If the lungs cannot be inflated in this manner, it may be attempted by

blowing through one of the nostrils, and at the same time keeping the

other close. Dr. Monro for this purpose recommends a wooden pipe fitted

at one end for filling the nostril, and at the other for being blown

into by a person’s mouth, or for receiving the pipe of a pair of

bellows, to be employed for the same purpose, if necessary.

When air cannot be forced into the chest by the mouth or nose, it may be

necessary to make an opening into the wind-pipe for this purpose. It is

needless, however, to spend time in describing this operation, as it

should not be attempted unless by persons skilled in surgery.

To stimulate the intestines, the fume of tobacco may be thrown up in

form of clyster. There are various pieces of apparatus contrived for

this purpose, which may be used when at hand; but where these cannot be

obtained, the business may be done by a common tobacco-pipe. The bowl of

the pipe must be filled with tobacco well kindled, and, after the small

tube has been introduced into the fundament, the smoke may be forced up

by blowing through a piece of paper full of holes wrapped round the

mouth of the pipe, or by blowing through an empty pipe, the mouth of

which is applied close to that of the other. This may also be done in

the following manner: A common clyster-pipe with a bag mounted upon it

may be introduced into the fundament, and the mouth of the bag may be

applied round the small end of a tobacco-pipe, in the bowl of which

tobacco is to be kindled, and the smoke blown up as directed above.

Should it be found impracticable to throw up the smoke of tobacco,

clysters of warm water, with the addition of a little salt and some wine

or spirits, may be frequently administered. This may be done by a common

clyster-bag and pipe; but, as it ought to be thrown well up, a pretty

large syringe will answer the purpose better.

While these things are doing, some of the attendants ought to be

preparing a warm bath, into which the person should be put, if the above

endeavours prove ineffectual. Where there are no conveniencies for using

the warm bath, the body may be covered with warm salt, sand, ashes,

grains, or such like. Tissot mentions an instance of a girl who was

restored to life, after she had been taken out of the water, swelled,

bloated, and to all appearance dead, by laying her naked body upon hot

ashes, covering her with others equally hot, putting a bonnet round her

head, and a stocking round her neck stuffed with the same, and heaping

coverings over all. After she had remained half an hour in this

situation, her pulse returned, she recovered speech, and cried out, _I

freeze, I freeze_; a little cherry-brandy was given her, and she

remained buried as it were under the ashes for eight hours; afterwards

she was taken out, without any other complaint except that of lassitude

or weariness, which went off in a few days. The Doctor mentions likewise

an instance of a man who was restored to life, after he had remained six

hours under water, by the heat of a dunghill.

Till the patient shews some signs of life, and is able to swallow, it

would be useless and even dangerous to pour liquors into his mouth. His

lips, however, and tongue, may be frequently wet with a feather dipt in

warm brandy or other strong spirits; and, as soon as he has recovered

the power of swallowing, a little warm wine, or some other cordial,

ought every now and then to be administered.

Some recommend a vomit after the patient is a little re-animated; but if

he can be made to puke without the sickening draught, it will be more

safe: this may generally be done by tickling the throat and fauces with

an oiled feather, or some other soft substance, which will not injure

the parts. Tissot in this case recommends the oxymel of squills, a

table-spoonful of which, diluted with water, may be given every quarter

of an hour, till the patient has taken five or six doses. Where that

medicine is not at hand, a strong infusion of sage, camomile-flowers, or

_carduus benedictus_, sweetened with honey, or some warm water, with the

addition of a little salt, may, he says, supply its place. The Doctor

does not intend that any of these things should be given in such

quantity as to occasion vomiting. He thinks emetics in this situation

are not expedient.

We are by no means to discontinue our assistance as soon as the patients

discover some tokens of life, since they sometimes expire after these

first appearances of recovering. The warm and stimulating applications

are still to be continued, and small quantities of some cordial liquor

ought frequently to be administered. Lastly, though the person should be

manifestly re-animated, there sometimes remain an oppression, a cough,

and feverishness, which effectually constitute a disease. In this case

it will be necessary to bleed the patient in the arm, and to cause him

to drink plentifully of barley-water, elder-flower-tea, or any other

soft pectoral infusions.

Such persons as have the misfortune to be deprived of the appearances of

life, by a fall, a blow, suffocation, or the like, must be treated

nearly in the same manner as those who have been for some time under

water. I once attended a patient who was so stunned by a fall from a

horse, that for above six hours he scarcely exhibited any signs of life;

yet this man, by being bled, and proper methods taken to keep up the

vital warmth, recovered, and in a few days was perfectly well. Dr.

Alexander gives an instance to the same purpose, in the Edinburgh

Physical and Literary Essays, of a man who was to all appearance killed

by a blow on the breast, but recovered upon being immersed for some time

in warm water. These, and other instances of a similar nature, which

might be adduced, amount to a full proof of this fact, that many of

those unhappy persons who lose their lives by falls, blows, and other

accidents, might be saved _by the use of proper means duly persisted

in_.

OF NOXIOUS VAPOURS.

Air may be many ways rendered noxious, or even destructive to animals.

This may either happen from its vivifying principle being destroyed, or

from subtle exhalations with which it is impregnated. Thus air that has

passed through burning fuel is neither capable of supporting fire nor

the life of animals. Hence the danger of sleeping in close chambers with

charcoal fires. Some indeed suppose the danger here proceeds from the

sulphureous oil contained in the charcoal, which is set at liberty and

diffused all over the chamber; while others imagine it is owing to the

air of the room being charged with phlogiston. Be this as it may, it is

a situation carefully to be avoided. Indeed, it is dangerous to sleep in

a small apartment with a fire of any kind. I lately saw four persons who

had been suffocated by sleeping in an apartment where a small fire of

coal had been left burning.

The vapour which exhales from wine, cyder, beer, or other liquors, in

the state of fermentation, contains something poisonous, which kills in

the same manner as the vapour of coal. Hence there is always danger in

going into cellars where a large quantity of these liquors is in a state

of fermentation, especially if they have been close shut up for some

time. There have been many instances of persons struck dead on entering

such places, and of others who have with difficulty escaped.

When subterraneous caves, that have been very long shut, are opened, or

when deep wells are cleaned, which have not been emptied for several

years, the vapours arising from them produce the same effects as those

mentioned above. For this reason, no person ought to venture into a

well, pit, cellar, or any place that is damp, and has been long shut up,

till the air has been sufficiently purified, by burning gunpowder in it.

It is easy to know, as has been observed in a former part of this work,

when the air of such places is unwholesome, by letting down a lighted

candle, throwing in burning fuel, or the like. If these continue to

burn, people may safely venture in; but where they are suddenly

extinguished, no one ought to enter till the air has been first purified

by fire.

The offensive smell of lamps and of candles, especially when their

flames are extinguished, operate like other vapours, though with less

violence, and less suddenly. There have however been instances of people

killed by the fumes of lamps which had been extinguished in a close

chamber, and persons of weak delicate breasts generally find themselves

quickly oppressed in apartments illuminated with many candles.

Such as are sensible of their danger in these situations, and retreat

seasonably from it, are generally relieved as soon as they get into the

open air, or, if they have any remaining uneasiness, a little water and

vinegar, or lemonade, drank hot, affords them relief. But when they are

so far poisoned, as to have lost their feeling and understanding, the

following means must be used for their recovery:

The patient should be exposed to a very pure, fresh, and open air; and

volatile salts, or other stimulating substances, held to his nose. He

should next be bled in the arm, or if that does not succeed, in the

neck. His legs ought to be put into warm water, and well rubbed. As soon

as he can swallow, some lemonade, or water and vinegar, with the

addition of a little nitre, may be given him.

Nor are sharp clysters by any means to be neglected; these may be made,

by adding to the common clyster, syrup of buckthorn and tincture of

senna, of each two ounces; or, in their stead, half an ounce of Venice

turpentine dissolved in the yolk of an egg. Should these things not be

at hand, two or three large spoonfuls of common salt may be put into the

clyster. The same means, if necessary, which were recommended in the

former part of this chapter, may be used to restore the circulation,

warmth, &c.

Mr. Tossach, surgeon at Alloa, relates the case of a man suffocated by

the steam of burning coal, whom he recovered by blowing his breath into

the patient’s mouth, bleeding him in the arm, and causing him to be well

rubbed and tossed about. And Dr. Frewen, of Sussex, mentions the case of

a young man who was stupified by the smoke of sea-coal, but was

recovered by being plunged into cold water, and afterwards laid in a

warm bed.

The practice of plunging persons suffocated by noxious vapours in cold

water, would seem to be supported by the common experiment of

suffocating dogs in the _grotto del cani_, and afterwards recovering

them, by throwing them into the neighbouring lake.

EFFECTS OF EXTREME COLD.

When cold is extremely severe, and a person is exposed to it for a long

time, it proves mortal, in consequence of its stopping the circulation

in the extremities, and forcing too great a proportion of blood towards

the brain; so that the patient dies of a kind of apoplexy, preceded by

great sleepiness. The traveller, in this situation, who finds himself

begin to grow drowsy, should redouble his efforts to extricate himself

from the imminent danger he is exposed to. This sleep, which he might

consider as some alleviation of his sufferings, would, if indulged,

prove his last.

Such violent effects of cold are happily not very common in this

country; it frequently happens, however, that the hands or feet of

travellers are so benumbed or frozen, as to be in danger of a

mortification, if proper means are not used to prevent it. The chief

danger in this situation arises from the sudden application of heat. It

is very common, when the hands or feet are pinched with cold, to hold

them to the fire; yet reason and observation shew that this is a most

dangerous and imprudent practice.

Every peasant knows, if frozen meat, fruits, or roots of any kind, be

brought near the fire, or put into warm water, they will be destroyed,

by rottenness, or a kind of mortification; and that the only way to

recover them, is to immerse them for some time in very cold water. The

same observation holds with regard to animals in this condition.

When the hands or feet are greatly benumbed with cold, they ought either

to be immersed in cold water, or rubbed with snow, till they recover

their natural warmth and sensibility: after which the person may be

removed into an apartment a little warmer, and may drink some cups of

tea, or an infusion of elder flowers sweetened with honey. Every person

must have observed, when his hands were even but slightly affected with

cold, that the best way to warm them was by washing them in cold water,

and continuing to rub them well for some time.

When a person has been so long exposed to the cold, that all appearances

of life are gone, it will be necessary to rub him all over with snow or

cold water; or, what will answer better, if it can be obtained, to

immerse him in a bath of the very coldest water. There is the greatest

encouragement to persist in the use of these means, as we are assured

that persons who had remained in the snow, or had been exposed to the

freezing air during five or six successive days, and who had discovered

no marks of life for several hours, have nevertheless been revived.

I have always thought, that the whitloes, kibes, chilblains, and other

inflammations of the extremities, which are so common among the peasants

in the cold season, were chiefly occasioned by their sudden transitions

from cold to heat. After they have been exposed to an extreme degree of

cold, they immediately apply their hands and feet to the fire, or, if

they have occasion, plunge them into warm water, by which means, if a

mortification does not happen, an inflammation seldom fails to ensue.

Most of the ill consequences from this quarter might be easily avoided,

by only observing the precautions mentioned above.

EFFECTS OF EXTREME HEAT.

The effects of extreme heat, though not so common in this country, are

no less fatal, and much more sudden than those of cold. In hot countries

people frequently drop down dead in the streets, exhausted with heat and

fatigue. In this case, if any warm cordial can be poured into the mouth

it ought to be done. If this cannot be effected, they may be thrown up

in form of a clyster. Volatile spirits, and other things of a

stimulating nature, may be applied to the skin, which should be well

rubbed with coarse-cloths, whipped with nettles, or other stimulating

things. Some of the ancient physicians are said to have restored to life

persons apparently dead, by beating them with rods.

CHAP. LIV.

OF FAINTING FITS, AND OTHER CASES WHICH REQUIRE IMMEDIATE ASSISTANCE.

Strong and healthy persons, who abound with blood, are often seized with

sudden fainting fits, after violent exercise, drinking freely of warm or

strong liquors, exposure to great heat, intense application to study, or

the like.

In such cases the patient should be made to smell to some vinegar. His

temples, forehead, and wrists ought at the same time to be bathed with

vinegar mixed with an equal quantity of warm water; and two or three

spoonfuls of vinegar, with four or five times as much water, may, if he

can swallow, be poured into his mouth.

If the fainting proves obstinate, or degenerates into a _syncope_, that

is, an abolition of feeling and understanding, the patient must be bled.

After the bleeding, a clyster will be proper, and then he should be kept

easy and quiet, only giving him every half hour a cup or two of an

infusion of any mild vegetable, with the addition of a little sugar and

vinegar.

When swoonings, which arise from this cause, occur frequently in the

same person, he should, in order to escape them, confine himself to a

light diet, confiding chiefly of bread, fruits, and other vegetables.

His drink ought to be water or small beer, and he should deep but

moderately, and take much exercise.

But fainting fits proceed much oftner from a defect than an excess of

blood. Hence they are very ready to happen after great evacuations of

any kind, obstinate watching, want of appetite, or such like. In these

an almost directly opposite course to that mentioned above must be

pursued.

The patient should be laid in bed, with his head low, and being covered,

should have his legs, thighs, arms, and his whole body rubbed strongly

with hot flannels. Hungary water, volatile salts, or strong smelling

herbs, as rue, mint, or rosemary, may be held to his nose. His mouth may

be wet with a little rum or brandy; and, if he can swallow, some hot

wine, mixed with sugar and cinnamon, which is an excellent cordial, may

be poured into his mouth. A compress of flannel dipt in hot wine or

brandy must be applied to the pit of his stomach, and warm bricks, or

bottles filled with hot water, laid to the feet.

As soon as the patient is recovered a little, he should take some strong

soup or broth, or a little bread or biscuit soaked in hot-spiced wine.

To prevent the return of the fits, he ought to take often, but in small

quantities, some light yet strengthening nourishment, as panado made

with soup instead of water, new laid eggs lightly poached, chocolate,

light roast meats, jellies, and such like.

Those fainting fits, which are the effect of bleeding, or of the violent

operation of purges, belong to this class. Such as happen after

artificial bleeding are seldom dangerous, generally terminating as soon

as the patient is laid upon the bed; indeed persons subject to this kind

should always be bled lying, in order to prevent it. Should the fainting

however continue longer than usual, volatile spirits may be held to the

nose, and rubbed on the temples, &c.

When fainting is the effect of too strong or acrid purges or vomits, the

patient must be treated in all respects as if he had taken poison. He

should be made to drink plentifully of milk, warm water, and oil,

barley-water, or suck like; emollient clysters will likewise be proper,

and the patient’s strength should afterwards be recruited, by giving him

generous cordials, and anodyne medicines.

Faintings are often occasioned by indigestion. This may either proceed

from the quantity or quality of the food. When the former of these is

the cause, the cure will be best performed by vomiting, which may be

promoted by causing the patient to drink a weak infusion of

camomile-flowers, _carduus benedictus_ or the like. When the disorder

proceeds from the nature of the food, the patient, as in the case of

weakness, must be revived by strong smells, &c. after which he should be

made to swallow a large quantity of light warm fluid, which may serve to

drown, as it were, the offending matter, to soften its acrimony, and

either to effect a discharge of it by vomiting, or force it down into

the intestines.

Even disagreeable smells will sometimes occasion swoonings, especially

in people of weak nerves. When this happens, the patient should be

carried into the open air, have stimulating things held to his nose, and

those substances which are disagreeable to him ought immediately to be

removed. But we have already taken notice of swoonings which arise from

nervous disorders, and shall therefore say no more upon that head.

Fainting fits often happen in the progress of diseases. In the beginning

of putrid diseases they generally denote an oppression at stomach, or a

mass of corrupted humours, and they cease after evacuations either by

vomit or stool. When they occur at the beginning of malignant fevers,

they indicate great danger. In each of these cases, vinegar used both

externally and internally is the best remedy during the paroxysm, and

plenty of lemon-juice and water after it. Swoonings which happen in

diseases accompanied with great evacuations, must be treated like those

which are owing to weakness, and the evacuations ought to be restrained.

When they happen towards the end of a violent fit of an intermitting

fever, or at that of each exacerbation of a continual fever, the patient

must be supported by small draughts of wine and water.

Delicate and hysteric women are very liable to swooning or fainting fits

after delivery. These might be often prevented by generous cordials, and

the admission of fresh air. When they are occasioned by excessive

flooding, it ought by all means to be restrained. They are generally the

effect of mere weakness or exhaustion. Dr. Engleman relates the case of

a woman “in child-bed, who, after being happily delivered, suddenly

fainted, and lay upwards of a quarter of an hour apparently dead. A

physician was sent for; her own maid, in the mean while, being out of

patience at his delay, attempted to assist her herself, and extending

herself upon her mistress, applied her mouth to her’s, blew in as much

breath as she possibly could, and in a very short time the exhausted

woman awaked as out of a profound sleep; when proper things being given

her, she soon recovered.

“The maid being asked how she came to think of this expedient, said she

had seen it practised at Altenburgh, by midwives, upon children with the

happiest effect.”

We mention this case chiefly that other midwives may be induced to

follow so laudable an example. Many children are born without any signs

of life, and others expire soon after the birth, who might, without all

doubt, by proper care, be restored to life.

From whatever cause fainting fits proceed, fresh air is always of the

greatest importance to the patient. By not attending to this

circumstance, people often kill their friends while they are

endeavouring to save them. Alarmed at the patient’s situation, they call

in a crowd of people to his assistance, or perhaps to witness his exit,

whose breathing exhausts the air, and increases the danger. There is not

the least doubt but this practice, which is very common among the lower

sort of people, often proves fatal, especially to the delicate, and such

persons as fall into fainting fits from mere exhaustion, or the violence

of some disease. No more persons ought ever to be admitted into the room

where a patient lies in a swoon than are absolutely necessary for his

assistance, and the windows of the apartment should always be opened, at

least as far as to admit a stream of fresh air.

Persons subject to frequent swoonings, or fainting fits, should neglect

no means to remove the cause of them, as their consequences are always

injurious to the constitution. Every fainting fit leaves the person in

dejection and weakness; the secretions are thereby suspended, the

humours disposed to stagnation, coagulations and obstructions are

formed, and, if the motion of the blood be totally intercepted, or very

considerably checked, _polypuses_ are sometimes formed in the heart or

larger vessels. The only kind of swoonings not to be dreaded are those

which sometimes mark the _crisis_ in fevers; yet even these ought, as

soon as possible, to be removed.

OF INTOXICATION.

The effects of intoxication are often fatal. No kind of poison kills

more certainly than an over-dose of ardent spirits. Sometimes, by

destroying the nervous energy, they put an end to life at once; but in

general their effects are more slow, and in many respects similar to

those of opium. Other kinds of intoxicating liquors may prove fatal when

taken to excess, as well as ardent spirits; but they may generally be

discharged by vomiting, which ought always to be excited when the

stomach is overcharged with liquor.

More of those unhappy persons, who die intoxicated, lose their lives

from an inability to conduct themselves than from the destructive

quality of the liquor. Unable to walk, they tumble down, and lie in some

awkward posture, which obstructs the circulation or breathing, and often

continue in this situation till they die. No drunken person should be

left by himself, till his clothes have been loosened, and his body laid

in such a posture as is most favourable for continuing the vital

motions, discharging the contents of the stomach, &c. The best posture

for discharging the contents of the stomach is to lay the person upon

his belly; when asleep he may be laid on his side, with his head a

little raised, and particular care must be taken that his neck be no way

bent, twisted, or have any thing too tight about it.

The excessive degree of thirst occasioned by drinking strong liquors,

often induces people to quench it by taking what is hurtful. I have

known fatal consequences even from drinking freely of milk after a

debauch of wine or sour punch; these acid liquors, together with the

heat of the stomach, having coagulated the milk in such a manner that it

could never be digested. The safest drink after a debauch is water with

a toast, tea, infusions of balm, sage, barley-water, and such like. If

the person wants to vomit, he may drink a weak infusion of

camomile-flowers, or lukewarm water and oil; but in this condition

vomiting may generally be excited by only tickling the throat with the

finger or a feather.

Instead of giving a detail of all the different symptoms of intoxication

which indicate danger, and proposing a general plan of treatment for

persons in this situation, I shall briefly relate the history of a case

which lately fell under my own observation, wherein most of those

symptoms usually reckoned dangerous concurred, and where the treatment

was successful.

A young man, about fifteen years of age, had, for a hire, drank ten

glasses of strong brandy. He soon after fell fast asleep, and continued

in that situation for near twelve hours, till at length his uneasy

manner of breathing, the coldness of the extremities, and other

threatening symptoms, alarmed his friends, and made them send for me. I

found him still sleeping, his countenance ghastly, and his skin covered

with a cold clammy sweat. Almost the only signs of life remaining were,

a deep laborious breathing, and a convulsive motion or agitation of his

bowels.

I tried to rouse him, but in vain, by pinching, shaking, applying

volatile spirits, and other stimulating things to his nose, &c. A few

ounces of blood were likewise taken from his arm, and a mixture of

vinegar and water was poured into his mouth; but, as he could not

swallow, very little of this got into the stomach. None of these things

having the least effect, and the danger seeming to increase, I ordered

his legs to be put into warm water, and a sharp clyster to be

immediately administered. This gave him a stool, and was the first thing

that relieved him. It was afterwards repeated with the same happy

effect, and seemed to be the chief cause of his recovery. He then began

to shew some signs of life, took drink when it was offered him, and came

gradually to his senses. He continued, however, for several days weak

and feverish, and complained much of a soreness in his bowels, which

gradually went off, by means of a slender diet, and cool mucilaginous

liquors.

This young man would probably have been suffered to die, without any

assistance being called, had not a neighbour, a few days before, who had

been advised to drink a bottle of spirits to cure him of an ague,

expired under very similar circumstances.

OF SUFFOCATION AND STRANGLING·

These may sometimes proceed from an infarction of the lungs, produced by

viscid clammy humours, or a spasmodic affection of the nerves of that

organ. Persons who feed grossly, and abound in rich blood, are very

liable to suffocating fits from the former of these causes. Such ought,

as soon as they are attacked, to be bled, to receive an emollient

clyster, and to take frequently a cup of diluting liquor with a little

nitre in it. They should likewise receive the steams of hot vinegar into

their lungs by breathing.

Nervous and asthmatic persons are most subject to spasmodic affections

of the lungs. In this case the patient’s legs should be immersed in warm

water, and the steams of vinegar applied as above. Warm diluting liquors

should likewise be drank; to a cup of which a tea-spoonful of the

parygoric elixir may occasionally be added. Burnt paper, feathers, or

leather, may be held to the patient’s nose, and fresh air should be

freely admitted to him.

Infants are often suffocated by the carelessness or inattention of their

nurses[203]. An infant when in bed should always be laid so, that it

cannot tumble down with its head under the bed-clothes; and when in a

cradle, its face ought never to be covered. A small degree of attention

to these two simple rules would save the lives of many infants, and

prevent others from being rendered weak and sickly all their days by the

injuries done to their lungs.

Instead of laying down a plan for the recovery of infants who are

suffocated, or overlaid, as it is termed by their nurses, I shall give

the history of a case related by Monsieur _Janin_, of the Royal College

of Surgery at Paris, as it was attended with success, and contains

almost every thing that can be done on such occasions.

A nurse having had the misfortune to over-lay a child, he was called in,

and found the infant without any signs of life; no pulsation in the

arteries, no respiration, the face livid, the eyes open, dull, and

tarnished, the nose full of snivel, the mouth gaping, in short it was

almost cold. Whilst some linen clothes and a parcel of ashes were

warming, he had the boy unswathed, and laid him in a warm bed, and on

the right side. He then was rubbed all over with fine linen, for fear of

fretting his tender and delicate skin. As soon as the ashes had received

their due degree of heat, Mr. _Janin_ buried him in them, except the

face, placed him on the side opposite to that on which he had been at

first laid, and covered him with a blanket. He had a bottle of _eau de

luce_ in his pocket, which he presented to his nose from time to time;

and between whiles some puffs of tobacco were blown up his nostrils: to

these succeeded the blowing into his mouth, and squeezing tight his

nose. Animal heat began thus to be excited gradually; the pulsations of

the temporal artery were soon felt, the breathing became more frequent

and free, and the eyes closed and opened alternately. At length the

child fetched some cries expressive of his want of the breast, which

being applied to his mouth, he catched at it with avidity, and sucked as

if nothing had happened to him. Though the pulsations of the arteries

were by this time very well re-established, and it was hot weather, yet

Mr. _Janin_ thought it advisable to leave his little patient three

quarters of an hour longer under the ashes. He was afterwards taken out,

cleaned and dressed as usual; to which a gentle sleep succeeded, and he

continued perfectly well.

Mr. Janin mentions likewise an example of a young man who had hanged

himself through despair, to whom he administered help as effectually as

in the preceding case.

Mr. Glover, surgeon in Doctors Commons, London, relates the case of a

person who was restored to life after twenty-nine minutes hanging, and

continued in good health for many years after.

The principal means used to restore this man to life were, opening the

temporal artery and the external jugular; rubbing the back, mouth, and

neck, with a quantity of volatile spirits and oil; administering the

tobacco clyster by means of lighted pipes, and strong frictions of the

legs and arms. This course had been continued for about four hours, when

an incision was made into the wind-pipe, and air blown strongly through

a canula into the lungs. About twenty minutes after this, the blood at

the artery began to run down the face, and a slow pulse was just

perceptible at the wrist. The frictions were continued for some time

longer; his pulse became more frequent, and his mouth and nose being

irritated with spirit of sal ammoniac, he opened his eyes. Warm cordials

were then administered to him, and in two days he was so well as to be

able to walk eight miles.

These cases are sufficient to shew what may be done for the recovery of

those unhappy persons who strangle themselves in a fit of despair.

OF PERSONS WHO EXPIRE IN CONVULSION FITS.

Convulsion fits often constitute the last scene of acute or chronic

disorders. When this is the case, there can remain but small hopes of

the patient’s recovery after expiring in a fit. But when a person, who

appears to be in perfect health, is suddenly seized with a convulsion

fit, and seems to expire, some attempts ought always to be made to

restore him to life. Infants are most liable to convulsions, and are

often carried off very suddenly by one or more fits about the time of

teething. There are many well-authenticated accounts of infants having

been restored to life, after they had to all appearance expired in

convulsions; but we shall only relate the following instance mentioned

by Dr. Johnson in his pamphlet _on the practicability of recovering

persons visibly dead_.

In the parish of St. _Clemens_ in _Colchester_, a child of six months

old, lying upon its mother’s lap, having had the breast, was seized with

a strong convulsion fit, which lasted so long, and ended with so total a

privation of motion in the body, lungs, and pulse, that it was deemed

absolutely dead. It was accordingly stripped, laid out, the passing-bell

ordered to be tolled, and a coffin to be made; but a neighbouring

gentlewoman who used to admire the child, hearing of its sudden death,

hastened to the house, and upon examining the child found it not cold,

its joints limber, and fancied that a glass she held to its mouth and

nose was a little damped with the breath; upon which she took the child

in her lap, sat down before the fire, rubbed it, and kept it in gentle

agitation. In a quarter of an hour she felt the heart begin to beat

faintly; she then put a little of the mother’s milk into its mouth,

continued to rub its palms and soles, found the child begin to move, and

the milk was swallowed; and in another quarter of an hour she had the

satisfaction of restoring to its disconsolate mother the babe quite

recovered, eager to lay hold of the breast, and able to suck again. The

child throve, had no more fits, is grown up, and at present alive.

These means, which are certainly in the power of every person, were

sufficient to restore to life an infant to all appearance dead, and who,

in all probability, but for the use of these simple endeavours, would

have remained so. There are however many other things which might be

done in case the above should not succeed; as rubbing the body with

strong spirits, covering it with warm ashes or salt, blowing air into

the lungs, throwing up warm stimulating clysters, or the smoke of

tobacco, into the intestines, and such like.

When children are dead born, or expire soon after the birth, the same

means ought to be used for their recovery, as if they had expired in

circumstances similar to those mentioned above.

These directions may likewise be extended to adults, attention being

always paid to the age and other circumstances of the patient.

The foregoing cases and observations afford sufficient proof of the

success which may attend the endeavours of persons totally ignorant of

medicine, in assisting those who are suddenly deprived of life by any

accident or disease. Many facts of a similar nature might be adduced,

were it necessary; but these, it is hoped, will be sufficient to call up

the attention of the public, and to excite the humane and benevolent to

exert their utmost endeavours for the preservation of their fellow-men.

_The society for the recovery of drowned persons_, instituted at

Amsterdam in the year 1767, had the satisfaction to find that not fewer

than 150 persons in the space of four years had been saved by the means

pointed out by them, many of whom owed their preservation to peasants

and people of no medical knowledge. But the means used with so much

efficacy in recovering drowned persons are, with equal success,

applicable to a number of cases where the powers of life seem in reality

to be only suspended, and to remain capable of renewing all their

functions, on being put into motion again. It is shocking to reflect,

that for want of this consideration many persons have been committed to

the grave, in whom the principles of life might have been revived.

The cases wherein such endeavours are most likely to be attended with

success, are all those called sudden deaths from an invisible cause, as

apoplexies, hysterics, faintings, and many other disorders wherein

persons in a moment sink down and expire. The various casualties in

which they may be tried are, suffocations, from the sulphureous damps of

mines, coal-pits, &c.; the unwholesome air of long unopened wells or

caverns; the noxious vapours arising from fermenting liquors; the steams

of burning charcoal; sulphureous mineral acids; arsenical effluvia, &c.

The various accidents of drowning, strangling, and apparent deaths, by

blows, falls, hunger, cold, &c. likewise furnish opportunities of trying

such endeavours. Those perhaps who to appearance are killed by

lightning, or by any violent agitation of the passions, as fear, joy,

surprise, and such like, might also be frequently recovered by the use

of proper means, as blowing strongly into their lungs, &c.

The means to be used for the recovery of persons suddenly deprived of

life are nearly the same in all cases; they are practicable by every one

who happens to be present at the accident, and require no great expence,

and less skill. The great aim is to restore the warmth and vital

motions. This may in general be attempted by means of heat, frictions,

bleeding, blowing air into the lungs, administering clysters and

generous cordials. These must be varied according to circumstances.

Common sense, and the situation of the patient, will suggest the proper

manner of conducting them. Above all we would recommend _perseverance_.

People ought never to despair on account of discouraging circumstances,

or to leave off their endeavours as long as there is the least hope of

success. Where much good and no hurt can be done, no one ought to grudge

his labour.

It were greatly to be wished, that an institution, similar to that of

Amsterdam, was established, upon a more extensive plan, in Great

Britain; and that a reward was allowed to every one who should be

instrumental in restoring to life a person seemingly dead[204]. Men will

do much for fame, but still more for money. Should no profit, however,

be annexed to those benevolent offices, the heartfelt pleasure which a

good man must enjoy, on reflecting that he has been the happy instrument

of saving one of his fellow-creatures from an untimely grave, is itself

a sufficient reward.

CHAP. LV.

CAUTIONS CONCERNING COLD BATHING, AND DRINKING THE MINERAL WATERS.

As it is now fashionable for persons of all ranks to plunge into the

sea, and drink the mineral waters, I was desirous of rendering this work

still more extensively useful, by the addition of some practical remarks

on these active and useful medicines. Finding it impossible to bring

these observations within so narrow a compass as not to swell the book,

already too large, into an enormous size, I resolved to confine myself

to a few hints or cautions; which may be of service to persons who

bathe, or drink the mineral waters, without being able to put themselves

under the care of a physician.

No part of the practice of medicine is of greater importance, or merits

more the attention of the physician, as many lives are lost, and numbers

ruin their health, by cold bathing, and an imprudent use of the mineral

waters. On some future occasion I may probably resume this subject, as I

know not any work that contains a sufficient number of practical

observations to regulate the patient’s conduct in the use of these

active and important medicines.

We have indeed many books on the mineral waters, and some of them are

written with much ingenuity; but they are chiefly employed in

ascertaining the contents of the waters by chymical analysis. This no

doubt has its use, but it is by no means of such importance as some may

imagine. A man may know the chymical analysis of all the articles in the

_materia medica_, without being able properly to apply any one of them

in the cure of diseases. One page of practical observations is worth a

whole volume of chymical analysis. But where are such observations to be

met with? Few physicians are in a situation to make them, and fewer

still are qualified for such a task. It can only be accomplished by

practitioners who reside at the fountains, and who possessing minds

superior to local prejudices, are capable of distinguishing diseases

with accuracy, and of forming a sound judgment respecting the genuine

effects of medicines.

Without a proper discrimination with regard to the disease and the

constitution of the patient, the most powerful medicine is more likely

to do harm than good. Every one knows that the same physician who, by

cold bathing, cured Augustus, by an imprudent use of the same medicine

killed his heir. This induced the Roman senate to make laws for

regulating the baths, and preventing the numerous evils which arose from

an imprudent and promiscuous use of those elegant and fashionable pieces

of luxury. But as no such laws exist in this country, _every one does

that which is right in his own eyes_, and of course many must do wrong.

People are apt to imagine that the simple element of water can do no

hurt, and that they may plunge into it at any time with impunity. In

this, however, they are much mistaken. I have known apoplexies

occasioned by going into the cold bath, fevers excited by staying too

long in it, and other maladies so much aggravated by its continued use,

that they could never be wholly eradicated. Nor are examples wanting,

either in ancient or modern times, of the baneful consequences which

have arisen also from an injudicious application of the _warm_ bath; but

as warm baths are not so common in this country, and are seldom used but

under the direction of a physician, I shall not enlarge on that part of

the subject.

Immersion in cold water is a custom which lays claim to the most remote

antiquity: indeed it must have been coëval with man himself. The

necessity of water for the purpose of cleanliness, and the pleasure

arising from its application to the body in hot countries, must very

early have recommended it to the human species. Even the example of

other animals was sufficient to give the hint to man. By instinct many

of them are led to apply cold water in this manner; and some, when

deprived of its use, have been known to languish, and even to die. But

whether the practice of cold bathing arose from necessity, reasoning, or

imitation, is an inquiry of no importance; our business is to point out

the advantages which may be derived from it, and to guard people against

an improper use of it.

The cold bath recommends itself in a variety of cases, and is peculiarly

beneficial to the inhabitants of populous cities, who indulge in

idleness, and lead sedentary lives. In persons of this description the

action of the solids is always too weak, which induces a languid

circulation, a crude indigested mass of humours, and obstructions in the

capillary vessels and glandular system. Cold water, from its gravity as

well as its tonic power, is well calculated either to obviate or remove

these symptoms. It accelerates the motion of the blood, promotes the

different secretions, and gives permanent vigour to the solids. But all

these important purposes will be more essentially answered by the

application of _salt-water_. This ought not only to be preferred on

account of its superior gravity, but likewise for its greater power of

stimulating the skin, which promotes the perspiration, and prevents the

patient from catching cold.

It is necessary, however, to observe, that cold bathing is more likely

to prevent, than to remove obstructions of the glandular or lymphatic

system. Indeed, when these have arrived at a certain pitch, they are not

to be removed by any means. In this case the cold bath will only

aggravate the symptoms, and hurry the unhappy patient into an untimely

grave. It is therefore of the utmost importance, previous to the

patient’s entering upon the use of the cold bath, to determine whether

or not he labours under any obstinate obstructions of the lungs or other

_viscera_; and where this is the case, cold bathing ought strictly to be

prohibited[205].

In what is called a plethoric state, or too great a fulness of the body,

it is likewise dangerous to use the cold bath, without due preparation.

In this case there is great danger of bursting a blood-vessel, or

occasioning an inflammation of the brain, or some of the _viscera_. This

precaution is the more necessary to citizens, as most of them live full,

and are of a gross habit. Yet, what is very remarkable, these people

resort in crowds every season to the sea-side, and plunge in the water

without the least consideration. No doubt they often escape with

impunity, but does this give a sanction to the practice? Persons of this

description ought by no means to bathe, unless the body has been

previously prepared by suitable evacuations.

Another class of patients, who stand peculiarly in need of the bracing

qualities of cold water, is the nervous. This includes a great number of

the male, and almost all the female inhabitants of great cities. Yet

even those persons ought to be cautious in using the cold bath. Nervous

people have often weak bowels, and may, as well as others, be subject to

congestions and obstructions of the _viscera_; and in this case they

will not be able to bear the effects of the cold water. For them,

therefore, and indeed for all delicate people, the best plan would be to

accustom themselves to it by the most pleasing and gentle degrees. They

ought to begin with the temperate bath, and gradually use it cooler,

till at length the coldest proves quite agreeable. Nature revolts

against all great transitions; and those who do violence to her

dictates, have often cause to repent of their temerity.

Wherever cold bathing is practised, there ought likewise to be tepid

baths for the purpose mentioned above. Indeed it is the practice of some

countries to throw cold water over the patient as soon as he comes out

of the warm bath; but though this may not injure a Russian peasant, we

dare not recommend it to the inhabitants of this country. The ancient

Greeks and Romans, we are told, when covered with sweat and dust, used

to plunge into rivers, without receiving the smallest injury. Though

they might often escape danger from this imprudent conduct, yet it was

certainly contrary to sound reason. I have known many robust men throw

away their lives by such an attempt. We would not however advise

patients to go into the cold water when the body is chilly; as much

exercise, at least, ought to be taken, as may excite a gentle glow all

over the body, but by no means so as to overheat it.

To young people, and particularly to children, cold bathing is of the

last importance. Their lax fibres render its tonic powers peculiarly

proper. It promotes their growth, increases their strength[206], and

prevents a variety of diseases incident to childhood. Were infants early

accustomed to the cold bath, it would seldom disagree with them; and we

should see fewer instances of the scrofula, rickets, and other diseases,

which prove fatal to many, and make others miserable for life.

Sometimes, indeed, these disorders render infants incapable of bearing

the shock of cold water; but this is owing to their not having been

early and regularly accustomed to it. It is however necessary here to

caution young men against too frequent bathing; as I have known many

fatal consequences result from the daily practice of plunging into

rivers, and continuing there too long.

The most proper time of the day for using the cold bath is no doubt the

morning, or at least before dinner; and the best mode, that of quick

immersion. As cold bathing has a constant tendency to propel the blood

and other humours towards the head, it ought to be a rule always to wet

that part as soon as possible. By due attention to this circumstance,

there is reason to believe, that violent head-achs, and other

complaints, which frequently proceed from cold bathing, might be often

prevented.

The cold bath, when too long-continued in, not only occasions an

excessive flux of humours towards the head, but chills the blood, cramps

the muscles, relaxes the nerves, and wholly defeats the intention of

bathing. Hence, by not adverting to this circumstance, expert swimmers

are often injured, and sometimes even lose their lives. All the

beneficial purposes of cold bathing are answered by one immersion at a

time; and the patient ought to be rubbed dry the moment he comes out of

the water, and should continue to take exercise for some time after.

When cold bathing occasions chillness, loss of appetite, listlessness,

pain of the breast or bowels, a prostration of strength, or violent

head-achs, it ought to be discontinued.

Though these hints are by no means intended to point out all the cases

where cold bathing may be hurtful, nor to illustrate its extensive

utility as a medicine; yet it is hoped they may serve to guard people

against some of those errors into which, from mere inattention, they are

apt to fall, and thereby not only endanger their own lives, but bring an

excellent medicine into disrepute.

_Of drinking the Mineral Waters._

The internal use of water, as a medicine, is no less an object of the

physician’s attention than the external. Pure elementary water is indeed

the most inoffensive of all liquors, and constitutes a principal part of

the food of every animal. But this element is often impregnated with

substances of a very active and penetrating nature; and of such an

insidious quality, that, while they promote certain secretions, and even

alleviate some disagreeable symptoms, they weaken the powers of life,

undermine the constitution, and lay the foundation of worse diseases

than those which they were employed to remove. Of this every

practitioner must have seen instances; and physicians of eminence have

more than once declared that they have known more diseases occasioned

than removed by the use of mineral waters. This doubtless has proceeded

from the abuse of these powerful medicines, which evinces the necessity

of using them with caution.

By examining the contents of the mineral waters which are most used in

this country, we shall be enabled to form an idea of the danger which

may arise from an improper application of them either externally or

internally, though it is to the latter of these that the present

observations are chiefly confined.

The waters most in use for medical purposes in Britain, are those

impregnated with salts, sulphur, iron, and mephitic air, either

separately, or variously combined. Of these the most powerful is the

saline sulphureous water of Harrowgate, of which I have had more

occasion to observe the pernicious consequences, when improperly used,

than of any other. To this, therefore, the following remarks will more

immediately relate, though they will be found applicable to all the

purging waters in the kingdom which are strong enough to merit

attention[207].

The errors which so often defeat the intention of drinking the purgative

mineral waters, and which so frequently prove injurious to the patient,

proceed from the manner of using them, the quantity taken, the regimen

pursued, or using them in cases where they are not proper.

A very hurtful prejudice still prevails in this country, that all

diseases must be cured by medicines taken into the stomach, and that the

more violently these medicines operate, they are the more likely to have

the desired effect. This opinion has proved fatal to thousands, and

will, in all probability, destroy many more before it can be wholly

eradicated. Purging is often useful in acute diseases, and in chronical

cases may pave the way for the operation of other medicines; but it will

seldom perform a cure; and by exhausting the strength of the patient,

will often leave him in a worse condition than it found him. That this

is frequently the case with regard to the more active mineral waters,

every person conversant in these matters will readily allow.

Strong stimulants applied to the stomach and bowels for a length of

time, must tend to weaken and destroy their energy; and what stimulants

are more active than salt and sulphur, especially when these substances

are intimately combined, and carried through the system by the

penetrating medium of water? Those bowels must be strong indeed, which

can withstand the daily operation of such active principles for months

together, and not be injured. This however is the plan pursued by most

of those who drink the purging mineral waters, and whose circumstances

will permit them to continue long enough at those fashionable places of

resort.

Many people imagine that every thing depends on the quantity of water

taken, and that the more they drink they will the sooner get well. This

is an egregious error; for, while the unhappy patient thinks he is by

this means eradicating his disorder, he is often in fact undermining the

powers of life, and ruining his constitution. Indeed nothing can do this

so effectually as weakening the powers of digestion by the improper

application of strong stimulants. The very essence of health depends on

the digestive organs performing their due functions, and the most

tedious maladies are all connected with indigestion.

Drinking the water in too great quantity, not only injures the bowels

and occasions indigestion, but generally defeats the intention for which

it is taken. The diseases for the cure of which mineral waters are

chiefly celebrated, are mostly of the chronic kind; and it is well known

that such diseases can only be cured by the slow operation of

alteratives, or such medicines as act by inducing a gradual change in

the habit. This requires length of time, and never can be effected by

medicines which run off by stool, and operate chiefly on the first

passages.

Those who wish for the cure of any obstinate malady from the mineral

waters, ought to take them in such a manner as hardly to produce any

effect whatever on the bowels. With this view a half-pint glass may be

drank at bed-time[208], and the same quantity an hour before breakfast,

dinner, and supper. The dose, however, must vary according to

circumstances. Even the quantity mentioned above will purge some

persons, while others will drink twice as much without being in the

least moved by it. Its operation on the bowels is the only standard for

using the water as an alterative. No more ought to be taken than barely

to move the body; nor is it always necessary to carry it this length,

provided the water goes off by the other emunctories, and does not

occasion a chillness, or flatulency in the stomach or bowels. When the

water is intended to purge, the quantity mentioned above may be all

taken before breakfast.

I would not only caution patients who drink the purging mineral waters

over night to avoid heavy suppers, but also from eating heavy meals at

any time. The stimulus of water, impregnated with salts, seems to create

a false appetite. I have seen a delicate person, after drinking the

Harrowgate waters of a morning, eat a breakfast sufficient to have

served two ploughmen, devour a plentiful dinner of flesh and fish, and,

to crown all, eat such a supper as might have satisfied a hungry porter.

All this, indeed, the stomach seemed to crave; but this craving had

better remain not quite satisfied, than that the stomach should be

loaded with what exceeds its powers. To starve patients was never my

plans; but I am clearly of opinion, that, in the use of all the purging

mineral waters, a light and rather diluting diet is the most proper; and

that no person, during such a course, ought to eat to the full extent to

what his appetite craves.

To promote the operation of mineral waters, and to carry them through

the system, exercise is indispensably necessary. This may be taken in

any manner that is most agreeable to the patient; but he ought never to

carry it to excess. The best kinds of exercise are those connected with

amusement. Every thing that tends to exhilarate the spirits, not only

promotes the operation of the waters, but acts as a medicine. All who

resort to the mineral waters ought therefore to leave every care behind,

to mix with the company, and to make themselves as cheerful and happy as

possible. From this conduct, assisted by the free and wholesome air of

those fashionable places of resort, and also the regular and early hours

which are usually kept, the patient often receives more benefit than

from using the waters.

But the greatest errors in drinking the purging mineral waters arise

from their being used in cases where they are absolutely improper, and

adverse to the nature of the disease. When people hear of a wonderful

cure having been performed by some mineral water, they immediately

conclude that it will cure every thing, and accordingly swallow it down,

when they might as well take poison. Patients ought to be well informed,

before they begin to drink the more active kinds of mineral waters, of

the propriety of the course, and should never persist in using them when

they are found to aggravate the disorder.

In all cases where purging is indicated, the saline mineral waters will

be found to fulfil this intention better than any other medicine. Their

operation, if taken in proper quantity, is generally mild; and they are

neither found to irritate the nerves, nor debilitate the patient so much

as the other purgatives.

As a purgative, these waters are chiefly recommended in diseases of the

first passages, accompanied with, or proceeding from, inactivity of the

stomach and bowels, acidity, indigestion, vitiated bile, worms, putrid

sordes, the piles, and jaundice. In most cases of this kind they are the

best medicines that can be administered. But when used with this view,

it is sufficient to take them twice, or at most three times a-week, so

as to move the body three or four times; and it will be proper to

continue this course for some weeks.

But the operation of the more active mineral waters is not confined to

the bowels. They often promote the discharge of urine, and not

unfrequently increase the perspiration. This shews that they are capable

of penetrating into every part of the body, and of stimulating the whole

system. Hence arises their efficacy in removing the most obstinate of

all disorders, _obstructions of the glandular and lymphatic system_.

Under this class is comprehended the scrofula or _King’s evil_, indolent

tumours, obstructions of the liver, spleen, kidnies, and mesenteric

glands. When these great purposes are to be effected, the waters must be

used in the gradual manner mentioned above, and persisted in for a

length of time. It will be proper however now and then to discontinue

their use for a few days.

The next great class of diseases where mineral waters are found to be

beneficial, are those of the skin, as the itch, scab, tetters,

ringworms, scaly eruptions, leprosies, blotches, foul ulcers, &c. Though

these may seem superficial, yet they are often the most obstinate which

the physician has to encounter, and not unfrequently set his skill at

defiance: but they will sometimes yield to the application of mineral

waters for a sufficient length of time, and in most cases of this kind

these waters deserve a trial. The saline sulphureous waters, such as

those of Moffat in Scotland, and Harrowgate in England, are the most

likely to succeed in diseases of the skin; but for this purpose it will

be necessary not only to drink the waters, but likewise to use them

externally.

To enumerate more particularly the qualities of the different mineral

waters, to specify those diseases in which they are respectively

indicated, and to point out their proper modes of application, would be

an useful, and by no means a disagreeable employment; but as the limits

prescribed to these remarks will not allow me to treat the subject at

more length, I shall conclude by observing, that whenever the mineral

waters are found to exhaust the strength, depress the spirits, take away

the appetite, excite fevers, distend the bowels, or occasion a cough,

they ought to be discontinued.

⁂ These _Cautions_ having been printed and sold separately for the

accommodation of those who had purchased the former editions of this

book, has induced some persons to consider them as a Treatise on

sea-bathing and drinking the mineral waters; whereas the author’s sole

intention was to furnish a few general hints to persons who frequent

those fashionable places of resort, without putting themselves under

the care of a physician. As he looks upon this subject however to be

of the greatest importance to the sick, he pledges himself to treat it

at more length on a future occasion.

APPENDIX:

CONTAINING

A List of Simples and of such Medicinal Preparations as ought to be

kept in Readiness for private Practice:

The Method of preparing and compounding such Medicines as are

recommended in the former Part of the Book, with the Addition of

several others of a similar Nature:

Remarks on the Doses, Uses, and Manner of applying the different

Preparations.

_Medicamentorum varietas ignorantiæ filia est._ BACON.

INTRODUCTION.

Ignorance and superstition have attributed extraordinary medical virtues

to almost every production of nature. That such virtues were often

imaginary, time and experience have sufficiently shewn. Physicians,

however, from a veneration for antiquity, still retain in their lists of

medicine many things which owe their reputation entirely to the

superstition and credulity of our ancestors.

The instruments of medicine will always be multiplied, in proportion to

men’s ignorance of the nature and cause of diseases: when these are

sufficiently understood, the method of cure will be simple and obvious.

Ignorance of the real nature and permanent properties of those

substances employed in the cure of diseases, is another reason why they

have been so greatly multiplied. Physicians thought they could effect by

a number of ingredients, what could not be done by any one of them.

Hence arose those amazing farragos which have so long disgraced the

medical art, and which were esteemed powerful in proportion to the

number of simples that entered their composition.

The great variety of forms into which almost every article of medicine

has been manufactured, affords another proof of the imperfection of the

medical art. A drug which is perhaps most efficacious in the simplest

form in which it can be administered, has been nevertheless served up in

so many different shapes, that one would be induced to think the whole

art of physic lay in exhibiting medicine under as many different modes

as possible.

Different forms of medicine, no doubt, have their use; but they ought

never to be wantonly increased. They are by no means so necessary as is

generally imagined. A few grains of powdered rhubarb, jalap, or

ipecacuanha, will actually perform all that can be done by the different

preparations of these roots, and may also be exhibited in as safe and

agreeable a manner. The same observation holds with regard to the

Peruvian bark, and many other simples of which the preparations are very

numerous.

Multiplying the ingredients of a medicine, not only renders it more

expensive, but also less certain, both in its dose and operation. Nor is

this all. The compound, when kept, is apt to spoil, or acquire qualities

of a different nature. When a medicine is rendered more safe,

efficacious, or agreeable, by the addition of another, they ought, no

doubt, to be joined; in all other cases, they are better kept asunder.

The combination of medicines embarrasses the physician, and retards the

progress of medical knowledge. It is impossible to ascertain the precise

effect of any one medicine, as long as it is combined with others,

either of a similar or dissimilar nature.

In the exhibition of medicine, regard should not only be had to

simplicity, but likewise to elegance. Patients seldom reap much benefit

from things that are highly disagreeable to their senses. To taste or

smell like a drug, is become a proverb; and to say truth, there is too

much ground for it. Indeed no art can take away the disagreeable taste

and flavour of some drugs, without entirely destroying their efficacy:

it is possible, however, to render many medicines less disgustful, and

others even agreeable; an object highly deserving the attention of all

who administer medicine.

The design of the following pages is, to exhibit such a list of drugs

and medicines as may be necessary for private practice. They are

considerably more numerous indeed than those recommended in the former

part of the Book, but are still greatly within the number contained in

the most reformed dispensatories. The same medicine is seldom exhibited

under different forms; and where different medicines answer nearly the

same intention, there is commonly no more than one of them retained.

Multiplying forms of medicine for the same intention tends rather to

bewilder than assist the young practitioner, and the experienced

physician can never be at a loss to vary his prescriptions as occasion

requires.

The chemical and other difficult preparations are for the most part

omitted. All of them that are used by any private practitioner are not

worth preparing. He will buy them much cheaper than he can make them.

Great care however is necessary to obtain them genuine. They are often

adulterated, and ought never to be purchased unless from persons of

known veracity. Such of them as are in common use are inserted in the

list of drugs and medicines. Their proper doses and manner of

application, are mentioned in the practical part of the Book, wherever

they are prescribed.

Such articles of medicine as are to be found in the house or garden of

almost every peasant, as barley, eggs, onions, &c. are likewise, for the

most part, omitted. It is needless to swell a list of medicines with

such things as can be obtained whenever they are wanted, and which spoil

by being kept.

The preparations made and sold by distillers and confectioners are also

generally left out. These people, by operating upon a larger plan,

generally make things better, while it is in their power to afford them

much cheaper, than they can be prepared by any private hand.

The quantity ordered of every medicine is as small as could well be

prepared, both to prevent unnecessary expence, and that the medicine

might not spoil by keeping. Almost every medicine suffers by being kept,

and should be used as soon after it has been prepared as possible. Even

simple drugs are apt to spoil, and should therefore be laid in in small

quantities; they either rot, are consumed by insects, or evaporate so as

to lose their peculiar taste or flavour, and often become quite

insignificant.

In the preparation of medicines, I have generally followed the most

improved dispensatories; but have taken the liberty to differ from them

wherever my own observations, or those of other practical writers, on

whose judgment I could depend, suggested an improvement.

In several compositions, the ingredient on which the efficacy of the

medicine principally depends is increased, while the auxiliaries, which

are generally ordered in such trifling quantities as to be of no

importance, are left out, or only such of them retained as are necessary

to give the medicine a proper consistence, or the like.

The colouring ingredients are likewise for the most part omitted. They

increase the bulk and price of the medicine; without adding any thing to

its value. It would be well if they were never used at all. Medicines

are often adulterated for the sake of a colour. Acrid and even poisonous

substances are, for this purpose, sometimes introduced into those

medicines which ought to be most bland and emollient. Ointment of elder,

for example, is often mixed with verdegrise to give it a fine green

colour, which entirely frustrates the intention of that mild ointment.

Those who wish to obtain genuine medicines should pay no regard to their

colour.

Some regard is likewise paid to expence. Such ingredients as greatly

increase the price of any composition, without adding considerably to

its virtue, are generally either omitted, or somewhat less expensive

substituted in their place. Medicines are by no means powerful in

proportion to their price. The cheapest are often the best; besides,

they are the least apt to be adulterated, and are always most readily

obtained.

With regard to the method of compounding medicines, I have generally

followed that which seemed to be the most simple and natural, mentioning

the different steps of the process in the same order in which they ought

to be taken, without paying an implicit regard to the method of other

dispensatories.

For many of the remarks concerning the preparation, &c. of medicines, I

have been obliged to the author of the New Dispensatory. The other

observations are either such as have occurred to myself in practice, or

have been suggested in the course of reading, by authors whose names I

am not able distinctly to recollect.

I have followed the alphabetical order, both with regard to the simples

and preparations. A more scientific method would have been agreeable to

some persons, but less useful to the generality of readers. The

different classes of medicine have no great dependance upon one another;

and, where they have, it is hard to say which should stand first or

last; no doubt the simple preparations ought to precede the more

compound. But all the advantages arising from this method of arrangement

do not appear equal to that single one, of being able, on the first

opening of the book, to find out any article, which, by the alphabetical

order, is rendered quite easy.

The dose of every medicine is mentioned whenever it appeared necessary.

When this is omitted it is to be understood that the medicine may be

used at discretion. The dose mentioned is always for an adult, unless

when the contrary is expressed. It is not an easy matter to proportion

the doses of medicine exactly to the different ages, constitutions, &c.

of patients; but, happily for mankind, mathematical exactness here is by

no means necessary.

Several attempts have been made to ascertain the proportional doses for

the different ages and constitutions of patients; but, after all that

can be said upon this subject, a great deal must be left to the judgment

and skill of the person who administers the medicine. The following

general proportions may be observed; but they are by no means intended

for exact rules. A patient between twenty and fourteen may take two

thirds of the dose ordered for an adult; from fourteen to nine, one

half; from nine to six, one-third; from six to four, one-fourth; from

four to two, one-sixth; from two to one, a tenth; and below one, a

twelfth.

Dispensatories are usually written in the Latin language. Even authors

who write in English, generally give their prescriptions in Latin; and

some of them shew so great an attachment to that language, as first to

write their _recipes_ in it, and afterwards translate them; while

others, to compromise the matter, write the one half in Latin and the

other in English. What peculiar charm a medical prescription, when

written in Latin, may have, I shall not pretend to say; but have

ventured to make use of the plainest English I could, and hope my

prescriptions will succeed no worse for it.

_N. B._ The Apothecary’s weights, and the English wine measures, are

used throughout the whole book, the different denominations of which

will appear from the following Table:

A pound contains twelve ounces.

An ounce − − eight drachms.

A drachm − − three scruples.

A scruple − − twenty grains.

A gallon contains eight pints.

A pint − − sixteen ounces.

An ounce − − eight drachms.

A spoonful is the measure of half

an ounce.

A LIST of SIMPLES, and of such MEDICINAL PREPARATIONS, as ought to be

kept in readiness for private Practice.

Agaric

Alum

Antimony, crude

—— cinnabar of

—— sulphur of

Balsam of Capivi

—— of Peru

—— of Tolu

Bark, cascarilla

—— cinnamon

—— mezereon

—— Peruvian

—— Winter’s, or canella alba

Borax

Calamine stone, levigated

Castor, Russian

Caustic, common

—— lunar

Earth, Fuller’s

—— Japan

—— Armenian bole

—— French ditto

Extracts of gentian

—— of guaiacum

—— of hellebore, black

—— of hemlock

—— of jalap

—— of liquorice

—— of Peruvian bark

—— of poppies

—— of wormwood

Flowers of camomile

—— colt’s foot

—— elder

—— rosemary

—— damask roses

—— red ditto

Fruits, almonds

—— bitter apple

—— cassia fistularis

—— Curassao oranges

—— figs, dried

—— French prunes

—— Jamaica pepper

—— juniper berries

—— nutmegs

—— tamarinds

Gums, aloes

—— ammoniac, in tears

—— arabic

—— asafœtida

—— camphor

—— galbanum

—— gamboge

—— guaiacum

—— kino

—— myrrh

—— opium

Hartshorn, calcined

—— shavings of

Herbs, lesser centaury

—— peppermint

—— spearmint

—— penny-royal

—— savin

—— trefoil

—— uva ursi

—— wormwood

Lead, Litharge

—— white

—— sugar of

Lemon-peel

Mace

Magnesia alba

Manna

Mercury, crude

—— calcinated

—— Æthiop’s mineral

—— calomel

—— corrosive sublimate

—— red precipitate

—— white ditto

Musk

Oil, essential, of amber

—— —— of annise

—— —— of cinnamon

—— —— of juniper

—— —— of lemon-peel

—— —— of peppermint

—— expressed, of almonds

—— —— of linseed

Oil of olives, or Florence oil

—— of palms

—— of turpentine

Orange-peel

Oyster-shells prepared

Poppy-heads

Resins, benzoin

—— —— flowers of

—— Burgundy pitch

—— dragon’s blood

—— frankincense

—— liquid storax

—— white, or rosin

—— scammony

Roots, birthwort

—— calamus aromaticus

—— contrayerva

—— garlic

—— gentian

—— ginger

—— hellebore, black, white

—— jalap

—— ipecacuanha

—— lily, white

—— liquorice

—— marsh-mallow

—— mezerion

—— rhubarb

—— sarsaparilla

—— seneka

—— squills

—— tormentil

—— turmeric

—— Virginian snake

—— wild valerian

—— zedoary

Saffron

Sal ammoniac, crude

—— volatile

Salt, Epsom

—— of Glauber

—— of hartshorn

—— nitre, purified, or prunel

—— Polychrest

—— Rochel

—— of tartar

Seeds, anise

—— carraway

—— cardamom

—— coriander

—— cummin

—— mustard

—— sweet fennel

—— wild carrot

Senna

Spanish flies

Sperma ceti

Spirits, æthereal, or æther

—— of hartshorn

—— of lavender, compound

—— of nitre

—— ditto dulcified

—— of sal ammoniac

—— of sea salt

—— of vinegar

—— of vitriol

—— of wine rectified

—— volatile aromatic

Steel, filings of

—— rust of, prepared

—— soluble salt of

Sulphur vivum

—— balsam of

Sulphur, flowers of

Tar

—— Barbadoes

Tartar, cream of

—— emetic

—— soluble

—— vitriolated

Tin prepared

Tutty, levigated

Turpentine, Venice

Verdegrise

Vitriol, green

—— blue

—— white

Wax, white

—— yellow

Woods, guaiacum

—— logwood

—— sassafras

—— saunders, red

Zinc, flowers of

MEDICINAL PREPARATIONS.

BALSAMS.

The subject of this section is not the natural balsams, but certain

compositions, which, from their being supposed to possess balsamic

qualities, generally go by that name.

This class of medicines was formerly very numerous, and held in great

esteem: modern practice, however, has justly reduced it to a very narrow

compass.

_Anodyne Balsam._

Take of white Spanish soap, one ounce; opium, unprepared, two drachms;

rectified spirit of wine, nine ounces. Digest them together in a gentle

heat for three days; then strain off the liquor, and add to it three

drachms of camphor.

This balsam, as its title expresses, is intended to ease pain. It is of

service in violent strains and rheumatic complaints, when not attended

with inflammation. It must be rubbed with a warm hand on the part

affected; or a linen rag moistened with it may be applied to the part,

and renewed every third or fourth hour, till the pain abates. If the

opium is left out, this will be the _saponacious balsam_.

_Locatelli’s Balsam._

Take of olive oil, one pint; Strasburg turpentine and yellow wax, of

each half a pound; red saunders, six drachms. Melt the wax with some

part of the oil over a gentle fire; then adding the remaining part of

the oil and the turpentine; afterwards mix in the saunders, previously

reduced to a powder, and keep them stirring together till the balsam is

cold.

This balsam is recommended in erosions of the intestines, the dysentery,

hæmorrhages, internal bruises, and in some complaints of the breast.

Outwardly it is used for healing and cleansing wounds and ulcers. The

dose, when taken internally, is from two scruples to two drachms.

_The vulnerary Balsam._

Take of benzoin, powdered, three ounces; balsam of Peru, two ounces;

hepatic aloes, in powder, half an ounce; rectified spirit of wine, two

pints. Digest them in a gentle heat for three days, and then strain the

balsam.

This balsam, or rather tincture, is applied externally to heal recent

wounds and bruises. It is likewise employed internally to remove coughs,

asthmas, and other complaints of the breast. It is said to ease the

colic, cleanse the kidnies, and to heal internal ulcers, &c.

The dose is from twenty to sixty drops.

This, though a medicine of some value, does not deserve the extravagant

encomiums which have been bestowed on it. It has been celebrated under

the different names of _The Commander’s Balsam_, _Persian Balsam_,

_Balsam of Berne_, _Wade’s Balsam_, _Friar’s Balsam_, _Jesuit’s Drops_,

_Turlington’s Drops_, &c.

BOLUSES.

As boluses are intended for immediate use, volatile salts and other

ingredients improper for being kept, are admitted into their

composition. They are generally composed of powders, with a proper

quantity of syrup, conserve, or mucilage. The lighter powders are

commonly made up with syrup, and the more ponderous, as mercury, &c.

with conserve; but those of the lighter kind would be more conveniently

made up with mucilage, as it increases their bulk less than the other

additions, and likewise occasions the medicine to pass down more easily.

_Astringent Bolus._

Take of alum, in powder, fifteen grains; gum kino, five grains; syrup, a

sufficient quantity to make a bolus.

In an excessive flow of the _menses_, and other violent discharges of

blood, proceeding from relaxation, this bolus may be given every four or

five hours, till the discharge abates.

_Diaphoretic Bolus._

Take of gum guaiacum, in powder, ten grains; flowers of sulphur and

cream of tartar, of each one scruple; simple syrup, a sufficient

quantity.

In rheumatic complaints, and disorders of the skin, this bolus may be

taken twice a day. It will also be of service in the inflammatory

quinsey.

_Mercurial Bolus._

Take of calomel, six grains; conserve of roses, half a drachm. Make a

bolus.

Where mercury is necessary, this bolus may be taken twice or thrice a

week. It may be taken over night; and if it does not operate, a few

grains of jalap will be proper next day to carry it off.

_Bolus of Rhubarb and Mercury._

Take of the best rhubarb, in powder, from a scruple to half a drachm; of

calomel, from four to six grains; simple syrup, a sufficient quantity to

make a bolus.

This is a proper purge in hypochondriac constitutions; but its principal

intention is to expel worms. Where a stronger purge is necessary, jalap

may be used instead of the rhubarb.

_Pectoral Bolus._

Take of sperma-ceti, a scruple; gum ammoniac, ten grains; salt of

hartshorn, six grains; simple syrup, as much as will make them into a

bolus.

This bolus is given in colds and coughs of long standing, asthmas, and

beginning consumptions of the lungs. It is generally proper to bleed the

patient before he begins to use it.

_Purging Bolus._

Take of jalap, in powder, a scruple; cream of tartar, two scruples. Let

them be rubbed together, and formed into a bolus, with simple syrup.

Where a mild purge is wanted, this will answer the purpose very well. If

a stronger dose is necessary, the jalap may be increased to half a

drachm or upwards.

CATAPLASMS AND SINAPISMS.

Cataplasms possess few or no virtues superior to a poultice, which may

be so made, as, in most cases, to supply their place. They are chiefly

intended either to act as discutients, or to promote suppuration; and as

they may be of service in some cases, we shall give a specimen of each

kind.

_Discutient Cataplasm._

Take of barley-meal, six ounces; fresh hemlock leaves, bruised; two

ounces; vinegar, a sufficient quantity. Boil the meal and hemlock in the

vinegar for a little, and then add two drachms of the sugar of lead.

_Ripening Cataplasm._

Take of white lily root, four ounces; fat figs and raw onions, bruised,

of each one ounce; yellow basilicum ointment, two ounces; gum galbanum,

half an ounce; linseed meal, as much as necessary. Boil the roots along

with the figs in a sufficient quantity of water; then bruise and add to

them the other ingredients, so as to form the whole into a soft

cataplasm. The galbanum must be previously dissolved with the yolk of an

egg.

Where it is necessary to promote suppuration, this cataplasm may be used

by those who chuse to be at the trouble and expence of making it. For my

part, I have never found any application more proper for this purpose

than a poultice of bread and milk, with a sufficient quantity of either

boiled or raw onion in it, and softened with oil or fresh butter.

_Sinapisms._

Sinapisms are employed to recal the blood and spirits to a weak part, as

in the palsy and atrophy. They are also of service in deep-seated pains,

as the sciatica, &c. When the gout seizes the head or the stomach, they

are applied to the feet to bring the disorder to these parts. They are

likewise applied to the patient’s soles in the low state of fevers. They

should not be suffered to lie on, however, till they have raised

blisters, but till the parts become red, and will continue so when

pressed with the finger.

The sinapism is only a poultice made with vinegar instead of milk, and

rendered warm and stimulating by the addition of mustard, horse-radish,

or garlic.

The common sinapism is made by taking crumb of bread and mustard-seed in

powder, of each equal quantities; strong vinegar, as much as is

sufficient, and mixing them so as to make a poultice.

When sinapisms of a more stimulating nature are wanted, a little bruised

garlic may be added to the above.

CLYSTERS.

This class of medicines is of more importance than is generally

imagined. clysters serve, not only to evacuate the contents of the

belly, but also to convey very active medicines into the system. Opium,

for example, may be administered in this way when it will not sit upon

the stomach, and also in larger doses than at any time it can be taken

by the mouth. The Peruvian bark may likewise be, with good effect,

administered in form of clyster to persons who cannot take it by the

mouth.

A simple clyster can seldom do hurt, and there are many cases where it

may do much good. A clyster even of warm water, by serving as a

fomentation to the parts, may be of considerable service in

inflammations of the bladder, and the lower intestines, &c.

Some substances, as the smoke of tobacco, may be thrown into the bowels

in this way, which cannot by any other means whatever. This may be

easily effected by means of a pair of hand-bellows, with an apparatus

fitted to them for that purpose.

Nor is the use of clysters confined to medicines. Aliment may also be

conveyed in this way. Persons unable to swallow, have been, for a

considerable time, supported by clysters.

_Emollient Clyster._

Take of linseed-tea and new milk, each six ounces. Mix them.

If fifty or sixty drops of laudanum be added to this, it will supply the

place of the _Anodyne Clyster_.

_Laxative Clyster._

Take of milk and water, each six ounces; sweet oil or fresh butter, and

brown sugar, of each two ounces. Mix them.

If an ounce of Glauber’s salt, or two table-spoonfuls of common salt, be

added to this, it will be the _Purging Clyster_.

_Carminative Clyster._

Take of camomile flowers, an ounce; anise-seeds, half an ounce. Boil in

a pint and a half of water to one pint.

In hysteric and hypochondriac complaints this may be administered

instead of the _Fœtid Clyster_, the smell of which is so disagreeable to

most patients.

_Oily Clyster._

To four ounces of the infusion of camomile flowers, add an equal

quantity of Florence oil.

This clyster is beneficial in bringing off the small worms lodged in the

lower parts of the alimentary canal. When given to children the quantity

must be proportionably lessened.

_Starch Clyster._

Take jelly of starch, four ounces; linseed oil, half an ounce. Liquify

the jelly over a gentle fire, and then mix in the oil.

In the dysentery or bloody flux, this clyster may be administered after

every loose stool, to heal the ulcerated intestines and blunt the

sharpness of corroding humours. Forty or fifty drops of laudanum may be

occasionally added; in which case, it will generally supply the place of

the _Astringent Clyster_.

_Turpentine Clyster._

Take of common decoction, ten ounces; Venice turpentine, dissolved with

the yolk of an egg, half an ounce; Florence oil, one ounce. Mix them.

This diuretic clyster is proper in obstructions of the urinary passages,

and in colicky complaints, proceeding from gravel.

_Vinegar Clyster._

This clyster is made by mixing three ounces of vinegar with five of

water-gruel.

It answers all the purposes of a common clyster, with the peculiar

advantage of being proper either in inflammatory or putrid disorders,

especially in the latter.

☞ We think it unnecessary to give more examples of this class of

medicines, as ingredients adapted to any particular intention may be

occasionally added to one or other of the above forms.

COLLYRIA, or EYE-WATERS.

Eye-waters have been multiplied without number, almost every person

pretending to be possessed of some secret preparation for the cure of

sore eyes. I have examined many of them, and find that they are pretty

much alike, the basis of most of them being either alum, vitriol, or

lead. Their effects evidently are, to brace and restore the tone of the

parts; hence they are principally of service in slight inflammations;

and in that relaxed state of the parts which is induced by obstinate

ones.

Camphor is commonly added to these compositions; but as it seldom

incorporates properly with the water, it can be of little use. Boles and

other earthy substances, as they do not dissolve in water, are likewise

unfit for this purpose.

_Collyrium of Alum._

Take of alum, half a drachm; agitate it well together with the white of

one egg.

This is the Collyrium of Riverius. It is used in inflammation of the

eyes, to allay heat, and restrain the flux of humours. It must be spread

upon linen, and applied to the eyes; but should not be kept on above

three or four hours at a time.

_Vitriolic Collyrium._

Take of white vitriol, half a drachm; rose-water, six ounces. Dissolve

the vitriol in the water, and filter the liquor.

This, though simple, is perhaps equal in virtue to most of the

celebrated collyria. It is an useful application in weak, watery, and

inflamed eyes. Though the slighter inflammations will generally yield to

it, yet in those of a more obstinate nature the assistance of bleeding

and blistering will often be necessary.

When a strong astringent is judged proper, a double or triple quantity

of the vitriol may be used. I have seen a solution of four times the

strength of the above used with manifest advantage.

_Collyrium of Lead._

Take sugar of lead, and crude sal ammoniac, of each four grains.

Dissolve them in eight ounces of common water.

Forty or fifty drops of laudanum may be occasionally added to this

collyrium.

Those who chuse may substitute instead of this the collyrium of lead

recommended by Goulard; which is made by putting twenty-five drops of

his _Extract of Lead_ to eight ounces of water, and adding a

tea-spoonful of brandy.

Indeed, common water and brandy, without any other addition, will in

many cases answer very well as a collyrium. An ounce of the latter may

be added to five or six ounces of the former; and the eyes, if weak,

bathed with it night and morning.

CONFECTIONS.

Confections containing above sixty ingredients are still to be found in

some of the most reformed dispensatories. As most of their intentions,

however, may be more certainly, and as effectually answered by a few

glasses of wine or grains of opium, we shall pass over this class of

medicines very slightly.

_Japonic Confection._

Take of Japan earth, three ounces; tormentil root, nutmeg, olibanum, of

each two ounces; opium dissolved in a sufficient quantity of Lisbon

wine, a drachm and a half; simple syrup and conserve of roles, of each

fourteen ounces. Mix and make them into an electuary.

This supplies the place of the Diascordium.

The dose of this electuary is from a scruple to a drachm.

CONSERVES AND PRESERVES.

Every Apothecary’s shop was formerly so full of these preparations, that

it might have passed for a confectioner’s warehouse. They possess very

few medicinal properties, and may rather be classed among sweetmeats

than medicines. They are sometimes, however, of use, for reducing into

boluses or pills some of the more ponderous powders, as the preparations

of iron, mercury, and tin.

Conserves are compositions of fresh vegetables and sugar, beaten

together into an uniform mass. In making these preparations, the leaves

of vegetables must be freed from their stalks, the flowers from their

cups, and the yellow part of orange-peel taken off with a rasp. They are

then to be pounded in a marble mortar, with a wooden pestle, into a

smooth mass; after which, thrice their weight of fine sugar is commonly

added by degrees, and the beating continued till they are uniformly

mixed; but the conserve will be better if only twice its weight of sugar

be added.

Those who prepare large quantities of conserve generally reduce the

vegetables to a pulp by the means of a mill, and afterwards beat them up

with the sugar.

_Conserve of Red Roses._

Take a pound of red rose buds, cleared of their heels; beat them well in

a mortar, and, adding by degrees two pounds of double-refined sugar, in

powder, make a conserve.

After the same manner are prepared the conserves of orange-peel,

rosemary flowers, sea-wormwood, of the leaves of wood-sorrel, &c.

The conserve of roses is one of the most agreeable and useful

preparations belonging to this class. A drachm or two of it, dissolved

in warm milk, is ordered to be given as a gentle restringent in weakness

of the stomach, and likewise in phthisical coughs, and spitting of

blood. To have any considerable effects, however, it must be taken in

larger quantities.

_Conserve of Sloes._

This may be made by boiling the sloes gently in water, being careful to

take them out before they burst; afterwards expressing the juice, and

beating it up with three times its weight of fine sugar.

In relaxations of the _uvula_ and glands of the throat, this makes an

excellent gargle, and may be used at discretion.

_Preserves_ are made by steeping or boiling fresh vegetables first in

water, and afterwards in syrup, or a solution of sugar. The subject is

either preserved moist in the syrup, or taken out and dried, that the

sugar may candy upon it. The last is the most useful method.

_Candied Orange Peel._

Soak Seville orange-peel in several waters, till it loses its

bitterness; then boil it in a solution of double-refined sugar in water,

till it becomes tender and transparent.

Candied lemon-peel is prepared in the same manner.

It is needless to add more of these preparations, as they belong rather

to the art of the confectioner than that of the apothecary.

DECOCTIONS.

Water readily extracts the gummy and saline parts of vegetables; and

though its action is chiefly confined to these, yet the resinous and

oily being intimately blended with the gummy and saline, are in great

part taken up along with them. Hence watery decoctions and infusions of

vegetables, constitute a large, and not unuseful, class of medicines.

Although most vegetables yield their virtues to water, as well by

infusion as decoction, yet the latter is often necessary, as it saves

time, and does in a few minutes what the other would require hours, and

sometimes days, to effect.

The medicines of this class are all intended for immediate use.

_Decoction of Althæa._

Take of the roots of marsh-mallows, moderately dried, three ounces;

raisins of the sun, one ounce; water, three pints.

Boil the ingredients in the water till one-third of it is consumed;

afterwards strain the decoction and let it stand for some time to

settle. If the roots be thoroughly dried, they must be boiled till one

half the water be consumed.

In coughs, and sharp defluctions upon the lungs, this decoction may be

used for ordinary drink.

_The Common Decoction._

Take of camomile flowers, one ounce; elder flowers, and sweet fennel

seeds, of each half an ounce; water, two quarts. Boil them for a little,

and then strain the decoction.

A medicine equally good may be prepared by infusing the ingredients for

some hours in boiling water.

This decoction is chiefly intended as the basis of clysters, to which

other ingredients may be occasionally added. It will likewise serve as a

common fomentation, spirit of wine or other things being added in such

quantity as the case may require.

_Decoction of Logwood._

Boil three ounces of the shavings, or chips, of logwood, in four pints

of water, till one half the liquor is wasted. Two or three ounces of

simple cinnamon-water may be added to this decoction.

In fluxes of the belly, where the stronger astringents are improper, a

tea-cupful of this decoction may be taken with advantage three or four

times a-day.

_Decoction of the Bark._

Boil an ounce of the Peruvian bark, grossly powdered, in a pint and a

half of water to one pint; then strain the decoction. If a tea-spoonful

of the weak spirit of vitriol be added to this medicine, it will render

it both more agreeable and efficacious.

_Compound Decoction of the Bark._

Take of Peruvian bark and Virginian snake-root, grossly powdered, each

three drachms. Boil them in a pint of water to one half. To the strained

liquor add an ounce and a half of aromatic water.

Sir John Pringle recommends this as a proper medicine towards the

decline of malignant fevers, when the pulse is low, the voice weak, and

the head affected with a stupor but with little delirium.

The dose is four spoonfuls every fourth or sixth hour.

_Decoction of Sarsaparilla._

Take of fresh sarsaparilla root, sliced and bruised, two ounces;

shavings of guaiacum wood, one ounce. Boil over a slow fire, in three

quarts of water, to one; adding towards the end, half an ounce of

sassafras wood, and three drachms of liquorice. Strain the decoction.

This may either be employed as an assistant to a course of mercurial

alteratives, or taken after the mercury has been used for some time. It

strengthens the stomach, and restores flesh and vigour to habits

emaciated by the venereal disease. It may also be taken in the

rheumatism, and cutaneous disorders proceeding from foulness of the

blood and juices. For all these intentions it is greatly preferable to

the _Decoction of Woods_.

This decoction may be taken, from a pint and a half to two quarts in the

day.

The following decoction is said to be similar to that used by _Kennedy_,

in the cure of the venereal disease, and may supply the place of Lisbon

diet drink:

Take of sarsaparilla, three ounces; liquorice and mezereon root, of each

half an ounce; shavings of guaiacum and sassafras wood, of each one

ounce; crude antimony, powdered, an ounce and a half. Infuse these

ingredients in eight pints of boiling water for twenty-four hours, then

boil them till one half of the water is consumed; afterwards strain the

decoction.

This decoction may be used in the same manner as the preceding.

_Decoction of Seneka._

Take of seneka rattle-snake root, one ounce; water, a pint and a half.

Boil to one pint, and strain.

This decoction is recommended in the pleurisy, dropsy, rheumatism, and

some obstinate disorders of the skin. The dose is two ounces, three or

four times a-day, or oftner, if the stomach will bear it.

_White Decoction._

Take of the purest chalk, in powder, two ounces; gum arabic, half an

ounce; water, three pints. Boil to one quart, and strain the decoction.

This is a proper drink in acute diseases, attended with, or inclining

to, a looseness, and where acidities abound in the stomach or bowels. It

is peculiarly proper for children when afflicted with sourness of the

stomach, and for persons who are subject to the heart-burn. It may be

sweetened with sugar, as it is used, and two or three ounces of simple

cinnamon-water added to it.

An ounce of powdered chalk, mixed with two pints of water, will

occasionally supply the place of this decoction, and also of the chalk

julep.

DRAUGHTS.

This is a proper form for exhibiting such medicines as are intended to

operate immediately, and which do not need to be frequently repeated; as

purges, vomits, and a few others, which are to be taken at one dose.

Where a medicine requires to be used for any length of time, it is

better to make up a larger quantity of it at once, which saves both

trouble and expence.

_Anodyne Draught._

Take of liquid laudanum, twenty-five drops; simple cinnamon water, an

ounce; common syrup, two drachms. Mix them.

In excessive pain, where bleeding is not necessary, and in great

restlessness, this composing draught may be taken and repeated

occasionally.

_Diuretic Draught._

Take of the diuretic salt, two scruples; syrup of poppies, two drachms;

simple cinnamon-water and common water, of each an ounce.

This draught is of service in an obstruction or deficiency of urine.

_Purging Draughts._

Take of manna, an ounce; soluble tartar, or Rochel salt, from three to

four drachms. Dissolve in three ounces of boiling water; to which add

Jamaica pepper water, half an ounce.

As manna sometimes will not sit upon the stomach, an ounce or ten

drachms of the bitter purging salts, dissolved in four ounces of water,

may be taken instead of the above.

Those who cannot take salts may use the following draught:

Take of jalap in powder, a scruple; common water, an ounce; aromatic

tincture, six drachms. Rub the jalap with twice its weight of sugar, and

add to it the other ingredients.

_Sweating Draught._

Take spirit of Mindererus, two ounces; salt of hartshorn, five grains;

simple cinnamon-water, and syrup of poppies, of each half an ounce. Make

them into a draught.

In recent colds and rheumatic complaints, this draught is of service. To

promote its effects, however, the patient ought to drink freely of warm

water-gruel, or of some other weak diluting liquor.

_Vomiting Draughts._

Take of ipecacuanha, in powder, a scruple; water, an ounce; simple

syrup, a drachm. Mix them.

Persons who require a stronger vomit may add to the above half a grain,

or a grain, of emetic tartar.

Those who do not chuse the powder, may take ten drachms of the

ipecacuanha wine; or half an ounce of the wine, and an equal quantity of

the syrup of squills.

ELECTUARIES.

Electuaries are generally composed of the lighter powders, mixed with

syrup, honey, conserve, or mucilage, into such a consistence, that the

powders may neither separate by keeping, nor the mass prove too stiff

for swallowing. They receive chiefly the milder alterative medicines,

and such as are not ungrateful to the palate.

Astringent electuaries, and such as have pulps of fruit in them, should

be prepared only in small quantities; as astringent medicines lose their

virtues by being kept in this form, and the pulps of fruits are apt to

ferment.

For the extraction of pulps it will be necessary to boil unripe fruits,

and ripe ones if they are dried, in a small quantity of water till they

become soft. The pulp is then to be pressed out through a strong hair

sieve, or thin cloth, and afterwards boiled to a due consistence, in an

earthen vessel, over a gentle fire, taking care to prevent the matter

from burning by continually stirring it. The pulps of fruit that are

both ripe and fresh may be pressed out without any previous boiling.

_Lenitive Electuary._

Take of senna, in fine powder, eight ounces; coriander seed, also in

powder, four ounces; pulp of tamarinds and of French prunes, each a

pound. Mix the pulps and powders together, and with a sufficient

quantity of simple syrup, reduce the whole into an electuary.

A tea-spoonful of this electuary, taken two or three times a day,

generally proves an agreeable laxative. It likewise serves as a

convenient vehicle for exhibiting more active medicines, as jalaps,

scammony, and such like.

This may supply the place of the electuary of _Cassia_.

_Electuary for the Dysentery._

Take of the Japonic confection, two ounces; Locatelli’s balsam, one

ounce; rhubarb in powder, half an ounce; syrup of marsh-mallows, enough

to make an electuary.

It is often dangerous in dysenteries to give opiates and astringents,

without interposing purgatives. The purgative is here joined with these

ingredients, which renders this a very safe and useful medicine for the

purposes expressed in the title.

About the bulk of a nutmeg should be taken twice or thrice a-day, as the

symptoms and constitution may require.

_Electuary for the Epilepsy._

Take of Peruvian bark, in powder, an ounce; of powdered tin, and wild

valerian-root, each half an ounce; simple syrup, enough to make an

electuary.

Dr. Mead directs a drachm of an electuary similar to this to be taken

evening and morning, in the epilepsy, for the space of three months. It

will be proper, however, to discontinue the use of it for a few days

every now and then. I have added the powdered tin, because the epilepsy

often proceeds from worms.

_Electuary for the Gonorrhœa._

Take of lenitive electuary, three ounces; jalap and rhubarb, in powder,

of each two drachms; nitre, half an ounce; simple syrup, enough to make

an electuary.

During the inflammation and tension of the urinary passages, which

accompany a virulent gonorrhœa, this cooling laxative may be used with

advantage.

The dose is a drachm, or about the bulk of a nutmeg, two or three times

a-day; more or less, as may be necessary to keep the body gently open.

An electuary made of cream of tartar and simple syrup will occasionally

supply the place of this.

After the inflammation is gone off, the following electuary may be used:

Take of lenitive electuary, two ounces; balsam of capivi, one ounce; gum

guaiacum and rhubarb, in powder, of each two drachms; simple syrup,

enough to make an electuary. The dose is the same as of the preceding.

_Electuary of the Bark._

Take of Peruvian bark, in powder, three ounces; cascarilla, half an

ounce; syrup of ginger, enough to make an electuary.

In the cure of obstinate intermitting fevers, the bark is assisted by

the cascarilla. In hectic habits, however, it will be better to leave

out the cascarilla, and put three drachms of crude sal ammoniac in its

stead.

_Electuary for the Piles._

Take flowers of sulphur, one ounce; cream of tartar, half an ounce;

treacle, a sufficient quantity to form an electuary.

A tea-spoonful of this may be taken three or four times a-day.

_Electuary for the Palsy._

Take of powdered mustard-seed, and conserve of roses, each an ounce;

syrup of ginger, enough to make an electuary.

A tea-spoonful of this may be taken three or four times a-day.

_Electuary for the Rheumatism._

Take of conserve of roses, two ounces; cinnabar of antimony, levigated,

an ounce and a half; gum guaiacum, in powder, an ounce; syrup of ginger,

a sufficient quantity to make an electuary.

In obstinate rheumatisms, which are not accompanied with a fever, a

tea-spoonful of this electuary may be taken twice a-day with

considerable advantage.

EMULSIONS.

Emulsions, beside their use as medicines, are also proper vehicles for

certain substances, which could not otherwise be conveniently taken in a

liquid form. Thus camphor, triturated with almonds, readily unites with

water into an emulsion. Pure oils, balsams, resins, and other similar

substances, are likewise rendered miscible with water by the

intervention of mucilages.

_Common Emulsion._

Take of sweet almonds, an ounce; bitter almonds, a drachm; water, two

pints.

Let the almonds be blanched, and beat up in a marble mortar; adding the

water by little and little, so as to make an emulsion; afterwards let it

be strained.

_Arabic Emulsion._

This is made in the same manner as the above, adding to the almonds

while beating, two ounces and a half of the mucilage of gum arabic.

Where soft cooling liquors are necessary, these emulsions may be used as

ordinary drink.

_Camphorated Emulsion._

Take of camphor, half a drachm; sweet almonds, half a dozen; white

sugar, half an ounce; mint-water, eight ounces. Grind the camphor and

almonds well together in a stone mortar, and add by degrees the mint

water; then strain the liquor, and dissolve in it the sugar.

In fevers, and other disorders which require the use of camphor, a

table-spoonful of this emulsion may be taken every two or three hours.

_Emulsion of Gum Ammoniac._

Take of gum ammoniac, two drachms; water, eight ounces. Grind the gum

with the water poured upon it by little and little, till it is

dissolved.

This emulsion is used for attenuating tough, viscid phlegm, and

promoting expectoration. In obstinate coughs, two ounces of the syrup of

poppies may be added to it. The dose is two table-spoonfuls three or

four times a-day.

_Oily Emulsion._

Take of soft water, six ounces; volatile aromatic spirit, two drachms;

Florence oil, an ounce; shake them well together, and add, of simple

syrup, half an ounce.

In recent colds and coughs, this emulsion is generally of service; but

if the cough proves obstinate, it will succeed better when made with the

paregoric elixir of the Edinburgh Dispensatory, instead of the volatile

aromatic spirit. A table-spoonful of it may be taken every two or three

hours.

EXTRACTS.