to be
applied to the _abdomen_[152].
Hysteric women are often afflicted with cramps in various parts of the
body, which are most apt to seize them in bed, or when asleep. The most
efficacious medicines in this case are opium, blistering-plasters, and
warm bathing or fomentations. When the cramp or spasm is very violent,
opium is the remedy most to be depended on. In milder cases, immersing
the feet and legs in warm water, or applying a blistering-plaster to the
part affected, will often be sufficient to remove the complaint. In
patients whose nerves are uncommonly delicate and sensible, it will be
better to omit the blistering-plaster, and to attempt the cure by
opiates, musk, camphire, and the warm bath.
Cramps are often prevented or cured by compression. Thus cramps in the
legs are prevented, and sometimes removed, by tight bandages; and when
convulsions arise from a flatulent distention of the intestines, or from
spasms beginning in them, they may be often lessened or cured by making
a pretty strong compression upon the _abdomen_ by means of a broad belt.
A roll of brimstone held in the hand is frequently used as a remedy for
cramps. Though this seems to owe its effect chiefly to imagination; yet,
as it sometimes succeeds, it merits a trial[153]. When spasms or
convulsive motions arise from sharp humours in the stomach and
intestines, no lasting relief can be procured till these are either
corrected or expelled. The Peruvian bark has sometimes cured periodic
convulsions after other medicines had failed.
OF HYPOCHONDRIAC AFFECTIONS.
This disease generally attacks the indolent, the luxurious, the
unfortunate, and the studious. It becomes daily more common in this
country, owing, no doubt, to the increase of luxury and sedentary
employments. It has so near a resemblance to the immediately preceding,
that many authors consider them as the same disease, and treat them
accordingly. They require however a very different regimen; and the
symptoms of the latter, though less violent, are more permanent than
those of the former.
Men of a melancholy temperament, whose minds are capable of great
attention, and whose passions are not easily moved, are, in the advanced
periods of life, most liable to this disease. It is usually brought on
by long and serious attention to abstruse subjects, grief, the
suppression of customary evacuations, excess of venery, the repulsion of
cutaneous eruptions, long-continued evacuations, obstructions in some of
the viscera, as the liver, spleen, &c.
Hypochondriac persons ought never to fast long, and their food should be
solid and nourishing. All acescent and windy vegetables are to be
avoided. Flesh-meats agree best with them, and their drink should be old
claret, or good madeira. Should these disagree with the stomach, water
with a little brandy or rum in it may be drank.
Cheerfulness and serenity of mind are by all means to be cultivated.
Exercise of every kind is useful. The cold bath is likewise beneficial;
and, where it does not agree with the patient, frictions with the
flesh-brush or a coarse cloth may be tried. If the patient has it in his
power, he ought to travel either by sea or land. A voyage or a long
journey, especially towards a warmer climate, will be of more service
than any medicine.
The general intentions of cure, in this disease, are to strengthen the
alimentary canal, and to promote the secretions. These intentions will
be best answered by the different preparations of iron and the Peruvian
bark, which, after proper evacuations, may be taken in the same manner
as directed in the preceding disease.
If the patient be costive, it will be necessary to make use of some
gentle opening medicine, as pills composed of equal parts of aloes,
rhubarb, and asafœtida, with as much of the elixir proprietatis as is
necessary to form the ingredients into pills. Two, three, or four of
these may be taken as often as it shall be found needful, to keep the
body gently open. Such as cannot bear the asafœtida may substitute
Spanish soap in its place.
Though a cheerful glass may have good effects in this disease, yet all
manner of excess is hurtful. Intense study, and every thing that
depresses the spirits, are likewise pernicious.
Though the general symptoms and treatment of nervous disorders were
pointed out in the beginning of this chapter; yet, for the benefit of
the unhappy persons afflicted with those obstinate and complicated
maladies, I have treated several of their capital symptoms under
distinct or separate heads. These however are not to be considered as
different diseases, but as various modifications of the same disease.
They all arise from the same general causes, and require nearly the same
method of treatment. There are many other symptoms that merit particular
attention, which the nature of my plan will not permit me to treat of at
full length. I shall therefore omit them altogether, and conclude this
chapter with a few general remarks on the most obvious means of
preventing or avoiding nervous disorders.
In all persons afflicted with nervous disorders, there is a great
delicacy and sensibility of the whole nervous system, and an uncommon
degree of weakness of the organs of digestion. These may be either
natural or acquired. When owing to a defect in the constitution, they
are hardly to be removed; but may be mitigated by proper care. When
induced by diseases, as long or repeated fevers, profuse hæmorrhages, or
the like, they prove also very obstinate, and will yield only to a
course of regimen calculated to restore and invigorate the habit.
But nervous affections arise more frequently from causes, which it is in
a great measure in our own power to avoid, than from diseases, or an
original fault in the constitution, &c. Excessive grief, intense study,
improper diet, and neglect of exercise, are the great sources of this
extensive class of diseases.
It has been already observed, that grief indulged destroys the appetite
and digestion, depresses the spirits, and induces an universal
relaxation and debility of the whole system. Instances of this are daily
to be seen. The loss of a near relation, or any other misfortune in
life, is often sufficient to occasion the most complicated series of
nervous symptoms. Such misfortunes indeed are not to be avoided, but
surely their effects, by a vigorous and proper exertion of the mind,
might be rendered less hurtful. For directions in this matter we must
refer the reader to the article GRIEF, in the chapter on the passions.
The effects of intense study are pretty similar to those occasioned by
grief. It preys upon the animal spirits, and destroys the appetite and
digestion. To prevent these effects, studious persons ought, according
to the Poet, _to toy with their books_[154]. They should never study too
long at a time; nor attend long to one particular subject, especially if
it be of a serious nature. They ought likewise to be attentive to their
posture, and should take care frequently to unbend their minds by music,
diversions, or going into agreeable company.
With regard to diet, I shall only observe, that nervous diseases may be
induced either by excess or inanition. Both of these extremes hurt
indigestion, and vitiate the humours. When Nature is oppressed with
fresh loads of food, before she has had time to digest and assimilate
the former meal, her powers are weakened, and the vessels are filled
with crude humours. On the other hand, when the food is not sufficiently
nourishing, or is taken too seldom, the bowels are inflated with wind,
and the humours, for want of regular fresh supplies of wholesome chyle,
are vitiated. These extremes are therefore with equal care to be
avoided. They both tend to induce a relaxation, and debility of the
nervous system, with all its dreadful train of consequences.
But the most general cause of nervous disorders is _indolence_. The
active and laborious are seldom troubled with them. They are reserved
for the children of ease and affluence, who generally feel their keenest
force. All we shall say to such persons is, that the means of prevention
and cure are both in their own power. If the constitution of human
nature be such, that man must either labour or suffer diseases, surely
no individual has any right to expect an exemption from the general
rule.
Those however who are willing to take exercise, but whose occupations
confine them to the house, and perhaps to an unfavourable posture,
really deserve our pity. We have in a former part of the book
endeavoured to lay down rules for their conduct; and shall only add,
that where these cannot be complied with, their place may, in some
measure, be supplied by the use of bracing and strengthening medicines,
as the Peruvian bark, with other bitters; the preparations of steel; the
elixir of vitriol, &c.
CHAP. XLIV.
DISORDERS OF THE SENSES.
We do not mean to treat of the nature of our sensations, or to give a
minute description of the various organs by which they are performed;
but to point out some of the diseases to which these organs are most
liable, and to shew how they may be prevented or remedied.
OF THE EYE.
No organ of the body is subject to more diseases than the eye; nor is
there any one of which the diseases are more difficult to cure. Though
more ignorant persons pretend to cure these than any other class of
diseases; yet a very superficial acquaintance with the structure of the
eye, and the nature of vision, will be sufficient to convince any one of
the danger of trusting to them. These diseases often exceed the skill of
the most learned physician; hence we may easily infer the danger of
trusting them to ignorant quacks, who, without all peradventure, put out
more eyes than they cure. But, though the diseases of the eye can seldom
be cured, they might often, by due care, be prevented; and, even where
the sight is totally lost, many things might be done, which are
generally neglected, to render the unhappy person both more useful to
himself and to society[155].
The eyes are hurt by viewing bright or luminous objects; keeping the
head too long in a hanging posture; violent head-achs; excessive venery;
the long use of bitters; the effluvia from acrid or volatile substances;
various diseases; as the small-pox, measles, &c. but, above all, from
night-watching, and candle-light studies. Long fasting is likewise
hurtful to the eyes, and frequent heats and colds are no less
pernicious. The eyes are often hurt by the stoppage of customary
evacuations; as morning sweats; sweating of the feet; the menses in
women; and the bleeding piles in men. All kinds of excess are likewise
hurtful to the sight, particularly the immoderate use of ardent spirits
and other strong liquors.
In all diseases of the eyes, especially those attended with
inflammation, the cool regimen ought to be observed. The patient must
abstain from all spirituous liquors. The smoke of tobacco, smoky rooms,
the vapours of onions and garlic, and all vivid lights and glaring
colours, are carefully to be avoided. The drink may be water, whey, or
small beer; and the aliment must be light and of easy digestion.
For preventing disorders of the eyes, issues and setons are of prime
use. Every person, whose eyes are tender, ought to have one or more of
these in some part of the body. It will likewise be of use to keep the
body gently open, and either to bleed or purge every spring and fall.
All excess and night studies are to be avoided. Such as do not chuse a
seton or an issue, will find benefit from wearing a small Burgundy-pitch
plaster between their shoulders.
A _gutta serena_, or _amaurosis_, is an abolition of the sight without
any apparent cause or fault in the eyes. When it is owing to a decay or
wasting of the optic nerve, it does not admit of a cure; but when it
proceeds from a compression of the nerves by redundant humours, these
may in some measure be drained off, and the patient relieved. For this
purpose, the body must be kept open with the laxative mercurial pills.
If the patient be young and of a sanguine habit, he may be bled.
Cupping, with scarifications on the back part of the head, will likewise
be of use. A running at the nose may be promoted by volatile salts,
stimulating powders, &c. But the most likely means for relieving the
patient are issues or blisters kept open for a long time on the back
part of the head, behind the ears, or on the neck. I have known these
restore sight, even after it had been for a considerable time lost.
Should these fail, recourse must be had to a mercurial salivation; or
what will perhaps answer the purpose better, twelve grains of the
corrosive sublimate of mercury may be dissolved in an English pint and a
half of brandy, and a table-spoonful of it taken twice a-day, drinking
half a pint of the decoction of sarsaparilla after it.
A _cataract_ is an obstruction of the pupil, by the interposition of
some opaque substance which either diminishes or totally extinguishes
the sight. It is generally an opacity of the crystalline humour. In a
recent or beginning cataract, the same medicines are to be used as in
the gutta serena; and they will sometimes succeed. But when this does
not happen, and the cataract becomes firm, it must be couched, or rather
extracted. I have resolved a recent cataract by giving the patient
frequent purges with calomel, keeping a poultice of fresh hemlock
constantly upon the eye, and a perpetual blister on the neck.
The _myopia_, or _short sightedness_, and the _presbyopia_, or _seeing
only at too great a distance_, are disorders which depend on the
original structure or figure of the eye, therefore admit of no cure. The
inconveniencies arising from them may however be, in some measure,
remedied by the help of proper glasses. The former requires the aid of a
concave, and the latter of a convex glass.
A _strabismus_, or _squinting_, depends upon an irregular contraction of
the muscles of the eye from a spasm, palsy, epilepsy, or an ill habit.
Children often contract this disorder by having their eyes unequally
exposed to the light. They may likewise acquire it by imitation from a
squinting nurse or play-fellow, &c. As this disorder can hardly be
cured, parents ought to be careful to prevent it. Almost the only thing
which can be done for it is, to contrive a mask for the child to wear,
which will only permit him to see in a straight direction.
_Spots_ or _specks_ on the eyes are generally the effect of
inflammation, and often appear after the small-pox, the measles, or
violent ophthalmias. They are very difficult to cure, and often occasion
total blindness. If the specks are soft and thin, they may sometimes be
taken off by gentle caustics and discutients; as vitriol, the juice of
celandine, &c. When these do not succeed, a surgical operation may be
tried: the success of this however is always very doubtful.
The _blood-shot_ eye may be occasioned by a stroke, a fall, retching,
vomiting, violent coughing, &c. I have frequently known it happen to
children in the hooping-cough. It appears at first like a bit of
scarlet, and is afterwards of a livid or blackish colour. This disorder
generally goes off without medicine. Should it prove obstinate, the
patient may be bled, and have his eyes fomented with a decoction of
comphrey roots and elder flowers. A soft poultice may be applied to the
eyes; and the body should be kept open by gentle purgatives.
The _watery_, or _weeping eye_, is generally occasioned by a relaxation
or weakness of the glandular parts of that organ. These may be braced
and strengthened by bathing the eye with brandy and water,
Hungary-water, rose-water with white vitriol dissolved in it, &c.
Medicines which make a revulsion are likewise proper; as mild
purgatives, perpetual blisters on the neck, bathing the feet frequently
in lukewarm water, &c.
When this disease proceeds from an obstruction of the lachrymal duct, or
natural passage of the tears, it is called a _fistula lachrymalis_, and
can only be cured by a surgical operation.
OF THE EAR.
The functions of the ear may be injured by wounds, ulcers, or any thing
that hurts its fabric. The hearing may likewise be hurt by excessive
noise; violent colds in the head; fevers; hard wax, or other substances
sticking in the cavity of the ear; too great a degree of moisture or
dryness of the ear. Deafness is very often the effect of old age, and is
incident to most people in the decline of life. Sometimes it is owing to
an original fault in the structure or formation of the ear itself. When
this is the case, it admits of no cure; and the unhappy person not only
continues deaf, but generally likewise dumb, for life[156].
When deafness is the effect of wounds or ulcers of the ears, or of old
age, it is not easily removed. When it proceeds from cold of the head,
the patient must be careful to keep his head warm, especially in the
night; he should likewise take some gentle purges, and keep his feet
warm, and bathe them frequently in lukewarm water at bed-time. When
deafness is the effect of a fever, it generally goes off after the
patient recovers. If it proceeds from dry wax sticking in the ears, it
may be softened by dropping oil into them; afterwards they must be
syringed with warm milk and water.
If deafness proceeds from dryness of the ears, which may be known by
looking into them, half an ounce of the oil of sweet almonds, and the
same quantity of liquid apodeldoch, or tincture of asafœtida, may be
mixed together, and a few drops of it put into the ear every night at
bed-time, stopping them afterwards with a little wool or cotton. Some,
instead of oil, put a small slice of the fat of bacon into each ear,
which is said to answer the purpose very well. When the ears abound with
moisture, it may be drained off by an issue or seton, which should be
made as near the affected parts as possible.
Some, for the cure of deafness, recommend the gall of an eel mixed with
spirit of wine, to be dropped into the ear; others, equal parts of
Hungary-water and spirit of lavender. Etmuller extols amber and musk;
and Brookes says, he has often known hardness of hearing cured by
putting a grain or two of musk into the ear with cottonwool. But these
and other applications must be varied according to the cause of the
disorder[157].
Though such applications may sometimes be of service, yet they much
oftner fail, and frequently they do hurt. Neither the eyes nor ears
ought to be tampered with; they are tender organs, and require a very
delicate touch. For this reason, what we would chiefly recommend in
deafness, is, to keep the head warm. From whatever cause the disorder
proceeds, this is always proper; and I have known more benefit from it
alone, in the most obstinate cases of deafness, than from all the
medicines I ever used.
OF THE TASTE AND SMELL.
Though these senses are not of so great importance to man in a state of
society, as the sight and hearing; yet, as the loss of them is attended
with some inconveniency, they deserve our notice. They are seldom to be
restored when lost; which ought to make us very attentive to their
preservation, by carefully avoiding whatever may in the least prove
injurious to them. As there is a very great affinity between the organs
of tasting and smelling, whatever hurts the one generally affects the
other.
Luxury is highly injurious to these organs. When the nose and palate are
frequently stimulated by fragrant and poignant dishes, they soon lose
the power of distinguishing tastes and odours with any degree of nicety.
Man, in a state of nature, may perhaps have these faculties as acute as
any other animal.
The sense of smelling may be diminished or destroyed by diseases; as,
the moisture, dryness, inflammation or suppuration of that membrane
which lines the inside of the nose, commonly called the olfactory
membrane; the compression of the nerves which supply this membrane, or
some fault in the brain itself at their origin. A defect, or too great a
degree of solidity, of the small spungy bones of the upper jaw, the
caverns of the forehead, &c. may likewise impair the sense of smelling.
It may also be injured by a collection of fœtid matter in those caverns,
which keeps constantly exhaling from them. Few things are more hurtful
to the sense of smelling than taking great quantities of snuff.
When the nose abounds with moisture, after gentle evacuations, such
things as tend to take off irritation, and coagulate the thin sharp
serum, may be applied; as the oil of anise mixed with fine flour;
camphire dissolved in oil of almonds, &c. The vapours of amber,
frankincense, gum-mastic, and benjamin, may likewise be received into
the nose and mouth.
For moistening the mucus when it is too dry, some recommend snuff made
of the leaves of marjoram, mixed with the oil of amber, marjoram and
aniseed; or a sternutatory of calcined white vitriol; twelve grains of
which may be mixed with two ounces of marjoram-water, and filtrated. The
steam or vapour of vinegar upon hot iron received up the nostrils is
likewise of use for softening the mucus, opening obstructions, &c.
If there is an ulcer in the nose, it ought to be dressed with some
emollient ointment, to which, if the pain be very great, a little
laudanum may be added. If it be a venereal ulcer, it is not to be cured
without mercury. In that case, the solution of the corrosive sublimate
in brandy may be taken, as directed in the gutta serena. The ulcer ought
likewise to be washed with it; and the fumes of cinnabar may be received
up the nostrils.
If there be reason to suspect that the nerves which supply the organs of
smelling are inert, or want stimulating, volatile salts, strong snuffs,
and other things which occasion sneezing, may be applied to the nose.
The forehead may likewise be anointed with balsam of Peru, to which may
be added a little of the oil of amber.
The _taste_ may be diminished by crusts, filth, mucus, aphthæ,
pellicles, warts, &c. covering the tongue: it may be depraved by a fault
of the saliva, which, being discharged into the mouth, gives the same
sensation as if the food which the person takes had really a bad taste;
or it may be entirely destroyed by injuries done to the nerves of the
tongue and palate. Few things prove more hurtful either to the sense of
tasting or smelling than obstinate colds, especially those which affect
the head.
When the taste is diminished by filth, mucus, &c. the tongue ought to be
scraped and frequently washed with a mixture of water, vinegar, and
honey, or some other detergent. When the saliva is vitiated, which
seldom happens unless in fevers or other diseases, the curing of the
disorder is the cure of this symptom. To relieve it however in the mean
time, the following things may be of use; if there be a bitter taste, it
may be taken away by vomits, purges, and other things which evacuate
bile. What is called a nidorous taste, arising from putrid humours, is
corrected by the juice of citrons, oranges, and other acids. A salt
taste is cured by plentiful dilution with watery liquors. An acid taste
is destroyed by absorbents, and alkaline salts, as powder of
oyster-shells, salt of wormwood, &c.
When the sensibility of the nerves which supply the organs of taste is
diminished, the chewing of horse-radish, or other stimulating
substances, will help to recover it.
OF THE TOUCH.
The sense of touching may be hurt by any thing that obstructs the
nervous influence, or prevents its being regularly conveyed to the
organs of touching; as pressure, extreme cold, &c. It may likewise be
hurt by too great a degree of sensibility, when the nerve is not
sufficiently covered by the cuticle or scarf-skin, or where there is too
great a tension of it, or it is too delicate. Whatever disorders the
functions of the brain and nerves, hurts the sense of touching. Hence it
appears to proceed from the same general causes as palsy and apoplexy,
and requires nearly the same method of treatment.
In a _stupor_, or defect of touching, which arises from an obstruction
of the cutaneous nerves, the patient must first be purged; afterwards
such medicines as excite the action of the nerves, or stimulate the
system, may be used. For this purpose, the spirit of hartshorn, _sal
volatile oleosum_, horse-radish, &c. may be taken inwardly; the
disordered parts, at the same time, may be frequently rubbed with fresh
nettles or spirit of _sal ammoniac_. Blistering-plasters and sinapisms
applied to the parts will likewise be of use, as also warm bathing,
especially in the natural hot baths.
CHAP. XLV.
OF A SCIRRHUS AND CANCER.
A scirrhus is a hard indolent tumour seated in some of the glands; as
the breasts, the armpits, &c. If the tumour becomes large, unequal, of a
livid, blackish, or leaden colour, and is attended with violent pain, it
gets the name of an _occult cancer_. When the skin is broken, and a
_sanies_ or ichorous matter of an abominably fœtid smell is discharged
from the sore, it is called an open or ulcerated cancer. Persons after
the age of forty-five, particularly women, and those who lead an
indolent sedentary life, are most subject to this disease.
CAUSES.——This disease is often owing to suppressed evacuations; hence it
proves so frequently fatal to women of a gross habit, particularly old
maids and widows, about the time when the menstrual flux ceases. It may
likewise be occasioned by excessive fear, grief, anger, religious
melancholy, or any of the depressing passions. Hence the unfortunate,
the choleric, and those persons who devote themselves to a religious
life in convents or monasteries, are often afflicted with it. It may
also be occasioned by the long-continued use of food that is too hard of
digestion, or of an acrid nature; by barrenness; celibacy; indolence;
cold; blows; friction; pressure; or the like. Women often suffer from
the last of these by means of their stays, which squeeze and compress
their breast so as to occasion great mischief. Sometimes the disease is
owing to an hereditary disposition.
SYMPTOMS.——This disorder seems often very trifling at the beginning. A
hard tumour about the size of a hazle-nut, or perhaps smaller, is
generally the first symptom. This will often continue for a long time
without seeming to increase, or giving the patient great uneasiness; but
if the constitution be hurt, or the tumour irritated by pressure, or
improper treatment of any kind, it begins to extend itself towards the
neighbouring parts by pushing out a kind of roots or limbs. It then gets
the name of _cancer_, from a fancied resemblance between these limbs and
the claws of a crab. The colour of the skin begins to change, which is
first red, afterwards purple, then bluish, livid, and at last black. The
patient complains of heat, with a burning, gnawing, shooting pain. The
tumour is very hard, rough, and unequal, with a protuberance, or rising,
in the middle; its size increases daily, and the neighbouring veins
become thick, knotty, and of a blackish colour.
The skin at length gives way, and a thin sharp ichor begins to flow,
which corrodes the neighbouring parts till it forms a large unsightly
ulcer. More occult cancers arise, and communicate with the neighbouring
glands. The pain and stench become intolerable; the appetite fails; the
strength is exhausted by a continual hectic fever; at last, a violent
hæmorrhage, or discharge of blood, from some part of the body, with
faintings, or convulsion fits, generally put an end to the miserable
patient’s life.
REGIMEN.——The diet ought to be light, but nourishing. All strong
liquors, and high-seasoned or salted provisions, are to be avoided. The
patient may take as much exercise as he can easily bear; and should use
every method to divert thought, and amuse his fancy. All kinds of
external injury are carefully to be guarded against, particularly of the
affected part, which ought to be defended from all pressure, and even
from the external air, by covering it with fur or soft flannel.
MEDICINE.——This is one of those diseases for which no certain remedy is
yet known. Its progress however may sometimes be retarded, and some of
its most disagreeable symptoms mitigated, by proper applications. One
misfortune attending the disease is, that the unhappy patient often
conceals it too long. Were proper means used in due time, a cancer might
often be cured; but after the disorder has arrived at a certain height,
it generally sets all medicine at defiance.
When a scirrhous tumour is first discovered, the patient ought to
observe a proper regimen, and to take twice or thrice a-week a dose of
the common purging mercurial pill. Some blood may also be let, and the
part affected may be gently rubbed twice a-day with a little of the
mercurial ointment, and kept warm with fur or flannel. The food must be
light, and an English pint of the decoction of woods or sarsaparilla may
be drank daily. I have sometimes discussed hard tumours, which had the
appearance of beginning cancers, by a course of this kind.
Should the tumour however not yield to this treatment, but, on the
contrary, become larger and harder, it will be proper to extirpate it,
either by the knife or caustic. Indeed, whenever this can be done with
safety, the sooner it is done the better. It can answer no purpose to
extirpate a cancer after the constitution is ruined, or the whole mass
of humours corrupted by it. This however is the common way, which makes
the operation so seldom succeed. Few people will submit to the
extirpation till death stares them in the face; whereas, if it were done
early, the patient’s life would not be endangered by the operation, and
it would generally prove a radical cure.
When the cancer is so situated that it cannot be cut off, or if the
patient will not submit to the operation, such medicines as will
mitigate or relieve the most urgent symptoms may be used. Dr. Home says,
that half a grain of the corrosive sublimate of mercury, dissolved in a
proper quantity of brandy, and taken night and morning, will often be of
service in cancers of the face and nose. He likewise recommends an
infusion of the _solanum_, or night-shade, in cancers of the breasts.
But the medicine most in repute at present for this disease is hemlock.
Dr. Stork, physician at Vienna, has of late recommended the extract of
this plant as very efficacious in cancers of every kind. The Doctor
says, he has given some hundred weights of it without ever hurting any
body, and often with manifest advantage. He advises the patient however
to begin with very small doses, as two or three grains, and to increase
the dose gradually till some good effect be perceived, and there to rest
without further increase. From two or three grains at first, the Doctor
says he has increased the dose to two, three, or four drachms a-day, and
finds that such doses may be continued for several weeks without any bad
consequences.
The regimen which the Doctor recommends during the use of the medicine,
is to avoid farinaceous substances not fermented, and too acrid
aromatics. He says, good wine will not be hurtful to those who are
accustomed to it, nor a moderate use of acids; and adds, that the
patient should live in a pure free air, and keep his mind as quiet and
cheerful as possible.
The Doctor does not pretend to fix the time in which a cancer may be
resolved by the use of hemlock, but says he has given it for above two
years in large doses without any apparent benefit; nevertheless the
patient has been cured by persisting in the use of it for half a year
longer. This is at least encouragement to give it a fair trial. Though
we are far from thinking the hemlock merits those extravagant encomiums
which the Doctor has bestowed upon it, yet, in a disease which has so
long baffled the boasted powers of medicine, we think it ought always to
be tried.
The powder of hemlock is by some preferred to the extract. They are both
made of the fresh leaves, and may be used nearly in the same manner. Dr.
Nicholson of Berwick says, he gradually increased the dose of the powder
from a few grains to half a drachm, and gave near four drachms of it in
the day with remarkably good effects. The hemlock may also be used
externally either as a poultice or fomentation. The sore may likewise be
kept clean by injecting daily a strong decoction of the tops and leaves
into it.
Few things contribute more to the healing of foul sordid ulcers of any
kind than keeping them thoroughly clean. This ought never to be
neglected. The best application for this purpose seems to be the carrot
poultice. The root of the common carrot may be grated, and moistened
with as much water as will bring it to the consistence of a poultice or
cataplasm. This must be applied to the sore, and renewed twice a-day. It
generally cleans the sore, eases the pain, and takes away the
disagreeable smell, which are objects of no small importance in such a
dreadful disorder[158].
Wort, or an infusion of malt, has been recommended not only as a proper
drink, but as a powerful medicine in this disease, It must be frequently
made fresh, and the patient may take it at pleasure. Two, three, or even
four English pints of it may be drank every day for a considerable time.
No benefit can be expected from any medicine in this disease, unless it
be persisted in for a long time. It is of too obstinate a nature to be
soon removed; and, when it admits of a cure at all, it must be brought
about by inducing an almost total change of the habit, which must always
be a work of time. Setons or issues in the neighbourhood of the cancer
have sometimes good effects[159].
When all other medicines fail, recourse must be had to opium, as a kind
of solace. This will not indeed cure the disease, but it will ease the
patient’s agony, and render life more tolerable while it continues.
To avoid this dreadful disorder, people ought to use wholesome food; to
take sufficient exercise in the open air; to be as easy and cheerful as
possible; and carefully to guard against all blows, bruises, and every
kind of pressure upon the breasts or other glandular parts[160].
CHAP. XLVI.
OF POISONS.
Every person ought, in some measure, to be acquainted with the nature
and cure of poisons. They are generally taken unawares, and their
effects are often so sudden and violent, as not to admit of delay, or
allow time to procure the assistance of physicians. Happily indeed no
great degree of medical knowledge is here necessary; the remedies for
most poisons being generally at hand, or easily obtained, and nothing
but common prudence needful in the application of them.
The vulgar notion, that every poison is cured by some counter-poison, as
a specific, has done much hurt. People believe they can do nothing for
the patient, unless they know the particular antidote to that kind of
poison which he has taken. Whereas the cure of all poisons taken into
the stomach, without exception, depends chiefly on discharging them as
soon as possible.
There is no case wherein the indications of cure are more obvious.
Poison is seldom long in the stomach before it occasions sickness, with
an inclination to vomit. This shews plainly what ought to be done.
Indeed common sense dictates to every one, that, if any thing has been
taken into the stomach which endangers life, it ought immediately to be
discharged. Were this duly regarded, the danger arising from poisons
might generally be avoided. The method of prevention is obvious, and the
means are in the hands of every one.
We shall not take up the reader’s time with a detail of the ridiculous
notions which have prevailed among ignorant people in different ages
with regard to poisons; neither shall we mention the boasted antidotes,
which have been recommended either for preventing or obviating their
effects; but shall content ourselves with pointing out the poisons most
common in this country, and the means of avoiding their dangerous
consequences.
Poisons either belong to the mineral, the vegetable, or the animal
kingdom.
Mineral poisons are commonly of an acrid or corrosive quality; as
arsenic, cobalt, the corrosive sublimate of mercury, &c.
Those of the vegetable kind are generally of a narcotic or stupefactive
quality; as poppy, hemlock, henbane, berries of the deadly night-shade,
&c.
Poisonous animals communicate their infection either by the bite or
sting. This poison is very different from the former, and only produces
its effects when received into the body by a wound.
MINERAL POISONS.——Arsenic is the most common of this class; and, as the
whole of them are pretty similar both in their effects and method of
cure, what is said with respect to it will be applicable to every other
species of corrosive poison.
When a person has taken arsenic, he soon perceives a burning heat, and a
violent pricking pain in his stomach and bowels, with an intolerable
thirst, and an inclination to vomit. The tongue and throat feel rough
and dry; and, if proper means be not soon administered, the patient is
seized with great anxiety, hiccuping, faintings, and coldness of the
extremities. To these succeed black vomits, fœtid stools, with a
mortification of the stomach and intestines, which are the immediate
forerunners of death.
On the first appearance of these symptoms the patient should drink large
quantities of new milk and sallad oil till he vomits; or he may drink
warm water mixed with oil. Fat broths are likewise proper, provided they
can be got ready in time. Where no oil is to be had, fresh butter may be
melted and mixed with the milk or water. These things are to be drank as
long as the inclination to vomit continues. Some have drank eight or ten
English quarts before the vomiting ceased; and it is never safe to leave
off drinking while one particle of the poison remains in the stomach.
These oily or fat substances not only provoke vomiting, but likewise
blunt the acrimony of the poison, and prevent its wounding the bowels;
but if they should not make the person vomit, half a drachm or two
scruples of the powder of ipecacuanha must be given, or a few spoonfuls
of the oxymel or vinegar of squills may be mixed with the water which he
drinks. Vomiting may likewise be excited by tickling the inside of the
throat with a feather. Should these methods however fail, half a drachm
of white vitriol, or five or six grains of emetic tartar, must be
administered.
If tormenting pains are felt in the lower belly, and there is reason to
fear that the poison has got down to the intestines, clysters of milk
and oil must be very frequently thrown up; and the patient must drink
emollient decoctions of barley, oatmeal, marsh-mallows, and such like.
He must likewise take an infusion of senna and manna, a solution of
Glauber’s salts, or some other purgative.
After the poison has been evacuated, the patient ought, for some time,
to live upon such things as are of a healing and cooling quality; to
abstain from flesh and all strong liquors, and to live upon milk, broth,
gruel, light puddings, and other spoon meats of easy digestion. His
drink should be barley-water, linseed-tea, or infusions of any of the
mild mucilaginous vegetables.
VEGETABLE POISONS, besides heat and pain of the stomach, commonly
occasion some degree of giddiness, and often a kind of stupidity or
folly. Persons who have taken these poisons must be treated in the same
manner as for the mineral or corrosive.
Though the vegetable poisons, when allowed to remain in the stomach,
often prove fatal; yet the danger is generally over as soon as they are
discharged. Not being of such a caustic or corrosive nature, they are
less apt to wound or inflame the bowels than mineral substances: no
time, however, ought to be lost in having them discharged.
Opium, being frequently taken by mistake, merits particular attention.
It is used as a medicine both in a solid and liquid form, which latter
commonly goes by the name of laudanum. It is indeed a valuable medicine
when taken in proper quantity; but as an over-dose proves a strong
poison, we shall point out its common effects, together with the method
of cure.
An over-dose of opium generally occasions great drowsiness, with stupor
and other apoplectic symptoms. Sometimes the person has so great an
inclination to sleep, that it is almost impossible to keep him awake.
Every method must however be tried for this purpose. He should be
tossed, shaked, and moved about. Sharp blistering-plasters should be
applied to his legs or arms, and stimulating medicines, as salts of
hartshorn, &c. held under his nose. It will also be proper to let blood.
At the same time every method must be taken to make him discharge the
poison. This may be done in the manner directed above, _viz._ by the use
of strong vomits, drinking plenty of warm water with oil, &c.
Mead, besides vomits, in this case, recommends acid medicines with
lixivial salts. He says, that he has often given salt of wormwood mixed
with juice of lemon in repeated doses with great success.
If the body should remain weak and languid after the poison has been
discharged, nourishing diet and cordials will be proper; but when there
is reason to fear that the stomach or bowels are inflamed, the greatest
circumspection is necessary both with regard to food and medicine.
OF THE BITES OF POISONOUS ANIMALS.
We shall begin with the bite of a mad dog, as it is both the most common
and dangerous animal-poison in this country.
The creatures naturally liable to contract this disease are, as far as
we yet know, all of the dog kind, _viz._ foxes, dogs, and wolves. Hence
it is called the _rabies canina_, or dog madness. Of the last we have
none in this island; and it so seldom happens that any person is bit by
the first, that they scarce deserve to be taken notice of. If such a
thing should happen, the method of treatment is precisely the same as
for the bite of a mad dog.
The symptoms of madness in a dog are as follow: At first he looks dull,
shews an aversion to food and company: he does not bark as usual, but
seems to murmur, is peevish, and apt to bite strangers: his ears and
tail droop more than usual, and he appears drowsy: afterwards he begins
to loll out his tongue, and froth at the mouth, his eyes seeming heavy
and watery: he now, if not confined, takes off, runs panting along with
a kind of dejected air, and endeavours to bite every one he meets. Other
dogs are said to fly from him. Some think this a certain sign of
madness, supposing that they know him by the smell; but it is not to be
depended on. If he escapes being killed, he seldom runs above two or
three days, till he dies exhausted with heat, hunger, and fatigue.
This disease is most frequent after long, dry, hot seasons; and such
dogs as live upon putrid stinking carrion, without having enough of
fresh water, are most liable to it.
When any person has been bit by a dog, the strictest inquiry ought to be
made whether the animal was really mad. Many disagreeable consequences
arise from neglecting to ascertain this point. Some people have lived in
continual anxiety for many years, because they had been bit by a dog
which they believed to be mad; but, as he had been killed on the spot,
it was impossible to ascertain the fact. This should induce us, instead
of killing a dog the moment he has bit any person, to do all in our
power to keep him alive, at least till we can be certain whether he be
mad or not.
Many circumstances may contribute to make people imagine a dog mad. He
loses his master, runs about in quest of him, is set upon by other dogs,
and perhaps by men. The creature, thus frightened, beat, and abused,
looks wild, and lolls out his tongue as he runs along. Immediately a
crowd is after him; while he, finding himself closely pursued, and
taking every one he meets for an enemy, naturally attempts to bite him
in self-defence. He soon gets knocked on the head, and it passes
currently that he was mad, as it is then impossible to prove the
contrary.
This being the true history of, by far, the greater part of those dogs
which pass for mad, is it any wonder that numberless whimsical medicines
have been extolled for preventing the effects of their bite? This
readily accounts for the great variety of infallible remedies for the
bite of a mad dog, which are to be met with in almost every family.
Though not one in a thousand has any claim to merit, yet they are all
supported by numberless vouchers. No wonder that imaginary diseases
should be cured by imaginary remedies. In this way, credulous people
first impose upon themselves, and then deceive others. The same medicine
which was supposed to prevent the effects of the bite, when the dog was
not mad, is recommended to a person who has had the misfortune to be bit
by a dog that was really mad. He takes it, trusts to it, and is undone.
To these mistakes we must impute the frequent ill success of the
medicines used for preventing the effects of the bite of a mad dog. It
is not owing so much to a defect in medicine, as to wrong applications.
I am persuaded, if proper medicines were administered immediately after
the bite is received, and continued for a sufficient length of time, we
should not lose one in a thousand of those who have the misfortune to be
bit by a mad dog.
This poison is generally communicated by a wound, which nevertheless
heals as soon as a common wound: but afterwards it begins to feel
painful, and as the pain spreads towards the neighbouring parts, the
person becomes heavy and listless. His sleep is unquiet with frightful
dreams; he sighs, looks dull, and loves solitude. These are the
forerunners, or rather the first symptoms of that dreadful disease
occasioned by the bite of a mad dog. But as we do not propose to treat
fully of the disease itself, but to point out the method of preventing
it, we shall not take up time in shewing its progress from the first
invasion to its commonly fatal end.
The common notion, that this poison may lie in the body for many years,
and afterwards prove fatal, is both hurtful and ridiculous. It must
render such persons as have had the misfortune to be bit very unhappy,
and can have no good effects. If the person takes proper medicines for
forty days after the time of his being bit, and feels no symptoms of the
disease, there is reason to believe him out of danger.
The medicines recommended for preventing the effects of the bite of a
mad dog, are chiefly such as promote the different secretions, and
antispasmodics.
Dr. Mead recommends a preventive medicine, which he says he never knew
fail, though in the space of thirty years he had used it a thousand
times.
The Doctor’s prescription is as follows:
“Take ash-coloured ground liver-wort, cleaned, dried, and powdered, half
an ounce; of black pepper powdered, a quarter of an ounce. Mix these
well together, and divide the powder into four doses; one of which must
be taken every morning fasting, for four mornings successively, in half
an English pint of cows milk warm.
“After these four doses are taken, the patient must go into the cold
bath, or a cold spring or river, every morning fasting, for a month; he
must be dipped all over, but not stay in (with his head above water)
longer than half a minute, if the water be very cold. After this he must
go in three times a-week for a fortnight longer.
“The person must be bled before he begins to use the medicine[161].”
We shall next mention the famous East India specific, as it is called.
This medicine is composed of cinnabar and musk. It is esteemed a great
antispasmodic; and, by many, extolled as an infallible remedy for
preventing the effects of the bite of a mad dog.
“Take native and factitious cinnabar, of each twenty-four grains, musk
sixteen grains. Let these be made into a fine powder, and taken in a
glass of arrack or brandy.”
This single dose is said to secure the person for thirty days, at the
end of which it must be repeated; but if he has any symptoms of the
disease, it must be repeated in three hours.
The following is likewise reckoned a good antispasmodic medicine:
“Take of Virginian snake-root in powder, half a drachm, gum asafœtida
twelve grains, gum camphire seven grains; make these into a bolus with a
little syrup of saffron.”
Camphire may also be given in the following manner:
“Take purified nitre half an ounce, Virginian snake-root in powder two
drachms, camphire one drachm; rub them together in a mortar, and divide
the whole into ten doses.”
Mercury is likewise recommended as of great efficacy, both in the
prevention and cure of this kind of madness. When used as a preventive,
it will be sufficient to rub daily a drachm of the ointment into the
parts about the wound.
Vinegar is likewise of considerable service, and should be taken freely,
either in the patient’s food or drink.
These are the principal medicines recommended for preventing the effects
of the bite of a mad dog. We would not however advise people to trust to
any one of them; but from a proper combination of their different
powers, there is the greatest reason to hope for success.
The great error in the use of these medicines lies in not taking them
for a sufficient length of time. They are used more like charms, than
medicines intended to produce any change in the body. To this, and not
to the insufficiency of the medicines, we must impute their frequent
want of success.
Dr. Mead says, that the virtue of his medicine consists in promoting
urine. But how a poison should be expelled by urine, with only three or
four doses of any medicine, however powerful, it is not easy to
conceive. More time is certainly necessary, even though the medicine
were more powerful than that which the Doctor prescribes.
The East India specific is still more exceptionable on this account.
As these and most other medicines, taken singly, have frequently been
found to fail, we shall recommend the following course:
If a person be bit in a fleshy part, where there is no hazard of hurting
any large blood-vessel, the parts adjacent to the wound may be cut away.
But if this be not done soon after the bite has been received, it will
be better to omit it.
The wound may be dressed with salt and water, or a pickle made of
vinegar and salt, and afterwards dressed twice a-day with yellow
basilicon mixed with red precipitate of mercury.
The patient should begin to use either Dr. Mead’s medicine, or some of
the others mentioned above. If he takes Mead’s medicine, he may use it
as the Doctor directs for four days successively. Let him then omit it
for two or three days, and again repeat the same number of doses as
before.
During this course, he must rub into the parts about the wound, daily,
one drachm of the mercurial ointment. This may be done for ten or twelve
days at least.
When this course is over, he may take a purge or two, and wait a few
days till the effect of the mercury be gone off. He must then begin to
use the cold bath, into which he may go every morning for five or six
weeks. If he should feel cold and chilly for a long time after coming
out of the cold bath, it will be better to use a tepid one, or to have
the water a little warmed.
In the mean time, we would advise him not to leave off all internal
medicines, but to take either one of the boluses of snake-root,
asafœtida, and camphire; or one of the powders of nitre, camphire, and
snake-root, twice a-day. These may be used during the whole time he is
bathing.
During the use of the mercurial ointment, the patient must keep within
doors, and take nothing cold.
A proper regimen must be observed throughout the whole course. The
patient should abstain from flesh, and all salted and high-seasoned
provisions. He must avoid strong liquors, and live mostly upon a light
and rather spare diet. His mind should be kept as easy and cheerful as
possible, and all excessive heat and violent passions avoided with the
utmost care.
I have never seen this course of medicine, with proper regimen, fail to
prevent the hydrophobia, and cannot help again observing, that the want
of success must generally be owing either to the application of improper
medicines, or not using proper ones for a sufficient length of time.
Mankind are extremely fond of every thing that promises a sudden or
miraculous cure. By trusting to these they often lose their lives, when
a regular course of medicine would have rendered them absolutely safe.
This holds remarkably in the present case. Numbers of people, for
example, believe if they or their cattle were once dipped in the sea, it
is sufficient; as if the salt-water were a charm against the effects of
the bite. This, and such like whims, have proved fatal to many.
It is a common notion, if a person be bit by a dog which is not mad,
that, if he should go mad afterwards, the person would be affected with
the disorder at the same time; but this notion is too ridiculous to
deserve a serious consideration. It is a good rule, however, to avoid
dogs as much as possible, as the disease is often upon them for some
time before its violent symptoms appear. The hydrophobia has been
occasioned by the bite of a dog which shewed no other symptoms of the
disease but listlessness and a sullen disposition.
Though we do not mean to treat fully of the cure of the hydrophobia, yet
we are far from reckoning it incurable. The notion that this disease
could not be cured, has been productive of the most horrid consequences.
It was usual either to abandon the unhappy persons, as soon as they were
seized with the disease, to their fate, to bleed them to death, or to
suffocate them between matrasses or feather-beds, &c. This conduct
certainly deserved the severest punishment! We hope, for the honour of
human nature, it will never again be heard of.
I have never had an opportunity of treating this disease, and therefore
can say nothing of it from my own experience; but the learned Dr. Tissot
says, it may be cured in the following manner:
1. The patient must be bled to a considerable quantity; and this may be
repeated twice, or thrice, or even a fourth time, if circumstances
require it.
2. The patient should be put, if possible, into a warm bath; and this
should be used twice a-day.
3. He should every day receive two, or even three emollient clysters.
4. The wound, and the parts adjoining to it, should be rubbed with the
mercurial ointment twice a-day.
5. The whole limb which contains the wound should be rubbed with oil,
and be wrapped up in an oily flannel.
6. Every three hours a dose of Cob’s powder should be taken in a cup of
the infusion of lime-tree and elder-flowers. This powder is made, by
rubbing together in a mortar, to a very fine powder, of native and
factitious cinnabar, each twenty-four grains; of musk, sixteen
grains[162].
7. The following bolus is to be given every night, and to be repeated in
the morning, if the patient is not easy, washing it down with the
infusion mentioned above: Take one drachm of Virginian snake-root in
powder; of camphire and asafœtida, ten grains each; of opium, one grain;
and, with a sufficient quantity of conserve, or rob of elder, make a
bolus.
8. If there be a great nausea at the stomach, with a bitterness in the
mouth, thirty-five or forty grains of ipecacuanha, in powder, may be
taken for a vomit.
9. The patient’s food, if he takes any, must be light; as panado, soups
made of farinaceous or mealy vegetables, &c.
10. If the patient should long continue weak, and subject to terrors, he
may take half a drachm of the Peruvian bark thrice a-day.
The next poisonous animal which we shall mention is the VIPER. The
grease of this animal rubbed into the wound is said to cure the bite.
Though that is all the viper-catchers generally do when bit, we should
not think it sufficient for the bite of an enraged viper. It would
surely be more safe to have the wound well sucked[163], and afterwards
rubbed with warm salad-oil. A poultice of bread and milk, softened with
salad-oil, should likewise be applied to the wound; and the patient
ought to drink freely of vinegar whey, or water-gruel with vinegar in
it, to make him sweat. Vinegar is one of the best medicines which can be
used in any kind of poison, and ought to be taken very liberally. If the
patient be sick, he may take a vomit. This course will be sufficient to
cure the bite of any of the poisonous animals of this country.
With regard to poisonous insects, as the bee, the wasp, the hornet, &c.
their stings are seldom attended with danger, unless when a person
happens to be stung by a great number of them at the same time; in which
case something should be done to abate the inflammation and swelling.
Some, for this purpose, apply honey, others lay pounded parsley to the
part. A mixture of vinegar and Venice treacle is likewise recommended;
but I have always found rubbing the part with warm salad-oil succeed
very well. Indeed, when the stings are so numerous as to endanger the
patient’s life, which is sometimes the case, he must not only have oily
poultices applied to the part, but should likewise be bled, and take
some cooling medicines, as nitre, or cream of tartar, and should drink
plentifully of diluting liquors.
It is the happiness of this island to have very few poisonous animals,
and those which we have are by no means of the most virulent kind.
Nine-tenths of the effects attributed to poison or venom in this
country, are really other diseases, and proceed from quite different
causes.
We cannot however make the same observation with regard to poisonous
vegetables. These abound every where, and prove often fatal to the
ignorant and unwary. This indeed is chiefly owing to carelessness.
Children ought early to be cautioned against eating any kind of fruit,
roots, or berries, which they do not know, and all poisonous plants to
which they can have access, ought, as far as possible, to be destroyed.
This would not be so difficult a task as some people imagine.
Poisonous plants have no doubt their use, and they ought to be
propagated in proper places; but, as they prove often destructive to
cattle, they should be rooted out of all pasture-grounds. They ought
likewise, for the safety of the human species, to be destroyed in the
neighbourhood of all towns and villages; which, by the bye, are the
places where they most commonly abound. I have seen the poisonous
hemlock, henbane, wolfsbane, and deadly night-shade, all growing within
the _environs_ of a small town, where, though several persons, within
the memory of those living in it, had lost their lives by one or other
of these plants; yet no method, that I could hear of, had ever been
taken to root them out; though this might be done at a very trifling
expence.
Seldom a year passes but we have accounts of several persons poisoned by
eating hemlock-roots instead of parsnips, or some kinds of fungus which
they had gathered for mushrooms. These examples ought to put people upon
their guard with respect to the former, and to put the latter entirely
out of use. Mushrooms may be a delicate dish, but they are a dangerous
one, as they are generally gathered by persons who do not know one kind
of fungus from another, and take every thing for a mushroom which has
that appearance.
We might here mention many other plants and animals of a poisonous
nature which are found in foreign countries; but, as our observations
are chiefly intended for this island, we shall pass these over. It may
not however be amiss to observe, for the benefit of such of our
countrymen as go to America, that an effectual remedy is now said to be
found for the bite of the rattle-snake.—The prescription is as follows:
Take of the roots of plantain and horehound, in summer, roots and
branches together, a sufficient quantity; bruise them in a mortar, and
squeeze out the juice, of which give, as soon as possible, one large
spoonful; if the patient be swelled, you must force it down his throat.
This generally will cure; but, if he finds no relief in an hour after,
you may give another spoonful, which never fails.—If the roots are
dried, they must be moistened with a little water. To the wound may be
applied a leaf of good tobacco moistened with rum.
We give this upon the faith of Dr. Brookes, who says it was the
invention of a negro; for the discovery of which he had his freedom
purchased, and a hundred pounds _per annum_ settled upon him during
life, by the General Assembly of Carolina.
It is possible there may be in nature specific remedies for every kind
of poison; but as we have very little faith in any of those which have
yet been pretended to be discovered, we shall beg leave again to
recommend the most strict attention to the following rules, _viz._ That
when any poisonous substance has been taken into the stomach, it ought,
as soon as possible, to be discharged by vomits, clysters, and purges;
and, when poison has been received into the body by a wound, that it be
expelled by medicines which promote the different secretions, especially
those of sweat, urine, and insensible perspiration; to which may be
joined antispasmodics, or such medicines as take off tension and
irritation; the chief of which are opium, musk, camphire, and asafœtida.
CHAP. XLVII.
OF THE VENEREAL DISEASE.
In the first edition of this book the venereal disease was omitted. The
reasons however which at that time induced me to leave it out, have upon
more mature consideration vanished. Bad consequences, no doubt, may
arise from ignorant persons tampering with medicine in this disorder;
but the danger from that quarter seems to be more than balanced by the
great and solid advantages, which must arise to the patient from an
early knowledge of his case, and an attention to a plan of regimen,
which, if it does not cure the disease, will be sure to render it more
mild, and less hurtful to the constitution.
It is peculiarly unfortunate for the unhappy persons who contract this
disease, that it lies under a sort of disgrace. This renders disguise
necessary, and makes the patient either conceal his disorder altogether,
or apply to those who promise a sudden and secret cure; but who in fact
only remove the symptoms for a time, while they fix the disease deeper
in the habit. By this means a slight infection, which might have been
easily removed, is often converted into an obstinate, and sometimes
incurable malady.
Another unfavourable circumstance attending this disease is, that it
assumes a variety of different shapes, and may with more propriety be
called an assemblage of diseases, than a single one. No two diseases can
require a more different method of treatment than this does in its
different stages. Hence the folly and danger of trusting to any
particular nostrum for the cure of it. Such nostrums are however
generally administered in the same manner to all who apply for them,
without the least regard to the state of the disease, the constitution
of the patient, the degree of infection, and a thousand other
circumstances of the utmost importance.
Though the venereal disease is generally the fruit of unlawful embraces,
yet it may be communicated to the innocent as well as the guilty.
Infants, nurses, midwives, and married women whose husbands lead
dissolute lives, are often affected with it, and frequently lose their
lives by not being aware of their danger in due time. The unhappy
condition of such persons will certainly plead our excuse, if any excuse
be necessary, for endeavouring to point out the symptoms and cure of
this too common disease.
To enumerate all its different symptoms, however, and to trace the
disease minutely through its various stages, would require a much larger
space than falls to this part of my subject; I shall therefore confine
my observations chiefly to circumstances of importance, omitting such as
are either trifling, or which occur but seldom. I shall likewise pass
over the history of the disease, with the different methods of treatment
which it has undergone since it was first introduced into Europe, and
many other circumstances of a similar nature; all of which, though they
might tend to amuse the reader, yet could afford him little or no useful
knowledge.
OF THE VIRULENT GONORRHŒA.
The virulent gonorrhœa is an involuntary discharge of infectious matter
from the parts of generation in either sex. It generally makes its
appearance within eight or ten days after the infection has been
received: sometimes indeed it appears in two or three days, and at other
times not before the end of four or five weeks. Previous to the
discharge, the patient feels an itching with a small degree of pain in
the genitals. Afterwards a thin glary matter begins to distil from the
urinary passage, which stains the linen, and occasions a small degree of
titillation, particularly in the time of making water; this gradually
increasing, arises at length to a degree of heat and pain, which are
chiefly perceived about the extremity of the urinary passage, where a
slight degree of redness and inflammation likewise begin to appear.
As the disorder advances, the pain, heat of urine, and running,
increase, while fresh symptoms daily ensue. In men the erections become
painful and involuntary, and are more frequent and lasting than when
natural. This symptom is most troublesome when the patient is warm in
bed. The pain which was at first only perceived towards the extremity,
now begins to reach all up the urinary passage, and is most intense just
after the patient has done making water. The running gradually recedes
from the colour of seed, grows yellow, and at length puts on the
appearance of matter.
When the disorder has arrived at its height, all the symptoms are more
intense; the heat of urine is so great, that the patient dreads the
making water; and though he feels a constant inclination this way, yet
it is rendered with the greatest difficulty, and often only by drops:
the involuntary erections now become extremely painful and frequent;
there is also a pain, heat, and sense of fulness about the seat, and the
running is plentiful and sharp, of a brown, greenish, and sometimes of a
bloody colour.
By a proper treatment the violence of the symptoms gradually abates; the
heat of urine goes off; the involuntary and painful erections, and the
heat and pain about the seat, become easier; the running also gradually
decreases, grows whiter and thicker, till at last it entirely
disappears.
By attending to these symptoms, the gonorrhœa may be generally
distinguished from any other disease. There are however some few
disorders for which it may be mistaken, as an ulcer in the kidnies or
bladder, the _fluor albus_ or whites in women, &c. But in the former of
these, the matter comes away only with the urine, or when the sphincter
of the bladder is open; whereas in a gonorrhœa, the discharge is
constant. The latter is more difficult to distinguish, and must be known
chiefly from its effects, as pain, communicating the infection, &c.
REGIMEN.——When a person has reason to suspect that he has caught the
venereal infection, he ought most strictly to observe a cooling regimen,
to avoid every thing of a heating nature, as wines, spirituous liquors,
rich sauces, spiced, salted, high-seasoned and smoke-dried provisions,
&c. as also all aromatic and stimulating vegetables, as onions, garlic,
shallot, nutmeg, mustard, cinnamon, mace, ginger, and such like. His
food ought chiefly to consist of mild vegetables, milk, broths, light
puddings, panado, gruels, &c. His drink may be barley-water, milk and
water, decoctions of marsh-mallows and liquorice, linseed-tea, or clear
whey. Of these he ought to drink plentifully. Violent exercise of all
kinds, especially riding on horseback, and venereal pleasures, are to be
avoided. The patient must beware of cold, and when the inflammation is
violent, he ought to keep his bed.
MEDICINE.——A virulent gonorrhœa cannot always be cured speedily and
effectually at the same time. The patient ought therefore not to expect,
nor the physician to promise it. It will often continue for two or three
weeks, and sometimes for five or six, even where the treatment has been
very proper.
Sometimes indeed a slight infection may be carried off in a few days, by
bathing the parts in warm milk and water, and injecting frequently up
the urethra a little sweet oil or linseed-tea about the warmth of new
milk. Should these not succeed in carrying off the infection, they will
at least have a tendency to lessen its virulence.
To effect a cure, however, astringent injections will generally be found
necessary. These may be various ways prepared, but I think those made
with the white vitriol are both most safe and efficacious. They can be
made stronger or weaker as circumstances may require; but it is best to
begin with the more gentle, and increase their power if necessary. I
generally order a drachm of white vitriol to be dissolved in eight or
nine ounces of common or rose-water, and an ordinary syringe full of it
to be thrown up three or four times a-day. If this quantity does not
perform a cure, it may be repeated, and the dose increased[164].
Whether injections be used or not, cooling purges are always proper in
the gonorrhœa. They ought not however to be of the strong or drastic
kind. Whatever raises a violent commotion in the body increases the
danger, and tends to drive the disease deeper into the habit. Procuring
two or three stools every second or third day for the first fortnight,
and the same number every fourth or fifth day for the second, will
generally be sufficient to remove the inflammatory symptoms, to diminish
the running, and to change its colour and consistence. It gradually
becomes more white and ropy as the virulence abates[165].
When the inflammatory symptoms run high, bleeding is always necessary at
the beginning. This operation, as in other topical inflammations, must
be repeated according to the strength and constitution of the patient,
and the vehemence and urgency of the symptoms.
Medicines which promote the secretion of urine, are likewise proper in
this stage of the disorder. For this purpose, an ounce of nitre and two
ounces of gum-arabic, pounded together, may be divided into twenty-four
doses, one of which may be taken frequently in a cup of the patient’s
drink. If these should make him pass his urine so often as to become
troublesome to him, he may either take them less frequently, or leave
out the nitre altogether, and take equal parts of gum-arabic and cream
of tartar. These may be pounded together, and a tea-spoonful taken in a
cup of the patient’s drink four or five times a-day. I have generally
found this answer extremely well both as a diuretic, and for keeping the
body gently open.
When the pain and inflammation are seated high towards the neck of the
bladder, it will be proper frequently to throw up an emollient clyster,
which, besides the benefit of procuring stools, will serve as a
fomentation to the inflamed parts.
Soft poultices, when they can conveniently be applied to the parts, are
of great service. They may be made of the flour of linseed, or of
wheat-bread and milk, softened with fresh butter or sweet oil. When
poultices cannot be conveniently used, cloths wrung out of warm water,
or bladders filled with warm milk and water, may be applied. I have
often known the most excruciating pains, during the inflammatory state
of the gonorrhœa, relieved by one or other of these applications.
Few things tend more to keep off inflammation in the spermatic vessels,
than a proper truss for the scrotum. It ought to be so contrived as to
support the testicles, and should be worn from the first appearance of
the disease till it has ceased some weeks.
The above treatment will sometimes remove the gonorrhœa so quickly, that
the person will be in doubt whether he really laboured under that
disease. This, however, is too favourable a turn to be often expected.
It more frequently happens, that we are able only to procure an
abatement or remission of the inflammatory symptoms, so far as to make
it safe to have recourse to the great antidote _mercury_.
Many people, on the first appearance of a gonorrhœa, fly to the use of
mercury. This is a bad plan. Mercury is often not at all necessary in a
gonorrhœa; and when taken too early, it does mischief. It may be
necessary to complete the cure, but can never be proper at the
commencement of it.
When bleeding, purging, fomentations, and the other things recommended
above, have eased the pain, softened the pulse, relieved the heat of
urine, and rendered the involuntary erections less frequent, the patient
may begin to use mercury in any form that is least disagreeable to him.
If he takes the common mercurial pill, two at night and one in the
morning will be a sufficient dose at first. Should they affect the mouth
too much, the dose must be lessened; if not at all, it may be gradually
increased to five or six pills in the day. If calomel be thought
preferable, two or three grains of it, formed into a bolus with a little
of the conserve of hips, may be taken at bed-time, and the dose
gradually increased to eight or ten grains. One of the most common
preparations of mercury now in use is the corrosive sublimate. This may
be taken in the manner afterwards recommended under the confirmed lues
or pox. I have always found it one of the most safe and efficacious
medicines when properly used.
The above medicines may either be taken every day or every other day, as
the patient is able to bear them. They ought never to be taken in such
quantity as to raise a salivation, unless in a very slight degree. The
disease may be more safely, and as certainly, cured without a salivation
as with it. When the mercury runs off by the mouth, it is not so
successful in carrying off the disease, as when it continues longer in
the body, and is discharged gradually.
Should the patient be purged or griped in the night by the mercury, he
must take an infusion of senna, or some other purgative, and drink
freely of water-gruel to prevent bloody stools, which are very apt to
happen should the patient catch cold, or if the mercury has not been
duly prepared. When the bowels are weak and the mercury is apt to gripe
or purge, these disagreeable consequences may be prevented by taking,
with the above pills or bolus, half a drachm or two scruples of
diascordium, or of the Japonic confection.
To prevent the disagreeable circumstance of the mercury’s affecting the
mouth too much, or bringing on a salivation, it may be combined with
purgatives. With this view the laxative mercurial pill has been
contrived, the usual dose of which is half a drachm, or three pills,
night and morning, to be repeated every other day; but the safer way is
for the patient to begin with two, or even with one pill, gradually
increasing the dose.
To such persons as can neither swallow a bolus nor a pill, mercury may
be given in a liquid form, as it can be suspended even in a watery
vehicle, by means of gum-arabic; which not only serves this purpose, but
likewise prevents the mercury from affecting the mouth, and renders it
in many respects a better medicine[166].
It happens very fortunately for those who cannot be brought to take
mercury inwardly, and likewise for persons whose bowels are too tender
to bear it, that an external application of it will answer equally well,
and in some respects better. It must be acknowledged, that mercury,
taken inwardly for any length of time, greatly weakens and disorders the
bowels; for which reason, when a plentiful use of it becomes necessary,
we would prefer rubbing to the mercurial pills. The common mercurial or
blue ointment will answer very well. Of that which is made by rubbing
together equal quantities of hog’s lard and quicksilver, about a drachm
may be used at a time. The best time for rubbing it on is at night, and
the most proper place the inner side of the thighs. The patient should
stand before the fire when he rubs, and should wear flannel drawers next
his skin at the time he is using the ointment. If ointment of a weaker
or stronger kind be used, the quantity must be increased or diminished
in proportion.
If, during the use of the ointment, the inflammation of the genital
parts, together with the heat and feverishness, should return, or if the
mouth should grow sore, the gums tender, and the breath become
offensive, a dose or two of Glauber’s salts, or some other cooling
purge, may be taken, and the rubbing intermitted for a few days. As
soon, however, as the signs of spitting are gone off, if the virulency
be not quite corrected, the ointment must be repeated, but in smaller
quantities, and at longer intervals than before. Whatever way mercury is
administered, its use must be persisted in as long as any virulency is
suspected to remain.
During this, which may be called the second stage of the disorder,
though so strict a regimen is not necessary as in the first or
inflammatory state, yet intemperance of every kind must be avoided. The
food must be light, plain, and of easy digestion; and the greatest
indulgence that may be allowed with respect to drink is, a little wine
diluted with a sufficient quantity of water. Spirituous liquors are to
be avoided in every shape. I have often known the inflammatory symptoms
renewed and heightened, the running increased, and the cure rendered
extremely difficult and tedious, by one fit of excessive drinking.
When the above treatment has removed the heat of urine, and soreness of
the genital parts; when the quantity of running is considerably
lessened, without any pain or swelling in the groin or testicle
supervening; when the patient is free from involuntary erections; and
lastly, when the running becomes pale, whitish, thick, void of ill
smell, and tenacious or ropy; when all or most of these symptoms appear,
the gonorrhœa is arrived at its last stage, and we may gradually proceed
to treat it as a gleet with astringent and agglutinating medicines.
OF GLEETS.
A gonorrhœa frequently repeated, or improperly treated, often ends in a
gleet, which may either proceed from relaxation, or from some remains of
the disease. It is however of the greatest importance in the cure of the
gleet, to know from which of these causes it proceeds. When the
discharge proves very obstinate, and receives little or no check from
astringent remedies, there is ground to suspect that it is owing to the
latter; but if the drain is inconstant, and is chiefly observable when
the patient is stimulated by lascivious ideas, or upon straining to go
to stool, we may reasonably conclude that it is chiefly owing to the
former.
In the cure of a gleet proceeding from relaxation, the principal design
is to brace, and restore a proper degree of tension to the debilitated
and relaxed vessels. For this purpose, besides the medicines recommended
in the gonorrhœa, the patient may have recourse to stronger and more
powerful astringents, as the Peruvian bark[167], alum, vitriol, galls,
tormentil, bistort, baldustines, tincture of gum kino, &c. The
injections may be rendered more astringent by the addition of a few
grains of alum, or increasing the quantity of vitriol as far as the
parts are able to bear it.
The last remedy which we shall mention in this case is the cold bath,
than which there is not perhaps a more powerful bracer in the whole
compass of medicine. It ought never to be omitted in this species of
gleet, unless there be something in the constitution of the patient
which renders the use of it unsafe. The chief objections to the use of
the cold bath are, a full habit, and an unsound state of the viscera.
The danger from the former may always be lessened, if not removed, by
purging and bleeding; but the latter is an insurmountable obstacle, as
the pressure of the water, and the sudden contraction of the external
vessels, by throwing the blood with too much force upon the internal
parts, are apt to occasion ruptures of the vessels, or a flux of humours
upon the diseased organs. But where no objection of this kind prevails,
the patient ought to plunge over head in water every morning fasting,
for three or four weeks together. He should not however stay long in the
water, and should take care to have his skin dried as soon as he comes
out.
The regimen proper in this case is the same as was mentioned in the last
stage of the gonorrhœa: the diet must be drying and astringent, and the
drink Spa, Pyrmont, or Bristol waters, with which a little claret or red
wine may sometimes be mixed. Any person may now afford to drink these
waters, as they can be every where prepared at almost no expence, by a
mixture of common chalk and oil of vitriol.
When the gleet does not in the smallest degree yield to these medicines,
there is reason to suspect that it proceeds from ulcers. In this case
recourse must be had to mercury, and such medicines as tend to correct
any predominant acrimony with which the juices may be affected, as the
decoction of China, sarsaparilla, sassafras, or the like.
Mr. Fordyce says, he has seen many obstinate gleets of two, three, or
four years standing, effectually cured by a mercurial inunction, when
almost every other medicine has been tried in vain. Dr. Chapman seems to
be of the same opinion; but says, he has always found the mercury
succeed best in this case when joined with terebinthinate and other
agglutinating medicines. For which reason the Doctor recommends pills
made of calomel and Venice turpentine[168]; and desires that their use
may be accompanied with a decoction of guaiacum or sarsaparilla.
The last kind of remedy which we shall mention for the cure of ulcers in
the urinary passage, are the suppurating candles or bougies: as these
are prepared various ways, and are generally to be bought ready made, it
is needless to spend time in enumerating the different ingredients of
which they are composed, or teaching the manner of preparing them.
Before a bougie be introduced into the urethra, however, it should be
smeared all over with sweet oil, to prevent it from stimulating too
suddenly; it may be suffered to continue in from one to seven or eight
hours, according as the patient can bear it. Obstinate ulcers are not
only often healed, but tumours and excrescences in the urinary passages
taken away, and an obstruction of urine removed by means of bougies.
Obstinate gleets may be removed by the use of bougies.
OF THE SWELLED TESTICLE.
The swelled testicle may either proceed from infection lately
contracted, or from the venereal poison lurking in the blood: the latter
indeed is not very common, but the former frequently happens both in the
first and second stages of a gonorrhœa; particularly when the running is
unseasonably checked, by cold, hard drinking, strong drastic purges,
violent exercise, the too early use of astringent medicines, or the
like.
In the inflammatory stage bleeding is necessary, which must be repeated
according to the urgency of the symptoms[169]. The food must be light,
and the drink diluting. High-seasoned food, flesh, wines, and every
thing of a heating nature, are to be avoided. Fomentations are of
singular service. Poultices of bread and milk, softened with fresh
butter or oil, are likewise very proper, and ought constantly to be
applied when the patient is in bed: when he is up, the testicles should
be kept warm, and supported by a bag or truss, which may easily be
contrived in such a manner as to prevent the weight of the testicle from
having any effect.
If it should be found impracticable to clear the testicle by the cooling
regimen now pointed out, and extended according to circumstances, it
will be necessary to lead the patient through such a complete
antivenereal course as shall ensure him against any future uneasiness.
For this purpose, besides rubbing the mercurial ointment on the part, if
free from pain, or on the thighs, as directed in the gonorrhœa, the
patient must be confined to bed, if necessary, for five or six weeks,
suspending the testicle all the while with a bag or truss, and plying
him inwardly with strong decoctions of sarsaparilla.
When these means do not succeed, and there is reason to suspect a
scrophulous or cancerous habit, either of which may support a scirrhous
induration, after the venereal poison is corrected, the parts should be
fomented daily with a decoction of hemlock, the bruised leaves of which
may likewise be added to the poultice, and the extract at the same time
taken inwardly[170]. This practice is strongly recommended by Dr. Stork
in scirrhous and cancerous cases; and Mr. Fordyce assures us, that by
this method he has cured diseased testicles of two or three years
standing, even when ulcerated, and when the scirrhus had begun to be
affected with pricking and lancing pains.
OF BUBOES.
Venereal buboes are hard tumours seated in the groin, occasioned by the
venereal poison lodged in this part. They are of two kinds; _viz._ such
as proceed from a recent infection, and such as accompany a confirmed
lues.
The cure of recent buboes, that is, such as appear soon after impure
coition, may be first attempted by _dispersion_, and, if that should not
succeed, by _suppuration_. To promote the dispersion of a bubo, the same
regimen must be observed as was directed in the first stage of a
gonorrhœa. The patient must likewise be bled, and take some cooling
purges, as the decoction of tamarinds and senna, Glauber’s salts, and
the like. If, by this course, the swelling and other inflammatory
symptoms abate, we may safely proceed to the use of mercury, which must
be continued till the venereal virus is quite subdued[171].
But if the bubo should, from the beginning, be attended with great heat,
pain, and pulsation, it will be proper to promote its suppuration. For
this purpose the patient may be allowed to use his ordinary diet, and to
take now and then a glass of wine. Emollient cataplasms, consisting of
bread and milk softened with oil or fresh butter, may be applied to the
part; and, in cold constitutions, where the tumour advances slowly,
white lily-roots boiled, or sliced onions raw, and a sufficient quantity
of yellow basilicon, may be added to the poultice.
When the tumour is ripe, which may be known by its conical figure, the
softness of the skin, and a fluctuation of matter plainly to be felt
under the finger, it may be opened either by a caustic or a lancet, and
afterwards dressed with digestive ointment.
It sometimes however happens, that buboes can neither be dispersed nor
brought to a suppuration, but remain hard, indolent tumours. In this
case the indurated glands must be consumed by caustic; if they should
become scirrhous, they must be dissolved by the application of hemlock,
both externally and internally, as directed in the scirrhous testicle.
OF CHANCRES.
Chancres are superficial, callous, eating ulcers; which may happen
either with or without a gonorrhœa. They are commonly seated about the
glans, and make their appearance in the following manner: First a little
red pimple arises, which soon becomes pointed at top, and is filled with
a whitish matter inclining to yellow. This pimple is hot, and itches
generally before it breaks: afterwards it degenerates into an obstinate
ulcer, the bottom of which is usually covered with a viscid mucus, and
whose edges gradually become hard and callous. Sometimes the first
appearance resembles a simple excoriation of the cuticle; which however,
if the cause be venereal, soon becomes a true chancre.
A chancre is sometimes a primary affection, but it is much oftner
symptomatic, and is the mark of a confirmed lues. Primary chancres
discover themselves soon after impure coition, and are generally seated
in parts covered with a thin cuticle, as the lips, the nipples of women,
the _glans penis_ of men, &c.[172].
When a chancre appears soon after impure coition, its treatment is
nearly similar to that of the virulent gonorrhœa. The patient must
observe the cooling regimen, lose a little blood, and take some gentle
doses of salts and manna. The parts affected ought frequently to be
bathed, or rather soaked, in warm milk and water, and, if the
inflammation be great, an emollient poultice or cataplasm may be applied
to them. This course will, in most cases, be sufficient to abate the
inflammation, and prepare the patient for the use of mercury.
Symptomatic chancres are commonly accompanied with ulcers in the throat,
nocturnal pains, scurfy eruptions about the roots of the hair, and other
symptoms of a confirmed lues. Though they may be seated in any of the
parts mentioned above, they commonly appear upon the private parts, or
the inside of the thigh. They are also less painful, but frequently much
larger and harder than primary chancres. As their cure must depend upon
that of the pox, of which they are only a symptom, we shall take no
further notice of them, till we come to treat of a confirmed lues[173].
Thus we have related most of the symptoms which accompany or succeed a
violent gonorrhœa, and have also given a short view of their proper
treatment; there are, however, several others which sometimes attend
this disease, as a _strangury_ or obstruction of urine, _phymosis_,
_paraphymosis_, &c.
A strangury may be occasioned either by a spasmodic constriction, or an
inflammation of the urethra and parts about the neck of the bladder. In
the former case, the patient begins to void his urine with tolerable
ease; but, as soon as it touches the galled or inflamed urethra, a
sudden constriction takes place, and the urine is voided by spurts, and
sometimes by drops only. When the strangury is owing to an inflammation
about the neck of the bladder, there is a constant heat and uneasiness
of the part, a perpetual desire to make water, while the patient can
only render a few drops, and a troublesome _tenesmus_, or constant
inclination to go to stool.
When the strangury is owing to spasm, such medicines as tend to dilute
and blunt the salts of the urine will be proper. For this purpose,
besides the common diluting liquors, soft and cooling emulsions,
sweetened with the syrup of poppies, may be used. Should these not have
the desired effect, bleeding, and emollient fomentations, will be
necessary.
When the complaint is evidently owing to an inflammation about the neck
of the bladder, bleeding must be more liberally performed, and repeated
according to the urgency of the symptoms. After bleeding, if the
strangury still continues, soft clysters, with a proper quantity of
laudanum in them, may be administered, and emollient fomentations
applied to the region of the bladder. At the same time, the patient may
take every four hours a tea-cupful of barley-water, to an English pint
of which six ounces of the syrup of marsh-mallows, four ounces of the
oil of sweet almonds, and half an ounce of nitre, may be added. If these
remedies should not relieve the complaint, and a total suppression of
urine should come on, bleeding must be repeated, and the patient set in
a warm bath up to the middle. It will be proper in this case to
discontinue the diuretics, and to draw off the water with a catheter;
but as the patient is seldom able to bear its being introduced, we would
rather recommend the use of mild bougies. These often lubricate the
passage, and greatly facilitate the discharge of urine. Whenever they
begin to stimulate or give any uneasiness, they may be withdrawn.
The _phymosis_ is such a constriction of the prepuce over the glans, as
hinders it from being drawn backwards; the _paraphymosis_, on the
contrary, is such a constriction of the prepuce behind the glans, as
hinders it from being brought forward.
The treatment of these symptoms is so nearly the same with that of the
virulent gonorrhœa, that we have no occasion to enlarge upon it. In
general, bleeding, purging, poultices, and emollient fomentations are
sufficient. Should these, however, fail of removing the stricture, and
the parts be threatened with a mortification, twenty or thirty grains of
ipecacuanha, and one grain of emetic tartar, may be given for a vomit,
and may be worked off with warm water or thin gruel.
It sometimes happens, that, in spite of all endeavours to the contrary,
the inflammation goes on, and symptoms of a beginning mortification
appear. When this is the case, the prepuce must be scarified with a
lancet, and, if necessary, divided, in order to prevent a strangulation,
and set the imprisoned glans at liberty. We shall not describe the
manner of performing this operation, as it ought always to be done by a
surgeon. When a mortification has actually taken place, it will be
necessary, besides performing the above operations, to foment the parts
frequently with cloths wrung out of a strong decoction of
camomile-flowers and bark, and to give the patient a drachm of the bark
in powder every two or three hours.
With regard to the _priapism_, _chordee_, and other distortions of the
_penis_, their treatment is no way different from that of the gonorrhœa.
When they prove very troublesome, the patient may take a few drops of
laudanum at night, especially after the operation of a purgative through
the day.
OF A CONFIRMED LUES.
We have hitherto treated of those affections in which the venereal
poison is supposed to be confined chiefly to the particular part by
which it was received, and shall next take a view of the lues in its
confirmed state; that is, when the poison is actually received into the
blood, and, circulating with it through every part of the body, mixes
with the several secretions, and renders the whole habit tainted.
The symptoms of a confirmed lues are, buboes in the groin, pains of the
head and joints, which are peculiarly troublesome in the night, or when
the patient is warm in bed; scabs and scurfs in various parts of the
body, especially on the head, of a yellowish colour, resembling a
honey-comb; corroding ulcers in various parts of the body, which
generally begin about the throat, from whence they creep gradually, by
the palate, towards the cartilage of the nose, which they destroy;
excrescences or exostoses arise in the middle of the bones, and their
spongy ends become brittle, and break upon the least accident; at other
times they are soft, and bend like wax; the conglobate glands become
hard and callous, and form, in the neck, armpits, groin, and mesentery,
hard moveable tumours, like the king’s evil; tumours of different kinds
are likewise formed in the lymphatic vessels, tendons, ligaments, and
nerves, as the _gummata_, _ganglia_, _nodes_, _tophs_, &c.; the eyes are
affected with itching, pain, redness, and sometimes with total
blindness, and the ears with a singing noise, pain, and deafness, whilst
their internal substance is exulcerated and rendered carious; at length
all the animal, vital, and natural functions are depraved; the face
becomes pale and livid; the body emaciated and unfit for motion, and the
miserable patient falls into an atrophy or wasting consumption.
Women have symptoms peculiar to the sex; as cancers of the breast; a
suppression or overflowing of the menses; the whites; hysteric
affections; an inflammation, abscess, scirrhus, gangrene, cancer, or
ulcer of the womb; they are generally either barren or subject to
abortion; or, if they bring children into the world, they have an
universal erysipelas, are half rotten, and covered with ulcers.
Such is the catalogue of symptoms attending this dreadful disease in its
confirmed state. Indeed they are seldom all to be met with in the same
person, or at the same time; so many of them, however, are generally
present as are sufficient to alarm the patient; and if he has reason to
suspect the infection is lurking in his body, he ought immediately to
set about the expulsion of it, otherwise the most tragical consequences
will ensue.
The only certain remedy hitherto known in Europe, for the cure of this
disease, is mercury, which may be used in a great variety of forms, with
nearly the same success. Some time ago it was reckoned impossible to
cure a confirmed lues without a salivation. This method is now however
pretty generally laid aside, and mercury is found to be as efficacious,
or rather more so, in expelling the venereal poison, when administered
in such a manner as not to run off by the salivary glands.
Though many are of opinion, that the mercurial ointment is as
efficacious as any other preparation of that mineral; yet experience has
taught me to think otherwise. I have often seen the most obstinate
venereal cases, where great quantities of mercurial ointment had been
used in vain, yield to the saline preparations of mercury. Nor am I
singular in this opinion. My ingenious friend, Mr. Clare, an eminent
surgeon of this city, assures me, that for some time past he has
employed, in venereal cases, a saline preparation of mercury with most
happy success. This preparation, rubbed with a sufficient quantity of
any mild powder, he applies, in small portions, to the tongue, where,
with a gentle degree of friction, it is immediately absorbed, and
produces its full effect; upon the system, without doing the least
injury to the stomach or bowels; a matter of the greatest importance in
the application of this most active and powerful remedy.
It is impossible to ascertain either the exact quantity of medicines
that must be taken, or the time they ought to be continued, in order to
perform a cure. These will ever vary according to the constitution of
the patient, the season of the year, the degree of infection, the time
it has lodged in the body, &c. But though it is difficult, as Astruc
observes, to determine _à priori_, what quantity of mercury will, in the
whole, be necessary to cure this distemper completely; yet it may be
judged of _à posteriori_, from the abatement and ceasing of the
symptoms. The same author adds, that commonly not less than two ounces
of the strong mercurial ointment is sufficient, and not more than three
or four ounces necessary.
The only chemical preparation of mercury which we shall take notice of,
is the corrosive sublimate. This was some time ago brought into use for
the venereal disease, in Germany, by the illustrious Baron Van Swieten;
and was soon after introduced into Britain by the learned Sir John
Pringle, at that time physician to the army. The method of giving it is
as follows: One grain of corrosive sublimate is dissolved in two ounces
of French brandy or malt spirits; and of this solution, an ordinary
table-spoonful, or the quantity of half an ounce, is to be taken twice
a-day, and to be continued as long as any symptoms of the disorder
remain. To those whose stomach cannot bear the solution, the sublimate
may be given in form of pill[174].
Several roots, woods, and barks, have been recommended for curing the
venereal disease; but none of them have been found, upon experience, to
answer the high encomiums which had been bestowed upon them. Though no
one of these is to be depended upon alone, yet, when joined with
mercury, some of them are found to be very beneficial in promoting a
cure. One of the best we know yet is sarsaparilla, which may be prepared
and taken according to the directions in the Appendix[175].
The mezereon root is likewise found to be a powerful assistant to the
sublimate, or any other mercurial. It may either be used along with the
sarsaparilla, as directed in the Appendix, or by itself. Those who chuse
to use the mezereon by itself, may boil an ounce of the fresh bark,
taken from the root, in twelve English pints of water to eight, adding
towards the end an ounce of liquorice. The dose of this is the same as
of the decoction of sarsaparilla.
We have been told that the natives of America cure the venereal disease,
in every stage, by a decoction of the root of a plant called the
Lobelia. It is used either fresh or dried; but we have no certain
accounts with regard to the proportion. Sometimes they mix other roots
with it, as those of the ranunculus, the ceanothus, &c.; but whether
these are designed to disguise or assist it, is doubtful. The patient
takes a large draught of the decoction early in the morning, and
continues to use it for his ordinary drink through the day[176].
Many other roots and woods might be mentioned which have been extolled
for curing the venereal disease, as the china-root, the roots of
soap-wort, burdock, &c. as also the wood of guaiacum and sassafras; but
as none of these have been found to possess virtues superior to those
already mentioned, we shall, for the sake of brevity, pass them over,
and shall conclude our observations on this disease with a few general
remarks concerning the proper management of the patient, and the nature
of the infection.
GENERAL OBSERVATIONS.
The condition of the patient ought always to be considered previous to
his entering upon a course of mercury in any form. It would be equally
rash and dangerous to administer mercury to a person labouring under any
violent acute disease, as a putrid fever, pleurisy, peripneumony, or the
like. It would likewise be dangerous in some chronic cases; as a slow
hectic fever, or the last stage of a consumption. Sometimes, however,
these diseases proceed from a confirmed lues; in which case it will be
necessary to give mercury. In chronic diseases of a less dangerous
nature, as the asthma, the gravel, and such like, mercury, if necessary,
may be safely administered. If the patient’s strength has been greatly
exhausted by sickness, labour, abstinence, or any other cause, the use
of mercury must be postponed, till by time, rest, and a nourishing diet,
it can be sufficiently restored.
Mercury ought not to be administered to women during the menstrual flux,
or when the period is near at hand. Neither should it be given in the
last stage of pregnancy. If, however, the woman be not near the time of
her delivery, and circumstances render it necessary, mercury may be
given, but in smaller doses, and at greater intervals than usual: with
these precautions, both the mother and child may be cured at the same
time; if not, the disorder will at least be kept from growing worse,
till the woman be brought to bed, and sufficiently recovered, when a
more effectual method may be pursued, which, if she suckles her child,
will in all probability be sufficient for the cure of both.
Mercury ought always to be administered to infants with the greatest
caution. Their tender condition unfits them for supporting a salivation,
and makes it necessary to administer even the mildest preparations of
mercury to them with a sparing hand. A similar conduct is recommended in
the treatment of old persons, who have the misfortune to labour under a
confirmed lues. No doubt the infirmities of age must render people less
able to undergo the fatigues of a salivation; but this, as was formerly
observed, is never necessary; besides, we have generally found, that
mercury had much less effect upon very old persons than on those who
were younger.
Hysteric and hypochondriac persons, and such as are subject to an
habitual diarrhœa or dysentery, or to frequent and violent attacks of
the epilepsy, or who are afflicted with the scrophula, or the scurvy,
ought to be cautious in the use of mercury. Where any one of these
disorders prevails, it ought either, if possible, to be cured, or at
least palliated, before the patient enters upon a course of mercury.
When this cannot be done, the mercury must be administered in smaller
doses, and at longer intervals than usual.
The most proper seasons for entering upon a course of mercury, are the
spring and autumn, when the air is of a moderate warmth. If the
circumstances of the case, however, will not admit of delay, we must not
defer the cure on account of the season, but must administer the
mercury; taking care at the same time to keep the patient’s chamber
warmer or cooler, according as the season of the year requires.
The next thing to be considered is the preparation necessary to be
observed before we proceed to administer a course of mercury. Some lay
great stress upon this circumstance, observing, that by previously
relaxing the vessels, and correcting any disorder which may happen to
prevail in the blood, not only the mercury will be disposed to act more
kindly, but many other inconveniencies will be prevented.
We have already recommended bleeding and gentle purges, previous to the
administration of mercury, and shall only now add, that these are always
to be repeated according to the age, strength, constitution, and other
circumstances of the patient. Afterwards, if it can be conveniently
done, the patient ought to bathe once or twice a-day, for a few days, in
lukewarm water. His diet in the mean time must be light, moist, and
cooling. Wine, and all heating liquors, also violent bodily exercise,
and all great exertions of the mind, are carefully to be avoided.
A proper regimen is likewise to be observed by such as are under a
course of mercury. Inattention to this not only endangers the patient’s
life but often also disappoints him of a cure. A much smaller quantity
of mercury will be sufficient for the cure of a person who lives low,
keeps warm, and avoids all manner of excess, than of one who cannot
endure to put the smallest restraint upon his appetites: indeed it but
rarely happens that such are thoroughly cured.
There is hardly any thing of more importance, either for preventing or
removing venereal infection than cleanliness. By an early attention to
this, the infection might often be prevented from entering the body;
and, where it has already taken place, its effects may be greatly
mitigated. The moment any person has reason to suspect that he has
received the infection, he ought to wash the parts with water and
spirits, sweet oil, or milk and water; a small quantity of the last may
likewise be injected up the urethra, if it can be conveniently done.
Whether this disease at first took its rise from dirtiness is hard to
say; but wherever that prevails, the infection is found in its greatest
degree of virulence, which gives ground to believe that a strict
attention to cleanliness would go far towards extirpating it
altogether[177].
When the venereal disease has been neglected, or improperly treated, it
often becomes a disorder of the habit. In this case the cure must be
attempted by restoratives, as a milk diet, the decoction of
sarsaparilla, and such like, to which mercury may be occasionally added.
It is a common practice in North Britain to send such patients to drink
goat-whey. This is a very proper plan, provided the infection has been
totally eradicated before-hand; but when that is not the case, and the
patient trusts to the whey for finishing his cure, he will often be
disappointed. I have frequently known the disease return with all its
virulence after a course of goat-whey, even when that course had been
thought quite sufficient for completing the cure.
One of the most unfortunate circumstances attending patients in this
disease, is the necessity they are often laid under of being soon well.
This induces them to take medicine too fast, and to leave it off too
soon. A few grains more of medicine, or a few days longer confinement,
would often be sufficient to perfect the cure; whereas, by neglect of
these, a small degree of virulence is still left in the humours, which
gradually vitiates, and at length contaminates the whole mass. To avoid
this, we would advise, that the patient should never leave off taking
medicine immediately upon the disappearing of the symptoms, but continue
it for some time after, gradually lessening the quantity, till there is
sufficient ground to believe that the disease is entirely eradicated.
It is not only difficult, but absolutely impossible, to ascertain the
exact degree of virulence that may attend the disease; for which reason
it will always be a much safer rule to continue the use of medicine too
long, than to leave it off too soon. This seems to be the leading maxim
of a modern practitioner of some note for the venereal disease, who
always orders his patient to perform a quarantine of at least forty
days, during which time he takes forty bottles of, I suppose, a strong
decoction of sarsaparilla, or some other antivenereal simple. Whoever
takes this method, and adds a sufficient quantity of corrosive
sublimate, or some other active preparation of mercury to the decoction,
will seldom fail to cure a confirmed lues.
It is peculiarly unfortunate for the cure of this disease, that not one
in ten of those who contract it, are either able or willing to submit to
a proper plan of regimen. The patient is willing to take medicine; but
he must follow his business, and, to prevent suspicions, must eat and
drink like the rest of the family. This is the true source of
nine-tenths of all the mischief arising from the venereal disease. I
never knew the cure attended with any great difficulty or danger where
the patient strictly followed the physician’s advice: but a volume would
not be sufficient to point out the dreadful consequences which proceed
from an opposite conduct. Scirrhous testicles, ulcerous sore throats,
madness, consumptions, carious bones, and a rotten progeny, are a few of
the blessings derived from this source.
There is a species of false reasoning, with regard to this disease,
which proves fatal to many. A person of a sound constitution contracts a
slight degree of the disorder. He gets well without taking any great
care, or using much medicine, and hence concludes that this will always
be the case. The next time the disease occurs, though, ten times more
virulent, he pursues the same course, and his constitution is ruined.
Indeed, the different degrees of virulence in the small-pox are not
greater than in this disease, though, as the learned Sydenham observes,
in some cases the most skilful physicians cannot cure, and in others the
most ignorant old woman cannot kill the patient in that disorder. Though
a good constitution is always in favour of the patient, yet too great
stress may be laid upon it. It does not appear from observation, that
the most robust constitution is able to overcome the virulence of the
venereal contagion, after it has got into the habit. In this case a
proper course of medicine is always indispensably necessary.
Although it is impossible, on account of the different degrees of
virulence, &c. to lay down fixed and certain rules for the cure of this
disease, yet the following general plan will always be found safe, and
often successful, _viz._ to bleed and administer gentle purges with
diuretics during the inflammatory state, and as soon as the symptoms of
inflammation are abated, to administer mercury, in any form that may be
most agreeable to the patient. The same medicine, assisted by the
decoction of sarsaparilla, and a proper regimen, will not only secure
the constitution against the further progress of a confirmed pox, but
will generally perform a complete cure.
CHAP. XLVIII.
DISEASES OF WOMEN.
Women, in all civilized nations, have the management of domestic
affairs, and it is very proper they should, as Nature has made them less
fit for the more active and laborious employments. This indulgence,
however, is generally carried too far; and females, instead of being
benefited by it, are greatly injured, from the want of exercise and free
air. To be satisfied of this, one need only compare the fresh and ruddy
looks of a milk-maid, with the pale complexion of those females whose
whole time is spent within doors. Though Nature has made an evident
distinction between the male and female with regard to bodily strength
and vigour, yet she certainly never meant, either that the one should be
always without, or the other always within doors.
The confinement of females, besides hurting their figure and complexion,
relaxes their solids, weakens their minds, and disorders all the
functions of the body. Hence proceed obstructions, indigestion,
flatulence, abortions, and the whole train of nervous disorders. These
not only unfit women for being mothers and nurses, but often render them
whimsical and ridiculous. A sound mind depends so much upon a healthy
body, that where the latter is wanting the former is rarely to be found.
I have always observed, that women who were chiefly employed without
doors, in the different branches of husbandry, gardening, and the like,
were almost as hardy as their husbands, and that their children were
likewise strong and healthy. But as the bad effects of confinement and
inactivity upon both sexes have been already shewn, we shall proceed to
point out those circumstances in the structure and design of females,
which subject them to peculiar diseases; the chief of which are, their
_monthly evacuations_, _pregnancy_, and _child-bearing_. These indeed
cannot properly be called diseases, but from the delicacy of the sex,
and their being often improperly managed in such situations, they become
the source of numerous calamities.
OF THE MENSTRUAL DISCHARGE.
Females generally begin to menstruate about the age of fifteen, and
leave it off about fifty, which renders these two periods the most
critical of their lives. About the first appearance of this discharge,
the constitution undergoes a very considerable change, generally indeed
for the better, though sometimes for the worse. The greatest care is now
necessary, as the future health and happiness of the female depends in a
great measure upon her conduct at this period[178].
If a girl about this time of life be confined to the house, kept
constantly sitting, and neither allowed to romp about, nor employed in
any active business, which gives exercise to the whole body, she becomes
weak, relaxed, and puny; her blood not being duly prepared, she looks
pale and wan; her health, spirits, and vigour decline, and she sinks
into a valetudinarian for life. Such is the fate of numbers of those
unhappy females, who, either from too much indulgence, or their own
narrow circumstances, are, at this critical period, denied the benefit
of exercise and free air.
A lazy indolent disposition proves likewise very hurtful to girls at
this period. One seldom meets with complaints from obstructions amongst
the more active and industrious part of the sex; whereas the indolent
and lazy are seldom free from them. These are in a manner eaten up by
the _chlorosis_, or green-sickness, and other diseases of this nature.
We would therefore recommend it to all who wish to escape these
calamities, to avoid indolence and inactivity, as their greatest
enemies, and to be as much abroad in the open air as possible.
Another thing which proves very hurtful to girls about this period of
life, is unwholesome food. Fond of all manner of trash, they often
indulge in it, till their whole humours are quite vitiated. Hence ensue
indigestions, want of appetite, and a numerous train of evils. If the
fluids be not duly prepared, it is utterly impossible that the
secretions should go properly on. Accordingly we find, that such girls
as lead an indolent life, and eat great quantities of trash, are not
only subject to obstructions of the _menses_, but likewise to glandular
obstructions; as the scrophula, or king’s evil, &c.
A dull disposition is also very hurtful to girls at this period. It is a
rare thing to see a sprightly girl who does not enjoy good health, while
the grave, moping, melancholy creature, proves the very prey of vapours
and hysterics. Youth is the season for mirth and cheerfulness. Let it
therefore be indulged. It is an absolute duty. To lay in a stock of
health in time of youth, is as necessary a piece of prudence, as to make
provision against the decays of old age. While, therefore, wise Nature
prompts the happy youth to join in sprightly amusements, let not the
severe dictates of hoary age forbid the useful impulse, nor damp, with
serious gloom, the season destined to mirth and innocent festivity.
Another thing very hurtful to females about this period of life is
strait clothes. They are fond of a fine shape, and foolishly imagine
that this can be acquired by lacing themselves tight. Hence, by
squeezing the stomach and bowels, they hurt the digestion, and occasion
many incurable maladies. This error is not indeed so common as it has
been; but, as fashions change, it may come about again: we therefore
think it not improper to mention it. I know many females who, to this
day, feel the direful effects of that wretched custom which prevailed
some years ago, of squeezing every girl into as small a size in the
middle as possible. Human invention could not possibly have devised a
practice more destructive to health.
After a female has arrived at that period of life when the _menses_
usually begin to flow, and they do not appear, but, on the contrary, her
health and spirits begin to decline, we would advise, instead of
shutting the poor girl up in the house, and dosing her with steel,
asafœtida, and other nauseous drugs, to place her in a situation where
she can enjoy the benefit of free air and agreeable company. There let
her eat wholesome food, take sufficient exercise, and amuse herself in
the most agreeable manner; and we have little reason to fear, but
Nature, thus assisted, will do her proper work. Indeed she seldom fails,
unless where the fault is on our side.
This discharge in the beginning is seldom so instantaneous as to
surprise females unawares. It is generally preceded by symptoms which
foretel its approach; as a sense of heat, weight, and dull pain in the
loins; distension and hardness of the breasts; head-ach; loss of
appetite; lassitude; paleness of the countenance; and sometimes a slight
degree of fever. When these symptoms appear about the age at which the
menstrual flux usually begins, every thing should be carefully avoided
which may obstruct that necessary and salutary evacuation; and all means
used to promote it; as sitting frequently over the steams of warm water,
drinking warm diluting liquors, &c.
After the _menses_ have once begun to flow, the greatest care should be
taken to avoid every thing that may tend to obstruct them. Females ought
to be exceeding cautious of what they eat or drink at the time they are
out of order. Every thing that is cold, or apt to sour on the stomach,
ought to be avoided; as fruit, butter-milk, and such like. Fish, and all
kinds of food that are hard of digestion, are also to be avoided. As it
is impossible to mention every thing that may disagree with individuals
at this time, we would recommend it to every female to be very attentive
to what disagrees with herself, and carefully to avoid it.
Cold is extremely hurtful at this particular period. More of the sex
date their disorders from colds, caught while they are out of order,
than from all other causes. This ought surely to put them upon their
guard, and to make them very circumspect in their conduct at such times.
A degree of cold that will not at the least hurt them at another time,
will at this period be sufficient entirely to ruin their health and
constitution.
The greatest attention ought likewise to be paid to the mind, which
should be kept as easy and cheerful as possible. Every part of the
animal economy is influenced by the passions, but none more so than
this. Anger, fear, grief, and other affections of the mind, often
occasion obstructions of the menstrual flux, which prove absolutely
incurable.
From whatever cause this flux is obstructed, except in the state of
pregnancy, proper means should be used to restore it. For this purpose
we would recommend sufficient exercise, in a dry, open, and rather cool
air; wholesome diet, and, if the body be weak and languid, generous
liquors; also cheerful company and all manner of amusements. If these
fail, recourse must be had to medicine.
When obstructions proceed from a weak relaxed state of the solids, such
medicines as tend to promote digestion, to brace the solids, and assist
the body in preparing good blood, ought to be used. The principal of
these are iron and the Peruvian bark, with other bitter and astringent
medicines. Filings of iron may be infused in wine or ale, two or three
ounces to an English quart, and after it has stood for two or three
weeks it may be filtered, and about half a wine-glass of it taken twice
a-day: or prepared steel may be taken in the dose of half a drachm,
mixed with a little honey or treacle, three or four times a-day. The
bark and other bitters may either be taken in substance or infusion, as
is most agreeable to the patient.
When obstructions proceed from a viscid state of the blood; or for women
of a gross or full habit, evacuations, and such medicines as attenuate
the humours, are necessary. The patient in this case ought to be bled,
to bathe her feet frequently in warm water, to take now and then a
cooling purge, and to live upon a spare thin diet. Her drink should be
whey, water, or small beer, and she ought to take sufficient exercise. A
tea-spoonful of the tincture of black hellebore may also be taken twice
a-day in a cup of warm water.
When obstructions proceed from affections of the mind, as grief, fear,
anger, &c. every method should be taken to amuse and divert the patient.
And that she may the more readily forget the cause of her affliction,
she ought, if possible, to be removed from the place where it happened.
A change of place, by presenting the mind with a variety of new objects,
has often a very happy influence in relieving it from the deepest
distress. A soothing, kind, and affable behaviour to females in this
situation is also of the last importance.
An obstruction of the _menses_ is often the effect of other maladies.
When this is the case, instead of giving medicines to force that
discharge, which might be dangerous, we ought by all means to endeavour
to restore the patient’s health and strength. When that is effected, the
other will return of course.
But the menstrual flux may be too great as well as too small. When this
happens, the patient becomes weak, the colour pale, the appetite and
digestion are bad, and œdematous swellings of the feet, dropsies, and
consumptions often ensue. This frequently happens to women about the age
of forty-five or fifty, and is very difficult to cure. It may proceed
from a sedentary life; a full diet, consisting chiefly of salted,
high-seasoned, or acrid food; the use of spirituous liquors; excessive
fatigue; relaxation; a dissolved state of the blood; violent passions of
the mind, &c.
The treatment of this disease must be varied according to its cause.
When it is occasioned by any error in the patient’s regimen, an opposite
course to that which induced the disorder must be pursued, and such
medicines taken as have a tendency to restrain the flux, and counteract
the morbid affections of the system from whence it proceeds.