Part 13

_Take a pipkin, or a tin sauce-pan, with a quart of water, a pint of vinegar, and two spoonfuls of honey; then take a funnel that will pretty well cover the vessel; then take a piece of iron, or some old nails, or a little stone, or what you have handy; heat it red hot, and put it into the pipkin, and put on the funnel so that steam may ascend through it. Over this let the patient hold his mouth, so that he breathes nothing but the steam; and to secure it the better, put something over his head, that he may reap the more the benefit of it. When the steam ceases, heat it again as before. Instead of heating it with the iron, it may be shifted with boiling, but the former is generally more handy._

In the mean time, if the patient should by the inflammation, be deprived of all nutriment, recourse must be had to nourishing clysters: milk in this respect is the best; but in want of that, fowl broth may be used; and if that is wanting, take water gruel. Milk however is superior to all: I shall give a receipt of each kind.

No. XXXVII

_Take milk and water, of each a pint; cinamon (16), one drachm; boil them and strain the liquor; then dissolve one ounce and an half of good loaf sugar; add six drops, of the essential oil of peppermint_ (U), _upon a little lump of sugar._

No. XXXVIII

_Take half a fowl, bruise the bones, and cut the flesh small; this boil in three pints of fresh water, with about one drachm of cinamon; strain it clear, and add as before, an ounce of sugar, with a few drops of the oil of peppermint.—A tea cupful of good white wine may be added, if the patient is very weak, and not feverish._

No. XXXIX

_Take oatmeal, two spoonfuls; malt, one spoonful; cinamon, two drachmes. Boil it in two quarts of water for some time, till when it is strained, it becomes one quart; put to it fine sugar, six ounces; a few drops of essential oil of peppermint, and a tea cupful of good wine._

These clysters are perfectly safe, and very nourishing. Some have added salt to the animal broth, perhaps through a notion to make it the more palatable, and so of course more nourishing; but probably they forget that the part they are now about to feed, differs widely from the depraved taste of the palate.

Salt is stimulating; besides, it indurates the aliment, that it never yields so much nourishment, because it always opposes assimulation; and it is universally known, that salt victuals is by far, less nourishing than fresh.

The quincey is sometimes so desperate, as to strangle the afflicted patient, particularly if assistance is given too late; in so much that _bronchotomy_, or opening the wind-pipe, has been the last resource in this deplorable dilemma. I have mentioned this operation, in the third lecture, and have only to observe, that in this case little hope is left after that operation, on account of the great inflammation of the parts; though we have instances of its success. If however the method which I have here laid down, together with strict observance of managing fevers is duly observed, there can scarce be a failure of success; for if I may be allowed to judge from my own experience and success, it is merely neglect, in the first setting out of these diseases, that for the most part, renders them so very desperate and mortal.

SECT. III.

_Of Diseases in the Breast_

Under this head, I mean principally to treat of diseases of the wind-pipe, the lungs, and the pleura, or membrane that lines the cavity of the breast, and encompasses the lungs.

_Of the Cough._

A Cough is generally occasioned by a cold; unless it is symptomatic with other inflammatory diseases, or the relict of a heavy sickness; in which case, it is either near a-kin to, or else the consumption itself.

If from a cold, it seldom is deep founded, and generally has its seat in the larynx, or in the wind-pipe; though indeed sometimes in the lungs.

It generally begins first with a tickling in the throat, and occasions a short dry cough; which gradually becomes strong, and is attended with a discharge.

It is surprizing what absurd remedies are sometimes given for the cough; as if they supposed that every thing taken should immediately march at the word of command into the wind-pipe, and there set to work accordingly. Amongst the many celebrated nostrums, spermaceti, or whales fat is remarkably celebrated; it softens the phlegm say they; but in fact, a little fat pork, or hog’s lard will do equally as much good.——The truth of the matter is, the cough proceeds from an obstructed perspiration. When a person gets cold, he generally first feels a snuffling, and obstruction in the nose, then a sore throat or hoarseness, and lastly a cough; all which is a gradual defluxion from the pituitous membrane, which reaches from the cavity of the nose, all down the lungs. Whatever medicines therefore, are capable of yielding benefit, must be calculated to open and remove the obstruction, and promote universal perspiration; whence therefore we find it is impossible to cure one, without the other.—Medicines neither do, nor is it fit they should come immediately farther, than the top of the larynx; for if they happen to come into the wind-pipe, the most innocent medicine would certainly act the part of a poison.

The first indication therefore in a cough, is to promote perspiration; for then nature will repair the respirative organs with the rest.

Let the patient take a draught or two of good sage punch, No. V. and thereby promote perspiration; and in order to continue this principal intention, and to assuage the slight inflammation in the throat, which the heavy cough occasions; make the following electuary.

No. XL

_Take honey, or sugar dissolved to syrup, two ounces; lemon juice, half an ounce; or elixir of vitriol, two drachmes; sweet oil, one ounce; mix them into a linctus._

Take of this, every half hour, but half a tea spoonful; and swallow it gradually, so that it may as it slides by, do some service to the larynx; and keeping the body all the time in a gentle perspiration. This method is superior to all your nonsensical pectorals, which have nothing but quackery for their foundation; for whatever you may take for the cough, it cannot possibly have any other effect on the part, till the real cause is removed, than barely to touch the larynx; for all goes to the stomach, and undergoes the same chance as your victuals. Therefore strike at the root of the evil; namely, to promote perspiration; and all the rest of the complaints will vanish, in consequence of this principal intention.

_Of the Pleurisy, and Peripneumony._

The _pleurisy_ is an inflammation of the lining of the inside of the pectoral cavity and lungs; and the _peripneumony_ an inflammation of the lungs themselves.

These two principal kinds of inflammation have given birth to the names of many other inflammations contiguous to those parts, which I hope to be excused from entering into, as it is of very little signification to the proper treatment of those disorders; for I have often known the most skilful practitioner, to be mistaken of these disorders in his diagnostics, and yet been successful in his cure. The signs of this inflammatory disease, is an acute fixt pain in the breast; on whatever side the disorder is in, with a difficulty of breathing, and frequently attended with a small short dry cough, which however stings the patient like so many daggers. A constant fever attends with all its symptoms; which adds greatly to the patient’s misery.

On the immediate signs of these symptoms, bleeding must be had recourse to; and if the inflammation is great, and the pain pungent, it must be repeated; though with skilful management. Bleeding may be repeated after the first twenty-four hours; yet in general it is needless, and sometimes dangerous; for my own part, I never approved of it; nor have I seen any necessity for it. Perspiration however should be promoted.

If the pain is violent, let the patient use the following medicine.

No. XLI

_Take sweet Spirit of Nitre_ (D) _twenty drops; Spirit of Wine and Camphor_ (A) _ten drops; Fever Powder_ (L) _one scruple; mix it up with sugar and water into a draught._

Let the patient take this every six hours; if there is a great nausea at the stomach, a small vomit of twelve grains of _Ipecacuanha_, (S) may be given first, notwithstanding it is great pain to the patient; and I have often known it productive of great good, and laid the first foundation to a successful cure.

If the pain still continues, twelve drops of _liquid laudanum_ (T) may be added to the above draught; No. XLI. If the spirits of the patient is low, give the _essential oil of Peppermint_ (U) to the quantity of three or four, or six drops upon a lump of sugar, either put, into the draught above-mentioned, or give it by itself occasionally.

To the inflamed side, warm cloths may be put wrapt up with a hot made trencher, brick, a bag of sand, or whatever will retain heat; as that will greatly facilitate the internal resolution.

Perspiration is the principal object to be considered in this acute disease, and should therefore be promoted; but every thing forcing that produces profuse sweats should be avoided, as that only encreases the fever.

If the patient is very restless, the fever depressed, and greatly oppressed in respiration, blisters may be applied; but if the patient can do without them, it is much better; as they very often are apt to encrease the inflammation.

Cooling clysters, No. XXXII. which at the same time promote urine, is of singular service; and in every respect methods must be taken, as have been directed in fevers, and the ulcerated sore throat; as all these inflammatory diseases are of one nature, and require almost one method of treatment. For farther particulars on this head, see my treatise on diseases of the lungs.

SECT. IV.

_Of Diseases of the Bowels, and the Alimentary Canal_

Diseases of mankind under this head are very numerous indeed; which are for the most part owing to their deviating too much from the common path of nature. But besides all this, seamen are particularly liable; not so much indeed on account of luxury as the confined diet, and the different climates they visit.

I shall in this be as concise as the subject will admit of, and confine myself to such diseases as occur most commonly; and by which others that are here omitted, may be understood.

_Of a Depraved Appetite._

There is nothing that people in general are more apt to fly to, when appetite fails them, than bitters; but if we consider what bitters really are, and by what means they act in the alimentary canal, we shall find them, either only to stimulate the coat of the stomach, or else add to the strength of the bile.

But generally the default of a bad appetite is a pituitous slime in the stomach, that prevents this viscera from performing its part towards assimilation; and therefore we generally find that such stimulants only spur it on for a little while longer, till at length it loses its tone, so as to be wholly unable to prepare the food for a good nutrition; or else the stomach becomes so used to these forcing stimulants, as not to be able to do without them.

But this is not all; for in bilious complaints, when the stomach is most disordered, bitters never fail of making evil worse. The stomach is a delicate viscera, and should ever be the most cautiously dealt with. Whatever part of the human body is in exquisite pain, the stomach from the nervous consent always partakes, and is apt to be depraved in its functions; whence a nausea is liable to ensue; and in such a case any stimulants, particularly where bitters are concerned, is ever of evil tendency.

In general however, a vomit is what nature points out; and which gives not only relief to the stomach, but assists in giving a general effort to the whole animal fabric. In short, there are so very few cases where bitters are of any benefit at all, except where the stomach has injuriously been used to those stimulants, that I have entirely exploded them from my catalogue; being persuaded that every body will do better without them.

When the stomach loaths victuals, the mouth is slimy, has a bitterish taste, and attended with sour belching, and the victuals siting heavy on the stomach, nothing is preferable to a vomit.

This I know has also been carried into abuse, as well as many other good medicines.——Yet that should be no rule; for if a vomit is properly and timely given, it will ever be attended with success. Take here the following direction for a foul stomach.

First take a vomit, and work it well off with bare luke warm water; then take every night, or when going to rest, a dose of _stomach powder_ (M). If the stomach seems very weak, add a few drops of the _essential oil of peppermint_ (U), which will soon convince you of the good effects.

If you require a stimulant in the morning, take _Turlington’s balsam_ (W), about a tea spoonful in a glass of wine, previously put on a lump of sugar, that it may the better incorporate: which is a good stomachic, and ever preferable to the customary bitters.

Dram drinking is another pernicious custom, whereby many have been sent to eternity long before the period of life prescribed by nature; and of which I would advise every man, who has the least regard for his health, to beware, as of a deadly poison.

On the whole, the want of appetite is what many complain of without reason. Some fancy themselves very bad, because they cannot eat their breakfast; those I would advise to stay till dinner time; others again have no appetite for their dinner, unless they wet their stomach with a glass of Stoughton, or some other bitters: Those should eat nothing in the morning, or else stay till supper time.——In short, nature should be consulted, both in the state of health, as well as in diseases, and her salutary dictates should be followed.

The custom of seasoning victuals with strong stimulating condiments is often prejudicial, and nothing should be used with more moderation; for though it may warm and stimulate the stomach, yet, it frequently gives cause to great weaknesses, and generally are the primitive causes of chronic distempers; as it hurries on the chylefaction, and thence is apt to feed the blood with many acrimonious humours.

This little dissertation on depraved appetite I hope will suffice, and doubt not if attended to, that health and longevity will become the intimate acquaintances of the man who wishes to enjoy their blessings.

_Of the Colic._

If we consider the length of the ailmentary canal from the mouth to the anus, namely six times the length of the subject they belong to; and if we consider the delicacy of its substance, as also, the office for which it is ordained; we shall not at all wonder, that so many disorders are incident to mankind in that part.

The colic however is the general term for various painful sensations in the intestines; though the causes as well as the seat, and the manner of its affecting the system, is materially different.

The general cause however, is a stimulant, which irritating the inner coat of the intestines to constriction; and whence a spasmodic contraction, and a perverted peristaltic motion is produced.

If the stomach is affected with the pain of the colic, so that a nausea and reaching attends, or has been previously felt, a vomit is the first, and most expedient method to be had recourse to; for by this, not only the crudities in the stomach gets disburdened, but from the joint action on the internal canal, a stool or two is generally produced, by which frequently the offending acrimony is carried off.

When however this avails not sufficiently, and the pain rather increases, particularly if the body at the same time is costive, recourse should be had to clysters; for purges in this case, do not operate speedily enough, and in cases of costiveness, is not always safe. The clyster No. XXIII. may be of great benefit, and if necessity requires it, occasionally repeated.

But more frequently, it is from a nervous affection, and then carminatives prove the most effectual; in such cases give the following,

No. XLII

_Take essential oil of peppermint_ (U), _six drops on a lump of sugar; elixir proprietatis_ (H), _five large tea spoonfuls; wine or water, half a tea cupful._

Let the patient take this immediately; a little _Turlington’s balsam_ (W) about a tea spoonful, also is very beneficial. If the pain still continues violent; let ten or twelve drops of _liquid laudanum_ (T), be added. Clysters should not be neglected, but plentifully administered; the same medicines as is given to the patient, may also be added to the clyster.

The dry belly-ach, is a spasmodic contraction of the intestines, and throws the patient into the greatest misery imaginable; clysters is the only recourse and anodynes, together with gentle mercurials will likewise prove beneficial; warm clothes and something that can retain the warmth should constantly be put to the bowels; and in great extremities, cold foot baths have often given immediate relief.

The bilious cholic is of a dangerous tendency, and always attended with the bilious belching and vomiting of bile. In this case vomits is the only method to be used with safety; and if properly continued, as long as the bile is brought up, will never fail of success. But bleeding in bilious complaints is ever pernicious. If a fever attends, method must be used accordingly.

_Of Looseness, and the Bloody Flux._

A Cholic is often the forerunner of a looseness, and if the looseness is not too violent very often is salutary, and carries off many kind of disorders in the body. But if a looseness continues after twenty-four hours, it is time something should be done, in order to prevent a bloody flux.

If the flux is attended with a nausea at the stomach, and an inclination to vomit, give without delay the following draught:

No. XLIII

_Take rhubarb_ (O) _one scruple; ipecacuanha, ten grains; stomach powder_ (M) _fifteen grains; calomel_ (N) _three grains; mix them and make it into a draught or bolus, with sugar and water._

This probably will vomit a few times, and then occasion a few stools; but as the rhubarb has an astringency as well as cathartic quality, it will in general, after the purging has gently carried off the acrimony, act as an astringent; particularly if after the above draught, the following paragoric is taken.

No. XLIV

_Take oil of peppermint_ (U) _four drops upon a lump of sugar; liquid laudanum_ (T) _eight drops; sweet spirits of nitre_ (D) _twenty drops; mixt in a glass of wine._

But if the patient still continues after these medicines, with great griping, a succession of stools, together with a _tenesmus_, (that is a perpetual inclination to go to stool) then give the following:

No. XLV

_Take rhubarb_ (O) _ten grains; stomachic powder_ (M) _fifteen grains; essential oil of peppermint_ (U) _three drops; calomel_ (N) _one grain; and make it into a bolus or draught._

Let the patient take this every six hours, for the first two days. If the stools are bloody, slimy, and attended with great pain; recourse must immediately be had to clysters, such as No. XXXVII, XXXVIII, XXXIX. mentioned in the quincey; for the more nourishing they can be made the better; as thereby they will lubricate the bowels, and strengthen them. In the mean time the _white decoction_ should be used as a constant drink, which make as follows:

No. XLVI

_Take chalk_ (18) _pounded small, three ounces; cinamon_ (16) _bruised, two drachms; boil them in two quarts of water for one hour, and strain off the decoction._

Of this let the patient drink for his constant drink; a few drops of oil of peppermint may be dropped upon a lump of sugar, and dissolved in it.

The same decoction may also be given as a clyster when the flux is very violent. After the two first days the rhubarb should be given but sparingly; for if the flux is bloody, we may justly suppose the intestines are in a state of inflammation, and even ulceration. In such extremity, a little calomel mixed with the clyster, as also liquid laudanum, will not only correct the acrimony, but give ease to the emaciated stamina of the intestines.

By this treatment the most inveterate bloody flux may be subdued, especially with the help of patience, cautious diet, and cleanliness.

SECT. V.

_Of the Scurvy_

If I was to write as much on that subject, as I have already written in this treatise, the whole would only amount to this, that the scurvy is a state of putrifying corruption in the living human body.

The causes of this disorder is a defective diet, contaminated air, and want of proper exercise.

In regard to the diet, salt provisions and foul water are the accessory means, which not only impoverishes the blood, but gives it a tendency to a putrescency, whereby it loses its spirit, the lymph its gelatinousness, and the crasamentous part its resinous consistency. Thence the serum becomes sharp and acrimonious; the lymphatic part in the blood unable to nourish the stamina of the solids; and the red crasamentous part becomes crumous, and void of its vivacity: and as the solids must in consequence suffer in proportion to the state of the blood, from whence they have their existence, and become maintained, it must follow also, that they degenerate into the same state of corruption: thence we find not only a universal lassitude and debility in the limbs, but gradually the smaller vessels become unable to circulate the corrupt humours, break, bleed, and even mortify of their own accord, without any other cause than the putrescent nature of their containing fluids.

Though the symptoms are in general too well known, not to be easily mistaken; yet I shall here describe this destructive disease in its various gradations.

When a patient first begins to be tainted with the scurvy, he feels a lassitude all over his body, and a peculiar proneness to indulgence and idleness; work becomes irksome; and neither has he strength, nor inclination, to do his work with the same chearfulness as before. He sleeps more in general, but his rest is for ever disturbed with heavy and melancholy dreams; and particularly of that nature, as for ever to be engaged in escaping from some sad danger, but unfortunately that his limbs are so remarkably heavy, that he cannot move them. With these and the like labour in vain phantoms his sleep is disturbed, till at length he awakes, and finds himself more fatigued than when he first went to rest. The mouth is always foul and slimy, and frequently attended with a disagreeable taint. The appetite is depraved, and the victuals sits very heavy on the stomach.

This is the first stage of the scurvy; and when a patient is sure of those symptoms, it is time some remedy should be used, in order to prevent the approaching evils; which gradually come on thus.

The gums begin to swell, though not very sore; and frequently bleed either on their own accord, or at the least touch of any thing that comes near them. The breath becomes very disagreeable, even to the patient himself. The teeth grow dark, brown or black, become loose, and the very jaw bone, together with the roots of the teeth are exposed and seem uncovered from the decayed gum.

Sometimes a scurfy itch ensues, and sometimes little spots appear. The body becomes remarkably weak, and sensibly falls away, and the colour of the skin gets a disagreeable tawny hew; which is most remarkable, together with other emaciated features in the patient’s countenance.

This is the second state, and now dissolution actually begins to take place.